

Ask HN: What would you do in case of a large Ebola outbreak? - rodrigocoelho


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masnick
This blog post provides some good, straight-forward information about
epidemiology, clinical characteristics, and infection control recommendations
for Ebola: [http://haicontroversies.blogspot.com/2014/07/ebola-
hemorrhag...](http://haicontroversies.blogspot.com/2014/07/ebola-hemorrhagic-
fever-primer.html) (It's written by an infectious disease physician.)

"Contact and airborne precautions are indicated for suspected and confirmed
cases" refers to:

\- Contact: wearing disposable gowns and gloves to interact with the patient

\- Airborne: putting the patient in a negative pressure room (to avoid
spreading air from the room around the hospital), and wearing a N-95
respirator or PAPR ([http://www.3m.com/Product/information/Powered-Air-
Purifying-...](http://www.3m.com/Product/information/Powered-Air-Purifying-
Respirator-PAPR.html)) in addition to the contact precaution stuff.

Source: [http://www.cdc.gov/HAI/settings/outpatient/basic-
infection-c...](http://www.cdc.gov/HAI/settings/outpatient/basic-infection-
control-prevention-plan-2011/transmission-based-precautions.html)

That gives you a sense of what you'd need to do to safely interact/care for
someone with Ebola. However, remember that several doctors treating Ebola have
come down with the disease during the current epidemic. Hopefully (for the
rest of us), there was some sort of infection control lapse that lead to their
infection, rather than these infection control measures not being sufficient.

~~~
dllthomas
_" rather than these infection control measures not being sufficient."_

Per my understanding of things, that seems frighteningly unlikely[1]. As I
understand it, there are a substantially greater portion of health workers
getting sick than in previous outbreaks, and those health workers are not tied
to a particular location. If that's the case (and mind you, this is all very
much Nth hand what-I-got-from-the-radio stuff - either of those could
certainly _not_ be the case) then it seems to follow that _probably_ this
strain of ebola has some attribute that makes the recommended countermeasures
inadequate (at least the countermeasures recommended for deployment in the
field, which may or may not be _this_ set of countermeasures).

[1]: That isn't to say "tremendously unlikely", just "unlikely enough to be
frightening."

~~~
snowwrestler
I doubt that all, and maybe _any_ , of those recommendations can be followed
by the medical staff currently responding to the outbreak in Africa. We're
talking about an area of the world that struggles to provide any clean water
to humans at all, and where many rural residents are actively hostile toward
medical staff.

~~~
jayshahtx
I found this comment to have an undertone of ignorance.

1) Implying a cluster of 54 countries are all homogeneous, have poor health
standard, etc

2) "Struggles to provide any clean water to humans at all" \- this is much
more heresy than fact. Please rely on statistics

African countries by no means are world superpowers, but this comment is
pretty ignorant. Please think twice about such comments, they can be
interpreted as offensive

~~~
dllthomas
Guinea, Liberia, and Sierra Leone are all poor countries with limited access
to health care.

Additionally,
[http://en.wikipedia.org/wiki/Water_supply_in_Sierra_Leone](http://en.wikipedia.org/wiki/Water_supply_in_Sierra_Leone)
opens with "Water supply in Sierra Leone is characterized by limited access to
safe drinking water."

The parent made no statement that all of Africa is so limited, only that _the
outbreak_ was in Africa. The countries most affected _by_ the outbreak were
correctly described.

------
Udo
Well, the infectiousness of Ebola specifically is questionable. In essence,
there is good reason to believe the virus won't be able to spread far outside
the areas where it already proved to be successful. So if you're in the EU or
the US, even large parts of Asia, you're probably safe.

But that doesn't mean a mutated strain _could_ potentially befall the whole
world. The same goes for the more terrifying types of the flu. There is always
the potential for a deadly _and_ extremely contagious pathogen to develop.

So what to do in a pandemic situation? I'm hesitant to admit it, but basically
the survivalists have it right: hole up somewhere off the beaten path and
avoid all outside contact, that potentially includes all kinds of animals like
birds and livestock. Then you'll have to wait until a vaccine is developed. If
a vaccine is feasible.

~~~
frigg
>So if you're in the EU or the US, even large parts of Asia, you're probably
safe.

Well, Germany announced that it accepted a patient with Ebola.[1] I guess it's
not completely out of the question now?

Wouldn't it make more sense to go where the virus is and not bring it home?

[1]
[http://www.telegraph.co.uk/news/worldnews/europe/germany/109...](http://www.telegraph.co.uk/news/worldnews/europe/germany/10998367/Ebola-
Germany-accepts-infected-patient-for-treatment.html)

~~~
Udo
That's not what I mean. Researchers in all countries get infected with these
things all the time, too. But it's questionable whether Ebola specifically can
take hold in the northern countries at all.

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ColonelPanic001
Wash my hands a lot, stay indoors, avoid people.

And if Ebola got loose around here, I guess I'd do that then, too.

~~~
jordsmi
>Wash my hands a lot, stay indoors, avoid people.

So just a normal day

~~~
productionQA
>So just a normal day

That is unfortunate

------
curtis
If an outbreak lasts longer than individual patients are sick (earlier
patients have either died or recovered), then you could start recruiting
survivors to help care for victims later in the outbreak. This will work
better for diseases with lower mortality (e.g. the 1918 Spanish Flu) than one
with a higher mortality like Ebola (Wikipedia says a 56% mortality rate, but
maybe that includes people who are still sick and haven't died _yet_ ).

This assumes that surviving the disease confers serious immunity, which I
believe is normally the case, but I don't really know. In the case of Ebola it
also assumes a relatively fast recovery time if the disease doesn't kill you,
but I don't know if that is true either.

------
chatmasta
Buy a boat, load it up with non-perishables, and go chill off the coast for a
few weeks until I can have a vaccine waiting for me when I come back to land.

------
yellowapple
Read my favorite book (Richard Preston's _The Hot Zone_ ) while barricading
myself in my apartment for awhile and waiting for things to blow over.

------
angersock
Probably tweet about it, and hope that it happens in SF.

Watching Valleywag or TechCrunch scamper to provide coverage would be
delightful.

"VCs suddenly interested in funding medical care"

"Marc Andresson calls out for single-payer healthcare"

"ebo.la: disrupting filoviruses"

~~~
gregcohn
$ rm hat.jpg

------
Mimu
I would probably die first.

------
lifeisstillgood
We probably should have nationwide "fire drills" for these sort of society-
level threats.

This reminds me of Bruce Schneier's Security Theatre - that we should not try
the preventative approach to terrorism (including spying on everyone) but
should focus on detective work and emergency response.

As a society, at the society wide level, we have few if any accepted plans.
Sure there is the usual martial law plus bits but that is bound to be resisted
or ignored. The fact that HN (with a higher % of the population of people who
actually ask themselves these sort of questions) has no single answer tells me
we need a commonly understood response - most people instinctively know "stay
inside, no travel" but the barest preparation would help exponentially if
anything did happen.

------
doubt_me
apply for a job at the CDC?

