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Medicine

WHO Timeline for Ebola Containment Proves Hard To Meet 78

Posted by timothy from the mythical-doctor-month dept.
The Associated Press, as carried by Salon, reports that the World Health Organization's intended timeline for limiting the spread of Ebola in the several West African countries where it has claimed thousands of lives has proved to be too optimistic. According to the article, Two months ago, the World Health Organization launched an ambitious plan to stop the deadly Ebola outbreak in West Africa, aiming to isolate 70 percent of the sick and safely Ebola 70 percent of the victims in the three hardest-hit countries — Guinea, Liberia and Sierra Leone — by December 1. Only Guinea is on track to meet the December 1 goal, according to an update from WHO. In Liberia, only 23 percent of cases are isolated and 26 percent of the needed burial teams are in place. In Sierra Leone, about 40 percent of cases are isolated while 27 percent of burial teams are operational.
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WHO Timeline for Ebola Containment Proves Hard To Meet More

WHO Timeline for Ebola Containment Proves Hard To Meet

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  • Plans made by politicians not working out? (Score:5, Insightful)

    by gweihir ( 88907 ) on Sunday November 30, 2014 @03:10PM (#48492591)

    This outcome has zero surprise value and is the _expected_ outcome. Pretty speeches and reality have this nasty tendency to diverge. This outbreak will be contained when there is a working cure or a working vaccine, not before. Anything else is only possible with a working medical and civil infrastructure, which does not exist in the affected areas and cannot be established in reasonable time.

    • Re: (Score:2)

      by amorsen ( 7485 )

      A lot more could be accomplished by just throwing (not very much) money at the problem. Like Sierra Leone where ambulance drivers are only on half pay due to government budget cuts. It is ridiculous that we (first world countries) cannot find the money to make sure that health care workers in the affected countries are paid reasonable wages.

      • It's a fairly classic collective action problem. We would all be better off if it were to be done; but maybe if I drag my feet you'll flinch and do it first, so I get all the benefits at zero cost. It is fairly unimpressive, though, because it isn't even some charitable exercise, it's totally pragmatic self interest. Augment the wages of some people in an area with fairly low wages and cost of living in order to reduce the odds of a nasty hemorrhagic fever making it to somewhere where I might get it, or hav

        • Re:Plans made by politicians not working out? (Score:4, Insightful)

          by ColdWetDog ( 752185 ) on Sunday November 30, 2014 @04:27PM (#48493019) Homepage

          Slippery slope. Pay the ambulance drivers. Then pay the nurses, docs, staff, pay for the building, pay for water treatment plant, pay for security to keep the water treatment plane from being disassembled. Pretty soon, you've taken over the country.

          I think most Americans and Europeans have little idea how bad the situation is vis-a-vis a basic, functional government. Until you have one, you can't really do much systematically. Should we take over Western Africa? Probably - if we want the situation to improve. But that is a huge commitment in time and money and has a lot of sticky morality issues attached.

          • Should we take over Western Africa? Probably - if we want the situation to improve. But that is a huge commitment in time and money and has a lot of sticky morality issues attached.

            Excuse my hyperbole, but this is a great idea, not just for West Africa, but Canada, Mexico, Central America, South America... and why not? The World, too. Imperialism is not a bad idea for the US... we sort of do it already, but then we abandon the people and natural resources for some reason and just pay for everything. But if we would annex what we want, we would make the place better, safer, healthier, the people better educated, will live longer, be happier... and we can keep the natural resources to f

          • Racist. Imperialist. Black people can't run their own countries, so the Americans have to step in and do it for them. Yeah, that worked out SO well for you in Somalia, yeah?

            • Re: (Score:2)

              by gweihir ( 88907 )

              Actually, African people cannot run their own countries well in most instances. The evidence is more than just compelling and there are no valid excuses for them anymore. Skin-color and race does not play a role. Culture and education does. On the other hand, looking at some tendencies in western countries, the devolution into kleptocracies and totalitarian regimes is well underway, with the US leading the charge downwards.

          • Re: (Score:2)

            by gweihir ( 88907 )

            In addition, there is no power in the world strong enough and rich enough to take over Africa. Even the US falls several orders of magnitude short.
             

      • We can't even find the money to make sure that everyone in our own countries are treated without bankrupting them, what makes you think we'd be able to pay another country's medical bills too?

        • Re: (Score:2)

          by amorsen ( 7485 )

          We can't even find the money to make sure that everyone in our own countries are treated without bankrupting them, what makes you think we'd be able to pay another country's medical bills too?

          a) Of course we can. Practically the entire Western world has universal healthcare, and the one country which does not pays more than average on health care per capita.

          b) We are not talking about actual treatment. Only about finding a few hundred million dollars to keep existing medical personnel paid while governments in the affected countries are in deep trouble.

          If Ebola gets to Western countries, a few hundred million dollars are gone in the blink of an eye.

      • I'm of the opinion we should be getting our own people healthcare before going out to save the world. Saving the world is great, but on a limited budget priorities are needed.

      • Re: (Score:1)

        by Anonymous Coward

        Duncan got his infection by driving a woman with Ebola to the hospital and your proposed solution is to hire more cab drivers?

        Here's a question: How many people would Thomas Duncan have infected if his family had been evacuated to a tent in New Jersey, and they razed the building after handing Duncan a lethal dose of Benzos and a glass of Vodka?

        Follow up question: How much money would that have cost the state of Texas?

        When treating Ebola infects 3x people, and there is a 50% mortality rate: the humane/cost

      • There are a lot of people who have realized that simply throwing money at problems in Africa doesn't help. Lately, a lot of them are African. People are recognizing that given one or the other, the "teach a man to fish" adage is the only effective way to help. The problem is that normally the money doesn't go where it will help the most. And from what I've seen NGOs don't always know the best places. If they did, there probably wouldn't be any more poverty there.

        • Re: (Score:2)

          by amorsen ( 7485 )

          I completely agree. In the normal situation. This is not a normal situation.

          This is a situation where health is put a risk on a global scale because we cannot be arsed to pay a few thousand ambulance drivers, and so infected people are left at home to infect their community. It is complete stupidity.

          Those ambulance drivers are risking their lives every day. The least we can do is pay them their normal wages.

          • Re: (Score:2)

            by gweihir ( 88907 )

            You do not understand. That is not possible. No, really not. The infrastructure and mind-set for that to be possible are not in place.

            • Re: (Score:2)

              by amorsen ( 7485 )

              It was possible in July. Why is it not possible in December?

              • Re: (Score:2)

                by gweihir ( 88907 )

                It was not possible in July either. Some people might have been kidding themselves about the effect their efforts had, but that is all there was.

                • Re: (Score:2)

                  by amorsen ( 7485 )

                  The ambulance drivers were being paid then. They are not being paid now. Fixing that is trivial.

                  • Re: (Score:2)

                    by gweihir ( 88907 )

                    No. You have no clue how these borderline-failed states work.

                    • Re: (Score:2)

                      by amorsen ( 7485 )

                      You have no clue how these borderline-failed states work.

                      Wow, your eloquent debating skills really showed me there. I shall immediately change my opinion.

      • Re: (Score:2)

        by gweihir ( 88907 )

        You cannot "throw money at the problem" either. Remember what happened when that was tried with whole plane-loads of dollars in Irak? The money just vanished and never reached those it was intended for. That is one of the primary defects of the infrastructure there: No way to distribute money so that it actually reaches those it is intended for.

    • I'm not inclined to optimism; but it is worth noting that all previous outbreaks were successfully contained without either a vaccine or a cure, in no small part because of how little infrastructure their was. Just a village or two in the sticks dropping off the map and not reporting back.

      The trouble this time is that the outbreak has landed squarely in the worst-of-both-worlds intermediate position, where the victims and potential victims are far too thickly settled to be more or less automatically isol

      • Re: (Score:2)

        by gweihir ( 88907 )

        Indeed. The outbreaks before burned themselves out. This one will not.

      • in no small part because of how little infrastructure their was. Just a village or two in the sticks dropping off the map and not reporting back.

        It might help if you did a little research. The first recorded outbreak was, surprisingly, communicated to the Belgian microbiology labs who dispatched a team to Yambuko. Coincident was an outbreak in Sudan which actually started earlier. The cotton factory that was the centre of infection there didn't exist in a vacuum, but it processed locally-grown cotton and ex

    • This outbreak will be contained when there is a working cure or a working vaccine, not before.

      The last time that I checked the laws of the universe, there was no guarantee that any particular disease had a cure. Or, for that matter a vaccine.

      But that (probably undue) pessimism aside, if an acceptable design for a vaccine becomes available on the (optimistic) time scale discussed a month or so ago, then it'll only become widely deliverable late in 2015. By that point, deaths will have reached the point th

  • The Ebola cases/deaths are vastly higher (2x-3x higher min) than what WHO is reporting. This is easily verifiable from WHO and others.

    When the disease is multiplying week after week, the reality and false reported numbers will diverge more and more. At what point in time will the "false fact" numbers repeated worldwide, and the cases/deaths reality on the ground be reconciled in the media?

    CAPTCHA: culpable!

    • Re: (Score:3)

      by Bengie ( 1121981 )
      When Ebola made land-fall in the USA, we had something like 9 cases reported. Of those cases, 1 death, 1 still sick, and the rest recovered. Small sample set, but that seemed a lot better than the large death percentages happening in Africa. From what I understand, most deaths are cause by dehydration. A simple IV drip could save a lot of lives.

    • > The Ebola cases/deaths are vastly higher (2x-3x higher min) than what WHO is reporting. This is easily verifiable from WHO and others.

      WHO estimates that there are twice as cases as WHO estimates there are? Something doesn't smell right in your post.

      However, if in fact WHO is reporting numbers 2-3 times higher than WHO is reporting, someone should report WHO. Who is reporting WHO to who?

      • Read for yourself, it's true (Score:1)

        by Anonymous Coward

        http://www.independent.co.uk/news/world/africa/ebola-outbreak-number-of-deaths-are-massively-underestimated-warns-who-9686662.html

        http://www.reuters.com/article/2014/08/15/us-health-ebola-idUSKBN0GD1US20140815

        http://www.huffingtonpost.com/2014/10/03/ebola-west-africa-underestimated_n_5926634.html

        The WHO itself talks about this problem in those articles, and on it's own website:

        Why the Ebola outbreak has been underestimated
        http://www.who.int/mediacentre/news/ebola/22-august-2014/en/

        The reporting situation ha

        • you can put the phrase "in Liberia and Sierra Leone" after each of your posts. In other words, no reason for alarm seen for cases outside those countries.

      • Re: (Score:2, Informative)

        by Anonymous Coward

        You are confusing the terms 'report' and 'estimate' and using them interchangeably. WHO is *reporting* numbers fed to them by local governments and labs. They are *estimating* that the *reported* numbers are too low based on a number of factors. It's science.

    • This weekend I think I heard that they ar rreporting 7000 died so far. I think they owe it to everyone to tell us what they really think the number is. Otherwise what are we paying them so much for. We could hire monkeys if all we wanted was to report numbers from countries in "image damage control."

  • The 'big drop' was in good part because of changes in the 'definitions'.
    .
    Here is someone with some details:
            http://youtu.be/XIDmK5qwarU [youtu.be]
    (Worth the time if you care about future .. and things.)

  • How do you "safely Ebola" somebody? It sounds pretty dangerous to me.
  • They got it under control in one country, which is quite good I think, considering the situation in these countries, and the high number of unregistered cases.
    The WHO plan has cost just 71 million, while Obama's Ebola plan costs 6.2 billion. Maybe that will work out.
    • Actually it is also more or less declining in Liberia, making it two countries.
    • And I don't get the "expert's" comment int he article:

      “You want to isolate 100 percent of patients with Ebola and have 100 percent safe burials,” said Sebastian Funk, director of the Centre for the Mathematical Modelling of Infectious Diseases at the London School of Hygiene and Tropical Medicine. “Getting to 70 percent doesn’t really mean a lot.”

      70 percent is enough to bring the epidemy to a decline. 100 percent is not achievable with reasonable effort, and can only come from a theorist.

  • So how you safely Ebola people?

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