Biggest Ebola Outbreak In History- ~10000 Cases

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Ziggy Stardust
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Re: Biggest Ebola Outbreak In History- 1000+ Cases

Post by Ziggy Stardust »

madd0ct0r wrote:oooh, that'd be cool.
I didn't have time today, but I will try to do something tomorrow. Chances are it wouldn't give us any more insight, really (the problem with this type of data is that it is always messy and there is basically jack all you can do about it). But I'll fiddle around a bit.
madd0ct0r wrote: I didn't bother running a logistical regression on it since the data was so swingy, and the overall number is the sum of cases over several geographical areas.
You might not even have to do a "formal" logistic regression (which is, technically, based on a logit model). A more basic logistic model is to regress your data on the log difference between baseline and endpoint infection. It's a very rough analysis, and isn't super powerful, but you sacrifice rigor for very easily interpretable results. The coefficients in the regression are directly interpretable as a percentage change in rate. It's not the kind of thing you see published in the New England Journal of Medicine, but it is the type of simple model often used by epidemiologists as sort of a back-of-the-napkin calculation to get a rough idea of the relationship between covariates and outcomes (sometimes studies will be powered based on this kind of a model, in fact, but that's a whole 'nother story).
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Re: Biggest Ebola Outbreak In History- 1000+ Cases

Post by Borgholio »

Meanwhile in Liberia - a mob raided and destroyed an Ebola clinic two days after it opened.

http://www.buzzfeed.com/jinamoore/two-d ... ia#2oslo6w

Now, at what point are the doctors and nurses who are bravely risking themselves to control the outbreak going to simply throw up their hands and say, "I give up. You just signed your own death warrants. I'm leaving. You're on your own."?

Eventually, even the most selfless person has to admit that if a society wants to kill itself, sometimes the only thing you can do is let it.
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Re: Biggest Ebola Outbreak In History- 1000+ Cases

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Their society doesn't want to "kill itself". If you're sitting in the comfort of your air conditioned home reaping the benefits of higher education and a sophisticated health care system then please take a moment to consider how fucking goddamn blessed you are. And don't use that enormous, titanic privilege as a jumping off point to disparage scared, poor and uneducated people who find themselves in the middle of a full scale Ebola outbreak, in a region where health care is unable to cope, and who are consequently condemned - for reasons entirely beyond their influence - to watching their loved ones die of one of the most horrible diseases on the planet. Because that makes you come off as someone whose empathic qualities are on the level of the average brick in my walls.
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Re: Biggest Ebola Outbreak In History- 1000+ Cases

Post by Borgholio »

Ok yes so fine, I am a privileged First-World citizen with all the creature comforts that these people would probably kill to have...thus I should be fully understanding and accepting when they say, "Here's a hospital that is has opened up to treat this really nasty disease. I don't trust them. Let's burn it down so NOBODY can make use of it just because I think it's malaria instead and the whole Ebola thing is a lie."

Yes, I know they're scared. Yes, I know they don't want to see their loved ones suffer. Yes I know they feel powerless and that they may not trust doctors. But for crying out loud they're taking things to an extreme that (God forbid) could turn half of the city's population from living, breathing people into something you have to clean up with a sponge. If a doctor is begging me to keep my child or spouse in the hospital and is SO AFRAID of what he claims my loved one is infected with that he won't even touch them to try and restrain them...shouldn't that give most people at least a moment's pause?
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Re: Biggest Ebola Outbreak In History- 1000+ Cases

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You did not say that scared people should be swayed by the heroic efforts of doctors. You did not even say that you do not comprehend why they did what they did. What you said was that even selfless people have to admit that "if a society wants to kill itself, sometimes the only thing you can do is let it". That is a statement that I take a significant amount of umbrage with. If you did not mean to say what you said, then I suggest next time you choose your words more carefully.
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Re: Biggest Ebola Outbreak In History- 1000+ Cases

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Siege wrote:Their society doesn't want to "kill itself". If you're sitting in the comfort of your air conditioned home reaping the benefits of higher education and a sophisticated health care system then please take a moment to consider how fucking goddamn blessed you are.
Higher education? This is stuff we figured out two and a half thousand years ago. There's literally a chapter in the Bible about quarantining sick people and burning contaminated fabric (Leviticus 13).
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Re: Biggest Ebola Outbreak In History- 1000+ Cases

Post by Simon_Jester »

There is, nonetheless, the question of how to prevent a society from destroying itself, given that one is committed to not letting it happen.

Part of me wants to ask, what are the local governments doing? Don't they have soldiers? Wouldn't this be a good use of soldiers, to guard these facilities and make sure quarantine is maintained, and that hospitals are not destroyed by mobs of fear-crazed superstitious/paranoid people?
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Re: Biggest Ebola Outbreak In History- 1000+ Cases

Post by Siege »

Grumman wrote:Higher education? This is stuff we figured out two and a half thousand years ago.
What's your point? Do you mean to say that they all deserve to die? Because that was the implied point I was objecting to.

I also find it morbidly amusing that you apparently think the how-to on effectively combating epidemics was common knowledge that long ago considering all the interesting (also terrible and deadly) plagues we've been through since then. I'm sure the three to five percent of the world's population that died of the Spanish flue circa 1918 will be pleased to hear we figured out how to effectively combat virulent diseases two and a half thousand years ago.
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Re: Biggest Ebola Outbreak In History- 1000+ Cases

Post by Borgholio »

That is a statement that I take a significant amount of umbrage with.
Let me rephrase then.

The doctors and volunteers who are in Africa attempting to treat people and stop the spread of this disease are heroes. They are good people trying to help ease suffering. However, when it gets to the point where gangs of armed thugs are trashing the very hospitals that you've set up to help them, and looting infected equipment / breaking out infected people which is only guaranteed to make things worse...all your hard work is undone. Furthermore, in the article I linked, it mentioned that one of the doctors was deliberately attacked as he tried to flee the mob. With those kinds of conditions, how many Good Samaritans would continue their work? How many would stay behind even though they're not doing one lick of good and everything they do only ends up making things worse? Most, I imagine, would move on to a place where what they do can actually make a lasting difference.

With that said, moving to another area where what the do actually has an impact is essentially abandoning the original population to die by their own hands. That's pretty much what I meant, but perhaps my choice of words was incorrect and I apologize.
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Re: Biggest Ebola Outbreak In History- 1000+ Cases

Post by Simon_Jester »

The idea that sickness is contagious and that things which have come into contact with the sick should be avoided is, well, rather old. That much is true, and is part of many traditional mechanisms of coping with epidemics. It often is not enough, because avoiding the spread of disease properly takes a full knowledge of transmission vectors and the means to disinfect surfaces.

But it is certainly very much a counterintuitive surprise when people attack a place where they know that victims of a terrible plague are located, and deliberately bring themselves into contact with the sickness. So I can understand how someone can look at that and be flabbergasted and go "wait, people have known to avoid contact with victims of an epidemic since time immemorial!"

Of course, this is not universal traditional knowledge in all societies, and different societies have different traditions, some of them more productive than others. For example, caring for the sick and nursing them closely, even in non-sterile environments, might work fairly well when the most dangerous diseases are actually parasite infections or insect-borne, because it increases the odds of palliative care being effective. But it's a terrible idea in the face of something like Ebola, which is very easy to catch if and only if you come into contact with the patient's bodily fluids.
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Re: Biggest Ebola Outbreak In History- 1000+ Cases

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Borgholio wrote:Meanwhile in Liberia - a mob raided and destroyed an Ebola clinic two days after it opened.

http://www.buzzfeed.com/jinamoore/two-d ... ia#2oslo6w

Now, at what point are the doctors and nurses who are bravely risking themselves to control the outbreak going to simply throw up their hands and say, "I give up. You just signed your own death warrants. I'm leaving. You're on your own."?

Eventually, even the most selfless person has to admit that if a society wants to kill itself, sometimes the only thing you can do is let it.
Just like to point out that its hardly all of society because these douchebag thugs also drove the patients out. Its clear there are people who want to be treated and are not being treated because of these arm thugs.

Lets put it another way. If a young girl in a red neck town with an infectious disease is being treated in an American hospital and the staff are being intimidated by their ignorant relatives and douchebags townfolks who believe in the power of prayer, and the "evils" of modern medicine, should the staff just pack up and go home? Or say fuck them, this person wants to be treated so we should?

Its not an easy answer and it depends on our ability to protect the medical staff. However I feel that you are giving up too easy even though its clear some people do want to be seen by doctors and nurses.
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Re: Biggest Ebola Outbreak In History- 1000+ Cases

Post by Grumman »

mr friendly guy wrote:Lets put it another way. If a young girl in a red neck town with an infectious disease is being treated in an American hospital and the staff are being intimidated by their ignorant relatives and douchebags townfolks who believe in the power of prayer, and the "evils" of modern medicine, should the staff just pack up and go home? Or say fuck them, this person wants to be treated so we should?
You say "intimidated" when the more accurate description would be "raided". The young girl isn't getting treated if some shit for brains burns the place down.
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Re: Biggest Ebola Outbreak In History- 1000+ Cases

Post by Lolpah »

Grumman wrote:
Siege wrote:Their society doesn't want to "kill itself". If you're sitting in the comfort of your air conditioned home reaping the benefits of higher education and a sophisticated health care system then please take a moment to consider how fucking goddamn blessed you are.
Higher education? This is stuff we figured out two and a half thousand years ago. There's literally a chapter in the Bible about quarantining sick people and burning contaminated fabric (Leviticus 13).
Simon_Jester wrote:But it is certainly very much a counterintuitive surprise when people attack a place where they know that victims of a terrible plague are located, and deliberately bring themselves into contact with the sickness. So I can understand how someone can look at that and be flabbergasted and go "wait, people have known to avoid contact with victims of an epidemic since time immemorial!"
The thing is, these people believe the entire thing is a hoax by their government and that Ebola doesn't even exist. Hence, they think they are not at risk of catching it.
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Re: Biggest Ebola Outbreak In History- 1000+ Cases

Post by Borgholio »

The thing is, these people believe the entire thing is a hoax by their government and that Ebola doesn't even exist. Hence, they think they are not at risk of catching it.
And sadly, the only thing that will convince them otherwise is when they wake up one morning vomiting blood.
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Re: Biggest Ebola Outbreak In History- 1000+ Cases

Post by fgalkin »

You have to remember, Liberia has 51 doctors for a country of 4 million. Most of the people there have never seen one in their entire lives. If the people they DO trust- the faith healers or what not say that Ebola is a hoax, whom are they going to believe?

Have a very nice day.
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Re: Biggest Ebola Outbreak In History- 1000+ Cases

Post by Irbis »

How trying to combat the spread looks in practice [video]. IMHO, contrast with what people in first world are familiar with and this is huge, apropos errors by medical personnel :?
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Re: Biggest Ebola Outbreak In History- 1000+ Cases

Post by mr friendly guy »

Grumman wrote:
mr friendly guy wrote:Lets put it another way. If a young girl in a red neck town with an infectious disease is being treated in an American hospital and the staff are being intimidated by their ignorant relatives and douchebags townfolks who believe in the power of prayer, and the "evils" of modern medicine, should the staff just pack up and go home? Or say fuck them, this person wants to be treated so we should?
You say "intimidated" when the more accurate description would be "raided". The young girl isn't getting treated if some shit for brains burns the place down.
Then I will use an even more harsher example. Christian fundies attacking abortion clinics who see lots of patients. The question remains, should we give in to them and forget about helping the patients? My inclination is not if we can provide some form of protection for the health workers, even though there is still going to be some risk because we can't guarantee 100% protection.
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Re: Biggest Ebola Outbreak In History- 1000+ Cases

Post by Borgholio »

The area of town where the mob destroyed the clinic has been blocked off and quarantined by the Liberian Army. A curfew is also in place.

http://www.bbc.com/news/world-africa-28862591
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Re: Biggest Ebola Outbreak In History- 1000+ Cases

Post by loomer »

Ebola is now in the DRC, but it may not be linked to the main outbreak. The Congo is the origin of the disease so it might just be a local population popping up, which could present problems if they're different strains.
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Re: Biggest Ebola Outbreak In History- 1000+ Cases

Post by loomer »

http://www.belfasttelegraph.co.uk/news/ ... 26906.html

Well, this seems a little concerning.
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Re: Biggest Ebola Outbreak In History- 1000+ Cases

Post by madd0ct0r »

updated the graph.

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Last time, we'd only just breached the 100 cases a day once.
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Re: Biggest Ebola Outbreak In History- 1000+ Cases

Post by madd0ct0r »

162 new cases in the last two days. updated, and fixed an error in the spreadhsheet that wasn't spreading infections between days correctly.

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Re: Biggest Ebola Outbreak In History- 1000+ Cases

Post by Broomstick »

That is certainly an ominous trend.
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Re: Biggest Ebola Outbreak In History- 1000+ Cases

Post by Darmalus »

If I understand correctly, the end part of that graph is inaccurate due to lag time involved in the the awareness of new cases, correct?

If I may make a suggestion, instead of using a line, why not color that part of the graph another color, like red.
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Re: Biggest Ebola Outbreak In History- 1000+ Cases

Post by madd0ct0r »

because that's more of a pain to keep updated. I'd have to rewrite the data range lookup for two data series, not just one.
Same reason I've not been tracking each country separately or deaths, even though that would be far more informative.

http://www.independent.co.uk/news/world ... 86662.html
Official estimates place the number of known, suspected and probable cases of Ebola at nearly 2,500, just over half of which have been fatal. However, in a detailed assessment of the true extent of the crisis, the WHO described a bleak situation in which “an invisible caseload of patients… are not being detected by the surveillance system”.
...
“The system wasn’t at its best to begin with. We are facing challenges getting the healthcare facilities up and running,” she said. “Roads are not in a perfect condition. We are in the rainy season, and there are patients who do not have Ebola unable to get the necessary healthcare.”

In remote villages, corpses are being buried before authorities are notified. In some cases, according to the WHO, epidemiologists reaching the villages have been forced to “count the number of fresh graves” as a crude indicator of Ebola deaths.

Tarik Jasarevic, a spokesman for the WHO, told The Independent it was not possible to estimate how many unrecorded Ebola cases and deaths had been caused. “It is not just being underestimated in terms of figures, but also in terms of the social, economic and security impact,” he said. “It is a health issue, with much wider consequences... Next week we will present an Ebola road map, based on what we have learnt so far and what it will take to put in place everything we need.”
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