Edits to post #25260009 by Feoric
Edited at 2014-10-10 11:57:03
Too little too late. We, as well as every other developed nation, should have not just sent troops, but more importantly doctors, supplies and money over to West Africa months ago. Going by the latest sitreps, it's likely that the threshold for containment has been crossed. There's too many infected people in Guinea, Liberia and Sierra Leone and too little resources and morale. Keep in mind that as the situation continues to deteriorate in these countries, so does their ability to not only report on new cases and deaths, but also to maintain quarantines and general rule of law. All bets are off when civil unrest occurs inside these countries.
If you want to see how to correctly contain a deadly outbreak, look at what Nigeria did:
"We have analysed epidemiological data of what appears to be a limited outbreak of EVD in Nigeria based on data available as of 1 October 2014, with no new EVD cases reported since 5 September 2014. The swift control of the outbreak was likely facilitated by the early detection of the index entering Nigeria from a country where disease is widespread, in combination with intense contact tracing efforts of all contacts of this index case and the subsequent isolation of infected secondary cases. In contrast, the initial outbreak in Guinea remained undetected for several weeks. This detection delay facilitated the transnational spread of the virus to Sierra Leone and Liberia, while difficulties and at times inability to track and contain infectious individuals compounded the situation and resulted in an as yet uncontrolled epidemic in these countries.
We estimated a mean case fatality rate of 40% (95% CI: 22–61) for the EVD outbreak in Nigeria. This estimate based on a small sample size is at the lower end of estimates from previous outbreaks, ranging from 41% to 89% and is likely a result of supportive care offered in dedicated facilities put in place in a timely fashion by the Nigerian authorities. In comparison, the EVD case fatality rate in the ongoing outbreak in Guinea, Sierra Leone and Liberia has been estimated at 70% (range: 61– 89). As is the case for any emerging infection, these estimates have to be considered with caution as they are prone to many biases, including under-reporting of milder symptomatic cases (affecting the denominator) and censoring effects related to the unknown final outcome of the most recent infections."
Keeping that in mind, this is why the ebola outbreak is "our problem:"
"Currently in the US, we see the following issues regarding preparedness:
1. Public health preparedness is a world away from true frontline medical preparedness. The two communities are talking past each other. The civilian medical community is compromised due to the upheaval of healthcare in our country.
2. Five airports are checking for fevers at checkpoints. LaGuardia was left off this list, prompting an airline worker strike. The US Department of State has not indicated whether / what they are doing in regards to the granting of Visas (the true core of the issue). DHS TSA has failed to provide key information regarding passenger movement beyond the Ports of Entry. Understanding critical information regarding intra-country travel beyond the Ports of Entry is essential at this juncture. We do not believe checking for fever at Ports of Entry addresses the core concern, which is the prevention of citizens from the core affected countries from entering the United States until containment has truly been achieved.
3. There continues to be a serious erosion in public confidence in public health's leadership writ large. This lack of confidence permeates our medical community.
In short, the situation is out of control, and our country remains exposed with the potential for more surprise translocations. We do not anticipate significant potential for an uncontrolled epidemic here in the US, however preparedness is a serious problem."
There will most likely be more confirmed ebola cases in the US and Europe as time goes on, but an outbreak here can't occur if we act fast upon seeing warning signs as well as following the proper procedures. Being cocky like how we were in Dallas is exactly how deadly pathogens spread and kill a bunch of people. Randomness and incompetence will be our fault lines. The CDC is projecting that the virus will infect over 1 million people in West Africa by the end of January. Once we reach those levels of infection the virus cannot be contained. Millions of people are likely to die, among them will almost certainly be Americans and Europeans. So, yes, this is absolutely something we have a vested interest in seeing contained.
Concerning travel bans: you run the risk of people just attempting to enter the US/Europe through countries where the ability to enforce containment is equally unlikely, thus spreading it there and abroad in the process. If you live in Libera and have the means to flee to the US and there's no commercial air traffic coming in/out of the country, chances are you're not just going to stay put and accept your fate.
Too little too late. We, as well as every other developed nation, should have not just sent troops, but more importantly doctors, supplies and money over to West Africa months ago. Going by the latest sitreps, it's likely that the threshold for containment has been crossed. There's too many infected people in Guinea, Liberia and Sierra Leone and too little resources and morale. Keep in mind that as the situation continues to deteriorate in these countries, so does their ability to not only report on new cases and deaths, but also to maintain quarantines and general rule of law. All bets are off when civil unrest occurs inside these countries.
If you want to see how to correctly contain a deadly outbreak, look at what Nigeria did:
"We have analysed epidemiological data of what appears to be a limited outbreak of EVD in Nigeria based on data available as of 1 October 2014, with no new EVD cases reported since 5 September 2014. The swift control of the outbreak was likely facilitated by the early detection of the index entering Nigeria from a country where disease is widespread, in combination with intense contact tracing efforts of all contacts of this index case and the subsequent isolation of infected secondary cases. In contrast, the initial outbreak in Guinea remained undetected for several weeks. This detection delay facilitated the transnational spread of the virus to Sierra Leone and Liberia, while difficulties and at times inability to track and contain infectious individuals compounded the situation and resulted in an as yet uncontrolled epidemic in these countries.
We estimated a mean case fatality rate of 40% (95% CI: 22–61) for the EVD outbreak in Nigeria. This estimate based on a small sample size is at the lower end of estimates from previous outbreaks, ranging from 41% to 89% and is likely a result of supportive care offered in dedicated facilities put in place in a timely fashion by the Nigerian authorities. In comparison, the EVD case fatality rate in the ongoing outbreak in Guinea, Sierra Leone and Liberia has been estimated at 70% (range: 61– 89). As is the case for any emerging infection, these estimates have to be considered with caution as they are prone to many biases, including under-reporting of milder symptomatic cases (affecting the denominator) and censoring effects related to the unknown final outcome of the most recent infections."
Keeping that in mind, this is why the ebola outbreak is "our problem:"
"Currently in the US, we see the following issues regarding preparedness:
1. Public health preparedness is a world away from true frontline medical preparedness. The two communities are talking past each other. The civilian medical community is compromised due to the upheaval of healthcare in our country.
2. Five airports are checking for fevers at checkpoints. LaGuardia was left off this list, prompting an airline worker strike. The US Department of State has not indicated whether / what they are doing in regards to the granting of Visas (the true core of the issue). DHS TSA has failed to provide key information regarding passenger movement beyond the Ports of Entry. Understanding critical information regarding intra-country travel beyond the Ports of Entry is essential at this juncture. We do not believe checking for fever at Ports of Entry addresses the core concern, which is the prevention of citizens from the core affected countries from entering the United States until containment has truly been achieved.
3. There continues to be a serious erosion in public confidence in public health's leadership writ large. This lack of confidence permeates our medical community.
In short, the situation is out of control, and our country remains exposed with the potential for more surprise translocations. We do not anticipate significant potential for an uncontrolled epidemic here in the US, however preparedness is a serious problem."
There will most likely be more confirmed ebola cases in the US and Europe as time goes on, but an outbreak here can't occur if we act fast upon seeing warning signs as well as following the proper procedures. Being cocky like how we were in Dallas is exactly how deadly pathogens spread and kill a bunch of people. Randomness and incompetence will be our fault lines. The CDC is projecting that the virus will infect over 1 million people in West Africa by the end of January. Once we reach those levels of infection the virus cannot be contained. Millions of people are likely to die, among them will almost certainly be Americans and Europeans. So, yes, this is absolutely something we have a vested interest in seeing contained.
Concerning travel bans: you run the risk of people just attempting to enter the US/Europe through countries where the ability to enforce containment is equally unlikely, thus spreading it there and abroad in the process. If you live in Liberia and have the means to flee to the US and there's no commercial air traffic coming in/out of the country, chances are you're not just going to stay put and accept your fate.
Edited at 2014-10-10 11:55:51
Too little too late. We, as well as every other developed nation, should have not just sent troops, but more importantly doctors, supplies and money over to West Africa months ago. Going by the latest sitreps, it's likely that the threshold for containment has been crossed. There's too many infected people in Guinea, Liberia and Sierra Leone and too little resources and morale. Keep in mind that as the situation continues to deteriorate in these countries, so does their ability to not only report on new cases and deaths, but also to maintain quarantines and general rule of law. All bets are off when civil unrest occurs inside these countries.
If you want to see how to correctly contain a deadly outbreak, look at what Nigeria did:
"We have analysed epidemiological data of what appears to be a limited outbreak of EVD in Nigeria based on data available as of 1 October 2014, with no new EVD cases reported since 5 September 2014. The swift control of the outbreak was likely facilitated by the early detection of the index entering Nigeria from a country where disease is widespread, in combination with intense contact tracing efforts of all contacts of this index case and the subsequent isolation of infected secondary cases. In contrast, the initial outbreak in Guinea remained undetected for several weeks. This detection delay facilitated the transnational spread of the virus to Sierra Leone and Liberia, while difficulties and at times inability to track and contain infectious individuals compounded the situation and resulted in an as yet uncontrolled epidemic in these countries.
We estimated a mean case fatality rate of 40% (95% CI: 22–61) for the EVD outbreak in Nigeria. This estimate based on a small sample size is at the lower end of estimates from previous outbreaks, ranging from 41% to 89% and is likely a result of supportive care offered in dedicated facilities put in place in a timely fashion by the Nigerian authorities. In comparison, the EVD case fatality rate in the ongoing outbreak in Guinea, Sierra Leone and Liberia has been estimated at 70% (range: 61– 89). As is the case for any emerging infection, these estimates have to be considered with caution as they are prone to many biases, including under-reporting of milder symptomatic cases (affecting the denominator) and censoring effects related to the unknown final outcome of the most recent infections."
Keeping that in mind, this is why the ebola outbreak is "our problem:"
"Currently in the US, we see the following issues regarding preparedness:
1. Public health preparedness is a world away from true frontline medical preparedness. The two communities are talking past each other. The civilian medical community is compromised due to the upheaval of healthcare in our country.
2. Five airports are checking for fevers at checkpoints. LaGuardia was left off this list, prompting an airline worker strike. The US Department of State has not indicated whether / what they are doing in regards to the granting of Visas (the true core of the issue). DHS TSA has failed to provide key information regarding passenger movement beyond the Ports of Entry. Understanding critical information regarding intra-country travel beyond the Ports of Entry is essential at this juncture. We do not believe checking for fever at Ports of Entry addresses the core concern, which is the prevention of citizens from the core affected countries from entering the United States until containment has truly been achieved.
3. There continues to be a serious erosion in public confidence in public health's leadership writ large. This lack of confidence permeates our medical community.
In short, the situation is out of control, and our country remains exposed with the potential for more surprise translocations. We do not anticipate significant potential for an uncontrolled epidemic here in the US, however preparedness is a serious problem."
There will most likely be more confirmed ebola cases in the US and Europe as time goes on, but an outbreak there can't occur if we act fast upon seeing warning signs as well as following the proper procedures. Being cocky like how we were in Dallas is exactly how deadly pathogens spread and kill a bunch of people. Randomness and incompetence will be our fault lines. The CDC is projecting that the virus will infect over 1 million people in West Africa by the end of January. Once we reach those levels of infection the virus cannot be contained. Millions of people are likely to die, among them will almost certainly be Americans and Europeans. So, yes, this is absolutely something we have a vested interest in seeing contained.
Concerning travel bans: you run the risk of people just attempting to enter the US/Europe through countries where the ability to enforce containment is equally unlikely, thus spreading it there and abroad in the process. If you live in Libera and have the means to flee to the US and there's no commercial air traffic coming in/out of the country, chances are you're not just going to stay put and accept your fate.
Too little too late. We, as well as every other developed nation, should have not just sent troops, but more importantly doctors, supplies and money over to West Africa months ago. Going by the latest sitreps, it's likely that the threshold for containment has been crossed. There's too many infected people in Guinea, Liberia and Sierra Leone and too little resources and morale. Keep in mind that as the situation continues to deteriorate in these countries, so does their ability to not only report on new cases and deaths, but also to maintain quarantines and general rule of law. All bets are off when civil unrest occurs inside these countries.
If you want to see how to correctly contain a deadly outbreak, look at what Nigeria did:
"We have analysed epidemiological data of what appears to be a limited outbreak of EVD in Nigeria based on data available as of 1 October 2014, with no new EVD cases reported since 5 September 2014. The swift control of the outbreak was likely facilitated by the early detection of the index entering Nigeria from a country where disease is widespread, in combination with intense contact tracing efforts of all contacts of this index case and the subsequent isolation of infected secondary cases. In contrast, the initial outbreak in Guinea remained undetected for several weeks. This detection delay facilitated the transnational spread of the virus to Sierra Leone and Liberia, while difficulties and at times inability to track and contain infectious individuals compounded the situation and resulted in an as yet uncontrolled epidemic in these countries.
We estimated a mean case fatality rate of 40% (95% CI: 22–61) for the EVD outbreak in Nigeria. This estimate based on a small sample size is at the lower end of estimates from previous outbreaks, ranging from 41% to 89% and is likely a result of supportive care offered in dedicated facilities put in place in a timely fashion by the Nigerian authorities. In comparison, the EVD case fatality rate in the ongoing outbreak in Guinea, Sierra Leone and Liberia has been estimated at 70% (range: 61– 89). As is the case for any emerging infection, these estimates have to be considered with caution as they are prone to many biases, including under-reporting of milder symptomatic cases (affecting the denominator) and censoring effects related to the unknown final outcome of the most recent infections."
Keeping that in mind, this is why the ebola outbreak is "our problem:"
"Currently in the US, we see the following issues regarding preparedness:
1. Public health preparedness is a world away from true frontline medical preparedness. The two communities are talking past each other. The civilian medical community is compromised due to the upheaval of healthcare in our country.
2. Five airports are checking for fevers at checkpoints. LaGuardia was left off this list, prompting an airline worker strike. The US Department of State has not indicated whether / what they are doing in regards to the granting of Visas (the true core of the issue). DHS TSA has failed to provide key information regarding passenger movement beyond the Ports of Entry. Understanding critical information regarding intra-country travel beyond the Ports of Entry is essential at this juncture. We do not believe checking for fever at Ports of Entry addresses the core concern, which is the prevention of citizens from the core affected countries from entering the United States until containment has truly been achieved.
3. There continues to be a serious erosion in public confidence in public health's leadership writ large. This lack of confidence permeates our medical community.
In short, the situation is out of control, and our country remains exposed with the potential for more surprise translocations. We do not anticipate significant potential for an uncontrolled epidemic here in the US, however preparedness is a serious problem."
There will most likely be more confirmed ebola cases in the US and Europe as time goes on, but an outbreak here can't occur if we act fast upon seeing warning signs as well as following the proper procedures. Being cocky like how we were in Dallas is exactly how deadly pathogens spread and kill a bunch of people. Randomness and incompetence will be our fault lines. The CDC is projecting that the virus will infect over 1 million people in West Africa by the end of January. Once we reach those levels of infection the virus cannot be contained. Millions of people are likely to die, among them will almost certainly be Americans and Europeans. So, yes, this is absolutely something we have a vested interest in seeing contained.
Concerning travel bans: you run the risk of people just attempting to enter the US/Europe through countries where the ability to enforce containment is equally unlikely, thus spreading it there and abroad in the process. If you live in Libera and have the means to flee to the US and there's no commercial air traffic coming in/out of the country, chances are you're not just going to stay put and accept your fate.
