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kurtster Avatar

Location: where fear is not a virtue
Gender: Male

Posted: Oct 17, 2014 - 5:17pm

 RichardPrins wrote:

Do you understand the concept of in-ter-pre-ters or even, gasp, foreign languages down in English-only!-Amerikanistan? {#Mrgreen}

Yeah, I've heard of them.

How about the death rate.  Isn't that a wee bit more important ?

Healthcare providers are dying at a higher rate than the patients.

Granted, your priorities have always been a bit different than mine. 


BlueHeronDruid Avatar

Location: planting flowers

Posted: Oct 17, 2014 - 5:15pm

 kurtster wrote:

Ya know that microbiologist who dressed up in a haz mat suit and walked through Atlanta's airport to express his concerns about the coming Ebola problem ?   This guy ...Dr. Gil Mobley said in an interview I heard last night that of all the Ebola fatalities so far, 56% have been health care workers !

Discuss ... 

Overall, the infection rate in healthcare workers is more like .09% according to WHO. Of those, yes, the fatality rate is high. No surprise there, actually, since we're talking Guinea, Liberia, Nigeria, and Sierra Leone. Not the highest quality of life in the first place.

R_P Avatar

Posted: Oct 17, 2014 - 4:43pm

 kurtster wrote:
Could it be that this one is the only one able to speak English ? (...)
Do you understand the concept of in-ter-pre-ters or even, gasp, foreign languages down in English-only!-Amerikanistan? {#Mrgreen}

kurtster Avatar

Location: where fear is not a virtue
Gender: Male

Posted: Oct 17, 2014 - 4:24pm

 RichardPrins wrote:
 What's wrong with how the West talks about Ebola in one illustration
A death in Africa, or Asia for that matter, should be as tragic as a death in Europe or the U.S.A., and it doesn't seem to be.

Could it be that this one is the only one able to speak English ? 

Here's a little tid bit for you Richard ...

Ya know that microbiologist who dressed up in a haz mat suit and walked through Atlanta's airport to express his concerns about the coming Ebola problem ?   This guy ...Dr. Gil Mobley said in an interview I heard last night that of all the Ebola fatalities so far, the death rate for healthcare workers is 56 % !

Discuss ... 


ScottFromWyoming Avatar

Location: Powell
Gender: Male

Posted: Oct 17, 2014 - 12:50pm

 aflanigan wrote:
A very interesting essay. This woman makes a lot of sense, at least from a lay-person's perspective.

I'm a Hazmat-Trained Hospital Worker: Here's What No One Is Telling You About Ebola

With a crappy headline. She doesn't say anything, really, about ebola. Her points about the hazmat procedures is correct, and that's what The Man was trying to say when he said there'd been a breach of protocol.


aflanigan Avatar

Location: At Sea
Gender: Male

Posted: Oct 17, 2014 - 12:26pm

A very interesting essay. This woman makes a lot of sense, at least from a lay-person's perspective.

I'm a Hazmat-Trained Hospital Worker: Here's What No One Is Telling You About Ebola


R_P Avatar

Posted: Oct 17, 2014 - 5:10am

Health Worker Who May Have Had Contact With Ebola Is on Cruise Ship
Adding a new and troubling dimension to the search for Americans possibly exposed to the Ebola virus, the State Department said Friday that an employee of Texas Health Presbyterian Hospital who may have had contact with specimens of the disease had left the United States aboard a cruise ship.

The employee and a traveling partner, who were not identified by name, had agreed to remain isolated in a cabin aboard the vessel, the State Department said, and “out of an abundance of caution” efforts were underway to repatriate them. A physician aboard the cruise ship had said the employee was in good health.

News reports quoting an official statement from the government of Belize said the ship was still in that country’s waters, but the authorities there refused to allow American officials to evacuate the passengers through their territory.

While United States officials “had emphasized the very low risk category in this case,” the statement said, “the government of Belize decided not to facilitate a U.S. request for assistance in evacuating the passenger through” an airport. (...)


R_P Avatar

Posted: Oct 17, 2014 - 4:47am

An Unprofitable Disease: In the Political Economy of Ebola, Who Lives and Who Dies? - Democracy Now

The Political Economy of Ebola - Leigh Phillips/Jacobin
What's wrong with how the West talks about Ebola in one illustration
A death in Africa, or Asia for that matter, should be as tragic as a death in Europe or the U.S.A., and it doesn't seem to be.

Ambulance Work in Liberia Is a Busy and Lonely Business
Video Feature: Fighting Ebola, Street by Street

Racing along cracked and bumpy roads here, Gordon Kamara shouted into his cellphone over the shrieking sirens of his ambulance. The phone had been ringing nonstop since 5 a.m.

“Not today! Not today!” Mr. Kamara, an ambulance nurse, yelled later in the day. “We are on the opposite side of town!”

The calls have all been the same in recent weeks: from friends, friends of friends, extended family, complete strangers. All of them have loved ones sick with Ebola and beg him to come quickly. Seven days a week, Mr. Kamara and his crew span Monrovia, Liberia’s capital, in a donated, old American ambulance — with California license plates still attached.

“It never stops,” said Mr. Kamara, getting another call the moment he hangs up.

The 15 or so ambulance teams bolting around the city have had many days of hard choices like this. Hundreds of new Ebola cases are reported each week in Monrovia, with many more never accounted for. And over the course of the epidemic, only a small percentage of them have ever made it to a hospital.

“We see it flow through the communities; first one, then many,” Mr. Kamara said. “The map is being painted red with the virus.”

To confront the spread of Ebola, some community groups have stepped in, motivated by altruism, desperation and, in some cases, political opportunism.

In some neighborhoods, teams of volunteers fan out to track victims and educate households on staving off the virus, though their pockets are so shallow that they often do not have enough supplies, like chlorine, to thwart the epidemic’s advance.

Mr. Kamara does not work for the government. He does not even have a dispatcher to tell him where to go, or which patients to pick up. Instead, his team is financed by an opposition member of Parliament, Saah H. Joseph, who imported two used American ambulances to Monrovia this year.

What this – the largest Ebola outbreak in history – tells the world
Deadly pathogens exploit weak health systems

What does this outbreak, that has been making media headlines for months, tell us about the state of the world at large? What does it tell world leaders, and the citizens who elect them, about the state and status of public health?

WHO Director-General, Dr Margaret Chan, sees 6 specific things.

First, the outbreak spotlights the dangers of the world’s growing social and economic inequalities. The rich get the best care. The poor are left to die.

Second, rumours and panic are spreading faster than the virus. And this costs money. Ebola sparks nearly universal fear. Fear vastly amplifies social disruption and economic losses well beyond the outbreak zones.

The World Bank estimates that the vast majority of economic losses during any outbreak arise from the uncoordinated and irrational efforts of the public to avoid infection.

Third, when a deadly and dreaded virus hits the destitute and spirals out of control, the whole world is put at risk. Our 21st century societies are interconnected, interdependent and electronically wired together as never before.

This became clear when the virus entered Nigeria’s oil and natural gas hub, the city of Port Harcourt. Nigeria is the world’s fourth largest oil producer and second largest supplier of natural gas. If that outbreak flares up again, it could dampen the economic outlook worldwide.

Fourth, decades of neglect of fundamental health systems and services mean that a shock, like an extreme weather event or a disease run wild, can bring a fragile country to its knees.

These systems cannot be built up during a crisis. Instead, they collapse. A dysfunctional health system also means zero population resilience to the range of shocks that our world is delivering, with ever greater frequency and force – whether from a changing climate, armed violence and civil unrest, or a deadly and dreaded virus.

Deadly pathogens exploit weak health systems

WHO is aware that, in the three hardest-hit countries, high numbers of deaths from other causes are occurring, whether from malaria and other infectious diseases, or zero capacity for safe childbirth.

The size of this “emergency within the emergency” is not precisely known, as systems for monitoring health statistics – not good to begin with – have now broken down completely.

It is, however, important to understand one point: these deaths are not “collateral damage”. They are all part of the central problem: no fundamental public health infrastructures were in place, and this is what allowed the virus to spiral out of control.

In the simplest terms, this outbreak shows how one of the deadliest pathogens on earth can exploit any weakness in the health infrastructure, be it inadequate numbers of health care staff or the virtual absence of isolation wards and intensive care facilities throughout much of sub-Saharan Africa.

WHO has been making these arguments for at least two decades. Some signs are beginning to suggest that they are now falling on more receptive ears.

When presidents and prime ministers in non-affected countries make statements about Ebola, they rightly attribute the outbreak’s unprecedented spread and severity to the “failure to put basic public health infrastructures in place”.

No incentive for research

A fifth especially striking issue is this: Ebola emerged nearly 40 years ago. Why are clinicians still empty-handed, with no vaccines and no cure? Answer: because Ebola has been, historically, geographically confined to poor African nations.

The R&D incentive is virtually non-existent. A profit-driven industry does not invest in products for markets that cannot pay.

Again, WHO has been trying to make this issue visible for more than a decade, most recently through the deliberations of the Consultative Expert Working Group on Research and Development: Financing and Coordination.

Now people see the reality of this R&D failure, this market failure, on TV screens and in the headline news: the world’s empty-handed clinicians in their hazmat suits, trying to help Africa’s desperate poor, putting their own lives at risk, and losing them.

Fast action on new therapies and vaccines

On the issue of experimental therapies and vaccines, WHO has moved fast in securing ethical approval and coordinating worldwide collaborative efforts to move the most promising products forward.

Three weeks ago, the Organization brought together more than 100 of the world’s leading experts on the many complex issues surrounding the use of these experimental medical products. As a result, this could be the first Ebola outbreak in history that can be tackled with vaccines and medicines.

For vaccines, testing on human volunteers has already begun. If all continues to go well, 2 vaccines could be ready for progressive introduction near the end of this year. Some 5 to 10 drugs are also being developed as quickly and safely as possible.

For vaccines, the projected year-end quantities are considered large enough to have at least some impact on the future of the outbreak’s evolution.

Blood from survivors holds hope

The experts also debated the pros and cons of treating Ebola patients with transfusions of whole blood taken from patients who survived their infection. This form of treatment has been used empirically in the past, in a small group of patients, with promising results.

Convalescent plasma was also considered as an alternative treatment option. Of the two options, use of convalescent plasma is technically more complex and more demanding in terms of facilities and skills. The eventual use of this experimental therapy in Guinea, Sierra Leone and the Democratic Republic of Congo will depend on the availability of skilled technical expertise.

The experts decided that both treatment options should be prioritized for further investigation. WHO is already in discussions with health experts in the Democratic Republic of Congo, Guinea, Liberia, Nigeria and Sierra Leone. These joint discussions are currently looking at the practicalities of using whole blood transfusions and convalescent plasma from survivors.

Finally, the world is ill-prepared to respond to any severe, sustained and threatening public health emergency. That statement was one of the main conclusions of the Review Committee convened, under the provisions of the International Health Regulations, to assess the response to the 2009 influenza pandemic.

The Ebola outbreak proves, beyond any shadow of a doubt, that this conclusion was spot on.

Scientists Rein In Fears of Ebola, a Virus Whose Mysteries Tend to Invite Speculation- Carl Zimmer

The Ebola virus, which first came to light in 1976 but which could have split off from viruses from 20 million years ago. Centers for Disease Control, via Associated Press

News that a nurse in full protective gear had become infected with the Ebola virus raised some disturbing questions on Monday. Has the virus evolved into some kind of super-pathogen? Might it mutate into something even more terrifying in the months to come?

Evolutionary biologists who study viruses generally agree on the answers to those two questions: no, and probably not.

The Ebola viruses buffeting West Africa today are not fundamentally different from those in previous outbreaks, they say. And it is highly unlikely that natural selection will give the viruses the ability to spread more easily, particularly by becoming airborne.

“I’ve been dismayed by some of the nonsense speculation out there,” said Edward Holmes, a biologist at the University of Sydney in Australia. “I understand why people get nervous about this, but as scientists we need to be very careful we don’t scaremonger.”

Ebola is a mystery that invites speculation. The virus came to light only in 1976, the first known outbreak. Forty years later, scientists are just starting to answer some of the most important questions about it.

Just last month, for example, Derek J. Taylor, an evolutionary biologist at the University at Buffalo, and his colleagues published evidence that Ebola viruses are profoundly ancient, splitting off from other viral lineages at least 20 million years ago. Dr. Taylor’s research suggests that for most of that time, strains of Ebola infected rodents and other mammals.

In 1976, the virus spilled over into the human population from one of those animals, possibly bats. And every few years since then, a new outbreak has emerged in different parts of Central Africa.

Each has been caused by a descendant of the 1976 strain, according to new research by Andrew Rambaut, an evolutionary biologist at the University of Edinburgh.

“It’s possible that there’s a diverse range of viruses, but just a few can make the jump,” Dr. Rambaut said.

Pardis C. Sabeti, a geneticist at Harvard, and her colleagues have analyzed the genomes of Ebola viruses isolated from patients in Sierra Leone to reconstruct the history of the current outbreak. Their research indicates it was the result of a single infection, probably last December.

Since then, the viruses have acquired new mutations as they have spread from person to person. Scary though that may sound, it does not surprise researchers.

All viruses are especially prone to making errors as they copy their genes, and many of these new mutations have no effect. Some are beneficial for the virus — but they don’t necessarily make it more deadly.

Evolutionary biologists see no evidence that new mutations in the Ebola virus are responsible for the huge size of the current outbreak.

“It’s far more plausible that the difference is that it’s gotten into a different human population,” Dr. Rambaut said.

Instead of being limited to remote villages, the virus ended up in cities like Freetown, Sierra Leone, and Conakry, Guinea. The combination of a big population of hosts and a medical system unable to control the infection has led to an epidemic.

“You’ve got a fairly standard Ebola virus,” Dr. Holmes said. “It’s just in the worst possible place.”

As the current outbreak spreads, the virus will continue to mutate. It is conceivable that those increased mutations will lead to evolutionary changes.

Many viruses alter their surface proteins, for example, enabling them to escape the immune system of their hosts. Dr. Sabeti and her colleagues have found some evidence of these shifts in Ebola.

She said it is vital to keep track of the evolution of these shifts. Otherwise, an experimental vaccine might target an out-of-date type of virus.

“We have the advantage over the virus,” she said. “We can see the genome in real time and respond to it.”

It is conceivable that Ebola might become more deadly during this outbreak, but it is by no means a certainty. Ebola outbreaks typically last only months, but other viruses have needed decades to make the change.

Like its close relatives, Ebola spreads through infected fluids, such as vomit and blood. There is no firm evidence that the strain that has caused human outbreaks can spread through the air.

Over the course of millions of years, viruses do sometimes switch their route of infection. “It does happen in an evolutionary context,” Dr. Holmes said.

But it would be a mistake, he warned, to imagine that with a single mutation Ebola might become an airborne pathogen. The change would require many mutations in many genes, and it might be nearly impossible for so many mutations to emerge during a single outbreak. The mutated viruses would survive only if they were superior to the ones spread by bodily fluids.

“The virus is doing pretty well right now,” Dr. Holmes said. “So it would need to be beneficial for the virus to make this quite big jump.”

Dr. Rambaut agreed that the odds were exceedingly low. “Viruses generally don’t change to that radical degree,” he said.

Dr. Sabeti said, “It is biologically plausible, but very unlikely.” Rather than give the virus the opportunity to evolve in any way, she argued, we should focus on stopping Ebola in its tracks.

“We do not know where it is going, but we do not want to wait to find out,” she said.

The ancient history of Ebola, just now coming to light, suggests we may expect to encounter more of its cousins in the future. This fearsome lineage of viruses may have been sprouting many evolutionary branches for tens of millions of years.

“There will be lots more things like Ebola out there,” Dr. Holmes said.

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