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Comment by maxerickson | Hacker News Reader

It's likely easier to control in the U.S. where there are a lot of resources and people are less likely to engage in a lot of physical contact with the infected, and where trust of doctors is a lot higher.

There is also a much more extensive public health system that is alert to the risk of an infected person entering the country.

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People keep repeating this as if it were a definitive rebuttal of all fears, but this story gives a few great examples of why the confidence might be misplaced: when your primary diagnostic criterion is a fever (common; easily suppressed with OTC medication) and affirmative answer to the question "have you been to West Africa?", it doesn't really matter how good your public health system is -- it's a going to be a leaky early warning system.

If someone makes it through the airport screens and carries the virus into a city, the epidemiology could become overwhelming before we know an outbreak has begun. So yes, we have the advantage that we have real hospitals and good infection control, but we have the disadvantage that we have huge cities, high population density and lots of personal mobility.

I dislike that you have characterized "It's likely easier" as "a definitive rebuttal of all fears".

I wasn't referring just to your comment; I've been hearing this as the default response to just about every rational concern since Trump started tweeting and it became a de facto left/right issue.

Obviously he's a moron, but the response from the other side of the debate has been almost as one-dimensional.

Not to mention the terrorism angle. How hard do you think it would be for al queda to get their hands on an ebola victim, harvest a gallon of body fluids, and smuggle it into the US? Because distribution wouldn't be hard at all; down here in texas, there are any number of outdoor misting systems that are aimed at busy streets full of sweltering tourists.

Bio-terrorism looks so easy.

Ebola is nothing new. If terrorists wanted to use it as a weapon, they could have done it a long time ago. Now would actually be a bad time for a bioterror attack, because people are on high alert for anything that could be ebola. It would be a lot more effective if it came out of the blue, giving it time to spread before anyone realized their fever was actually ebola.

>If someone makes it through the airport screens and carries the virus into a city, the epidemiology could become overwhelming before we know an outbreak has begun.

Could, but very unlikely to, as Ebola doesn't spread as easily as cold or flu viruses.

Most of the outbreaks in Africa, where numerous dangerous practices such as hospitals reusing needles helped spread the virus, have had only a few hundred cases. The latest outbreak is pushing towards 2000 cases but local practices that don't exist in the West are contributing significantly.

The point of comfort for the U.S. is that ebola transmission currently requires direct contact with bodily fluids--not that it's easy to diagnose.

If you had a fever and went to work, and it turned out you had ebola, it's still unlikely you would infect your coworkers, because it is rare for American workers to directly contact each others' bodily fluids.

Think of ebola like AIDS that kills faster. That's the right mental model for how it is transmitted. And, it's a good reminder that we have decades of practice managing diseases transmitted that way.

"The point of comfort for the U.S. is that ebola transmission currently requires direct contact with bodily fluids"

Doctors who knew they were working with Ebola still managed to get infected. So it can't be that hard to get it.

We don't need to panic, but it would be unwise to be too complacent.

They may have known they were dealing with Ebola, but they didn't have the equipment or facilities to take all the steps necessary to prevent transmission.

Keep in mind these doctors were surrounded by hundreds of cases and potential cases, in field hospitals without even running water. It's quite understandable that they would be at risk even while taking what precautions they could.

> Doctors who knew they were working with Ebola still managed to get infected.

Yes, but these doctors often don't even have the equipment to provide proper antiseptic medical care let alone containment-type biosuits.

In addition, quarantines can be rolled out quickly and effectively in modern countries with well-developed communication infrastructure.

This is not to say that we should be complacent. However, a bad flu epidemic poses more direct hazard to the modern world.

I'm not arguing for complacency, but comparing the transmissibility of ebola to the flu is just simply inaccurate.

Here's the thing: most people get the flu by contact via "bodily fluids". You cough, sneeze, drool, wipe your nose, and so on, then touch something. Someone later touches the same thing (or you), then touches their face, and the transmission has occurred. There have been papers on this.

It's easy to get fixated on aerosol transmission because it's fancy, but "bodily fluids" are a damned effective vector for the everyday transmission of a virus.

(Also, HIV is a pretty poor model for this. As viruses go, HIV is pretty hard to transfer -- even heterosexual sex has a low rate of seroconversion.)

The flu virus is very good at getting you to spread your bodily fluids all over the place: it makes you cough violently. The droplets are also invisible, so it's easy for others to touch them without knowing.

Ebola has many symptoms, but coughing isn't one of them. By the time you start coughing up blood, most people in the developed world will know better than to touch that blood.

You don't need blood. It's transmitted in sweat, saliva, tears...everything.

The point I was trying to make is that Ebola patients don't spray their bodily fluids the way flu patients spray saliva.

> Ebola is not like the flu. You're not going to catch the disease from simply being across the room from someone who has it.

> Basically every health agency in the world agrees on this point. In order to catch Ebola, you have to come in contact with bodily fluids — such as sweat, saliva, vomit, or diarrhea — of someone who already has Ebola and is exhibiting symptoms. (A person who is infected but not yet showing symptoms generally isn't infectious.)

> And yet, remarkably, many readers have been unconvinced by this point.

http://www.vox.com/2014/8/10/5980553/ebola-outbreak-virus-ae...

This was the first of many available sources in a quick Google search.

I don't understand why there seems to be so much interest in hyping the threat of ebola to the U.S. Maybe it has to do with the many doomsday virus stories in our culture?

An analogy: a friend of mine worked at a "Wild West" type museum. He got a call from someone who wanted to know if there were any black cowboys. My friend told the caller that yes, there had been many black cowboys. The caller said "that can't be true. How come I never saw any in western movies??"

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