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Ebola in north america

westwoody

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Fair enough.

As stated, many posters here and other people in media assert that if all proper procedures are followed, the virus should not be transmitted.

I gave an example of a person who thought they were following all proper procedures but caught the virus.
I am sure the US tv cameraman was also careful.
Other foreign health care workers have also contracted the virus.
These are professionals who are trained to follow procedure and have the necessary equipment on hand to do so.
My argument is that the claims of non-tranmissability are grossly over optimistic, and there are cases to support that.

The second paragraph is meant to provide a contrast between the ideal environment of a professional health care worker -- the Spanish nurse -- and the day to day reality of life in Canada. If a person working in an isolation ward can contract the virus it is probable that people in our communities will also catch it.

Imagine how many people get on transit busses and go to work in factories or retail where they come in contact with hundreds of other people daily.
Many of these people will not stay at home just because they have flu symptoms. Many people think it is most admirable to come to work even if they are on death's doorstep, coughing, puking and sneezing. I gave a specific example from my own workplace ie the woman who came in last week coughing and blowing her nose for eight hours straight.
I spoke to a friend who had a co-worker bring their sick child to work. The child was too sick to go to school and the parent, a single father, had nowhere/nobody to care for them. So the child ran around the cubicles playing with the computers and doubtless spreading his virus/germs as he went.
So if these people somehow contract Ebola and become infectious themselves they are going to be vectors themselves, contaminating their contacts. No amount of proper procedure will stop the spread.

This is the reality I am trying to emphasize. Yes in an ideal world Ebola could easily be contained. We do not live in an ideal world though, do we? If everyone drove their cars properly there would be no accidents and nobody would ever be hurt. Is that what happens?
 

sevenofnine

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Nov 21, 2008
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You would not believe how many people have coughed in my face.

The man in Dallas died, a policeman who was at the scene is in the hospital with flu like symptoms
Duncan the Dallas man was receiving the best medical care, a week or so after being hospitalized and maybe only after his family complained.

Most people being infected I have read are health care workers, front line workers.
I just read and article that said wait and see, all the talking heads are saying we got this,
but the sars epidemic that almost got away doesn't really bolster any confidence.

My personal opinion this isn't going away.
Its never what you think that screws you up, its something you haven't thought off have not prepared for.

I still don't understand why they have not limited air travel.
I would think maybe the risk to the U.S and Canada is low I agree,
I defiantly agree with that,

But there are third world countries poor countries that could be easily be over come with this disease
Haiti Mexico South America Central America India Pakistan etc, What do you think Ebola would do to a slum in India or Mexico or the Philippians

I would be more worried to Ebola jumping to a third world slum then landing at yyc or Vancouver

Its interesting that this is the worst Ebola out break ever, where most outbreaks were contained and died away,
More people have died in this outbreak then all other outbreaks combined. and it continues to spread.

It was estimated a billion dollars worth of aid was needed to deal with this in West Africa. so far only a paltry few million have been donated.

I dunno but I think this is the biggest story in the world today.

More of a threat then ISIS.
But so far it has only killed a few black people and some aid workers so who the hell cares.

Like I said interesting to watch, Billions being spent on the war against ISIS, But critics have said foreign policy created this mess, and is likely not to stop it either. When the most dangerous thing the world faces is Ebola.
 

sevenofnine

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Nov 21, 2008
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Interesting to note, the only known treatment for Ebola??????

Comes from Winnipeg a doctor there working in the High Level disease lab there has isolated anti- bodies from monkeys.

Which are then grown in tobacco plants in a lab in
Arizona I believe.

Has produced a drug called z-ma???? which is in very limited supply, it is what has believed to have saved the aid workers to this point,


My opinion is simply that my opinion,
But I wish people that threw out facts and figures, would actually know of what they speak,
 

sevenofnine

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Nov 21, 2008
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Sorry Miss Melody I did not read your post,

But I think what I heard in a documentary was different research.

Not ten years ago but pretty recent actually.
and had nothing to do with transmission or vectors of the disease.
more about a cure or a treatment then whether a pig could give it to a monkey.


Any way

You don't need anyone to cough on you,
or sneeze not even any physical direct physical contact,

Just like you can catch a cold from a door handle. You can catch Ebola.

One survivor stated he only touched a railing and contracted Ebola. A railing that a sick patient had touched.

Any way, what ever,

Its the biggest news story in the world at the moment, forgive me for having and opinion and wanting to talk about it.

I actually think its fascinating.
People are scared, Airport workers have walked off the job because they have to clean planes with out proper equipment and training.

In a hospital in Calgary today, patients are lined up in the hallways and in lounges there are no beds.
A survey of front line hospital workers were asked whether they thought the hospitals were prepared for any kind of out break.

The answer was a resounding no.

My honest opinion we are not doing enough fast enough to contain this.

Read the news, Pretty much the experts agree, we need to do more faster,
before people do panic and well there are cases our hospitals have to deal with.

Read the news out of Dallas the city is scared and nervous. And they have had one case who traveled to this country..

They need to stop it before people do panic.

And I bet you a lot of people are worried about the same thing, the disease and a panicked population on top of it.
 

vancity_cowboy

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Jan 27, 2008
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They need to stop it before people do panic.

And I bet you a lot of people are worried about the same thing, the disease and a panicked population on top of it.
...a panicked population WITH THE RIGHT TO BEAR ARMS!!!

not a pretty picture at all :eek:
 

Tugela

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Oct 26, 2010
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Yep. You're right there. Remember how western civilization collapsed and there were millions dead in the streets when there was that SARS outbreak a few years back. It will all happen again in exactly the same way if a few people with ebola are not caught within hours of entering a western country.
Ebola is quite a few levels higher than SARS in terms of risk.
 

Tugela

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Interesting to note, the only known treatment for Ebola??????

Comes from Winnipeg a doctor there working in the High Level disease lab there has isolated anti- bodies from monkeys.

Which are then grown in tobacco plants in a lab in
Arizona I believe.

Has produced a drug called z-ma???? which is in very limited supply, it is what has believed to have saved the aid workers to this point,


My opinion is simply that my opinion,
But I wish people that threw out facts and figures, would actually know of what they speak,
It isn't the only experimental treatment, there are a number of others as well. In fact, one of them is being developed right here in Burnaby.
 

Tugela

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Ok. I believe I covered that pig/monkey study earlier. Again, my friend knows about the study (he told me about it long before it was in the news). I believe I quoted him earlier, perhaps you should read it.

The vaccine/treatment that was used on the cases in Georgia this summer (with great success!) is the one that was developed in Winnipeg 10 years ago.

Catching it from a door knob IS physical contact, isn't it? It sure isn't airborne ;)

We needed to do more earlier, it's too little too late now. Unfortunately at this point I think more people will get sick before this goes away. A lot more.

My friend knew about this from when the first few cases were diagnosed, he knew they were asking for help and not receiving it. Suddenly it's a white man problem and everyone is screaming for action. It's pretty shitty. Until the first public cases hit the USA, no one here even gave a shit (except my friend and some of his colleagues and a few people).

Maybe next time people will pay more attention.

I hope the governments who didn't heed the calls for aid get some public recognition in their role in this.

He and I have been watching this from the start, he predicted it would get this big. He's been upset about it for a long time. He's requested leave from the uni so he can go help, he's awaiting word back about that.
I disagree with your statement that "no one gave a shit". They did, but there is not much they can do.

Those countries in Africa say they want help, but they don't really, at least not the sort of help that would make a difference. You saw what happened to that medical team that was out looking for patients, they were murdered for their trouble by local villagers. That is just a small taste of what will happen if outsiders arrive in force. There is a lot of suspicion and distrust of outsiders in places like that, so there is a limit on what can be done. Not to mention, in most places in Africa indigenous medicine plays a big role in local attitudes towards diseases like this. So a large number of people will be essentially relying on magic to treat the disease and be off the reservation so to speak. And what do you do about them, since they will be a reservoir of disease even if you did treat everyone else?

An example of how this attitude works: in South Africa there is a belief that having sex with a virgin will cure aids, and as a result they have a big problem with little girls being raped. And a few years ago when the previous president was in charge his health minister was promoting beetroot (of all things) as a treatment for AIDS when the country was in a crisis situation regarding the extent of AIDS infection (http://en.wikipedia.org/wiki/Manto_Tshabalala-Msimang). That resulted in an estimated 300000 deaths. It is that kind of mindset in a not insignificant part of the population has that anyone who helps will have to deal with.

What those west African countries need to do is lock the whole place down and stop all movement, using military to enforce it. That is the only thing that is going to work now. They are in an absolute crisis situation, and they are essentially doing nothing. If the rest of the world comes to help, someone has to perform that function and I can guarantee that the locals will not like it one little bit and will not cooperate.
 

Tugela

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Fortunately our system will handle any cases that show up, so the chances of a large scale outbreak is basically zero for that exact reason. It won't have the chance to get out of control, unless MASSES OF PEOPLE flood our country and don't report their illness and everyone stops washing their hands/basic hygiene.

We will have a handle on it from the beginning, the way they would have in Africa if their calls for aid hadn't been ignored.
You are wrong. It just takes one irresponsible person to seed infection all over the place. Any infected person who gets into our country uncontrolled is potentially a big problem. And basic hygiene is not enough.

One or two people doing this will be controllable, but if dozens do it, some will slip through and then we will have a big problem. Treating a few people is manageable, treating a few hundred is manageable, but a thousand? Not so much. And ten thousand - not at all. Remember, even though they take precautions, a high percentage of health care workers get infected as well, and at some point we will run out of health care workers. The only difference between Canada and west Africa in that regard is that we have more health care workers and facilities, so it will take longer to reach a point of systemic collapse. Keep in mind that when our health care systems collapse, unlike Africa we will not be able to fly extra help in to take care of the shortfall.

Once the disease reaches a critical mass the ability of society to contain it will be destroyed and once it reaches a second critical mass the ability of society to treat it will also be destroyed. When that happens, our society will collapse since 9 out of 10 people will die.

I don't think that people understand that this might be the last happy summer for a very long time. Apocalypse is coming in the not too distant future and we will also be standing on the edge looking into the abyss. You need to be not so worried about what happens to a bunch of people in Africa who probably won't cooperate if you try to help them anyway, and be more worried about what is going to happen to you and your neighbors.
 

Tugela

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No, it wasn't. When SARS came at us we didn't know what bacterium or virus caused it (a corona virus). We didn't didn't know what animal(s) hosted it (civets). We didn't know its incubation period or if it was infectious before symptoms showed. We quickly learned that it was an airborne pathogen and victims often needed mechanical assistance to support respiration & there were a limited number of such equipment available even of first world countries.

Ebola we know. We know of various strains of the virus. We know that it isn't airborne. We know that it isn't infectious until the infected person is symptomatic. We know that it is hosted in fruit bats and a number of other animals. We have some treatments that show promise. The most basic treatment of the disease does not require equipment that is in short supply in first world countries. And we've had months and months to get our ducks in a row to prepare for it's eventual arrival.
Risk is a function of ease of infection and the outcome of infection. In SARS a negative outcome happened in 5-10% of known infections, so even if everyone got infected a lot of people would die but society would not collapse. Prior immunisation against flu provides some protection, so the number of unrecorded (and non-fatal) infections is likely quite a bit higher than the known infection, which means that the real mortality rate is quite a bit lower. Ebola has a 60-90% negative outcome rate, depending on the level of treatment the infected person receives. There is no immunity derived from exposure to other virus, so a successful infection is going to be a known infection. The mortality rate from ebola is at least an order of magnitude higher than that for SARS, and probably more than that.

A high percentage of people who get infected are health care workers, which means that people who would provide the sort of care required to reduce the mortality rate are among the first to go. Once their numbers decrease and the disease becomes more widespread the mortality rate will go up sharply. A global mortality rate in the 80-90% range would without question cause a complete social collapse of society as we know it.

SARS might be a serious infection but it is not a civilization ending infection. Ebola is.
 

Tugela

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Well my friend knows people who were on the ground when the first cases were discovered. They were asking for help, and were not given nearly enough. Help can be in the form of supplies, you know! And I'm well aware of the distrust, again my friend has studied infectious disease in Africa and told me first hand what he experienced. The local witch doctors want to keep control so they tell their people that the white man BROUGHT Ebola!

I am aware of these things, I assure you. My previous statement is true. The WHO is hugely under-funded, it receives a fraction of what the cdc gets, yet it's expected to handle these types of situations anywhere in the world.
The problem at the beginning of the epidemic was not treatment or control of those who were sick, it was controlling those who didn't know or believe they were sick. Lack of supplies might have meant people were more likely to die, but it was not responsible for the spread of the disease. That is a management issue that properly belongs to the governments of those countries and societies. Or more accurately, a lack of functional management. It is not something outsiders realistically could have done anything about since they don't run those governments.
 

vancity_cowboy

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Jan 27, 2008
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cbs reports that one of the health care providers in dallas has now tested positive for ebola. further confirmatory test results are still awaited

this was a person wearing the recommended gear, who had been trained in how to use it
 

mimi

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Article from the University of Minnesota Center for infectious disease research and policy...I found this interesting and logical.

"...There is also some experimental evidence that Ebola and other filoviruses can be transmitted by the aerosol route. Jaax et al24 reported the unexpected death of two rhesus monkeys housed approximately 3 meters from monkeys infected with Ebola virus, concluding that respiratory or eye exposure to aerosols was the only possible explanation.

Zaire Ebola viruses have also been transmitted in the absence of direct contact among pigs,25 and from pigs to non-human primates,26 which experienced lung involvement in infection. Persons with no known direct contact with Ebola virus disease patients or their bodily fluids have become infected.12

Direct injection and exposure via a skin break or mucous membranes are the most efficient ways for Ebola to transmit. It may be that inhalation is a less efficient route of transmission for Ebola and other filoviruses, as lung involvement has not been reported in all non-human primate studies of Ebola aerosol infectivity.27 However, the respiratory and gastrointestinal systems are not complete barriers to Ebola virus. Experimental studies have demonstrated that it is possible to infect non-human primates and other mammals with filovirus aerosols.25-27..."

Here is the link to the article...it explains a lot about Ebola, Influenza, aerosols, particulates, and so on...stuff most people know, and put aside because they are told by authorities that such a thing is not possible. Everyone in health care knows that when you walk into a room where a person has vomited or had diarrhea you are exposed to particulates. If you can smell it...you are eating it. Plus, the folks wearing the masks in a video I watched (in Africa) were sweating profusely on the exposed skin of their faces.

http://www.cidrap.umn.edu/news-pers...ers-need-optimal-respiratory-protection-ebola
 

Fullhouse

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Nov 6, 2007
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How many times do I have to say it: the virus they studied isn't relevant to the one that's is affecting west Africa. That study is about OTHER filoviruses, it even says so.
.
Gee, Miss Melody, kudos to you for trying to educate us on medical issues such as infectious diseases, viruses, medication, injections and God knows what all.

I appreciate your stellar efforts, Melody, but you should keep in mind that you are preaching to a crowd who's 'medical expertise is not the strong suit of the members on here. Heck, 95% of us don't even know what 'filoviruses' are,- never ming trying to spell it - and the other 5% are liars.

But we do know about injections - the kind that involve 'crack' ---- the powdery stuff or the one situated between a lady's legs. (I much prefer to 'inject' the latter of the 2.)

And medication -- well now, who hasn't heard of those little wonder pills called Viagra or Ciallis, - that can transform an aging limp penis into a throbbing boner.

So, Melody, relax a little bit and enjoy this long weekend, and don't be so upset if we don't comprehend your well informed comments.

Keep smiling.:D
 

Tugela

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Oct 26, 2010
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Risk is a function of what you know about the issue in the moment as well as those other things. We know a lot about ebola and knew little about SARS. We have a fairly good understanding of what needs to be done to deal with the few cases of ebola that will make their way to Canada and robust capability to execute. Given the dispersed nature of civilization in te world today, it is unlikely that any natural disease has the capability to end civilization. It would likely take the impact of a fairly large celestial body to end civilization.

Ebola is not a civilization ending disease for any first world country. Protocols may need to be adjusted, that is all. Infection control protocols are made only as arduous and complex as necessary to mitigate the risk. To date, it looks like there are rare instances where contact is made with the contaminated outside of PPE and health professionals' mucous membranes or eyes without adequate washing (with either soap & water or alcohol based sanitizer) in between. They are also only double gloving and not triple gloving. There are still more robust decontamination procedures that can be undertaken before beginning to remove the PPE than the existing protocol calls for so the protocol can be upgraded as needed.

As for health professionals being a high percentage of the infected, this is not mathematically possible, given the high numbers of infected and the very low numbers of health workers on the ground in the affected areas. Given that a great number of the indigenous health workers had no PPE at all, not even disposable gloves & masks, and the clinics were all open wards there should be no surprise that such folks who spend a lot of time caring for many infected people become infected.
As of 2 months ago, approximately 240 health care workers had become infected, it is probably quite a bit more now. So the rate of infection among health care workers is considerably higher than the general population. In the event of a widespread outbreak they will be the first sub-population to be taken out, and after that who does the nursing? You will have to take care of your family yourself, and you will not be equipped to do that and escape infection yourself. Single people will die alone in their condos, the city will be saturated with corpses all over that no one knows about. It will be a mess. That is the problem with something like Ebola, it is manageable in small isolate outbreaks, but in a pandemic it will be devastating.

No matter what protocols are used in hospitals, eventually a slip up will happen. We have already seen this happen twice in the half dozen or so patients being treated in American/European hospitals. And these are hospitals with a single patient to deal with, where they are being extra careful. What do you think is going to happen when they have 10 patients, then 100, then 1000, then 10000, then 100000? What happens when the guys who make medical gloves, who deliver them (for example) stop doing that because they are either dead or too scared to go to work? The wheels will fall off, and in a sophisticated highly interdependent society like ours, when the wheels fall off, they will REALLY fall off. All the stuff and services you take for granted will suddenly stop. It is not just ebola you are going to have to worry about, it is how you are going to get food, get water, get gas for your car, and how to fend off the people who want those things more badly than you, not to mention the bodies of your neighbors slowly piling up in their beds because everyone is too scared to go and collect them. When numbers get so big in terms of dead you will see things like bulldozers burying masses of corpse in pits, just like during the earthquake in Haiti, only on a much, much larger scale and everywhere, not just in one city. There will be no where to run to, no where to hide. You are going to experience what your ancestors experienced when Bubonic plague hit Europe and the Middle East in the middle ages.

If this disease gets a foothold in North America or Europe, shit is going to happen like you won't believe. If they are really serious about containing this they need to stop all non-essential travel, both outside national borders and within. And those who do travel with cause should be required to undergo quarantine/screening when moving past checkpoints. That will at least slow progression down enough to allow medical researchers time to come up with a way of dealing with this, and on a scale where it is effective. Having a large percentage of the world population die is bad enough, but the effect of that will be mitigated if that dieing is staggered over time, so society has a chance to adjust resources in response. A worst case scenario is where we all get sick at around the same time, if that happens we will be returning to pre industrial style culture for the next generation.
 

sevenofnine

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Nov 21, 2008
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No the sky is not falling,

But it is not something to ignore or take at all lightly,

I agree that it wouldn't take a hell of a lot for our system to be overloaded and people to panic,

In my opinion it wouldn't take much at all.

It is comforting to see the powers that be moving in the right direction. Airport screening etc, protocols in place and testing them in the case of false alarms.

It is nice to know a vaccine is on the horizon as well.

If you knew what I did for a job, some of us are in a high risk category.
I would be among the first people possible exposed well Im certainly at a higher risk then the average person to exposure.

And also I would be at a higher risk to passing it on.
I could easily expose hundreds of people daily, unknowingly. Easily hundreds of people.

It is understandable that some people are more nervous then others.

In Calgary right now there is some sort of virus flu going around, I have been on and off sick for the last two months.
Like I said people coughing in your face all the time, Not direct contact, but enough contact to pass anything between two people, airborne or other wise.

Best advice a doctor ever said don't ever touch your face, even to scratch your nose or blow your nose without washing your hands. Something you touched then you touch your face, mouth area, its all it takes.


Any way those poor people in Africa when will help ever come to them.
It is so sad.

we sit here in all our arrogance,
if and when a vaccine becomes available who will get it first.
 

Tugela

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Oct 26, 2010
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Utter tripe of the worst kind. A comparison not of of apples with oranges but of apples with Lego blocks.

Yes, in those African countries the small number of health care workers infected represent a large percentage of the workers there, but they still represent a minority of the cases. Since the majority of the local health workers had no capability of enacting the recommended protocols they had little chance. The western health workers that came in were also grossly short of equipment, materiel and supplies and working in primitive clinics and wards. They've done somewhat better but are challenged when things as simple as bleach are sometimes in short or erratic supply.

Looking at first world countries, how many infected people have been evacuated to them so far? 10? 20? About 20 or so health care workers work on each case so more than 200 health workers have had their first live ebola case to deal within their hospitals. Out of them, a couple slipped up: less than 1%. Those cases will cause the protocols to be tweaked and cause health workers to redouble their focus on getting it right. There will be more cases brought into first world countries, both evacuations and people arriving infected. There will be more cases of error, but the error rate is likely to drop as people train more intensively in the protocols.
240 infected 2 months ago represented about 5-10% of the total. That is not an insignificant number when you consider the ratio of doctors to patients out there (closer to 100000 to 1). Granted, that includes nurses and nurse aids, but still, that is a very high percentage relative to the general population.

European and American hospitals have low re-infection rates now because they are dealing with one or two patients, so they can be extra carefull. It will be different when there are many patients, then infection rates among health care providers will soar.

Infection rates are doubling every three weeks, and the mortality rate is rising as well. It is currently at 70%. The main indicator of probability of survival is access to adequate medical care. If it is adequate then your chances of survival are about 50%. With poor or no medical care your chances of survival are about 10%. The fact that the mortality rate is increasing means that more and more people are receiving little or no care, in other words the health care systems in those countries is in the process of collapsing because they are being overwhelmed. That can be slowed down somewhat by bussing health care providers in from other parts of the world for a while, but when ebola becomes a pandemic, that supply of health care workers will stop abruptly because those people will be dealing with their own problem at home.
 
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