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macckone
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[*] posted on 19-10-2014 at 13:20


Rocco> R naught of less than one means the probability of
each case infecting someone else is low. This means that
in developed countries we are unlikely to have sustained
outbreaks. In the US each infected individual entering the
country has a 50% chance of infecting one person.
To get substantial numbers of people infected we would
need substantial numbers of infected people travelling.
But infected people are likely to be too sick to travel.

Now the death tolls in the developing world are likely to
be substantial. Even most south American countries are
likely to have lower R naught than Liberia. But even west
African countries like Nigeria have reasonable control
over the epidemic. Again the situation may change and
Where the epidemic is raging the situation is dire. For the
US and Europe the situation is actually pretty good.
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[*] posted on 19-10-2014 at 13:35


I disagree that sick patients are unlikely to travel; we don't necessarily know that. Sierra Leone had 12-14 infected people return from a funeral via plane. We have two nurses in the U.S. who flew repeatedly and a scare where a worker used a cruise ship. Historically, we have a sick nurse Mayinga traveling. This is complicated by potential travel during prodromal or presymptomatic stages.

Affected nations don't have enough hospital space and the WHO seems unable to meet demand.
http://www.washingtonpost.com/national/health-science/the-om...

Some sources claim we only have 9 dedicated Ebola rooms in the country:
http://mashable.com/2014/10/16/ebola-us-hospital-capacity/

All it takes is one "super spreader" funeral, field trip, or individual with the flu and Ebola and we could easily reach capacity. Then we begin triage, and releasing patients it is in our best interest to be able to observe (Sacra) for post treatment issues. 9 or so beds for something like Ebola was plenty when it wasn't here. Now reassessment is being considered, from the CDC, in designating Ebola hospitals in each state and changing Ebola healthcare guidelines. The Pentagon is even creating an Ebola rapid response team to assist civilian healthcare domestically, which may have Posse Comitatus questionability if not sheepdipped (not that I expect anyone to mind). To the best of my knowledge, the legality of the Army acting in Preston was never really questioned much or resolved. To be involved, the Pentagon must be concerned.

Here is an article from a former FDA deputy commissioner stating we just don't know what to expect, since we know little and we have never dealt with anything like this in a healthcare admin perspective.
http://www.forbes.com/sites/scottgottlieb/2014/10/17/in-the-...

I'm not even necessarily concerned about the Ebola virus itself... the strain on our healthcare system is enough to be concerned. All this is using huge amounts of resources that could negatively impact future care, even if temporarily, in an economic climate where healthcare wages, retirement, sick leave, etc. is being decreased for providers.

[Edited on 19-10-2014 by Chemosynthesis]
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Rosco Bodine
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[*] posted on 19-10-2014 at 14:02


Quote: Originally posted by macckone  
Rocco> R naught of less than one means the probability of
each case infecting someone else is low. This means that
in developed countries we are unlikely to have sustained
outbreaks. In the US each infected individual entering the
country has a 50% chance of infecting one person.
To get substantial numbers of people infected we would
need substantial numbers of infected people travelling.
But infected people are likely to be too sick to travel.

Now the death tolls in the developing world are likely to
be substantial. Even most south American countries are
likely to have lower R naught than Liberia. But even west
African countries like Nigeria have reasonable control
over the epidemic. Again the situation may change and
Where the epidemic is raging the situation is dire. For the
US and Europe the situation is actually pretty good.


What you are saying is based upon assumptions that may not hold true, and the R nought value resultant is affected by the population density as well as the standards of care.
An R nought value below 1 in an isolated village produces far less total mortality than the same value at rush hour in Grand Central Station. It is also an endpoint ex post facto *average* value which does not rule out the worst case scenario example as possible, nor is it a limiting factor but is simply a figure that may or may not hold true for estimating a result for a *similar model* that has roughly the same parameters as those that which produced that R nought value which described one regional outbreak. Comparing the R nought generated by an outbreak in an isolated village is not valid for modeling what may occur in a large city. Nothing is written in stone and it is an oversimplification to think the R nought gives a good prediction for what will happen when different variables are at work. With air travel thrown into the model, and the whole world population made the global village, with population density another aggravation ......such factors could cause a higher realized R nought in spite of the best medical care facilities and strategies that would mitigate the outcome.

Anyway the R nought for ebola is more than 1 even in the case of isolated village populations of Africa and to make the assumption that ebola should necessarily have a lower R nought in densely populated cities having better sanitation and medical care may not be a valid assumption since population density alone may more than offset those factors which otherwise should cause a lower R nought. It is a total crap shoot what ebola could do if set loose in a large city.

http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2...

[Edited on 19-10-2014 by Rosco Bodine]
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[*] posted on 20-10-2014 at 07:39


No one has actually caught Ebola on a plane.
And we have had active patients flying and in
Major cities with no known transmission except nurses.
In Africa most of the transmission has been
To care givers, not strangers on a bus.
Even Duncan's family did not get infected
While dealing with his illness. R naught in
The case of Ebola does not appear to be
Related to population density as much as the
number of care givers for the ill.
Monrovia is a major city and although there
Thousands infected the R naught is still
Slightly over one. In Nigeria and another African
Country the outbreaks were contained as
They were in Spain. Only three countries have
Sustained transmission and so far R naught
In the US is still below 1. Even with improperly
sending Duncan home and allowing one sick nurse
To fly. The CDC is improving protocols and preparing
Specific hospitals to manage potential patients.
Unless we start seeing a much higher R naught
In countries with better health care this does not
Seem like as much of an issue as the flu that
Kills more people annually in the US than Ebola has
Infected ever. It may be deadly but Ebola doesn't
Have the spread potential of measles or the flu.
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[*] posted on 20-10-2014 at 09:08


public service announcement from the new ebola czar
https://www.youtube.com/watch?v=AHa-AvLk4no

<iframe sandbox width="640" height="360" src="//www.youtube.com/embed/AHa-AvLk4no?rel=0" frameborder="0" allowfullscreen></iframe>
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[*] posted on 20-10-2014 at 09:30


Keep in mind the terrorism factor. All it would take is some extremest flying to Liberia, chopping the finger off of a corpse and flying to any major airport and dripping the bloody residue on handrails, door knobs etc. Hundreds of new cases widely distributed and impossible to trace. Cold and flu season is coming up making it difficult tell which is which in the early stages. The entire USA has about 20 class 4 hospital beds.

The US spent trillions of $, 100,000 of lives and created millions that hate us because they though Iraq was working on bio-weapons. An here one is ready to go.

The disease IS airborne. What changed in the way the hospitals are supposed to handle the disease? They now wear respirators instead of paper masks. Winter is approaching (higher humidity and less UV to kill the virus meaning it will stay viable longer in the air and on surfaces). Africa quite a sunny place.

The virus is found in ALL body secretions. It can infect epithelial cells which means it can leave and enter the body through the respiratory tract. HIV cannot do this. Colds and the flu can, but the infection is limited to the lining of the respiratory tract so the damage they can do is limited.

Clearly, illegal immigrants don't have it now, but what if Ebola enters Mexico city?

On the positive side the stock market has not crashed so plenty of smart people, who often get it right think this will pass without incident.


[Edited on 20-10-2014 by gregxy]
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[*] posted on 20-10-2014 at 10:20


Quote: Originally posted by gregxy  
Keep in mind the terrorism factor.

Lots of things can be used as terrorism agents.
Sars is a lot more contagious and about as deadly.
No one is in China hunting civet cats.
I would be more worried about someone lining up
in an airport security line and detonating the wednesday
before thanksgiving.
Quote: Originally posted by gregxy  

The disease IS airborne. What changed in the way the hospitals are supposed to handle the disease? They now wear respirators instead of paper masks.

The disease is not classified as airborne.
Yes droplets can be expelled containing the virus
and yes they can penetrate the paper masks.
But this is not the same as the flu for example.
This is more of a projectile vomit in your face thing.
Although it has also been transmitted via blood splatter
from patients that are moving around a lot.
Interestingly enough blood, vomit and sputum seem
to be the primary methods of transmission although
the virus is also excreted in feces, sweat and semen.


The Duncan case is probably the worst case in the US.
He was sent home when he was contagious and
even though his family spent three days caring for him,
none of them were infected (now 21 days with clean test).
They cleaned up his vomit, his feces and were exposed to
his sweat but were not infected even without proper
protective gear. This gives some indication of how hard it
actually is to catch this disease.

[Edited on 20-10-2014 by macckone]
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[*] posted on 20-10-2014 at 10:40


Quote: Originally posted by gregxy  
Keep in mind the terrorism factor. All it would take is some extremest flying to Liberia, chopping the finger off of a corpse and flying to any major airport and dripping the bloody residue on handrails, door knobs etc. Hundreds of new cases widely distributed and impossible to trace. ...

[Edited on 20-10-2014 by gregxy]


Whoa there. Don't let techno-thriller-ready plots get ahead of reality.

Such a scenario is conceivable - that someone might try to do something like this. But you need to think carefully about how effective this would really be.

The Ebola virus only lasts a few hours on surfaces. Getting it on a surface or surfaces that would really have lots of people touch, and getting them infected is not that easy. The active virus count is going to be dramatically lower than what health care workers handling actual infected patients see.

This form of biological warfare delivery, called "fomites" is actually very hard to get to work well. People always underestimate the problems, and overestimate the effectiveness. Back in the days of biological weapons research using fomites was considered to be an ineffective technique.

Impossible to trace? Nothing could be further from the truth. If there were a focus of infection in an airport, this would be evident very quickly and people who were at potential risk could quickly be identified as well even though the number might be large (we already went through this with SARS) .
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[*] posted on 20-10-2014 at 13:45



If Nigeria can do it so can the US.
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[*] posted on 20-10-2014 at 13:55


Quote: Originally posted by jock88  

If Nigeria can do it so can the US.


They closed their borders, tracked down everyone exposed, had soldiers carrying full auto weapons refusing anyone to come in without permission. Works just fine doesn't it.

"The Ebola virus only lasts a few hours on surfaces."

If they would fly aircraft into buildings they have no problem exposing themselves and getting in through the southern border before any signs would be visible. After they started feeling ill visiting all the highly populated areas they could until they dropped dead. Don't kid yourself Sublette. Even a poor Chess player could reason this scenario out.





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[*] posted on 20-10-2014 at 14:20


Quote: Originally posted by macckone  
No one has actually caught Ebola on a plane.
And we have had active patients flying and in
Major cities with no known transmission except nurses.

We do not know we have had active (symptomatic?) patients flying, unless you mean the patients in specialized isolation wards on the way Emory and the NIH, which is hardly comparable. It is suspected in the case of one nurse. What happens if you have someone with transmissible Ebola and a secondary flu infection? What happens if we reach isolative capacity? Altering how a hospital functions is not a trivial task. It will be time consuming. We do not know enough about Ebola in general, or this current mutating strain, to expect salivary or mucosal viral titers to be too low to transmit via aerosol if a patient sneezes due to influenza. Primates have been infected with nebulized Ebola in experimental conditions. That scenario is a nightmare for a pressurized plane with circulating airflow. Suddenly you have a super spreader that exceeds both U.S. Ebola transport and isolative capacity.

Quote:
The CDC is improving protocols and preparing
Specific hospitals to manage potential patients.


I have said this before, yes, but hospitals can barely manage the flu. The CDC is updating guidelines, which now emphasis better hazmat/BSL PPE... which many hospitals don't have as I linked in a previous post. Hospitals nationwide lack both appropriate training and safety gear. The expense to equip, train, and get hospitals set up with makeshift BSL-4 isolation rooms and a lab will be prohibitive, and will potentially impact patient care regardless of whether you have Ebola or a sprained ankle. Staff will not be able to rapidly transition from Ebola duty to normal rounds without risking nosocomial infection. Personnel will likely need two weeks or more or training, which is time spent not treating patients. Lab work will be slowed. Patients will want to avoid an "Ebola hospital." Ebola hospitals will almost certainly be well equipped teaching institutions with high standards of care. If there is only one per state, how do you expect to transport patients from all over the state to said hospital? Isolation is expensive. Airlifts are expensive. Are we going to take an ambulance out of rotation as dedicated Ebola transport ambulances on standby in each hospital around a state?

I am hardly arguing we are in for the apocalypse, or even that Ebola itself will be a problem in the U.S. The repercussions of Ebola are a problem. Listen, hospital funding is low. This is because government research is low, and economy is not burgeoning. I am not sure if you know any medical personnel or have worked in a hospital, but the hospitals here have had to decrease employee retirement, sick leave, and paid vacations. The way pensions are counted at the state and county level has had to change. The reason for these is that hospitals are suffering financially. Pensions are also unfunded liabilities in most states (not linked).
http://healthworkscollective.com/danyelljones/119531/hospita...

http://www.aha.org/content/00-10/05fragilehosps.pdf

http://www.dispatch.com/content/stories/local/2014/07/13/ill...

http://healthaffairs.org/blog/2013/12/31/health-care-prepare...

You mention that Ebola has not killed as many people as the flu. Perhaps if we stick to using the U.S. for both those numbers, since projections for Ebola deaths are 1.4 million by the new year globally, sure. Swine flu didn't kill many patients in the U.S. either, or infect many compared to "normal flu." I still had to hear hospital meetings where top administrators struggled to find overflow ward space in schools and nursing homes. These people do have jobs, despite what many staff believe, and they were taking time away from other issues to deal with overflow, which is inadequate. When you get flu season and are sealing off parts of the hospital for an Ebola ward, you will have logistical problems.

Ebola specialists say there is a risk of future airborne transmission, even if it is remote. If there is even the possibility of Ebola mutating to appear more like Reston in transmissibility, while retaining Zaire's fatality rate, some bureaucratic hospital administrator has to start managing hospital money that would pay for the sunk cost of an emergency surgery performed on someone who couldn't pay whatever insurance didn't cover. No hospital wants to tell you this, but this is very likely to diminish quality of care, at least in the short term. It will prevent the hiring of another nurse, physician, pharmacist, PhD, technician, replacement microscopes, a remodel/opening of a more up-to-date ward-- whatever. It will reduce bed space, lab capacity, an ICU for isolation. An ICU is kind of a big deal for children with EV-D68, or the elderly or immunocompromised with flu. ICU visits (not deaths) for influenza are underreported, by the way, since they are voluntary disclosures.

The Texas hospital that treated one patient and infected two healthcare workers shut down. That affects people's lives. Now patients need to go elsewhere and add strain to another hospital that was only set up to treat their local citizens. Now you have staff out of work. Now that building and equipment aren't being used to treat people.
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[*] posted on 20-10-2014 at 15:04


Quote: Originally posted by macckone  
The Duncan case is probably the worst case in the US. He was sent home when he was contagious and even though his family spent three days caring for him, none of them were infected (now 21 days with clean test). They cleaned up his vomit, his feces and were exposed to his sweat but were not infected even without proper protective gear. This gives some indication of how hard it actually is to catch this disease.
No, this tells us very little.

1. There are multiple concurrent strains of this virus which has mutated a demonstrated 50-55,000 times in the current outbreaks, in one strain. We cannot assume each strain will have the same characteristics, as Ebola Reston is demonstrably different from its relative Zaire in many ways, while genetically similar.

2. Viral titers vary by stage of infection. We know little about this for any strain. It turns out the CDC believes the tow Texas nurses were infected because of exposed skin, hence the new guidelines on PPE. Dr. Sacra contracted Ebola from an unknown route while treating patients thought to be Ebola free.

3. I am not seeing any reports detailing the care given to Duncan by his family. Where are you getting your information from? What I see is that his sheets were "soiled" without mention of what fluids/waste was left uncleaned, or that he was incapable of using the bathroom unassisted. Ebola patients are typically able to walk for some time even after the internal bleeding commences (Mayinga, Sacra, Pham, probably Duncan in the hospital initially all walked while symptomatic), and diahrrea isn't necessarily incontinence.
http://www.usatoday.com/story/news/nation/2014/10/19/ebola-q...

4. Duncan is speculated as having contracted Ebola from helping a collapsed pregnant woman. This does not sound particularly invasive, and so we do not end up with much actual information about how easily transmitted this strain is.
http://www.cnn.com/2014/10/19/health/us-ebola/index.html
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[*] posted on 20-10-2014 at 15:48


I also think it is suspicious how quickly the Dallas hospital gave in....
Must have been enormous pressure on them.

I have not seen any detailed report on precisely how the 3 nurses in western hospitals caught the disease. Were they stuck with needles? Did they get vomit all over them? Where was this uncovered skin?

The following states viruses can survive on surfaces for 3 to 12 weeks
(no specific data on Ebola).
http://www.unc.edu/courses/2008spring/envr/421/001/WHO_Virus...

Duncan probably told his family to keep their distance. If you have been over there and tended to a sick person isn't that what you would do, even if you weren't feeling sick?
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[*] posted on 20-10-2014 at 16:30


Quote: Originally posted by IrC  
Quote: Originally posted by jock88  

If Nigeria can do it so can the US.


They closed their borders, tracked down everyone exposed, had soldiers carrying full auto weapons refusing anyone to come in without permission. Works just fine doesn't it.

"The Ebola virus only lasts a few hours on surfaces."

If they would fly aircraft into buildings they have no problem exposing themselves and getting in through the southern border before any signs would be visible. After they started feeling ill visiting all the highly populated areas they could until they dropped dead. Don't kid yourself Sublette. Even a poor Chess player could reason this scenario out.



Having self-infected Ebola vectors travelling around to infect others is an entirely different scenario than the one gregxy was postulating, and one I didn't comment on (and see my response to grexy below).

Dial back the attitude please.

It is certainly possible to deliberately import an Ebola infection during the latency period.

But visiting populated areas does not pass on infection.

Exposing the mucuous membranes or skin breaks of people to bodily fluids/secretions of the infectious sick does.

Once symptoms show, you get very sick very quickly.

This suggests this strategy is limited in the number of secondary cases it can generate. In the midst of an Ebola scare people are not going to want to come into intimate contact with a very ill stranger.

Is he jabbing people with needles in public? An obviously ill man doing this would get apprehended it pretty quickly.

Please, "Mr. Chess Player" think this thing through. The end-game is all important.


[Edited on 21-10-2014 by careysub]
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[*] posted on 20-10-2014 at 16:36


Quote: Originally posted by gregxy  
..
The following states viruses can survive on surfaces for 3 to 12 weeks
(no specific data on Ebola).
http://www.unc.edu/courses/2008spring/envr/421/001/WHO_Virus...

...


Then you should have looked up a relevant study that did provide specific data on Ebola. Your "3-12 weeks" is for Adenoviruses, which the paper you cited notes is the most environmental resistant virus group. Ebola is a Filovirus.

Here is a paper that does address this question:
http://www.phac-aspc.gc.ca/lab-bio/res/psds-ftss/ebola-eng.p...

The specific situation you are proposing - blood smeared open surfaces that people might touch - is addressed with this:
"One study could not recover any Ebolavirus from experimentally contaminated surfaces (plastic, metal or glass) at room temperature".

So, no, it would not spread infection.

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[*] posted on 20-10-2014 at 17:42


Quote: Originally posted by careysub  

Here is a paper that does address this question:
http://www.phac-aspc.gc.ca/lab-bio/res/psds-ftss/ebola-eng.p...

The specific situation you are proposing - blood smeared open surfaces that people might touch - is addressed with this:
"One study could not recover any Ebolavirus from experimentally contaminated surfaces (plastic, metal or glass) at room temperature".

So, no, it would not spread infection.


Ummmm......
Quote:

"One study could not recover any Ebolavirus from experimentally contaminated surfaces (plastic, metal or glass) at room temperature"


That statement is hardly supportive of the over reaching conclusion making a generalization because it is one study only....and there could be a dozen other studies that show different results. UV light and humidity and temperature and pH are probably all factors in what would be the longevity of virus in the environment.
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[*] posted on 21-10-2014 at 07:46


If I had an 'attitude' it would have been far more aggressive, you are assuming attitude. So be it. I have read 4 pages so far of people talking about how it is so hard one would think we are supposed to believe it is nearly impossible to contract Ebola. Yet over 4,500 have died in 2014 thus far per CDC and WHO. A reasonable person would expect a citizen trapped in the location of the outbreak would be going as far out of their way as is possible to avoid the disease due to the fear factor and simple human nature, the will to survive. So how did such a large number die in under a year. Obviously not so difficult to contract as so many are saying in this thread.

Assuming a set 70 percent fatality rate obviously greater than 6,400 have contracted the virus. Each one at least trying to avoid the disease if at all possible. Also, virtually all of them knew the score meaning warned so at least protected by the knowledge of the presence of Ebola. Here in the states this is not so, people go about their day assuming Ebola is somewhere else. They may read news stories and are somewhat concerned but not being surrounded by death and misery on a mass scale they are effectively not warned, they go about their lives as if the danger is somewhere in the distance. So they are not in the survival mode of taking every possible precaution and paying very close attention as are virtually all the people in the affected areas in Africa.

Also no one will convince me a victim is not contagious until they are spewing vomit, blood, and other materials. I think it far more likely they can spread it before that stage for one simple reason. The numbers in Africa. Does anyone actually believe the people over there are not avoiding as much as possible all those with such clearly evident signs. Therefore the only answer to the growing numbers in the hot zones is exposure to those who do not appear obviously violently ill. It would have to be more than only those clearly ill, which most people would be avoiding at all costs. Simple common sense. I see no reason to believe many who appear safe at the time are not possible sources of contagion.

You effectively stated the opposite of this by asking me to rethink my Chess comment among other words such as the chance of terrorists spreading Ebola in a Mall is near zero. If this were so then how is it outbreaks are occurring in multiple hot spots in Africa. The people are not that ignorant and as I said unlike here they know Ebola is all around so they have a much more heightened sense of self preservation than average citizens going about their lives over here.

"The specific situation you are proposing - blood smeared open surfaces that people might touch - is addressed with this:
"One study could not recover any Ebolavirus from experimentally contaminated surfaces (plastic, metal or glass) at room temperature".

So, no, it would not spread infection."

One study proof does not make and since I have read for months in many sources 48 hours to a week is how long Ebola can survive on a surface I do not buy your statement it cannot survive at all. That contacting infected substances on a surface a few hours after it is deposited is safe. So you say. So your 'one study says', I for one believe neither. When there are conflicting reports which differ by this much a wise person errs on the side of caution and does not so cavalierly say "So, no, it would not spread infection". Also, why do the hazmat teams suit up and so carefully clean an area a day or two later putting everything into bio-hazard containment. Why bother. The two fools hosing down the vomit outside the home of patient zero in Texas in plain clothes must have known what they are doing? I doubt it.

You may choose to believe this but I for one do not. There is a reason so many have died even though being aware of the danger they have tried as best they can to avoid it. There is a reason reports by virologists have suggested over a million deaths by January is very possible and that reason is not because you can only contract Ebola from someone so obviously ill they are a day or three away from death. I also find it odd that studies on the ease of contracting Ebola I read 10 years ago are virtually erased online and now everywhere you look you read about facts more in line with the position you are taking. That it is very hard to be infected unless a victim is puking or bleeding all over you.

I do not buy it for one minute. Too many medical people highly trained and well equipped taking all precautions have caught the virus in Africa for me to believe the current prevailing 'calm the people and allay all fears' studies which are so recently showing up everywhere you look.

I am not now nor will I ever be a Lemming no matter how many people think it is 'trendy' today.

https://www.google.com/search?q=ebola+lifetime+on+surface&am...:official&client=firefox-a&gws_rd=ssl

So many opinions out there.

http://www.infowars.com/scientists-ebola-can-spread-by-air-i...

While I have no doubt few approve of this site, at least someone is keeping this information in public view.


caresub, just using phrases towards members such as "irc's rant" is insulting and combative for it creates nothing but negative impressions which broadly categorize the worth of all the statements in the entire post. Why don't you grow up.

I put this reply to the below post of yours here since I can still edit this post and this does not warrant a new post which would start things all over again. I had respect for you and your work and even gave you a glowing welcome. Consider that no longer valid.



[Edited on 10-22-2014 by IrC]




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[*] posted on 21-10-2014 at 12:38


careysub: Thanks for the reference. I had been looking for the life time of the virus under various conditions. Going from 4C to room temp greatly reduces its lifetime on surfaces. Note the aerosol remains viable for over an hour at room temp.

There are much more effective ways for terrorists to spread the stuff that smearing it on door knobs. But I don't want to give them ideas....

My point is that, if you consider ebola the WMD that it is, in addition to building this expensive ebola ward in the hospital, now you need to guard it with soldiers to stop some ISIS wanabe from stealing a contaminated Q-tip. (And there are endless other means for them to get it).


Allowing un-quarantined people leave west Africa helps no one
and is very dangerous until an effective treatment is found.

Do you trust what they are saying about ebola enough to let someone you care about sit next to a person on a bus or plane with ebola?

Maybe the Russians or Chinese will have some sense....
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[*] posted on 21-10-2014 at 15:44


Quote: Originally posted by gregxy  
My point is that, if you consider ebola the WMD that it is, in addition to building this expensive ebola ward in the hospital, now you need to guard it with soldiers to stop some ISIS wanabe from stealing a contaminated Q-tip. (And there are endless other means for them to get it)

I doubt that will be too much of an issue in the U.S. Soldiers in particular would likely not be necessary if it were a security issue; a couple state police officers would be less controversial and stand out less than soldiers if thst became an issue. Hospital security (sometimes all sworn law enforcement) and secured rooms to keep patients inside combined with what should be standard incineration of hazardous medical waste will likely keep anyone out who isn't supposed to wander their way in anywhere.
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[*] posted on 21-10-2014 at 16:54


I leave it to the reader to judge whether irc's rant above is exhibiting "attitude" or not.

Quote:
One study proof does not make and since I have read for months in many sources 48 hours to a week is how long Ebola can survive on a surface I do not buy your statement it cannot survive at all. That contacting infected substances on a surface a few hours after it is deposited is safe. So you say. So your 'one study says', I for one believe neither.


So cite your sources and the conditions which they are discussing.

I was discussing exactly one specific situation that had been offered as a terror attack scenario - a contaminated dry surface in a well lit airport.

There are certainly other situations where virus survival is much longer, but they weren't what was under discussion.

Details matter.

It would help this discussion tremendously if you learned something about the transmission of infectious disease from real scientific sources, and paid close attention to what is actually being said instead of leaping to ill-informed conclusions.

If you want to debate, cite real evidence, and be able to interpret accurately what is conveyed.

Here are the gory details of the CDC EbolaResponse model that projects possible course of the epidemic with varying responses (from doing nothing to effective response):

http://www.cdc.gov/mmwr/preview/mmwrhtml/su6303a1.htm#Append...

It projects the epidemic reaching a toll of more than a million by January if nothing is done to change the transmission process.

The crucial factor in any epidemic disease is the basic reproduction number, known as R0. For an epidemic to be possible it has to have a value greater than 1 under conditions that are widely prevalent.

Seasonal influenza, which circulates around the world, infecting 5-10% of the population, has R0=1.28 through casual contact between people, and handling infected surfaces on which the virus persists for several hours. The spread is greatly facilitated by the fact that most cases are mild, half are asymptomatic, and especially by an extremely short generation time (the time from infection to being able to transmit infection). Great flu pandemics have arisen when, due to mutation, R0 is larger - sometimes as high as 2.0.

SARS, which was transmitted in actual practice by airborne droplets, had R0=3 and yet it was rapidly brought under control with a worldwide pandemic peaking at fewer than 9000 people total.

Diseases considered high infectious can have R0 ranging from 4 to 18.

The Ebola epidemic is being driven by infections occurring at home with no effective isolation, where R0=1.8, and by unsafe burial practices. At home where effective isolation protocols are observed is it is only R0=0.18, a situation where the epidemic would quickly die out. Once moved to a hospital R0=0.12. Handling the epidemic is essentially a matter of setting up sufficient care facilities, and educating Liberians how to monitor for illness, and how to handle those who become ill.

If those basic steps are taken the EbolaResponse model predicts the epidemic coming to an end by February next year with a total number of cases throughout Africa (including unreported cases) of about 37,000.

Quote:
There are much more effective ways for terrorists to spread the stuff that smearing it on door knobs. But I don't want to give them ideas....


Let's not pussy-foot around discussing the possibilities of using Ebola as a terror weapon for fear of "giving terrorists ideas". That is just plain silly. There are plenty of Islamic extremists with PhDs, and their imaginations and Googling skills are in no way inferior to yours.

The most damaging attack that could be staged would be something along the lines of the 1984 Rajneeshee bioterror attack where microorganisms were sprayed on food at buffet restaurants in The Dalles, Oregon, infecting 750. Staging would require a terror cell in the U.S. and an imported Ebola case (presumably entering before symptoms showed) - it would be a bit much to expect a someone succumbing to the disease, newly arrived from abroad, to be able stage it successfully himself.

If you want to really scare yourself with the possibilities of a great pandemic, watch the movie "Contagion." It is very well done, and is very realistic about what could happen if a new highly infectious disease were to emerge from the wild environment. This strain of Ebola is not that disease however. Some other filovirus might be.

As with all other threads on this forum is it is incumbent upon you to do your homework, understand what you are posting about, and be able to provide legitimate references that you read and understand.


[Edited on 22-10-2014 by careysub]
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[*] posted on 21-10-2014 at 17:03


Quote: Originally posted by Rosco Bodine  
...

That statement is hardly supportive of the over reaching conclusion making a generalization because it is one study only....and there could be a dozen other studies that show different results. UV light and humidity and temperature and pH are probably all factors in what would be the longevity of virus in the environment.


If you can cite a study showing that under the conditions postulated for the airport contamination attack - that dry secretions exposed at ambient room temperature under the conditions typical in an airport remain infectious please post.

Yes, humidity, temperature and light exposure all influence survival, but in the airport scenario every one of them is negative for virus survival.

Notice that none of the conditions under which active virus survival is known - fluid secretions, darkness, low temperature - apply.

[Edited on 22-10-2014 by careysub]
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[*] posted on 21-10-2014 at 17:49


Thank you for the excellent link.
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[*] posted on 21-10-2014 at 17:56


News on the topic in the past day, an anonymous doctor who was being treated for ebola and an NBC news reporter who was being treated for ebola have both been completely recovered, declared ebola free and released. The Dallas nurse Nina Pham has been upgraded to good condition and is improving. No news about her boyfriends condition or about the other Dallas nurse Amber Vinson.

A liberian passenger arriving ill in the U.S. via a connecting flight from Brussels has been put in isolation. Port authority police, airport police, police unions and other security and medical workers are pleading for a travel ban for travellers from the epidemic affected countries.

There has been a protest from military families and others about U.S. troops having only four hours special training and inadequate equipment who have been sent by the thousands to Africa hot zones to provide humanitarian assistance while not being adequately trained or equipped for their own safety.

http://www.nbcnewyork.com/news/local/Newark-Airport-Passenge...

Also there are two patients in isolation in Chicago
http://abc7chicago.com/news/university-of-chicago-medical-ce...



[Edited on 22-10-2014 by Rosco Bodine]
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[*] posted on 21-10-2014 at 23:28


Latest on the boyfriend, no symptoms:
http://www.ibtimes.com/ebola-nurse-nina-phams-boyfriend-rumo...


The chicago family doesn't appear to be at risk and the
quarantine is voluntary and did not involve vomiting as
originally reported:
http://www.chicagotribune.com/news/local/breaking/ct-ebola-q...
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[*] posted on 21-10-2014 at 23:34


The second nurse also appears to be improving:

http://www.nydailynews.com/life-style/health/ebola-stricken-...
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