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Comment by arrrg | Hacker News Reader

The likelihood of any kind of pandemic is extremely low, sure. However, your dismissal of this epidemic and its impact is arrogant and disgusting.

It’s still a disaster in the affected countries, with many knock-on effects. Also, it would have been better to spend more money earlier to prevent unnecessary deaths.

This Ebola epidemic is actually something people hardly care about. Hardly anyone is donating, for example.

Help is needed. Actually. For real. And with better support and a better reaction this could have turned out better.

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I am having a hard time understanding why people keep saying that donations are the way to go to solve this issue. From what I have seen, many rural communities are rejecting and acting against foreign assistance. I am not sure of the circumstances in urban settings, but I read that they are just as superstitious. How can we help those that do not want our help, especially when it is deadly to help either because of the disease or fear of attack?

This is a reason to donate. These rural areas clearly lack education, knowledge and need help. Just because they are scared/ignorant today doesn't mean they always have to be. For example if radios were distributed to all these communities education programs could start about ways to avoid disease transmission etc. This is going to be a long term strategy and wont happen in a day.

To be honest, I’m not sure how effective these targeted donations are at all. My point was more that in this case, while scary (and probably unrealistic) scenarios of the West somehow being affected were a popular pastime (and seemingly the main frame to view this disaster), hardly anyone seems to actually care about those who are affected by it. (I personally don’t think, for example, that I know better than a charity how to best allocate resources and I think targeted donations tied to a specific cause are quite irresponsible.)

Also, there may have been unique complications that make fighting the spread harder, though we don’t really know how widespread those are and were. They make for good stories, but are they the whole picture? I very much doubt that.

Additionally, it seems to me that even if those troubles were widespread it was possible to a) do something against them with more money (mostly in terms of improving communication about the virus) and b) make up for other deficiencies in resources (like a lack of space and beds and personal).

as far as donations are going, Time had a good breakout. There are many who have gone there, given money, and risked their lives. hint they aren't the type that frequent tech boards but posters here are quick to dismiss some of them for their religious convictions

NPR's Planet Money had a podcast that tried to understand the difficulties of fundraising for a situation like the Ebola outbreak:

http://www.npr.org/blogs/money/2014/09/26/351515481/episode-...

The tl;dr is that people donate a lot more when they can tangibly understand that a disaster has happened and they make an emotional connection to the disaster (e.g. 9/11, Haitian Earthquake, etc).

When donors are asked to contribute money to prevent something, the emotional connection is a lot harder to make and funds are a lot harder to raise.

I don't know if you can call it a disaster. The total number of cases, as reported by the CDC, is less than 7000 so far.

I don't mean to be callous, but compare that number to the number of total deaths to Malaria or even the flu, and that number pales in comparison. I am not callous to say that we shouldn't care about the Ebola outbreak, but if you look at the numbers, directing that money to buy more mosquito nets or Malaria vaccines will likely save more lives.

Malaria kills close to a million people a year. If you're looking for a cause for donation, the most value per dollar could be directed there.

Malaria has a steady death rate. It's obviously a serious issue that doesn't get enough attention in the West, but immediate action will affect it only marginally.

The issue with Ebola isn't how many people it's killed so far (although the number is already tragic), but the number of deaths it can potentially cause. If left entirely unchecked at this point, it would kill over a million people in the next year. A half assed response limits it to hundreds of thousands, while a solid response limits it to tens of thousands (conceptually, numbers pulled out of ass but reasonable, I'd argue).

Outbreaks grow exponentially unless contained; the point of fast action is to prevent or curtail the exponential growth.

Last week, the total number of cases was ~6500. One month ago it was ~3000. Two months ago it was ~1300. How do you call a process that duplicates itself every fixed unit of time (in this case, every ~3 weeks)?

Of course, we should not fall into panic. Many factors will affect what ends up being the total effect of this outbreak in the mid to long term. But dismissing it as a non issue because "there are just a few thousand cases" misses the point completely.

Hm so that would mean assuming this rate of exponential growth that in ~150 days there would be ~ 1 million cases and roughly a year to reach 100 million. I wonder how well they can model travel patterns, then you could write down an ode for the disease on say a country level and couple them.

I am not saying that this will grow exponentially for ever. For what I know, disease expansion is modeled with a sigmoid curve: exponential at first, then slows down once a saturation level in the population is reached.

According to Wikipedia, the total population of the 3 most affected countries - Liberia, Guinea and Sierra Leone - is roughly 20 millions. So there is at least that upper bound.

The real risk of pandemia comes from the fact that as the number of cases grows, the more likely it is that some of those cases travel through a porous border into other countries which lack the infrastructure and professional discipline to contain new outbreaks. If/when that is the case, each new region will start its own sigmoidal worth.

Well the sigmoid curve you are referring to would be for the case that patients who have contracted the virus and survived would be immune or die. In an SIR model (http://en.wikipedia.org/wiki/Compartmental_models_in_epidemi...) that takes death rate and population number into account you would then expect a disease to either reach a disease free equilibrium or a endemic equilibrium. What I was suggesting is to couple those equations on the country level by modelling travel patterns (flow of Suscebtible Recovered Infected across borders), the result would most likely be that western countries would be able to reach a disease free equilibrium, as they have better recovery rates and lower infection rates, whereas ebola would remain endemic in africa.

Thanks, I was not aware of the SIR model.

Regarding your original question... if you can identify individual regions where the model can be applied, maybe you could use Markov chains to model the transitions between states in each region. I am not qualified enough to do that, but I imagine that the result would be a few endemic nodes where the disease is always present (with different degrees of intensity over time) and from where outbreaks get sporadically "exported" to disease free nodes.

I will stop being concerned about Ebola as soon as I start seeing this log-scale graph start bending down hard: http://en.wikipedia.org/wiki/File:Evolution_of_the_2014_Ebol...

And note the WHO already did bend the curve down once before, back when there were only a couple hundred cases, and then they lost control again. Not confidence-inspiring.

It's not that they lost control per se: when the hard detective work of determining the cause was done, it was already rather late in the game. The foreigners showed up in force but the locals refused to cooperate, hiding it until it couldn't be hidden, at which point it was too late for those three counties, and very possibly a very large part of West Africa or worse.

Donations are always tricky and effectively allocating resources to aid is hard … but can you at least recognise that similarly sized catastrophes get much more attention and money?

More than 3,000 people dead, potentially more, and many of the affected places don’t have enough resources to deal with it in a satisfactory manner. That’s the situation here. This could have been controlled better, probably.

Recently an arsonist alledgedly set fire to a dog shelter in the UK.

They raised over £1m in a few days.

> The blaze, which was tackled by more than 30 firefighters, killed about 60 animals.

> Within 24 hours, more than £1m pounds had been raised to help around 150 surviving dogs.

This happened while Ebola was happening.

Dogs are both cuter and easier for us English to relate to than Africans.

So what? Those are completely different situations. One is a human doing intentional harm to a bunch of innocent creatures. The other is mother nature vs. mankind. One tugs at the heartstrings, fills us with protective emotions for the poor doggies. The other is just another natural disaster. "Thank goodness it didn't happen to me", we think. I don't find this surprising or depressing.

> I don't find this surprising or depressing.

What? It might not be surprising, but how is it not depressing?

I don't see it as depressing or heartening—it's just the way we humans tend to react to things. Why do you find it depressing?

> Hardly anyone is donating, for example.

It might be beneficial to provide a link to where people could/should donate.

Médecins Sans Frontières/Doctors Without Borders is the first organization that jumps to mind -- they've been helping to lead the response in Africa, more or less on a shoestring.

Their US donation page is here: https://donate.doctorswithoutborders.org/onetime.cfm

Folks in other countries can find their local donation pages here: http://www.msf.org/donate

EDIT - To give you a sense of how involved MSF has been in the Ebola response: "Since March 2014, 14 MSF staff members have become ill, among whom 8 have sadly passed away." (Source: http://www.msf.org/article/ebola-workers-risk-tragic-reality...)

There's a comprehensive rundown of their efforts to date to help contain Ebola across West Africa here: http://www.msf.org/article/ebola-crisis-update-sept-25th

Thanks for the info, just did a small donation. I suspect it's well beyond their ability to control at this point, but even slightly slowing down that exponential curve can be worth a lot.

Where is the most effective place to donate?

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