Ebola Update - October 2018

[patriotman]

 From the always great Raconteur Report blog:


Sorry about sharing this:

Since our last 21-day Ebola checkup, things have gone rather sh*t-sandwichy.
Recall then that things were basically flat-lined: no growth, just maintenance of the outbreak.
It's now started growing again.

Cases: 252
Deaths: 159
Contacts: 5,723!

IOW, the kill rate is still running 82% over three weeks time, and the number of people exposed and being tracked doubled in the last two weeks. 15 more people have survived and been discharged, and false alarms of possible EVD were reported in five neighboring countries.

Oh, and those numbers are a few days old.

The only good news is they managed to vaccinate another 3300 people last week. Over 22,000 total. But in a region with 1M people, mostly refugees, that's nothing much to be proud about.

So this has officially gone around the bend, and violence in the region has made that worse.

This is now probably going to skyrocket presently, because it's going to keep spreading exposure faster than they can contain it and vaccinate around it, not least of which because they had over 40 burials that were not done properly, which exposes family members to the virus from contaminated corpses.

That's how you get an outbreak that won't taper off.
https://raconteurreport.blogspot.com/2018/10/well-thats-problem.html

Here is a previous series on Ebola with some relevant quotes. This was from an email I sent out to some people on August 31st, 2018.

EBOLA UPDATE (Raconteur Report)

The Ebola Outbreak Part Deux (JR NOTE: This is a series of six articles I highly recommend that you read. Ebola has largely fallen off of the radar of the news cycle and nearly all Americans, but another outbreak is currently ongoing in the Congo. In this series - mostly in responses to comments - Raconteur lays out exactly what the threat it and how bad it can potentially get. This is no joke, and he speaks from a position of authority - he has experiences as a high level RN.)

Keep an Occasional Eye on This One (8/16/18)
Remember two things:
1) 34 doublings to go from nobody to everybody. (This one is now between 6 and 7.)
That's just basic Epidemic Math.

2) In fifteen days, this outbreak has surpassed what the last one did in four months.
Which underlines:
     a) virulence
     b) transmissibility in this region
     c) difficulty of doing what's necessary to halt the spread

It's still small potatoes, but moving roughly eight times faster than the last outbreak means it bears some scrutiny. If it gets to a population center/starts hurdling international borders, we're off to the races again like it's 2014. The only saving grace is that this time around we don't have an illegal alien Muslim idiot riding shotgun on the anti-apocalypse circus. Panic is never a good idea. Calm, rational forethought is always a good idea. Act accordingly. Think happy thoughts, and hopefully MSF/WHO manage to corral this before gets away from them, and it turns into another wildfire sh*tshow. Dealing with a biblically epic pandemic may very well be the last thing on your preparedness things-to-do, for good and prudent reasons. But it should still be on the list. I'll be very happy not to have to do another round of coverage of the Insane Clown Posse.

Addendum:
WIKIPEDIA page link for this outbreak.
Bonus fact to drive the point home:

"The area in question, North Kivu, is also currently in the middle of the Kivu Conflict, a military conflict with thousands of displaced refugees. The affected areas host over one million displaced people and shares borders with Rwanda and Uganda, with frequent cross border movement due to trade activities. The prolonged humanitarian crisis and deterioration of the security situation is expected to affect any response to the outbreak. There are about 70 armed military groups in North Kivu. The armed fighting has displaced thousands of individuals." - Wikipedia

Because what you really want is an area crawling with teenagers with AK-47s, and refugee camps cram-packed with potential infectees, right next to two international borders. And the virus, so far in this outbreak, is enjoying an approximate 80% mortality rate. What could possibly go wrong...?
https://raconteurreport.blogspot.com/2018/08/keep-occasional-eye-on-this-one.html

Ebola Meter (8/24/18)
Bad News:

It's still a thing. From outbreak onset on 8/1, there were 20 deaths originally (which is how they cleverly deduced it was Ebola). It took another 14 days to get to 40 deaths.
It's only taken another 6 days to get to 20 more. IOW, it's tracking with exponential spread quite nicely. The contacts have gone from 900 on 8/3, to over 2400 now as of 8/20. This, in a rural war-torn area teeming with 1M displaced refugees in sprawling camps, doesn't bode well for getting a handle on this anytime soon.
And as usual, it's killing the critically short ranks of health care workers there disproportionately, which means they haven't got precautions and sufficient protective apparel anywhere near in place yet. And the 45 new confirmed cases mainly came from among those in the "suspected" category.

The case tally and lethality is bouncing around, partly because some people are being ruled out, partly because you're always dealing with people who take their shoes off to count above ten, and partly because increasing numbers of victims makes some governmental ministries there look bad. It is what it is.
Reported Ebola-attributed deaths, however, have just about exactly tripled in three weeks. This isn't new, it's just exactly as gloomy as it looked on first glance.

Good News:

It hasn't jumped to someplace disastrous, like Kinshasa (pop. 13M), Luanda (pop. 6M), or Nairobi (pop. 3.5M). Yet. Also, the number of "suspected" cases tally has actually diminished, exactly as "confirmed" cases have ballooned, so either they're getting testing done more rapidly (very good), or more likely, the probables simply died, changing their status via pathology exams (very bad). You can get odds on which is likelier. And at 111 cases, it's at Level 7 (out of 34) on the Pandemic Meter.

Better News:

No one with Ebola has hopped onto a flight to Cairo, Riyadh, Rome, London, Rio, NYFC, or Atlanta. That we know of.
https://raconteurreport.blogspot.com/2018/08/ebola-meter.html

You don't LIKE a Fustercluck? This is how you GET a fustercluck.
Let's be clear: Ebola in Kivu, right now, is nowhere near as bad as it was in West Africa in 2014. Yet. Now, that said, and with all due respect to the commenter, my reply to that: I was like that once, too. Right up until I started digging, out of curiosity, in early 2014. Springtime, IIRC. Then Reality, with a predictability like sunrise, did its thing.

[........]

1) The modern system is exactly the problem with Ebola. One infected reference patient, Patient Zero, walks into your ER lobby with what looks like just another set of flu symptoms. During flu season. (How helpful for you.) After an hour (or as little as ten minutes, as numerous dead former cab drivers in Guinea, Liberia, and Sierra Leone could attest, if only we could dig up their ashes and re-animate them before their former owners died of Ebola infections from giving patients rides to the hospital) in the same lobby as ten other people, you have eight more Ebola patients, and you won't know it for 5-21 days. And they'll infect the triage nurse, the doctor, and the treating RN, unless you have everyone in Ebola-proof gear 24/7/365 pro-actively...
What? Of course neither you nor anyone else does that? Ever? Sux to be you, man.

Then, if you're really lucky, and Triage is on that, they ask the magic questions:
"Have you been exposed to Ebola?" "Oh, no sir."
"Have you been to Africa recently?" "Oh, no sir."

2) Once the symptoms of Ebola pop up, they've already exposed people for 1-3 weeks, so it's the 500 contacts you didn't know about that are going to be the next casualties. And they expose 50,000 more contacts you don't know about. And they expose 5,000,000 contacts you didn't know about. And they expose virtually everyone in the continent, and you're still waiting for the first patient's diagnosis to come back from the lab. How does America with a few million to a few hundred million dead sound to you? Another 10% of that crippled for life, and carrying the disease in their own bodies? Wildlife becoming a native virus reservoir on this continent, forever? Coyotes, rats, skunks, bats, whatever.
We still don't even know where in hell it lives in Africa, after looking for decades.

3) Quarantine? You're kidding me, right?
Look up Kaci Hickox.
Then Dr. Craig Spencer.
Then Dr. Nancy Snyderman.

4) Look up how Ebola was handled at Texas Health Presbyterian Hospital. One case infected two nurses (for life, it appears) despite them scrupulously following the CDC "guidelines" (instead of the actual field-tested MSF/DWB protective gear guidelines), they generated tons of medical waste, lost their ICU and ER wholesale for months, and nearly bankrupted the hospital. For one case. Then three cases. Then, they shipped the two surviving nurses to Emory in Atlanta ricky-tick, one of the actual BL-IV hospitals, and virtually shuttered their hospital for months, until the stigma and the story finally went away. Think about that: a cornerstone regional acute care hospital, 968-beds, turned into a virtual ghost town for three people. (Oh, and about a gazillion dollars in indefensible liability suits.) Their entire ER staff basically told management, "Either close the ER, now, or we all walk forever." The hospital closed that week. They had to; their patient census that week dropped literally to single digits. It was costing them more to turn the lights and AC on for a day than they were making in a month of that.

5) Hospitals here, outside the four BL-IV hospitals actually trained and sort-of staffed to care for a grand continent-wide total of - wait for it - eleven Ebola patients, maximum, are utterly, completely, and massively unprepared to deal with this , as the Dallas example proved in about 21 days, and neither they nor the CDC wants to talk honestly about this. Neither you, I, nor 2M other RNs nor 1M doctors has the slightest effing CLUE about dealing with this (unless they volunteered in West Africa in 2014) and come the day, they're going to make simple mistakes that'll get them dead, along with thousands to millions of their patients. The suiting up and decon process takes half an hour each coming and going, requires scrupulous attention to detail at every step, unless you want to die, the gear is hot, a lot hotter than most people can work in for more than a couple of hours, and a "simple" pee break requires the entire 30 minute decon, then another 30 minutes to re-suit. It takes two people who do nothing but suit you up, and another who does nothing but monitor you peeling out of it without effing up and killing yourself. So imagine with me a staffing ratio of four people for every one person who can actually render bedside treatment. And you think the nursing shortage is bad now?

Bear in mind the age of the average nurse in the US is something like 50 years old, not 21 or 22. So you'll have people old enough to be retirees in the military, in the equivalent of MOPP Level IV, which is hotter than hell even in an air-conditioned room, sweating like a pigs, and doing everything through a fogged up facepiece and two layers of gloves, in a rubber suit, with a virus that only has to get lucky once, with delirious feverish patients oozing blood from every orifice onto everything, and coughing a miasma of bloody sputum into the air. Yeah, that should work. And then, tell me how many CNAs, EMTs, and PCTs are going to risk their lives for $10-15/hr.? In someone's effing dreams, baby; hospitals will become ghost towns, just like Texas Health in Dallas did. In minutes and hours, not days. You'll have patients and staff going out the fire escapes and jumping down laundry chutes, mark my words. In Africa, they make Ebola survivors unpaid help with patient care. They have to help anyways, since they get stoned and shunned in town when they come out afterwards, and it's the only place they can get fed. And anyways, most of the victims are the very people they infected, and who infected them: family, friends, and neighbors. Good luck pulling that off here.

And it requires literal fuck-tons of gear, that your hospital and mine don't have and never will, dedicated facilities that they don't have, HEPA-filtered air- and waste-handling facilities they've never had, and generates even more fuck-tons of BL-IV HazMat waste that no one on the entire continent knows how to or is willing to deal with. The pyres burning it are going to look like Kuwait in 1991, people downwind fleeing the ashes are going to look like villagers fleeing Mongol hordes, and if you try to ship it across state lines, the trucks and trains will be met by smiling national guardsmen, with bayonet-mounted locked-and-loaded rifles and battle-ready tanks, and a serious dose of the ass with you for trying to transship it.

6) Canada has zero BL-IV beds, AFAIK. But hey, free health care! Just like in Ebola clinics in the African bush. Should work out great for them. Mexico has...wait, you're shitting me, right? Mexico has what you'd expect Mexico to have: a corrupt government, and an overabundance of expendable and illiterate peones. No points for guessing who'll handle clean-up there. Then take the disease home to papi y los niños, Tío Juan and Tía Julietta, y los viejos. Who will cheerfully and unknowingly spread it to all their friends, and pretty soon, you solved the immigration problem by erasing everyone from Tijuana to Tierra del Fuego, except maybe some lucky isolated Indians in the deep Amazon rainforest. ¡Viva! So, in between those two, there are actually 23 BL-IV hospital beds, but cleverly, only 11 are actually staffed to operate anytime, and you can't just call Joe's Nursing Registry in Missoula or Baltimore or Omaha or Atlanta and whistle up more BL-IV-qualified nurses to pick up the open shifts. Bummer. Oh, and one to three of those 11 beds are reserved by law for the potential military casualties at their neighboring state-of-the-art Infectious Disease (and chem-bio warfare, which of course we swear we don't do military research center(s) in UT and MT, so there are really, actually only 8 beds. We have 8 beds for 453,000,000 people (those poor Caribbean islanders from Cuba around to Trinidad can just suck it, like they always do). Bermuda is looking pretty good, but only if they shoot down incoming aircraft, and sink cruise liners off the continental shelf at the merest suspicion of a pandemic.

So Twelve Ebola cases flood and overflow every available BL-IV treatment bed extant in North America. Twenty actual Ebola cases will shut down any city in America. Overnight. For months.
Fifty cases, and the USA is Liberia in 2014. Times 1,000. That's not a guesstimate, those are the hard numbers. There are 52 active cases in Congo right now, who haven't died. Yet. 80% of them will. And the survivors will carry virus reservoirs in their bodies functionally forever. And probably go blind from retinal damage due to disease-related coagulopathy. (That includes the two nurses from Dallas who contracted it, BTW. You'll notice a deafening silence on that, since 2014.) God help those people, every one of them.
IMHO, it's a dice roll whether living with Ebola or dying from it are worse.

This disease is from Hell.

In 2014, we had TEN cases here. We were two Ebola patients away from swamping the lifeboats, and turning any other hospital into Texas Health Presbyterian, which was Tier One disasterpiece theater. They exposed thousands of people, unwittingly. They had the infected guy in once, misdiagnosed it totally, and sent him home. They didn't catch on until he was brought in again in total collapse, and after throwing the entire best the first world had to offer at him, he died anyways. And infected a perfect R-naught of 2 additional victims. Only fate, or a benevolent deity, kept that incident from turning Dallas into Freetown, Liberia in about two weeks, and wiping out their whole ER shift staff that night. Poorly protected clean-up crews in Dallas were pressure-washing the guy's vomit - live, active virus - onto everything within yards of his apartment in suburban Dallas, the day after it happened. Because illegal aliens with a fourth-grade education are the front line in that clean-up, hired by companies with no more sense than God gave a jackass about Hazmat gear, or proper Ebola precautions. In NYFC, they were handling stuff with no PPE whatsoever. Hand to God on that.
https://raconteurreport.blogspot.com/2018/08/you-dont-like-fustercluck-this-is-how.html

This is Why I Blog (8/26/18)
When the house is on fire, perhaps pulling an alarm is what's called for.

But hey, thanks for letting us know that life will go on fine, once everyone realizes they can't go to work, school, church, the mall, the grocery store, the gas station, the pharmacy, the bank, the ATM, or anywhere else, nor touch anything they haven't disinfected with bleach and sunlight for 10 minutes, after gowning up in the equivalent of MOPP IV, including N95 respirator, head to toe disposable overgarments including hood, goggles, and face covering, rubber booties, and two pairs of gloves, and following a strict series of decontamination again when they remove the garments, any time they venture outside their perimeter (God knows why they would, other than oh, I dunno, the exact food, water, medicine, money, and all those other luxuries we can skip for a few months/years). Or else stay locked up in their homes with food, water, medicine, and such, for at least 40+ days after the last reported case, nor come closer than 20' to anyone coughing or sneezing until 10 or more minutes have passed to let the droplets settle, if they're crazy enough to go out at all, for any reason whatsoever, because that won't affect the largest economy in the world in the SLIGHTEST, will it, jackass?

Do you have a spare two years' income handy? In cash? Do you have twenty-four months' food at home? The 2013 outbreak wasn't over until 2016 in West Africa.(But, you knew that, right?) And you've also got a 40' ISO container full of limitless supplies of HazMat gear, and an incinerator and fuel to dispose of used gear properly?
And hundreds of gallons of bleach? And a sprayer for it? Who's going to spot for you putting it on and taking it off? Or were you just going to wing it? Who's going to run the water plant when everyone stays home? How will water get pumped when no one comes to work at the power plant either? Who's going to fill up barrels and distribute water door to door when there's no gas, no water supply, and no power? You? How many cops and firemen will come to work at all, let alone when they have to work in gear so hot you can't do it for more than a couple of hours? Who's going to be giving those vaccinations when no one comes to work at the hospital, for all the reasons outlined above? (Oh, BTW, as the name would imply, "ring vaccination" isn't vaccinating "those at highest risk" - that would be medical relief workers, primarily, and probably be called "highest risk vaccination" - it means vaccinating those proximately closest to those already infected, i.e. family, neighbors, friends, and other closest contacts, and putting a literal ring of immunized people around the outbreak. Plain English is funny like that: it tends to mean what it says. If you're going to be the smartest guy in the room, and sling the terms around, it's probably a good idea to get them right. Just saying.) What happens if it doesn't work so well? If your weasel-worded ("apparently") morphs into "Whoops, my bad, not so much..."

What are you going to do with the 25% idiots who won't even get vaccinated now? Shoot them? Round them up? Ignore them and let them die? And merrily spread the outbreak in the meantime? What about their minor children? Do we just let mommy and daddy give them Mr. Jones' nice cup of kool-aid? Because father knows best?

As a certifiable jet-fuel genius technocrat with all the answers, tell us how to deal with that. And then you're going to do...what, exactly, about those 75M dead bodies, from Ebola, in some cases, but also from heart attacks, dehydration, heatstroke or freezing to death, running out of their meds, not to mention what happens when any semblance of civil government breaks down and blows away in the wind? Who's going out on body pick up and disposal? What are you going to do about the 20% of America on anti-depressants and other psych meds when they run out? Who you gonna call when there's no power for that information grid, TV, radio, cell towers, or the internet, about three days after this hits any place, and the lights start going out?

In 2014, with exactly that sort of "We can do this!" thinking, Texas Health managed, despite the CDC's sub-standard "protocols", to infect 2 ICU nurses, despite more information, protective gear, and better training than you've got right now, and exactly doubled the US outbreak in less than 21 days, while exposing thousands more to the potential to become the next wave, shutting down schools, completely closing that entire 968-bed major hospital in our 9th largest city for one patient, and spreading the exact amount of fear and panic totally justified when TPTB turn out to be so stupid, incompetent, and recklessly dismissive of the public's safety and best interests.

So, wow. Totally fucking ignorant of reality much there?

And just to help your reading comprehension along, notice where I said that this Congo outbreak now isn't nearly as bad now as it was in West Africa 2014. Yet. But the post was in reply to someone, a trained medical professional, in fact, who - exactly like you - didn't think this was that big a deal at all. So I'm guessing the return fire landed inside your perimeter, and you're running critically low on butthurt creme, right?
https://raconteurreport.blogspot.com/2018/08/this-is-why-i-blog.html

And The Hits Just Keep On Coming (8/27/18)
This is not the story, or topic, I wanted to open the week with. I was going to put off even looking at the topic until the end of the week, for just a cursory check-in, like last week. I would have been happy not to speak of this story again. Ever. That's how "alarmist" I am. Well, so much for fond hopes. Y'all do as you like. For me, this news moves the currently-small outbreak in DRC from an occasional glance, to a regular visit, with both eyes on:

WSJ - "This outbreak is still in the escalation phase,” said Robert Redfield, director of the U.S. Centers for Disease Control and Prevention, which has staff working to stem the outbreak in Congo, neighboring countries and the Geneva headquarters of the World Health Organization. “The key is identifying (patients’) contacts and getting people vaccinated.” On Friday, the WHO said a doctor in the town of Oicha in Ituri province had become ill with Ebola and may have infected his wife. The cases are the first in “an area of high insecurity,” said Peter Salama, the WHO’s emergency response chief. “It really was the problem we were anticipating, and the problem at the same time that we were dreading,” he said. Officials have identified 97 people in the town who may have been exposed and need to be vaccinated, but haven’t been able to reach them all due to security concerns, Dr. Salama said.

[......]

That all is concerning, but they bury the real money quotes at the bottom of the article:

WSJ - The 1.3 million people, including thousands of refugees, who live in the region have endured violent insurgencies dating back to the 1990s. But it is their first time experiencing an Ebola outbreak, stunning a rural population where many believe the virus is sent by evil spirits, aid officials say. “Many can’t comprehend the idea of not being able to bury dead loved ones according to tradition,” said Hassan Coulibaly, a field director in eastern Congo for the International Rescue Committee. “We are trying to educate them, but the environment is hostile”. Last week, locals angered by health officials’ insisting they forego traditional burial practices, including washing bodies to avoid infection, burned down a health center in Mangina, the epicenter of the outbreak, pushing out medical personnel, according to the WHO. A local team administering vaccinations was also beaten up in Manbangu village, some 10 kilometers west of Mangina, while the IRC was forced to close down its health facility in the village of Mabalako following an attack from locals.

So, just like with the ignorant tribal jackholes in West African nations in 2014, this is going to take months to try and get a handle on, not days nor even weeks, by which time it will multiply by several orders of magnitude, like it does, to hundreds and thousands of cases, even with a vaccine, and cross one or two international borders, and so on, and so on, and so on. And it's already off to the races now.

Grab your hats; here we go again.
https://raconteurreport.blogspot.com/2018/08/and-hits-just-keep-on-coming.html

Nothing Good to See Here (8/28/18)
UPDATE: Today's Ebola box score (with figures from WHO 8/24 report):
 
117 Ebola cases
73 dead
3,421 contacts.
 
So the metric to watch is to see what that looks like in 21 days.
I.e., From 8/3-8/24, they went from 33 deaths to 72, so it's doubling a bit faster than expected. Not good. On or about 9/14, if they have 144 deaths, they're on track for no control on the outbreak. The first batch were the people infected largely before the outbreak was detected, because you're always behind the curve with this disease. The 40 or so who've died since 8/3 are the second wave. The 72 probable between now and 9/14 are the next wave. If the dead count is less than 144 then - assuming the counting is accurate (because Africa) - that means vaccinations and so on are slowing the spread. That would be hopeful news. If it's 144 or more, that's very, very bad.
 
That the contacts they need to trace have already quadrupled in three weeks is the reason epidemics become pandemics. One other note on the panel on Wikipedia:
 
IGNORE their published CFR. They're doing it wrong.
 
Allow me to explain:
The death rate isn't the number dead now vs. the number infected now. Ebola isn't a lightning bolt.In 2014, Duncan, with first-world ICU care, took 10 days to die. He'd been sick several days before that. In Africa, a week, or two, or more between obvious infection, and death, is not uncommon. So if you're going to be honest, look at how many cases they had 21 days ago (that time span being the rough average of 5-42 days between contraction and appearance of Ebola) and how many dead people they have now. 21 days ago, there were 76 cases. Today, there are 72 dead. That's a CFR of 95%.
So unless they're going to publish survivor numbers, this thing is doing what you'd expect it to do in Africa: it's killing 95% of the people who catch it. It's like scoring bowling. With strikes and spares, you know you have to go a frame or three back, to get the correct current score.
 
You can shorten the time frame to the average number of days an infected person lives in a Congolese Ebola clinic, or you can tell us how many of the people infected two week ago are dead now, and how many have recovered; those are both statistically honest options. Anything else is b.s.ing with numbers, and purely dishonest. And whatever mook at Wikipedia is skewing the percentage should know that (and either isn't savvy enough to grasp this simple epidemiological concept, or someone there is holding their thumb on the scale). It's a coin-toss there; you can guess which option, stupid or evil, is more likely. Neither one makes them look very good. If they plead "we're just re-posting the numbers from WHO", which are the numbers from DRCongo, that's fine, but it simply underlines the biggest problem with Ebola: Africa wins again.
 
Note:
Unless this either
a) crosses an international border,
b) appears in a major (pop. > 1M) city, or
c) some modern Thomas Duncan gets through an airport and brings it outside DRCongo,
d) something really major happens, internationally
 
we're still keeping an eye on this, but won't be talking about it much, if at all, for the next three weeks. Anything other than that, grim as it may be, will just be Africa being Africa.
Which it does just fine whether we watch, or not. I brought it up at all, because it's moved into being a thing, and mainly - since neither you nor I can affect what's happening 6000 miles away - as a reminder to make sure (or start making sure) you could ride things out at home if this goes as sideways as - or, God forbid, worse than - it did in 2014. Which is well within the possible likely course of action.
https://raconteurreport.blogspot.com/2018/08/nothing-good-to-see-here.html

[Erick]

Interesting post.
It makes many good points and a couple of questionable ones mostly vis-a-vis the nuances of the infection rates as a function of transmission rates.

While infectiousness of Ebola is extremely high, its transmissibility is quite low.
Whats the difference?

Infectiousness is a measure of how likely you are going to get sick if the pathogen gets into your system.
Ebola is extremely infectious it takes very few virions (we think, 1-10) to infect a person.

Transmissibility is the ease (or lack thereof!) which with a pathogen can get to your system.. This is very low number for ebola .
It not very transmissible at all... this is mostly a function of how fragile it is in air and on surfaces.. it pretty much needs physiological ph (around 7.4) and be in in a watery environment to stay viable for more than a (very) few minutes.....and it generally takes repeat contact with folks shedding lots of virus (usually, albeit not always, that means blood) for transmission to occur.
In other words your vulnerable populations are really medical providers and close family of afflicted.

Even transmission in airplanes via recirculated air is not as easy as most people seem to think as the recirculated air is filtered these days (and even then it is not an airborne disease... the fact it has shown capable of infection via aerosolization in means very little as this applies to most pathogens known to man.)

I may find more time to write on this but I am super busy right now and if I dont make it to Africa for this particular outbreak, I hope to make it for the next one.

EDITED for clarity

[patriotman]

Glad you enjoyed it. I wish I could personally speak more about the topic but I don't have any background in it. I know that his background is as an emergency room nurse. I think in one of the articles he explains how he views the transmissibility of it. Lemme take a look.

[JohnyMac]

Patriotman,
Erick is our resident expert on nuclear melt down and infectious disease. Go into the archives and look up some great articles he has posted here.

Since he is one of the guys that goes into the den of the beast for a living, make sure you wear gloves, a 3M respirator, and a Tyvex suit when you meet him.

 

[Nemo]

And get your shots first.

Nemo

[Kbop]

And get your shots first.

Nemo

i prefer tequila.

[Nemo]

Shots similar to that was the gist of my reference.

Nemo   

[patriotman]

Interesting to see the differences between the two terms. I knew it wasn't the most contagious but that is a short time for it to live if it is not in optimal conditions.

Let's hope that it stays with a low transmissibility and they can contain it regardless. Ebola is a nasty little disaster.

[Nemo]

Whats the mutate capability.  Can it go to long term survival of a couple days or weeks?  Air transmittable?  Only infect liberals?

Nemo

[patriotman]

Only infect liberals?

Nemo

    

[patriotman]

https://raconteurreport.blogspot.com/2018/11/crystal-ball-score-2-0-today.html

    Centers for Disease Control and Prevention Director Robert Redfield said Monday that the Ebola outbreak in conflict-ridden Congo has become so serious that international public health experts need to consider the possibility that it cannot be brought under control and instead will become entrenched.

    If that happened, it would be the first time since the deadly viral disease was first identified in 1976 that an Ebola outbreak led to the persistent presence of the disease. In all previous outbreaks, most of which took place in remote areas, the disease was contained before it spread widely. The current outbreak is entering its fourth month, with nearly 300 cases, including 186 deaths.

    If Ebola becomes endemic in substantial areas of North Kivu province, in northeastern Congo, “this will mean that we’ve lost the ability to trace contacts, stop transmission chains and contain the outbreak,” said Tom Inglesby, director of the Johns Hopkins Center for Health Security, which hosted the briefing on Capitol Hill that featured the Ebola discussion with Redfield.

    In that scenario, there would be a sustained and unpredictable spread of the deadly virus, with major implications for travel and trade, he said, noting that there are 6 million people in North Kivu. By comparison, the entire population of Liberia, one of the hardest-hit countries during the West Africa Ebola epidemic of 2014-2016, is about 4.8 million.

    The outbreak is taking place in a part of Congo that is an active war zone. Dozens of armed militias operate in the area, attacking government outposts and civilians, complicating the work of Ebola response teams and putting their security at risk. Violence has escalated in recent weeks, severely hampering the response. The daily rate of new Ebola cases more than doubled in early October. In addition, there is community resistance and deep mistrust of the government.

    Some sick people have refused to go to treatment centers, health-care workers are still being infected, and some people are dying of Ebola or spreading the virus to new areas. An estimated 60 to 80 percent of new confirmed cases have no known epidemiological link to prior cases, making it very difficult for responders to track cases and stop transmission. In late August, the United States withdrew some of the CDC’s most seasoned Ebola experts who had been stationed in Beni, the province’s urban epicenter, because of security risks.

[Nemo]

Its out there.  And getting bigger.  Just beginning below.  Go read the rest.  Boy Scout!  Be Prepared!!

Nemo


https://www.express.co.uk/news/world/1044207/ebola-outbreak-congo-2018-ebola-symptoms-vaccine-who-latest

Ebola outbreak Congo: ‘WORST in Congo’s history’ 319 cases - 198 dead as disease SPREADS
THE current Ebola outbreak in the Democratic Republic of Congo is the most severe in the country's history with 319 confirmed and probable cases and at least 198 dead.
By Katie Mansfield
PUBLISHED: 13:46, Mon, Nov 12, 2018 | UPDATED: 14:24, Mon, Nov 12, 2018

The DRC’s health ministry said the hemorrhagic fever is believed to have killed 198 people in North Kivu and Ituri provinces, where attacks by armed groups and community resistance to health officials have complicated the response. The outbreak, the second this year, began in North Kivu before spreading east to Ituri. Oly Ilunga Kalenga, the DRC’s minister of public health, said efforts to contain the deadly outbreak have been thwarted by violence against health officials and civilians as militant groups battle for control in the affected region.

The minister said two health workers were killed in one attack. Last month 11 civilians and a soldier were killed in the city of Beni - the centre of the outbreak.

Mr Kalenga said: "No other epidemic in the world has been as complex as the one we are currently experiencing.”

The United States Agency for International Development (USAID) said there is a worry the outbreak is in an active conflict zone in North Kivu, making it hard for health workers to track down and isolate cases.

A USAID official, speaking on condition of anonymity, told Reuters: "We are absolutely concerned about the ongoing outbreak in the Democratic Republic of Congo.


.   .   .

[patriotman]

The second-largest Ebola outbreak in history has spread to a major city in eastern Congo, as health experts worry whether the stock of an experimental vaccine will stand up to the demands of an epidemic with no end in sight.

Butembo, with more than 1 million residents, is now reporting cases of the deadly hemorrhagic fever. That complicates Ebola containment work already challenged by rebel attacks elsewhere that have made tracking the virus almost impossible in some isolated villages.

“We are very concerned by the epidemiological situation in the Butembo area,” said John Johnson, project coordinator with Medecins Sans Frontieres in the city. New cases are increasing quickly in the eastern suburbs and outlying, isolated districts, the medical charity said.

The outbreak declared on Aug. 1 is now second only to the devastating West Africa outbreak that killed more than 11,300 people a few years ago. There are currently 471 Ebola cases, of which 423 are confirmed, including 225 confirmed deaths, Congo’s health ministry said late Thursday.

Without the teams that have vaccinated more than 41,000 people so far, this outbreak could have already seen more than 10,000 Ebola cases, the health ministry said .

This is by far the largest deployment of the promising but still experimental Ebola vaccine, which is owned by Merck. The company keeps a stockpile of 300,000 doses, and preparing them takes months.

“We are extremely concerned about the size of the vaccine stockpile,” WHO’s emergencies director, Dr. Peter Salama, told the STAT media outlet in an interview this week, saying 300,000 doses is not sufficient as urban Ebola outbreaks become more common.

Health workers, contacts of Ebola victims and their contacts have received the vaccine in a “ring vaccination” approach, but in some cases all residents of hard-to-reach communities have been offered it. The prospect of a mass vaccination in a major city like Butembo has raised concerns. Salama called the approach “extremely impractical.”

A WHO spokesman said shipments of doses arrive almost every week to ensure a sufficient supply for the ring vaccination. “No interruptions of vaccine supply have occurred to date,” Tarik Jasarevic said in an email to The Associated Press. “Merck is actively working to ensure sufficient number of doses continue to be available to meet the potential demand.”

This Ebola outbreak is like no other, with deadly attacks by rebel groups forcing containment work to pause for days at a time. Some wary locals have resisted vaccinations or safe burials of Ebola victims as health workers battle misinformation in a region that has never encountered the virus before.

A “fringe population” has regularly destroyed medical equipment and attacked workers, Health Minister Dr. Oly Ilunga Kalenga told reporters on Wednesday.

The Ebola virus is spread via bodily fluids of those infected, including the dead.

The outbreak “remains serious and unpredictable,” the World Health Organization said in an assessment released Wednesday. Nine health zones have reported new cases in the last week, and some have been unrelated to known victims, meaning that gaps in tracking remain in a region with a dense, highly mobile population.

Thousands of people have been organized by Red Cross societies and others to go house-to-house dispelling rumors and checking on possible contacts of victims.

Dr. Fatoumata Nafo-Traore, Africa regional director for the International Federation of Red Cross and Red Crescent Societies, joined one awareness campaign in the outbreak’s epicenter, Beni, this week.

The head of one family thanked her for the face-to-face contact, saying he didn’t even have a radio and didn’t understand what was happening. “Ignorance is the enemy,” another resident said.

Given the years of conflict in eastern Congo, it’s essential that households trust why the health workers are there, Nafo-Traore told the AP.

While she called the insecurity “very worrying,” she said that with new tools at hand, including vaccines, “there is great hope.”

https://www.apnews.com/86fd89fa73594ed0aa098c6c5a063300

[patriotman]

On more than a few recent occasions this year,
(Why This Is A Problem,
8/16/2018, 8/24/2018, 8/28/2018,
9/15/2018,
10/6/2018, 10/11/2018, 10/28/2018,
11/17/2018)
I've warned you that things in Kivu Province, DRC, aren't going well with respect to Ebola, and the current outbreak.

They still aren't.

(Note that's only 9 posts out of 300 or so in that time span. This is not "The Ebola Blog", nor ever will be. I'm just better - and righter - on it than ABCCNNBCBS combined, nine days out seven. I concede that's a pretty low bar to get over. For reference, I started paying attention to Ebola in 2014 in the spring, and didn't even blog about it at all here until early August 2014, at which point it was over 1000 cases in W.Africa. Note that right now, we aren't but halfway to that point now. I still beat 99.9999% of the MSM to the punch by about 2 months then. In 2014 terms, we are now where we were in June of 2014. In October 2014, it got to the U.S., and we were off to the races. Think about that timeframe long and hard.)

As you'll note at sites like Peter's BRM or Old NFO's, people familiar with math and common sense (and in Peter's case, Africa itself) are beginning to pick up on things. Before they actually get here, and without me pulling the fire alarm.

Read their posts, and then come back; I'll wait.

- - -

So, let's look at that bastion of accuracy, Wikipedia, and see how they're doing covering it.
Oh, surprise! Not well, with respect to Ebola. Just like Kivu. Color me shocked.

Here is their current graph showing time and cases.
(We'll skip the obligatory caveat in Africa of "If they can count past 20 with their shoes on, if they're not lying to save face", etc. etc.)



Seems straightforward, right?
Unfortunate growth of the Ebola outbreak currently, but slow, steady and increasing.
So, where does the "Lying" part of "Lying with statistics" show up?
Look at the x-axis (for Common Core grads, that's the horizontal line) which measures time.
Not quite 150ish days, from 8/12018 to present, a couple of weeks from Christmas 2018.
Fair enough.
Now look at the y-axis (again, for the Common Core-ons, that'd be the vertical measurement line on the left side). It doesn't show 0-150, like it should if it were an honest graph.
It instead shows you 0-600.

IOW: It's lying to you, to your face, by a factor of 4X.

Here's what is should look like, it if were an honest graph:



Sorry if you can't read it now, but that's because I made the time axis correspond 1:1 to the number-of-people-affected axis, by shrinking the x-axis to 1/4 of the original.
Note how the graph from zero to any point- cases, deaths, whatever - is now far more vertical. In layman's terms, that's a viral outbreak liftoff.
Like a Saturn-V moon rocket.

Here's the same graph, but with the typical r-naught exponential growth of Ebola (of r=2) plotted roughly (inaccuracy due entirely to my freehand crayon-like art skills with Paint) with a bold red line.



Whoopsie. Oh dear! It seems Ebola in Kivu is above that line, substantially.
That means Ebola in Kivu is growing much faster than the unchecked spread would, meaning human activity (stupidity, pre-literacy, unscientific ignorance, the local asswipes burning Ebola Treatment Centers, and hordes of criminal thugs roaming around with AK-47s shooting up medical relief workers, for instance) is causing Ebola to spread there right now more rapidly than simply doing nothing would.

Greeeeeeeeeaaaaaaaaaaaaaaaaaat.

So, how bad is it, really?
Let me help again, with Paint's crayon:



Holy shit, Batman! The r-naught for deaths isn't 2, it's 4!
For total Ebola cases,  it's 6!!
So, Congolese incompetence and international apathy, unchanged since we started telling you about things this year, is spreading the current DRCongo Ebola outbreak at 2-3 times the speed it would progress if people just walked around doing nothing.

Well-played, fucktards.
You're now improving on 2014 by 2-3 orders of magnitude, and we're still only at Stage 10 (out of 34) levels of death and pestilential spread.

2019 is going to get interesting. In a Chinese curse kind of way.

This thing has now hit a large (Butembo: pop. 1M), if isolated, city already.
That's going to pay yuuuuuuge dividends in deaths, momentarily.

And if it gets to Nairobi (pop. 3M)?
One of the largest cities on the continent Nairobi, international air hub Nairobi?
And it jumps the continent?

Start stocking canned goods, water, ammunition, and concertina wire. Again.
Not necessarily in that order.
(And like you should be already, for a gazillion other contingencies.)

Es kommt.
Nochmal.

Merry Christmas.

https://raconteurreport.blogspot.com/2018/12/ebola-2018-update-lying-with-statistics.html

[patriotman]

In the aftermath of yesterday's Ebola update, the following:

    Q. I have a question about the contagiousness of this once it finds a new population group. Do the natives of central Africa have any advantages of having a higher immunity to Ebola?

No. Neither do we. In a U.S. ICU, with normally anal-retentive nurses (second only to those in OR) following the (idiotically flawed) CDC protocols, the first U.S patient infected exactly 2 nurses, i.e. the same r-naught one would expect with no precautions, with Ebola in the wild. Based on all current data, both you and they have the same immunity to Ebola as you do to nerve gas and bullets, i.e. none.

    Q. Does living with the amount of germs the typical African does daily give them an advantage over western populations? I would hope that western populations with better hygiene practices and avoiding the funeral body washing will be an advantage. However is there any studies that suggest western populations may be less immune or more susceptible to contracting contagious diseases from a lack of exposure to the environment that Africa has?

Based on morbidity and mortality figures from the African continent, they are worse off than Western populations, mainly because they're debilitated and malnourished from dealing with living with a higher amount of germs daily. "Cleanliness is next to godliness" is the best medicine ever practiced, even by Poor Richard's Almanac.
Hoping for magical immunity based on geography is a forlorn expectation, counter-factual to all available evidence.

    Q. My biggest concern is that there is an unknown reservoir species in Africa that keeps Ebola alive and available for reinfection.

Mine too. GMTA.

    Q. If it gets here, will it establish itself in a similar species, and Ebola becomes endemic in the US?

Overwhelmingly likely that's also a "yes".

    Q. Or Indonesia, Vietnam, China, India?

Also "yes".

    Q. The gift that keeps on giving.

 Precisely.

    Q. Would you stick around if you were offered the vaccine?

Yes. Long enough to get the vaccine.
Currently, of those who have received the experimental vaccine on an emergency basis, there have been zero Ebola infections, and no serious side effects noted.
Once I had gotten it, I would still GTFO of Dodge, and then hunker down somewhere behind concertina wire with clear fields of fire.

    Q. What are the chances that vaccinated people could inadvertently infect a loved one by accidentally bringing the virus home through poor infectious control procedures?


Exactly the same as unvaccinated people doing that. If Ebola comes in, GTFO.
Period. If you can get vaccinated first, do that. Then GTFO.

    Q. Is it even possible to ramp up vaccine production to one hundred million or a billion doses? We know Ebola can produce enough virus. 

No effing idea. That's a question for the bean counters at Merck, Glaxo-Smith-Klein, etc. It's mainly a question of time, resource allocation, and facilities available. Making Ebola vaccine probably means they're not making tetanus, measles, and flu shots, for example, which killed more people in the 20th century than Ebola has in all outbreaks combined. In any event, it's a months-long process, and depending on when you start, you may be too late to succeed, because you won't have enough until six months after everyone in the affected area is dead. Complicating things is that so far, the vaccine is still experimental, and only being used on humans in the affected hot zone(s), because so far, there's been no full clinical trials.

    I hope President Trump takes this seriously. We may get past this outbreak, but what about the one in 2021, and 2024, and...

 That was the exact question in 2014-15 too. that outbreak stopped for no apparent reason, since exactly none of the infection control criteria laid out by WHO/CDC/MSF to contain it were ever met, in any of the affected countries. IIRC, the entire country of Sierra Leone was effectively written off in November or December of 2014.

{Just a personal hunch, but as it had killed some 3-4X more people in reality than what was credited in "official" reports (the biggest open secret of the entire outbreak), I think that the high-risk areas were finally depopulated of all available stupid people.}
 
And just a reminder, but the "survivors", besides suffering Post-Ebola virus syndrome, are apparently infected for life. Every subsequent screening finds them all, male and female, with reservoirs of live EVD in their bodies, to the present date.
 

    Q. I'm not following this biology math. If ebola was as contagious as you say, then the last time it was in the US with the sick nurse going to her wedding etc. then it should have taken off. That set of events was an experiment from which contagiousness in the US environment can be estimated. How does that estimate turn out?

What sick nurse, going to what wedding??
Amber Vinson, not contagious at the time, tried on her wedding dress at a shop in Ohio. Being scrupulous, she noted an increase in her temperature while on that trip, and on her return to Dallas, checked in to hospital, where she was diagnosed with Ebola. (The dress shop, OTOH, a 20-year going business concern, closed permanently and went bankrupt as a direct result of just that one contact. Multiply that times a few hundred to a few thousand businesses, and tell me how you see that contagion experiment going here, anywhere.)

Both infected nurses (who had done everything they were told as far as PPE) were isolated nearly immediately after first showing signs of elevated body temperature, and were not wandering the streets for two weeks while fully contagious and coughing out virus. Unlike just about nearly every infected person in Africa.

In very short order, they were both moved to full BL-IV isolation, because clearly the CDC protocols were fatally flawed (as the infection of two nurses proved rather devastatingly in exactly 21 days), and no one else at THP wanted to play any more.
The entire ER and ICU staff there threatened to quit if the hospital didn't close.
Given that as Ebola Central, THP had a patient census now in the single digits, they shut their doors for several months, and barely avoided bankruptcy.

And at the height of the outbreak, we had exactly one open BL-IV bed left in all of North America.

So you were exactly two patients from Dallas becoming Monrovia, Liberia, at the height of the outbreak.

Followed by the entire country rapidly becoming West Africa.

Ebola, with no precautions, in the wild, doubles every 21 days, on average.
Ebola in the US, with full infectious disease precautions and hazmat gear, doubled in 21 days.
Then we stopped f**king around, and put all infectees into Level IV hazmat isolation.

That, and the fact that Duncan was the only contagious person to slip out of W. Africa and into the US, is the only reason the disease didn't take hold here and go all Black Death on us.
Pure, dumb luck.

Getting a grasp on how contagious it is now?

    Q. So how many cases in the US before you would go into Lockdown mode?

One.
Next question.

And by "Lockdown" *I* mean:
No flights into or out of the affected country(ies) for the duration of the outbreak plus 40 days, except military mercy flights. No entry of individuals from those countries directly nor indirectly, except after entering full 40-day absolute quarantine seclusion prior to being permitted to proceed. That incudes all healthcare and medical staff, without exception, even if totally asymptomatic on arrival.
No "home seclusion" bullshit, no "wandering outside the house at will", but rather being behind armed guards and barbed wire, sitting in a tent or locked room for 40 days, and showing not one single sign of illness for the duration.

On Day 41, they can walk out.
And the traveler pays the full cost of the personnel to monitor them, and 6 weeks' worth of MREs or equivalent.

If they don't like it, they can stay in the Hot Zone country and wait a few months until the outbreak is resolved.

Their choice.

And don't try any civil rights bullshit. Quarantine law is well-established, going back 600 years.
If anybody in the Do-Gooder Brigade doesn't like it, they should stay their ass in Ebola City over there, or stay their ass home here without going to Ebolaville in the first place.

Any country or air carrier not scrupulously implementing the exact same protocol will be barred from entering US airspace, and any persons arriving from them subject to the same quarantine and rules.

Or take a Sidewinder missile up their tailpipe, and uncontrolled descent at the coastal ADIZ. Flaming Jet A/Jet-A1 is a great sterilizer. So is 2000' of seawater over the wreckage.
 
Also from comments: the US Army field manual in pdf form on Physical Security.
 
https://www.wbdg.org/FFC/ARMYCOE/FIELDMAN/fm31930.pdf
 
But if you can fence a yard, you can do this.
 
The FM stuff is for stopping people a bit more motivated to breach that perimeter.
(If it comes to that, The Walking Dead  and World War Z are documentaries, not works of fiction. Ponder that.)
 
Ebola and droplet precautions means you only need 10-20 yards of separation, and no outside contact.
Gowning up to play amongst it is a 30-45 minute procedure both coming and going, and requires 2 people also suited up as monitors for watching you putting the gear on and taking it off without contaminating yourself.
 
Along with a metric fuckton of supplies for that, and the ability to safely burn all contaminated items.
 
You won't have that, so you ain't doing that. If it comes to the worst, don't even try.

https://raconteurreport.blogspot.com/2018/12/questions-i-get-questions.html

[Erick]

In the aftermath of yesterday's Ebola update, the following:

    Q. 1 I have a question about the contagiousness of this once it finds a new population group. Do the natives of central Africa have any advantages of having a higher immunity to Ebola?

No. Neither do we. In a U.S. ICU, with normally anal-retentive nurses (second only to those in OR) following the (idiotically flawed) CDC protocols, the first U.S patient infected exactly 2 nurses, i.e. the same r-naught one would expect with no precautions, with Ebola in the wild. Based on all current data, both you and they have the same immunity to Ebola as you do to nerve gas and bullets, i.e. none.

    Q. 2 Does living with the amount of germs the typical African does daily give them an advantage over western populations? I would hope that western populations with better hygiene practices and avoiding the funeral body washing will be an advantage. However is there any studies that suggest western populations may be less immune or more susceptible to contracting contagious diseases from a lack of exposure to the environment that Africa has?

Based on morbidity and mortality figures from the African continent, they are worse off than Western populations, mainly because they're debilitated and malnourished from dealing with living with a higher amount of germs daily. "Cleanliness is next to godliness" is the best medicine ever practiced, even by Poor Richard's Almanac.
Hoping for magical immunity based on geography is a forlorn expectation, counter-factual to all available evidence.

    Q. 3 My biggest concern is that there is an unknown reservoir species in Africa that keeps Ebola alive and available for reinfection.

Mine too. GMTA.

    Q. 4 If it gets here, will it establish itself in a similar species, and Ebola becomes endemic in the US?

Overwhelmingly likely that's also a "yes".

    Q. 5 Or Indonesia, Vietnam, China, India?

Also "yes".

    Q. 6 The gift that keeps on giving.

 Precisely.

    Q. 7 Would you stick around if you were offered the vaccine?

Yes. Long enough to get the vaccine.
Currently, of those who have received the experimental vaccine on an emergency basis, there have been zero Ebola infections, and no serious side effects noted.
Once I had gotten it, I would still GTFO of Dodge, and then hunker down somewhere behind concertina wire with clear fields of fire.

    Q. 8 What are the chances that vaccinated people could inadvertently infect a loved one by accidentally bringing the virus home through poor infectious control procedures?


Exactly the same as unvaccinated people doing that. If Ebola comes in, GTFO.
Period. If you can get vaccinated first, do that. Then GTFO.

    Q. 9 Is it even possible to ramp up vaccine production to one hundred million or a billion doses? We know Ebola can produce enough virus. 

No effing idea. That's a question for the bean counters at Merck, Glaxo-Smith-Klein, etc. It's mainly a question of time, resource allocation, and facilities available. Making Ebola vaccine probably means they're not making tetanus, measles, and flu shots, for example, which killed more people in the 20th century than Ebola has in all outbreaks combined. In any event, it's a months-long process, and depending on when you start, you may be too late to succeed, because you won't have enough until six months after everyone in the affected area is dead. Complicating things is that so far, the vaccine is still experimental, and only being used on humans in the affected hot zone(s), because so far, there's been no full clinical trials.

    I hope President Trump takes this seriously. We may get past this outbreak, but what about the one in 2021, and 2024, and...

 That was the exact question in 2014-15 too. that outbreak stopped for no apparent reason, since exactly none of the infection control criteria laid out by WHO/CDC/MSF to contain it were ever met, in any of the affected countries. IIRC, the entire country of Sierra Leone was effectively written off in November or December of 2014.

{Just a personal hunch, but as it had killed some 3-4X more people in reality than what was credited in "official" reports (the biggest open secret of the entire outbreak), I think that the high-risk areas were finally depopulated of all available stupid people.}
 
And just a reminder, but the "survivors", besides suffering Post-Ebola virus syndrome, are apparently infected for life. Every subsequent screening finds them all, male and female, with reservoirs of live EVD in their bodies, to the present date.
 

    Q. 10 I'm not following this biology math. If ebola was as contagious as you say, then the last time it was in the US with the sick nurse going to her wedding etc. then it should have taken off. That set of events was an experiment from which contagiousness in the US environment can be estimated. How does that estimate turn out?

What sick nurse, going to what wedding??
Amber Vinson, not contagious at the time, tried on her wedding dress at a shop in Ohio. Being scrupulous, she noted an increase in her temperature while on that trip, and on her return to Dallas, checked in to hospital, where she was diagnosed with Ebola. (The dress shop, OTOH, a 20-year going business concern, closed permanently and went bankrupt as a direct result of just that one contact. Multiply that times a few hundred to a few thousand businesses, and tell me how you see that contagion experiment going here, anywhere.)

Both infected nurses (who had done everything they were told as far as PPE) were isolated nearly immediately after first showing signs of elevated body temperature, and were not wandering the streets for two weeks while fully contagious and coughing out virus. Unlike just about nearly every infected person in Africa.

In very short order, they were both moved to full BL-IV isolation, because clearly the CDC protocols were fatally flawed (as the infection of two nurses proved rather devastatingly in exactly 21 days), and no one else at THP wanted to play any more.
The entire ER and ICU staff there threatened to quit if the hospital didn't close.
Given that as Ebola Central, THP had a patient census now in the single digits, they shut their doors for several months, and barely avoided bankruptcy.

And at the height of the outbreak, we had exactly one open BL-IV bed left in all of North America.

So you were exactly two patients from Dallas becoming Monrovia, Liberia, at the height of the outbreak.

Followed by the entire country rapidly becoming West Africa.

Ebola, with no precautions, in the wild, doubles every 21 days, on average.
Ebola in the US, with full infectious disease precautions and hazmat gear, doubled in 21 days.
Then we stopped f**king around, and put all infectees into Level IV hazmat isolation.

That, and the fact that Duncan was the only contagious person to slip out of W. Africa and into the US, is the only reason the disease didn't take hold here and go all Black Death on us.
Pure, dumb luck.

Getting a grasp on how contagious it is now?

    Q. 11 So how many cases in the US before you would go into Lockdown mode?

One.
Next question.

And by "Lockdown" *I* mean:
No flights into or out of the affected country(ies) for the duration of the outbreak plus 40 days, except military mercy flights. No entry of individuals from those countries directly nor indirectly, except after entering full 40-day absolute quarantine seclusion prior to being permitted to proceed. That incudes all healthcare and medical staff, without exception, even if totally asymptomatic on arrival.
No "home seclusion" bullshit, no "wandering outside the house at will", but rather being behind armed guards and barbed wire, sitting in a tent or locked room for 40 days, and showing not one single sign of illness for the duration.

On Day 41, they can walk out.
And the traveler pays the full cost of the personnel to monitor them, and 6 weeks' worth of MREs or equivalent.

If they don't like it, they can stay in the Hot Zone country and wait a few months until the outbreak is resolved.

Their choice.

And don't try any civil rights bullshit. Quarantine law is well-established, going back 600 years.
If anybody in the Do-Gooder Brigade doesn't like it, they should stay their ass in Ebola City over there, or stay their ass home here without going to Ebolaville in the first place.

Any country or air carrier not scrupulously implementing the exact same protocol will be barred from entering US airspace, and any persons arriving from them subject to the same quarantine and rules.

Or take a Sidewinder missile up their tailpipe, and uncontrolled descent at the coastal ADIZ. Flaming Jet A/Jet-A1 is a great sterilizer. So is 2000' of seawater over the wreckage.
 
Also from comments: the US Army field manual in pdf form on Physical Security.
 
https://www.wbdg.org/FFC/ARMYCOE/FIELDMAN/fm31930.pdf
 
But if you can fence a yard, you can do this.
 
The FM stuff is for stopping people a bit more motivated to breach that perimeter.
(If it comes to that, The Walking Dead  and World War Z are documentaries, not works of fiction. Ponder that.)
 
Ebola and droplet precautions means you only need 10-20 yards of separation, and no outside contact.
Gowning up to play amongst it is a 30-45 minute procedure both coming and going, and requires 2 people also suited up as monitors for watching you putting the gear on and taking it off without contaminating yourself.
 
Along with a metric fuckton of supplies for that, and the ability to safely burn all contaminated items.
 
You won't have that, so you ain't doing that. If it comes to the worst, don't even try.

https://raconteurreport.blogspot.com/2018/12/questions-i-get-questions.html

Couple of additions I'd like to make to the 2nd Question;

Q2 The Expert who was answering the question missed something significant
Namely that despite our populations being cleaner there is an interesting difference.
In the previous major outbreak the one from 2014 for which we have very good data, and which is by many ( including myself) considered a mild strain.. one thing jumped out:

There were no survivors over 45 years old. None, zero, zilch.

So African populations do have a significant advantage over us in that they are much younger.
They also have a disadvantage in that our population at large and especially preppers of course are much more aware of cleaning and isolation procedures and have both the ability and the will to follow them.

Q 4: There is absolutely no indication for this. Its mere speculation for a reservoir to establish u need a reservoir population thats largely immune but not so immune not to allow viral replication in.. a careful balance and a ready availability of such a species can not be taken for granted.

Q8: The answer given is rubbish.. In order to be infectious you need to be shedding virus. In order to be shedding virus you need to be ill at least a little bit.. If vaccination confers protection from illness it will will as  a minimum greatly diminish to a much smaller window any infectiousness.....

Q9 The correct answer for this question is not " no effing idea" its: Vaccine cannot be easily produced in the hundreds of millions of doses. Not under current standards of FDA Quality Control.

Q10: The Interviewed is not answering the question but engaging in sloganeering and scare mongering.

I dont know who this guy is who got interviewed..and what makes him a worthwhile interviewee.. He mixes up droplets of knowledge + common sense with a ignorance and hyperbole to give this curious mix.

Listen I know we all have our favorite apocalypse and a reset might not be such a bad thing..
But Ebola isnt it folks no matter what the strain.

The true pandemic threats are with the influenza family of viruses. Period.

[Nemo]

😱 We're all just gonna die  😱

So eat, drink and be merry.

Nemo

[patriotman]

😱 We're all just gonna die  😱

So eat, drink and be merry.

Nemo

Not the worst advice

 

[Kbop]

The modern plague. 

[patriotman]

As multiple commenters have observed, we've brought an M.D. exposed to Ebola in DRC, but asymptomatic and not contagious, back to Nebraska for observation.

Ok, fine, so far.

This is how it's supposed to work for everyone exposed, even TV spokeshole doctors and whiny Mimi Crybabypants "nurses" who think they should have the right to run hither and yon and hopefully not start infecting people when they pop a fever. Or not. Because they're special, and the sun shines out of their anuses, apparently. Contrary to quarantine policy and black-letter health laws going back 700 years.

Sending the guy to quarantine at Nebraska Medical Center is fine too, as it's home of one of the four BL-IV treatment centers with the 11 actual BL-IV beds extant in North America, should that become necessary, and their patient becomes symptomatic.

The gaping flaw in what they're doing is that they plan to observe Doctor Oopsie for two weeks - fourteen days.

But Ebola Virus Disease incubates for between 1 and 25+ days, NOT JUST 14 DAYS(!), and while 99% of cases appear in 25 days or less, 1% of cases don't show up until after 25 days.
(Another very small but non-zero percentage of persons exposed are asymptomatic, but may still carry the disease and be infectious without symptoms. Nobody is talking about that last part, either, because if you pretend it doesn't exist, you don't have to deal with it. Until you do.)

Geniuses in action, right there.

It will be cold comfort to anyone subsequently infected if they stop checking Dr. Oopsie on Day 15, and he doesn't become symptomatic, and thus infectious, until Day 18, or 23. Especially if he celebrates the end of his quarantine at the mall or movie theater, coughing out virus onto random passersby.

If you're going to half-ass a quarantine (and clearly, they ARE doing exactly that in this case), better to not do one at all, and just tell people to kiss their asses goodbye, because - EXACTLY LIKE IN 2014 - TPTB are playing roulette with the entire populace, because for them, that's more convenient.

Sleep tight.
And cross your fingers.

Oh, and that Congo outbreak itself?
 
As we warned, it's accelerating out of control, growing from 503 cases on 11/30 to 692 cases as of 12/21, a week ago. IOW, more new cases in the last 21 days than the total number of cases for the first ten weeks from August to mid-October.
The experimental vaccine is still, AFAIK, 100% effective, but the outbreak has blown through every containment ring like a brushfire in a gasoline-soaked forest.
 
Buckle up. 2019 is looking seriously fugly.
 
And that doctor is just the first case we're watching.
He won't be the last.

UPDATE:
And for those unwilling to follow this closely, bringing him here is not the problem.
Bringing back 12 or more symptomatic patients is the problem - because we don't have that 12th Ebola bed - as is cessation of his/their infection monitoring before the likelihood of infection gets to at least a 99% chance of safety.

And if you bring 100 exposed people back, that statistically guarantees that one of them will be the 1% long period incubation that you'll release into the wild here, and we're off to the races.

A quarantine has traditionally meant 40 days ("You could look it up." - Casey Stengel), and that standard should apply yet again, in this case. Six weeks' surveillance, not two.
Anything less is rolling the dice, and we're all the chips in that wager.

http://raconteurreport.blogspot.com/2018/12/ebola-update.html

Also, from American Partisan: https://www.americanpartisan.org/2018/12/ebola-bad-to-worse/

[Nemo]

Be ready to be in isolation with your house for 30 days and group/neighbors/trustable friends for 120.  There should be mass casualties and relatively limited spread after that.   Provided reasonable precautions taken.  And limited persons in the area it could spread to.

I suspect it would not be difficult to get supplies in your area by after that and we all would spend a lot of time scrubbing our isolation suits after disposing of bodies.

I expect this could easily and quickly become a world wide epidemic.  2nd and 3rd world nations would probably suffer 90% population loss. 

China and Russia may keep it at 40% to 50% by mass elimination of infected towns and small cities along with neighborhood.

Talk about ending global warming.

Nemo   


No joy on link included above--   
Also, from American Partisan: https://www.americanpartisan.org/2018/12/ebola-bad-to-worse/

[patriotman]

Be ready to be in isolation with your house for 30 days and group/neighbors/trustable friends for 120.  There should be mass casualties and relatively limited spread after that.   Provided reasonable precautions taken.  And limited persons in the area it could spread to.

I suspect it would not be difficult to get supplies in your area by after that and we all would spend a lot of time scrubbing our isolation suits after disposing of bodies.

I expect this could easily and quickly become a world wide epidemic.  2nd and 3rd world nations would probably suffer 90% population loss. 

China and Russia may keep it at 40% to 50% by mass elimination of infected towns and small cities along with neighborhood.

Talk about ending global warming.

Nemo   


No joy on link included above--   
Also, from American Partisan: https://www.americanpartisan.org/2018/12/ebola-bad-to-worse/

Yeah, not looking particularly good. I know the MSM is hardly reporting on this to avoid panic, but the outbreak couldn't have happened in a worse place...

[patriotman]

More cheery news

https://www.dailystar.co.uk/news/world-news/751455/ebola-europe-sweden-contamination-emergency-room-enkoping-uppsala

[JohnyMac]

It is time for a pandemic as the world has not lived through one in a long time.

[Nemo]

It starting to get some news.  Let the news spread slow so everyone hears about it, but not in a rush.  Let it get out easy with no public scare.   3 Bs plus 2.

Nemo


https://www.courant.com/nation-world/sns-tns-bc-congola-ebola-20190104-story.html



   

Congo's Ebola outbreak exceeds 600 cases, WHO says
dpa | Jan 04, 2019 | 11:15 AM

VIENNA There are now more than 600 confirmed or probable cases of Ebola in Congo, the World Health Organization (WHO) said on Friday.

The majority of new cases occurred in cities and urban areas in eastern North Kivu province, where an Ebola outbreak was declared in August.

Numerous militia groups are fighting for control over the country's rich natural resources in the province, hampering efforts to combat the epidemic in the impoverished nation.

Mass protests that erupted in recent days over a delay in Congo's presidential elections have also frustrated the work of aid officials.

A hospital was attacked in city of Beni, for example, which resulted in fewer Ebola vaccines being handed out, the WHO said, adding that a further deterioration in security would undermine the fight against the life-threatening hemorrhagic fever.

According to the latest figures, 560 cases of Ebola have been confirmed and 48 other cases are considered likely. This Ebola outbreak is the second-worst ever recorded, the WHO said.



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