Friday, October 17, 2014

Ebola - Uncharted Waters and Seas of Speculation

If you’re in uncharted waters, you are in a situation unfamiliar to you, in which you have no experience and don’t know what might happen, leading to endless speculation.

American Idiom

With the spread of the Ebola virus to America, with the cropping up of three documented cases and fear of dozens more to come, we are in midst of a sea of speculation of how the West African Ebola epidemic will affect the U.S. people.

These events and possible chain of future events, have created a political crisis for the Obama administration, It responded by holding an emergency cabinet meeting on Ebola and appointing a political czar, Ron Klain, a Washington insider, who is long on politics and short on health care, and who served as chief of staff for Vice-Presidents Gore and Biden, to orchestrate the federal response, which I will predict will eventuate in a travel ban from West Africa.

What is at stake here may be a political disaster for Democrats based on lack of competence in handling events protecting the public’s health care prior to the midterm elections. This criticism may be unfair because this looming pandemic, which will probably never develop, is unprecedented, human mistakes will be made, lessons are being rapidly learned, and new protocols are being put in place.

Predicting the future of the Ebola epidemic has become an exercise in predicting the future through mathematical models.
Two of these models are frequently cited.

One is the Center for Disease Control and Prevention mode, which explains what may happen in this article , “Estimating the Future Number of Cases in the Ebola Epidemic - Liberia and Sierra Leone, “by nine authors in the CDC’s Morbidity and Mortality Report , September 26, 2014.

The report predicts the number of cases will double every 20 days from September 23 for the next 30 days, reaching 14, 000 cases (37,000 when corrected for under-reporting, and by January afflicting 550,000 people (1.4 million when corrected for under-reporting).

Two is the World Health Organization (WHO ) report, “Ebola Virus Disease in West Africa – The First Nine Months of Epidemic and Forward Projections, “ which is reported in the October 16, 2014 New England Journal of Medicine, The WHO numb ers are much more conservative and estimate 20,000 cases by early November.
Both reports assume the Ebola epidemics will proceed unchecked , which is unlikely .

An October 1 report in Vox by Suzanne Locke “The 6 Myths About Ebola” sets forth these myths about Ebola,

1) Ebola outbreaks are unstoppable. Ebola outbreaks since 1976 have been stopped in rural West Africa.

2) Ebola is a death sentence – the survival rate is closer to 50% than 70%.

3) Ebola patients always have hemorhagic disease, generally dying from internal hemorrhage.

4) Ebola is an airborne disease - Not true so far. It is usually transmitted by touch and exposure to body fluids.

5) Ebola is easy to catch – Not so. You have to have contact with a victim with fever and other symptoms.

6) Ebola is the most serious disease in West Africa – HIV/Aids, respiratory diseases, diarrhea, malaria, and strokes are much more common causes of death.

Predicted U.S. Ebola Cases

There may be as many as two dozen people in the U.S. infected with Ebola by the end of the month, according to researchers tracking the virus with a computer model.

The actual number will probably be far smaller and limited to a couple of airline passengers who enter the country already infected without showing symptoms, and the health workers who care for them, said Alessandro Vespignani, a Northeastern University professor who runs computer simulations of infectious disease outbreaks. The two newly infected nurses in Dallas don’t change the numbers because they were identified quickly and it’s unlikely they infected other people, he said.

The problem with mathematical models if that they offer nothing but estimatec guesses, but their guesses are the best science can offer in stormy political seas.

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