EBOLA MAIN EBOLA DISCUSSION THREAD - 10-01-2014 TO 10-15-2014

Link to previous thread:


http://www.timebomb2000.com/vb/show...EBOLA-DISCUSSION-THREAD-09-16-2014-09-30-2014

The "ebola in dallas" thread is now getting all the action. Suggest we officially fork this discussion into "ebola in the US" and "ebola elsewhere".

OUR community plan (provided for your consideration) is being prepared to literally lock our gate.
At a certain point (still hashing out details) we lock it and no one is allowed in. People can LEAVE anytime they wish but there is no "right of return" until the crisis is over.

That is plan A - ensuring we are good to go here.

Plan B is devising a system whereby we can quarrentine folks without endangering the community as a whole. Tough to do in our nascent off grid status ( we are still pretty primitive)

Mongo said:

OUR community plan (provided for your consideration) is being prepared to literally lock our gate.
At a certain point (still hashing out details) we lock it and no one is allowed in. People can LEAVE anytime they wish but there is no "right of return" until the crisis is over.

That is plan A - ensuring we are good to go here.

Plan B is devising a system whereby we can quarrentine folks without endangering the community as a whole. Tough to do in our nascent off grid status ( we are still pretty primitive)

Click to expand...

Check out the results of doing this during the 1918 Flu; there were some holes....

skeptic said:

The "ebola in dallas" thread is now getting all the action. Suggest we officially fork this discussion into "ebola in the US" and "ebola elsewhere".

Click to expand...

Yeah.....one for Dallas/US.....one thread for elsewhere

For links see article source.....
Posted for fair use.....
http://www.cbc.ca/news/world/ebola-virus-in-liberia-creates-body-recovery-dangers-1.2781892

Special Report
Ebola virus in Liberia creates body recovery dangers

Workers struggle to gather and dispose of corpses as outbreak spreads

By Stephanie Jenzer, CBC News Posted: Sep 30, 2014 5:00 AM ET| Last Updated: Sep 30, 2014 9:22 PM ET

It�fs a sad fact of life in Monrovia, Liberia, these days.

The wail of an ambulance siren doesn�ft mean help is on the way. More often than not, it signals that a convoy carrying the "dead body management team" is about to arrive.


On Monday, CBC News rode along in one of those convoys. The weather was miserable. The task at hand was even more so.
�¡LIVE BLOG | Ebola crisis: Follow CBC News in Liberia
�¡VIDEO | Ebola outbreak: Liberia's health workers face tough choices
�¡LATEST | Stories, photos, videos from CBC News
�¡MAP | Track the Ebola outbreak
�¡Worst-ever Ebola outbreak, by the numbers


Overnight, the Liberian Red Cross had received a list of names: 19 people whose lives may have been taken by Ebola, the disease that has galloped across West Africa and claimed more than 3,000 lives, according to the most recent figures from the World Health Organization.


In thick Monday-morning traffic and a heavy downpour, the ambulance and the siren really just clear a quick path for the young men riding in the vehicles farther behind.


They are the ones who will suit up in full protective gear, enter the private homes of grieving families and haul away a body to the flatbed truck that makes up the rear of the convoy.


On this day, six Red Cross teams spread out across the Liberian capital. Victor Lacken of the International Federation of the Red Cross tells us Monrovia clearly needs more.

�gWe�fre behind the curve on this,�h he says.


The team we accompany is led by Alex Wiah, a mortician by trade who says most of the victims he�fs seen recently are female. �gIt�fs because women do most of the caring for people who are sick.�h

Ebola deaths
CBC's Adrienne Arsenault talks to team leader Alex Wiah. He�fs a mortician by trade but admits this job, handling Ebola victims, is particularly tough. 'It hurts because they are our family,' he says. (Stephenie Jenzer/CBC)


And sure enough, the first name on the list given to Wiah's team is a woman.


We travel to a part of the city known as Waterside, a short walk from the poor neighbourhoods of West Point where the Ebola outbreak led to an unpopular quarantine in August.


The team suits up and climbs a slippery, rocky slope to the home of Teresa Jacobs, her husband and three children.


Neighbours say she�fd been sick for years, suffered from a liver disease and did not die from Ebola.


Still, the new reality in Monrovia dictates all of the very ill should be isolated.


A community Ebola awareness group advised her husband to keep his wife from seeing her kids and locked the gate to a room where her body was left after she passed away.


And in the end, they called the body management team.


Lacken explains that sometimes in a household or community, there�fs concern about the stigma attached to the disease.

Safety procedures
The Red Cross has organized six teams that pick up bodies across the Liberian capital. The organization's Victor Lacken says more are needed. "We are behind the curve on this." (Stephanie Jenzer/CBC)


�gSometimes it�fs a bit of denial,�h he says. �gPeople don�ft like to admit a person in the house has Ebola.�h


As the Red Cross team carefully yet quickly hauls away the body of Jacobs, neighbours gather to watch and some cry out in sorrow.


Her body will end up at the crematorium, along with all the others who were on the Red Cross list this day.

Tomorrow there will be another one. Everyone hopes it will be shorter.

In all likelihood, it will not.

For links see article source.....
Posted for fair use.....
http://www.washingtonpost.com/news/...ola-liberia-is-descending-into-economic-hell/

Ebola-stricken Liberia is descending into economic hell

By Fred Barbash September 30 „³
Commentsƒö 76

People hold up signs as they protest for jobs to deal with the Ebola virus outbreak, outside the health ministry in Monrovia September 29, 2014. (James Giahyue/Reuters)

Liberia, the West African nation hardest it by Ebola, has begun a frightening descent into economic hell.

That¡¦s the import of three recent reports from international organizations that seem to bear out the worst-case scenarios of months ago: that people would abandon the fields and factories, that food and fuel would become scarce and unaffordable, and that the government¡¦s already meager capacity to help, along with the nation¡¦s prospects for a better future, would be severely compromised.

They are no longer scenarios. They are real. While these trends have been noted anecdotally, the cumulative toll is horrific.

The basic necessities of survival in Liberia ¡X food, transportation, work, money, help from the government ¡X are rapidly being depleted, according to recent reports by the United Nations Food and Agricultural Organization, the International Monetary Fund and the World Bank.

The FAO says that food is in increasingly short supply. Fields in some regions have been abandoned in part because people perceive Ebola may be coming from them or from the water used to irrigate them.

¡§People are terrified by how fast the disease is spreading,¡¨ Alexis Bonte, FAO Representative in Liberia, said in a statement. ¡§Neighbors, friends and family members are dying within just a few days of exhibiting shocking symptoms, the causes of which are not fully understood by many local communities. This leads them to speculate that water, food or even crops could be responsible. Panic ensues, causing farmers to abandon their fields for weeks.¡¨

The International Monetary Fund said in a separate report that restrictions on public transport, internal travel and trade are burdening the country¡¦s ability to distribute the food that is available.

The combination is driving up food prices rapidly, said the IMF even as ¡§panic buying¡¨ is boosting demand, according to the World Bank. The IMF is projecting an inflation rate of 13.1 percent by year¡¦s end, compared with 7.7 percent before the Ebola epidemic started taking its toll.

Transportation has been badly disrupted, one indicator being a drop of between 20 and 35 percent in fuel sales.

The services sector, about half of Liberia¡¦s economy, employing about 45 percent of the work force, has experienced a drop in turnover of 50 to 75 percent, the World Bank says.

According to the World Bank report, Liberia¡¦s single-most important agricultural export, rubber, has been severely ¡§disrupted by both the reduced mobility of the workforce and the difficulty in getting the products to the ports due to the quarantine. Rubber exports which were initially expected to be about $148 million in 2014 are estimated to drop 20 percent,¡¨ it said.

Palm oil, another big industry in Liberia, has also been hard hit. According to the World Bank, Sime Darby, the world¡¦s largest producer of palm oil, is mostly now focusing on simple maintenance of its facilities because of the ¡§evacuation of managerial and supervisory personnel.¡¨ It put on hold the construction of a new $10 million palm mill that was to be completed in 2015.

1 of 48

Struggling to contain Ebola epidemic in Africa

Sept. 27, 2014

Sept. 24, 2014

Sept. 22, 2014

Sept. 20, 2014

Sept. 19, 2014

Sept. 18, 2014

As the death toll rises to more than 3,000, the U.S. Centers for Disease Control and Prevention issues a dire forecast.--

Sept. 30, 2014 | Residents of the village of Freeman Reserve, about 30 miles north of Monrovia, Liberia, watch members of District 13 ambulance service disinfect a room as they pick up six suspected Ebola sufferers who had been quarantined. (Jerome Delay/AP)


Outside of agriculture, the World Bank said a major mining company, China Union, closed its operation in August. It had projected production of about 2.4 million tons of iron ore in 2014.

Savings and loan programs, called ¡§susu,¡¨ that finance ¡§micro-trade¡¨ and small businesses ¡X especially those run by women ¡X have been ¡§completely depleted,¡¨ with participants no longer able to pay their debts, said the FAO.

Projections for short-term and long-term economic growth are getting ratcheted downward, with the worst-case estimates nothing short of catastrophic. The World Bank, looking at 2014 alone, projected a reduction in growth in Liberia from 5.9 percent to 2.5 percent, a plunge that would be considered calamitous in any country. In 2015, under its most dire but altogether realistic scenario, Liberia¡¦s output could decrease by nearly 12 percent in 2015.

Projections for inflation are moving upward, with the IMF estimating an inflation rate of 13.1 percent by year¡¦s end, compared with 7.7 percent the year before.

On top of it all, the revenue coming in to the Liberian government has dropped sharply, by 20 percent, Liberia¡¦s foreign minister Augustine Kpehe Ngafuan told the United Nations earlier this week. ¡§Consequently, our ability to provide for basic social services and continue to fund key development projects are significantly diminished.¡¨

¡§As we and our many international partners struggle to douse the wildfire caused by Ebola, we have been left with inadequate resources, time and personnel to attend to other routine illnesses like malaria, typhoid fever and measles, thereby causing many more tangential deaths. An increasing number of pregnant women are dying in the process of bringing forth life. In short, our public health system, which totally collapsed during years of conflict and was being gradually rebuilt, has relapsed under the weight of the deadly virus,¡¨ said Ngafuan.A

The death toll from the West African Ebola outbreak is at least 3,091, according to the latest figures, which are regarded as signficantly lower than reality because of underreporting. The number of deaths in Liberia, 1,830, is about three times more than either of the other two most affected countries, Guinea and Sierra Leone.

All the countries hit by Ebola are in bad shape, to be sure, but Liberia does indeed appear to be the worst of the lot.

¡§The Ebola epidemic is washing away years of progress and hard work,¡¨ said the FAO in its Sept. 23 report.

¡§With the highest number of new and cumulative Ebola cases recorded to date, Liberia is the country most affected by the epidemic in West Africa,¡¨ said IMF officials in a statement on Sept. 29 recommending more aid to the country. ¡§In addition to exacting a heavy human toll, the Ebola outbreak is having a severe economic and social impact, and could jeopardize the gains from a decade of peace.¡¨

workerbee said:

Yeah.....one for Dallas/US.....one thread for elsewhere

Click to expand...

Will be difficult as more often than not the news will be intermingled with various locations.


For instance:

https://news.yahoo.com/ebola-case-stokes-concerns-liberians-dallas-053920222.html

Ebola case stokes concerns for Liberians in Texas
Associated Press
By DAVID WARREN and LAURAN NEERGARD 54 minutes ago

DALLAS (AP) — The first case of Ebola diagnosed in the U.S. has been confirmed in a man who recently traveled from Liberia to Dallas, sending chills through the area's West African community whose leaders urged caution to prevent spreading the virus.

The unidentified man was critically ill and has been in isolation at Texas Health Presbyterian Hospital since Sunday, federal health officials said Tuesday. They would not reveal his nationality or age.

Authorities have begun tracking down family, friends and anyone else who may have come in close contact with him and could be at risk. Officials said there are no other suspected cases in Texas.

At the Centers for Disease Control and Prevention, Director Tom Frieden said the man left Liberia on Sept. 19, arrived the next day to visit relatives and started feeling ill four or five days later. Frieden said it was not clear how the man became infected.

"I have no doubt that we'll stop this in its tracks in the U.S. But I also have no doubt that — as long as the outbreak continues in Africa — we need to be on our guard," Frieden said, adding that it was possible someone who has had contact with the man could develop Ebola in the coming weeks.

"But there is no doubt in my mind that we will stop it here," he said.

Stanley Gaye, president of the Liberian Community Association of Dallas-Fort Worth, said the 10,000-strong Liberian population in North Texas is skeptical of the CDC's assurances because Ebola has ravaged their country.

"We've been telling people to try to stay away from social gatherings," Gaye said at a community meeting Tuesday evening. Large get-togethers are a prominent part of Liberian culture.

"We need to know who it is so that they (family members) can all go get tested," Gaye told The Associated Press. "If they are aware, they should let us know."

Ebola symptoms can include fever, muscle pain, vomiting and bleeding, and can appear as long as 21 days after exposure to the virus. The disease is not contagious until symptoms begin, and it takes close contact with bodily fluids to spread.

The association's vice president encouraged all who may have come in contact with the virus to visit a doctor and she warned against alarm in the community.

"We don't want to get a panic going," said vice president Roseline Sayon. "We embrace those people who are coming forward. Don't let the stigma keep you from getting tested."

Frieden said he didn't believe anyone on the same flights as the patient was at risk.

"Ebola doesn't spread before someone gets sick and he didn't get sick until four days after he got off the airplane," Frieden said.

Four American aid workers who became infected in West Africa have been flown back to the U.S. for treatment after they became sick. They were treated in special isolation facilities at hospitals in Atlanta and Nebraska. Three have recovered.

A U.S. doctor exposed to the virus in Sierra Leone is under observation in a similar facility at the National Institutes of Health.
The U.S. has only four such isolation units, but Frieden said there was no need to move the latest patient because virtually any hospital can provide the proper care and infection control.

The man, who arrived in the U.S. on Sept. 20, began to develop symptoms last Wednesday and sought care two days later. But he was released. At the time, hospital officials didn't know he had been in West Africa. He returned later as his condition worsened.

Blood tests by Texas health officials and the CDC separately confirmed his Ebola diagnosis Tuesday. State health officials described the patient as seriously ill. Goodman said he was able to communicate and was hungry.

The hospital is discussing if experimental treatments would be appropriate, Frieden said.

Since the summer months, U.S. health officials have been preparing for the possibility that an individual traveler could unknowingly arrive with the infection. Health authorities have advised hospitals on how to prevent the virus from spreading within their facilities.

Passengers leaving Liberia pass through rigorous screening, the country's airport authority said Wednesday. But those checks are no guarantee that an infected person won't get through and airport officials would be unlikely to stop someone not showing symptoms, according to Binyah Kesselly, chairman of the Liberia Airport Authority's board of directors.

CDC officials are helping staff at Monrovia's airport, where passengers are screened for signs of infection, including fever, and asked about their travel history. Plastic buckets filled with chlorinated water for hand-washing are present throughout the airport.

Liberia is one of the three hardest-hit countries in the epidemic, along with Sierra Leone and Guinea.

Ebola is believed to have sickened more than 6,500 people in West Africa, and more than 3,000 deaths have been linked to the disease, according to the World Health Organization. But even those tolls are probably underestimates, partially because there are not enough labs to test people for Ebola.

Two mobile Ebola labs staffed by American naval researchers arrived this weekend and will be operational this week, according to the U.S. Embassy in Monrovia. The labs will reduce the amount of time it takes to learn if a patient has Ebola from several days to a few hours.

The U.S. military also delivered equipment to build a 25-bed clinic that will be staffed by American health workers and will treat doctors and nurses who have become infected. The U.S. is planning to build 17 other clinics in Liberia and will help train more health workers to staff them.

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Discussion at PFI


Exodia wrote:
The patient traveled from Liberia to the United States via Brussels and Dulles, VA, on to Dallas, TX.

That sounds right, sounds likely.

Brussels has the most incoming flights from West Africa right now. Their doors are pretty much wide open.

Any hub city can host one of these patients as their gateway, before they continue to their destination city. Remember the tracking of the New SARS (MERS) case in Chicago who had attended the swank gathering of our top scientists and physicians at the Fairmont Hotel while ill with that virus? The tracking of his contacts involved thirty states.

end snip

Brussels should be a vector city to keep an eye on.

Thompson: Associate of Dallas Ebola patient under close monitoring
Marjorie Owens , WFAA 8:56 a.m. CDT October 1, 2014
Ebola case in North Texas

http://www.wfaa.com/story/news/heal...n-dallas-county-ebola-patient-cases/16524303/

DALLAS — Due to close contact with a patient diagnosed with the Ebola virus, a second person is under the close monitoring of health officials as a possible second patient, said the director of Dallas County's health department Wednesday morning in an interview with WFAA.

Zachary Thompson, the director of Dallas County Health and Human Services, says all those who've been in close contact with the diagnosed patient are being monitored as a precaution. However, Thompson pointed to one person in particular as a potential second case.

"Let me be real frank to the Dallas County residents, the fact that we have one confirmed case, there may be another case that is a close associate with this particular patient," he said in a Wednesday interview with WFAA. "... So this is real. There should be a concern, but it's contained to the specific family members and close friends at this moment."

The director continued to assure residents that the public isn't at risk as health officials have the virus contained.

Tuesday, the Center for Disease Control confirmed a patient at Texas Health Presbyterian Hospital Dallas was the first person to be diagnosed with the Ebola virus in the United States.

The patient left Liberia on September 19 and arrived in Dallas the following day. On September 26, he sought treatment at the hospital after becoming ill but was sent home with a prescription for antibiotics. Two days later, he was admitted with more critical symptoms, after requiring an ambulance ride to the hospital.

Local health officials say the patient was in contact with several children before he was hospitalized. Thompson says each of those children have been kept home and are under precautionary monitoring.

The Dallas County school district says they're working closely with health officials.

"DISD is in contact with Dallas County Health Department regarding the Ebola investigation," read a statement from Jon Dahlander, a spokesman with the district. "They are consulting with the County on any additional action that may need to be taken during the course of investigation. This is part of routine emergency operations during a health incident in the county. This is same protocol taken during things like flu and Tuberculosis cases."

More than a half a dozen employees with the CDC arrived in Dallas after news of the confirmed diagnosis broke. The CDC and Dallas County are working together in what they call a "contact investigation." Anyone who has had contact with the patient, including emergency room staff, will be under the observation of health officials for 21 days. If any of those under monitoring show symptoms, they'll be placed in isolation.

The three paramedics who transported the patient are temporarily off duty and among those under observation.

Accompanied by state health director David L. Lakey, Gov. Rick Perry will hold a press conference to address the diagnosis at noon from Texas Health Presbyterian Hospital.

WFAA's Jenny Doren contributed to this report

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VIA PFI

Sierra Leone News : Over 1,000 of 2,000 Lab-Confirmed Ebola Cases are not Accounted For!
By Awareness Times
Sep 29, 2014, 12:14

An article in the internationally acclaimed NEW YORK TIMES newspaper has openly mocked the Government of Sierra Leone’s announced numbers concerning Ebola patients by quoting a Western diplomat who said of the numbers:-

“Even a 2-year-old child can look at them and see they don’t add up!”

The NYTIMES article which was published on September 25th 2014 reported thus:
The numbers for Sierra Leone come from the Ministry of Health, and diplomats and international health officials say they are largely inaccurate, substantially underplaying the gravity of the situation on the ground. “Even a 2-year-old child can look at them and see they don’t add up,” the Western diplomat here said.

Many other internationally credible articles had revealed of greater number of burials of Ebola patients than was announced. These articles sparked widespread debates on social media with strong accusations amongst citizens that the Government was being deliberately dishonest.

However, it is a fact that the Government had very honestly informed in a Published Statement as far back as 24th September 2014 that the STAY AT HOME campaign which took place from 19th to 21st September, had revealed, "The true picture portrays a situation that is worse than what was being reflected in reports".

Despite this, many questions continued to be posed around especially at Dr. Sylvia Blyden, the Special Executive Assistant to the President who regularly engages citizens on social media. In response to the numerous queries, Dr. Blyden past Saturday September 27th took time to write the following which instantly went viral as it, for the first time, comprehensively showed cause of under-estimates.

UPDATE BY DR. SYLVIA BLYDEN

Let me thank all who have posed observations and questions to me about the incomprehensible difference in totals of announced lab-confirmed cases versus number of survivors & number of deaths. You are all quite right that the difference is currently like one thousand and clearly, such a large number of over 1,000 Ebola patients, are not to be found in health centers around the country. You are quite correct! So, where are these compatriots?

The fact is that a few of these unaccounted-for numbers are currently admitted in Ebola centers but I can categorically state today that the vast majority of the [over] 1,000 patients are already DEAD and lying in their graves. Yes, they are dead and buried! Hundreds of them! :-( May their souls rest in peace.

As some have repeatedly stated for months now, the numbers we are being given from Health Ministry as official Ebola death figures are absolutely incorrect. Before going further, let me state that the initial appearance of the hitherto unknown Ebola disease was a strange situation for us to handle and as can be perfectly understood, we had a tough learning curve during which we, as a country, made a series of blunders. One such blunder is the reason behind the erroneous death figures.

Let me explain.

The erroneous death figures within the laboratory-confirmed category, are NOT caused by deliberate massaging but a flight of common sense; probably caused by the stress of what was unfolding on us. What am I saying here? Please read the following explanation carefully...

Now, most of the missing patients not currently accounted for, have resulted from a policy where sick patients blood samples are collected from them in their villages and towns and these samples taken to the lab in Kenema, Kailahun or Freetown for testing whilst the patients were left behind in their communities, waiting for their results. By the time, the results were available as confirmed positive and health officials prepared and went back to the villages/towns with ambulances to collect the patients, only a few were met still alive. Many of these patients (most of whom had been seriously ill), had already died in their communities and been buried. May their souls rest in perfect peace.

Now here comes the 'interesting' part.

Former Health Minister Miatta Kargbo and former World Health Organisation Representative Dr. Jacob Mufunda, had ordered that ONLY DEATHS INSIDE CLINICAL FACILITIES were to be recognised as "confirmed deaths" to be announced. So, all those laboratory positive patients who died in their towns and villages before they could be collected in ambulances for treatment at Ebola Centers, were never announced as deaths though already announced amongst number of laboratory positive cases. These unannounced deaths of our compatriots, ran up to HUNDREDS of deaths of laboratory confirmed cases! May their souls rest in perfect peace.

This, is the simple reason behind the incorrect (fake) death figures in the laboratory confirmed categories. Sierra Leone was not counting our compatriots who died outside of health facilities. May their souls rest in perfect peace.

This grave error that resulted in skewed death figures, was immediately picked up by the new Health Minister, Dr. Abubakarr Fofanah, on assuming office and, in a poignant presentation to the Presidential Task Force on Ebola which included all top international diplomats, opposition party leaders, SLMDA doctors and key civil society members, the Health Minister Dr. Abubakar Fofanah carefully explained what had been happening under the watch of his predecessor. You just need to read the U.S. Embassy's Facebook updates posted after that Presidential Task Force meeting. (Check Sept 8th and Sept 10th U.S. Embassy updates. They speak volumes).

So, based on analytic presentation of the new Health Minister, it is now a Government policy that the death figures being announced for laboratory confirmed cases, should be reviewed - eventually. The Health Minister has already informed the CDC and the WHO on this.

As you can well imagine, after impending review, the death rates, Case Fatality Rate (CFR) and other attendant aspects will be significantly changed and a better understanding of the serious gravity of what is unfolding in Sierra Leone, will be known by the whole world. Please brace yourselves. The news is not good. However, rest assured that working together, we can overcome Ebola.

In addition, the review will also ensure proper inclusion of all SUSPECTED and PROBABLE deaths as per World Health Organisation definitions. Keen observers might have noticed that it is only recently, in last one month, that an attempt has been made to include suspected and probable deaths in the death numbers being announced.

Fellow Citizens and Friends of Sierra Leone, let us continue to keep our beautiful country's Ebola crisis in the mainstream of the world's attention. We have a very, very serious situation on our hands.

We made a lot of mistakes in the early stages because we had a steep learning curve. However, we can no longer blame a steep learning curve for any more mistakes. Let us gear up against Ebola!

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Globe in Monrovia: Forced cremation a final indignity in Ebola-stricken Liberia

MONROVIA — The Globe and Mail
Published Monday, Sep. 29 2014, 9:46 PM EDT
Last updated Tuesday, Sep. 30 2014, 10:38 AM EDT

The Globe’s Geoffrey York is in Liberia’s capital, Monrovia, as the nation worst-hit by West Africa’s Ebola outbreak grapples with an overwhelming public-health challenge. Follow him on Twitter at @geoffreyyork for updates.

When the body collectors arrived at the home of Theresa Jacob, at the top of a rocky hillside in Liberia’s capital, her family fought to keep her body. She didn’t die of Ebola, they insisted, showing a stack of hospital documents.

It was a futile battle. After a long argument, a team of Red Cross specialists entered the house in full Hazmat suits, goggles, masks, hoods, boots and two layers of gloves. They disinfected the body of the 24-year-old woman with a heavy chlorine spray, put her into a body bag, carried her down the hillside to their truck and drove her away to be cremated.

Because of the risk of Ebola, every body in Monrovia now is collected and burned, regardless of the cause of death. It’s a symptom of a nearly collapsed state in a massive emergency, when extraordinary measures are needed. With at least 1,830 deaths by official count – and two or three times that number by unofficial estimate – Liberia is the most devastated country in the Ebola zone.

Ms. Jacob’s neighbours were shocked when they saw how her body was collected. “Oh, they’re putting her in a plastic bag,” said one woman, wailing with grief.

Everyone in the neighbourhood knew that Ms. Jacob died of the liver illness that had left her bedridden for the past four years. But now she will never have a grave. Her family will have nowhere to visit on Decoration Day, the annual Liberian holiday when everyone goes to the cemetery to clean and decorate the graves of their ancestors, often painting Biblical inscriptions and images on the tombs to thank the ancestors for their sacrifices.

Ebola tests are not even conducted on dead bodies any more, because it’s believed that the information is not worth the extreme infection risk of taking samples from the bodies, and the delay of waiting two days for the results.

Many Liberians are furious at the removal policy. Ms. Jacob’s neighbours say her body was burned “like a dog.” Her husband, Isaiah, isn’t just worried about the absence of a grave for his wife. He also worries about his three children, and the stigma they might suffer for their perceived connection to an Ebola death.

Just hours after the Red Cross team removed Ms. Jacob’s body on Monday morning, two mysterious men showed up at her house and demanded that it be placed under quarantine. They refused to identify themselves, the neighbours say, but it was an early sign of the stigma the family will now endure.

One neighbour, Sam David, said it was painful to see Ms. Jacob’s body carried away by men in full Hazmat suits who sprayed her with disinfectant. “I felt very bad,” he said. “If it’s not Ebola, they should turn the body over to the family.”

Her death is likely to be officially categorized as a “possible” Ebola death, even though Red Cross officials admit it is unlikely that she died of Ebola.

Before any body is carried away, a Red Cross team leader always has a lengthy conversation with the family to explain why the strict policy of cremation has become so essential.

“He explains that they can’t take any chances,” said Red Cross spokesman Victor Lacken. “It has been upsetting, but we have to get the communities to accept that this has to be done. We try to do it as humanely and gently as possible.”

The Red Cross convoys, known as “dead body management” teams, collect corpses from across Monrovia almost every day. If families handle the dead on their own, there is a high risk of infection from Ebola victims, since the bodies are extremely contagious if touched in the first hours after death.

In the early months of the Ebola crisis, angry families often expressed open hostility to the Red Cross collection teams. Even on Monday, as Ms. Jacob’s body was removed, one neighbour could be heard muttering that the collectors were “lying.” But the hostility has eased as Liberians begin to understand the epidemic better.

For the Red Cross teams, the work is arduous and risky. Even though they are paid about $1,000 a month – a huge amount of money in impoverished Liberia – some staff have quit and the Red Cross has been obliged to search for new recruits.

The teams suffer the stigma of their Ebola association, but they also suffer the incredible heat and discomfort of their Hazmat suits. They can only wear them for about 40 minutes at a time, and sometimes they must change suits 10 or 15 times a day.

http://www.theglobeandmail.com/news...e-all-bodies-infected-or-not/article20852648/

There is at least one suspect case from the family/contact of the Dallas Ebola case.

http://fluboard.rhizalabs.com/forum/viewtopic.php?f=5&t=12456&start=2

However, Thompson pointed to one person in particular as a potential second case.

"Let me be real frank to the Dallas County residents, the fact that we have one confirmed case, there may be another case that is a close associate with this particular patient," he said in a Wednesday interview with WFAA. "... So this is real. There should be a concern, but it's contained to the specific family members and close friends at this moment."

Therefore, we are not in a lucky moment, such as the one cited in the book, The Hot Zone, where the nurse wandered from hospital to hospital, contacting many but infecting none.

The HCW's who contacted patient zero during his first trip to the ER are very much at risk. How did they not recognize that he was a Liberian with recent travel from that area? Perhaps a fatal error.

Posted by Exodia at the PFI Forum. This is quite good, penetrating questions that will probably never be answered without a lot of arm-twisting.


One more question, Dr. Frieden: 13 things we'd like to know about the first US Ebola diagnosis

By Jon Cohen Martin Enserink Kai Kupferschmidt 30 September 2014 9:30 pm
http://news.sciencemag.org/health/20...#disqus_thread

At a press conference this afternoon, Tom Frieden, the director of the U.S. Centers for Disease Control and Prevention (CDC), announced the first case of Ebola from the current epidemic who was diagnosed outside of Africa. The patient arrived in Dallas, Texas, on 20 September to visit relatives. Until today, the handful of people with Ebola in the United States were all diagnosed in Africa, carefully transported, and immediately provided with care in isolation units at hospitals.

The new patient had his temperature taken before boarding the flight out of Liberia on 19 September, U.S. officials say, and had no disease symptoms at the time. He first started feeling ill on 24 September, sought medical care two days later, and was hospitalized on 28 September. Labs at the CDC and the Texas Department of State Health Services both reported that his blood tested positive today for the Ebola strain circulating in West Africa.

Two ScienceInsider reporters called in to the press conference, but there was so much interest from the media that they did not get a chance to ask a question. Here, however, are some of the questions they would like to have asked.

Q: Dr. Frieden, it sounds like the patient wasn't tested for Ebola when he first sought medical care, on 26 September, even though he had just arrived from a country with an Ebola epidemic. Why not? Did the health care provider who saw him know he had arrived from Liberia six days earlier?

Q: How many health care workers and how many others came into contact with the patient before he was isolated?

Q: You said the patient's contacts are now being monitored. Can you give some details about this? Does it include going to their homes and taking their temperature daily? Or do you communicate with them by electronic means, such as phone calls, text messages, and e-mails?

Q: Are contacts being told to isolate themselves from their friends and family while they are being monitored?

Q: Does the government have any legal authority to force potential contacts to cooperate if they don't want to? Are they free to travel?

Q: Has the house where the patient was staying been disinfected, and if so, how exactly?

Q: What experimental therapies are available now for the patient, should he want to use them? Would you recommend anything specific?

Q: Does the patient or his family members have an idea about how he got infected?

Q: Virologist Heinz Feldmann has described procedures at the airport in Monrovia as a "disaster" and said it was the most dangerous situation he encountered during his visit to Liberia. Could the patient have become infected at the airport? Is that possibility being investigated?

Q: What is the estimated number of people entering the United States each week who have recently been in one of the countries affected by the epidemic?

Q: The number of Ebola cases is roughly doubling every three weeks; CDC's own worst case-scenario says there may be as many as 1.4 million patients by 20 January. Should the US and other countries prepare to see imported cases on a regular basis?

Q: The World Health Organization has raised the possibility that Ebola could become endemic in West Africa. If that happens, how should the U.S. deal with people traveling from these countries in the future?

Q: One more question, Dr. Frieden. The United States is paying a lot of attention to this single case right now. Do you think that will increase the amount of money and number of people the U.S. is willing to dedicate to containing the outbreak in West Africa?

*The Ebola Files: Given the current Ebola outbreak, unprecedented in terms of number of people killed and rapid geographic spread, Science and Science Translational Medicine have made a collection of research and news articles on the viral disease freely available to researchers and the general public.

Do not be concerned that other threads pop up and people will express their opinions and exclamations on them. We still need one uncluttered thread with the unfolding of events and main concerns.

Let them pound the tables on the side threads!!

42 confirmed, suspected Ebola cases die in northern Equateur province: DRC

INSHASA, Oct. 1 (Xinhua) — A total of 42 people has been killed by confirmed and suspected Ebola infection in the Equateur province in northern Democratic Republic of Congo (DRC), Felix Kabange, minister of public health said on Wednesday.

A total of 30 cases had be confirmed, out of which 16 died, 2 in isolation and 12 healed, according to the minister. Other deaths are among the 14 suspected and 26 probable cases.

He said 243 people are being monitored among the 245 who had been in contact with Ebola patients.

“The dead include eight health workers and three isolation cases, all in Djera,” he added.

By Monday, 139 specimens had been tested, and the last positive case was confirmed on Sept. 24, according to the minister.

With the first case confirmed in mid-August, the DR Congo’s is experiencing the seventh Ebola outbreak since 1976.

http://maxwellreyes.com/42-confirmed-suspected-ebola-cases-die-in-northern-equateur-province-drc/

Ben Berkowitz ‏@BerkowitzBT 30m30 minutes ago
Sales of full-body Tyvek suits are up nearly 19,000 percent in the last 24 hours on Amazon. #EbolaOutbreak

from twitter

So are we running two threads on ebola, one for the US and one for the rest of the world or what in the heck are we doing? I don't know where to post what right now??? Confused?

She

Posted by Pixie at the PFI Forum. I somewhat like Perry. This confirms that he has more guts than brains.

Perry plans Dallas news conference on Ebola case

The Associated PressOctober 1, 2014 Updated 30 minutes ago
http://www.heraldonline.com/2014/10/.../100/107/&rh=1

DALLAS — Gov. Rick Perry has scheduled a news conference at a Dallas hospital where a man with the first case of Ebola diagnosed in the U.S. remains in isolation.

Perry plans to speak at noon CDT Wednesday at Texas Health Presbyterian Hospital. He'll be joined by Dr. David Lakey, who's commissioner of the Texas Department of State Health Services.

Medical officials on Tuesday confirmed that the critically ill patient has tested positive for Ebola. He recently flew from Liberia to Dallas to be with relatives.

Experts from the Centers for Disease Control and Prevention are working to help locate his family, friends or others who came in contact with the sick man.

Mayor Mike Rawlings has activated the emergency's operations center at Dallas City Hall.
_______

SheWoff said:

So are we running two threads on ebola, one for the US and one for the rest of the world or what in the heck are we doing? I don't know where to post what right now??? Confused?

She

Click to expand...

I am posting the U.S. stories on both threads.

SheWoff said:

Ben Berkowitz ‏@BerkowitzBT 30m30 minutes ago
Sales of full-body Tyvek suits are up nearly 19,000 percent in the last 24 hours on Amazon. #EbolaOutbreak

from twitter

Click to expand...

We'll be seeing how quickly basic supplies run out. It will be like trying to get .22 ammo. There simply isn't enough of a capacity to ramp up the just in time supply system. If anyone needs them and can't find them online then go down to your local box store, hardware store, home improvement store or paint store and purchase the 'paint' suits. Same thing for the masks, respirators and gloves. If people get concerned locally and put two plus two together these sources will quickly deplete as well. Hopefully most of us have acted before it became a concern because you just know the prices will start going up too.

Posted by Pixie at the PFI Forum. Now the experts, (who are not under orders), chime in. WE ARE NOW IN THE MERCILESS HANDS OF CHAOS.


Top doc: 'Several people were exposed,' more will be infected by Dallas Ebola case

BY PAUL BEDARD | OCTOBER 1, 2014 | 9:36 AM
http://washingtonexaminer.com/article/2554213?

A former Food and Drug Administration chief scientist and top infectious disease specialist said that several people were exposed to the Ebola virus by the unidentified patient in Dallas, America’s first case, and it’s likely that many more will be infected.

Dr. Jesse L. Goodman, now a professor of medicine at Georgetown University Medical Center, said while the nation shouldn’t panic, it’s best to prepare for the worst.

“It is quite appropriate to be concerned on many fronts,” he said in a statement provided to Secrets. “First, it is a tragedy for the patient and family and, as well, a stress to contacts, health care workers and the community at large. Second, it appears several people were exposed before the individual was placed in isolation, and it is quite possible that one or more of his contacts will be infected,” he added.

What’s more, he conceded that it was “only a matter of time” that the swift-killing African virus arrived in the U.S.

“If anyone did not agree before, bringing the epidemic in Africa under control is an absolute emergency and requires a massive effort and global commitment now long overdue. This is a matter not just of preventing death and suffering in Africa, but, as this case brings home to the U.S., of global safety and security,” he warned.

He also strongly suggested that the one case will not be the end.

“While there is an expectation that this case, and likely future ones, can be contained, it is important not to be overconfident and to continuously, now and in the future, reexamine both how the virus is behaving and also the public health and medical response to see what can potentially be improved,” he said.

Like others in the medical field, Goodman asked why it is that the Ebola case wasn’t detected earlier and he demanded that testing protocols be reevaluated.

“It is critical for hospitals and health care workers everywhere to be sure they are alert, obtain travel histories and, if there is any question at all it could be Ebola, contact CDC and, while sorting things out, act to isolate a sick patient returning from an epidemic area,” he said.

Georgetown’s medical staff has been on high alert for Ebola, as have other local hospitals. What’s more, Georgetown University has been closely following the case because it has close to ties to many of the impacted countries and has educators who have traveled to the region.

Nonetheless, Goodman suggested that travel now be limited to the area.

“If less people traveled, risks may be reduced, and active follow-up and education of travelers could also be facilitated.”

Paul Bedard, the Washington Examiner's "Washington Secrets" columnist, can be contacted at pbedard@washingtonexaminer.com.
_______________

Medical Maven said:

I am posting the U.S. stories on both threads.

Click to expand...

Sounds good to me..thanks MM

Posted at the PFI Forum by Pixie. (It just keeps getting worse. Negative test results at this point mean NOTHING).


EMS crew exposed to Ebola victim tests negative

The Associated Press 10:02 a.m. CDT October 1, 2014
http://www.khou.com/story/news/local...ion/16522207/?

DALLAS (AP) - Three members of the ambulance crew that transported a man diagnosed with Ebola to a Dallas hospital have tested negative for the virus and are restricted to their homes as health officials monitor their conditions.

Dallas city spokeswoman Sana Syed says the Dallas Fire-Rescue EMS crew was tested Tuesday night and sent home. They have not exhibited any symptoms of the virus.

Syed says the man transported to Texas Health Presbyterian Hospital on Sunday was vomiting when the ambulance arrived.

She says the ambulance crew is among 12 to 18 people health officials are monitoring because they were exposed to the man. Some are members of his family, but not all.
_______

Medical Maven said:

Posted at the PFI Forum by Pixie. (It just keeps getting worse. Negative test results at this point mean NOTHING).


EMS crew exposed to Ebola victim tests negative

The Associated Press 10:02 a.m. CDT October 1, 2014
http://www.khou.com/story/news/local...ion/16522207/?

DALLAS (AP) - Three members of the ambulance crew that transported a man diagnosed with Ebola to a Dallas hospital have tested negative for the virus and are restricted to their homes as health officials monitor their conditions.

Dallas city spokeswoman Sana Syed says the Dallas Fire-Rescue EMS crew was tested Tuesday night and sent home. They have not exhibited any symptoms of the virus.

Syed says the man transported to Texas Health Presbyterian Hospital on Sunday was vomiting when the ambulance arrived.

She says the ambulance crew is among 12 to 18 people health officials are monitoring because they were exposed to the man. Some are members of his family, but not all.
_______

Click to expand...

WHAT EFFING HAPPENED TO THE 21 DAY QUARANTINE???!!!???

I was the OP on the other thread. I created a new thread because it was the first and it was still unconfirmed.
Now that it has been confirmed, with all of the news releases leading up to confirmation, it would seem reasonable to close it at some point and return to posting updates on a main thread for all new cases so there is one place to go for updates.

raven said:

I was the OP on the other thread. I created a new thread because it was the first and it was still unconfirmed.
Now that it has been confirmed, with all of the news releases leading up to confirmation, it would seem reasonable to close it at some point and return to posting updates on a main thread for all new cases so there is one place to go for updates.

Click to expand...

Yeah, I don't care WHAT thread.....just please limit it to ONE.....going back and forth between two threads is a pita.

I'm going to stick with this thread, I think... and my apologies if this article was already posted. I hadn't seen it.

http://www.usatoday.com/story/news/nation/2014/10/01/texas-ebola-patient/16525649/

Officials: Second person being monitored for Ebola


DALLAS — Health officials are closely monitoring a possible second Ebola patient who had close contact with the first person to be diagnosed in the U.S., the director of Dallas County's health department said Wednesday.

All who have been in close contact with the man diagnosed are being monitored as a precaution, Zachary Thompson, director of Dallas County Health and Human Services, said in a morning interview with WFAA-TV.

"Let me be real frank to the Dallas County residents: The fact that we have one confirmed case, there may be another case that is a close associate with this particular patient," he said. "So this is real. There should be a concern, but it's contained to the specific family members and close friends at this moment."

The director continued to assure residents that the public isn't at risk because health officials have the virus contained.

On Tuesday, the Centers for Disease Control and Prevention confirmed a patient at Texas Health Presbyterian Hospital Dallas was the first person to be diagnosed in the United States with the Ebola virus.

The patient left Liberia on Sept. 19 and arrived in Dallas the following day. On Sept. 26, he sought treatment at the hospital after becoming ill but was sent home with a prescription for antibiotics. Two days later, he was admitted with more critical symptoms, after requiring an ambulance ride to the hospital.

The patient was in contact with several children before he was hospitalized, health officials here said.

Each of those children have been kept home from school and are under precautionary monitoring, Thompson said.

The Dallas County school district officials said they are working closely with health officials.

"They are consulting with the county on any additional action that may need to be taken during the course of investigation," district spokesman Jon Dahlander said in a statement. "This is part of routine emergency operations during a health incident in the county. This is same protocol taken during things like flu and tuberculosis cases."

More than a half a dozen CDC employees arrived in Dallas after news of the diagnosis broke. The CDC and Dallas County are working together in what they call a contact investigation.

Anyone who has had contact with the patient, including emergency room staff, will be under health officials' observation for 21 days. If any of those being monitored show symptoms, they'll be placed in isolation.

The three paramedics who transported the patient in Dallas are temporarily off duty and among those under observation.

Stanley Gaye, president of the Liberian Community Association of Dallas-Fort Worth, said the 10,000-strong Liberian population in North Texas is skeptical of the CDC's assurances because Ebola has ravaged their country.

"We've been telling people to try to stay away from social gatherings," Gaye said at a community meeting Tuesday. Large get-togethers are a prominent part of Liberian culture.

Ebola symptoms can include fever, muscle pain, vomiting and bleeding and can appear as long as 21 days after exposure to the virus. The disease is not contagious until symptoms begin, and it takes close contact with bodily fluids to spread.

Texas Gov. Rick Perry and the state's health director, David Lakey, will have a noon CT press conference at Texas Health Presbyterian Hospital here to address the diagnosis.

Contributing: Jenny Doren, WFAA-TV, Dallas-Fort Worth; The Associated Press

How Bad Could It Get?
US Government Order Of 160,000 HazMat Suits Gives A Clue


Submitted by Tyler Durden on 10/01/2014 11:17 -0400
http://www.zerohedge.com/news/2014-...vernment-order-160000-hazmat-suits-gives-clue

Now that Ebola is officially in the US on an uncontrolled basis, the two questions on
everyone's lips are i) who will get sick next and ii) how bad could it get?

We don't know the answer to question #1 just yet, but when it comes to the second
one, a press release three weeks ago from Lakeland Industries, a manufacturer and
seller of a "comprehensive line of safety garments and accessories for the industrial
protective clothing market" may provide some insight into just how bad the US State
Department thinks it may get. Because when the US government buys 160,000
hazmat suits specifically designed against Ebola, just ahead of the worst Ebola
epidemic in history making US landfall, one wonders: what do they know the we
don't?

From Lakeland Industries:Of course, purchases by the US government are bought and paid for by taxpayers.
For everyone else there's $1200 mail-order delivery:



That said... 160,000 HazMats
for a disease that is supposedly not airborne? Mmmk.

workerbee said:

Yeah, I don't care WHAT thread.....just please limit it to ONE.....going back and forth between two threads is a pita.

Click to expand...

I wonder if there was a way they could close it and pin it somewhere for folks that got to the party late and want to see history unfold

A friend commented today on the mistakes being made. These are not mistakes, these are crimes. They are only mistakes if the people don't know what to do.

No, there is no 21 day quarantine, only monitoring of the exposed HCW's.

On the other hand, if you had no ability to treat or effectively isolate such a walk-in patient, would you let him into your hospital to expose/kill your staff and other patients or send him home?

Difficult question for difficult days. Until there is a rapid response ready to take such patients into a true isolation unit, such as one of the 22 known hospital beds in the country, or even to a FEMA camp for treatment by people in space suits, admitting such a patient is a death sentence for some of your best people - some of the best people in the city.

If the broken government doesn't get its act together and fast, anarchy is coming. Count on it.

The Ebola Epidemic Is About to Get Worse. Much Worse.

As in: We need to order 500 million vaccines. Now.

By MICHAEL T. OSTERHOLM

Michael T. Osterholm is director of the Center for Infectious Disease Research and Policy at the University of Minnesota.



September 30, 2014

Ebola is spreading faster than anyone would like to admit, and the current, slow international response to the deadly disease is morphing into a modern tragedy. On Tuesday, the Centers for Disease Control and Prevention (CDC) in Atlanta confirmed the first case in the United States, in Dallas. If Ebola has already arrived on these shores, imagine how quickly it could be spreading in Africa.

Ebola’s dispersion on the African continent must be stopped soon. But right now there exists no realistic scheme to do so: Plan A is failing, there is no real Plan B and the best chance for a magic bullet—Plan C—is at best many months away.

Plan A—smothering the virus where it is currently an epidemic—hinges on having a sufficient number of Ebola treatment-center beds in African countries and necessary health-care providers for every Ebola virus disease (EVD) patient. In this ideal setting, each EVD patient is isolated and is no longer in a position to transmit the virus to family members or others in the community. Once patients are identified, public health workers begin to track down their contacts to ensure that if contacts become sick with EVD-like symptoms they are quickly provided a treatment-center bed, where they, in turn, can be isolated and the process repeats itself. This strategy has worked in containing every previous Ebola outbreak.

But Plan A is clearly not good enough this time. The truth is that we are failing miserably at containing Ebola, despite daily pledges by governments and philanthropic organizations to provide more health-care workers and additional financial and logistical support. It’s also despite the heroic work of a limited number of national and international volunteer health-care workers and public health professionals who are risking their lives daily so that others may live and the epidemic can be stopped.

Plan B—stopping any further spread—doesn’t exist, either for quickly stopping the transmission of the virus within Liberia, Sierra Leone and Guinea or for squelching it if it leaps to the slums of other large urban areas across Africa. Nigeria and Senegal, together with the CDC, succeeded in halting the virus’ spread after single introductions of the disease. If an infected person reaches a crowded area where health-care services are limited, however, it could spread exponentially.

In the end, the only guaranteed solution to ending this Ebola crisis is to develop, manufacture and deliver an effective Ebola vaccine, potentially to most of the people in West Africa, and maybe even to most of the population of the African continent. This is Plan C, and it is still a long way off. While the U.S government has done more than other international players to support the possibility of developing an effective vaccine, current efforts still fall short of what is needed to implement an effective vaccination strategy.

***

How bad is the Ebola epidemic? It’s bad, but the honest answer is we don’t know just how bad.

So far, the reported number of deaths from Ebola in Africa is 3,044, and the World Health Organization believes the actual death toll could be three times that many. Just last week, the WHO estimated that as many as 20,000 EVD cases would likely occur in the three affected countries by early November. Meanwhile, the CDC projected a worse-case scenario of 1.4 million cases in Liberia and Sierra Leone by the middle of January unless effective interventions are implemented. These widely varying estimates by the world’s two leading public health agencies illustrate how little we know about the future course of this crisis, and demonstrate the need to scrutinize the statistical models used to estimate future case numbers. Any such estimates are only as good as the imprecise assumptions statisticians use to create the models. I don’t even try to predict the number of Ebola cases and deaths over the next few months except to conclude that there will be a lot of them—more than we should ever imagine.

The optimists tell us the disease is under control. Bill Gates, whose foundation has donated $50 million to respond to the epidemic, said earlier this week, “There’s a pretty clear road map of what needs to be done. … What’s taking place now is quite impressive.” Tony Banbury, the WHO official who oversees the emergency operations center for the Ebola crisis, declared this past week, “The United Nations is moving at lightning speed to bring a response on the ground to meet the challenges posed by this terrible disease.”

But this kind of rhetoric is not being translated into action, according to Joanne Liu, the international president of the NGO Doctors Without Borders. The promised surge of aid is still largely a promise, with beds and medicine in short supply. Liu said this week. “[E]verybody in their intentions is moving fast, but in the field we are moving at the speed of a turtle.” Tragically, every credible report from the front lines of the Ebola battle supports Liu’s more pessimistic assessment.

Plan A continues to fail today for one simple reason. Donor countries and organizations are operating on “program or bureaucracy time,” while the epidemic is unfolding on “virus time.” Thirty days of planning to deliver on-the-ground support might be considered lightning speed to a foreign aid officer, but it is an eternity for a virus being transmitted by physical contact between many people living in intensely crowded conditions. Each day of delay is also another day of hell for newly infected Ebola patients and their exhausted health-care providers.

Think of fighting a forest fire. Imagine waiting days before the necessary resources arrive; it means the blaze has expanded by the hour. And stopping a 100-acre fire is a lot different than containing a 100,000-acre fire. Every day the global response to Ebola falls far short in terms of treatment beds, health-care providers, public health workers and even adequate food and safe water is another day the epidemic grows substantially and becomes that much harder to contain. What might have been an adequate response last month now becomes much less effective.

We’ve seen increased finger-pointing about who didn’t and still hasn’t provided critical leadership or necessary resources. This debate will play out for years to come. But no one individual or group of individuals is to blame; instead, almost everyone involved is. And, unfortunately, far too many leaders, organizations and agencies still don’t understand the concept of virus time or the desperate need for command and control leadership in the affected countries.

Imagine if the only plan for Minneapolis to respond to a rapidly spreading fire were to call the New York City fire department for mutual aid. Leaders in both cities would speak proudly of the caravan of fire trucks and firefighters making their way westward. In the meantime, downtown Minneapolis would quickly become an inferno. That’s essentially the international response to the West African Ebola epidemic. World leaders have never prepared themselves or the global community for the public health actions necessary to combat this type of situation.

Doctors Without Borders and other NGOs on the front lines tried to warn the public health community as early as March that this Ebola outbreak was very different and would require unprecedented response resources. No one listened then, and the virus continued to spread unfettered across the three countries. Once it got a foothold in crowded, poverty-stricken West African cities, it was like igniting gasoline.

The U.S. government has in recent days taken a leadership role in responding to this international crisis. President Obama has urged a comprehensive, rapid response. His willingness to deploy military troops to support critical transportation, logistics and supply chain needs is an important step. (But again, the president’s promises of a month ago have been slow to become reality, and in many instances have not yet been acted upon.) CDC Director Dr. Tom Frieden has issued clear and compelling warnings over the last six weeks about the dire consequences of our ineffective response. CDC professionals are also providing valuable support in trying to track and stop new cases.

But the international public health community had never seriously planned for a “black swan” event such as this epidemic, so having an alternative to Plan A was never considered. You might call the recent quarantine restrictions employed by the governments of Liberia and Sierra Leone as an attempt at Plan B. But these measures have largely failed to control the disease’s spread, while they have been a humanitarian disaster.

For the affected countries, sadly, it’s already too late for a Plan B. Regardless of whose case estimates you believe, those put forward by the WHO or the worst-case numbers put forward by the CDC, the number of cases in these countries will increase substantially in the coming months. Everything in my 40 years of experience as a public health official and infectious disease researcher tells me this virus has a high likelihood of spreading to other African countries. And unlike in Nigeria and Senegal, it might not be so easily contained this time. What is our plan to fight this Ebola war on multiple African fronts when we can’t handle the current battles in West Africa?

We know how the disease will likely spread in the months ahead. Each year, thousands of young West African men and boys are part of a migratory work population not too dissimilar from U.S. migrant farm workers. Crop-friendly rains wash over West Africa from May to October, forming the growing season. These young men typically help with harvesting in their home villages from August to early October, but afterward head off for temporary jobs in artisanal gold mines in Burkina Faso, Mali, Niger and Ghana; cocoa nut and palm oil plantations in Ghana and Cote d’Ivoire; palm date harvesting and fishing in Mauritania and Senegal; and illicit charcoal production in Senegal, Mali, Cote d’Ivoire, Ghana, Burkina Faso and Niger.

This migration is about to begin, even for young men whose villages have been recently hit by EVD. These workers find daily laborer jobs at $5 per day, half of which they remit to their families back home. Like their ancestors before them, they use little-known routes and layovers through forests to avoid frontier checkpoints. They usually have ECOWAS ID cards, providing free passage to all the member states of the Economic Community of West Africa States. It takes one to three days to travel from the EVD-affected countries to these work destinations. There is no need for Ebola to hop a ride on an airplane to move across Africa: It can travel by foot.

Densely populated African cities such as Dakar, Abidjan, Lagos and Kinshasa—teeming with jam-packed slums as far as the eye can see—could be most at risk. This is the nightmare scenario. It is all too real, and yet no international, coordinated plan exists for how to respond to what would likely be an even more catastrophic event. Ask the world's intelligence and security experts what an Ebola epidemic unleashed on Africa’s megacities could mean for the continent’s stability. We need a Plan B, or hundreds of thousands of people may die.

And what of Plan C? The use of effective, safe vaccines has been a foundation of modern public health. We even eradicated one of the Lion Kings of infectious disease—smallpox—with an effective vaccine. Unfortunately, not all infectious agents can be relegated to the history books through vaccination. We are still searching for effective and safe vaccines for diseases such as AIDS, malaria and TB. But I feel certain that a safe and effective Ebola vaccine is on it way.

Will it come soon enough? On virus time? And on the scale that the disease demands? Only a month ago, the primary discussion around developing, approving, manufacturing and distributing an effective and safe Ebola vaccine was to protect a few thousand health-care workers and prevent the few remaining community-acquired Ebola cases that continued to occur. But it’s now a different ballgame. This epidemic could grow much, much larger and become what we call an endemic disease—one that doesn't go away. Science recently published two must-read articles, by Jon Cohen and Kai Kupferschmidt, about the grim reality of trying to find and produce an effective vaccine: Their conclusion was that government bureaucracy, a lack of adequate funding and battles between government and private-sector companies have prevented progress.

The first critical mistake public-health officials often make amid such outbreaks is failing to consider another black-swan scenario. At the moment, they are focused only on meeting the vaccine need in the three affected countries. If this virus makes it to the slums of other cities, the epidemic to date will just be an opening chapter. Africa contains more than a billion people, and is growing faster than anywhere else in the world. If world leaders don’t make it a priority now to secure up to 500 million doses of an effective Ebola virus vaccine, we may live to regret our inaction. It’s that serious.

Securing 500 million doses of an effective Ebola virus vaccine is going to require a partnership between government and vaccine manufacturers that puts it on the same footing as our response to an emerging global influenza pandemic. This will require mobilizing people and resources on a massive scale—it has to be the international community’s top priority.

In the words of Sir Winston Churchill, “It’s no use saying, ‘We’re doing our best.’ You have got to succeed in doing what is necessary.” It’s time to do what is necessary to stop Ebola. Now.

Michael T. Osterholm is director of the Center for Infectious Disease Research and Policy at the University of Minnesota.

Read more: http://www.politico.com/magazine/sto...#ixzz3EvNXZVQz

WHO Situation reports: Ebola response roadmap

• Situation report - 1 October 2014
  pdf, 1.32 Mb

All situation reports

The Liberian Dallas case had helped carry his landlord's daughter to the hospital. She and her brother have since died.

He knew he was exposed, and came to the US for health care, just as some had worried after the huge PR campaign about Brantly and friends.

Wouldn't you do the same, if you thought you could get here before falling ill, in his case?

The main and, sadly, overwhelmingly fatal problem we have in our elite corps, whether they be media, corporate hedgehogs, or government leaders, is that they have no concept of human nature. They live in secure bubbles, far removed from the nitty gritty of real life. I know, used to live and work in those circles. They have never felt hunger, or real fear of being stripped of everything. Their worst problems might involve an annoyed spouse because a tennis date conflicted with her expectations.

We are living out the inevitable collapse, and it appears to have begun.

http://fluboard.rhizalabs.com/forum/viewtopic.php?f=5&t=12465&start=5

"
Mr. Duncan may have become infected after his landlord’s daughter fell gravely ill. On Sept 15, Mr. Duncan helped his landlord and his landlord’s son carry the stricken woman to the hospital, his neighbors and the woman’s parents said. She died the next day.

Soon, the landlord’s son also became ill, and he died on Wednesday in an ambulance on the way to the hospital. Two other residents in the neighborhood who may have had contact with the woman have also died. Their bodies were collected on Wednesday as well."

Gotta love this quote from the Dr. in Dallas:


Question from person:
"What are the chances of the United States facing a major Ebola outbreak? The only reason I'm asking is due to the fact that we are still allowing people from Africa to enter this country and one has already tested positive for the Ebola virus. "

Answer:

"John Carlo:
Very low likelihood. Not much you can do to avoid having people come and go. We are a global community."

http://www.wfaa.com/story/news/health/2014/10/01/ebola-chat-dr-john-t-carlo/16544267/

Baloo said:

Gotta love this quote from the Dr. in Dallas:


Question from person:
"What are the chances of the United States facing a major Ebola outbreak? The only reason I'm asking is due to the fact that we are still allowing people from Africa to enter this country and one has already tested positive for the Ebola virus. "

Answer:

"John Carlo:
Very low likelihood. Not much you can do to avoid having people come and go. We are a global community."

http://www.wfaa.com/story/news/health/2014/10/01/ebola-chat-dr-john-t-carlo/16544267/

Click to expand...

In any other profession, you'd be fired for such a lame and stupid answer. All these mouth pieces are morally culpable for whatever happens!

Squib said:

In any other profession, you'd be fired for such a lame and stupid answer. All these mouth pieces are morally culpable for whatever happens!

Click to expand...

And Dr. Sanjay Gupta on CNN is just as bad in most of his reports. They have had him on about every 30 minutes all day long.

These two paragraphs from the main posted article are what caught my attention. Things are about to go exponentially exponential.



The Ebola Epidemic Is About to Get Worse. Much Worse.

As in: We need to order 500 million vaccines. Now.

By MICHAEL T. OSTERHOLM

Michael T. Osterholm is director of the Center for Infectious Disease Research and Policy at the University of Minnesota.
http://www.politico.com/magazine/sto...#ixzz3EvNXZVQz



September 30, 2014



We know how the disease will likely spread in the months ahead. Each year, thousands of young West African men and boys are part of a migratory work population not too dissimilar from U.S. migrant farm workers. Crop-friendly rains wash over West Africa from May to October, forming the growing season. These young men typically help with harvesting in their home villages from August to early October, but afterward head off for temporary jobs in artisanal gold mines in Burkina Faso, Mali, Niger and Ghana; cocoa nut and palm oil plantations in Ghana and Cote d’Ivoire; palm date harvesting and fishing in Mauritania and Senegal; and illicit charcoal production in Senegal, Mali, Cote d’Ivoire, Ghana, Burkina Faso and Niger.

This migration is about to begin, even for young men whose villages have been recently hit by EVD. These workers find daily laborer jobs at $5 per day, half of which they remit to their families back home. Like their ancestors before them, they use little-known routes and layovers through forests to avoid frontier checkpoints. They usually have ECOWAS ID cards, providing free passage to all the member states of the Economic Community of West Africa States. It takes one to three days to travel from the EVD-affected countries to these work destinations. There is no need for Ebola to hop a ride on an airplane to move across Africa: It can travel by foot.

The Ebola code of silence: Column
http://www.usatoday.com/story/opinion/2014/10/01/ebola-risk-airborne-danger-texas-column/16542763/

Happy talk from politicians and public health leaders won't stop infectious diseases. The public needs to know and understand is this: Ebola is a deadly virus and like all viruses it can and will mutate and change.

Right now the disease only spreads from person to person by bodily fluids but there is a possibility that could change and the disease could become airborne. If it does, we could face a public health challenge like we haven't seen in this country since smallpox or polio. Worse yet: even if Ebola doesn't mutate, there is a good chance that some other novel infectious disease that we know about now (or will find out about in the future) will cause a pandemic and result in a significant loss of life.

The public needs to be cognizant of these real and present dangers to calibrate their expectations about the limited capabilities of our health care and public health systems and to increase our community resilience to deal with these threats.
Even after the arrival of Ebola in Texas, the national dialogue in the United States remains naive, overly optimistic and full of misleading assurances from elected officials and public health experts. What the
We currently have an overconfident view about the capabilities of our health care and
public health systems in this country. This overconfidence comes in part due to willful ignorance and in part due to leaders who want the public to believe they've got things more under control than they actually do. The reality is that we have significantly underinvested in public health for decades.

The lack of infectious disease outbreaks gave the public the idea that public health was no longer a concern and policymakers capitalized on this by taking away funding for public health. The annual budget for the Centers for Disease Control and Prevention is about $11 billion. To put that number into perspective, there is a chance that Americans could spend close to that amount on Halloween festivities this year.

The state of public health funding at the state and local level is even more dire. Many public health departments in the past few years have had to cut critical programs and initiatives due to dramatic funding cuts. There is no other way to slice it — our public health system is not ready to deal with a challenge like Ebola if the situation takes a turn for the worse.

Americans also have an overconfident view of our health care system as a whole. The reality is that the surge capacity of our existing health care system is limited and any large-scale disease outbreak could overwhelm that system. While we have plans to
large-scale disease outbreak could overwhelm that system. While we have plans to use portable pop-up hospital tents and beds to expand surge capacity, we haven't yet figured out how to create pop-up nurses and doctors to staff them. In addition, infection control in our hospitals is a concern. The SARS outbreak demonstrated just how hard it is to prevent the spread of some infectious diseases and how easy it can be for those diseases to spread in hospitals despite our best efforts to contain them.

The most significant panacea that gets waved before the public is a miracle vaccine. Given our success with vaccines in Western countries, the public assumes that vaccines can be developed and administered quickly. This is a naive belief that doesn't match with the facts. It could take a year or more to develop a vaccine for a novel infectious disease that could be ready for widespread use. In the interim, a disease would have free reign to spread through the population with a limited number of non-pharmacological interventions to stop it.

Our leaders seem to be so concerned about avoiding panic that they are willing to give the public any type of assurance to placate them. We were initially told that the current Ebola outbreak would be contained and wouldn't be that large. Now we are being told that estimates put the number that could get the disease at more than a million.

Sending 3,000 troops to West Africa is a Band-Aid solution to a much larger problem. In today's globalized world we can't pretend that diseases "over there in Africa" are no longer our concern. We also can no longer pretend that our country's greatest threats are from terrorists.

We need to change our world view (sooner rather than later) to appreciate that novel infectious disease outbreaks may be one of our greatest threats that require real resources and significant funding if we are to stand a chance.

THIS IS WORTH REPOSTING.

Head between the knees. Prepare for impact.

Dallas Ebola patient vomited outside apartment on way to hospital

http://news.yahoo.com/traveler-liberia-first-ebola-patient-diagnosed-u-003007621--finance.html
By Lisa Maria Garza

DALLAS (Reuters) - Two days after he was sent home from a Dallas hospital, the man who is the first person to be diagnosed with Ebola in the United States was seen vomiting on the ground outside an apartment complex as he was bundled into an ambulance.

"His whole family was screaming. He got outside and he was throwing up all over the place," resident Mesud Osmanovic, 21, said on Wednesday, describing the chaotic scene before the man was admitted to Texas Health Presbyterian Hospital on Sunday where he is in serious condition.

The hospital cited the man's privacy as the reason for not identifying him. However, Gee Melish, who said he was a family friend, identified the man in Texas infected with Ebola as Thomas Eric Duncan.

The New York Times said that Duncan, in his mid-40s, helped transport a pregnant woman suffering from Ebola to a hospital in Liberia, where she was turned away for lack of space. Duncan helped bring the woman back to her family's home and carried her into the house, where she later died, the newspaper reported. Four days later Duncan left for the United States, the Times said, citing the woman's parents and neighbors.

Texas health officials said that up to 18 people, including five children, had contact with the Ebola patient after he traveled to the United States from Liberia in late September. The children had gone to school early this week but have since been sent home and are being monitored for symptoms.

The Dallas Ebola case has prompted national concern over the potential for a wider spread of the deadly virus from West Africa, where at least 3,338 people have died in the worst outbreak on record.

U.S. health officials have said the country's healthcare system was well prepared to contain any spread of Ebola, through careful tracking of people who had contact with the patient and appropriate care for those admitted to hospital.

U.S. stocks fell sharply. Airline and hotel company shares dropped over concerns that Ebola's spread outside Africa might curtail travel.

Drugmakers with experimental Ebola treatments in the pipeline saw their shares rise.

SENT HOME

The patient had initially sought treatment at Texas Health Presbyterian Hospital late on Thursday and was sent home with antibiotics rather than being observed further, even though he told a nurse he had recently returned from West Africa. By Sunday, he needed an ambulance to return to the same hospital, where he was admitted.

A nurse asked about the travel as part of a triage checklist and was told about it. “Regretfully, that information was not fully communicated throughout the full teams. As a result, the full import of that information wasn’t factored into the full decision making,” Texas hospital official Mark Lester said.

Infectious disease experts said that time gap represented a critical missed opportunity that may have led others to be exposed to the virus.

At the apartment complex, Osmanovic said he met the man three times over the years when he was visiting his family. Most of the neighborhood is from Liberia, Somalia or the Sudan. Osmanovic is from Bosnia.

The only sign Wednesday of the family's presence was someone occasionally pulling back the white blinds to peek out into the parking lot. A security officer blocked the entrance to the complex, with instructions only to let residents in and out.

Dr. Christopher Perkins, Dallas County Health and Human Services Medical Director, said that of the 18 people who had been in contact, many were "close family members."

The children among them "did not have any symptoms and so the odds of them passing on any sort of virus is very low," said Mike Miles, Dallas Independent School District superintendent.

Miles said the four different schools they attended would be staffed with additional health professionals and classes would remain in session.

Texas officials said health workers who took care of the patient had so far tested negative for the virus and there were no other suspected cases in the state. Texas Governor Rick Perry told a news conference he was confident the virus would be contained, as did other officials.

Ebola spreads through contact with bodily fluids such as blood or saliva, which health experts say limits its potential to infect others, unlike airborne diseases. Still, the long window of time before patients exhibit signs of infection, such as fever, vomiting and diarrhea, means an infected person can travel without detection.

snip

A Liberian official said the man traveled through Brussels to the United States. United Airlines said in a statement that the man took one of its flights from Brussels to Washington Dulles Airport, where he changed planes to travel to Dallas-Fort Worth.

(Additional reporting by Jon Herskovitz in Austin, Texas; Jeffrey Dastin in New York; Susan Heavey and Alphonso Toweh in Washington; and David Lewis in Dakar; Writing by Grant McCool; Editing by Michele Gershberg, Howard Goller and Lisa Shumaker)

Comment: If any situation in recent memory qualifies for being typified by the phrase FUBAR, I think this would be it. (And that is saying a lot these days).
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