Wednesday, October 8, 2014

Ebola is an unsuccessful disease - why is it creating such impact?

Ebola is a lousy and ineffective virus, as a virus goes – at least in the human sphere.  The epidemiology math  “p” factor in morbidity and virulence  is lousy and requires massive mutation to ever make the big time in becoming a world class killer, like HIV or ubiquitous malaria. 

Retching blood in great agony, or crying tears of blood is great drama, far more terrifying than night chills of malaria or the sarcoma of AIDS, and makes great press.  And like any body fluid spreading disease with high levels  of morbidity – and with all  the blood and gore – it’s  first hit is noted and effective, to say the least.  But the fact it does kill in such a gruesome high profile way with lots of  fluids slopping around, makes it more a terrible and deadly test of basic infrastructure and public health policy than as a effective killer disease.  Most locales have no problem dealing with Ebola, it is a minor though dramtic.  Obviously many African locales are failing utterly.

But Ebola is not a major health risk for the world.

The current press and media are either deliberately doing great harm so as to sell ad space, or they are maliciously  enjoying this gruesome tale, or they are very poor journalists and have made no effort to define the story and get the facts. The press coverage on Ebola is close to or is criminal.

Epidemiology, the science backing the spread of a disease or condition, is  well understood and specific.  The Atlanta based CDC has released a model for Ebola at where one can download a easily used Excel spread sheet. 

  Inputs for the population of the area of concern; the ground zero beginning carriers numbers;  the infectious time for the carriers;  hospital, home quarantine and wanderers commitment rates;  how infectious or effective in transmission the disease is while in the hospital, home quarantine, or wandering around – all these variables can be entered to find out how many Ebola cases will occur.  Then a 40% mortality rate can be applied to calculate the deaths Ebola can cause.
I used a very high number of 20 Ebola carriers make it to the USA and go to 20 different cities, not knowing they have Ebola at first. But as soon as they are thought to be at risk I have 95% hospitalized, 3% under home quarantine, and 2% loose in the population.  The 20 different locales means this happens to a population of 200,000,000 (20 times cities of 10MM – obviously a very dramatic number), and the transmission rate of the disease I use .001% in the hospital,  5% while in home quarantine and those wandering around having a 30% infection rate.

The numbers – and keep in mind this is well understood science with little if no debate in this outcome – well a 5% confidence band which is what I instructed the CDC model to solve to – comes out with a Ebola, as far as the US is concerned, a non-event. No Brad Pitt World War Z.

Since this is material is easily found and can be vetted by those more experienced than I quickly, and since the CDC has made this available in a very easy form to understand and do “what ifs”, some disturbing conclusions emerge.

  1. Why isn’t the CDC and the US public health authorities making this well known?  One can conclude that they are spinning Ebola, again from the US perspective, into a monster story into realms of fiction – why? Why aren’t the US public health guys doing their job at a a most critical time of public concern?  Why are they allowing this panic to emerge?
  2.  If I am wrong and the public health authorities are making this available to the press – this CDC spread sheet was easily found – why is the press deliberately ignoring the facts and spinning this into a Hollywood horror sci-fi horror movie?  If the press is aware I can only see this as one of the most callous if not criminal acts of the press that I can remember.
  3.  Or is the press  simply stupid and have been swamped by Twittter and have been reduced to a most ineffective and unprofessional status?  If they are bungling to the point of malfeasance the Ebola story – what other stories are they also “blowing”?  is this Ebola hack coverage defining?
  4. This presents a very grim picture of how terrible lifestyle , infrastructure and public policy is for those stricken African countries.   If the most basic hygiene were applied or the most basic hygiene applied at mortuary or tending to the dead, or just if everyone would wash hands – Ebola would be as it should be, a bizarre one off event striking like lightening some very unlucky folks. 
Ebola is piker of a disease, even in Africa it is at best semi-pro.

What is killing Africans is not Ebola, but that  a very easily contained disease like Ebola can kill so many.  It is the basic African lifestyle and infrastructure that is the disease.  Case in point is that Nigeria, not high on many folk’s list of successful countries, has dealt with Ebola successfully.  That is a frighteningly damning for those countries not dealing with Ebola successfully.  They must be hell on earth.  At the very least all countries need to be brought up to the relative “rich” levels of Nigeria in terms of public health – at the very least.

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