Ebola

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She traveled by air to and from Ohio after treating the 1st Ebola patient. Should she have known that was not a good decision?

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Apparently she called the CDC and told them she had a temp of 99.5. They said, "Hey, it's below the cutoff -- no problem, go wherever you want."

Ebola's greater spread in this outbreak can be adequately explained by greater mobility in the affected population, and the fact that it reached major urban centers. High rates of infection in medical personnel have been features of previous outbreaks as well, so they don't necessarily indicate any change. In this outbreak, MSF has had few of its workers infected, thanks to rigorous procedures, proper equipment and good training.Other comments:
You don't have to be paranoid or hysterical to be concerned about an uncontrolled epidemic of a disease with a 70% case fatality rate and virtually no natural immunity.An R0 of 2 is lower than for many viruses, but it's about the same as most influenza epidemics. I don't find that very reassuring.

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Ah, yes, the bats.

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The Ebola virus has shown in West Africa because the people there eat roadkill en masse.

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When will we be ready to rightly attribute the cause of this outbreak to bad and inferior cultural practices?

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And, more so, will we be ready to actually start doing something real about these bad cultural practices?

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They don't eat roadkill; they eat wild game, the same as people all over the world have done since forever. And eating game to avoid malnutrition is hardly a bad cultural practice. My brother-in-law eats wild game that he catches in the Midwest. Is that a bad cultural practice too?

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But it is very different from the sorts of animals typically hunted in the Midwest.

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Yes, people tend to hunt the animals that actually live in their area -- unless they're hindered by bad cultural practices, that is.

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Being malnourished is.

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Being malnourished is not a cultural practice. Just quit digging.(It's not like domesticated animals are necessarily any safer than wild game, by the way. They've brought us MERS, SARS and every episode of pandemic influenza. )

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Essentially, yes. The Ebola pandemic is largely the result of failed states incapable of providing even the basics of necessities to their citizens.

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It's not that it's impossible for West Africa to do anything meaningful about Ebola; but that it's impossible for the failed states of West Africa to do anything meaningful about Ebola.

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I know it feels good to treat these nations as though they are capable, but they are clearly not. Their failure to be capable and the West's failure to acknowledge theirs has gone a long way in allowing this outbreak to spread.

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I have seen no failure by the West to acknowledge the the states in question are screwed up. In fact, every account of the outbreak seems to mention that fact. The failure of the rest of the world to respond has much more to do with their indifference, short-sightedness and fuck-witted insistence on cutting budgets.

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The right response was to quarantine the region until it got its shit together.

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Congratulations. Short of actually shipping infected people to major cities around the world, you've hit on possibly the worst strategy for containing the epidemic. You can't quarantine the region. The danger from the outbreak isn't that an infected person will fly to Dallas -- Dallas can handle Ebola, their own bad cultural practices notwithstanding -- but that it will continue to spread indefinitely until it becomes a global pandemic. Borders are porous, especially in that region, and they continue to leak cases even after they've been closed. If you want to stop it, you have to stop it where it is. And since, as you point out, they're not capable of stopping it themselves, that means the rest of the world has to be able to go there.

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Wanna help? Send people in. No need to let them back out, though, until the job is done.

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People won't go in unless they're allowed to come back out again.

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The rest of the world didn't fail in deciding not to quarantine the region? It didn't fail in deciding that travel in and out of the region would still be allowed? It didn't fail in not mentioning in the popular media that the Ebola virus in humans comes from eating tainted vermin much like AIDS?

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No, the rest of the world failed by inadequately implementing control measures that actually work, rather than your ridiculous suggestions. (And the fact that Ebola outbreaks originate in bushmeat has been all over the popular media.)

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And yet, if flights in and out of the region had been suspended, there would be no cases in Europe or America.

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Which would have done nothing at all to stem the outbreak. We could reduce mortality and morbidity in the US far more by infringing personal liberties in other ways than by restricting travel to West Africa. (Mind you, if I were in charge of Haiti or Pakistan or the like, I'd probably quarantine anyone coming from the three outbreak countries, because countries like that may not be able to handle Ebola.)

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As I said: No need to let them back out, though, until the job is done.

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And as I said, then they won't go. The outbreak is going to last at least a year, and possibly much longer. Why are you trying to make it harder to control it?

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The disease has a known incubation period. It does no good to screen for symptoms at airports because infected people could be in asymptomatic stages. If air travel to and from the region is required, it is not at all unreasonable to limit it to essential persons and only allow them out of the region after they have been quarantined for 1.5 the max incubation period to ensure they have not contracted the disease.

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Is this unreasonable?

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If that were logistically possible, it might be effective in eliminating the tiny risk (relative to many public health problems) posed by Ebola cases entering the US and Europe. But as I said, we could save far more lives by imposing other restrictions that you would probably be less happy with.

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Do you think this might have gone a long way in preventing the spread of the disease to Europe and America?

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Why should I care about it?

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Sure it is. It is a reflection on the failed states and their inability to provide basic necessities.

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Or are you saying that governments and the things they do aren't part of a society's cultural practices?

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I'm saying that "being malnourished" is not a practice of any kind. "Malnourished" is a condition, and "being" is not a practice. Many cultural practices have contributed to that condition; some of those practices are local, and some exist in the outside world. I'm all in favor of reducing poverty and malnutrition around the world. Telling people not to eat bushmeat does nothing to contribute to that goal.

Yes, measles' R0 is well above 2. Above 10, in fact. It's one of the many viruses that I alluded to that have R0 > 2.

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Which of these is more worrisome:

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1. A disease with a 90% mortality rate that infects 10,000 people.

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2. A disease with a 0.1% mortality rate that infects 1 billion people.

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Depends. Is disease 1 permanently confined to those 10,000, or are freely infecting others?

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If that outbreak is confined to 10,000, which is more worrisome?

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I wouldn't call either one worrisome. Disease 2 will certainly kill more people. What's the point?

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In case 1 you have 10% survivors or 1,000 survivors with antibodies to pass on to descendants. If they are carriers then potentially 90% of human population could die.

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You don't pass antibodies to your descendants.

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Someone said that they were more worried about the mortality rate than they were the rate of transmission. I was trying to contrast the two, showing that a virus with a much lower mortality rate but higher rate of transmission will cause more deaths.

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But that's not what you did. You contrasted the total number of infected, rather than the rate of infection. As long as the reproduction rate is greater than 1, the epidemic is going to continue growing; all the transmission rate affects is how quickly it grows. An epidemic that doubles in size every week will infect the entire planet in 8 months. An epidemic that grows at 1/4 the speed will take 2.5 years -- but everyone still gets sick.That's why we're worried about Ebola. It's not how many are currently infected -- it's the possibility that it's going to keep growing, with no obvious end in sight.

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What IS passed on is if you are someone who is resistant to a disease, you pass on your resistance to your descendants.

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Sometimes.

Sure, mother's antibodies stick around in the baby for a few months. That doesn't seem very relevant.

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Yes, I should have said ...

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In case 1 you have 10% survivors or 1,000 survivors with antibodies, ~500 which can pass them on to descendants. If the 1,000 are carriers then potentially 90% of human population could die.

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Antibodies are passed from mother to child, not just in the womb but via mother's milk. Once acquired they are there for life. This is one of the ways mammals have an advantage for survival.

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No, you really don't pass antibodies on to your descendants; antibodies are proteins, and they do not last for life. Infants stop being protected by maternal antibodies 3 - 6 months after birth (see e.g. here).