Eeek!

Global experts issued stark new warnings of the scale of West Africa’s Ebola outbreak on Tuesday, with the U.S. government estimating between 550,000 and 1.4 million people might be infected in the region by January.

And:

But he warned that if control efforts are only partly successful, Ebola viral disease in the human population could become “a permanent feature of life in West Africa”.

So much for the comforting words a few weeks back that because it was quite difficult to catch thus the epidemic will die out…..

48 comments on “Eeek!

  1. The fact that several western medics who have the knowledge and PPE to protect themselves have also caught it, suggests it is not as difficult to catch as first thought.

    However the mortality rate is not as high as in previous outbreaks.

    It could end up being the “new flu”, highly infectious but with mortality of <5%, it would make sense for it to evolve in that way.

  2. Ask yourself this question:
    You’ve been informed of a new & exciting employment/business opportunity in Sierra Leone. Will you be flying out there next week?
    The effect on the West African economy could far outweigh the effect of the disease. If it spreads further, the entire continent.

  3. Strains so far die out quickly. Not airborne and apparently only infectious when symptoms appear. Condemns them.

    The problem is when people live loads to a room, eat from a common plate using their hands and hygiene at all levels is poor, combined with a poorly educated and supersticious population…

    Mutation is the big fear. If it goes airborne and becomes infectious before symptoms…. Mutation may favour us but I wouldn’t bet on it.

    Until now, the danger has been small, isolated and not well known. It sounds harsh but this crisis is going to bring it to the forefront and resources will be applied. This is of course no consolation to the affected, but in the wider picture..

    Again, the underlying problem is poverty among the majority and lack of development in the countries concerned. Sewage systems and a reliable and cheap electricity supply along with a reduction of corruption would go a long way to help

  4. @VC – in 2005 chief medical mentalist Sir Liam Donaldson said up to 750,000 people in the UK would die of bird flu in a pandemic. UN scaremonger David Nabarro said up to 150 million deaths worldwide.

    Total H5N1 deaths according to WHO – 386.

    Of course there hasn’t actually been a pandemic so far so they’re not wrong yet…

  5. Vir Cantium – Only a handful (literally, like, less than a dozen) of human to human transmissions of bird flu have ever been recored. It has never been given the opportunity to evolve in the way Ebola has and is.

    With trillions of Ebola virions now running amok it only takes the odd chance mutation to become more or less deadly, more or less contagious.

  6. Global experts issued stark new warnings…

    When are they ever doing anything else? And how do we know this won’t be cooked-up bullshit aimed at securing more money, power, and prestige for themselves.

    Therein lies the dangers of crying wolf too often.

  7. TN – Along similar lines to this comment on CiF

    “Seen it all before, remember, most of us should be dead from AIDS by now according to the UN in the 1980s”

    Perhaps part of the reason these issues don’t grow to uncontrollable levels in the UK is that we are scared in to action by the warnings we are given.

    AIDS for example, they told us to take action / change behaviour, we did, it never became a huge problem in Europe, now people are saying that because the pandemic never occurred it must have all just been scaremongering. Staggering logic considering the AIDS situation in Africa where warnings weren’t heeded.

  8. “Global experts say while things not perfect, nothing to really worry about” doesn’t tend to generate headlines.

  9. magnusw – “AIDS for example, they told us to take action / change behaviour, we did, it never became a huge problem in Europe, now people are saying that because the pandemic never occurred it must have all just been scaremongering.”

    No we didn’t. Actually. Behaviours did not change much – although there is some evidence of people being scared straight and certainly highly promiscuous Gay people toned it down a little bit. The pandemic was scaremongering, and it was known to be scaremongering because early on in the drama a bunch of British haemophilliacs got HIV. Mostly married people with HIV. A trivial percentage of their spouses got HIV despite years of unprotected sex.

    “Staggering logic considering the AIDS situation in Africa where warnings weren’t heeded.”

    The AIDS situation in Africa where no one much has died? That AIDS situation?

  10. Magnusw>

    “The fact that several western medics who have the knowledge and PPE to protect themselves have also caught it, suggests it is not as difficult to catch as first thought.”

    I don’t know if there’s any hard corroborative evidence, but as I understand it the problem there is that the precautions needed are relatively straightforward, because Ebola isn’t a big problem if you do the right things, but once medics are working flat-out in an epidemic, they get too tired to fully observe the precautions. It only takes one slip of the wrong kind, and they get infected.

    So depending on what precisely you’re referring to, the statement that Ebola is hard to catch can be both true and untrue.

  11. “The AIDS situation in Africa where no one much has died? That AIDS situation?”

    http://apps.who.int/gho/data/view.main.22600WHO?lang=en

    1,000,000-1,300,000 deaths from AIDS in Africa in 2012 alone. Some (large) African countries have lost more than 1% of their population to AIDS in the last decade or so. Without checking the full data, looking at the country-by-country stats and assuming some linearity, some countries have lost as much as three or four percent of their population through AIDS deaths alone, leave aside the collateral deaths.

  12. Don’t forget mad cow disease. We’re all supposed to be dead of Creutzfeldt-Jakob disease today, at least if we ate any meat in the 1980s and 1990s. Presumably like Y2K, the only reason we aren’t dead is because we listened to the experts and addressed the problem in time.

  13. SMfS – “Behaviours did not change much – although there is some evidence of people being scared straight and certainly highly promiscuous Gay people toned it down a little bit.”

    Behaviour didn’t change, except for where behaviour changed?

    “The AIDS situation in Africa where no one much has died? That AIDS situation?”

    We may have different ideas about what constitutes a bad situation, but a million deaths per year is not “no one much”. And the situation is improving as, guess what, action is taken and more people have access to drugs.

  14. Dave – “1,000,000-1,300,000 deaths from AIDS in Africa in 2012 alone. Some (large) African countries have lost more than 1% of their population to AIDS in the last decade or so. Without checking the full data, looking at the country-by-country stats and assuming some linearity, some countries have lost as much as three or four percent of their population through AIDS deaths alone, leave aside the collateral deaths.”

    Actually no. Since the 1990s people have been raising their estimates of the population of most African countries once it became obvious that lots of people were not dying. So you can’t use population figures because they are garbage. They are best guesses. Africans can’t conduct anything close to a census.

    Which means those million deaths are also estimates. So the claim has been that in much of Africa 10% of the general population has HIV. 10% of them have not died. Not even close. Not even one percent. Not even half a percent – even if that claim is true,

    Having made the bullsh!t claim, they are forced to defend their bullsh!t. The million death claim is a gradual backing off from their bullsh!t.

    magnusw – “Behaviour didn’t change, except for where behaviour changed?”

    Behaviour didn’t change except for a few anecdotes and a tiny percentage of the population.

    “We may have different ideas about what constitutes a bad situation, but a million deaths per year is not “no one much”. And the situation is improving as, guess what, action is taken and more people have access to drugs.”

    Out of more than a billion people? And even then it is their garbage estimate. No more. No one knows what is going on in Africa. But their population keeps going up and up. So in short, despite doing nothing whatsoever about HIV, despite being Ground Zero for the infection, The situation is not going anywhere as people continue to do nothing even though some governments are wasting a lot of money on drugs that probably aren’t needed and are not likely to be used correctly anyway.

  15. Global Experts’ blanket DDT ban has killed over 50 million, so even counting the African AIDS horror, they’ve have offed more people than they’ve saved.
    As Dave says, the current Ebola epidemic is likely caused by poor medical procedures. Specifically, if you get contaminated while wearing a HazMat suit, you must go through a decontaminating shower before removing it. Otherwise you just transfer the contamination from the outside of your suit to your hands and thence to all and sundry. I’ve seen several reports confirming this is what’s happening.

  16. I used to know a little old lady who worked as a doctor in Africa decades ago. She got slammed many times for leaving places she was working once a week for rest. Of the 30 doctors she was a part of she was the only one who survived more than 5 years. 29 dead doctors due to tiredness, being too exhausted to follow procedures, being too exhausted to fight off infection, being unable to step back and rest themselves in order to not get sick.
    She made sure her staff, when she was assigned any, got regular rest including being away from work and not being contacted until rest period ended.
    She always claimed inability to take rest killed too many trained staff.

  17. Global Experts’ blanket DDT ban has killed over 50 million

    This is a prime example of a made-up argument. There is no blanket DDT ban.

  18. @andrew m

    A chap I was at school with is a world authority on Creutzfeldt-Jakob disease. He says wait and see. Expects a large number of deaths from it, with not much we can do.

    A small c conservative most ungiven to panic/dire warning etc.

  19. @paul b

    “This is a prime example of a made-up argument. There is no blanket DDT ban.”

    True – I’ve seen it being used in some hot countries myself. But its use has been restricted and there are claims (disputed) that millions of people have died as a result. So his point is validish.

  20. As far as i can tell, most of the people dying of Ebola are in Africa so I can’t get very excited about it.

    Wake me up if it spreads to Hampshire.

  21. As somebody who’s been to all the countries in question a few times – the spread of the disease does not surprise me in the slightest.

    The issue actually is the arithmetic – and the actual lack of verifiable accurate information. The local governments by and large will I suspect attempt to suppress the extents of any epidemic – aided by woeful administrative infrastructure.

    The numbers from MSF et al are ratcheting up and the graphs show the inertia present – more cases = more chances to infect…. The locals by and large don’t understand what they are dealing with and are quite leery of western medicine in a lot of cases… so simple preventative measures aren’t practiced.

    The medical facilities down there must already be overwhelmed and this actually could go “biblical” IMHO

    That said – somebody’s going to blame it on climate change – if they haven’t already.

  22. I’m an athiest as far as climate change goes – but I’ll blame this outbreak on climate change! After all it didn’t exist prior to the 1970s! (Tongue in cheek).

  23. Martin D – I wondered if the Nigerian practice of poking an unconscious (or dead) person with a long stick is a folk memory of previous epidemics….

  24. Viruses have had four billion years of evolution to perfect the art of infectiveness, 100% fatality, jumping species, passing from victim (even dead) to victim, etc.
    They haven’t managed it yet.
    So in a short era where we’ve got some handle on how to combat them (washing your hands, quarantine, etc) suddenly we’ve got a virus that can wipe out the planet and be number one life form.
    I smell a rat, probably an infected one.

  25. “She made sure her staff, when she was assigned any, got regular rest including being away from work and not being contacted until rest period ended.
    She always claimed inability to take rest killed too many trained staff.”

    IIRC this phenomenon – people working themselves to death trying to fix *everything* – is a know, quantified and standard problem in aid work.

    A chap I know (works in management for a big aid agency) has the job of making sure people are rotated out. Often pretty forcefully.

  26. Why do the aid people get rotated out? Most of us are working ourselves to death trying to fix everything. Usually fixing the stuff that got broken by the cheap Indians who can apparently do our jobs (when we’re around to fix the stuff they break). When do we get the (non-permanent) rotation?

  27. Ebola is not that much of a terrifying disease. From the sounds of the media reports the moment you get one single virus, you’re infected and incurable and are guaranteed to die a slow and painful death within hours. In reality its easily handled and the main thing to do is to keep hydrated as the lack of it is what is killing most people in Africa who are infected. If you don’t get rehydration, then mortality can be up to 90%. If you are cared for properly, mortality drops down to less than 25%. In African countries with poor hygiene and not much in the way of medical care then it not surprising that death rates are high. But if Ebola hit a Western country which has a high level of medical care and where even ordinary soap has anti bacterial properties the levels of mortality will likely be very low. More people will survive Ebola than die in a Western country. Yes it would be bad, but like Aids, Bird Flu, etc, it won’t be as bad as they authorities make it out to be.

  28. This is a prime example of a made-up argument. There is no blanket DDT ban.
    That’s a prime example of a guardianista’s rebuttal.
    In 1972 the US EPA imposed a complete ban on the use of DDT in the USA. Soon after the State Department made US aid contingent on countries not using any pesticide that was banned in the US and the US Agency for International Development discontinued its support for DDT spraying programmes.
    Plenty of people have modelled the resulting deaths by taking the 1945-1973 reductions (usually about 95%) due to DDT use in the affected countries and subtracting the 1973 rate from the rates reported post-ban. Some estimates top 100 million.
    A triumph of environmentalism.

  29. There is no ban on DDT use for disease vector control. Any model that assumes otherwise is made up rubbish.

    Bans on DDT use in agriculture have save an estimated 200 million* lives by slowing down the evolution of DDT-resistant mosquitoes.

    *Estimated by me at random. But unlike JeremyT’s ridiculous number, my estimate is at least in the right direction.

  30. PaulB – “There is no ban on DDT use for disease vector control. Any model that assumes otherwise is made up rubbish.”

    That is a truth that is so distorted it is a lie. The UN has, in theory, agreed to the use of DDT for vector control. But a lot of European and American aid agencies disagree. They have refused to fund DDT. Which means most people have to stop using it:

    It has also been alleged that donor governments and agencies have refused to fund DDT spraying, or made aid contingent upon not using DDT. According to a report in the British Medical Journal, use of DDT in Mozambique “was stopped several decades ago, because 80% of the country’s health budget came from donor funds, and donors refused to allow the use of DDT.”[133] Roger Bate asserts, “many countries have been coming under pressure from international health and environment agencies to give up DDT or face losing aid grants: Belize and Bolivia are on record admitting they gave in to pressure on this issue from [USAID].”[134]

    The United States Agency for International Development (USAID) has been the focus of much criticism. While the agency is currently funding the use of DDT in some African countries,[135] in the past it did not. When John Stossel accused USAID of not funding DDT because it wasn’t “politically correct,” Anne Peterson, the agency’s assistant administrator for global health, replied that “I believe that the strategies we are using are as effective as spraying with DDT … So, politically correct or not, I am very confident that what we are doing is the right strategy.”[136] USAID’s Kent R. Hill states that the agency has been misrepresented: “USAID strongly supports spraying as a preventative measure for malaria and will support the use of DDT when it is scientifically sound and warranted.”[137] The Agency’s website states that “USAID has never had a ‘policy’ as such either ‘for’ or ‘against’ DDT for IRS. The real change in the past two years [2006/07] has been a new interest and emphasis on the use of IRS in general – with DDT or any other insecticide – as an effective malaria prevention strategy in tropical Africa.”[135] The website further explains that in many cases alternative malaria control measures were judged to be more cost-effective that DDT spraying, and so were funded instead.[138]

    If the people paying for it refuse to allow it, it is a ban in effect. And DDT is uniquely effective against malaria. Largely because it does not require a great deal of actual competence to spray. Which is why it works in Africa. Everywhere it gets banned, deaths go up.

    As for your estimate, the 20 million child deaths is the estimate of a real scientist:

    Robert Gwadz of the US National Institutes of Health said in 2007, “The ban on DDT may have killed 20 million children.”[128]

    http://ngm.nationalgeographic.com/ngm/0707/feature1/text4.html

    By the way, if using DDT causes resistance, why is DDT still used? Surely all the poor little mosquitoes are resistant to it by now?

  31. SadButMadLad – “If you are cared for properly, mortality drops down to less than 25%. In African countries with poor hygiene and not much in the way of medical care then it not surprising that death rates are high.”

    The lack of competence and basic efficiency in the Third World is really amazing. I mean, you think of the Third World like the First World, only poorer, but it isn’t.

    Just think on this for a second. You can save most Ebola patients by providing them with some sugary water. Without massive First World aid, African countries cannot do this.

    Is it any surprise that when the NHS is so dependent on nurses from the Third World British patients also die of thirst?

  32. The lack of competence and basic efficiency in the Third World is really amazing.

    This staggered me in Nigeria. I don’t know what it is that drives competence, and I am sure it is not merely intelligence, but I never came across a task so simple that it wouldn’t get fucked up in Nigeria. Just the ability to follow a simple set of instructions and repeat the actions was completely lacking, almost universally. It might have to do with incentives, I really don’t know, but I found in the 3rd world people get distracted really easily from the task at hand. When the task at hand involves changing a dirty needle for a sterilized one, this is important.

  33. Tim Newman

    funnily enough the recent history of Ebola – one of the first medical investigations found that the outbreak had been largely fueled by Belgian missionaries in Congo using the same needles on a procession of locals …. It’s not just sub Saharan Africa that has woeful hygiene practices – I once saw a “crocodile” of about 20 Egyptian workers given a flu shot with the same vintage hypodermic…

    This program
    http://www.bbc.co.uk/programmes/b04hcthj

    gave a (for the BBC) quite balanced take on the present outbreak with some relevant history – you’d have thought they’d have left it up for a few months given the present state of play – but nope = cnuts.

  34. A couple of points:

    1. Not sure how reliable, but apparently this Ebola epidemic is killing >50% (close to 70%) of those infected so is considerably worse in that respect than the “usual” which is >25%. The numbers infected are simply not known, and the deaths are guesses.

    2. DDT wasn’t officially banned and the the unofficial ban didn’t lead it it ceasing being used initially. In many cases (Sri Lanka is the best example), the effective use of DDT drove malaria cases to almost zero in the early 60’s so the entire program was discontinued.

    DDT was then widely discouraged because of extreme over-use as an agricultural chemical driving widespread resistance in the targeted insects including malarial mosquitos. When used in a targeted way the development of resistance is much reduced; one of the useful properties of DDT used as an anti-malarial agent is that its presence not only poisons susceptible mosquitos but repels them even when it doesn’t kill. So used as a spot spray inside it is very effective.

    When widely used as a general insecticide it is initially effective but induces widespread resistance. So a ban on area spraying is almost certainly the correct approach, and the guesstimates of casualties from that are as a result emotional bullshit. However the resistance to its use in a targeted way will have led to casualties, just nothing likerthe numbers bandied about.

    As usual, the truth is somewhere in between. FWIW, IMHO, and all that.

  35. To repeat: DDT is not and never has been banned for malaria control. It’s ridiculous to estimate of the effects of a non-existent ban.

    If the people paying for it refuse to allow it, it is a ban in effect

    You’ve quoted the people paying for it as saying

    USAID strongly supports spraying as a preventative measure for malaria and will support the use of DDT when it is scientifically sound and warranted.

    So your “if” is doing a lot of work.

    if using DDT causes resistance, why is DDT still used? Surely all the poor little mosquitoes are resistant to it by now?

    Some are, some aren’t. For example, here‘s a recent paper from India.

    The ban on agricultural use of DDT has helped malaria control by slowing down the evolution of DDT-resistant mosquitoes, but hindered it by making DDT less readily available. There is no evidence at all that the net effect is adverse.

  36. PaulB – “To repeat: DDT is not and never has been banned for malaria control. It’s ridiculous to estimate of the effects of a non-existent ban.”

    This remains Jesuitical. Although for some reason the First World prefers to pretend they are not banning it, in actual reality they have banned it. Presumably because the Congressmen who fund these policies are not as bat-sh!t insane Greenies as the people who implement such policies.

    “when it is scientifically sound and warranted.”

    “So your “if” is doing a lot of work.”

    Not at all. You are just playing silly games or are woefully unacquainted with bureaucratic language. People who use DDT say they use it. People who might consider it say they might consider it. People who won’t use it no matter how many died but don’t want to say so openly hide behind tricky little phrases. When it is sound and warranted is never.

    “Some are, some aren’t. For example, here‘s a recent paper from India.”

    And yet they keep using it.

    “The ban on agricultural use of DDT has helped malaria control by slowing down the evolution of DDT-resistant mosquitoes, but hindered it by making DDT less readily available. There is no evidence at all that the net effect is adverse.”

    So the ban prevented something that might not have happened. We have had so much of this hysteria. HIV infections were going to kill us all. The planet should have died from heat last Wednesday. You can’t say what it would have done. You can only say what it might have done. It looks like a grasping at straws in an effort to avoid admitting killing millions to me.

  37. TomO – “funnily enough the recent history of Ebola – one of the first medical investigations found that the outbreak had been largely fueled by Belgian missionaries in Congo using the same needles on a procession of locals”

    I kind of doubt that but if it is true it was an innocent mistake. No one knew Ebola was about. Now they do.

    A third of African HIV cases may come from hospitals.

    The Third World is truly hopelessly incompetent. I mean really basic stuff.

  38. Not sure how reliable, but apparently this Ebola epidemic is killing >50% (close to 70%) of those infected so is considerably worse in that respect than the “usual” which is >25%. The numbers infected are simply not known, and the deaths are guesses.

    I think it’s the other way around: this West African outbreak is less deadly than the earlier ones, which were mainly in Central Africa.

  39. So Much for Subtlety

    The guy who discovered the 2nd hand needle thing in Congo is interviewed on the BBC prog I linked. True story. Somebody might be Torrenting the prog – it’s worth a watch.

    As to the 3rd world – yeah – well – it ain’t helped by sending out millions of quids worth of halfwit econuts to lecture them on warbal gloming eh?

    I see the cretins at The Guardian are girding themselves to blame Ebola on capitalism and climate change and “progressive” Noggie pols are as per usual digging into other folks money to fund their pet projects.

    see here:
    http://t.co/lrnjYYulxU

  40. So Much for Subtlety

    on reflection injecting a procession of people at a clinic with the same needle is NOT an innocent mistake – it’s culpable negligence. Quite a few of the sprouts paid for their mistake too.

  41. TomO – “on reflection injecting a procession of people at a clinic with the same needle is NOT an innocent mistake – it’s culpable negligence. Quite a few of the sprouts paid for their mistake too.”

    It is today. But in the 1950s?

    Libya put some Bulgarian nurses on trial for infecting children with HIV. Presumably they were too lazy or too cash strapped to throw away the needles. Or they did not heat them long enough. But willful negligence is such a hard claim to make here. I expect that the nurses were guilty of being lazy. They should go to jail. But if they just had no choice? It was re-use a dirty needle or not at all? Hard to say.

    In most of Africa you pay for a clean needle. Either officially or unofficially. Not the sort of thing that would encourage nurses to clean old ones properly.

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