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CDC director warns that Congo's Ebola outbreak may not be containable (washingtonpost.com)
158 points by loisaidasam 11 days ago | hide | past | web | favorite | 55 comments

The real fear is that one person makes it out of the area and into another part of the world, similar to what happened in Dallas. The more people are infected in that area the more the odds of escape go up. Any place in the world can wind up with an outbreak within a short time. Given the response of the hospital in Dallas, it's very likely most medical facilities would not recognize Ebola before transmission had already occurred.

I'd think (hope?) that any hospital ER is trained to recognize hemorragic fever when it presents.

Whether the patient will see a doctor in the early or late stages of Their Ebola infection will depend on whether they have health insurance. So here’s another reason for socialized healthcare.

Socialized healthcare doesn't really apply here. Regardless of whether or not the healthcare is free, people still go see a doctor anyway.

Even if this point were granted, the timeline is the issue at hand. When cost is an immediate and pressing concern, people delay the decision to seek out medical attention.

Disagree. I have many family members who I cannot convinvce to go to a doctor, for thay are terrified of financial ruin. Literally will not go near a healthcare facility.

Then there are the family and acquaintances who go to the hospital Emergency Room, because although they have no insurance, an Emergency facility is generally required to treat them.

On one hand, we have people who do not receive routine care, who only seek healthcare long after a point where early diagnosis or treatment would have been inexpensive.

On the other hand, we have people who use a military-grade triage center for flu symptoms.

Both situations are ruinously expensive. And continue to contribute to trillion-dollar government-budget shortfalls. To say nothing of the inevitable, preventable zombie apocalypse.

I don't want to pay my insurance deductible... Many people "worse off" than me pay nothing and get to go to the hospital no problem... I'd be much more interested in everyone paying a reasonable amount like it was decades ago

> Many people "worse off" than me pay nothing and get to go to the hospital no problem...

Those people are absolutely paying a cost; having to make healthcare decisions based on money, bad credit when you can’t pay the bill, job insecurity because you’re sick or injured, incessant (and often overtly insulting) debt collection calls/mail, and of course that perpetual gnawing anxiety that arises from knowing that all of these costs you’re paying for being poor are making you poorer.

I’m sorry you don’t like paying your deductible, though.

> Many people "worse off" than me pay nothing and get to go to the hospital no problem...

This is terribly misconstruing the facts. They get to go to ER treatement only, no midterm care. The problem is if they don’t pay, their credit record is heavily penalized. This may seem like nothing but for someone with out money or means it spells a quick down hill slide to homelessness. No problem =/= homeless

FYI the #1 cause of home foreclosures in the US is medical bills

> This is terribly misconstruing the facts

When you're broke, you're broke. Just because you have health insurance doesn't mean you can afford to use it. I had better healthcare as a homeless person than as a massively indebted recent college grad with a health plan through work.

How did you have better healthcare as a homeless person than through your employer? Like what were the numbers (e.g., monthly cost, deductibles, prescription cost, co-pays, and coverage). This is hard to believe.

If you're referring to EMTALA requiring emergency rooms stabilize all patients, (1) EMTALA applies to everyone, and (2) EMTALA is not healthcare.

Medi-Cal was free. Basically everything covered on Medi-Cal was free, or super cheap, and it covered a lot. While on my health insurance plan provided by work, the job where I wasn't making enough money to save or meet my deductible, I got into a bicycle accident & ended up with a $50,000 USD out-of-network hospital bill.

In case you don't know, one of the reasons that some chronically homeless people don't have healthcare is that many don't bother to get it. There's guy in my neighborhood that told me he hasn't gone (but probably should go) to our local government to get his $100-ish/month, food stamps, and healthcare. Also, he ends up in a local emergency room because someone calls an ambulance when he's drunk, passed, and shaking out on the sidewalk. I've called an ambulance a few times for people in that state myself. He also ends up in the emergency room because he routinely gets assaulted while sleeping on the street because there's are not enough shelters for him.

I totally believe this.

When we first met, my wife was still in school, and I had been working in computer stuff for about 10 years. I had good benefits, and thought that medical insurance was a solution to a big problem.

Then watched as my wife tried to get treated for some routine stuff. Not available via the campus clinic, and yet her student "insurance" was not accepted anywhere else within 150 miles without a "co-pay" that was larger than the cost for uninsured patients.

The situation only got worse when we were married later that year. My insurance would only apply after she had sought coverage through her school plan.

We called it "anti-insurance": a form of coverage that, when encountering actual insurance, annihilates it in a violent explosion of virtual particles and real paperwork.

Yeah. The system is fucked.

I believe you.

If you don't want to pay then don't pay no pay. The people who pay nothing have a higher insurance deductible than you because they have all these chronic health problems and they have the expensive medications that they have to take... healthcare isn't cheap, even for the people who live in socialism

It looks like a case of the flu when it first presents. Unless you have a specific reason to suspect Ebola, you wouldn’t suspect it.

I'm beginning to think there's a Bill Burr bit for every scenario.


I didn't even realize there was recent outbreak. This hasn't been in the news at all.

FYI, the WHO [1] and CDC [2] post regularly on the status of various outbreaks all over the world.

For Ebola particularly, WHO posts weekly updates. And a cursory look of the most recent posts paints an increasingly worrying situation.

[1] http://www.who.int/csr/don/archive/year/2018/en/ [2] https://www.cdc.gov/outbreaks/index.html

It’s been reported on for months in major outlets, just not with the fervency of last time. Find new news sources or pay closer attention to your existing ones behind the outrage cycle.

Almost everything is reported in major outlets somewhere, to the point that it's pretty remarkable when something isn't. There's just so much news out there that the priority they give to it matters.

Most people (I assume) don't look beyond aggregation feeds, or at best, the front/landing page of whatever news source they prefer.

I’ve always believed the “World News” section of major written news outlets must be among the most unread things in the world, I almost feel bad for the thankless work it must be for the journalists involved.

If you're in the US PBS Newshour does a good job of covering that sort of thing.

"CDC director warns that Congo's Ebola outbreak may not be containable" especially as the locals insist on following traditional burial methods such as washing the deceased and sitting in for days on end with cadaver.

US, UK, France, UAE,... insist on traditional bombing of countries for peace.

I would love to see regularly updated and triaged "backlogs" for countries, and subsequently the world. And then maybe just report on the top 100 in each news cycle.

Just lists of most important tickets in a global todo list - because this would just rise to the top pretty quickly and make us rethink mid terms, Brexit and train delays.

Something like https://ourworldindata.org/ but with more frequent updates? I ask because I too am interested in the very same type of dashboard, and instead have a "Dashboard" bookmarks folder with a variety of links for data.

More akin to the Copenhagen Institute thingamijig that Biorn Lomborg hosts, that tries to get bigwig economists to prioritise interventions based on cost benefit (various low cost high impact projects like innocuoation and medical / public health top the bill)

Something that takes this concept and runs with it, taking both identifiable problems (Ebola outbreak) and solutions (do nothing, invade, stop subsidising petrol in that country)

I suspect that the equivalent of National Security Advisor in each major country does this. I guess what I want is to steal each of their daily briefing documents and make a combined one, and have it read out each day onthe daily news.


Uganda is preemptively vaccinating front line/first responder workers with an experimental, unlicensed vaccine (with WHO backing) that has shown efficacy in attempts to contain the virus.

> Country becomes first to administer experimental vaccine without active outbreak of the deadly disease, in bid to protect 2,000 medics close to DRC border

> “In previous [Ebola] outbreaks, Uganda lost health workers, including the renowned Dr Matthew Lukwiya, as they cared for patients,” said Yonas Tegegn Woldemariam, WHO’s Uganda representative. “Scientists believe such invaluable lives would have been saved had a vaccine been in existence then.”


> including the renowned Dr Matthew Lukwiya

Short video about Dr. Lukwiya's story. He was on a sabbatical, but rushed back to provide aid, while others were running in panic: https://www.youtube.com/watch?v=X7LpjpuOvc8

"Look for the helpers" -- Mr. (Fred) Roger's mother.

That's the thing about a disease that kills >50% of the people it infects -- there's no ethical risk in using untested, unproven vaccines to fight it. It's still better than the alternative, even if there's bad side effects.

Some interesting data about the efficacy of the experimental vaccine that is being used to try to control the outbreak.

> Merck's Jakub Simon, MD, MS, addressing a session at the American Society of Tropical Medicine's (ASTMH) annual meeting here, showed two charts tracking Ebola during this past spring's outbreak in the DRC's Equateur province and the subsequent one now raging in the North Kivu and Ituri provinces. In both, health workers on the ground have been using the Merck vaccine in a so-called ring vaccination strategy to contain the epidemic. Although not yet formally approved for marketing, the vaccine has been cleared for emergency use.

> In Equateur, immediately after vaccination began with the Merck product, the outbreak petered out.

> But the experience in North Kivu and Ituri has been quite different. Although new cases dropped significantly after vaccination began in early August, they never approached zero, and 2 months later they rocketed back to the level seen before vaccinations began.


That's not great! I wonder if Ebola is especially quick to mutate. This article: https://jvi.asm.org/content/early/2015/12/08/JVI.02701-15 suggests that it is. A mitigating factor is that it doesn't seem to tolerate mutations very well (i.e. lots of mutations lead to non-viable strains), but I guess with a large enough patient pool it could have out-run the vaccine.

It’s scary to consider it making it to some of the large slums in Nairobi, India, or Pakistan.

That's a bit racist to call a place a slum

Comment currently says "Slums in" a place.

Seems like a bigger problem than a bunch of migrants slowly walking towards the southern border.


You asked for reasons along with any downvotes. I'm here to oblige you.

Contrary to what has been reported in the Fox News / Trump Birds bubble, the people in the caravan have expressed their intention to follow a fully legal process of applying for asylum.

As to why people lawfully applying for asylum might be a problem, I don't think it is a one. You may agree... or if you disagree, I would point out the fact that such acts follow a long tradition of lawful immigration to the United States, one which has built our country from some of the most motivated people in the world. But you may be laboring under the false assumption that they are intending to enter the US illegally.

Based on the amount of false information being pushed by people with a lot of money and very loud voices, it seems likely that your opinion that the caravan is a problem may be based on this particular misunderstanding of what's going on... that you think they plan to enter illegally.

If not, we're in a different conversation entirely, about what America is at its core.

Every single person in the caravan has expressed their intention to follow a fully legal process for applying for asylum? That is good to know, I guess there isn't any chance that they are lying or they don't understand the asylum process.

Thank you for not adding to the false information being pushed by people with money.

> This doesn't seem like a problem to the welfare of Americans at all, while the caravan is.

[citation needed]

Immigration is pretty much required for a healthy economy[0]

0. https://www.usnews.com/news/best-countries/articles/2017-07-...

"better for the economy" doesn't always translate to better lives for the laymen. Also you have to understand some people don't want immigrants at all.

But I was just giving a reason as to why this isn't on the media. No point on making this political.

> "better for the economy" doesn't always translate to better lives for the laymen.

It arguably does far more times than it doesn't.

> Also you have to understand some people don't want immigrants at all.

Putting aside the fact that 99% of the time they are decedents of immigrants, I've yet to hear one compelling reason why they should be taken seriously.

I see that you’re not making any distinction between legal controlled immigration and illegal uncontrolled immigration. I think it’s arguable that illegal uncontrolled immigration is worse, and I’d start the argument by pointing to the condition of various communities in the United States that have the highest percentages of illegal immigrants.

Whether you think that they should be taken seriously or not is irrelevant; they are citizens with a right to vote so their concerns are valid. Not taking people seriously and not listening to them over uncontrolled immigration is what led to Brexit. It is a serious problem for many people for a variety of reasons.

Having a right to vote does not automatically make all concerns, including false and deluded ones, valid.

Yes concerns should be listened to, and if the people have utterly ludicrous concerns, the people should be educated.

"Consent of the governed?"

EDIT: Good to see the down votes

Actually, the way we gain quorum on what is better for the laymen is an incredibly political subject.

Sure. We have a huge shortage of unskilled labor in the US, if this shortage isn't addressed, it might put upward pressure on wages for unskilled workers. We can not allow this to happen to the ownership class

Who will wipe you when you are 97? Hard to find a citizen to do it.

Keep the unskilled labor tight, put upward pressure on wages for unskilled labor.

How is the caravan a problem to the welfare of Americans?

Finding that many beds, jobs, and teachers with room in their classes is hard to do. Even if every adult was skilled this would be a hard ask. Add the number of Americans who feel they are being ignored by the political class and we get a big ole stinking problem with lots of unsavory solutions.

The caravan is about 5,000 people. It's shrinking steadily. There are approximately 11,000 babies born each day in the US. This does not look like a real problem.

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