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#271821 - 09/24/14 10:26 PM Re: EBOV versus Pandemic Flu Preparedness [Re: Arney]
Teslinhiker Offline
Veteran

Registered: 12/14/09
Posts: 1357
Originally Posted By: Teslinhiker
...it serves to demonstrate that the average person in Africa has a far greater chance of dying of Malaria then Ebola.


Originally Posted By: Arney

Malaria and Ebola are in different leagues in terms of perceived danger. Granted, hundreds of millions of people may contract malaria in a given year, but because we have treatments for it, the vast majority of people who can receive treatment will survive it. The majority of people who contract malaria are young children, not adults. Caring for someone with malaria does not put your life at risk. People who contract Ebola have, at best, a 50-50 chance of surviving, but in many cases, much worse odds, and anyone who tries to help you risks their own life.

A death is a death regardless of how a person dies or their age. Given that Malaria kills over 1/2 million people per year, it is far more deadly then all Ebola outbreaks combined.

Originally Posted By: Arney

The statistics in that book probably do not include this current, unfolding Ebola outbreak, which is the largest ever, by far.
The preface of the book specifically mentions that it occurs contemporaneously in 2014 along with the largest Ebola outbreak in African history.

Originally Posted By: Arney

The CDC just released the results of a computer model of the current Ebola outbreak. Applying a correction factor for the underreporting of cases, they estimate that as many as 1.4 million people may contract Ebola just in Sierra Leone and Liberia alone by the end of January 2015 if effective control measures are not implemented. If half of them die, that's a significant death toll--comparable to malaria's global death toll.


My technical background/work and hobby/interests is in big data analysis, statistics and computer modelling. Past and recent history in this field is replete with many, many results that can be wrong as computer modelling is not an exact science and not without its limitations as noted below. Have you actually read the full CDC report?

Abstract and Conclusion section:
The U.S. government and international organizations recently announced commitments to support these measures. As these measures are rapidly implemented and sustained, the higher projections presented in this report become very unlikely.

Limitations section outlines on how modelling can be limited...and taken out of context by the media and general public who do not understand the report. The media as proven with this report, extracts the juicy 1.4 million number instead of reporting the above wording in the Abstract section. It goes without saying that the media will conveniently report the more sensationalistic numbers.

The findings in this report are subject to at least five limitations. First, extrapolating current trends in increase of cases to forecast all future cases might not be appropriate. Underlying factors such as a spontaneous change in contacts with ill persons or burial practices or substantial changes in movement within countries or across borders could alter future growth patterns. Therefore, limiting model-calculated projections to shorter durations such as 3 months might be more appropriate. Second, assuming that this epidemic has similar epidemiologic parameters to previous outbreaks (e.g., incubation and infectiousness periods) might not be accurate, although anecdotal evidence to date has not indicated otherwise. Third, reliance on expert opinion to estimate a correction factor regarding number of beds in use might not account sufficiently for factors such as patients being turned away from full ETUs. Fourth, the correction factor could change substantially over time. Notable regional differences in underreporting might mean that using one correction factor across an entire country is inappropriate. Finally, the illustrative scenario does not consider the logistics needed to increase the percentages of patients who are receiving care in an ETU or at home or in a community setting such that there is a reduced risk for disease transmission (including safe burial when needed).

In my own conclusion, is Ebola a dangerous disease? Yes it is but not nearly as deadly as the vast majority of people in the world die from a much higher percentage of diseases and medical conditions that are listed here.
_________________________
Earth and sky, woods and fields, lakes and rivers, the mountain and the sea, are excellent schoolmasters, and teach some of us more than we can ever learn from books.

John Lubbock

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#271823 - 09/24/14 11:00 PM Re: EBOV versus Pandemic Flu Preparedness [Re: Teslinhiker]
hikermor Offline
Geezer in Chief
Geezer

Registered: 08/26/06
Posts: 6471
Loc: southern Cal
You are correct, but....

The thing is - Ebola is new, with many unknowns, and there is no handy vaccine. All the more reason to applaud and support those who are on the front lines right now ....
_________________________
Geezer in Chief

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#271827 - 09/24/14 11:21 PM Re: EBOV versus Pandemic Flu Preparedness [Re: hikermor]
Am_Fear_Liath_Mor Offline
Carpal Tunnel

Registered: 08/03/07
Posts: 3077

You cannot really predict the future, but you can look at the historic record.

http://pmj.bmj.com/content/81/955/315.full.pdf

There are some spooky similar mathematic parametrics of the current mathematic modeling projections.

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#271867 - 09/26/14 12:45 AM Re: EBOV versus Pandemic Flu Preparedness [Re: Teslinhiker]
Arney Offline
Pooh-Bah

Registered: 09/15/05
Posts: 2485
Loc: California
Yes, I read the full report in MMWR and I'm fully aware of the limitations of such extrapolation of current trends into the future.

I wrote a long reponse but decided it's not helpful to most readers to argue the points.

"Deadly" to most people is a subjective term, not a statistical one, and as I said, I think Ebola is perceived as the deadlier disease in the subjective sense. I then mention the CDC report to illustrate the gravity of the current outbreak because the trends indicate that without a robust response, Ebola could become deadly in the statistical sense, too, possibly killing in the neighborhood of the same number of people as malaria without a robust intervention. No prior Ebola outbreak has taken off like this before or infected so many people across such a wide area, so no one has any idea how or when this particular outbreak ends.

I'm not confident that there will be a widespread, sustained response to set up enough ETU's to put a dent in the natural course of the outbreak. Nor am I confident that the underreporting situation will noticeably improve, so in my opinion, corrected (and numerically higher) estimates are the better number to use. These are the two major components of the model that humans can directly influence in the weeks and months ahead. Of course, no one can predict how the virus itself will change over time.

Because I think the human intervention effort will fall short, I'm hoping that the virus makes some unexpected change that causes the outbreak to quickly subside on its own, leaving people wondering where the heck Ebola went. That would be the best case scenario.

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#271868 - 09/26/14 05:35 AM Re: EBOV versus Pandemic Flu Preparedness [Re: Meadowlark]
Arney Offline
Pooh-Bah

Registered: 09/15/05
Posts: 2485
Loc: California
Here's an area where the US healthcare system is totally unprepared to deal with even one Ebola patient--disposing of medical waste. Even the CDC's elite ward at Emory University hospital was not prepared.

US hospitals unprepared to handle Ebola waste

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#271934 - 09/30/14 04:24 AM Re: EBOV versus Pandemic Flu Preparedness [Re: Meadowlark]
wildman800 Offline
Carpal Tunnel

Registered: 11/09/06
Posts: 2810
Loc: La-USA
A "possible" Ebola case has been isolated in Dallas, Tx according to news via radio.

KVLI-AM in Beaumont, Tx is where I heard that report.
_________________________
QMC, USCG (Ret)
The best luck is what you make yourself!

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#271935 - 09/30/14 02:28 PM Re: EBOV versus Pandemic Flu Preparedness [Re: wildman800]
AKSAR Offline
Old Hand

Registered: 08/31/11
Posts: 1097
Loc: Alaska
Reports say the patient is in strict isolation based on symptoms and travel history. I take this as good news that our medical system is alert to the risks and is taking fast and appropriate action.

Another report in WaPo indicates that Ebola may be less contagious than the "Spanish Flu" pandemic. This is thought to be the worst pandemic of modern times. It killed 50 to 100 million people in 1918 - 1920, which represented about 3-5% of the world population at that time.


Edited by AKSAR (09/30/14 02:42 PM)
_________________________
"Toto, I've a feeling we're not in Kansas any more."
-Dorothy, in The Wizard of Oz

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#271937 - 09/30/14 04:02 PM Re: EBOV versus Pandemic Flu Preparedness [Re: AKSAR]
MartinFocazio Offline

Pooh-Bah

Registered: 01/21/03
Posts: 2148
Loc: Bucks County PA
Ebola is bad for business.
The business of America is Business.
Ergo, America will do What it Takes to contain Ebola.

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#271940 - 09/30/14 05:22 PM Re: EBOV versus Pandemic Flu Preparedness [Re: wildman800]
Arney Offline
Pooh-Bah

Registered: 09/15/05
Posts: 2485
Loc: California
Originally Posted By: wildman800
A "possible" Ebola case has been isolated in Dallas, Tx according to news via radio.

They seem very hush-hush about this potential case. Can't find any specifics, like was this a businessperson who was in the region? Another aid worker who became infected with the Ebola response? A foreign visitor?

Unless this person became symptomatic while in the hospital, I would assume this person was already symptomatic and potentially infectious out in public, and the authorities would need to find and track down all the potentially exposed people.

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#271941 - 09/30/14 05:32 PM Re: EBOV versus Pandemic Flu Preparedness [Re: Meadowlark]
Arney Offline
Pooh-Bah

Registered: 09/15/05
Posts: 2485
Loc: California
More good news in this article. For the time being, it seems that Nigeria's outbreak has been contained.

The article says an already existing Gates Foundation funded emergency coordinating center for polio outbreaks was used for this Ebola outbreak in Nigeria. When I first read a while back that Ebola was in Lagos, its sprawling mega-city of a capital, I had a sinking feeling, but this is good news. People died, but the chain of transmission seems to have been broken.

Nigeria is a relatively wealthy African country, with a decent public health infrastructure from what I've read in the past, so Nigeria's experience is probably more indicative of what might happen in a First World outbreak, rather than being an example for other much poorer African countries.

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