241 replies to this topic

[TryinginFL]

Carleeta

 

Why our military?  Why not medical professionals who are NOT in the military?  Yes, these people need help and we need to try to stop the spread of this horrible disease but I feel that our military are needed in another place - doing what the military does...

[FiveNotions]

CDC: Ebola Worst-Case Scenario Has More Than 500,000 Cases
http://www.bloomberg...-000-cases.html

[FiveNotions]

Here are two of my worries .... How do we protect our service men and women from getting this disease? What good are 1,700 new hospital beds (17 hospitals x 100 beds each), in the face of a potential 500,000 cases?

 

Who is going to provide the hundreds, if not 1,000s of physicians and nurses that are needed, when medical personnel native to these countries are dying in large numbers, and now abandoning clinics and refusing to serve?
 

[FiveNotions]

Another question I have is what about the diseases coming across our wide open southern border? Why aren't our troops being sent there, to close the border, which is also a direct threat to us?

 

Just one ebola-infected West African who avoids detection would be enuf to get it started here. (We only catch about 3-5% of those crossing the border illegally, and it's not just Latin Americans coming over the border, also those from China, Africa and the Middle East.)

[BelaLugosisDad]

Carleeta

 

Why our military?  Why not medical professionals who are NOT in the military?  Yes, these people need help and we need to try to stop the spread of this horrible disease but I feel that our military are needed in another place - doing what the military does...

 

Because by and large your military is comprised of brave people. People who are trained to deal with threats. A threat is not simply a gun or an ideology, a threat can be a virus. They signed up to PROTECT you the American people against threats.

They are trained in containment. They are trained in handling hazerdous situations in challenging environments. Their job is to protect the American people and by proxy their allies amongst other people.

 

When and if mass panic sets in, military ais is necessary. They should be supported by Medical Professionals and they will be. MSF and a heck of a lot of doctors from MSF and other bodies around the world.

 

I applaud them. Some of my best memories are trading our ration packs (which were tastier) with your guys for furniture which they had an endless supply of, particually comfortable matresses on TODs. And drinking beer. We did a lot of that.

[FiveNotions]

BLD, thank you for the additional perspective and understanding... points I had not thought of, or, found in the articles I'm reading.

I just hope our brave, and oh so precious, 3,000 are enuf to stop this ... based on that rough progression chart I posted, we're going to need a lot more "boots on the ground" ...
 
And, thank you for your military service!! (Love that your food traded for our furniture, esp. mattresses )

[FiveNotions]

Carleeta, yet again I'm out of "like" when I need them !!

[fishinghat]

Now a case in Nebraska.

[FiveNotions]

Gosh, and it's another one of our aid workers .... if/when it's one of our precious military members, I doubt the VA will be equipped to care for them ... only the best hospitals in the US have the special isolation units/rooms designed for these diseases, and there are only 1 or 2 such rooms at each hospital.

Doctors Expect Nebraska Ebola Patient to Recover
http://abcnews.go.co...ecover-25575050

[FiveNotions]

Well, here's some positive news .. related to Brzghoff's initial post about GSK working on a vaccine ...

British volunteer receives Ebola vaccine in second human trial
Washington Post, 9/17/2014
http://www.washingto...nd-human-trial/

And, some grim point-counterpoint...

Ebola vaccine: Little and late
Science magazine, the journal of the American Association for the Advancement of Science, 9/16/2014
http://news.sciencem...little-and-late

[Carleeta]

Carleeta
 
Why our military?  Why not medical professionals who are NOT in the military?  Yes, these people need help and we need to try to stop the spread of this horrible disease but I feel that our military are needed in another place - doing what the military does...

TryningFl, some of our missionaries went over there (there were three or four who contracted ebola), then the CDC sent more. The president met with CDC and was briefed on the seriousness of this outbreak. WHO (world health organization) has now been involved. Our government is now involved. Our military is the best option to go mainly because of their training and organization. BLD has explained it best. Hope this clarifies things for you...

[FiveNotions]

Yep ... I don't want them to go, for a lot of reasons...but after reading/rereading BLD's post, and taking another long hard look at the outbreak trajectory if we don't get it contained ... and, reading about the violence that's already erupting over there...against medical workers and in the society itself as those societies break down ... I want to just isolate us here, but this really is a global threat, to humanity ....damn I hate saying that

I guess I need to accept that there's any way to do this without an international involvement including the military ...but not just America, every single country ... in Africa and outside of Africa ... needs to get involved ...

[Carleeta]

FiveNotions, most likely the military won't be sent to our borders unless there is proof of infected individuals crossing over into out borders, with it being a threat to the American people. I'm more concerned of the American parents who don't believe in having their children receive shots and vaccinations. This is where more diseases show up again and in numbers. Just like the measles...This is still around, and unvaccinated children will be more likely to catch this. Honestly! I don't know much about this new virus you are referring to in the US.

[BelaLugosisDad]

Yep ... I don't want them to go, for a lot of reasons...but after reading/rereading BLD's post, and taking another long hard look at the outbreak trajectory if we don't get it contained ... and, reading about the violence that's already erupting over there...against medical workers and in the society itself as those societies break down ... I want to just isolate us here, but this really is a global threat, to humanity ....damn I hate saying that

I guess I need to accept that there's any way to do this without an international involvement including the military ...but not just America, every single country ... in Africa and outside of Africa ... needs to get involved ...

 

The thing is, many countries have outsourced their military needs to the US. It's part of the price of having bases in over a hundred countries world wide.

[FiveNotions]

And yet another significant point I'd neither thought of, or read, BLD ... and, of course, Obama intends to downsize (is doing so) our military to pre WWII levels ... our military guys and gals are under unbelievable stress and pressure just from their repeated rotations in the Middle East ... and now we've got to take care of West Africa as well ... this is more than humanly possible ... no wonder the VA and military docs hand out anti-d's like candy ...

Here's The Most Terrifying Thing About Ebola
Business Insider, 9/20/2014
http://www.businessi...ut-ebola-2014-9

FTA: ". . . several factors about this outbreak have some of the world’s top health professionals gravely concerned:

Its kill rate: In this particular outbreak, a running tabulation suggests that 54 percent of the infected die, though adjusted numbers suggest that the rate is much higher.

Its exponential growth: At this point, the number of people infected is doubling approximately every three weeks, leading some epidemiologists to project between 77,000 and 277,000 cases by the end of 2014

The gruesomeness with which it kills: by hijacking cells and migrating throughout the body to affect all organs, causing victims to bleed profusely.

The ease with which it is transmitted: through contact with bodily fluids, including sweat, tears, saliva, blood, urine, semen, etc., including objects that have come in contact with bodily fluids (such as bed sheets, clothing, and needles) and corpses.

The threat of mutation: Prominent figures have expressed serious concerns that this disease will go airborne, and there are many other mechanisms through which mutation might make it much more transmissible.

Affected parties are almost all medical professionals and family members, snared by Ebola while in the business of caring for their fellow humans. More strikingly, 75 percent of Ebola victims are women, people who do much of the care work throughout Africa and the rest of the world. In short, Ebola parasites our humanity.
-----------------------------

[FiveNotions]

This is outstripping even that linear progression I posted above, which I thought would be proven wrong, due to intervention efforts now starting to happen...

CDC warns 500,000 will be infected with Ebola by January as effort to contain the virus fail
News.com.au (Australia), 9/21/2014
http://www.news.com....v-1227065489923

The linear progression predicted these numbers for Jan. 2015  ... unless my horrid math skills are even "horrider" than I thought ... what the CDC is predicting is 10 x what that projection suggested ....

Dec, 2014 – Infected: 27,753 Dead: 16,652
Jan, 2015 – Infected: 51,621 Dead: 30,973
Feb, 2015 – Infected: 96,016 Dead: 57,610
Mar, 2015 – Infected: 178,590 Dead: 107,154
Apr, 2015 – Infected: 332,177 Dead: 199,306
May, 2015 – Infected: 617,849 Dead: 370,709
Jun, 2015 – Infected: 1,149,199 Dead: 689,519
Jul, 2015 – Infected: 2,137,510 Dead: 1,282,506

[BelaLugosisDad]

I think the problem with the military is efficiency. Downsizing it as opposed to streamlining it is a recipe for disaster.

[BelaLugosisDad]

This is outstripping even that linear progression I posted above, which I thought would be proven wrong, due to intervention efforts now starting to happen...

CDC warns 500,000 will be infected with Ebola by January as effort to contain the virus fail
News.com.au (Australia), 9/21/2014
http://www.news.com....v-1227065489923

The linear progression predicted these numbers for Jan. 2015  ... unless my horrid math skills are even "horrider" than I thought ... what the CDC is predicting is 10 x what that projection suggested ....

Dec, 2014 – Infected: 27,753 Dead: 16,652
Jan, 2015 – Infected: 51,621 Dead: 30,973
Feb, 2015 – Infected: 96,016 Dead: 57,610
Mar, 2015 – Infected: 178,590 Dead: 107,154
Apr, 2015 – Infected: 332,177 Dead: 199,306
May, 2015 – Infected: 617,849 Dead: 370,709
Jun, 2015 – Infected: 1,149,199 Dead: 689,519
Jul, 2015 – Infected: 2,137,510 Dead: 1,282,506

 

Your calculations do not allow for weighting and adjustment due to containment. I think they are a worse case scenario.

[FiveNotions]

Agreed, BLD ... those definitely aren't my calculations, I can't even balance my checkbook correction ... help me out with this, because I'm now totally confused ...

 

Those progression numbers were taken from another website...the guy who did them noted your point strongly, that he had not factored in intervention/containment but was doing a straight linear progression, based on a transmission factor of 1.86, which was itself based on the infection/transmission data from the CDC up through August when he wrote the article ...

 

So here's my question (as a totally math challenged person) ... why is the CDC predicting 500,000 by/in January ... and the linear progression dude who's numbers I quoted is predicting just over 50,000 ...

 

the linear dude said he wasn't factoring in adjustment due to containment and that his projections were thus going to be on the high side ...

 

Why are the CDC's numbers 10 times higher?

 

Is this linear vs. exponential ?

[FiveNotions]

Source, unless noted otherwise: CIA World Factbook https://www.cia.gov/...ields/2226.html

Liberia:
200 Doctors for 3.5 Million People
http://allafrica.com...d/00019203.html
Population: 4,092,310 (July 2014 est.)
Doctors per 1,000: 0.01 physicians/1,000 population (2008)

Sierra Leone:
Population: 5,743,725 (July 2014 est.)
Doctors per 1,000: 0.02 physicians/1,000 population (2010)

Guinea
Population: 11,474,383 (July 2014 est.)
Doctors per 1,000: 0.1 physicians/1,000 population (2005)

[FiveNotions]

Well, this is a shocker ...

I saw one of my Liberian neighbors/acquaintances in the store here in my building (he's the night manager on weekends).

He told me that 1 of his 4 sons just arrived here yesterday, from Monrovia, and is living with him in his apartment here in my building!!

I asked him how he got out, aren't all the flights shut down ... he told me, don't know if it's true, that his son not only got a travel visa from the US Embassy in Monrovia, but that he was able to fly out on Brussels airlines, into Amsterdam, change planes and arrive in Dulles.

And, he's waiting for the US embassy to issue the travel visas (they are still doing this!!) for his other 3 sons, and they will also leave Monrovia and fly here.

Once here, the US has instituted a new policy of allowing people from those countries to "legally overstay" their visas, in order to keep them from having to return to their God forsaken ebola infested homes.

If this is what's really going on with travel out of West Africa and to the US, Europe, etc., ebola is a done deal... If it's not here now, in people moving freely around, it's gonna' be here soon. This is just one example of the likely hundreds, if not thousands, who are still fleeing from Liberia, Guinea and Sierra Leone. Apparently, there's no shut down on travel to those who have $$$....

[FiveNotions]

Well I'll be damned... Brussels Airlines is still flying in and out of Monrovia, Liberia ... to most major cities in Europe ... but they don't fly to Amsterdam, so this guy didn't tell me the full truth...

And, I just checked our Embassy in Monrovia... US visitors visas still being issued ..

http://monrovia.usem...rant_visas.html

Also re-checked Brussels Airlines ... they are also still flying out of Sierra Leone and Guinea ... to all major European cities ...

I bet this guy's son flew into Brussels, not Amsterdam ... but he would have had to change to another airline cuz Brussels Airlines doesn't fly to the US.

Edited by FiveNotions, 21 September 2014 - 07:55 PM.

[TryinginFL]

OMG....

[BelaLugosisDad]

Well I'll be damned... Brussels Airlines is still flying in and out of Monrovia, Liberia ... to most major cities in Europe ... but they don't fly to Amsterdam, so this guy didn't tell me the full truth...

And, I just checked our Embassy in Monrovia... US visitors visas still being issued ..

http://monrovia.usem...rant_visas.html

Also re-checked Brussels Airlines ... they are also still flying out of Sierra Leone and Guinea ... to all major European cities ...

I bet this guy's son flew into Brussels, not Amsterdam ... but he would have had to change to another airline cuz Brussels Airlines doesn't fly to the US.

 

Brussels airline is part of the Star Alliance, the largest airline network in the world. United are in there.

 

http://www.brusselsa...r-alliance.aspx

 

I think you are panicing a little here FN. Airline travel is a fact of life. It's unavoidable. When I was still flying I remember the hysteria that surrounded SARS in ASIAPAC. It was mental with everyone running around wearing masks.

 

The regulators, the airlines and the govenments are taking every reasonable precaution to protect passengers all the time. We also are concious of our cargo, disease vectors and a myriad of other things we don't worry you about. Everything we do is about managing risk. Everything. You look ill on my flight? Company, Dispatch, ATC, Border & Environment know about it before the guy sitting across the aisle does. I'll already have backup routes plotted to land the thing somewhere else if need be. It's routine.

 

A final saftey valve is the Captain of the flight. He's got his skin in the game (unlike your doctor) and any risk means we don't pull back from the gate.

[FiveNotions]

Thanks, BLD ... I'm not panicking. Just researching and fact-checking.  

 

But I sure do wish we had you pilots in charge of a lot more stuff than planes....like big pharma, etc..... I'd feel a lot safer.

What I should have noted is that we here in the US have been told that the US Embassy in Liberia stopped issuing visitors visas (tourists and business) to the US a couple of months ago.(I don't recall what, if anything, was said about Sierra Leone and Guinea, or about student visas.) So, what I found out yesterday seems to show that what we've been told isn't true. (I'm also quite open to believing that this fellow didn't tell me the truth, as Carleeta noted some "holes" in the previous information he'd given me.

 

Question -- If this disease has at least a 21 day incubation period, and people do not necessarily show any symptoms for the first week or two, how can you, as the captain of the plane, or any of your crew, detect the illness and prevent boarding? You professionals seem to be the main line of detection and protection for the rest of us.

It has has mutated significantly, and isn't necessarily as readily detectable as it was, for example with Patrick Sawyer. The early symptoms, as reported in some of the European and Canadian press, may no longer include fever, vomiting, skin boils, bleeding. The Canadian equivalent of our CDC said a couple of weeks ago that it's highly probably that the disease is airborne, and even if not airborne, it is aerosolized via sneezing, coughing, nose blowing, etc.

If this is true, then it seems to me that unless the person has been quarantined for the full 21 days, or a bit longer, immediately prior to boarding the plane to travel out of those countries, there is no way to know if he/she is coming here sick or not. We have no quarantine or de-planning mechanisms in place here, except for a possible temperature check (Carleeta may have told us that)as far as I've been able to determine. Supposedly there are pre boarding screenings being done at Roberts Airport, but I've seem photos of the set-up, and it doesn't encourage confidence.

This fellow whose son came here told me that he wasn't checked (no temperature taken, etc) pre-boarding in Monrovia or upon deplaning here at Dulles Airport. I didn't ask about his European change of planes. (Again, there's no way of knowing if he was telling me the truth.)

I'm simply noting what seems to be large discrepancies between what we here in the US are being told by the officials, and what's really happening. Discrepancies bother me...as a lawyer, I was trained to look carefully for them ...

And, I'll be the first to admit that I've become extremely distrustful of government and medical "authorities", given the discrepancies I personally encountered, uh, no  ... experienced ... between what the "officials" told me about Cymbalta and the reality of the drug. Let's just say my former implicit trust that they know what they're doing and have my best interests in mind is in the negative range.

[FiveNotions]

This is right in line with what you said above, BLD....

Ebola warning: CDC tells airlines to 'treat all body fluids as infectious'
Washington Examiner, 9/21/2014
http://washingtonexa...article/2553738

FTA: The Centers for Disease Control and Prevention, increasing their warnings on Ebola, is advising airlines and jet staff to treat all body fluids as infectious, even on domestic flights.

“Treat all body fluids as though they are infectious,” said the latest CDC update to airlines. The update notes that if Ebola is suspected, aircraft can be cleaned mid-flight. The update is apparently meant to stress the rights airlines have to block anyone who appears "ill" from boarding.

[FiveNotions]

This site is excellent ..

International Society for Infectious Diseases ... Alerts ... searchable, tons of interesting global info on every possible infectious disease
http://www.promedmail.org/

Here's the ISID 9/21 alert on ebola
http://www.promedmai....php?id=2790986

[Carleeta]

FiveNotions. ..all the transportation news to look for are signs and symptoms of ebola.. Yes it has an incubation period of two to three weeks. The most important aspect of this virus is that it's not an airborne disease. .If not airborne, the concern of transportation is not that high due to an individual needs to come into contact through bodily fluids. Therefore if you are sitting next to an infected individual and her or she sneezes or coughs, it won't spread to that individual/individuals. Someone is more likely to catch a cold or the flu...

[FiveNotions]

Well, the "experts" don't seem so sure about that anymore ...

COMMENTARY: Health workers need optimal respiratory protection for Ebola
Center for Infectious Disease Research and Policy (CIDRAP)
University of Wisconsin, 9/17/2014
http://www.cidrap.um...rotection-ebola


FTA: "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.
. . .
There has been a lot of on-line and published controversy about whether Ebola virus can be transmitted via aerosols. Most scientific and medical personnel, along with public health organizations, have been unequivocal in their statements that Ebola can be transmitted only by direct contact with virus-laden fluids2,3 and that the only modes of transmission we should be concerned with are those termed "droplet" and "contact."

These statements are based on two lines of reasoning. The first is that no one located at a distance from an infected individual has contracted the disease, or the converse, every person infected has had (or must have had) "direct" contact with the body fluids of an infected person.

This reflects an incorrect and outmoded understanding of infectious aerosols, which has been institutionalized in policies, language, culture, and approaches to infection control. We will address this below. Briefly, however, the important points are that virus-laden bodily fluids may be aerosolized and inhaled while a person is in proximity to an infectious person and that a wide range of particle sizes can be inhaled and deposited throughout the respiratory tract."

[Carleeta]

FiveNotions! Lol lol...I'll put this to make you feel a bit at ease. Yes these respirators would definitely be needed! Just to make sure or even rule out the possibility of this becoming airborne. These respirators add more safety control to the health care field workers both on a physical level as a psychological level (making them feel safe without fear, so they can concentrate on their work instead of letting fear boggle their minds).

At this point we are still believing it is not airborne, and will not become airborne. This is not to say it will not become airborne. The possibility of any virus can become airborne (including Ebola) if and only if it keeps mutating and continues to mutate and taking on different properties through spreading more and more and more. At this point, since our military will be going there, our main objective is get it controlled in the areas of the breakout to avoid mutating too far.

If there was an individual who caught ebola without coming in contact with an infected individual (through bodily fluids), this individual most likely caught it through investing contaminated food. I'm certain food is contaminated there.

The only positive we have that this is not airborne at this point is due to the fact, it would have spread farther and much faster than it has....let's hope it doesn't mutate, over and over.