outbreak! (ebola, sars, coronavirus, etc)

http://www.nybooks.com/blogs/nyrblog/2014/oct/27/hidden-truth-about-ebola/

Even as Ebola hysteria rages in the US, the epidemic here in Liberia, which is supposed to be its epicenter, seems to be subsiding. According to official counts, this impoverished West African country of 4 million people is currently home to fewer than four hundred Ebola patients. Not millions of patients; not tens of thousands of patients; not even thousands of patients. Fewer than four hundred patients. Even as the World Health Organization warns that any day now we could be seeing thousands of new cases, and Obama’s UN Ambassador Samantha Power claims the global response to the epidemic is “failing,” the number of new cases each week in Liberia is falling, not rising. In August, the streets of Monrovia were strewn with bodies and emergency Ebola clinics were turning away patients. Today, nearly half of the beds in those treatment units are empty. I’ve been here a week and have yet to see a single body in the street. Funeral directors say business is off by half.

Of course, the situation remains very serious. More than two thousand have succumbed to the disease here since the outbreak began—along with thousands more in neighboring Sierra Leone and Guinea, according to the CDC—and Liberia faces looming economic and political crises. This fragile country urgently needs help—both for the well being of its own people, and for the safety of the rest of this interconnected world. But the epidemic is far from the cataclysmic disaster currently on display on American TV screens. Why does this matter? By portraying Ebola as an out-of-control threat to humanity—the foolish calls for border controls, the needless and cruel quarantining of a healthy volunteer nurse, the canceling of contracts, trade and other exchanges—US politicians and the media are making the disease harder to fight. And that could make the epidemic far more dangerous than it currently is.....

But what about in America? How did those nurses get it? If you wear gloves and masks, is that enough? If the blood/vomit/sputum gets on you, is that enough, or does it have to get in you?

― Josh in Chicago, Monday, October 27, 2014 2:22 PM (5 hours ago)

infected bodily fluids have to get in you somehow, either by contact with mucous membranes or through a cut in the skin. the necessary inoculum size is probably small, though i haven't seen any research address this specifically, probably because it's still early in the information-gathering process in many respects.

and yeah, bears repeating that while the case-fatality rate is alarmingly high (~70% last i saw), that's also partly a function of the resources at the epidemic's epicenter. with world-class supportive care, the case-fatality rate should probably be half that

Iirc from half-watching news broadcasts, the gear the TX nurses were originally given didn't cover their necks--there were gowns/suits of some kind and some facial covering but nothing in between, and if THAT'S the level of protection their employer provided, you can imagine. Also they were often working alone and I think disrobing alone, which should never be allowed--someone else should always be there to watch/help and help you with on/off so you don't accidentally come into contact w fluids.

very good NYT editorial this morning

http://www.newyorker.com/wp-content/uploads/2014/10/daily-cartoon-141028-travelban-690-719.jpg

my god

https://twitter.com/hashtag/KaciHickox?src=hash

just look at these people fume

https://twitter.com/GenghisConsrv/status/527133230974394368

Bill Godfrey ‏@BillnShari 1m1 minute ago
#KaciHickox: Kaci's ATTORNEY feels she doesn't have Ebola and that her rights supersede the rest of U.S. citizens. So did other patients!

HABEAS CORPUS CAN SUCK MY DICK

Can't wait until this freak-out media scare is over so there's some kind of news on that I want to watch.

Between the NFL and ebola, there hasn't been a news segment of interest to me in weeks.

To the best of my knowledge, public health officials have almost unlimited power to impose and enforce quarantines. It is not a criminal matter, so habeas corpus is kind of irrelevant.

It's pointless to make a rational argument against the word vomit contained in those tweets. #OBOLA #TEAPARTY #DISESE

another cyberspace-teems-with-hateful-ignorant-jerks shocker

yeah, ugh. i need to take a shower. people are horrible.

To the best of my knowledge, public health officials have almost unlimited power to impose and enforce quarantines. It is not a criminal matter, so habeas corpus is kind of irrelevant.

― Scapa Flow & Eddie (Aimless), Tuesday, October 28, 2014 1:24 PM (2 hours ago) Bookmark Flag Post Permalink

1) where are these powers enumerated?
2) so far i'm not aware of any controversial public health-body sanctioned quarantine. the cuomo/christie ones have been ordered by elected officials and have been ordered despite the very clear objections of scientists.

courts have recently deferred to executive actions taken in the interest of "national security" or the like, which i'm sure is what these officials will claim. still their legal defense is anything but airtight imo

I saw Obama referred to as Obola on a anti-vax site today.

public health officials have almost unlimited power to impose and enforce quarantines. It is not a criminal matter, so habeas corpus is kind of irrelevant.

― Scapa Flow & Eddie (Aimless),

seriously, Aimless? Where'd you read this?

It has probably been said itt already but holy christ, it's insane how something that is a mainly a huge humanitarian crisis on the other side of the ocean has been turned in a referendum on Obama. Conservative media will really stretch anything out.

aimless is correct but iirc those laws aimless is referring to date back to influenza days and haven't really been used since then

GOD BLESS OUR CLUSTERFUCK

On Monday night, Mr. Cuomo’s office released an order from the acting state health commissioner, Dr. Howard A. Zucker, outlining the quarantine protocols. Dr. Zucker planned to present the protocols to county health officials on Tuesday....

In what Mr. Christie called “tough, common-sense policy,” the governors on Friday outlined a mandatory 21-day quarantine for travelers who had direct contact with Ebola patients.

But on Monday, after fierce criticism from a nurse detained in Newark, Mr. Christie announced she was being released after three days of quarantine. He said Maine, where she lives, would determine her treatment.

Revealing a new policy detail, Mr. Christie said the nurse — who registered a fever on a forehead thermometer at the airport, but did not when her temperature was taken orally — could be released because she had not had a fever for 24 hours.

New Jersey officials would not say if 24 hours was the new standard for releasing someone from the hospital. Instead, the governor’s office issued a news release on Sunday and two on a Monday declaring that the policy had not changed.

Mr. Christie was defiant. “I didn’t reverse my decision,” he told reporters as he campaigned with Gov. Rick Scott, a fellow Republican, in Florida. “Why are you saying I reversed my decision? If she was continuing to be ill, she’d have to stay.”...

The American Civil Liberties Union of New Jersey filed an open records request for details of the quarantine policy. “We’ve been left with no option, because no one knows,” said Udi Ofer, the executive director. “I’m not sure Governor Christie knows.”...

Mr. Cuomo, meanwhile, all but said quarantine could be a time for rest and relaxation.

“Enjoy your family, enjoy your kids, enjoy your friends,” said the governor, also a recently published author. “Read a book. Read my book.”

http://www.nytimes.com/2014/10/28/nyregion/two-governors-shifts-on-ebola-are-criticized-as-politics-not-science.html

i'm aware that these powers exist, but they were granted by congress and carried out by executives; ultimately their use has to be justified against an individual's 4th amendment rights and right to due process. and hopefully any judge with a pulse would throw out orders that weren't scientifically based

So the Ebola epidemic must be finally over in Africa, I guess, since everything's all about the USA everywhere?

yep, it's all good

One of the chief concerns with US pol power plays is that it could affect the movement of med personnel to West Africa, Stan.

http://www.cdc.gov/quarantine/aboutlawsregulationsquarantineisolation.html

cuomo is so hateful

why don't we quarantine the politicians amirite?

cuomo is so hateful

― I dunno. (amateurist), Tuesday, October 28, 2014 11:40 PM Bookmark Flag Post Permalink

x 1000

This strikes me as sensible commentary:

http://www.bloombergview.com/articles/2014-10-28/what-science-can-t-tell-you-about-ebola

finally, a layperson with ideas about public health

ha ha

o. nate otm.

kev strangely overlooks the fact that, in the commentary o nate linked, the author repeatedly stresses that he agrees with kev's position. he just says that the tenor of kev's arguments in favor of his position are kind of simplistic and a bit stupid. did I mention that the author agreed with kev's position? because he did. repeatedly.

yeah I thought it was a good piece, seemed spot on

Where I disagree is that "the science" doesn't argue *against* mandatory quarantines, it just doesn't support them. However, public health expertise, an understanding of what's most important and useful in stopping this epidemic, does argue against it. It's not "trust the numbers, you dumdums" it's "trust our greater understanding and experience in dealing with these crises as a whole."

I mean if his argument is that the narrative of "panicky folk against science" is stupid then yeah, totally, because all simplistic narratives of news events are stupid as fuck. The way news is reported is mostly stupid. All the time. We all know this.

As a matter of fact I might mostly agree with this piece but it has a crappy headline. Omg am I ~part of the problem~?

I just think a lot of the "it's the science" dismissals are a little too glib and tend to talk past the concerns people are actually raising. Like over and over again I just see the same thing repeated "You can only get Ebola from contact with bodily fluids of a symptomatic person." Ok, but it's very easy to think of scenarios where a person might become symptomatic before they make it to a hospital, after which some other person might become exposed to their bodily fluids. Not to mention that the disease can survive for a decent amount of time on surfaces after bodily fluids touch them -- I realize this doesn't mean I'm going to get Ebola from the fact that a guy with mild symptoms touched a subway pole or bowling ball with his vaguely sweaty hand, but if a slightly more symptomatic person vomited on a crowded subway, that could most certainly infect others. If the argument is that the harm of a quarantine for medical workers who have been close to the disease outweighs the benefit, that's fair, but don't tell me there's "no reason whatsoever" to do it because of "the science," because I'm not fucking stupid and I can clearly see that there are at least vaguely arguable reasons to do it.

Non-quarantine also requires absolute trust in individuals' self-monitoring and self-reporting willingness and capacity.

if a slightly more symptomatic person vomited on a crowded subway, that could most certainly infect others.

I mean I guess if they rubbed it into their open sores.

Or if it got on someone's hands and they shortly thereafter touched their eyes or mouth

Like people are talking about it as though it's communicable in exactly the same ways as HIV, and no more. That's not the case.

Because if you got SOMEONE ELSE'S VOMIT on your hands obviously the first thing to do is put your hands in your mouth. Oh you meant without knowing it, like you touched their vomit residue on the seat (or floor because you rubbed your hands on the floor?) a few hours later assuming an MTA employee cleaned it up badly without using a disinfectant product, well luckily the virus doesn't survive more than a few hours on hard surfaces so

Sure there are scenarios where it could happen but the probability is SO LOW under normal conditions much less with people on alert and washing their hands more/using sanitizer/whatever.

posted in the world music thread but:
https://www.youtube.com/watch?v=ruYQY6z3mV8
http://artsbeat.blogs.nytimes.com/2014/10/29/how-to-protect-yourself-from-ebola-in-song/

The song, which was written by Kandia Kora and Sekou Kouyaté, both of whom are among the performers, is based on ideas and lyrics sketched out by Carlos Chirinos, a professor at New York University who specializes in music, radio and social change. It runs about five and a half minutes, and is packed with warnings (not to touch the bodies of the sick or the dead, to avoid shaking hands) and encouragements (trust doctors, wash your hands).

I think we'll get a much better view of just how infectious this strain of ebola is following the 82 exposed to [Mali's patient zero](http://www.reuters.com/article/2014/10/28/us-health-ebola-who-mali-idUSKBN0IH0SW20141028) during a bus ride on Oct. 20, or during subsequent medical care. Among the fellow riders, it may be the (experimentally) cleanest exposure record to date.

I mean I guess if they rubbed it into their open sores.

I am pretty sure that none of the highly trained medical practitioners who have contracted ebola had been rubbing infected vomit into open sores on their skin. Yet somehow, against all probability, they contracted the disease anyway. This suggests to me that there might be other less avoidable avenues of transmission than vomit rubbed into open sores.

From this very thread: i think it's key that if you're around a patient in the worst stages of the disease—as health-care workers are going to be—they are emitting lots of fluids, and those fluids are likely to contain the ebola virus.

it probably seems like it's more contagious than it actually is since we don't read news stories about the 100s of medical professionals working in west africa who don't get ebola.

― I dunno. (amateurist), Monday, October 27, 2014 8:27 PM (3 days ago) Bookmark Flag Post Permalink

Africa is full of overcrowded public transport — buses, minivans and some trains. There are no known instances of transmission in those environments. On July 20, a dying Liberian-American flew to Nigeria and was vomiting on the plane. All 200 people aboard were monitored; none fell ill.

http://well.blogs.nytimes.com/2014/10/03/ebola-ask-well-spread-public-transit/

So, what you are trying to say here is that rubbing infected vomit into open sores is the only known method of ebola transmission? Or are you still only saying that the probablility of contracting ebola through proximity to infected vomit is fairly low, because I acknowledge that. I also acknowledge that the very best way to prevent the spread of an infectious disease is to reduce the reservoir of infected individuals as much as possible, which means that Africa is where 99.5% of the effort needs to be concentrated.

But, it would be nice if someone would clearly explain how those very few medical practitioners, who knew they are being exposed to live ebola virus and who were using best-practice protective measures, managed to contract it anyway. Because I am fairly sure that these low-probability cases represent an avenue of infection that a) exists and b) is difficult to prevent 100% of the time through the prescribed protective measures.

You can't just hand wave away these cases and insist that 'you can't get ebola unless you're extraordinarily careless or stupid.' These cases prove that contention is false.

the point is those doctors/nurses were directly treating people who were in final stages of the disease producing huge amounts of fluids, exponentially greater risk for infecting others and those are not the kind of people who can sneak out to Williamsburg on the subway to go bowling they will be p much incapacitated already

IDK, I like to get a little incapacitated when I go to Brooklyn Bowl too