

Patients’ Symptoms Raise Concern About Ebola in New York - craigc
http://www.nytimes.com/2014/08/05/health/patient-at-mount-sinai-has-ebola-like-symptoms-hospital-says.html?_r=1

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nospecinterests
Update: Man Most likely does NOT have Ebola but they are still testing
him/waiting for tests to come back.

"A New York City hospital is examining a sick patient who recently returned
from a West African country where the deadly Ebola virus has been spreading,
but authorities said it's unlikely that the man has Ebola."

[http://www.nbcnewyork.com/news/local/New-York-City-
Hospital-...](http://www.nbcnewyork.com/news/local/New-York-City-Hospital-
Examines-Man-Travel-West-Africa-Symptoms-
Ebola-269878301.html?_osource=SocialFlowTwt_NYBrand)

~~~
timr
The HN title is linkbaity (and editorialized). The original is better:

 _" Patients’ Symptoms Raise Concern About Ebola in New York"_

Which is true, and still interesting. At this point, I wouldn't bet against
the disease showing up in an international city, and it's nice to know the
state of things.

~~~
dang
It wasn't editorialized. The NYT changed their title. You can still see the
original in the URL.

We've followed suit.

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ericcumbee
I understand the cause for concern. But I can not think of a single time i've
had a virus that did not involve a fever, stomach problems, and or a headache.

~~~
nospecinterests
But how many times have you had a flu where you bleed out of your orifices?
Me.... none.

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MarcScott
One child a minute dies from Malaria.
[http://www.who.int/features/factfiles/malaria/malaria_facts/...](http://www.who.int/features/factfiles/malaria/malaria_facts/en/index2.html)

~~~
dllthomas
And that sucks, and we need to do more there... but that doesn't mean it
doesn't make sense to pay additional attention to things that are more likely
to present a direct threat to me.

~~~
phurley
[http://www.cdc.gov/malaria/about/facts.html](http://www.cdc.gov/malaria/about/facts.html)

You are far more likely to be infected by malaria than ebola. Ebola is scary
and makes for great news that draws lots of attention -- but it is largely
sensational and not truthfully something you need to rationally fear, unless
you work with infected individuals.

~~~
dllthomas
No. Based solely on rates in the past, rather than any sort of projection into
the future, I'm incredibly unlikely to be likely to be infected by either
(note from your link, that of the <2k/yr of malaria in the US we see "almost
all in recent travelers").

 _If_ I am infected by either, I am overwhelmingly more likely to survive a
bout of malaria.

And during an _unusual_ outbreak (which is the case for ebola at present),
looking simply at past incidence will underestimate my risk.

It's _still_ probably not a _high_ risk, and there are higher risks (which I
try to pay _more_ attention), but I don't think it's wrong to say it poses a
greater threat _to me_ (or to the overwhelming majority on this site) than
does malaria.

~~~
danieltillett
Actually it is very difficult to place any risk estimate on ebola (or any
other new viral strain) as we don’t really know much about it.

Imagine that it is 1918 again and someone was trying to make a prediction of
the likelihood of influenza becoming a deadly pandemic that would kill 100
million people over the next 18 months. They would look at the past history of
influenza and say there is a negligible risk of this happening. Of course now
since we know that influenza can become very serious we keep our eyes on it,
but for something like ebola we really know very little.

~~~
dllthomas
Based on previous outbreaks of _things generally_ I think it's most likely to
be correct that this outbreak is also of low risk to the US population at
large. Which is _not_ to say that there's not a tremendously high value of
information - the next thing we learn _could_ change that (and again, probably
won't, but...). I think it does make sense to be paying some attention as
random individuals, and more attention as health workers or CDC employees, and
I think it is probably still the case that my drive home is more likely to
kill me (but I pay a lot of attention to my drive home!).

~~~
danieltillett
Humans tend to overestimate the danger of apparent low probability, high
impact events (like pandemic ebola) and underestimate the risks involved in
mundane events (like driving a car).

Given how infrequent pandemics occur, a better way to judge the risks involved
would be to take a much long term view and try to measure the risk of a major
pandemic occurring in your lifetime. When you look at the history of plagues
over the last 2500 years they are infrequent, but common enough that we can
get some handle on the risk. My very rough calculations based on past pandemic
frequencies and death rates put the risk at around 1 in 1000 of being killed
by a pandemic sometime during your lifetime. This is not huge, but at the same
time it is not trivial.

Edit. I added the word apparent to the “…danger of…” as I realise that my
wording is confusing without it.

~~~
dllthomas
You seem to have approximately restated what I said. That's fine, but it's
best to note that that's your intent...

~~~
danieltillett
Not really, well not by intent :)

I might have worded it better, but pandemics are actually one of those areas
that people get the risks wrong for the opposite reason than usual. While
pandemics are considered low frequency, high risk events and so over-worried
about, they are actually relatively frequent events on a historical time scale
and are not worried about as much as they should be. They are really more in
the car crash category not the stuck by lightning category, but we get
complacent because a big one has not happened in living memory (unless you
count HIV).

~~~
dllthomas
Ah, yeah, that _is_ a bit of a different angle on it. Truth be told, I'm not
sure whether or not we're underrating the risk. On the one hand, increased
travel and population density should see faster spread.

On the other hand we have a lot of changes in our favor: understanding how
diseases are spread (starting with germ theory, all the way up through
population models), understanding how many more diseases are treated, an
astoundingly better ability to communicate, probably a better ability to
coordinate...

I don't know how it nets out. The streak we've had should be taken as some
evidence that it breaks in our favor. Certainly we should not succumb to the
gambler's fallacy, there. However, I think we're well served to keep an eye on
things.

~~~
danieltillett
Yes it is really difficult to know how the two major forces are tipping the
likelihood. We have a better understanding of how contagious disease is spread
and on average much better immune systems because of better diets (the average
person was starving when most plagues struck in the past). Balancing this is
as you mention increased travel and much high population densities. You just
have to see the spread of a contagious disease through a modern animal feedlot
to know what this does. All of this makes it really hard to know which way the
risk has changed.

My biggest fear is a pandemic Rhadinovirus since it is airborne, has a long
incubation phase and leukaemia is the outcome [1]. Something like a human
pathogenic Ateline or Saimiriine herpesvirus could spread through the human
population without us knowing until it is too late.

Interestingly, Saimiriine herpesvirus has recently been linked to idiopathic
pulmonary fibrosis [2]. All it would take is a more pathogenic strain of this
virus and we would be in a lot of problems.

[1]
[http://en.wikipedia.org/wiki/Rhadinovirus](http://en.wikipedia.org/wiki/Rhadinovirus)

[2]
[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4050527/](http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4050527/)

