Is Ebola's Exponential Spread Uncontainable?

In summary: April 12, 2019.In summary, the conversation revolved around the concern over the Ebola virus outbreak in West Africa and its potential to spread to other parts of the world. Participants discussed the exponential growth of new infections and the difficulty in obtaining reliable data from the affected areas. They also touched on the possibility of the virus spreading to more populated areas with better travel infrastructure. The conversation also mentioned the challenges in containing the virus and the potential for it to continue for years if a vaccine or effective treatment is not developed. Finally, the conversation mentioned the possibility of some individuals in West Africa having natural immunity to the virus.
  • #71
Dallas nurses cite sloppy conditions in Ebola care
http://news.yahoo.com/dallas-nurses-cite-sloppy-conditions-ebola-care-042120774.html

https://www.yahoo.com/health/ebola-what-does-it-do-inside-the-body-ebola-100013486857.html

Obama: Feds must tackle Ebola 'in a much more aggressive way'
http://news.yahoo.com/obama--govern...-in-a-much-more-aggressive-way-221014200.htmlSecond Dallas nurse with Ebola was on Frontier Airlines Flight 1143
http://news.yahoo.com/ebola-diagnosed-in-second-dallas-nurse-105542930.html
An air ambulance carried her to Atlanta Wednesday evening.

Dallas was Flight 1143's last stop on Monday and Frontier said the aircraft “received a thorough cleaning per our normal procedures.” But Flightaware.com, a flight-monitoring website, told the Los Angeles Times that the Airbus A320 made five additional flights on Tuesday before being taken out of service for decontamination on Wednesday.
 
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  • #72
The CDC gave the nurse permission to fly back to Dallas ! Who gave her permission to fly to Ohio in the first place.

DALLAS — The second Dallas nurse diagnosed with Ebola shouldn't have traveled on a commercial flight due to her exposure to the virus prior to her diagnosis, said Tom Frieden, director of the Centers for Disease Control and Prevention.

But the CDC has now confirmed that it gave Amber Vinson permission to return to Dallas by air after making a trip to Ohio.

However, because of her exposure to the virus, Vinson shouldn't have traveled on the commercial flight, the CDC director said on Wednesday. Frieden revealed the nurse registered a low-grade fever of 99.5 degrees before she boarded the plane.

It was later confirmed that the CDC gave Vinson permission to get on the plane because she was showing no other symptoms of the virus, and her temperature didn't reach the threshold of 100.4 degrees.

Where did they get that specific number from, out of a hat!

http://www.wfaa.com/story/news/heal...las-hospital-worker-diagnosed-ebola/17290677/
 
  • #73
Well, until now, it has been widely accepted/believed that Ebola is only transmissible by contact with fluids: blood, vomit, feces, sweat, . . . . from infected patients. However, apparently University Of Minnesota CIDRAP Researchers claim Ebola Is airborne!

Ebola is airborne, according to a new report by the Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota. Researchers at the university just advised the World Health Organization (WHO) and the Centers for Disease Control (CDC) that “scientific and epidemiologic evidence” now exists that proves Ebola has the potential
Read more at http://www.inquisitr.com/1541821/ebola-is-airborne-university-of-minnesota-cidrap-researchers-claim/

Dallas hospital exec on Ebola crisis: 'We are deeply sorry'
Doctor will tell Congress that mistakes were made, lessons learned
http://news.yahoo.com/hospital-exec-on-ebola-crisis-we-are-deeply-sorry-051612718.html

More Ebola cases in Dallas 'very real possibility' - county official
http://news.yahoo.com/video/more-ebola-cases-dallas-39-151157631.htmlI presume that at least 5 others on the Airbus 320 who sat in the seat occupied by Vinson may be at risk for Ebola infection. I hope the CDC is tracking them down.

Meanwhile - Nurse with fever admitted to French hospital on Ebola fears
http://news.yahoo.com/nurse-fever-admitted-french-hospital-ebola-fears-144328468.html

There is hope -
Oct 4 - First French Ebola patient leaves hospital
http://news.yahoo.com/first-french-ebola-patient-leaves-hospital-144706059--finance.html

Oct 4 - Two health workers in W. Africa cured of Ebola in Europe
http://news.yahoo.com/french-nurse-cured-ebola-contracted-liberia-001646108.html
 
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  • #74
Purely anecdotal but I happened to be at a Kaiser clinic today and asked if they had been trained or briefed on dealing with Ebola. The answer was no even though the government has claimed that the DC metro area is ready if we have a case. I would think that being 'ready' would include training the medical personnel who may encounter patients with Ebola. I find it very disturbing that so little seems to be getting done given the spread of the disease. Unfortunately, it appears that hospitals won't do anything until it lands on their doorstep.
 
  • #75
Astronuc said:
Well, until now, it has been widely accepted/believed that Ebola is only transmissible by contact with fluids: blood, vomit, feces, sweat, . . . . from infected patients. However, apparently University Of Minnesota CIDRAP Researchers claim Ebola Is airborne!

Read more at http://www.inquisitr.com/1541821/ebola-is-airborne-university-of-minnesota-cidrap-researchers-claim/

I don't think they mean airborne in the sense of the flu, and in fact, they decided to not use the world airborne to describe it; instead, they are talking about what happens if particles of blood, vomit, feces, etc get put into the air (for example, by flushing a toilet).

http://www.cidrap.umn.edu/news-pers...ers-need-optimal-respiratory-protection-ebola
 
  • #76
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  • #77
I had to go get my toe looked at today at an Urgent Care clinic in Tacoma (sigh, an infection due to a toe trauma I got while hiking last weekend - antibiotics seem to be working though!). Before they would even ask me what I was there for, I had to fill out a form with three questions: Have you recently traveled to West Africa? Have you been in proximity to someone with symptoms of Ebola (list of symptoms)? Are you experiencing a fever, diarrhea, or vomiting? Then they checked me in as normal.

I was happy to see they're at least asking relevant questions.

Honestly I was much more concerned with the people who were there with flu. They give those people masks to reduce the chance of contagion, and they looked pretty miserable. Flu is hitting early this year, and my flu shot isn't scheduled until October 29!
 
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  • #79
nsaspook said:
This is a crazy overreaction. People drink and say stupid things at casinos and nobody blinks an eye but if a dumb guy makes an Ebola joke he's arrested for 'inducing panic'.
http://www.cleveland.com/metro/index.ssf/2014/10/cleveland_man_accused_of_jokin.html

Charged with felony inducing panic? There was no panic. I can't find two accounts of the story that read the same.

Officials said Smith spent several hours at the casino Wednesday before leaving about 5 p.m. "Two hours later", the casino's surveillance office reported to the casino commission that Smith had mentioned Ebola.

Reported two hours later and that is a panic?
 
  • #80
Some good news in the battle against Ebola - Spaniard with Ebola beats the disease, test shows
http://news.yahoo.com/spain-nursing-assistant-clear-ebola-virus-190214536.html and

Friends, family of Ebola patient Thomas Eric Duncan reach milestone
http://news.yahoo.com/friends-family-ebola-patient-reach-milestone-170521749.html

CDC to revise Ebola protocol, Pentagon preps team
http://news.yahoo.com/fauci-protocols-call-now-skin-showing-134441808--politics.html

ATLANTA (AP) — Revised guidance for health care workers treating Ebola patients will include using protective gear "with no skin showing," a top federal health official said Sunday, and the Pentagon announced it was forming a team to assist medical staff in the U.S., if needed.
 
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  • #81
edward said:
Where did they get that specific number [100.4=fever] from, out of a hat!
An adult oral temperature of 100.4 is just the standard definition of a medically significant fever. They recommend that you do not treat anything under that. If you Google "fever temperature", you will see 100.4 a lot. Considering how fevers fluctuate during the day, it is probably a bad standard to use for ebola risk.
 
  • #83
x

Astronuc said:
Texas Hospital: 'We Are Deeply Sorry' For Missing Ebola Diagnosis
http://www.npr.org/blogs/thetwo-way...-are-deeply-sorry-for-missing-ebola-diagnosis

This is what I was waiting to hear:

Dallas Hospital Letter to the Community 101914 [text version]
...
Many are speculating about how Ms. Pham and Ms. Vinson. both skilled and careful nurses. became infected
despite their compliance with the protective equipment and safety procedures. Our focus is on the facts,
and we are determined to get all of the answers as soon as we can. We have interviewed our staff and reviewed
our records and are bringing in outside expertise to completely analyze what happened and how.

Based on what we already know. I can tell you that many of the theories and allegations being presented in the
media do not align with facts stated in the medical record and the accounts of caregivers who were present
on the scene. We have remained committed to complying with CDC guidelines from the start: we believe our
procedures complied with the CDC Ebola guidelines and our staff implemented them diligently.

As we look into and analyze what happened, we are interviewing those who participated in Mr. Duncan's care
and are encouraging staff with information and insights related to his care to share those with our team to help
us learn from this event.
...
(bolding mine)

Having retired recently from working 29 years in a Hospital, two nurses getting Ebola didn't make much sense to me, given what has been publicized as transmission modes.

I would share an anecdotal story of how I was exposed to Hepatitis by a patient one day, 28 years ago, but I've heard anecdotal stories are frowned upon.
 
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  • #84
Nigeria could have had an outbreak of Ebola, but for one doctor!

How 1 doctor saved Nigeria from Ebola catastrophe
http://news.yahoo.com/ebola-nigeria-hero-doctor-adadevoh-122828747.html
A day after the World Health Organization https://news.yahoo.com/nigerias-ebola-outbreak-officially-over-104227798.html , the doctor who treated the country's first case of the deadly virus and later died from the disease herself is being hailed as a hero for helping stop the outbreak.

Dr. Stella Ameyo Adadevoh, a doctor at First Consultant Hospital, oversaw treatment of Patrick Sawyer, Nigeria's Ebola patient zero, when he arrived sick in Lagos, Nigeria's former capital and Africa's largest city, on a flight from Liberia in July.
. . . .
Adadevoh, the Telegraph writes, "effectively saved the country from disaster by spotting that its first Ebola patient was lying about his condition, and then stopped him leaving her clinic."

Sawyer, who had been caring for his Ebola-stricken sister, was reportedly set on visiting one of Nigeria's Pentecostal churches "in search of a cure from one of the so-called miracle pastors," the BBC said.
 
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  • #87
zoki85 said:
70 % of people immune?
Whaaat?

Interesting. It might be some kind of smallpox-cowpox type relationship. I found the other day that there are 5 types of Ebola. One of them had not been listed in any of the epidemics.

I believe it was called "Reston".
 
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  • #88
OmCheeto said:
Interesting. It might be some kind of smallpox-chickenpox type relationship. I found the other day that there are 5 types of Ebola. One of them had not been listed in any of the epidemics.

I believe it was called "Reston".

That is interesting, except that I thought it was smallpox - cowpox? People who had been infected with cowpox were immune to smallpox. I will have to ask a milk maiden if I can find one.

Reston virus (RESTV) is one of five known viruses within the genus Ebolavirus. Reston virus causes Ebola virus disease in non-human primates; unlike the other four ebolaviruses, it is not known to cause disease in humans, but has caused asymptomatic infections.

bold mine.

http://en.wikipedia.org/wiki/Reston_virus
 
  • #89
edward said:
That is interesting, except that I thought it was smallpox - cowpox?
Of course I meant "cowpox". Thank you. It is fixed.
People who had been infected with cowpox were immune to smallpox. I will have to ask a milk maiden if I can find one.

While reading about the Reston Ebola virus, I ran across a couple that have an extensive history, studying the virus: Dr. Joseph McCormick and his wife Dr. Susan Fisher-Hoch

I then found an interesting article posted 3 weeks ago (ancient history).
EBOLA: WHY THIS OUTBREAK IS UNLIKE ANY OTHER OF THIS DISEASE...
During their field studies, Fisher-Hoch and McCormick heard many of the same fears being voiced today, that somehow Ebola is now airborne.
McCormick said, "One, we have not seen the evidence. Two, we don't have any evidence of other viruses having done that. And so I think that we are, we can safely argue, continue that this is not airborne."
But the couple says this outbreak is different. In the past, Ebola killed only a few hundred people. This time, thousands have died. They say the reason has more to do with humans than Ebola.
Fisher-Hoch said, "The conditions, the average living conditions, the squalor, the poverty, the crowding are horrendous really. So that allows a virus to spread around."
Dr. McCormick says what angers him the most about the current outbreak is that two potential vaccines were identified a decade ago, but there was no serious interest to develop them until now. ...

hmmm... I suppose I should have just googled PF in the first place:

The Scientist - Human Ebola vaccine trial begins
iansmith, Physics Forums, https://www.physicsforums.com/threads/the-scientist-human-ebola-vaccine-trial-begins.9564/threads/the-scientist-human-ebola-vaccine-trial-begins.9564/

Phase I safety test of the multimodal vaccine's DNA component will last 1 year | By Jeffrey M Perkel
The leader of the team that designed an Ebola vaccine and tested it in macaque monkeys expects to see no adverse effects in the human trial of the vaccine, which began last Tuesday (November 18). ...
 
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  • #90
  • #92
There is something seriously wrong with the PPE requirements and procedures if medical personnel are getting sick and this doctor thought it was safe to be in public so soon after arriving from a hot zone after being in direct contact with infected victims.
 
  • #93
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  • #94
nsaspook said:
There is something seriously wrong with the PPE requirements and procedures if medical personnel are getting sick and this doctor thought it was safe to be in public so soon after arriving from a hot zone after being in direct contact with infected victims.
This! This has been bugging me all along. I think there's some kind of subliminal thinking among Westerners who, when confronted with the fact that African medical workers are being infected at high rates, might think: oh, it's because they don't have Western training or equipment, it's because they're poor. Total BS, IMO! These doctors and nurses are professionals. Every day, they do the same procedures Western docs do: set bones, stitch wounds, assist births, perform surgeries. They know how to protect themselves from diseases Western medicos only see once or twice (or never) in their careers.

The PPE protocol should be getting a close review, IMO.

As far as the doctor who just tested positive, I wish him all the best.
 
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  • #95
nsaspook said:
There is something seriously wrong with the PPE requirements and procedures if medical personnel are getting sick...
Did you read some of the things the nurses union was saying about the Texas PPE protocols? The protocols they did receive didn't work. After complaining that their necks weren't covered, they were instructed to wrap themselves in surgical tape! Unbelievable.
http://www.cnn.com/2014/10/15/health/texas-ebola-nurses-union-claims/
 
  • #96
lisab said:
As far as the doctor who just tested positive, I wish him all the best.

I wish the doctor well too but I don't think he should have been bowling or having close contact with others until the possible incubation period had passed.
 
  • #97
nsaspook said:
I wish the doctor well too but I don't think he should have been bowling or having close contact with others until the possible incubation period had passed.

This just tells me that the doctor considered that there was zero risk that he had been infected, based on available information.

I contracted whooping cough about 10 years ago. It is also not considered an "airborne" transmissible disease. Yet, its infection rate is staggering.
I was working in a hospital at the time, and although there was a "this is not a problem" official attitude, a friend working in the pharmacy confided that Pertussis inoculations had been ordered for all doctors and nurses.

If a patient sneezes, or coughs, and a doctor, moments later, walks into their room, what's to keep him from catching it?

It's still my guess, that this is not a PPE problem.

And I'm not implying that Pertussis is anything nearly as bad as Ebola, I'm only inferring a potential transmission mode.

Pertussis in Other Countries
Worldwide, it is estimated that there are 16 million pertussis cases and about 195,000 pertussis deaths in children per year. Despite generally high coverage with childhood pertussis vaccines, pertussis is one of the leading causes of vaccine-preventable deaths worldwide. Most deaths occur in young infants who are either unvaccinated or incompletely vaccinated.

Hopefully, the clinics the Army Corp of Engineers are building in the affected nations, have no windows.
Sometimes, western technology, makes things worse.
 
  • #98
OmCheeto said:
This just tells me that the doctor considered that there was zero risk that he had been infected, based on available information.

Logically it seems that assumption of near zero risk is flawed in some way.
http://news.yahoo.com/1st-ebola-case-nyc-3-others-quarantined-060226282.html
A three-week quarantine makes sense for anyone "with a clear exposure" to Ebola, said Dr. Richard Wenzel, a Virginia Commonwealth University scientist who formerly led the International Society for Infectious Diseases.

Some health workers could "have a kind of denial there are any exposures," and an automatic quarantine would address that, Wenzel said.

At the same time, he conceded health workers might be leery of volunteering if they knew they would be confined to their homes for three weeks after they got back.
...
Graham said the federal government should rent out a hotel — perhaps one in the Caribbean, to ease public fears — and then staff it with doctors and quarantine all returning health care workers there for three weeks.
I might volunteer for a three week Caribbean vacation.

http://www.reuters.com/article/2014/10/24/us-health-ebola-newyork-idUSKCN0IC2CU20141024
Reuters) - The Obama administration is considering quarantines for healthcare workers returning from Ebola-ravaged West African countries, an official said on Friday, as authorities in New York retraced the steps of a doctor with the disease.
...
Dr. Anthony Fauci, director of the NIH's National Institute of Allergy and Infectious Diseases, said he could not pinpoint anyone factor that contributed to Pham’s speedy recovery. He said it could be any of a number of factors, including the fact that “she's young and very healthy” and was able to get intensive care very quickly.

Pham received donated blood plasma from Dr. Kent Brantly, who contracted Ebola working in Liberia for a Christian relief group and survived after being treated with an experimental drug. Brantly was released from a hospital in August.

It's good to see that early treatment works so fast.
 
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  • #99
Many New Yorkers were dismayed to learn that in the days after he came home, Dr. Craig Spencer rode the subway, took a cab, went bowling, visited a coffee shop and ate at a restaurant in the city of 8 million.

Spencer, a 33-year-old emergency room doctor, returned to the U.S. on Oct. 17 and sought treatment Thursday after suffering diarrhea and a 100.3-degree fever. He was listed in stable condition at a special isolation unit at Bellevue Hospital Center, and a decontamination company was sent to his Harlem home. His fiancee, who was not showing symptoms, was being watched in a quarantine ward at Bellevue.
So he returned home Oct 17, and by Thursday, Oct 23, he was seeking treatment for symptoms that were indicative of Ebola, after he returned to New York City from treating Ebola patients in Guinea. He should have quarantined himself!

So now - after the fact - NY, NJ order Ebola quarantine for doctors, others arriving from West Africa and who may or did have had contact with victims of the disease.
http://news.yahoo.com/1st-ebola-case-nyc-3-others-quarantined-060226282.html Why don't Ebola doctors returning from West Africa quarantine themselves?
'As long as a returned staff member does not experience any symptoms, normal life can proceed,' Doctors Without Borders says
http://news.yahoo.com/why-dont-ebola-doctors-self-quarantine-140038847.html
According to Dr. Mary Travis Bassett, New York City's health commissioner, "Spencer had been taking his temperature twice a day."
Yahoo said:
He began feeling sluggish on Tuesday but did not develop a fever until Thursday at 11 a.m., when he discovered he was running a 100.3-degree temperature. Spencer alerted Doctors Without Borders, which in turn alerted New York health officials.
Meanwhile, back in W. Africa - Mali reports first case.
http://news.yahoo.com/doctors-without-borders-ebola-risk-cant-zero-120707049.html

BAMAKO, Mali (AP) — Many people in Mali are at high risk of catching Ebola because the toddler who brought the disease to the country was bleeding from her nose as she traveled on a bus from Guinea, the World Health Organization warned Friday.

The U.N. agency is treating the situation as an emergency since many people may have had "high-risk exposures" to the 2-year-old girl during her journey through several towns in Mali, including two hours in the capital, Bamako. The girl was traveling with her grandmother.
. . . .
 
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  • #100
OmCheeto said:
And I'm not implying that Pertussis is anything nearly as bad asEbola, I'm only inferring a potential transmission mode.

It's suspected in some circles that Ebola transmits via aerosols.
http://www.cidrap.umn.edu/news-pers...ers-need-optimal-respiratory-protection-ebola
We believe there is scientific and epidemiologic evidence that Ebola virus has the potential to be transmitted via infectious aerosol particles both near and at a distance from infected patients, which means that healthcare workers should be wearing respirators, not facemasks.1

Here's their reference 1:
http://www.ajicjournal.org/article/S0196-6553(07)00774-2/abstract
Conclusion
None of these surgical masks exhibited adequate filter performance and facial fit characteristics to be considered respiratory protection devices.

A few TV news reports have shown personnel wearing face protection with an external air hose, suggesting they're full face respirators like I'm used to from the Nuke plant.

This is how we learn, by experience.
 
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  • #101
http://news.yahoo.com/number-ebola-cases-passes-10-000-101744209.html

DAKAR, Senegal (AP) — More than 10,000 people have been infected with Ebola and nearly half of them have died, according to figures released Saturday by the World Health Organization, as the outbreak continues to spread.
The number of confirmed, probable and suspected cases has risen to 10,141. Of those cases, 4,922 people have died, according to the UN/WHO.

It is the largest outbreak yet. Hopefully, it will be the last.
 
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  • #102
Astro, why do you think it will be the last? I think our experience is that diseases don't just disappear. They have to be eradicated.
 
  • #103
US journalist
Vanadium 50 said:
Astro, why do you think it will be the last? I think our experience is that diseases don't just disappear. They have to be eradicated.
I not thinking it will be the last, but hoping it will be the last major outbreak. There are apparently vaccines being developed, or at least treatments, but unless folks change their ways, there will likely be more such occurrences.

US journalist Ashoka Mukpo discusses his experience with Ebola
http://news.yahoo.com/us-journalist-says-body-war-ebola-192305250.html
Receiving a blood transfusion from Ebola survivor Dr. Kent Brantly, who was treated in Atlanta, was a turning point. The next day, Mukpo's eyesight was clearer, his headache and fever had lessened, and his body felt more under his control.
 
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  • #104
Poor health systems in Asia cause for concern/alarm regarding Ebola.
http://news.yahoo.com/poor-health-systems-asia-cause-ebola-alarm-051240578.html [/PLAIN]
SINGAPORE (AP) — The longer the Ebola outbreak rages in West Africa, the greater chance a traveler infected with the virus touches down in an Asian city.

How quickly any case is detected — and the measures taken once it is — will determine whether the virus takes hold in a region where billions live in poverty and public health systems are often very weak. Governments are ramping up response plans, stepping up surveillance at airports and considering quarantine measures. Still, health experts in the region's less developed countries fear any outbreak would be deadly and hard to contain.
. . . .
 
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  • #105
dimensionless said:
Have any of you been tracking the rate of new Ebola infections? It seems that there is pretty clear exponential growth, and the virus is anything but contained. Is anyone else bothered by this? By looking at this just mathematically, some huge swath of people will become infected. At a certain point the shear number of infections could threaten to collapse the efforts to contain it. Maybe the outbreak is just too big to contain. Maybe the outbreak is too slow moving to cause a health care collapse. I'm no epidemiologist, but I'm guessing that this outbreak will continue for years into the future.

About a week a ago, I saw a bar graph on wiki of the number of reported cases per week:

pf.2014.10.26.0914.West_Africa_Ebola_2014_12_Reported_Cases_per_Week_Total.png
It looked as though the cases per week had leveled off. Unfortunately, the author did not reference the source. So I snooped around and found the "situation reports" at the WHO, where I found periodic total count numbers for the 3 primary affected nations.

After entering in the data, and doing a little bit of smoothing, as the data out of Liberia is really jumpy, it looks as though the above graph is moderately accurate.

Here's my graph:

pf.2014.10.26.0918.Ebola.cases.per.day.smoothed.jpg

​
So it does appear that the new case rate per day has been dropping.

Interpolating the data some more, I took the numbers from the 4 highest count consecutive reports, and the numbers from the four latest reports, and determined that the reduction in reported cases is about 2.17 per day over a 26 day period. Which, if the trend continues, the epidemic will be over a couple of weeks before Christmas.

Let's cross our fingers. :)

Here's my csv file with the raw data, in case anyone else has a better way of interpreting the data.
 

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