
Some Ebola experts worry virus may spread more easily than assumed - shill
http://www.latimes.com/nation/la-na-ebola-questions-20141007-story.html
======
rsync
"I really don't have any more confidence because the CDC has been saying "it
will be fine" than I did when the Japanese officials said Fukushima would be
fine."

As someone who has a small bit of background understanding of Ebola (that is,
I read The Hot Zone, and then some follow-up texts related to it) and as
someone who has an appreciation for the role that air travel would play in a
pandemic, the lack of a proper travel quarantine procedure out of the affected
west african countries is _stupefying_.

It is beyond all understanding that there is not a 21 day
monitoring/quarantine period enforced for air travel out of these three
affected countries.

EDIT: I have created this change.org petition which suggests what are, in my
opinion, common sense travel guidelines that would avert a possible pandemic:

[https://www.change.org/p/barack-obama-and-u-s-senate-and-
u-s...](https://www.change.org/p/barack-obama-and-u-s-senate-and-u-s-house-of-
representatives-institute-quarantine-procedures-for-travel-out-of-countries-
with-ebola-outbreaks)

~~~
pfortuny
Completely agree: totally unbelievable that they are dealing with this without
any serious quarantine efforts.

~~~
hga
Ponder why this is the universal response of our Ruling Class....

~~~
pan69
They have their own planes...

------
forkandwait
It never ceases to amaze me how much humanity clings to the feeling that they
understand something, even when history tells us that surprises are far more
common than predictability. It seems to me that planning for Ebola (or a
battle, or climate change, or the economy, or anything vaguely important)
wouldn't be something along the lines of "Ok, we know what's going on, no need
to freak out or to spend any extra effort" but "Wow, these things go sideways
_all the time,_ let's assume our models are limited, in ways we don't even
know yet, and throw everything we have at it; even then we will probably be
lucky if we dodge a disaster."

I really don't have any more confidence because the CDC has been saying "it
will be fine" than I did when the Japanese officials said Fukushima would be
fine.

Enough optimism for the morning...

~~~
seren
Before the nurse contamination in Spain, I was pretty optimistic. Now that
someone got contaminated in a highly controlled environment with training and
procedures, where people knew they were dealing with a Ebola patient, there is
no way that "everything will be fine" in the coming months. And they only had
1 patient to deal with at once ! Now imagine with 10 or 100 patients in a
given hospital.

~~~
Shivetya
Spain isn't exactly the first world country people assume it is, there are
many commentators on other sites bemoaning the state of medicine there
including links to articles describing the lack of proper protection for
health care workers.

I think the problem many people are having is you have governments telling
everyone to quit fear mongering while at the same time they are demonstrating
they haven't got a real hand on this.

[http://www.reddit.com/r/worldnews/comments/2ignxj/nurse_infe...](http://www.reddit.com/r/worldnews/comments/2ignxj/nurse_infected_with_ebola_in_spain/cl2479g)

~~~
seren
I think you're first sentence is a bit of rationalization. Because it is kind
of slippery slope : "You know Alabama is not really well known for its
hospitals", then "You can't really find a good clinic south of 8 Mile", etc.
At this rate, it is going to end at your doorstep.

I remember plenty of recommendation and planning for H1N1, but currently I
don't see anything really being implemented for Ebola in Western countries.
Not sure it would have been really efficient in case of a full blown flu
epidemic, but at least some things were organized.

~~~
JoeAltmaier
Ebola is scarey, but really washing hands and quarantine are the most
effective public health efforts. In the US with plenty of clean water and
soap, the chances of an epidemic become small.

~~~
DanBC
Rates of hospital acquired infection show that you are perhaps a bit
complacent.

These are people who know the risks; are trained to wash their hands; who have
access to clean hot water and soap; who have gloves; and who face consequences
when patients die.

And yet, even in these excellent hospital settings, on any one day about 1 in
25 people will have a hospital acquired infection.

~~~
intopieces
Only 1 in 25? Considering how many people are immune suppressed or elderly or
very sick from the start, that number seems low. That means 24 out of 25
people don't get a hospital acquired infection, or 96%. I was a little worried
about Ebola before your comment, now I'm not worried at all.

------
denzil_correa
Prof. Peter Piot - scientist who discovered Ebola in 1976 had to say the
following on Ebola becoming a pandemic [0]

    
    
        There will certainly be Ebola patients from Africa who 
        come to us in the hopes of receiving treatment. And they 
        might even infect a few people here who may then die. But 
        an outbreak in Europe or North America would quickly be 
        brought under control. I am more worried about the many 
        people from India who work in trade or industry in west 
        Africa. It would only take one of them to become infected, 
        travel to India to visit relatives during the virus's 
        incubation period, and then, once he becomes sick, go to a 
        public hospital there. Doctors and nurses in India, too, 
        often don't wear protective gloves. They would immediately 
        become infected and spread the virus.
    

[0] [http://www.theguardian.com/world/2014/oct/04/ebola-zaire-
pet...](http://www.theguardian.com/world/2014/oct/04/ebola-zaire-peter-piot-
outbreak)

~~~
DanBC
Experts said that the current outbreak would only be a couple of hundred
people. Then they said it might be maybe 20,000. Now they're saying it could
be one million.

It's frustratingly hard to steer the course of taking it seriously while not
giving anything to the over-reactors.

------
aric
It's wise to prepare. Panicking and being prepared are two very different
though overlapping behaviors. The part that 'bugs' ( _sorry_ ) me the most
lately is when someone claims certainty about Ebola's chances of spreading.
It's un-scientific to speak with literal, absolute certainty in most contexts.
The early guest on The Colbert Report last Thursday, for instance, was
resolute in saying the chance of Ebola spreading in the United States is
"zero." Attempting to balance against a flip-side of sensationalism is an
inadequate excuse. Sure, memories of The Hot Zone panic are alive and well.
That came and went. Too many factors are at play though. Anyone who states
proof of "zero" seems to only play a fool or propagandist ( _unless the topic
is mathematics_ ).

Ebola is probably high on a list of threats in the form of plausible
terrorism. I'll be glad to be wrong. There's no shortage of it to procure. It
presumably can't be detected easily. It can survive numerous transatlantic
mailings for cultivation. It has about a week delay in symptoms. Short bursts
of it in dense populations where people eat/interact would cause huge
catastrophe in panic alone. That's one factor. Hopefully, an increased
response will thwart its growth altogether and we can again see it as "zero."

~~~
maxerickson
He tells Colbert that he has a zero percent chance of getting infected (it's
as a response to a question). I take your point that he is being somewhat
dismissive, but he doesn't actually say that there is zero chance of it
spreading. The rest of the discussion is quite a lot more measured:

[http://www.thedailybeast.com/articles/2014/10/03/dr-kent-
goe...](http://www.thedailybeast.com/articles/2014/10/03/dr-kent-goes-toe-to-
toe-with-colbert-on-ebola.html)

~~~
aric
Colbert: "What are the odds that I'm going to get Ebola?"

Sepkowitz: "Zero. Next question."

\---

Thanks for posting the link. I wouldn't interpret what he said as only
directed to Colbert. It's normal for an interviewer to place him/herself as
the subject where it's understood that the implied subject is [ _any other
person like me in this region /nation_]. He's being far more than "somewhat
dismissive." Even if he (oddly) were only specifically addressing Colbert by
saying zero, that would be presumptuous. But that's my take.

~~~
maxerickson
I admit the possibility of a conversational zero. I don't see much point in
arguing over it. Given current information, I don't expect to even change my
behavior over Ebola (but I'm not in Dallas and I already didn't have plans to
travel to west Africa). That meets my hand wavy, just invented definition of a
conversational zero.

I posted the link because you said _resolute in saying the chance of Ebola
spreading in the United States is "zero."_. I figured it was fair for people
reading that to have an easy shot at interpreting the video themselves.

~~~
aric
You're quite right to post it. It confirmed how I remembered it. He was
resolute in that sense. To say that an arbitrary person (the implied subject)
has a chance of "zero" is to effectively say it's "zero" for a whole. Anyway.
Keep it easy. Get in the habit of bowing instead of shaking hands and you'll
have already made inroads. :)

------
cryptoz
The CDC's communication to the public about Ebola has been extremely one-
sided: they seem to only care about reducing the likelihood of panic, to the
point where they spread lies and falsehoods that will eventually cause panic!
As the article says, the audacity of saying "At this point there is zero risk
of transmission on the flight" is astounding. Expressing such confidence in
something that is clearly unknowable (or worse, false) is dangerous.

There's no need to panic unless the authorities _continue_ to downplay the
seriousness of the disease, and _continue_ to show their incompetence in
handling contagious diseases.

~~~
rsync
Another aspect of the CDC communication was the deliberate obtuse response
that the CDC head had to suggestions of travel restrictions.

"Centers for Disease Control and Prevention Director Tom Frieden warned
Saturday that imposing a travel ban to the countries known to be dealing with
an Ebola outbreak could make the problem worse, as it would cut off the
affected areas from receiving necessary medical aid."

But, of course, nobody anywhere has suggested a ban on travel _into_ the
affected countries. And he well knows that.

EDIT: Here is a change.org petition that I created today which I think
addresses the issue of aid workers and medical transfer patients, etc.:

[https://www.change.org/p/barack-obama-and-u-s-senate-and-
u-s...](https://www.change.org/p/barack-obama-and-u-s-senate-and-u-s-house-of-
representatives-institute-quarantine-procedures-for-travel-out-of-countries-
with-ebola-outbreaks)

~~~
CanSpice
Not many people are going to fly into a country that has an outbreak knowing
they can't get out.

~~~
hga
There's a zillion sane ways to handle that problem: for the not obviously
infected, confine them for 21+ days of being nonsymptomatic. That would have
caught our current index case (AKA Patient Zero). For the infected, send them
straight to a hospital equipped for this, we've got 4 of them, our military is
building one in Liberia right now, we could make more, and more beds in the
ones we have, here and over there.

------
supermatou
It's been known for a while:

[http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2672.2010....](http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2672.2010.04778.x/full)

~~~
hga
Now a Hacker News item:
[https://news.ycombinator.com/item?id=8421295](https://news.ycombinator.com/item?id=8421295)

------
snowwrestler
There are at least 2 locations in Africa where Ebola has been detected but (so
far) adequately contained.

[http://www.npr.org/blogs/goatsandsoda/2014/10/06/354054915/f...](http://www.npr.org/blogs/goatsandsoda/2014/10/06/354054915/firestone-
did-what-governments-have-not-stopped-ebola-in-its-tracks)

[http://www.csmonitor.com/World/Africa/2014/1006/Nigeria-
cont...](http://www.csmonitor.com/World/Africa/2014/1006/Nigeria-contains-
Ebola-and-US-officials-want-to-know-more)

So, while caution is always a good idea, there seems to be some practical
evidence that supports the current sense of how easily (or not) ebola spreads.

edit: spelling

------
swframe
At a minimum, we should quarantine travelers from that region when they
arrive. We should require them wear a tracking device to be sure they are
staying in place. It would be expensive but worth it if it catches a few
infected people.

As a result of the spanish nurse's infection, I think health care workers need
to be quarantined too just in case the protections don't work as we expected.

BTW, did you read the article about the Canadian experimental medicine that is
available but not being shipped because the US exclusive distributor doesn't
yet know how to handle the distribution. It is scary that a company that
stands to make a huge profit, if the disease spreads to a first world country,
is holding back the distribution of a cure.

------
001sky
_" Those monkeys were dying in a pattern that was certainly suggestive of
coughing and sneezing — some sort of aerosol movement," Bailey said. "They
were dying and spreading it so quickly from cage to cage. We finally came to
the conclusion that the best action was to euthanize them all."_

The money line. Caged primates spreading ebola. They would have been
physically proscribed from direct contact.

~~~
shill
My memory of the Reston chapters in Hot Zone is a little fuzzy, but I believe
the virus spread not only from cage to cage, but from room to room throughout
the facility. Of course there could have been some human vector, but it could
have also been airborne in the ventilation system.

------
BenderrTheRobot
Please... Why can't someone call this for what it is... The CDC's response is
highly based on political concerns.

------
Geee
Isn't it obvious that it spreads through air, if it causes coughing and
sneezing? How could the virus have evolved to cause coughing and sneezing?
Although, using this mechanism, the virus could just spread to other surfaces
and liquids through air, but not directly (for some odd reason). Of course,
it's possible that having another virus at the same time might enable this
mechanism too.

~~~
hga
The critical distinction here is that Ebola doesn't seem to infect the outer
part of the respiratory system like colds or influenza. There's not a huge
mass of cells there to be shedding viri and getting into the air, and it would
take more than a few mutations for that to change.

Ebola viri have been found in saliva, tears, can come from bleeding in the
respiratory system, so it obviously can get airborne that way. Exactly what
that means (how big are the droplets, how long do they stay in the air etc.),
how significant that is as a mode of transmission (which includes iffy
estimates of how many viri (virus particles) are required to make an infective
dose) ... we just don't know. But with our current Ebola importation policy,
it's very likely we will start to get answers to these questions....

~~~
001sky
Ebola is in the various fluids discharged by coughing and sneezing (its in the
article). The problem for the urban areas is that ebola seems to persist (as
long as its in a fluid) and its so infectious (small threshold exposure). The
two may conspire to create an issue that 99.99% clean isn't clean enough.
Thus, discharged fluids even in small amounts may very well transmit the virus
in trace amounts (again, in the linked piece). From there its purely semantic
about whther or not 'water vapour' or 'aerosolized liquids' are equal to
"airborne". As you allude, eath pathogen may be airborne in various ways (the
air has many pollutants and impurities).

