Ebola Cases Could Reach 1.4M in 4 Months, C.D.C. Estimates
nytimes.com
nytimes.com
Today parameter estimates were published in the NEJM [0] that conflict with the model's default settings. The Eichner incubation distribution, and an infectious duration of maybe 11 days are better inputs, in my opinion.
[0] http://www.nejm.org/doi/full/10.1056/NEJMoa1411100?query=fea...
I played with your suggested settings and while they are indeed alarming, I'm curious why you think they are better suited. They don't seem to fit the historical curve quite as well as the default CDC ones.
Do you have more background there?
It's best to think of it as a programming language unto itself :)
Same. I work in Excel pretty much all day and rock at using it as a swiss army knife. But when people use it to build these hectic models then I'm still thoroughly impressed.
"In the best-case model...would be “almost ended” by Jan. 20..."
"The current official case count is 5,843, including 2,803 deaths, according to the World Health Organization."
It would be a very smart investment to contain this outbreak of Ebola and put boots on the ground.
Sadly enough, this is a perfect place to use drones, God help us.
EDIT:
So, do you downvote because you despise the idea of maintaining quarantine with lethal force, because you find the idea of using drones to kill horrendous, or what?
My point was both reasonable and succinct.
You were probably downvoted because a little of column A and a little of column B.
The situation hasn't deteriorated to the point that remote lethal force is the solution. Education and proper containment protocols would solve the problem without the need for indiscriminate murder.
There's a lot to be said for proper containment protocols and education, but let's not kid ourselves--the populations in question are already willfully acting against such things, supposing (in many cases) a Western bugaboo.
Regardless, the meta issue here is that a bunch of HNers downvoted something merely because they disagreed with it (which is annoying but hardly the first time it's happened to this account) but also failed to contribute meaningfully to the discussion (which is sad). A lot of fools decry "oh no HN is close-minded" while spouting rubbish, but sometimes the accusation is well-founded.
In our present example, there is an interesting discussion to be had: could the use of drones for quarantine purposes present as the next step down that slippery slope? What sort of precedent might that set? Were it to be wrong, what exactly would make it so?
But, no; instead the users blindly downvote away and click onwards, safely avoiding that heavy burden of exploratory thinking.
Which takes us to the point of how, exactly, do you think you can enforce a quarantine using drones? Sure, you can blow up everything that moves in a perimeter... but how are you going to pick your targets if civil authorities do not close all roads/ports/air-traffic? And how do you minimize the spread within the city once they have done that? You need boots on the ground to do that effectively!
Drones are the atomic bombs of 21th century. A specific technology with extremely specific military applications that gets transformed by popular imagination into a symbol of limitless power. e.g. Drones have become the ultimate thought stoppers.
http://www.granma.cu/idiomas/ingles/cuba-i/15sept-Cuba%20app... http://www.who.int/mediacentre/news/statements/2014/cuban-eb...
Hell, if you listened to some people in the US you'd think the US-Mexican border was one giant hot zone. I shudder to think what would happen if Ebola turned up in France or someplace.
20 Sep 2014: 6,185 infections, 2,909 deaths.
"WHO has stated the reported numbers "vastly underestimate the magnitude of the outbreak", saying there may be 2.5 times as many cases as officially reported. Cases in remote areas may also be missed"
The problem is that the intervention consists of increasing the percent of patients getting treatment from 10 percent to 70 percent. But with under reporting by 2x that would be an actual increase from 5 percent to 35 percent, which would have a much less significant effect on the total number infected - possibly not even ending the epidemic. Perhaps they assume the intervention will include solving the under reporting problem.
Otherwise a very nice report: http://www.cdc.gov/mmwr/preview/mmwrhtml/su63e0923a1.htm?s_c...
http://mobile.nytimes.com/2014/09/23/world/africa/23ebola.ht...
http://racingheartblog.tumblr.com
Considering the doubling rate I would personally increase that number by at least 2-5 doublings...
If the under estimation is by a factor of 5 then you're looking at 44.8 million.
The exponential value is really important, especially in the early and end games ;)
The entire developing world might be incapacitated by the Ebola epidemic. The western world, not so much.
[1] with bleach
But if someone arrives in a US city unwittingly carrying Ebola and gets on a crowded bus or subway car, that's not so easy to track. Likewise if the person goes to a nightclub or other crowded place. Suppose it's a returning American who attends a baseball or football game - the NSA may well be able to ID almost everyone who attended the event, but trying to screen/isolate tens of thousands of people who might have come in contact with an infected individual wandering around a stadium is easier said than done.
http://news.yahoo.com/liberian-ebola-symptoms-dies-nigeria-o...
If an infection does come over, then expect people the laud the NSA's spying because it'll be the thing that makes it possible to identify, target, and quarantine.
However, the more people that are infected, the more chance of Ebola mutating some novel route of infection.
I.e. in the worst case....airborne.
Then it becomes a serious issue in the first world. An apocalyptic issue...
- WHO says 21,000 by mid January
- NEJM says ~10,000 by mid January http://www.nejm.org/doi/full/10.1056/NEJMoa1411100?query=fea...
The CDC report and the article present both worst-case and best-case scenarios for Liberia and Sierra Leone. 1.4M is worst-case (no intervention) and "almost ended" is best-case ("If, by late December 2014, approximately 70% of patients were placed either in ETUs or home or in a community setting such that there is a reduced risk for disease transmission [...] then the epidemic in both countries would almost be ended by January 20, 2015").
How now?
You might want to read an article or two about the proposed Liberia mission -- and about what is actually being proposed as a role for the U.S. troops there; and why this proposal has gotten the support of the World Health Organization, among others -- rather than just put out whatever fanciful speculations that might pop into your head.
1. http://www.nytimes.com/2014/09/16/world/africa/obama-to-anno...
Have you seen the facilities they have over there now? I think battlefield hospitals are a huge step up. Logistics is also a core function of the military, so once a plan is in place they will bring in whatever that plan calls for and get stuff done.
Where the military doesn't work is when politics is involved and the mission is not so clear.
It's not about winning hearts and minds. It's about containment.
When you don't have trust, you get dead healthcare workers: http://www.bbc.co.uk/news/world-africa-29256443
Fighting ebola has been compared to fighting an insurgency, and I think the comparison is quite apt. You can't win with force alone.
Actually you can, you just need to use enough force and nobody is willing to do that. Ebola could become a threat to the point where the healthy start shooting people trying to escape quarantined areas or simply burning them down.
At the most extreme you could just firebomb or nuke the areas infected. That would be excessive force, but it would solve the problem.
It is difficult, if not impossible, to build trust because the population isn't educated, they don't trust the government from before, and there is no infrastructure for wide-spread dissemination of information.
> You can't win with force alone.
You can.
I think that the part of the problem is that they try to take care of the sick, but they don't have resources, the equipment, the personnel, the education... nothing. The sick can walk out (if they can), anybody can walk in, other people try to "liberate" them, etc. It's mess. Compare their conditions with how ebola-infected people are handled in the west (isolation and containment facilities).
What do to instead: just write off the infected, however cruel that may seem, and transfer them to a closed isolation facility, guarded by military. Heck, I don't think that anything else would be feasible even in any western country if suddenly a few thousand people got infected.
World: We have a small problem in Africa.
US: You need us to invade? No sweat.
World: We have two small problems in Africa.