
Firestone Stopped Ebola in Its Tracks - mdturnerphys
http://www.npr.org/blogs/goatsandsoda/2014/10/06/354054915/firestone-did-what-governments-have-not-stopped-ebola-in-its-tracks/
======
Someone1234
Honestly what it really boils down to is resources and money ("resource" can
also be described as "money" therefore really money and money).

Up until very recently there were simply not enough hazmat suits, not enough
burn-able bedding, not enough people (who wants to work with Ebola?), not
enough disinfectant, and heck even clean water in SOME areas.

Then you have to consider how damn hot it is there, so a $5 hazmat suit may
not cut it (this article covers that). Now you're dealing with suits costing
tens of times more than that for basic AC, just to allow the people in them to
work longer shifts.

You also have a lot of local population pushback. The hazmat suits scare
people, and all locals see is Ebola patients go into treatment and die. There
is a lot of suspicion that Westerners are getting people sick to kill them, so
they hide away family members until they get infectious.

What can be done? Money, and resources. It isn't a magic bullet but if you
train a metric ton of local people and give them everything they could
possibly need it would at least slow the spread if not reverse it entirely...

PS - This article is exactly WHY I am not legitimately concerned about a wide-
spread infection in the Western world. We are simply too rich, we have or can
acquire the resources, and even your average Joe Smith on the street can
Google how to protect themselves from Ebola exposure.

~~~
danieltillett
>This article is exactly WHY I am not legitimately concerned about a wide-
spread infection in the Western world.

Leaving aside the moral argument of preventing huge numbers of innocent people
from dying Ebola if we can, there are two reason we in the west should be
concerned:

1\. There is a serious risk that Ebola will mutate to become more infectious.
It is very unlikely to become airborne (this is about as likely as pigs
becoming airborne), but it could relatively easily mutate to slow down its
kill speed. At the moment Ebola kills so quickly that there is little time for
a patient to spread it to other people. Ebola is under huge selection pressure
to slow down the disease progression in humans. We could see a strain arise
that takes a month to kill you where you are asymptotically infectious for a
couple of weeks. Model this sort of virus and things look far less rosy for us
in the west. The more people we let Ebola infect the more likely that such a
strain will arise.

2\. Once the number of cases get very large (25,000 a day by Jan 2015
according to the CDC) this is going to start disrupting international trade as
countries close their borders. We already saw the sort of recession that can
result from disruptions to trade when this happened in the GFC and the Asian
crisis in the 90s. With interest rates at or near zero in most countries there
is not much that can be done to buffer us economically.

~~~
phkahler
>> There is a serious risk that Ebola will mutate to become more infectious.

Not likely. Survival of the fittest for a virus usually means allowing the
host to live longer - in other words LESS lethal. It is not likely to become
airborne, and if it did it would not be ebola any more. The symptoms of most
diseases are not an accident, they are tied to the means of transmission:
Colds make you cough and sneeze. Flu makes you cough, sneeze, barf and sweat.
Rabies makes you crazy and want to bite. STDs some think may make people
horny. Ebola makes you barf, shit, bleed, sweat.

The one scary thing is I once read that a single gene make Ebola hemoragic,
and if that were to transfer to a flu, that would be very deadly. But it would
also be less virulent due to that same deadliness and so would be selected
against as our response to related flu vidii would wipe it out.

None of that is helpful short term, but this notion of the virus getting more
horrible than it already is, I don't think so.

~~~
ObviousScience
The GP said "more infectious", not "more lethal".

Your comment is violently agreeing with his point.

~~~
phkahler
My point was that more infections would mean less lethal in this case.

~~~
seanflyon
Which is a confusing way of putting it because being less lethal would make it
kill more people.

------
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/)

Send MSF money and we will see more successes like this.

Ebola can be beaten, but only if the resources are there.

------
danieltillett
All this story tells us is that what we have known since the mid 70s that if
you can get and keep patients in a proper infection control facility that you
can stop Ebola.

The problem we have right now is that we don’t have anywhere near enough
functioning infection control facilities in the affect countries and we are
not doing anywhere near enough to put them in place. The scale required is
beyond anything ever attempted outside of a war setting.

------
facepalm
"They grabbed a bunch of hazmat suits for dealing with chemical spills at the
rubber factory and gave them to the hospital staff. The suits worked just as
well for Ebola cases."

I suppose having a rubber factory nearby helped a lot. Not to diminish their
managerial achievement, but I imagine getting proper equipment might be a
major obstacle in other parts of the country.

------
swframe
I think a "corporate micro-city" might be the solution for poverty in the 3rd
world. I think a joint venture with google, facebook, apple, and 1st world
governments etc to build a "hong kong/singapore styled city" next to a 3rd
world capital could be the catalyst for transforming the country. I don't
think providing internet access is enough. You need to break the cycle of
poverty from birth to college. And you need a vehicle/brand that the 1st world
can invest in/trust. I think you can avoid the obvious pitfalls by creating
multiple independent neighboring "corporate mirco-cities" so there is
competition for residents.

~~~
phkahler
>> I think a "corporate micro-city" might be the solution for poverty in the
3rd world.

Funny, I was thinking it contributes to the problem. It clearly creates
inequality which can be seen in this article. The company simply doing the
minimum to exploit the resources in the area with no spill-over into the
larger region. It would be more helpful to the locals if they were vertically
integrated right there - producing tires. That would require building more
infrastructure and more manufacturing capability and such. But no, they just
want to grow the rubber there and keep the higher value stuff elsewhere.

To clarify, I'm not saying "companies=bad" just that companies only have self-
interest and are not inherently good for the broader region they inhabit. This
is abundantly clear from TFA which I don't think is the message they wanted us
to take away.

------
BrandonMarc
All I can do is scratch my head, wondering what the reporter _isn 't_ saying.
Just what is it that Firestone is doing differently? It sure appears to be
working, so it would be great to replicate if possible.

Marbel is a company town of 80,000 ... a city more or less owned and run by
Firestone, benevolently it appears, for nearly a century.

Perhaps they're better at guarding and enforcing their border ... effectively
keeping themselves mostly isolated from disease vectors coming in.

Perhaps that helps them avoid being outnumbered by the sick and, more
importantly, the ignorant [1]. After all, it's easy to keep an eye on those
exposed when they're comparatively few and you have reliable information ...
which comes from having a literate, educated population you've been working
with for decades.

Perhaps it's also easier to get honest [2], voluntary compliance when you're a
close-knit community and the infected are usually coming from the outside
(and, again, are few in number).

It sure is interesting that while Firestone has hazmat suits intended for
dealing with chemical spills, that infected nurse in Spain [3] says the blame
goes to her Level 2 biosafety suit since it wasn't the preferred Level 4.
Please correct me if I'm wrong ... I get the sense Firestone's suits aren't
comparable to Level 4.

Contrast this to the success (lack thereof) of the CDC, WHO, RSF, and other
aid organizations. Sadly, they're either overwhelmed or incompetant. So what's
needed is more Firestones, really? That's interesting.

\-----

[1] Yes, ignorance is massively lethal. See this story from August, of a mob
who decided it would be fun to ransack and rob and already-overwhelmed Ebola
clinic, stealing everything and taking it home ... all while taking Ebola home
with them.

[http://pjmedia.com/richardfernandez/2014/08/16/man-
without-a...](http://pjmedia.com/richardfernandez/2014/08/16/man-without-a-
country/)

[2] As opposed to the diplomat who deceived his way into continuing on to a
meeting of regional leaders ... thereby effectively causing the outbreak in
Nigeria. And as opposed to the CDC today handing out fliers in airports and
expecting voluntary compliance, in a sense informing travelers of how to lie
in order to get into the USA where the good hospitals are.

[3] [http://pjmedia.com/richardfernandez/2014/10/07/paradigm-
shif...](http://pjmedia.com/richardfernandez/2014/10/07/paradigm-shift/)

~~~
tjohns
> It sure is interesting that while Firestone has hazmat suits intended for
> dealing with chemical spills, that infected nurse in Spain [3] says the
> blame goes to her Level 2 biosafety suit since it wasn't the preferred Level
> 4. Please correct me if I'm wrong ... I get the sense Firestone's suits
> aren't comparable to Level 4.

As unfortunate as it is, it's more likely that the Spanish nurse was infected
while removing her PPE.

Removing contaminated PPE is a non-trivial process. It requires practice,
strict attention to detail, and ideally an equally trained buddy watching you
while you're doing it. From what I've read, it sounds like they were just
given 10 minutes of training.

Which isn't to say that better equipment and a proper decon shower wouldn't
have helped. But the training is just as important as the equipment.

------
mcguire
" _Forty-eight were treated in the hospital and 18 survived._ "

That's an interesting point on the actual lethality of the disease under more
modern treatment conditions. Still, 60% is only slightly less scary than 90%.

------
dammitcoetzee
Wow, a company that can handle a thing like this in stride has to make a good
product. I will look at them next time I need tires.

~~~
innguest
Wow, someone that understands capitalism. :)

~~~
mcguire
Or is simply vulnerable to good marketing campaigns.

It's been a while since I used Firestone tires, but I'll bet anyone quite a
lot that their product development and quality control have very little to do
with their human resources practices in the third world. (Even though I think
they sound really good, too.)

~~~
innguest
It's a marketing campaign that ends up helping people and the real world.

They have that money to spare because their customers think their products are
desirable.

It seems to me you're trying to detract from what happened here by trying to
argue that their products aren't _that_ good? I'm not sure what you're
implying, but I'll repeat, they've only been able to help, even as a marketing
ploy, because they have accumulated profits - proof that their customers value
what they produce.

The quality of their product, in the eyes of their customers, has everything
to do with their ability to pull off this stunt.

~~~
mcguire
I'm not trying to detract from anything they've done, and their products are
fine, as far as I know.

What I'm saying is that there is no correlation between their success in
dealing with an infectious disease in the area around one of their facilities
and the quality of their consumer products.

~~~
innguest
The quality of their products (in the eyes of their consumers) is what enabled
them to have all this money sitting around, that came from profits, to help
deal with this situation.

I see some correlation there, no?

------
peter303
Nigeria has ended Ebola too. But its proximity to the main infections could
mean reoccurence.

------
serge2k
Amazing what happens when western money has an interest in Africa.

------
taivare
Anyone is free to use this Ebola awareness poster I made
[http://bit.ly/1vF1COO](http://bit.ly/1vF1COO)

~~~
dllthomas
Also, the UCSC ebola portal is worth a look:
[https://genome.ucsc.edu/ebolaPortal](https://genome.ucsc.edu/ebolaPortal)

------
saulrh
Yep. Ebola is just not a very scary disease. Its incubation period is short
and reliable, it doesn't become infectious until symptoms display, it's not
particularly infectious in the first place, and its transmission mechanisms
are downright pedestrian. 90% of the first world can make themselves
completely safe by googling "Ebola Safety". The other 10% are homeless or
hippies and will either get similarly informative pamphlets or are living in
communes and won't infect the rest of us. And even if all of that fails, we
have the industry to literally _give_ every American a hazmat suit. Ebola may
become a _crisis_ , but it will not become a _pandemic_.

~~~
nathannecro
Let me respond point by point.

> Ebola is just not a very scary disease.

Ebola is a frightening disease. On a psychological point, I feel like the
shock of the symptoms itself is lessened due to the fact that most of the
infected have dark skin. End-stage Ebola leads to the patient bleeding
everywhere. Not only is the patient bleeding from obvious places like the
eyes, nose, mouth, ears, penis, vagina, rectum, the whole body becomes covered
with bloody petechiae
([http://en.wikipedia.org/wiki/Vasculitis#mediaviewer/File:Vas...](http://en.wikipedia.org/wiki/Vasculitis#mediaviewer/File:Vasculitis.JPG)).
On lighter skin, the patient's agony is really apparent. Their bedsheets will
be dripping with blood and their eyes swell up and turn a deep maroon color.

> Its incubation period is short and reliable, it doesn't become infectious
> until symptoms display,

Yep.

> it's not particularly infectious in the first place

I feel like that's a point that doesn't have nearly enough information.
Previous outbreaks have generally been limited the virus burning its way
through a small population before it can hit a major population center.
Healthcare workers who are currently treating Ebola patients (who should know
proper protocol), are being infected at a rate far higher than expected.
([http://www.who.int/mediacentre/news/ebola/25-august-2014/en/](http://www.who.int/mediacentre/news/ebola/25-august-2014/en/))

> its transmission mechanisms are downright pedestrian

I'll grant you that transmission by fluid is generally fairly easy to contain.
However, when the patient is draining all of their bodily fluids out onto the
floor, cleaning and containment becomes far harder. Not only that, there have
been several incidents (at least before this current Mar 2014 outbreak) of
patients infecting health workers by coughing and aerosolizing blood droplets
into the mouth, nose, and eyes of their caregivers.

> 90% of the first world can make themselves completely safe by googling
> "Ebola Safety"

I don't think it's that simple. Currently, the CDC holds training sessions
for:

"Currently licensed by a recognized professional agency to provide clinical
care in some jurisdiction (e.g., hold a medical license to provide care in a
state in the United States) and have recent (current or within the past 2
years) relevant experience providing direct care to patients. Participants
should be licensed medical doctors (MD, DO, MBBS degrees), licensed nurses
(RN, BSN, LPN, etc.), or other licensed clinical care providers (e.g.,
paramedics, physician assistants, and other clinical providers)."

These training sessions solely concern biohazard safety and last for three
full days. Given that the target audience has already has extensive medical
training, three full days of lecture, procedure, equipment, and technical
training seems far above and beyond what we should expect from a normal
citizen. Let me also point out that even with training and equipment,
healthcare providers are still getting sick.
([http://www.cdc.gov/vhf/ebola/hcp/safety-training-
course/inde...](http://www.cdc.gov/vhf/ebola/hcp/safety-training-
course/index.html?s_cid=cs_1344))

> The other 10% are homeless or hippies and will either get similarly
> informative pamphlets or are living in communes and won't infect the rest of
> us.

I don't even know where you get that 10% from. It's also facetious to state
that people "living in communes" "won't infect the rest of us"...do people in
communes live in outer space?

> And even if all of that fails, we have the industry to literally give every
> American a hazmat suit.

I'd like to see how you arrived at that conclusion.

> Ebola may become a crisis, but it will not become a pandemic.

I agree. Ebola may not become a pandemic, but it will still cause great
suffering to a large amount of people. I'll also grant that until it becomes a
real problem in western countries, no one will really make a move as
generally, western pharma ignore diseases which don't hold the promise of
profit (see schisto). However, there is a very real chance that we can help
and reduce the spread of the suffering by taking violent action _now_.

This goes without saying, but the one thing that anybody can do is to donate
to Doctors Without Borders or any other institution trying to quell the
crisis.

[http://www.msf.org/donate](http://www.msf.org/donate)

~~~
danieltillett
You make a lot of very good points. The only things I disagree with you on is
your final point.

>This goes without saying, but the one thing that anybody can do is to donate
to Doctors Without Borders or any other institution trying to quell the
crisis.

The scale of the outbreak is now beyond what MSF or any NGO can handle. Only
the military can now command the resources needed to get things under control.
All donating to MSF is doing is delaying the point in which we activate the
military.

~~~
lotsofmangos
On your last point. MSF are not just fighting Ebola on the ground, they are
also putting pressure on governments. Sending them money helps them have the
resources to do both jobs more effectively. Sure, we should be putting
pressure on our governments to do more ourselves, but I do not think that
there is an inverse relationship between funding MSF and the speed of
government response, when MSF are one of the groups trying to increase the
rate of government response.

~~~
danieltillett
I suspect donations are not going to have any impact on the effectiveness of
MSF’s lobbying efforts (i.e. I don’t think MSF’s lobbying for military
intervention by the west is money constrained). I am more than happy to be
corrected on this if anyone has any data.

What I am hoping by my comment is breaking people out of the thinking that
this can be solved by donations to NGO’s like MSF. I believe it is far too big
now for any NGO to deal with no matter how well resourced. If we can only get
on top of the outbreak by military action lets stop messing around and start
lobbying for this directly - every day we delay is only making the problem
bigger and harder.

