Ebola virus outbreak

Doctor Jimbob

realweirdo wrote: »

The whole point of isolating west africa has little to do not with restricting people but restricting the spread of a highly contagious disease. Clearly this is a concept far above the heads of some people.

Instead they have the racist card at the ready to play at every opportunity. They are more interested in childishly accusing others of racism than fighting ebola. Immature and sad really.

What is isolation actually going to solve though? As others have pointed out, people will still find a way to cross the border. Some might become ever more determined to do so if people are trying to close them in.

realweirdo

My name is URL wrote: »

More like nobody has put forward their opinions or a proposal on how it would be effectively achieved.

Who is responsible for it.. how will it be enforced over tens of thousands of square miles of 'border' areas, and how do you deal with the inevitable panic and rushes to the border once people are told they have to just stay where they are and face death?

Would you try to leave a place where you were told that people could not leave because they are doomed? I fcuking would.

You can never fully seal borders. You can reduce the risk however. I'd imagine there are already some limits, in fact there are restrictions such as tests at airports in Liberia and Sierra Leone which I'm sure the bleeding heart liberals in the west will be outraged by if they hear of them. There's a time for open borders and in the middle of an ebola epidemic that's not the time. Sealing off might be extreme, but restrictions are definitely needed. And it all depends how effective the tests are. So far the main test seems to be if someone is displaying symptoms such as high temperature or fever. But these symptoms only display in the final days of the disease. The spanish nurse went away and was fine for a couple of days and then started feeling ill.

realweirdo

Doctor Jimbob wrote: »

What is isolation actually going to solve though? As others have pointed out, people will still find a way to cross the border. Some might become ever more determined to do so if people are trying to close them in.

The only way to fight ebola is isolation. Its the main pillar of any strategy. Without isolation, you can forget about defeating it. This has been proved time and time again.

In any case my suggestion about isolating entire countries was a worst case scenario, eg if significant numbers of ebola infections turned up elsewhere in the world as a result of travel from west africa. We aren't at that stage yet. In an extreme case, it would need to be looked at, a last resort as it were.

ElizaT33

Spring Onion wrote: »

I can't wait to see the amount of people bleeding from the eyes at Halloween.

That's just warped .......:mad:

ProfessorPlum

miss no stars wrote: »

The inability to read statistical information in general is shocking.

"Ebola has an R number of only 2, compared with HIV which has an R number of 4"

Sure, but half the people with Ebola die from it fairly quickly after contracting it. People with HIV tend to live years (and presently decades) after contracting it.

I think that it's safe to say that makes Ebola HIGHLY contagious.

realweirdo wrote: »

Agreed Miss...the longer people live the more people they can potentially infect. Someone might survive it but pass it on to others who might die.

As for the R number, I think it refers to over the lifetime of a person. So an infected HIV person could infect 4 over a number of decades. An ebola person could infect 2 over a number of days.

In other words, the R number doesn't tell much. People cite it as a reason not to panic, but its meaningless in the case of ebola. The daily number of new cases and how fast it is spreading is more intuitive. And eventually a decision will have to be made to isolate West Africa from the rest of the world, whether people like it or not.

Epidemiologists like to talk about R numbers. Generally they are people who are pretty good at statistics. Of course it's not meaningless. Put it this way: Measles has an R number somewhere approaching 18. It also would have about the same timeline of being infectious as Ebola. Also, as a downside for bystanders, people with measles tend to be in contact with more people while they're ill (owning to the fact that they're not lying down dying in their bed). Measles is highly contagious. 18 is 9 times 2. Ebola is contagious, but not highly contagious in the grand scheme of things.


As for isolating West Africa from the rest of the world - do any of you realise how big a land mass you're talking about. I'm guessing you don't. (The maps we use massively underrepresent the size of Africa)
As URL says, how are we going to do it? How about Guinea - there's only a (relatively) tiny portion of the country affected - do 'we' lock the whole place down? How about Nigeria and Senegal. Spain and the USA for that matter. I think we need to be a little more nuanced here with our approach.
Oh, and those epidemiologists I was talking about earlier - the majority feel closing borders would be the wrong thing to do.

LuckyLloyd wrote: »

Set up containment facilities in bordering nations. Returning personnel get quarantined there for 21 days first.

I'm sure the bordering Nations will be delighted with that plan.

realweirdo wrote: »

In terms of isolating west africa, the nearest analagy would be a gangrenous limb.

You can cut off the gangrenous limb and save the patient, or you can keep the gangrenous limb and watch the patient slowly succumb, all limbs intact.

Tough choices will have to be made at some stage.

Your analogy translates more like - if you have a gangrenous little toe, you should cut off both the lower limbs to save the patient.

dalyboy

According to the W.H.O its not an airbourne virus and is only spread "through human-to-human transmission, with infection resulting from direct contact (through broken skin or mucous membranes) with the blood, secretions, organs or other bodily fluids of infected people, and indirect contact with environments contaminated with such fluids". In other its all but impossible to contract this virus in normal every day activities. I for one will sleep well while I laugh at the idiots on tv wearing their masks and protective suits. The only way this virus will make it to Ireland is if it is purposely planted here.

ProfessorPlum

realweirdo wrote: »

You can never fully seal borders. You can reduce the risk however. I'd imagine there are already some limits, in fact there are restrictions such as tests at airports in Liberia and Sierra Leone which I'm sure the bleeding heart liberals in the west will be outraged by if they hear of them. There's a time for open borders and in the middle of an ebola epidemic that's not the time. Sealing off might be extreme, but restrictions are definitely needed. And it all depends how effective the tests are. So far the main test seems to be if someone is displaying symptoms such as high temperature or fever. But these symptoms only display in the final days of the disease. The spanish nurse went away and was fine for a couple of days and then started feeling ill.

It is ridiculously easy to get past fever screening. A couple of paracetamol will do it. And so far (as of earlier today at least) of all those stopped at borders in affected countries with a fever, none had Ebola. So I'm not sure how well the strategy is working.

ElizaT33

Im terrified about this - have just text my son who's due to travel home from holiday in Spain tomorrow. Told him to stay away from anyone who seems sick and to avoid airplane toilets if possible - these are scary times !

Doctor Jimbob

realweirdo wrote: »

The only way to fight ebola is isolation. Its the main pillar of any strategy. Without isolation, you can forget about defeating it. This has been proved time and time again.

In any case my suggestion about isolating entire countries was a worst case scenario, eg if significant numbers of ebola infections turned up elsewhere in the world as a result of travel from west africa. We aren't at that stage yet. In an extreme case, it would need to be looked at, a last resort as it were.

What? What has been proved time and time again? This is the only ebola outbreak on anything close to this scale. What exactly are you making a comparison with here?

Also you can gloss it over anyway you like, but saying infected countries should just be sealed off is at best callous and at worst outright racist. Would you feel the same if something similar started in Ireland and the rest of the world decided to just seal us off?

realweirdo

ProfessorPlum wrote: »

Epidemiologists like to talk about R numbers. Generally they are people who are pretty good at statistics. Of course it's not meaningless. Put it this way: Measles has an R number somewhere approaching 18. It also would have about the same timeline of being infectious as Ebola. Also, as a downside for bystanders, people with measles tend to be in contact with more people while they're ill (owning to the fact that they're not lying down dying in their bed). Measles is highly contagious. 18 is 9 times 2. Ebola is contagious, but not highly contagious in the grand scheme of things.


As for isolating West Africa from the rest of the world - do any of you realise how big a land mass you're talking about. I'm guessing you don't. (The maps we use massively underrepresent the size of Africa)
As URL says, how are we going to do it? How about Guinea - there's only a (relatively) tiny portion of the country affected - do 'we' lock the whole place down? How about Nigeria and Senegal. Spain and the USA for that matter. I think we need to be a little more nuanced here with our approach.
Oh, and those epidemiologists I was talking about earlier - the majority feel closing borders would be the wrong thing to do.





I'm sure the bordering Nations will be delighted with that plan.



Your analogy translates more like - if you have a gangrenous little toe, you should cut off both the lower limbs to save the patient.

In fairness, I agree about West Africa. I mean Liberia and Sierra Leone should in a worst case scenario be isolated as much as possible. I agree it wouldn't be possible to full isolate by land. But as much as possible flights out should be restricted. The reason for this has nothing to do with racism or the like. The reason is I don't trust the testing proceedures. There are reports of people being tested, coming up negative, only for them to become sick with ebola days later. In other words, testing has failed in some cases.

What testing can they do at an airport? Blood tests? Nope. Urine tests? Nope, and probably pointless in the case of ebola. They are doing temperature checks. My understanding is ebola has an encupation period of about 21 days. Someone could pass a test in the early days of infection, and appear perfectly normal. Its risky in the extreme.

realweirdo

Doctor Jimbob wrote: »

What? What has been proved time and time again? This is the only ebola outbreak on anything close to this scale. What exactly are you making a comparison with here?

Also you can gloss it over anyway you like, but saying infected countries should just be sealed off is at best callous and at worst outright racist. Would you feel the same if something similar started in Ireland and the rest of the world decided to just seal us off?

With a post as ignorant as this, I've nothing further to say to you, particularly your ignorance of the need to isolate ebola patients.

realweirdo

ProfessorPlum wrote: »

It is ridiculously easy to get past fever screening. A couple of paracetamol will do it. And so far (as of earlier today at least) of all those stopped at borders in affected countries with a fever, none had Ebola. So I'm not sure how well the strategy is working.

Which supports my argument, in a worst case scenario. The tests could be next to useless for all we know. Of course people will display fever symptoms in a late stage infection. But early stage?

the_monkey

ElizaT33 wrote: »

Im terrified about this - have just text my son who's due to travel home from holiday in Spain tomorrow. Told him to stay away from anyone who seems sick and to avoid airplane toilets if possible - these are scary times !

You should worry more about him getting hit by a bus ffs ..

miss no stars

ProfessorPlum wrote: »

Epidemiologists like to talk about R numbers. Generally they are people who are pretty good at statistics. Of course it's not meaningless. Put it this way: Measles has an R number somewhere approaching 18. It also would have about the same timeline of being infectious as Ebola. Also, as a downside for bystanders, people with measles tend to be in contact with more people while they're ill (owning to the fact that they're not lying down dying in their bed). Measles is highly contagious. 18 is 9 times 2. Ebola is contagious, but not highly contagious in the grand scheme of things.

My own experience is that most people - even those who use them a lot - have poor intuition for statistics. Most people who use stats a lot will tell you that even though you can learn how to use the really in-depth stuff, the really "difficult" statistical methods, if you don't get the basics, you probably never actually will get it. Like I saw an article laughing about the fact that just about half of parents considered their child to be of above average intelligence...

Statistics are really only valid if you're comparing like with like. Something that kills rapidly is not like something that kills over the course of decades. The implications are also different, one might leave you with pock marks (measles!), whereas the other is more likely to kill you (Ebola). When assessing risk, you have to assess the probability of occurrence AND the consequence of occurrence. Therefore the R number alone is simply NOT adequate to conclude that Ebola is not a high risk highly contagious disease. One also has to look at the precautions taken around the disease - gloves at best for measles; full on level 4 protection for Ebola -- and we've since seen that even level 2 protection appears not to be adequate as that poor Spanish nurse who appears to have followed protocol got infected anyway.

R numbers can be a useful starting point. An epidemiologist will talk about the R number because they're concerned about how a disease can spread, however, the timeframe simply CANNOT be ignored. If each Ebola victim passes it on to 2 people within the space of 3 weeks, and each of those pass it on to 2 people and so forth, this is what happens:

T0: 1 person infected
T3 (weeks): 3 (1+2)
T6: 7 (1+2+4)
T9: 15 (1+2+4+8)
T12: 31 (1+2+4+8+16)

So within 3 months, ONE infection has caused 30 others. Here's how it would look for a HIV infection:

T0: 1
T3: 1
T6: 1
T9: 1
T12: 1

So if you're going to look to R numbers in any sort of useful way for containing a disease, you MUST put them in the context of the time-frame in which they occur. The ONLY reason that Ebola doesn't have a higher R number is that people simply don't live long enough to pass it on to more people. Hence my comment about the most dangerous mutation that could occur being a reduction in the mortality rate.

the_monkey

ElizaT33 wrote: »

Im terrified about this - have just text my son who's due to travel home from holiday in Spain tomorrow. Told him to stay away from anyone who seems sick and to avoid airplane toilets if possible - these are scary times !

What Ebola hangs around the toilets does it ???

have you any idea how the disease is actually spread or are you just in here spouting mindless scaremongering crap ?

Meglamonia

ElizaT33 wrote: »

Im terrified about this - have just text my son who's due to travel home from holiday in Spain tomorrow. Told him to stay away from anyone who seems sick and to avoid airplane toilets if possible - these are scary times !

Ah jesus.

PucaMama

the_monkey wrote: »

What Ebola hangs around the toilets does it ???

have you any idea how the disease is actually spread or are you just in here spouting mindless scaremongering crap ?

think you need to do a bit of reading yourself on how ebola can spread

ProfessorPlum

realweirdo wrote: »

What testing can they do at an airport? Blood tests? Nope. Urine tests? Nope, and probably pointless in the case of ebola. They are doing temperature checks. My understanding is ebola has an encupation period of about 21 days. Someone could pass a test in the early days of infection, and appear perfectly normal. Its risky in the extreme.

Can't find where I read it - it was a WHO or CDC document. They've been isolating those with a temperature, refusing travel, and testing them for ebola. They've all come up negative. Most have had malaria.
It seems fairly pointless. Closing borders is impossible.

miss no stars

the_monkey wrote: »

What Ebola hangs around the toilets does it ???

Actually, yes.

Bodily fluids....

Lives happily on cool hard surfaces...

The feckin STATE of airplane toilets at times...

Doctor Jimbob

realweirdo wrote: »

With a post as ignorant as this, I've nothing further to say to you, particularly your ignorance of the need to isolate ebola patients.

So you don't actually have a response and are going to resort to insults. Not surprising.

realweirdo

the_monkey wrote: »

What Ebola hangs around the toilets does it ???

have you any idea how the disease is actually spread or are you just in here spouting mindless scaremongering crap ?

Most ebola victims suffer from severe diarrhoea. Would you use a toilet seat after an ebola victim?

Thought not!

ProfessorPlum

A bit of perspective needed lads...

Asymptomatic persons or patients with very early symptoms will have low viral loads, so unless you go into the loo after a bloke who febrile, pucking and oozing blood from orifices, the chances of catching it like that is negligible.
We're back to the toilet seat/HIV panicking

realweirdo

ProfessorPlum wrote: »

Can't find where I read it - it was a WHO or CDC document. They've been isolating those with a temperature, refusing travel, and testing them for ebola. They've all come up negative. Most have had malaria.
It seems fairly pointless. Closing borders is impossible.

Stopping flights is not impossible. You are making my argument by the way. And I am not really referring to late stage ebola infection. People in late stages are usually very sick, high fever, severe pain and diarrhoea. It's unlikely they would be getting on a flight and if they did, would be spotted right away. It's the early stage victims that are far more dangerous, who present no visible symptoms. I'd imagine the guy from Texas had early stage infection when he flew home.

TheBeardedLady

ElizaT33 wrote: »

Im terrified about this - have just text my son who's due to travel home from holiday in Spain tomorrow. Told him to stay away from anyone who seems sick and to avoid airplane toilets if possible - these are scary times !

Relax. Only one confirmed case here (in Spain). Better to keep things in perspective than to lose the plot (at least that's what I'm trying to do here).

ElizaT33

the_monkey wrote: »

What Ebola hangs around the toilets does it ???

have you any idea how the disease is actually spread or are you just in here spouting mindless scaremongering crap ?

Yes I do, as do a great amount of posters online at the min - u must be actually STUPID ! Stop bothering the discussion:mad:

ProfessorPlum

realweirdo wrote: »

Stopping flights is not impossible. You are making my argument by the way. And I am not really referring to late stage ebola infection. People in late stages are usually very sick, high fever, severe pain and diarrhoea. It's unlikely they would be getting on a flight and if they did, would be spotted right away. It's the early stage victims that are far more dangerous, who present no visible symtoms. I'd imagine the guy from Texas had early stage infection when he flew home.

I don't think anyone is referring to late stage ebola sufferers traveling anywhere, are we.
Yes, you could stop flights. And would have economic consequences, delay aid from getting in and out, and still not stop people leaving. As has been pointed out, as soon as it looks like there'll be a lock down, people are likely to try and leave. Especially people who think they might be sick. And it's a very blunt tool. Are we talking obout stopping flights to the countries affected? The cities? What?

IMO the effort needs to be at a very local level, not at the national borders. That's not going to solve anything in the medium to long term and will probably make the situation worse.

ProfessorPlum

realweirdo wrote: »

Most ebola victims suffer from severe diarrhoea. Would you use a toilet seat after an ebola victim?

Thought not!

Agghhhh. By the time they have sever diarrhoea, they won't be on your plane. And as you rightly pointed out, everyone will know to stay well clear.

FullblownRose

TheBeardedLady wrote: »

Relax. Only one confirmed case here (in Spain). Better to keep things in perspective than to lose the plot (at least that's what I'm trying to do here).

Absolutely.

realweirdo

ProfessorPlum wrote: »

Agghhhh. By the time they have sever diarrhoea, they won't be on your plane. And as you rightly pointed out, everyone will know to stay well clear.

I agree they won't. I was responding to a poster however who said it can't be spread via toilet seats. In theory it probably can be.

jsd1004

realweirdo wrote: »

Totally agree but it has been largely an African issue, mostly related to the consumption of bush meat. There should be more than enough wealth and resources in Africa to come up with a vaccine, if governments weren't more interested in going to wars against each other or stealing their nations wealth.
The west can't be blamed for Ebola or its spread.

Oh yes.. The old bush meat and shagging monkeys bit..