Ebola outbreak - general thread #8

[IMO]

IMO----as an epidemiologist, you know the sample size of USA citizens surviving Ebola is 100%.......out of what? 4?

Come on!

Also, the worldwide death rate of enterovirus-68 & the garden variety flu that is currently going around do not have the reported worldwide death rate percentage as Ebola does. Percentage-wise, Ebola is much more lethal.

Yes, I am an epidemiologist, and yes, I am aware of the sample size, which is why I expressed my thoughts as speculation. Nonetheless, if you take the total number of cases that have been treated in the US, to date there have been nine cases and one death. Why do you think that is? At least five should be dead.

I am also aware of worldwide death rates from various illnesses. However, the likelihood of being exposed to influenza is far higher. Therefore, your risk of dying from influenza is orders of magnitude greater than dying from Ebola in the US. Again, there is an issue with risk perception here. For a direct comparison, at least 250,000 people will die from influenza worldwide in 2014. Fewer than 5000 have died from Ebola.

 

[Lyra500]

I think too many conclusions are being made based on one person (Mr. Duncan). We know that in Africa numerous family members have been infected.

BBM That is because In West Africa relatives often nurse someone until death or until very close to death because there is not enough capacity in the treatment centres. They are therefore having close contact when their relatives are far more contagious with a much higher viral load in their bodily fluids. That is a crucial difference.

 

[ATasteOfHoney]

Yes, I am an epidemiologist, and yes, I am aware of the sample size, which is why I expressed my thoughts as speculation. Nonetheless, if you take the total number of cases that have been treated in the US, to date there have been nine cases and one death. Why do you think that is? At least five should be dead.

I am also aware of worldwide death rates from various illnesses. However, the likelihood of being exposed to influenza is far higher. Therefore, your risk of dying from influenza is orders of magnitude greater than dying from Ebola in the US. Again, there is an issue with risk perception here.

Risk perception has a high degree of personal decision-making and choices. For instance, I choose not to ride on the back of a motorcycle or handle rats in a lab without wearing gloves---that's me. I leave risk analysis to the actuarials.

What I worry about is a cavalier attitude and statistics leading to a conclusion on such a small sample size of Ebola infected people within this country. Yes, we have better sanitation methods than African countries so we will probably not have the lethal percentage of Ebola cases here in the USA but we do have a dense population in NYC with its own unique methods of transmitting potentially contagious diseases (ie subways, theaters, etc).

As you very we'll know, viruses vary greatly regarding their timeframe of contagiousness, shedding, hosts' immunity vs susceptibility, and so on. They are unique critters & tend to mutate.

And I'm certain you have the utmost of respect for their uniqueness and adaptability. My question to you is not about risk or exposure......my question to you is not about interpretation , politics, defusing panic for whatever reasons, etc, etc---
or risk analysis but rather on the qualities of the actual virus itself. ***Lets talk details of the virus itself***

I think it should be handled more aggressively than what I've seen occurring. A comprehensive pro-active, coordinated approach is key.

Remember, at the end of the day, doctors trained and properly suited came down with the virus.

Moo

 

[epiphany]

[h=1]After Negative Ebola Test, Quarantined Nurse Criticizes Treatment at Newark Airport[/h]
http://www.nytimes.com/2014/10/26/nyregion/nurse-in-newark-tests-negative-for-ebola.html?_r=0

Doctors Without Borders, Oct. 23, 2014:

<snip>

As long as a returned staff member does not experience any symptoms, normal life can proceed. Family, friends, and neighbors can be assured that a returned staff person who does not present symptoms is not contagious and does not put them at risk. Self-quarantine is neither warranted nor recommended when a person is not displaying Ebola-like symptoms.

Yet...Doctors Without Borders, Oct. 23, 2014:

However, returned staff members are discouraged from returning to work during the 21-day period. Field assignments are extremely challenging and people need to regain energy. In addition, people who return to work too quickly could catch a simple bacterial or viral infection (common cold, bronchitis, flu etc.) that may have symptoms similar to Ebola. This can create needless stress and anxiety for the person involved and his/her colleagues. For this reason, MSF continues to provide salaries to returned staff for the 21-day period.

http://www.doctorswithoutborders.org/article/msf-protocols-staff-returning-ebola-affected-countries

Hmm...wouldn't traveling on public transportation in crowded major cities such as NYC be a problem for returning staff members?

If colleagues & HCWs experience stress & anxiety, what about the public's stress and anxiety?

 

[jjenny]

BBM That is because In West Africa relatives often nurse someone until death or until very close to death because there is not enough capacity in the treatment centres. They are therefore having close contact when their relatives are far more contagious with a much higher viral load in their bodily fluids. That is a crucial difference.

We don't want it to spread here like it did in West Africa. Even if most people treated here won't die.
Considering the economic impact even a single case can have on a business.

 

[SteveS]

If colleagues & HCWs experience stress & anxiety, what about the public's stress and anxiety?

Why would the public have stress and anxiety from seeing an unknown person in public, or riding the bus or subway?

 

[jjenny]

Doctor Spencer is entering the next phase of Ebola. Whatever that means.
"New York City health officials updated Ebola patient Dr. Craig Spencer's condition Saturday night, saying he is "awake and communicating" and "entering the next phase of his illness, as anticipated with the appearance of gastrointestinal symptoms.""
http://www.cbsnews.com/news/ebola-o...ctor-craig-spencer-fiancee-to-leave-hospital/

 

[ATasteOfHoney]

Why would the public have stress and anxiety from seeing an unknown person in public, or riding the bus or subway?

Maybe from sweat, sneezing droplets, coughing sputum.......you know, the same way as usual

 

[chipmunk]

<modsnip>


Yes that's what I was thinking I need a patron saint of the physically ill. My bone marrow is lazy, seriously. My hgn is often <10. :fainted::fainted: Days of the Dead is what I feel like way too often! My background is in public health and when my brain's not fuzzy I can talk pretty well.

 

[LaborDayRN]

:blushing: Just shows I have lost all of my reading comprehension!

It's also possible I might have had one or two of these :beersign:

:giggle:

 

[Woe.be.gone]

http://www.nytimes.com/interactive/2014/07/31/world/africa/ebola-virus-outbreak-qa.html?_r=0

700 have gone to West Africa, 210 are serving now, 3 caught the disease.

The link has some great graphics explaining the Ebola outbreak in West Africa and elsewhere.

Haven't all three of the cases been recent? I wonder why. When did these brave volunteers begin serving in Africa? They're not all Americans, are they? No.

Good article and I should read it first before asking questions! The three doctors; one from Norway, one from France and one from the U.S.

 

[ATasteOfHoney]

On tv news just now, 3 states have instituted a mandatory 21 day quarantine for those coming in from particular African regions.

 

[chipmunk]

I know that's going to be deleted, my last post, OT. :cheerful:

 

[jjenny]

I found the article on phases of Ebola.
First three days are flu like symptoms and profound weakness.
Both Amber Vinson and Dr. Spencer appears to have experienced this weakness yet for whatever reason neither recognized it as first stage of Ebola.
So I am assuming Dr. Spencer is now entering the second stage.
I am amazed that we are being told that until fever the person is asymptomatic. Yet weakness is clearly a symptom and both of them had it for several days prior to onset of fever. So were they symptomatic or not?

http://www.huffingtonpost.com/2014/08/02/ebola-symptoms-infection-virus_n_5639456.html

 

[SteveS]

I know you're joking but let's see how funny this is in another month (& I hope I'm wrong, Steve).

I know we all want to head for the hills and lock everyone up, just because ...

...but when we have enough evidence to know what happened, we keep seeing the same thing: a person caught the disease when they were in contact with someone who was close to death - which is when the virus is super-strong in the fluids, and those fluids are oozing out of every orifice and making new ones.

We saw it with Duncan, with Nina, with Amber ...all caught it at that stage. We also saw tons and tons who didn't catch it because they came across the infected person much earlier in the process, when the virus was relatively weak and the fluids were little to none.

I'm not willing to dismiss the evidence we keep seeing, just because it doesn't feed our fears and biases. Do I believe what I'm saying? My 91-yr-old dad and 88-yr-old mom had multiple appts at Presby Med Center a week ago, and I saw no reason to warn them away. They were blessed with easy-to-get prime parking spots, and no lines in the doc's offices, as a result.

 

[SStarr33]

It was reported before that he slept on every mattress, which sounded very bizarre. Now we find out he was kept in a separate room. I think it's rather obvious they suspected he had Ebola (or at least some infectious disease) and took measures to protect themselves by isolating him.

These people were from Liberia, they had family who still live in Liberia. These are not stupid people--some are in the medical profession. IMO, they knew about Ebola and they protected themselves from him and this is why they are Ebola free.

 

[epiphany]

Why would the public have stress and anxiety from seeing an unknown person in public, or riding the bus or subway?

Concern was displayed to staff members and "colleagues" by discouraging staff workers from returning to work due to (in addition to being prone to other viruses and infections)...due to the "needless stress & anxiety" which might be experienced by "colleagues" according to DWB.

Salary for staff workers would be provided for 3 wks/21 days.

NYC is a densely populated city...staff members shouldn't be riding on public transportation since such concern for their health already existed according to DWB.

Same courtesy should be shown to the public until more is understood.

IMO, colleagues are being protected and rightly so. So should the public.

 

[chipmunk]

Haven't all three of the cases been recent? I wonder why. When did these brave volunteers begin serving in Africa? They're not all Americans, are they? No.

Good article and I should read it first before asking questions! The three doctors; one from Norway, one from France and one from the U.S.

Just a note on the NYT article on MSF health personnel who have served in W Africa, etc. It was data from Oct 23 or earlier, each section's figures gives a date as I recall.

 

[jjenny]

These people were from Liberia, they had family who still live in Liberia. These are not stupid people--some are in the medical profession. IMO, they knew about Ebola and they protected themselves from him and this is why they are Ebola free.

Well, I agree. It's just that we've been hearing very conflicting information on what went on in the apartment.

 

[faw720]

We don't want it to spread here like it did in West Africa. Even if most people treated here won't die.
Considering the economic impact even a single case can have on a business.

With the outbreak of ebola in the medical community it is my hope that those medical professional who have contracted ebola will be able to shed a lot of light to other medical professionals on facts of how how they became infected with the disease & exactly what treatment improved their condition. It seems to me if they all get together & share information in 'medical speak' a better understanding of the disease & it's treatment could be beneficial. They should be able to gain a greater understanding because of a professional to professional dialogue.