More Data

NEJM: Ebola Virus Disease in West Africa — The First 9 Months of the Epidemic and Forward Projections

6 responses to “More Data

  1. garbage in, garbage out. Given the broken-down statistical reporting in these W. African Black holes, the current ebola numbers must be 5x-10x higher. I’m also impressed with Zero sending in 3,000 U.S. troops, for reasons which remain murky. Since there’s little or no oil involved, and Israeli security is not at issue, one might almost suspect they’re there to contract Ebola and bring it home

    • It’s likely closer to about double, not 5-10x. But it doubles on avg. every 21 days. WHO is basically a week or two behind the curve, as they have been on this outbreak since Day One.

      There’s nothing sinister or suspicious about sending people to help stop things there to stop them from spreading here; it’s no more suspicious than trying to help your neighbor put out his house on fire before it spreads to yours.

      The problem is, it’s too little, too late, and thus represents the flailing efforts of a President hopelessly out of his mental depth (like he is on pretty much anything more complicated than his gold swing), and what’s worse than him not knowing what to do, is that he doesn’t know he doesn’t know what to do.

      So in the end, contracting Ebola and then bringing it home may be the exact result, but probably not before some unquarantined civilian (or twenty) flying commercial air does it first, and much earlier.

      For CA, another link full of cheery good news:

      Money quote, buried in the tenth graf:

      Experts say it is only a matter of time before at least some infected patients are diagnosed in U.S. hospitals, most likely walking into the emergency department seeking treatment. “

      Sleep tight, America.
      Obama’s on the case.

      • “WHO is basically a week or two behind the curve, as they have been on this outbreak since Day One.”

        Wouldn’t that be Day Seven or Day Fifteen?

  2. Highlights for me, and a synopsis for each (emphasis mine):
    “This analysis shows that by September 14, a total of 70.8% of case patients with definitive outcomes have died, and this rate was consistent among Guinea, Liberia, and Sierra Leone. Assessing the case fatality rate during this epidemic is complicated by incomplete information on the clinical outcomes of many cases, both detected and undetected. Estimates of the case fatality rate derived by calculating the ratio of all reported deaths to all reported cases to date are low in comparison with historical outbreaks.”
    So the actual fatality rate is higher than 71%, we just can’t say how much higher exactly.
    2) “The critical determinant of epidemic size appears to be the speed of implementation of rigorous control measures.”
    Go draconian early, or everything goes to hell.
    3) “As of September 14, the doubling time of the epidemic was 15.7 days in Guinea, 23.6 days in Liberia, and 30.2 days in Sierra Leone. We estimate that, at the current rate of increase, assuming no changes in control efforts, the cumulative number of confirmed and probable cases by November 2 (the end of week 44 of the epidemic) will be 5740 in Guinea, 9890 in Liberia, and 5000 in Sierra Leone, exceeding 20,000 cases in total. The true case load, including suspected cases and undetected cases, will be higher still.”
    Everyone is in over their heads, with no end in sight.
    4) “[T]he current epidemiologic outlook is bleak. Forward projections suggest that unless control measures — including improvements in contact tracing, adequate case isolation, increased capacity for clinical management, safe burials, greater community engagement, and support from international partners — improve quickly, these three countries will soon be reporting thousands of cases and deaths each week, projections that are similar to those of the Centers for Disease Control and Prevention. Experimental therapeutics and vaccines offer promise for the future but are unlikely to be available in the quantities needed to make a substantial difference in control efforts for many months, even if they are proved to be safe and effective. Furthermore, careful assessment of the most effective means of utilizing such interventions (e.g., vaccination or treatment of contacts versus health care workers) will be required while stocks remain limited. For the medium term, at least, we must therefore face the possibility that EVD will become endemic among the human population of West Africa, a prospect that has never previously been contemplated. The risk of continued epidemic expansion and the prospect of endemic EVD in West Africa call for the most forceful implementation of present control measures and for the rapid development and deployment of new drugs and vaccines.”
    We hope that will work. We don’t even want to think about what happens if it gets loose from W. Africa.

    Oh, and they don’t even want to address what happens when any or all of those governments, and their tenuous grip on order – like enforcing those rigorous quarantine and control measures – collapses completely, because that’s not a medical problem, it’s a geopolitical one.

  3. They are losing their grips now. Sierra Leone 6.09M, Liberia 4.29M. Figure a million cases there by end Jan maybe sooner. 10pct of the population will definitely cause some larger problems. I would guess that 5pct will get it done. The recent effort of “lockdown” is an indicator that it’s going south. 3-6 months max IMHO.

    • Actually, in about 7 months, 8 months max, Liberia ceases to exist demographically. By mid-May (at current rates, which could get worse=faster) all three of the primary infected nations are infected, which means 70-90% of 20M people dead or dying. It took Stalin 30 years to do that; Ebola will do it in a little more than 1.
      Long before then, the governments there and any control collapses, and it bombshells to the four compass points as fast as people can travel, on foot, canoe, bicycle, bus, or 737.

      Nobody among TPTB are talking much about that…yet.