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macckone
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Maine judge refuses to issue quarantine order:
http://www.cnn.com/2014/10/31/health/us-ebola/index.html
In other news the CDC has updated its website to provide an explanation of the difference between airborne and droplet spread of the disease:
http://www.cdc.gov/vhf/ebola/pdf/infections-spread-by-air-or...
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Chemosynthesis
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Quote: Originally posted by macckone  | | The statistical sample is very small and hence unreliable but it is what it is. If we were to take it to the extreme we could say that only african
males are contagious in the US and they only infect non-white females. I think the grouping of those that arrived both ways is valid because even in
africa the major spread of the virus is in a care setting or post death setting. |
There is no mechanistic
reasoning behind reducing statistics to the level of absurdity you suggest. I have actually had to publish on patient data analyses, and so I
understand how important sampling is. There is no etiological reasoning to pull racial disparity in this case. There are real physical,
epidemiological differences between the groups you are conflating, and no statistical significance gained from including patients who skew the numbers
in favor of your views. Your conclusions may be valid, but there is no drastically powerful reason to believe so.
Only addressing the parts relevant between us, the two groupings are not that comparable because the patients transported here in isolation could have
infected people in Africa before being placed in isolation on a special plane with infectious disease/Ebola specialists who are not indicative of
standard medical care in the U.S. Some of the riskiest medical procedures (diagnosis via blood drawing) took place in Africa. Patients known to have
Ebola have lab samples treated differently than suspected cases. Most medical personnel do not have adequate Ebola equipment nor Ebola training.
Neither of these apply to the cases of confirmed patients being transported, very expensively, in isolation to the handful of special BSL-4 clinical
facilities in the country staffed by personnel who were previously trained, well equipped, and fully aware of the patient history before treating.
If a patient did transmit Ebola in Africa, but was transported to the U.S. in isolation and received special care, this skews both transmission and
patient outcomes in the U.S. because it is inferring that a patient known to have Ebola will be treated by specialists the same way a suspected
patient in an E.R. would be a random floor nurse. It also presumes that care in the limited BSL-4 clinical facilities is equivalent to elsewhere, not
distinguishing the hospital in Texas. Obviously the outcome variation and nosocomial transmission indicates that this may not be the case, and so it
must be tested with valid stastics before inferring a conclusion either way. Were I invited to review a paper drawing conclusions from such low
numbered, non-paired samplings, I would reject it.
As for SARS, which is another matter, strict quarantine procedures were in place all over the world, including Canada, and travel bans were undertaken
in Asian countries which reduced necessity of travel bans in the U.S.... though the WHO considered international travel bans, even issuing a travel
advisory against visiting/egress from Toronto (where over 500 people were placed in quarantine+isolation at one point). The case numbers were also
very different, and so comparing the two is very difficult. However, estimated costs for treating Ebola are much higher than SARS, and so expense
should be considered. Luckily for me, I am not in the extrapolation business, so if the WHO or CDC estimates are wrong, they get to take
responsibility. Hospitals are in tenuous financial positions.
http://edition.cnn.com/2014/09/24/business/ebola-cost-warnin...
http://unpan1.un.org/intradoc/groups/public/documents/APCITY...
http://bloomberg.com/news/2014-10-07/bill-for-ebola-adds-up-...
http://businessweek.com/articles/2014-10-30/treatment-for-eb...
http://www.cnn.com/2003/HEALTH/05/24/sars.wrap/
[Edited on 31-10-2014 by Chemosynthesis]
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macckone
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Even if we exclude the three people who were brought to the US on medical flights we have an R naught of .5 which is well below the threshold for
sustained transmission. That also gives us a fatality rate of .25. I would argue that Duncan may have lived if given treatment earlier. I admit the
sample size is small but it is what it is.
It certainly doesn't warrant the shooting of people as advocated by one forum member.
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Chemosynthesis
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| Quote: Originally posted by macckone | Even if we exclude the three people who were brought to the US on medical flights we have an R naught of .5 which is well below the threshold for
sustained transmission. That also gives us a fatality rate of .25. I would argue that Duncan may have lived if given treatment earlier. I admit the
sample size is small but it is what it is.
It certainly doesn't warrant the shooting of people as advocated by one forum member. |
The sample size is not just small, it is insignificant. If you want to convince me otherwise you need calculate the statistical power and confidence
intervals. You should also state whether you believe the data to be normal or non-parametric, and preferably error in making the choice.
As for whether a patient would have lived or not, that is pretty bold if he wasn't your patient and if you don't have broad case experience to draw
from.
Whether or not people get shot is more of a moral argument between you two. I try to avoid those discussions as they are irreconcilable due to
grounding in subjective value, not objective fact.
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Rosco Bodine
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Ebola Truthers are hard at work trying rewrite the actual facts about ebola to better conform with the stylish new world order "global village"
propaganda meant to minimize risk awareness and risk aversion policies that are common sense, and attempt to reeducate people with a politically
correct "socially enlightened" view.......while scientific and medical and prudent security concerns that are entirely valid and have been known for
years, can just be damned.
CDC has propagandized the story about ebola in ways consistent with a political agenda to make the U.S. the world's ebola treatment clinic whether or
not U.S. citizens approve of that idea or accept the risks it involves, the decision is being made for them without their consent just like so many
other things where the hubris of incompetent government is without limit.
http://www.thegatewaypundit.com/2014/10/vanished-cdc-deletes...
Canada and Australia have both now enacted travel bans because it is the sensible thing to do.
http://www.cbc.ca/news/politics/ebola-canada-suspending-visa...
[Edited on 1-11-2014 by Rosco Bodine]
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gregxy
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Airborne vs droplets:
If you read the reference I posted at the start of this thread you will see that
droplets quickly evaporate to become small airborne particles.
Maccone: From the reference you gave me you will see the virus survives drying and remains viable in air for 90 minutes.
Viral load in saliva is probably low until the later stages of the disease, is seems to prefer the lining of blood vessels. But during the later
stages does appear in all bodily fluids.
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IrC
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| Quote: Originally posted by macckone | Even if we exclude the three people who were brought to the US on medical flights we have an R naught of .5 which is well below the threshold for
sustained transmission. That also gives us a fatality rate of .25. I would argue that Duncan may have lived if given treatment earlier. I admit the
sample size is small but it is what it is.
It certainly doesn't warrant the shooting of people as advocated by one forum member. |
He came from an Ebola infested area actually handling an Ebola stricken lady. Then when he gets here he does not tell them he likely had Ebola which
he damn well knew. You cannot expect us to believe he was unaware of why all the people were dying around him or that he did not suspect Ebola was
what he had. If he would have simply on the first visit stated clearly 'hey I think I have Ebola' telling them of his contact with people dying of it
do you think they would have sent him home with antibiotics. Not to mention so callously exposing Americans to the disease. He got what he deserved. I
do not know which member you speak of about shooting them but that would be wrong in most circumstances. If a person was claiming they had Ebola and
saying I'm going to spit on you as they approached I know what I would do. So circumstances matter in such a discussion. It must be from a prior post
I missed but you did not state which member you are talking about.
I do know your constant posts stating to the effect don't worry be happy there is zero danger, are detritus worthy to sum my opinion of your
statements in a mild way.
"Science is the belief in the ignorance of the experts" Richard Feynman
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Rosco Bodine
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It was me who said that a person defying a mandatory quarantine for ebola should be shot dead on the spot. I stand by that assertion based upon
understanding and training that a quarantine is meant to be an enforced cordon for isolation, likewise for a ship violating a quarantine the proper
action is to sink it, aircraft ......shoot it down. An enforced quarantine is not a discussion.
FWIW I recently talked to a retired French Foreign Legion who had duty on a military cordon detail for ebola in Liberia and that is precisely what is
done for people who violate and defy quarantine ......they get shot dead on the spot.....and it never makes the news .....just like a lot worse that
happens never makes the news. And for the military on location ebola is considered airborne for all practical purposes.
[Edited on 1-11-2014 by Rosco Bodine]
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IrC
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| Quote: Originally posted by Rosco Bodine | It was me who said that a person defying a mandatory quarantine for ebola should be shot dead on the spot. I stand by that assertion based upon
understanding and training that a quarantine is meant to be an enforced cordon for isolation, likewise for a ship violating a quarantine the proper
action is to sink it, aircraft ......shoot it down. An enforced quarantine is not a discussion.
FWIW I recently talked to a retired French Foreign Legion who had duty on a military cordon detail for ebola in Liberia and that is precisely what is
done for people who violate and defy quarantine ......they get shot dead on the spot.....and it never makes the news .....just like a lot worse that
happens never makes the news. And for the military on location ebola is considered airborne for all practical purposes.] |
In a situation such as that it only makes common sense. Dead is dead. Whether from a maniac charging with a gun or someone who cares nothing about the
death they are spreading from Ebola. I repeat dead is dead regardless of the cause and in either case you are being put in danger by another. In dire
pandemic circumstances where officials have with good cause ordered a quarantine to prevent loss of innocent life they should shoot anyone defying it,
they will end up infecting people unless they are stopped. I see no difference between someone choosing to kill with a disease and someone with a
weapon. Whats the difference? Either case is simple self defense and we have a right to protect ourselves from anyone seeking to do us harm.
"Science is the belief in the ignorance of the experts" Richard Feynman
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Rosco Bodine
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There are aspects about an ebola outbreak that can turn it into a military security issue that gets priority above any humanitarian or medical
mission.
That won't be on the news because it is disagreeable with some people's social conscience to a point they can't handle and shouldn't know the truth
about what gets done because it is what has to be done and that is something they aren't mentally equipped to handle, so it is kept from them.
The outbreak of ebola will be contained but you can be guaranteed some of the aspects of exactly how it was contained will be classified. There will
be one story in the trusted journals. And that will be the part of the story that is published.
When thousands of troops from different countries are converging in an ebola outbreak area what is their mission is to slam shut the lid on pandoras
box. And that's exactly what they will do.
China just announced it is sending 500 troops that are an elite army medical unit.
http://www.abc.net.au/news/2014-10-31/china-to-send-elite-ar...
I think when you have a pathogen that is identified by world authorities as a class A bioterrorism agent, the point should not be missed that there is
really no operational distinction ultimately about preventing transport of that threat regardless of whether it is contained in vials in an icebox or
whether it is being knowingly or unknowingly transported by a mule in their own body and therein resides the security risk which can be exploited for
nefarious purpose. It is likewise the same order of security concern as if someone was carrying a nuclear bomb hidden in their household furniture
......it becomes irrelevant whether they are aware of this or not when the security concern is preventing that device from being brought into a city.
Whatever is needed to abate the risk becomes justified as a practical matter where the end justifies the means......and there definitely are
exceptions where the job getting done no matter how it gets done is the imperative to the exclusion of all other considerations.......and ebola fits
that description whether that fact is comfortable with some persons sensibilities or not is totally irrelevant.
interesting editorial here
http://canadafreepress.com/index.php/article/67214#.VFThs7Q_...
It wasn't much publicized that the male living partner is a nursing student at a nearby college which suspended him from attending classes for the 21
day duration of the quarantine, reenforced by the nursing student body of the nursing college declaring they would stage a student walkout if Ted
trespassed on campus during that period, and would basically shut down the university until he was removed from their midst.
It wasn't much publicized either that there is a petition drive by other registered nurses seeking that her license and credentials be revoked for a
demonstrated lack of professionalism and poor judgment that reflects badly on the profession.
Kaci Hickox told among other things .....Don't come into town and don't leave town.
http://wagmtv.com/state-of-maine-document-reports-kaci-hicko...
http://dailycaller.com/2014/10/31/report-kaci-hickoxs-roomma...
Nobel prize winning medical doctor supports quarantine as sensible and prudent
http://dailycaller.com/2014/10/30/nobel-prize-winning-physic...
[Edited on 1-11-2014 by Rosco Bodine]
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Rosco Bodine
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Hypothesis: The deliberate importation of ebola, (and other diseases) by the "open borders" and "unrestricted travel" policies of the U.S. government
is a calculated scheme for population reduction by means of biological warfare which is supported by a confidence ebola will disparately impact the
elderly or those already living in less than perfect health, so the resultant mortality will be a population reduction producing a desirable outcome
for the bottom line .....less social security payments for a reduced population of pensioners and less health care costs on account of the most
burdensome demographic being dead from ebola, used as an expedient tool for removal of useless eaters who represent the greatest portion of "unfunded
liabilities" that is burdensome to the budget.
There is less worry about the prospect of wholesale, genocidal scale killing perhaps eventually millions of people with an engineered pandemic if it
is mostly that demographic most desirably targeted and most impacted which is most burdensome to government who will be killed. This scheme is a
variant of eugenics, which is a deliberate, scientific and selective extermination. Quite an ingenious plan of budget deficit reduction. First, kill
all the old and already sick people.
http://www.nejm.org/doi/full/10.1056/NEJMoa1411680
http://americanthinker.com/articles/2014/10/understanding_ob...
http://raconteurreport.blogspot.com/2014/11/fear-mongering-n...
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Chemosynthesis
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How is that a falsifiable hypothesis?
MDR-TB would be a much better choice, in my opinion; high HIV and elderly fatality rate, airborne transmission in nursing homes and prisons, high
recurrence, false positives in elderly, and a higher first line treatment complication rate of hepatoxicity in the 65+ age bracket, which is
retirement age. Tuberculosis disproportionately affects the homeless who often neglect treatment. New antibiotics to fight tuberculosis are undergoing
testing, but unavailable for several years.
http://m.bmb.oxfordjournals.org/content/73-74/1/17.full
http://www.lung.org/lung-disease/tuberculosis/factsheets/mul...
http://www.merckmanuals.com/professional/infectious_diseases...
And yes, Alex Jones and those whacky Pentagon think groups, for the right price, I consult.
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Amos
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Hey guys, anybody of you out there infected yet? No? Anyone in any of your hometowns? No? Really??? Okay, just checking.
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Rosco Bodine
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I did say ebola (and other diseases) to identify an agenda that is inherently a multipronged approach and a deliberate security breach.
I suppose that the "science" that is not skewed by political correctness could never be reconciled with analysis that could correctly identify a
Machiavellian scheme for exactly what it is.........on its face.
Maybe instead of proposing this as a hypothesis it would be more fair to identify such speculation as a reasonable conclusion that may be drawn by
inference. Others are free to draw their own conclusions as to which is more believable, that either [A] the apparently "senseless" policy is based
upon the incompetent defective thinking of Pollyannas who truly believe their delusions or, in the alternative [B] that the decision makers know
exactly what they are doing and have nefarious intent.
I vote [B]
9 dead and 50 paralyzed child victims in the U.S. of enterovirus imported from Central America by "refugee" illegal aliens transfer relocated across
the U.S. over the protests of the citizen populations residing in the same locations of those outbreaks unaninously also vote [B]
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Chemosynthesis
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Why check now when the CDC and WHO estimates go well into two additional months time? Doesn't add much new to discussion.
The problem with a lethal virus with non-human reservoir is that unless and until it goes the way of Smallpox or (soon) Polio, which is unlikely,
there is always some threat posed to humans: the hypothetical "next time."
People in affected regions may have internet, so the rhetorical question tactic might not be the most considerate way to go in case someone reads the
thread after searching for Ebola.
| Quote: Originally posted by Rosco Bodine | | 9 dead and 50 paralyzed child victims in the U.S. of enterovirus imported from Central America by "refugee" illegal aliens transfer relocated across
the U.S. over the protests of the citizen populations residing in the same locations of those outbreaks unaninously also vote [B]
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Not really a scientific claim if you can't cite it. There are other unflattering explanations that don't
fall into that false dichotomy, but they aren't substantiatable in a scientific sense either.
[Edited on 3-11-2014 by Chemosynthesis]
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Rosco Bodine
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President Ebola and the propaganda ministry that is now the CDC are pursuing a plan to make the U.S. into a limited accomplishment model of another
Sierra Leone. Ebola itself failed to get the memo in many places that mortality for a local population according to R nought should not be 100%
......so ebola not knowing any better from its viral directorate authority just proceeded to kill everyone there.
http://news.yahoo.com/leone-ebola-outbreak-catastrophic-aid-...
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Rosco Bodine
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| Quote: Originally posted by Chemosynthesis | | Quote: Originally posted by Rosco Bodine | | 9 dead and 50 paralyzed child victims in the U.S. of enterovirus imported from Central America by "refugee" illegal aliens transfer relocated across
the U.S. over the protests of the citizen populations residing in the same locations of those outbreaks unaninously also vote [B]
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Not really a scientific claim if you can't cite it. There are other unflattering explanations that don't
fall into that false dichotomy, but they aren't substantiatable in a scientific sense either.
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The scientific evidence jury is still out because the laboratories that would do the gene mapping to blow the whistle conclusively have their reserach
grants at risk for publishing what would be an indictment of their patron.
http://dailycaller.com/2014/10/31/obamas-border-policy-fuele...
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Chemosynthesis
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The part where you ascribe motive and then speak for families of newly disabled children is what I find unscientific. Circumstantial arguments about
immigration and disease can be made with science, but any more than that goes from statistics and facts to something else.
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macckone
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Closely related people in an extended family group are more likely to share immunological profiles. This means that a given population may have
family groups where no one dies and family groups where everyone dies because of basic genetics. Without clean water and medical support more people
will die then with medical support and proper hydration. R naught greater than one means it is likely everyone in a village can get it. Less than
one means that transmission will generally cease before everyone gets it. Survival is very low without proper care. With proper care the survival
rate goes up considerably. With the seven people treated in the US only one died and of course that one did not get as good of treatment as he could
have. However as we see in sierra leone lack of care is very bad for survival rates. Once care takers in small villages get sick there is no one to
get water or food for the sick. People then die from dehydration very quickly. In a hospital setting people almost never die from dehydration.
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Chemosynthesis
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This might be pedantic, but
this is not an accurate statement in actual patient populations. While it may home true, unless you specifically have a mechanistic reason to view
patient population as homogenous with respect to transmission, there may be confounding variables such as genetics, diet, relative
elevation/downstream or cleanliness.
R is just an average, and as long as the average transmission rate exceeds the number of immune or resistant people offsetting it, you can get
misleading models extrapolated from this.
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macckone
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| Quote: Originally posted by Rosco Bodine | | Quote: Originally posted by Chemosynthesis | | Quote: Originally posted by Rosco Bodine | | 9 dead and 50 paralyzed child victims in the U.S. of enterovirus imported from Central America by "refugee" illegal aliens transfer relocated across
the U.S. over the protests of the citizen populations residing in the same locations of those outbreaks unaninously also vote [B]
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Not really a scientific claim if you can't cite it. There are other unflattering explanations that don't
fall into that false dichotomy, but they aren't substantiatable in a scientific sense either.
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The scientific evidence jury is still out because the laboratories that would do the gene mapping to blow the whistle conclusively have their reserach
grants at risk for publishing what would be an indictment of their patron.
http://dailycaller.com/2014/10/31/obamas-border-policy-fuele... |
There is still no actual scientific evidence as to where the current strain of Enterovirus D68 originated. Nor has a definitive link between this
virus and the paralysis. Quite a few of the paralysis patients tested negative for the virus. However all of the patients that died of respiratory
symptoms tested positive. One suspect is a co-infection of an as yet unidentified virus. Ie. people can get more than one virus at a time. Of
course it is possible that the test for D68 is not testing properly for a mutated version in all patients. It should be noted that this virus
regularly circulates in the US population so it is possible that the virus mutated in the US because no outbreaks in other countries have been
identified. That isn't saying it couldn't have developed in asia or africa or latin america but right now it looks home grown.
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macckone
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| Quote: Originally posted by Chemosynthesis | This might be pedantic, but
this is not an accurate statement in actual patient populations. While it may home true, unless you specifically have a mechanistic reason to view
patient population as homogenous with respect to transmission, there may be confounding variables such as genetics, diet, relative
elevation/downstream or cleanliness.
R is just an average, and as long as the average transmission rate exceeds the number of immune or resistant people offsetting it, you can get
misleading models extrapolated from this. |
Yes, that is why I said can rather than will. In any given population genetics is a major factor in who gets something and who won't and more
importantly in the ebola case, who lives and who dies. Actual transmission in the case of ebola is primarily (not totally) determined by blood
exposure. In a small village in Sierra Leone, most people are probably related and will take care of their relatives, meaning the risk of
transmission is much greater and the R naught is very high compared to a city environment where most people will avoid a sick person and where
relatives may not be caring for a person. You are correct R naught is an average and it definitely differs between a city environment and a rural
american environment and an african village environment. The reality is this disease attacks care takers not total strangers. That isn't saying you
can't get it from a stranger but the risk is very low if you avoid people puking blood. Which again, most people avoid people puking blood unless
there is a familial tie or they are health care providers.
One avenue of spread that isn't really being discussed as much in the Sierra Leone case is the funeral practices. In Liberia whole villages were
infected by contact with dead people who were literally leaking ebola laden fluids. Something similar could be happening in Sierra Leone.
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Rosco Bodine
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If the enterovirus is homegrown then it is a bizarre coincidence for a sudden surge of cases that the mapped outbreak locations almost perfectly
overlay with the timing and transhipment locations of illegal aliens. Substantial numbers of them did test postive for the same strain of enterovirus
as did populations tested in their home countries. The data of course is not conclusive but the logical association for cause and effect is already
there and this is old news. CDC is not addressing this AFAIK because there is another topic that is ebola that seems to be providing a convenient
diversion. And enterovirus is not the only communicable disease that has been imported. The numbers of illegal aliens arriving sick with untreated
communicable diseases could have and perhaps should have won them the designation of "medical refugees" seeking their fair share of obamacare, free
medical care arranged in advance by executive order having its own standards specifying security concerns involving either health or criminal
background would be waived. If you don't want disease and criminals coming into a country then you don't put out the red carpet and welcome it as an
invited guest.
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Chemosynthesis
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Which doesn't take into account immunity, which is why I take issue with your phrasing. Someone immune to a strain of a disease can't get said strain,
as I am sure you know. Similarly, resistant people are unlikely, not likely to get infected (relatively speaking). The R nought is a ratio or
sometimes rate, like in chemical kinetics, and has no inherent bearing on the thermodynamics of a reaction, or in the case of epidemiology, total case
number. Poor analogy.
While your speculation on villages in Sierra Leone seems sound, if unsubstantiated, relatively large cities are stricken as well. Cities with easy
access to Red Cross and WHO body disposal teams. These confound your rationale:
http://aljazeera.com/story/2014923101918947105
[Edited on 3-11-2014 by Chemosynthesis]
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Rosco Bodine
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Off topic but related interest science fiction movie Elysium
One of the suggestions that makes most sense is to recruit and train the persons who have contracted and survived ebola and have developed a natural
immunity, to be caregivers and burial details for the present and new ebola victims. Implement quarantines and watch the outbreak burn itself out.
[Edited on 3-11-2014 by Rosco Bodine]
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