
Using a Tactic Unseen in a Century, Countries Cordon Off Ebola-Racked Areas - 001sky
http://www.nytimes.com/2014/08/13/science/using-a-tactic-unseen-in-a-century-countries-cordon-off-ebola-racked-areas.html 
======
awakened
Ebola is a Level 4 Biohazard. Try getting into or out of a CDC certified Level
4 facility. All of this is documented and easily understood. It's highly
contagious, there is no cure and and there is no telling how long the outbreak
will last:
[http://en.wikipedia.org/wiki/Biological_hazard#Classificatio...](http://en.wikipedia.org/wiki/Biological_hazard#Classification)

~~~
rtkwe
I wouldn't call it highly contagious. That should be reserved for things that
can spread through the air not things like Ebola which require contact with
bodily fluids to transmit.

~~~
bkeroack
Ebola Reston (which fortunately only affected non-human primates) _did_ spread
through the air, or at least that's the only plausible explanation as to how
it spread.

While the outbreak strain of Ebola may not be airborne _now_ , it's not
inconceivable that it could mutate at some point.

~~~
pmorici
That's the plot of the movie Outbreak.

~~~
ethbro
And the _much_ (!!) better (and functionally non-fiction) book it was based
on.

[http://en.wikipedia.org/wiki/The_Hot_Zone](http://en.wikipedia.org/wiki/The_Hot_Zone)

------
vfclists
This discussion of Ebola is simply degenerating into the the usual prejudices
about Africa and African people, masquerading as informed speculating and I'm
finding it very irritating..

I want to ask a few questions here:

1\. Is there any recorded instance of the particular strain of Ebola in West
Africa being transmitted from a bat or another forest animal to a human being?

2\. Has that that strain of Ebola virus been found in any bats or other
animals in the infected areas?

3\. Is there some hard knowledge about the migratory patterns of bats or some
other forest creatures to indicate that they have been able to carry the virus
all the way from Central Africa to the far end of West Africa without
infecting any other people of animals in between?

Why don't people check these facts before they start blaming everything on
African backwardness, cultural practices and beliefs? Instead all we have is
innuendo from so called experts maligning Africans and ignoring the most
likely fact.

This Ebola outbreak was most likely transmitted by humans of which there are
two kinds.

1\. People who got infected with the disease or harboured a strain of it from
Central Africa, travelled to West Africa and infected someone people there.
But it doesn't explain how those people did not infect any locals or trigger
an outbreak at the source before leaving for West Africa.

2\. Researchers who have access to the virus and through carelessness or
otherwise managed to infect West Africans with it, said researchers being
mainly Westerners working for state institutions, universities or corporations
with access to the virus.

Unless there is hard evidence explaining how some animals infect with Ebola
travelled over a 1000 miles without infecting whole areas in between whether
animals or humans, the search for its origin must focus on the most likely
cause, and that means human beings.

If some angry West Africans are attacking western medical personnel in the
belief that they are the source of the Ebola virus, they are quite logical in
doing so, as Western medical personnel and researchers are the visible common
link between the presence of Ebola in Central Africa and West Africa.

This comment may not be focused on how the outbreak may be contained, but it
needs to get out there.

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kazinator
> _" When cordons are imposed, “human rights have to be respected,” said
> Gregory Hartl, a spokesman for the World Health Organization,"_

Glib words there, Mr. WHO Spokesman!

How do you restrict people to a cordoned area, while respecting their rights?

"Please don't cross this barricade, because I can't do anything to stop you.
This gun is a plastic prop issued by the WHO because of your human rights."

Come on, this is purely about sacrificing the few to protect the many. These
is no "human rights" about it. It's about the lottery of life handing some
people the short straw, and tough luck.

~~~
anigbrowl
'any cordon must let food, water and medical care reach those inside.' This
should be obvious, even to someone with your boolean approach to these issues.
I don't think your snark advances the discussion.

~~~
kazinator
I don't agree that those allowances constitute respect for human rights. At
least, not full respect.

If that is so, it follows that, for instance, kidnappers respect human rights
because they provide food, water and any needed medical care. Kidnappers
respect human rights only to the extent to which their actions up to any point
in time have not shown them to be complete savages.

Using phrases like "human rights" is obviously not applicable in this
situation. We must acknowledge that the rights of people who are forcibly
confined in a cordoned are _are_ in fact being trampled on (separately from
whether or not we agree with the justification for doing so.)

Pretending that human rights are not trampled on if food, water and medicine
are provided into the cordoned doesn't help anything.

The question is: can you agree with it, while properly acknowledging that it
involves violation of rights. That's my angle, not "boolean thinking".

~~~
deciplex
Is there a net positive utility to a kidnapping, like there is (or, can be)
with a cordon sanitaire?

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arjn
I recall reading about how they did this back during the plague days in
France. Cordon off an affected town and don't let anyone in our out.

~~~
vidarh
There are also cautionary tales that were handed down in Europe from plague
affected areas, about how a single person violating quarantine caused the
death of large portion of a town.

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coldcode
You can see how effective is can be in the app "Plague Inc". Even though it's
a game and obviously simplified, the model does give you a reasonable idea on
how to deal with outbreaks who options there are. The CDC even suggested it
was a great way to educate people about the real world problems.

~~~
soperj
That game kills your battery fyi.

~~~
soperj
Don't know why I got down-modded for giving a little insight. It chews through
your battery really quickly, my phone would almost over-heat and wouldn't last
until even noon if I played the game.

------
autism_hurts
Quarantine is one of the BEST ways to stop a disease's spread. These countries
don't have the medical infrastructure to risk NOT implementing quarantine.

~~~
tomjen3
No, it is a horrible way. You are signing the death warrent for anyone being
forced to stay inside the area, sacrificing human lives like so many tribes of
old.

The best way, the only acceptable way, is to have medicine for the decease. We
have some that we just aren't putting into trials because we aren't sure that
it won't kill them - when they are going to die anyway in an absolutely
horrible way.

~~~
harshreality
It is not safe to go into an area in Africa with an ebola outbreak and try to
treat it. Medical workers are not properly adhering to safety protocols. The
numbers of medical personnel infected during this outbreak demonstrate that.
You can't ask medical personnel to take major risks with their lives to help a
few people with ebola. If they and their organizations want to continue to
render aid, that's their choice, but if there aren't enough foreign aid
resources to set up proper treatment centers with proper quarantine, and when
the locals for whatever reason are violating quarantines and putting everyone,
other locals and medical staff at risk, then it's simply not safe enough. The
only remaining option is to quarantine the afflicted areas.

It's also only a death warrant if the people in the quarantine zones don't
observe proper safety. If my city (in the U.S.) had an outbreak of ebola, I'd
stay home, and barring someone purposely trying to infect me, I'd be safe.
Ebola is not an evil spirit that infects everyone in the quarantine area who
doesn't flee. Even if it were a more easily transmissible strain of ebola, if
you're not in a housing unit sharing air with people who are infected, you're
pretty safe.

~~~
ghshephard
" if you're not in a housing unit sharing air with people who are infected,
you're pretty safe."

Certainly true - but, it's important to note that ebola is not airborne. You
can safely sit beside someone with ebola, and as long as they don't throw up
on you, and you don't touch any body fluids - you are also pretty safe.

~~~
ethbro
Not to fear-monger, but there was this article on the BBC linking to
laboratory-verified airborne transmission of Ebola. The summary describes it
as large fluid droplets being passed through the air (airborne in this sense
being a gradient rather than yes/no).

[http://www.bbc.com/news/science-
environment-20341423](http://www.bbc.com/news/science-environment-20341423)

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agravier
I question "Unseen in a Century". I lived in Gabon in 2001-2002, and I
remember that this was pretty much the way Ebola outbreaks were handled then
and there.

~~~
richardwigley
Or Flu in 2009 by Chinese - they kept people in their hotels [1]. I'm guessing
the Journo wanted to 'big' the story up.

[1]
[http://www.reuters.com/article/2009/05/02/idUSHKG2279](http://www.reuters.com/article/2009/05/02/idUSHKG2279)

~~~
nostrademons
The article is describing a form of quarantine much more severe than keeping
people in their hotels. They're talking about cordoning off the _entire
affected area_ \- basically, the area around all infection sites becomes one
big border with armed guards that only allow food, water, and medical supplies
in, and nobody out.

The reason this is controversial is because there are close to 2 million
people in the affected districts, and only about 500 of them currently have
Ebola. At best, you're severely inconveniencing 99.975% of the population, and
at worst, you're leaving them to die. It'd be like cutting San Francisco off
from the outside world, with armed guards on the bridges and San Bruno
Mountain, because measles was found on BART.

I don't know what the situation in Gabon was like, but as I understand it they
depended upon local quarantines of villages, and didn't close the border of
the whole country, right?

~~~
etimberg
Part of the problem is that health officials really have no idea how many
people could be exposed inside the regions as many do not trust health care
providers. Quarantining entire areas is probably the safest thing that can be
done right now.

"Its size is due in part to weaknesses in the affected countries’ health
systems and a lack of trust in the health workers who are struggling to combat
the virus" [0]

Not sure the reliability of this source, but "The health security situation is
worsened by an apparent lack of trust by the local population in their own
governments and medical staff. Warnings against the consumption and selling of
bush meat for instance have largely fallen on deaf ears with an inherent
belief of the local populations that Ebola either must be a myth or a scam on
behalf of corrupt politicians to deprive them of their most basic needs and
livelihoods." [1]

[0] - [http://www.intrahealth.org/page/ebola-outbreak-
underscores-n...](http://www.intrahealth.org/page/ebola-outbreak-underscores-
need-for-stronger-frontline-health-workforce-in-west-africa)

[1] - [http://www.securitynewsdesk.com/2014/08/12/ebola-west-
africa...](http://www.securitynewsdesk.com/2014/08/12/ebola-west-africa-a-
global-biosecurity-risk/)

~~~
richardwigley
There was a BBC video, a female reporter, went around looking at what was
going on/wrong - they population didn't trust the government as they had been
lied to about everything else - why should they trust the Government now?

It is difficult to educate a population in this situation about hygiene. Let
alone asking them to not eat bush meat.

Searching for 'BBC Ebola' is now a thankless task - so I can't find the
reference.

------
VLM
From the article "Health workers protected themselves with gloves, coveralls,
masks, bleach spray and the burning of used gear."

From the WHO website: "Health-care staff fear for their lives. To date, more
than 170 health-care workers have been infected"

[http://www.who.int/csr/disease/ebola/overview-
august-2014/en...](http://www.who.int/csr/disease/ebola/overview-
august-2014/en/)

From the wikipedia article:

"The virus may be acquired upon contact with blood or bodily fluids of an
infected animal (commonly monkeys or fruit bats).[1] Spread through the air
has not been documented in the natural environment."

Something about this story isn't adding up if you combine multiple legitimate
sources. So you can only catch it via bodily fluid (like AIDS). But if you
wear the health care worker space suit and bleach and burn everything, then
you're probably gonna die.

My theory is its converting into an air-transmission disease. In that case, a
military quarantine sounds quite wise. (edited to add, my point being that if
its known not to be caused by a civil engineering fixable problem like
mosquitos or infected sewage or whatever, then human guards closing the
borders to humans is the wisest possible solution, and if we're not being
given the whole story which is probably true, this would indicate that what is
known, to folks other than us, is that it is definitely not civil-engineering-
fixable like if it was spread by contaminated water or vampire bats or wtf.
Which is a mildly interesting analysis.)

In submitting too fast punishment mode:

cwal37 is quite possibly correct. I am attempting to find death stats from the
numerous historical outbreaks. Presumably "20% of the dead being medical
workers" should apply in past outbreaks.

cwal37 - Update: from CDC MMWR wrt the Uganda '00 outbreak, with lower tech
and less experience the Gulu district of Uganda had 393 total cases of which
22 were health care workers. So the infection percentage of healthcare workers
under slightly worse conditions was documented at about 5.6%. The stat for
this time around is 170 medical workers some time ago vs a CDC reported 1848
confirmed cases or about 9%.

There are several ways to interpret these stats. One is that the rate is
increasing despite experience and technology getting better. Maybe. Another is
the reported number of infected might be half or less of total infected.
Maybe. If you assume "about 1 in 20 infected will be health care workers" from
historical experience, then 170 infected workers would imply the total number
actually infected as of some time ago is closer to 3500 or so rather than the
official count of 1800 or so.

So that's the numbers. I continue to research to figure out which of many
possible interpretations is most likely.

"That is straight up fear-mongering." LOL if I wanted to do that, I could do a
better job. "Its all obama's fault" "Buy overpriced ammo from me" "I'm getting
a commission on these MREs" etc.

disputin - I see I have been scooped by zerohedge. Embarrassing because I
often scan zerohedge headlines. On the other hand a bunch of stock traders are
not going to have much of anything intelligent to say about non-economic
issues, beyond being pretty good at making "isn't that odd" connections, like
this post.

~~~
cwal37
There is no evidence that it is air-transmissible. That is straight up fear-
mongering. It is spread through bodily fluids. As the sickness progresses you
are losing bodily fluids in a number of different ways in conditions that are
not always sanitary.

Health workers get infected because they are physically dealing with patients
in areas with some of the lowest healthcare standards in the world. Throw in
some local wariness of foreign workers, and resistance to treatment until it's
too late and it is totally understandable why 170 health-care workers have
been infected.

~~~
dredmorbius
Hey, dat you?

