

Day 7: Brutal Triage – Freetown, Sierra Leone - hblanks
http://pfmhcolumbia.wordpress.com/2014/10/12/les-roberts-the-prediction-landscape-is-looking-bad/

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hblanks
These are the numbers in Sierra Leone from Les Roberts, WHO Foreign Medical
Team Coordinator.

Les is a long-time epidemiologist and sanitation engineer; he's served in
dozens of outbreaks and conflict situations including both of the cholera
epidemics in Goma following the Rwandan genocide.

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mturmon
From the OP, which is worth reading in its entirety:

"[...] this is not about treating the ill as much as it is about minimizing
infections. [...] We are primarily trying to facilitate people to die without
infecting others. Very little of this logic beyond the ORS [oral rehydration
supplement] is about treatment."

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danieltillett
There are so many unanswered questions. Why would any family bring a loved one
to one of these ECUs? You are basically abandoning someone you love to die
alone in great pain. Who is going to volunteer to work in one of these ECU as
they will be basically unprotected and at great risk? Even if everything go
according to plan they will be worse in a months time than they are now?

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malandrew

        " We are about to assist thousands and thousands of people 
        to die an excruciating death at home without even the most 
        mild of pain relief."
    

I simply don't understand this. Why isn't humane assisted suicide an option
considered in this scenario? If I were one of the people who was going to be
left to die an excruciating death, all I would want is one syringe with a
super potent does of heroin... i.e. enough to slip into a warm coma and then
shut down my breathing and nervous system. How hard can it be to repurpose
seized drug shipments for such a purpose if shit is truly hitting the fan.

The longer the host stays alive, the longer the virus has to multiply in the
host and get caretakers sick.

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d0mine
50% survive.

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malandrew
The number I've seen is 30% and I've haven't seen anything written on the
quality of life afterwards...

But either way, a 50% survival rate under circumstances where I am more likely
to infect those I love the longer I'm alive makes it a much easier choice. At
an R0 of 2, I'm statistically likely to take one other life, who will go on to
take one other life etc. At an R0 of greater than 2, I'm going to result of
many more people. Only at an R0 less than 2 is it even reasonable to consider
trying your chances to stay alive.

~~~
d0mine
50% is for the current outbreak in West Africa.

Total Cases: 9937 Total Deaths: 4877

[http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-
africa/inde...](http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-
africa/index.html)

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danieltillett
I wish I had someway to up vote this post to the top of HN. I feel like I am
in a theatre on fire and everyone is ignoring it and just complaining that the
smoke is blocking their view of the stage.

