View topic - Ebola • Redscape

: rickyp; Statesman; Posts: 11324; Joined: 15 Aug 2000, 8:59 am

27 Oct 2014, 2:26 pm

freeman3

You tried to claim that the quarantines were mostly for senior homes. Are you claiming that was from article, too?

I said that the "voluntary quarantines" were, to my recollection, seniors homes, because I was here for SARS Toronto. And have a relative in a seniors home.

EDITORIAL from New England Journal of Medicine...
Ebola and Quarantine

http://www.nejm.org/doi/full/10.1056/NE ... red_home&&

freeman3

4 years college, 4 years medical school, 1 year internship, 3 years residency to become a dermatologist , the specialty that Ricky made fun of

I didn't make fun of them.
I made fun of you for resorting to the opinion poll of a doctors face book forum for medical expertise.
I'm certain that the program you describe makes them perfectly fit to offer expert opinion on skin diseases.
However they aren't as qualified to offer as worthy opinions on infectious disease as a specialist in infectious disease, or on heart disease as a cardiologist. Are they?

freeman3

What I can't believe is your smug attitude that the worst infectious disease in a century is nothing to worry about.

Ebola is not the worst infectious disease in a century. The Flu killed between 20 and 40 million people world wide in 1918.
Cholera has killed 570,000 in the last 40 years.

http://en.wikipedia.org/wiki/Cholera_ou ... _pandemics

AIDS has killed 39,000,000
Asian Flu killed 2,000,000 in 1958
Hong Kong Flu killed 1,000,000 in 1968
http://news.nationalgeographic.com/news ... -pandemic/

Smug? Being well informed leads to smugness then,
Unless you live in one of the poorest regions of Africa ebola is not a serious threat in any way.
And the three countries affected represent exactly 2% of the population of Africa...

: Sassenach; Emissary; Posts: 3405; Joined: 12 Jun 2006, 2:01 am

27 Oct 2014, 2:34 pm

Malaria kills 1 million people every year, mostly in Africa. HIV is even worse. Ebola has killed what, 4000 people so far ? I'd say it has an awful long way to go before it rivals either of those two diseases.

: freeman3; Adjutant; Posts: 3741; Joined: 17 May 2013, 3:32 pm

27 Oct 2014, 2:38 pm

The best way to prevent people from dying from low mortality diseases is to make sure they are getting enough to eat , enough water, proper sanitation, and they get adequate medical treatment. There is only so much government can do to prevent people dying who are old, have weak immune systems, or are malnourished. Even if you are old you probably have a very low chance at dying from the flu if you are reasonably healthy, but if you have several chronic diseases it may provide a last push. Highly vulnerable patients , even if they are protected from one thing, will likely die from something else. Ebola's high mortality threatens the general population regardless of health and that means people are dying who would not die from something else.

: freeman3; Adjutant; Posts: 3741; Joined: 17 May 2013, 3:32 pm

27 Oct 2014, 2:40 pm

HIV is difficult to transmit otherwise it would have been a bigger concern for the West.

: freeman3; Adjutant; Posts: 3741; Joined: 17 May 2013, 3:32 pm

27 Oct 2014, 2:48 pm

Ricky the comment about it being the worst in a century meant since the Spanish Flu. I don't think that any of those other cited pandemics had the same effect on any society as Ebola has had on the affected countries. The lethality of the disease has extreme psychological and economic effects not seen in less lethal diseases. That is one of the reasons we have to keep it out. The first thing it would do is cripple the economy

: Sassenach; Emissary; Posts: 3405; Joined: 12 Jun 2006, 2:01 am

27 Oct 2014, 2:54 pm

You're proposing that we overreact to a disease that's highly unlikely to ever be a problem for us. That's not a rational response.

: danivon; Ambassador; Posts: 16006; Joined: 15 Apr 2004, 6:29 am

27 Oct 2014, 3:06 pm

freeman3 wrote:4 years college, 4 years medical school, 1 year internship, 3 years residency to become a dermatologist , the specialty that Ricky made fun of. http://work.chron.com/educational-requi ... -8497.html.
It takes 14 years to be a cardiologist.

In the UK, it would be 2 years at college/6th form to do A levels, and then medical school is 5 years, plus one as an intern. A dermatologist then needs 4 years of training to be qualified. http://www.gmc-uk.org/Dermatology_3_Jul ... 542322.pdf

For cardiology in the UK, it would take about 9 years post-graduate training to qualify, as they have to spend at least 3 years to get vascular medicine down and another 2 on other pre-qualification training before they even start on the 4 year cardio curriculum.

Looks roughly comparable to me. Having shared a flat with medical students for two years, I can tell you it was not an easy course for them.

Yeah I expect that is a bit more than most other countries.

I expect that it is going to be comparable to most developed countries, and that undeveloped countries tend to see their local medics get training in the West. Want to look at real comparisons to? Or just guess that the USA must be better because... well because USA perhaps.

: freeman3; Adjutant; Posts: 3741; Joined: 17 May 2013, 3:32 pm

27 Oct 2014, 3:19 pm

All I am proposing is a travel ban, Sass. The arguments against it are weak.

: danivon; Ambassador; Posts: 16006; Joined: 15 Apr 2004, 6:29 am

27 Oct 2014, 3:23 pm

freeman3 wrote:Ricky the comment about it being the worst in a century meant since the Spanish Flu. I don't think that any of those other cited pandemics had the same effect on any society as Ebola has had on the affected countries. The lethality of the disease has extreme psychological and economic effects not seen in less lethal diseases. That is one of the reasons we have to keep it out. The first thing it would do is cripple the economy

I suspect AIDS has had a greater impact across Africa in the last 30 years - it has led to massive economic issues in countries like Botswana: http://en.wikipedia.org/wiki/Economic_i ... f_HIV/AIDS

Ebola has an acute effect on the countries where it appears, but not a lasting one (so far). This is, of course, the worst outbreak yet, but if it is contained and dealt with at source, the affected countries are likely to recover pretty quickly.

Yes, Ebola is scary. But giving in to that fear isn't really going to help much. The way that Kaci Hickox has been treated is shameful, but the policy did allow a couple of Governors to look like they were doing something. To deal with the problem in Africa we need more medical staff to volunteer. Will they do so knowing that their homeland will be so grateful on their return? I see Cuomo has relented on where quarantine can be served.

: freeman3; Adjutant; Posts: 3741; Joined: 17 May 2013, 3:32 pm

27 Oct 2014, 3:55 pm

Well, all I originally said is that US doctors have exceptionally difficult requirements. I did not compare them to other countries--the whole point is to compare them to the general US population. Apparently, you took that as typical American bravado. After your post I then did try to check foreign countries' requirements, but came up empty in a quick search so I posted US requirements and said I thought it was more than most. I did not say better than most Western countries . Anyway, you have proven that British doctors are just as well-trained as in the US, so you won a fight I did not pick.

: freeman3; Adjutant; Posts: 3741; Joined: 17 May 2013, 3:32 pm

27 Oct 2014, 6:18 pm

This problem of what about to about returning health care professionals is a serious one. My solution would be two-fold: (1) pay them very well, this is hazardous work and they should be well-compensated for the risks they are taking , (2) set up comfortable facilities outside of West Africa where they will go for a 21 day decontamination period.

: rickyp; Statesman; Posts: 11324; Joined: 15 Aug 2000, 8:59 am

28 Oct 2014, 6:18 am

freeman3

This problem of what about to about returning health care professionals is a serious one

Your solution is demeaning and useless. all it does is make the commitment to a tour in west Africa more difficult. It needs to be easier for professionals not more difficult.
The returning health care professionals are better qualified than anyone regarding the risks, and treatments of Ebola. They understand it because of their educations (which you have taken great pains to illustrate as extensive) , and because they have been treating symptomatic and very infectious individuals . They have hands on experience in the worst circumstance.
And they actually do understand the risks and what to do, as opposed to political hacks who want to use the topic as a political football, and are quite willing to fan the flames of fear in an ignorant and ill formed public. (Ill informed by the irresponsible media, and irresponsible political hacks.)
No group is better able to self diagnose and seek treatment before they become infectious.
No group deserves our respect and admiration more, than those who go to fight the disease in Africa. And no group deserves more support.
They certainly don't need ignoramuses like Chris Christie to thrust them into an unnecessary incarceration in order to combat a non-existent threat.

One of the more ridiculous hypothesis is that ebola will mutate to become "airborne" and genuinely risky in the way that flu is...
Here's a great explanation of why that won't happen.

Here is why Ebola won’t go airborne.
First, diseases in general, including viruses, do change which species they infect sometimes, and they change in virulence and the exact effects on the host, but they really don’t change their mode of transmission. At the largest evolutionary scale there have been some novelties, obviously (or there would be no variation!). I am pretty sure many of the influenza viruses are not transmitted through the air, but the only ones we bother to name and study do, and are a subset of a larger group that transmits via water. I may have that wrong (going on old personal communications here) but if I am wrong that just crosses off Influenza as a virus that changed mode of transmission. Ebola is in a large group of viruses that are actually found in plants. Obviously, there was a change in transmission at the origin of Ebola. But really, this does not happen very often. If you can think of examples please tell me. (For a non virus example, Malaria is transmitted the same way all the time even if it changes (rarely) which species it affects or otherwise evolves like crazy to stay ahead of interventions.)
In short, we expect strong phylogenetic inertia in mode of transmission.
Second, there is no in place mechanism, probably. Ebola does not infect the tissues it would need to infect to make its way into a sneeze or cough. That would require a major change.
Third, developmentally, the first step in a virus’s life cycle is getting itself into a cell. Airborne viruses need to have a key that matches a lock on the outside of respiratory tissues. So Ebola not only lacks the means for getting out through a sneeze or cough, it also lacks the ability to do much if it did.
Fourth, it is not adaptive. Yes, a virus can mutate to do something stupid and maybe get a Darwin Award, but the chances are at least somewhat reduced. Ebola is very deadly in humans. Humans and the animal vectors that may stand between fruit bats (the likely wild host) and humans are not good hosts for Ebola. The chances of Ebola evolving to infect an unsuitable host are reduced.

More here. And well worth the read.
http://scienceblogs.com/gregladen/2014/ ... re-is-why/

By the way. The claims that Ebola is a "deadly" disease with a high mortality rate are not supported by the American experience. Only 1 has died in the US, and had he been diagnosed properly and admitted when he showed up, its possible aggressive treatment would have saved him too.
Of course, only 2 have been infected in the US, the others treated were sick medical staff brought home.

: freeman3; Adjutant; Posts: 3741; Joined: 17 May 2013, 3:32 pm

28 Oct 2014, 8:39 am

You can disagree but it's not demeaning. And you know the thoughts of health care professionals, Ricky? The guy who writes the blog you cited appears to take Ebola lot more seriously than you do. For one thing, he says in the comments section that people should not be allowed on an airplane from the area without testing.

: Doctor Fate; Ambassador; Posts: 21062; Joined: 15 Jun 2002, 6:53 am

28 Oct 2014, 9:07 am

danivon wrote:I'm sorry, but I trust "common sense" a good deal less than I do epidemiologists.

So smart, they are. That's why we have Ebola here in the first place. We're doing what the experts advise.

A doctor gets back from West Africa, goes to a bar, goes bowling, etc. If this virus mutates, we're in a world of hurt.
A virus mutates every time it infects a new host. But it would take a great deal of change for it to be transmissible before symptoms present (because it's the symptoms of fluid discharge that are the means of transmission). He went to hospital as soon as he saw his temperature was high.

And, certainly, he was monitoring that . . . every frame. :no:

You guys can yuck it up all you want, but government fails: Katrina, Obamacare website, etc. If there is a more serious mistake here, it will overwhelm the system. That's why the success rate here is not that impressive. It's easier to cure half a dozen cases than 5,000, 20,000, or 100,000. If the genie gets all the way out of the bottle, you all will be laughing out of the other side of your mouths.

: Doctor Fate; Ambassador; Posts: 21062; Joined: 15 Jun 2002, 6:53 am

28 Oct 2014, 9:12 am

rickyp wrote:By the way. The claims that Ebola is a "deadly" disease with a high mortality rate are not supported by the American experience. Only 1 has died in the US, and had he been diagnosed properly and admitted when he showed up, its possible aggressive treatment would have saved him too.
Of course, only 2 have been infected in the US, the others treated were sick medical staff brought home.

It's clear then: Obama is a racist. If he wasn't, we would save all the Africans. After all, we are crushing Ebola here, so why not over there? It has to be racism.

Or . . . could it be scale?

Could it be that curing a few people with all hands on deck is different? Hmm, I think I may be onto something. Okay, the President is not a racist.

Rickyp, it is a deadly disease. It's not AS deadly when all the best Western care and medicine is focused upon it 24/7. However, that is impossible to replicate when the virus is as widespread as it is in West Africa.

So, it would seem the key is this: don't let it spread. The best way to do that is . . . to stop it from traveling the world.

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