[CFrance]

Originally Posted by graciegirl

OCTOBER 16,2014
Ebola Virus Disease in West Africa — The First 9 Months of the Epidemic and Forward Projections

WHO Ebola Response Team
N Engl J Med 2014; 371:1481-1495October 16, 2014DOI: 10.1056/NEJMoa1411100
Comments open through October 22, 2014
Share:








AbstractArticleReferencesCiting Articles (2) Comments (14)
Background

On March 23, 2014, the World Health Organization (WHO) was notified of an outbreak of Ebola virus disease (EVD) in Guinea. On August 8, the WHO declared the epidemic to be a “public health emergency of international concern.”
Full Text of Background...


Methods

By September 14, 2014, a total of 4507 probable and confirmed cases, including 2296 deaths from EVD (Zaire species) had been reported from five countries in West Africa — Guinea, Liberia, Nigeria, Senegal, and Sierra Leone. We analyzed a detailed subset of data on 3343 confirmed and 667 probable Ebola cases collected in Guinea, Liberia, Nigeria, and Sierra Leone as of September 14.
Full Text of Methods...


Results

The majority of patients are 15 to 44 years of age (49.9% male), and we estimate that the case fatality rate is 70.8% (95% confidence interval [CI], 69 to 73) among persons with known clinical outcome of infection. The course of infection, including signs and symptoms, incubation period (11.4 days), and serial interval (15.3 days), is similar to that reported in previous outbreaks of EVD. On the basis of the initial periods of exponential growth, the estimated basic reproduction numbers (R0 ) are 1.71 (95% CI, 1.44 to 2.01) for Guinea, 1.83 (95% CI, 1.72 to 1.94) for Liberia, and 2.02 (95% CI, 1.79 to 2.26) for Sierra Leone. The estimated current reproduction numbers (R) are 1.81 (95% CI, 1.60 to 2.03) for Guinea, 1.51 (95% CI, 1.41 to 1.60) for Liberia, and 1.38 (95% CI, 1.27 to 1.51) for Sierra Leone; the corresponding doubling times are 15.7 days (95% CI, 12.9 to 20.3) for Guinea, 23.6 days (95% CI, 20.2 to 28.2) for Liberia, and 30.2 days (95% CI, 23.6 to 42.3) for Sierra Leone. Assuming no change in the control measures for this epidemic, by November 2, 2014, the cumulative reported numbers of confirmed and probable cases are predicted to be 5740 in Guinea, 9890 in Liberia, and 5000 in Sierra Leone, exceeding 20,000 in total.
Full Text of Results...


Conclusions

These data indicate that without drastic improvements in control measures, the numbers of cases of and deaths from EVD are expected to continue increasing from hundreds to thousands per week in the coming months.
Full Text of Discussion...


Read the Full Article...

Gracie, what do you think they mean by "control methods"? My take was they are talking about control at the source--enough beds, proper quarantine methods, and a possible vaccine.

I still don't believe we all need to close our doors and crawl under our beds. We need to do everything we can to help stop this at the source.

[graciegirl]

Originally Posted by CFrance

Gracie, what do you think they mean by "control methods"? My take was they are talking about control at the source--enough beds, proper quarantine methods, and a possible vaccine.

I still don't believe we all need to close our doors and crawl under our beds. We need to do everything we can to help stop this at the source.

C. It is the virus I fear, and those handling the problem who don't understand fully any vermin they can't swat with a fly swatter.

I want medical people to handle this medical problem and use the others for the grunt work like closing doors, what doors to close, and how long the doors should be closed.

[graciegirl]

Originally Posted by graciegirl

OCTOBER 16,2014
Ebola Virus Disease in West Africa — The First 9 Months of the Epidemic and Forward Projections

WHO Ebola Response Team
N Engl J Med 2014; 371:1481-1495October 16, 2014DOI: 10.1056/NEJMoa1411100
Comments open through October 22, 2014
Share:











AbstractArticleReferencesCiting Articles (2) Comments (14)
Background

On March 23, 2014, the World Health Organization (WHO) was notified of an outbreak of Ebola virus disease (EVD) in Guinea. On August 8, the WHO declared the epidemic to be a “public health emergency of international concern.”
Full Text of Background...


Methods

By September 14, 2014, a total of 4507 probable and confirmed cases, including 2296 deaths from EVD (Zaire species) had been reported from five countries in West Africa — Guinea, Liberia, Nigeria, Senegal, and Sierra Leone. We analyzed a detailed subset of data on 3343 confirmed and 667 probable Ebola cases collected in Guinea, Liberia, Nigeria, and Sierra Leone as of September 14.
Full Text of Methods...


Results

The majority of patients are 15 to 44 years of age (49.9% male), and we estimate that the case fatality rate is 70.8% (95% confidence interval [CI], 69 to 73) among persons with known clinical outcome of infection. The course of infection, including signs and symptoms, incubation period (11.4 days), and serial interval (15.3 days), is similar to that reported in previous outbreaks of EVD. On the basis of the initial periods of exponential growth, the estimated basic reproduction numbers (R0 ) are 1.71 (95% CI, 1.44 to 2.01) for Guinea, 1.83 (95% CI, 1.72 to 1.94) for Liberia, and 2.02 (95% CI, 1.79 to 2.26) for Sierra Leone. The estimated current reproduction numbers (R) are 1.81 (95% CI, 1.60 to 2.03) for Guinea, 1.51 (95% CI, 1.41 to 1.60) for Liberia, and 1.38 (95% CI, 1.27 to 1.51) for Sierra Leone; the corresponding doubling times are 15.7 days (95% CI, 12.9 to 20.3) for Guinea, 23.6 days (95% CI, 20.2 to 28.2) for Liberia, and 30.2 days (95% CI, 23.6 to 42.3) for Sierra Leone. Assuming no change in the control measures for this epidemic, by November 2, 2014, the cumulative reported numbers of confirmed and probable cases are predicted to be 5740 in Guinea, 9890 in Liberia, and 5000 in Sierra Leone, exceeding 20,000 in total.
Full Text of Results...


Conclusions

These data indicate that without drastic improvements in control measures, the numbers of cases of and deaths from EVD are expected to continue increasing from hundreds to thousands per week in the coming months.
Full Text of Discussion...


Read the Full Article...

Bumping my own post for those who continue to minimalize the risk.

[TexaninVA]

Originally Posted by CFrance

Yes. Why would the gvt. do one more thing that looks suspicious when they are so on the hot seat right now. Why would the current administration? I am looking for the proof of your statement. I get the feeling from your posts that you are very suspicious of any kind of government control. You accuse others of not knowing what they're talking about, when in fact they do.

I have to say … when you post “Why would the gvt. do one more thing that looks suspicious when they are so on the hot seat right now. Why would the current administration?” that my eyebrows involuntarily raised up as in … did she really say that???

Regarding my reasoning, I invite you to reread earlier post regarding Mr. Klain’s appointment as Ebola Caar, and which I’ve reposted here for ease of reference.

“It occurred to me … if I was a senior official, and I had a problem, what type of person would I appoint to solve it? Well, obviously it would depend on the nature of the problem I had, wouldn’t it?

For example, if I had a military problem, it would make sense to appoint a military leader to solve it.

If I had a business problem, I would find an expert business leader to solve it.

Not surprisingly, if I had a medical problem I would appoint a doctor or medical administrator to get rid of the problem.

But, on the other hand, if I appointed a political operative, what does that say about how I view the nature of the problem I have to solve?”


Thus, if one simply refuses to acknowledge the obvious, to wit that Mr. Klain’s appointment is political intended to solve a political problem, and notwithstanding the circumstances of his background (ie bare knuckles politics), I can only conclude the refusal is based on grounds of (secular) faith, not reason.

Actually, you asked in one of your earlier posts why right of center people lack “faith” in the government’s ability etc. First of all, I would say faith is best reserved for one’s higher power, assuming one has one. But, to your point, I think the question is better asked as why people lack “trust.” Well, that’s pretty easy to answer. When the senior leader makes an obvious political appointment in the most cynical of ways, especially during a potential life/death matter such as Ebola, and where people are concerned for their safety, can you not see where trust is further shattered? The cynicism and crass calculations that led to such an appointment are glaring IMHO. I can recount other examples of shattering trust (ignoring immigration laws, and in effect allowing a terror army to arise after we had won the war in Iraq etc … but that would get us off thread so I’ll defer)

When people left of center then try to rationalize Klain’s appointment, or defend the indefensible with “hey, he’s a really good coordinator” or “he’s just the best at cutting thru red tape” and at the same time ignore the dysfunctional reporting structure (Klain reports to two staff officers, not even directly to POTUS), and overlook the lack of budgetary clout etc … yes, I repeat --- people saying that do not understand how DC really works. I will grant they may be unknowingly naïve because they’ve never worked there or, more likely, because their “faith” remains strong. It’s not an accusation, it’s simply a statement that reflects the reality of the situation.

The DC “czar strategy” is designed to make the credulous and lightly informed across the country feel better, “hey, he’s appointed a czar…problem solved!” It’s further designed to take the heat off senior appointed officials who actually have line management responsibility while they scramble to actually solve the problem. However, in this instance, it is also being done with an eye on the calendar for early November. If you deny that, there’s not much else that can be said. As I stated in an earlier post, this technique seems to fool the gullible pretty much every time it’s tried, and not just with this administration I might add.


Regarding one of you earlier posts, I asked you to explain why you think a travel ban is “simplistic” (ie your term) but you have not yet responded. I would really like to hear a brief summary of your reasoning which led you to that conclusion, and specifically to the term “simplistic.” This implies that you have a much more enlightened solution. Please share it.

[Challenger]

If the Surgeon General of the United States were a trained medical professional (doctor, nurse, etc) and a recognized expert in public health issues, There would be no need for a CZAR. Should we not have such a qualified person in office?

Can anyone name a Surgeon General who has served in the last 8-10 years?
I remember Koop but no others. He directed a major anti-smoking effort that was apparently quite efffective.

[CFrance]

Originally Posted by TexaninVA

I have to say … when you post “Why would the gvt. do one more thing that looks suspicious when they are so on the hot seat right now. Why would the current administration?” that my eyebrows involuntarily raised up as in … did she really say that???

Regarding my reasoning, I invite you to reread earlier post regarding Mr. Klain’s appointment as Ebola Caar, and which I’ve reposted here for ease of reference.

“It occurred to me … if I was a senior official, and I had a problem, what type of person would I appoint to solve it? Well, obviously it would depend on the nature of the problem I had, wouldn’t it?

For example, if I had a military problem, it would make sense to appoint a military leader to solve it.

If I had a business problem, I would find an expert business leader to solve it.

Not surprisingly, if I had a medical problem I would appoint a doctor or medical administrator to get rid of the problem.

But, on the other hand, if I appointed a political operative, what does that say about how I view the nature of the problem I have to solve?”


Thus, if one simply refuses to acknowledge the obvious, to wit that Mr. Klain’s appointment is political intended to solve a political problem, and notwithstanding the circumstances of his background (ie bare knuckles politics), I can only conclude the refusal is based on grounds of (secular) faith, not reason.

Actually, you asked in one of your earlier posts why right of center people lack “faith” in the government’s ability etc. First of all, I would say faith is best reserved for one’s higher power, assuming one has one. But, to your point, I think the question is better asked as why people lack “trust.” Well, that’s pretty easy to answer. When the senior leader makes an obvious political appointment in the most cynical of ways, especially during a potential life/death matter such as Ebola, and where people are concerned for their safety, can you not see where trust is further shattered? The cynicism and crass calculations that led to such an appointment are glaring IMHO. I can recount other examples of shattering trust (ignoring immigration laws, and in effect allowing a terror army to arise after we had won the war in Iraq etc … but that would get us off thread so I’ll defer)

When people left of center then try to rationalize Klain’s appointment, or defend the indefensible with “hey, he’s a really good coordinator” or “he’s just the best at cutting thru red tape” and at the same time ignore the dysfunctional reporting structure (Klain reports to two staff officers, not even directly to POTUS), and overlook the lack of budgetary clout etc … yes, I repeat --- people saying that do not understand how DC really works. I will grant they may be unknowingly naïve because they’ve never worked there or, more likely, because their “faith” remains strong. It’s not an accusation, it’s simply a statement that reflects the reality of the situation.

The DC “czar strategy” is designed to make the credulous and lightly informed across the country feel better, “hey, he’s appointed a czar…problem solved!” It’s further designed to take the heat off senior appointed officials who actually have line management responsibility while they scramble to actually solve the problem. However, in this instance, it is also being done with an eye on the calendar for early November. If you deny that, there’s not much else that can be said. As I stated in an earlier post, this technique seems to fool the gullible pretty much every time it’s tried, and not just with this administration I might add.


Regarding one of you earlier posts, I asked you to explain why you think a travel ban is “simplistic” (ie your term) but you have not yet responded. I would really like to hear a brief summary of your reasoning which led you to that conclusion, and specifically to the term “simplistic.” This implies that you have a much more enlightened solution. Please share it.

I have stated my feeling about this. As Madelaine Amee has stated, and I agree with her, the world is flat. Banning flights from those countries is not going to stop ebola from entering the country. People can enter the country in many different ways.

Stemming this epidemic at the source is what is going to stop ebola from entering this country, in my opinion.

You may have military experts who can oversee the broad field in a military operation (but I doubt that one, too) and business leaders who can see the whole picture of an ailing company, etc. etc. But as for a medical person being able to bring several agencies together and force them to communicate in an effective way? I doubt that. That's a communication problem, which has bee admitted, and it needs an expert in the field of communication. No one doctor has broad knowledge over all of this. The different fields need to come together to work on the problem--medical, military, public health, disease control.

[graciegirl]

Originally Posted by CFrance

I have stated my feeling about this. As Madelaine Amee has stated, and I agree with her, the world is flat. Banning flights from those countries is not going to stop ebola from entering the country. People can enter the country in many different ways.

Stemming this epidemic at the source is what is going to stop ebola from entering this country, in my opinion.

You may have military experts who can oversee the broad field in a military operation (but I doubt that one, too) and business leaders who can see the whole picture of an ailing company, etc. etc. But as for a medical person being able to bring several agencies together and force them to communicate in an effective way? I doubt that. That's a communication problem, which has bee admitted, and it needs an expert in the field of communication. No one doctor has broad knowledge over all of this. The different fields need to come together to work on the problem--medical, military, public health, disease control.

It could be much better handled than it is now. Trouble is not over and the experts aren't on the team.

[CFrance]

Originally Posted by CFrance

I have stated my feeling about this. As Madelaine Amee has stated, and I agree with her, the world is flat. Banning flights from those countries is not going to stop ebola from entering the country. People can enter the country in many different ways.

Stemming this epidemic at the source is what is going to stop ebola from entering this country, in my opinion.

You may have military experts who can oversee the broad field in a military operation (but I doubt that one, too) and business leaders who can see the whole picture of an ailing company, etc. etc. But as for a medical person being able to bring several agencies together and force them to communicate in an effective way? I doubt that. That's a communication problem, which has bee admitted, and it needs an expert in the field of communication. No one doctor has broad knowledge over all of this. The different fields need to come together to work on the problem--medical, military, public health, disease control.

And BTW, let's not nitpick words. I have faith in the government just as I have faith in people around me who I love. And I trust the gvt. will get this right.

If I didn't have faith or trust in my government, I personally would live somewhere else. But I would rather live nowhere else but here, despite the few warts we may have.

[TexaninVA]

Originally Posted by CFrance

I have stated my feeling about this. As Madelaine Amee has stated, and I agree with her, the world is flat. Banning flights from those countries is not going to stop ebola from entering the country. People can enter the country in many different ways.

Stemming this epidemic at the source is what is going to stop ebola from entering this country, in my opinion.

You may have military experts who can oversee the broad field in a military operation (but I doubt that one, too) and business leaders who can see the whole picture of an ailing company, etc. etc. But as for a medical person being able to bring several agencies together and force them to communicate in an effective way? I doubt that. That's a communication problem, which has bee admitted, and it needs an expert in the field of communication. No one doctor has broad knowledge over all of this. The different fields need to come together to work on the problem--medical, military, public health, disease control.

No one said banning travel from the affected countries is going to stop Ebola 100%. But, it will obviously *reduce* it. It’s not about one perfect solution … it’s about a basket of common sense solutions that, take together, actually work. That’s why essentially every African country has banned travel. Senegal did it ASAP (I know because my son was there at the time) and so far it seems to have worked.

The argument that we need to stop Ebola at its source is fine, and I agree, but you seem to feel that we can only take one action, not multiple actions which makes no sense. I’m not trying to be insulting, but your argument is illogical.

I also fully agree that multiple fields need to come together to solve the problem … but that’s a given and true of any significant problem which crosses organization boundaries. But that premise by no means then leads to, ergo “…put a political operative in charge.”

Let me ask you, why is Secretary Burwell not “in charge?” She runs Health and Human Services, has 77,000 employees, has a trillion dollar budget and we pay her $200,000 per year. She can cross boundaries, butt heads if needed and get it done. Give her whatever help she needs. Leadership is what’s required, which includes communications skills etc. We do not need nor want politics. If she can’t display the needed leadership, fire her and get a new Secretary HHS. But right now, the Czar solution is not serious and, as I said, is obviously political in nature with an eye to diverting the credulous most especially before the election. This guy didn’t even show up for work until today and missed key meetings over the weekend.

[TexaninVA]

Originally Posted by CFrance

And BTW, let's not nitpick words. I have faith in the government just as I have faith in people around me who I love. And I trust the gvt. will get this right.

If I didn't have faith or trust in my government, I personally would live somewhere else. But I would rather live nowhere else but here, despite the few warts we may have.

It’s not nitpicking in the least … it zeros in on the key issue which is “trust" as in lack thereof. If leadership (in any organization) takes repeated actions which shatter trust, and continue to demonstrate untrustworthiness, you cannot expect faith to follow.

I have faith in the American people and key institutions (ie US military for one) but the current leaders have shown us they are not worthy of trust. I’m sure you love the country as much as I do … we just see things differently. When I see leaders in office (not just talking Federal) it’s precisely because of my love of country that I want to pursue electoral and other legal means to replace them with more qualified people who can regain my trust, and then hopefully my faith.

[sunnyatlast]

"As Madelaine Amee has stated, and I agree with her, the world is flat. Banning flights from those countries is not going to stop ebola from entering the country. People can enter the country in many different ways."

Again, stop the people, not the flights. They cannot come into the U.S. without a visa.

Latin American and Caribbean nations get it--that infecting the nursing, technical and medical staffs of the best hospitals the nation has will reduce the civil order to ruin and chaos!

http://www.miamiherald.com/news/nati...le3073953.html

[janmcn]

Originally Posted by sunnyatlast

Again, stop the people, not the flights. They cannot come into the U.S. without a visa.

Latin American and Caribbean nations get it--that infecting the nursing, technical and medical staffs of the best hospitals the nation has will reduce the civil order to ruin and chaos!

Ebola fears spur travel bans in Latin America, Caribbean | The Miami Herald

"Stop the people, not the flights". Why would the flights continue to operate, if people are not allowed to fly on them? This doesn't make any sense.

The airlines that fly in and out of these three countries would probably like an excuse to stop servicing these routes, in order to protect their own employees and aircraft.

[janmcn]

Ebola Patient Nina Pham's Dog, Bentley, Tests Negative for Virus - NBC News


Bentley, the Cavalier King Charles Spaniel owned by Nina Pham, tested negative for the Ebola virus. He will continue his 21 day quarantine, under the watchful eye of animal services in Dallas.

Excellent news for all concerned.

[cologal]

Originally Posted by Challenger

If the Surgeon General of the United States were a trained medical professional (doctor, nurse, etc) and a recognized expert in public health issues, There would be no need for a CZAR. Should we not have such a qualified person in office?

Can anyone name a Surgeon General who has served in the last 8-10 years?
I remember Koop but no others. He directed a major anti-smoking effort that was apparently quite efffective.

There is no Surgeon General because of the usual gridlock in Washington.

Not being political just stating a fact.

[sunnyatlast]

Originally Posted by janmcn

"Stop the people, not the flights". Why would the flights continue to operate, if people are not allowed to fly on them? This doesn't make any sense.

The airlines that fly in and out of these three countries would probably like an excuse to stop servicing these routes, in order to protect their own employees and aircraft.

It doesn't make any sense? I didn't say stop ALL the people on a flight.

Stop giving visas to the people who are disqualified at the Ebola screening entry points and disease testing results review at the Embassy, and rescind the visas of the 13,000 outstanding ones who fail to pass Ebola Screening/Testing by U.S. Consulates in their countries!

Duncan entered the U.S. on a Tourist visa!

From the U.S. Embassy in Liberia:

"All visitors to the United States Embassy – including visa applicants – must pass through security screening. Because of the outbreak of Ebola Virus Disease (EVD) in Liberia, visa applicants will be screened for symptoms of EVD and any visitor exhibiting symptoms of EVD will be required to leave the consular section. "

Nonimmigrant Visas | Embassy of the United States Monrovia, Liberia