3 ms·

I'm trying to remain calm about this, but its growing increasingly difficult. We're not far off pandemic territory. 10k new cases per week? Very very alarming

I'm trying to remain calm about this, but its growing increasingly difficult. We're not far off pandemic territory. 10k new cases per week? Very very alarming.

jerhinesmith 12y ago
I'm really interested to see if the r-naught is sustainable in developed countries. This paper (http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20894 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2...) projects it as between 1.0 and 2.0 -- the nurse in Dallas makes it at least 1 for the first US case, but it could be a few more weeks to know if she was the only one.
- simplemath 12y ago
  >Our statistical analysis of the reproduction number of EVD in West Africa has demonstrated that the continuous growth of cases from June to August 2014 signalled a major epidemic, which is in line with estimates of the Rt above 1.0. Moreover, the timing of Rt reaching levels above one is in line with a concomitant surge in cases in Sierra Leone and Liberia. In a worst-case hypothetical scenario, should the outbreak continue with recent trends, the case burden could gain an additional 77,181 to 277,124 cases by the end of 2014. Not good. R~2 is a deeply scary figure. R1.7 is better but still wildly explosive. 1.4 puts us in run of the mill "ballooning epidemic" territory. The best case estimates of R-naught for Africa don't have a whole lot of "best" about them. Clearly the dataset outside Africa isn't large enough to support meaningful analysis yet. I hope it stays that way, and Africa can get its arms around this thing before it kills millions.
- lifeisstillgood 12y ago
  For others who wondered about the R-naught reference - how many people one infected person will then onwards infect. http://en.m.wikipedia.org/wiki/Basic_reproduction_number http://en.m.wikipedia.org/wiki/Basic_reproduction_number Measles is 12-18, Ebola 1-2. Before that makes you feel comforted, 1918 flu had r0 of 2-3. Great.
  - hga 12y ago
    Problem is, the data from West Africa is so bad in quality it could easily be 3 (e.g. I believe that's in line with the CDC's worst case estimate for January). Which to echo simplemath is deeply scary.
- azakai 12y ago
  > the nurse in Dallas makes it at least 1 for the first US case, but it could be a few more weeks to know if she was the only one. Since it's a single case though, this is far from statistically significant. We don't know what R0 will be in the US.
MichaelGG 12y ago
Malaria kills over half a million people a year, out of over 200M cases. Why is ebola so much more alarming?
- adventured 12y ago
  A few reasons. 1) Because malaria is 'over there' and ebola is threatening to come 'over here.' 2) Ebola has been hyper sensationalized, and is not as well understood as malaria. 3) Ebola has a very high mortality rate, with an almost coin-flip chance of surviving it. 4) The world has been dealing with malaria for a very long time. Ebola is new on the block. It seems any new virus tends to make waves these days, from SARS to West Nile.
- sigmar 12y ago
  You pretty much answered your own question- .5M deaths out of 200M. Ebola kills 50-90%
  - pdabbadabba 12y ago
    I think the answer can be summarized: "human-to-human" transmission. Malaria, to be sure, has been a much more significant public health problem historically, but with ebola you have the possibility of human-to-human transmission and, thus, geometric growth. You also have the possibility that it will spread elsewhere in the world. And we're not just talking about the western world here either (though that surely drives more than its fair share of the panic). Imagine, for instance, ebola in Mumbai or Mexico City.
    - hyperpape 12y ago
      Uncertainty is really the kicker. Ebola may turn out to be substantially less significant than malaria. But we can't rule out it being a good deal worse.
- fiatmoney 12y ago
  Malaria is mosquito-borne; effectively a condition of geography. One moves to a non-malaria zone and is no longer susceptible; or one can invest in some mosquito netting and dramatically cut their risk. Caring for the infected or burying the dead does not increase the risk. Ebola is person-to-person and by all accounts highly infectious, particularly targeting caregivers. It's a recipe for a much more severe social breakdown. It's also clear the number of malaria cases is bounded, at a level that is in some sense "livable". It is not clear at what level Ebola will top out at; it may not be compatible with maintaining a functioning society in particularly hard-hit areas.

I'm trying to remain calm about this, but its growing increasingly difficult. We're not far off pandemic territory. 10k new cases per week? Very very alarming.

jerhinesmith 12y ago

I'm really interested to see if the r-naught is sustainable in developed countries. This paper (http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20894 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2...) projects it as between 1.0 and 2.0 -- the nurse in Dallas makes it at least 1 for the first US case, but it could be a few more weeks to know if she was the only one.

simplemath 12y ago
>Our statistical analysis of the reproduction number of EVD in West Africa has demonstrated that the continuous growth of cases from June to August 2014 signalled a major epidemic, which is in line with estimates of the Rt above 1.0. Moreover, the timing of Rt reaching levels above one is in line with a concomitant surge in cases in Sierra Leone and Liberia. In a worst-case hypothetical scenario, should the outbreak continue with recent trends, the case burden could gain an additional 77,181 to 277,124 cases by the end of 2014. Not good. R~2 is a deeply scary figure. R1.7 is better but still wildly explosive. 1.4 puts us in run of the mill "ballooning epidemic" territory. The best case estimates of R-naught for Africa don't have a whole lot of "best" about them. Clearly the dataset outside Africa isn't large enough to support meaningful analysis yet. I hope it stays that way, and Africa can get its arms around this thing before it kills millions.
lifeisstillgood 12y ago
For others who wondered about the R-naught reference - how many people one infected person will then onwards infect. http://en.m.wikipedia.org/wiki/Basic_reproduction_number http://en.m.wikipedia.org/wiki/Basic_reproduction_number Measles is 12-18, Ebola 1-2. Before that makes you feel comforted, 1918 flu had r0 of 2-3. Great.
- hga 12y ago
  Problem is, the data from West Africa is so bad in quality it could easily be 3 (e.g. I believe that's in line with the CDC's worst case estimate for January). Which to echo simplemath is deeply scary.
azakai 12y ago
> the nurse in Dallas makes it at least 1 for the first US case, but it could be a few more weeks to know if she was the only one. Since it's a single case though, this is far from statistically significant. We don't know what R0 will be in the US.

MichaelGG 12y ago

Malaria kills over half a million people a year, out of over 200M cases. Why is ebola so much more alarming?

adventured 12y ago
A few reasons. 1) Because malaria is 'over there' and ebola is threatening to come 'over here.' 2) Ebola has been hyper sensationalized, and is not as well understood as malaria. 3) Ebola has a very high mortality rate, with an almost coin-flip chance of surviving it. 4) The world has been dealing with malaria for a very long time. Ebola is new on the block. It seems any new virus tends to make waves these days, from SARS to West Nile.
sigmar 12y ago
You pretty much answered your own question- .5M deaths out of 200M. Ebola kills 50-90%
- pdabbadabba 12y ago
  I think the answer can be summarized: "human-to-human" transmission. Malaria, to be sure, has been a much more significant public health problem historically, but with ebola you have the possibility of human-to-human transmission and, thus, geometric growth. You also have the possibility that it will spread elsewhere in the world. And we're not just talking about the western world here either (though that surely drives more than its fair share of the panic). Imagine, for instance, ebola in Mumbai or Mexico City.
  - hyperpape 12y ago
    Uncertainty is really the kicker. Ebola may turn out to be substantially less significant than malaria. But we can't rule out it being a good deal worse.
fiatmoney 12y ago
Malaria is mosquito-borne; effectively a condition of geography. One moves to a non-malaria zone and is no longer susceptible; or one can invest in some mosquito netting and dramatically cut their risk. Caring for the infected or burying the dead does not increase the risk. Ebola is person-to-person and by all accounts highly infectious, particularly targeting caregivers. It's a recipe for a much more severe social breakdown. It's also clear the number of malaria cases is bounded, at a level that is in some sense "livable". It is not clear at what level Ebola will top out at; it may not be compatible with maintaining a functioning society in particularly hard-hit areas.