
Ebola: The tolling bell - superfx
http://stanfordlawyer.law.stanford.edu/2014/10/ebola-the-tolling-bell/
======
jostmey
Stopping Ebola now could be one of the single most important decisions the
world makes this century. Just imagine what would happen if Ebola emerged in
lets say _India_. It doesn't sound so far fetched now that we have seen a case
in America.

Exponential growth tends to catch people off-guard. Just like Moore's Law lead
to a rapid emergence of the home computer, a deadly disease could reshape the
world overnight.

~~~
tomjen3
The viral factor of ebola is 1.7, but it is also is the place in the world
where there is the least amount of medical staff.

In addition it would be a lot easier to ban plane travel out of Africa than it
would be to end the ebola outbreak. Both options would prevent ebola getting
into India.

In addition I am not that terrified of India - the kind of people who live
about the airline are the kind of people who have access to medical resources.
I don't want to live in India, but it is not entirely a third-world country,
certainly not for the middle-class and above.

Now if it got into the slums of Calcutta we might a bigger problem.

~~~
616c
Unfortunately, with all do respect, you do not know the current plight of
Indian and South Asian population.

Many of them work in the Persian Gulf in labor camps. ANd I do not mean a
couple thousand. In Qatar, there is 10 million plus population, the population
is overwhelmingly male, and the Qataris are less one million of that
population. Male South Asian laborers are the largest demographic group in the
whole country. This is an increasingly common pattern in the region.

There is little or no medical care, and despite first class medical care for
expats, it would be way too late for the unprepared MoH units, which receive
basically minimal training from the CDC to react in time. This area,
specifically Qatar, has become a major transportation for hub internationa
flights, hence the real underlying panic for MERS (Middle East Respiratory
Syndrome).

If South Asia (India, Pakistan, Nepal, etc.) were hit in any real way, the
world would be fucked ... probably in the course of weeks.

------
startupfounder
“No man is an island, entire of itself; every man is a piece of the continent,
a part of the main. If a clod be washed away by the sea, Europe is the less,
as well as if promontory were, as well as if a manor of thy friends or thine
own were. Any man’s death diminishes me, for I am involved in mankind; and
therefore never send to know for whom the bell tolls; it tolls for thee.” -
John Donne, Meditation XVII, Devotions upon Emergent Occasions (1624)

It's important that we realize that theses people being affected by viral
spread of Ebola are people just like you, me, our families and friends.

~~~
a3voices
Well what about all the wildlife and rainforests that have been devastated by
human population growth in Africa? The continent would be better off without
so many people. After all, they're not doing anything to advance humanity
technologically. They are just wrecking ecosystems and wasting resources.

~~~
lotsofmangos
Have we double booked the Ebola thread with the support group for "Arseholes
Anonymous"?

Anyone from Europe or America who likes to sit in sneering judgment over the
wide variety of cultures in Africa either has no education in their own
history or hasn't the strength of character to face up to it.

~~~
goldfeld
I'm unsure what's more terrifying going forward, Ebola or the fact that at
least three users on this Hacker News story--as opposed to a mainstream
newspaper's website comment section where bigotry and ignorant patriotism is
the order of the day--have seen no issue in declaring their views
unanomymously. Much like death tolls go, how many more wanted to have made
similar comments but still had a minimum sense to restrain themselves?

~~~
newuser88273
Lemmesee. Catch Ebola... or have to read three interweb comments seriously
lacking in sensitivity? Tough choice.

Good luck, Ebola-Chan.

------
lotsofmangos
Donation pages for Médecins Sans Frontières:

[http://www.msf.org.uk/make-a-donation](http://www.msf.org.uk/make-a-donation)

[https://donate.doctorswithoutborders.org/](https://donate.doctorswithoutborders.org/)

Better to cough up cash now...

------
Alex3917
I think the author is overestimating how prepared the US healthcare system is
to handle a real threat if one arises:

\- The U.S. has been advertising that we're the ones with the cure for ebola,
so where is anyone with money going to go as soon as they get exposed? And
while most of the victims are among the urban poor, there will be more wealthy
people who become infected as the epidemic increases in scale.

\- Even if we have better technology, the cost of treating each victim here is
exponentially higher. The cost for each patient could easily be close to a
million dollars if you count 2+ weeks in the ER, licensed biohazard disposal
and decontamination, network tracing, quarantining exposed contacts, etc.

\- Nearly 50M Americans don't have health insurance. If going into the ER
risked you getting kept there while waiting for test results, possibly losing
your job, and getting getting stuck with a bill for tens of thousands of
dollars even if you don't have ebola, it's hard to imagine that many of those
people aren't going to just wait a few extra days.

\- In the US healthcare workers are generally paid well enough that they can
just leave their jobs, maybe not comfortably, but with enough money to at
least feed themselves and get by. It's hard to imagine that we won't have
large numbers of healthcare workers just taking off if this ever gets serious.
Especially since US healthcare workers aren't trained to deal with ebola, and
largely aren't interested -- notice how most of the people going to west
Africa to volunteer in this crisis are missionaries, not doctors.

\- We have all sorts of religious fundamentalists in the US who think it's
god's will that the US be destroyed for condoning homosexuality or whatever
who would be more than happy to help the process along, and more than enough
people abroad who would gladly sacrifice their own lives to disrupt our
foreign/domestic policy.

------
adventured
"The current Ebola epidemic may well become the worst human disaster in this
century. And we are not doing enough about it."

Ok, I think anyone here generally understands how dangerous Ebola is and could
become if it continues to spread.

That being said, already this century:

Smoking has killed roughly 60 million people

HIV / AIDS has killed 20 to 25 million

Malaria has killed eight million

Diarrhoea has killed perhaps 15 million

We're a long ways yet from Ebola competing as a worst human disaster
candidate. To put it in stark perspective, it could kill a million people
before it's contained (100+ fold more than it likely currently has), and it
still wouldn't get near the health disasters I listed. I don't really
understand why people persist with inflating Ebola's stature (or downplaying
the other health disasters, however you want to look at it). The only
conclusions I've come to, are that Ebola has been sensationalized for years by
Hollywood and the media (on-going), and its mortality rate and rapid nature
are obvious fear points. I still don't see how the fear adds up when compared
to millions of children dying from diarrhoea, except that these are things
most people think they can't get / won't die from.

~~~
ajani
At what age did people who died from smoking, first get infected? How many
years did they live with the infection? Did they have the difficult but still
viable option to quit smoking and survive a few more years or even have a full
life?

How many people contracted HIV by hugging someone? Or being in the same
environment for a prolonged period of time? How many contracted it because of
unprotected sex, or perhaps sharing needles? Again, how long did they live
with the disease?

How many people did _not_ die from Diarrhoea and Malaria? Do we have medicines
for these diseases?

It takes two weeks to die from Ebola from the moment you are infected. You
don't have any choice in the matter. It has extremely low survival rates. We
have no cure. It infects anyone and everyone. Being infected with Ebola is
closer to being the victim of a random shooting than any of the diseases you
mentioned.

And finally, in numbers alone, from the original article: "WHO and Centers for
Disease Prevention and Control (CDC) both estimate that the number of people
infected is doubling roughly every 20 days. This means that in 20 days 6,000
infections would become 12,000 and in 100 days, 6,000 infections would become
about 200,000. In 200 days – early April 2015—there would be 6 million
infections and in 400 days—roughly Halloween 2015—we would see over 6 billion
people infected, nearly as many as the world’s total population."

He does go on to say: "Unsustainable trends will stop; that rate of new
infections will slow down.[3] We will not see the world’s whole population
infected with, and more than half of us dead of, Ebola before the end of 2015.
It is possible that outbreak may end up largely confined to the three current
epidemic countries in West Africa. Other parts of the developing world provide
some hopeful signs."

So, there is hope. And it may not be as bad as the whole world being infected,
but the possibility is much larger than 60, 25, 6 or 15 million. That too in
one year, and not in 14.

------
ivanca
The fact that this article has been flagged (is no longer in the front page
despite being way up there minutes a go) and the lack of upvotes (compared to
other less important articles) makes me fear for the future of humanity.
Because despite being made of fairly smart people not even the HN crowd still
realizes the gravity of the situation.

------
Sebpereira
This could become the new trend, as populations concentrate more and more in
cities, creating slums, the conditions to catalyze outbreaks increase
exponentially. I agree with the author that the cause of the recent epidemic
has to do with the geographic location of the initial cases.

------
oxioxi
I am sad that Ebola has become an epidemic, but worried that it might be used
as a weapon by a fundamentalist. Our cavalier attitude in treating that man
from Liberia who developed Ebola in the US Presents a difficult problem to
prevent. That was an accidental event. What precautions can we take against
intentional events?

------
bjornsing
Does anybody know how the (immune) survivors are engaged in the health care
system of the affected countries? The treatment itself doesn't seem so
advanced, it's main challenge being not getting infected. Being immune would
be a huge advantage.

~~~
bjornsing
Seems there are quite serious plans to even tap their blood:
[https://news.ycombinator.com/item?id=8410437](https://news.ycombinator.com/item?id=8410437)

------
jliptzin
I read somewhere about a black market for ebola survivor blood. At first I
misread the title and thought it meant a black market for ebola-infected blood
(or ebola-infected cadavers). Now that is a truly scary possibility -
terrorists intentionally infecting themselves with ebola, then going into
airports and other high density areas, infecting surfaces and as many people
as they can before succumbing (or maybe even blowing themselves up with a
suicide bomb - who knows). I think that's one possibility that's been
overlooked and underscores why we really need to be funding greater
vaccine/cure research (in addition to the obvious reason of potentially saving
millions of lives in Africa).

~~~
anigbrowl
Terrorists could have done that years ago with AIDS or Hepatitis C but they
never have - it's not obviously an effective propaganda tool and religious
terrorists are likely to have hangups about dying in an unclean fashion.

~~~
noir_lord
> it's not obviously an effective propaganda tool

It's actually a terrible propaganda tool, the "goal" so far as there is one is
to strike terror into your opponents (and gain supporters) while not doing
something so heinous that you call down the wrath of your target since
terrorism is usually the far weaker side opposing the stronger side.

I think for example IS/ISIL/ISIS are just about to cross that line if they
haven't already.

------
Havoc
While the situation is serious - it will be contained eventually in my view.

As cynical as it sounds I think there are many positive effects being
overlooked here. People need a good wake-up every now and again.

We suddenly realized that there is zero global coordination. There is just no
global immediate response mechanism in place to deal with this type of stuff.
In the Hollywood movies you see the American tanks roll in as a show of force
to contain an area...but where are the American tanks in Nigeria?

Sure eventually UN & US mechanisms kicked in (which is great) but I still feel
it was subpar. Not in the sense of the people under-performed (they're great)
but rather that the structures in place under-performed / don't exist.

Personally I think there should be a global response team. i.e. one group that
has the ability to declare an emergency (Ebola) and then specific governments
can buy in or not (and delegate power & funding). Based on that buy-in the
team either has power or it does not. In this case, with EU and US buy-in such
a team would have vast of power over many nations - and many other nations
will follow a US/UN/EU alliance blindly (imagine finding yourself on the wrong
side of that). With THAT kind of response you can counter an epidemic.

Thats a bit of a pipe dream sure, but it illustrates what I mean by saying we
lack a global immediate response team. Now I'm not suggesting the above should
be implemented - its more of a thought experiment...the fact remains that the
current model is not capable of deal with Ebola let alone other stuff (that
shall remain unnamed in the interest of keeping things on track)

~~~
jerf
I often think that people just can not conceive of the scales of disasters
that are possible and can befall anybody, including the US. You look at the
frankly incredible measures that may be necessary to prevent an outbreak, and
it's easy to imagine the _costs_ , the screaming from the affecting (and,
given the topic, possibly the _literal_ screaming on the evening news of
perfectly innocent people against their will being confined in their own
houses unto literal death), the economic costs of shutting things down and
quarantining people, etc., politically and economically all very expensive,
and in the face of an imagination unable to truly, fundamentally _believe_
these things are possible, the will to take the necessary actions can not be
found, because the _benefits_ are literally inconceivable.

And there are oh-so-many things that are so much more _fun_ to spend time on
for those in authority, and the odds that their fundamental preparations will
be found wanting so low during their tenure, that the appeal of shifting all
resources and money away from basic prep is tempting to the point of
irresistibility.

Unfortunately, the disasters that can occur are not bounded by our
imagination.

(And I do mean _fun_ for those in authority. Contemplating emergencies is not
fun. Exerting primate dominance over others in the so very many varied ways
that humans are capable of is so much more _fun_.)

~~~
joezydeco
People need an emotional connection to a disaster or emergency before they
begin to contemplate the effects and either take action or donate
time/money/resources to help. Asking for money to help prevent a _future_
disaster is a lot harder connection to make with donors.

A recent NPR Planet Money podcast highlighted the difficulty in raising money
to fight Ebola:

[http://www.npr.org/blogs/money/2014/09/22/349962559/why-
rais...](http://www.npr.org/blogs/money/2014/09/22/349962559/why-raising-
money-to-fight-ebola-is-hard)

 _" Donors like being part of a recovery story. In Haiti, buildings and lives
were destroyed. The pitch was, let's help them rebuild. In the case of Ebola,
it's been harder to make a pitch."_

