5 ms·

Ask HN: What would you do in case of a large Ebola outbreak?

22 points by rodrigocoelho 12y ago

doubt_me 12y ago
apply for a job at the CDC?
angersock 12y ago
Probably tweet about it, and hope that it happens in SF. Watching Valleywag or TechCrunch scamper to provide coverage would be delightful. "VCs suddenly interested in funding medical care" "Marc Andresson calls out for single-payer healthcare" "ebo.la: disrupting filoviruses"
- gregcohn 12y ago
  $ rm hat.jpg
ColonelPanic001 12y ago
Wash my hands a lot, stay indoors, avoid people. And if Ebola got loose around here, I guess I'd do that then, too.
- jordsmi 12y ago
  >Wash my hands a lot, stay indoors, avoid people. So just a normal day
  - productionQA 12y ago
    >So just a normal day That is unfortunate
Udo 12y ago
Well, the infectiousness of Ebola specifically is questionable. In essence, there is good reason to believe the virus won't be able to spread far outside the areas where it already proved to be successful. So if you're in the EU or the US, even large parts of Asia, you're probably safe. But that doesn't mean a mutated strain could potentially befall the whole world. The same goes for the more terrifying types of the flu. There is always the potential for a deadly and extremely contagious pathogen to develop. So what to do in a pandemic situation? I'm hesitant to admit it, but basically the survivalists have it right: hole up somewhere off the beaten path and avoid all outside contact, that potentially includes all kinds of animals like birds and livestock. Then you'll have to wait until a vaccine is developed. If a vaccine is feasible.
- dllthomas 12y ago
  Limiting contact to limit spread is hugely important, but that has to be weighed against maintaining support for those working on vaccines, treatments, and cures.
- tetha 12y ago
  Only thing I am missing here: Become realistic. You will need to make decisions. Some of your decisions might kill you. Some of your decisions might save you. Some of your decisions might seem scary and end up with no impact. Some of your decisions might look beneficial and end up with no impact. At some point, you have to act upon instinct and that's fine. And in the case of a serious pandemic, we'll all die or end up in the stone age within 5 - 10 years anyway.
  - noir_lord 12y ago
    1918 - Spanish Flu killed 50-100 million people (hard to count accurately back then especially on the back of a world war) at the time 3-5% of the population, it was a horrible mutation that attacked the young and strong as well as the old and weak. The chance of that happening is remote in any particularly decade the chance of something worse that would "put us back to the stone age" happening is incredibly unlikely. Hell Europe survived the black death and by some counts that took out a third of the population of some countries. It's not sunshine and flowers but it's not a world ender either.
- frigg 12y ago
  >So if you're in the EU or the US, even large parts of Asia, you're probably safe. Well, Germany announced that it accepted a patient with Ebola.[1] I guess it's not completely out of the question now? Wouldn't it make more sense to go where the virus is and not bring it home? [1] http://www.telegraph.co.uk/news/worldnews/europe/germany/10998367/Ebola-Germany-accepts-infected-patient-for-treatment.html http://www.telegraph.co.uk/news/worldnews/europe/germany/109...
  - Udo 12y ago
    That's not what I mean. Researchers in all countries get infected with these things all the time, too. But it's questionable whether Ebola specifically can take hold in the northern countries at all.
curtis 12y ago
If an outbreak lasts longer than individual patients are sick (earlier patients have either died or recovered), then you could start recruiting survivors to help care for victims later in the outbreak. This will work better for diseases with lower mortality (e.g. the 1918 Spanish Flu) than one with a higher mortality like Ebola (Wikipedia says a 56% mortality rate, but maybe that includes people who are still sick and haven't died yet). This assumes that surviving the disease confers serious immunity, which I believe is normally the case, but I don't really know. In the case of Ebola it also assumes a relatively fast recovery time if the disease doesn't kill you, but I don't know if that is true either.
masnick 12y ago
This blog post provides some good, straight-forward information about epidemiology, clinical characteristics, and infection control recommendations for Ebola: http://haicontroversies.blogspot.com/2014/07/ebola-hemorrhagic-fever-primer.html http://haicontroversies.blogspot.com/2014/07/ebola-hemorrhag... (It's written by an infectious disease physician.) "Contact and airborne precautions are indicated for suspected and confirmed cases" refers to: - Contact: wearing disposable gowns and gloves to interact with the patient - Airborne: putting the patient in a negative pressure room (to avoid spreading air from the room around the hospital), and wearing a N-95 respirator or PAPR (http://www.3m.com/Product/information/Powered-Air-Purifying-Respirator-PAPR.html http://www.3m.com/Product/information/Powered-Air-Purifying-...) in addition to the contact precaution stuff. Source: http://www.cdc.gov/HAI/settings/outpatient/basic-infection-control-prevention-plan-2011/transmission-based-precautions.html http://www.cdc.gov/HAI/settings/outpatient/basic-infection-c... That gives you a sense of what you'd need to do to safely interact/care for someone with Ebola. However, remember that several doctors treating Ebola have come down with the disease during the current epidemic. Hopefully (for the rest of us), there was some sort of infection control lapse that lead to their infection, rather than these infection control measures not being sufficient.
- dllthomas 12y ago
  "rather than these infection control measures not being sufficient." Per my understanding of things, that seems frighteningly unlikely[1]. As I understand it, there are a substantially greater portion of health workers getting sick than in previous outbreaks, and those health workers are not tied to a particular location. If that's the case (and mind you, this is all very much Nth hand what-I-got-from-the-radio stuff - either of those could certainly not be the case) then it seems to follow that probably this strain of ebola has some attribute that makes the recommended countermeasures inadequate (at least the countermeasures recommended for deployment in the field, which may or may not be this set of countermeasures). [1]: That isn't to say "tremendously unlikely", just "unlikely enough to be frightening."
  - masnick 12y ago
    The problem is that contact + airborne precautions are the highest level of infection control precautions that hospitals in the US usually do. The blog post I linked to above indicates that there are additional recommendations on top of contact + airborne that are unusual in the US. Infection control practices are assumed to be effective when adhered to. With a disease like Ebola, it's almost guaranteed that health care providers will follow the rules to the letter, at least in the US (and hopefully everywhere). So: scary.
yellowapple 12y ago
Read my favorite book (Richard Preston's The Hot Zone) while barricading myself in my apartment for awhile and waiting for things to blow over.
lifeisstillgood 12y ago
We probably should have nationwide "fire drills" for these sort of society-level threats. This reminds me of Bruce Schneier's Security Theatre - that we should not try the preventative approach to terrorism (including spying on everyone) but should focus on detective work and emergency response. As a society, at the society wide level, we have few if any accepted plans. Sure there is the usual martial law plus bits but that is bound to be resisted or ignored. The fact that HN (with a higher % of the population of people who actually ask themselves these sort of questions) has no single answer tells me we need a commonly understood response - most people instinctively know "stay inside, no travel" but the barest preparation would help exponentially if anything did happen.
chatmasta 12y ago
Buy a boat, load it up with non-perishables, and go chill off the coast for a few weeks until I can have a vaccine waiting for me when I come back to land.
Mimu 12y ago
I would probably die first.

22 points by rodrigocoelho 12y ago

apply for a job at the CDC?

Probably tweet about it, and hope that it happens in SF. Watching Valleywag or TechCrunch scamper to provide coverage would be delightful. "VCs suddenly interested in funding medical care" "Marc Andresson calls out for single-payer healthcare" "ebo.la: disrupting filoviruses"

gregcohn 12y ago
$ rm hat.jpg

ColonelPanic001 12y ago

Wash my hands a lot, stay indoors, avoid people. And if Ebola got loose around here, I guess I'd do that then, too.

jordsmi 12y ago
>Wash my hands a lot, stay indoors, avoid people. So just a normal day
- productionQA 12y ago
  >So just a normal day That is unfortunate

Udo 12y ago

Well, the infectiousness of Ebola specifically is questionable. In essence, there is good reason to believe the virus won't be able to spread far outside the areas where it already proved to be successful. So if you're in the EU or the US, even large parts of Asia, you're probably safe. But that doesn't mean a mutated strain could potentially befall the whole world. The same goes for the more terrifying types of the flu. There is always the potential for a deadly and extremely contagious pathogen to develop. So what to do in a pandemic situation? I'm hesitant to admit it, but basically the survivalists have it right: hole up somewhere off the beaten path and avoid all outside contact, that potentially includes all kinds of animals like birds and livestock. Then you'll have to wait until a vaccine is developed. If a vaccine is feasible.

dllthomas 12y ago
Limiting contact to limit spread is hugely important, but that has to be weighed against maintaining support for those working on vaccines, treatments, and cures.
tetha 12y ago
Only thing I am missing here: Become realistic. You will need to make decisions. Some of your decisions might kill you. Some of your decisions might save you. Some of your decisions might seem scary and end up with no impact. Some of your decisions might look beneficial and end up with no impact. At some point, you have to act upon instinct and that's fine. And in the case of a serious pandemic, we'll all die or end up in the stone age within 5 - 10 years anyway.
- noir_lord 12y ago
  1918 - Spanish Flu killed 50-100 million people (hard to count accurately back then especially on the back of a world war) at the time 3-5% of the population, it was a horrible mutation that attacked the young and strong as well as the old and weak. The chance of that happening is remote in any particularly decade the chance of something worse that would "put us back to the stone age" happening is incredibly unlikely. Hell Europe survived the black death and by some counts that took out a third of the population of some countries. It's not sunshine and flowers but it's not a world ender either.
frigg 12y ago
>So if you're in the EU or the US, even large parts of Asia, you're probably safe. Well, Germany announced that it accepted a patient with Ebola.[1] I guess it's not completely out of the question now? Wouldn't it make more sense to go where the virus is and not bring it home? [1] http://www.telegraph.co.uk/news/worldnews/europe/germany/10998367/Ebola-Germany-accepts-infected-patient-for-treatment.html http://www.telegraph.co.uk/news/worldnews/europe/germany/109...
- Udo 12y ago
  That's not what I mean. Researchers in all countries get infected with these things all the time, too. But it's questionable whether Ebola specifically can take hold in the northern countries at all.

curtis 12y ago

If an outbreak lasts longer than individual patients are sick (earlier patients have either died or recovered), then you could start recruiting survivors to help care for victims later in the outbreak. This will work better for diseases with lower mortality (e.g. the 1918 Spanish Flu) than one with a higher mortality like Ebola (Wikipedia says a 56% mortality rate, but maybe that includes people who are still sick and haven't died yet). This assumes that surviving the disease confers serious immunity, which I believe is normally the case, but I don't really know. In the case of Ebola it also assumes a relatively fast recovery time if the disease doesn't kill you, but I don't know if that is true either.

masnick 12y ago

This blog post provides some good, straight-forward information about epidemiology, clinical characteristics, and infection control recommendations for Ebola: http://haicontroversies.blogspot.com/2014/07/ebola-hemorrhagic-fever-primer.html http://haicontroversies.blogspot.com/2014/07/ebola-hemorrhag... (It's written by an infectious disease physician.) "Contact and airborne precautions are indicated for suspected and confirmed cases" refers to: - Contact: wearing disposable gowns and gloves to interact with the patient - Airborne: putting the patient in a negative pressure room (to avoid spreading air from the room around the hospital), and wearing a N-95 respirator or PAPR (http://www.3m.com/Product/information/Powered-Air-Purifying-Respirator-PAPR.html http://www.3m.com/Product/information/Powered-Air-Purifying-...) in addition to the contact precaution stuff. Source: http://www.cdc.gov/HAI/settings/outpatient/basic-infection-control-prevention-plan-2011/transmission-based-precautions.html http://www.cdc.gov/HAI/settings/outpatient/basic-infection-c... That gives you a sense of what you'd need to do to safely interact/care for someone with Ebola. However, remember that several doctors treating Ebola have come down with the disease during the current epidemic. Hopefully (for the rest of us), there was some sort of infection control lapse that lead to their infection, rather than these infection control measures not being sufficient.

dllthomas 12y ago
"rather than these infection control measures not being sufficient." Per my understanding of things, that seems frighteningly unlikely[1]. As I understand it, there are a substantially greater portion of health workers getting sick than in previous outbreaks, and those health workers are not tied to a particular location. If that's the case (and mind you, this is all very much Nth hand what-I-got-from-the-radio stuff - either of those could certainly not be the case) then it seems to follow that probably this strain of ebola has some attribute that makes the recommended countermeasures inadequate (at least the countermeasures recommended for deployment in the field, which may or may not be this set of countermeasures). [1]: That isn't to say "tremendously unlikely", just "unlikely enough to be frightening."
- masnick 12y ago
  The problem is that contact + airborne precautions are the highest level of infection control precautions that hospitals in the US usually do. The blog post I linked to above indicates that there are additional recommendations on top of contact + airborne that are unusual in the US. Infection control practices are assumed to be effective when adhered to. With a disease like Ebola, it's almost guaranteed that health care providers will follow the rules to the letter, at least in the US (and hopefully everywhere). So: scary.

yellowapple 12y ago

Read my favorite book (Richard Preston's The Hot Zone) while barricading myself in my apartment for awhile and waiting for things to blow over.

lifeisstillgood 12y ago

We probably should have nationwide "fire drills" for these sort of society-level threats. This reminds me of Bruce Schneier's Security Theatre - that we should not try the preventative approach to terrorism (including spying on everyone) but should focus on detective work and emergency response. As a society, at the society wide level, we have few if any accepted plans. Sure there is the usual martial law plus bits but that is bound to be resisted or ignored. The fact that HN (with a higher % of the population of people who actually ask themselves these sort of questions) has no single answer tells me we need a commonly understood response - most people instinctively know "stay inside, no travel" but the barest preparation would help exponentially if anything did happen.

chatmasta 12y ago

Buy a boat, load it up with non-perishables, and go chill off the coast for a few weeks until I can have a vaccine waiting for me when I come back to land.

Mimu 12y ago

I would probably die first.