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  • Don’t Panic: A Continuing Series

    Posted by Jay Manifold on October 16th, 2014 (All posts by )

    [Readers needing background may refer to the first member of this series, Don’t Panic: Against the Spirit of the Age, posted last month. This post, unlike that one, was hastily written due to time constraints involving, perhaps ironically, international travel to a Third World country.]

    Constructive foreword: suggested case studies in disruption are the Chicago blizzard of 1/13-14/1979 (~3 million commuters immobilized) and the Milwaukee Cryptosporidiosis outbreak of 3/23-4/8/1993 (~400k residents sickened simultaneously).

    Thesis: I argue that, at least with Ebola, inept and overwrought responses pose far greater risks to American society than the disease itself. With regard to managing the risks associated with Ebola in the US, it is vital that we identify easily disrupted institutions and design our processes intelligently to avoid creating bottlenecks, mostly by resisting the urge to overreact; likely candidates include …

    Airports – Domestic air travel in the US is deeply vulnerable to disruption at the margin, such that the distance over which people will choose to drive rather than fly increases significantly if changes make flying seem too arduous or dangerous. Either lengthy medical screening procedures or rumors of disease transmission at airports or aboard airplanes will cause just such a shift. Driving only 20 kilometers on even the safest (that is, limited-access) highways is as risky as flying 5,000 kilometers from the Atlantic to the Pacific coast. Vehicular fatalities will increase by at least several thousand per year in the event of any substantial stress on the airline industry, just as they did in the year after 9/11/2001.

    Hospitals – Massive redirection of ICU and other resources – typically high-double-digit numbers of staff – to the care of even a single suspected Ebola patient will severely draw down, and for all but the largest hospitals exhaust, patient-care resources available for most other acute-care needs. Any breach of protocol which appears to threaten any critical-care staffers with infection will greatly exacerbate the problem by both directly removing those staffers from the available resource pool and by requiring the dedication of their own sizeable retinue of caregivers. Such a positive-feedback loop would bring any hospital to a standstill in a matter of weeks, effectively eliminating medical care for hundreds or even thousands of people at a time.

    Mass Transit Facilities – Similar to the airport case in that cumbersome screening and perceived infection risk would be immediately disruptive, except that alternatives to mass transit, especially for commuting, are logistically problematic for many people. The specific risk is of a general economic slowdown as workers are unable or unwilling to report to their jobs. Telecommuting can mitigate this in many cases, but only insofar as management is flexible. In the extreme case, this would become a selective pressure in the Darwinian sense, eliminating unresponsive American businesses in metropolitan areas characterized by heavy use of public transit.

    Schools – The problematic response in this area is most likely to consist of parents simply removing their children from school for the perceived duration of the infection-risk period. Sharply lower student populations would reduce funding, but the effect on institutional functionality would be minor by comparison with the atmosphere of general hysteria.

    Large Entertainment/Sport Venues – Not an immediate matter of life and death, to be sure, but precisely for that reason, any sufficient combination of cumbersome screening and perceived infection risk would hit them hard. As for churches and synagogues, I suppose we’ll find out just who has, and has not, internalized Psalm 91.

     

    9 Responses to “Don’t Panic: A Continuing Series”

    1. Andrew_M_Garland Says:

      An outbreak of communicable disease must be handled cheaply. That means cheap in dollars and nursing hours.

      That may seem harsh, but the current display of CDC and medical response is to spend say $300,000 per patient. An outbreak of 500 ill people would overwhelm the care and tracking systems now in place.

      The big risk is not the few patients now being treated. It is the spread of Ebola to Mexico or Central America and then to Mexico.

      The flood of borderline symptomatic people to the US would quickly overwhelm the US medical system.

      Where is the plan for managing widespread quarantine?

    2. TMLutas Says:

      The biggest risk of ebola in the United States in 2014 is, frankly, transmission to an animal reservoir population that we can’t manage to eliminate much like bats are a suspected reservoir for Africa. An ebola outbreak that has to cross the oceans to get here is orders of magnitude less scary than one that is hanging out in our own back yards and adjusting to new territory and new hosts. All of the problems go from bad to worse if ebola becomes native to North America.

    3. Joe Wooten Says:

      The biggest problem is the continuing streams of lies from the 0bama administration on other matters and the massive infusion of political correctness into the bureaucracies has left a reservior of mistrust in the government institutions that are supposed to handle these problems. The performance of the CDC, NIH, and various hospitals has not helped either.

    4. Jim Says:

      TMLutas – Something like that has already happened with West Nile fever in the Houston area. This disease was once unknown here but is now established in the local mesquitoes. Harris County Mesquito Control
      constantly tests mesquitoes throughout the Houston area to determine where to concentrate control measures.
      However there is no expectation of eradicating the disease now. They are just trying to keep it under control.

      The great majoriity of victims of West Nile recover but about 1% of cases result in severe neurological impairment.

    5. Jay Manifold Says:

      Actually, West Nile is now endemic in most of the US.

    6. TimL Says:

      Possible case at the Pentagon. You know how many people work there? This crew is so incompetent it is unbelievable. But Frieden is on the transfats so no worries.

      http://wtop.com/139/3724393/Possible-Ebola-case-at-the-Pentagon

    7. Subotai Bahadur Says:

      Joe Wooten Says:
      October 17th, 2014 at 7:26 am

      This. One of the reasons that the regime has given to not cut off travel from the Ebola hotbed countries is that actions make statements, and that statement would be degrading to the citizens of those countries.

      Actions do make statements. So far the actions of the US government are plainly stating to US citizens that the US government does not give an airborne pelvic thrust for the lives of US citizens, and that they are taking every step that they can think of to ensure the spread of not only Ebola but also other deadly diseases throughout the country. The naming of a corrupt Democrat political operative [mind you that is an identifier, not any comparative endorsement of Republican political operatives] whose personal history is a history of opposition to the Constitution and looting the public fisc, and whose career is the political equivalent of an ambulance chaser which is as close as he has ever been to anything medical as the Ebola Czar is a statement. It is a statement that the government has no intention of doing anything to stop or slow the spread of Ebola anywhere in the country. And that such is the mandate he was given at the highest level.

      Until that problem is resolved, none of the other problems can be.

      Subotai Bahadur

    8. tomw Says:

      Subotai, I believe you are describing the flagrant itching of Teh Won’s nose with his middle digit as done during some of his campaigns. Otherwise known as flipping the bird to the citizenry of the USA.
      The bureaucrats of the CDC had no real ‘protocol’ handed off to the hospitals throughout the country, and suggested minimal protective gear compared to what they used in their own workspace.
      Given that hospitals remain reservoirs of MRSA and C.Difficle, and regularly pass said infectious material from patient to patient, it is absurd to expect them to handle the Ebola virus without contamination and creation of new infections. Some hospitals thought they had successfully erased difficult bacterium, such as C.diff, but then found cases spreading from ‘isolation’ rooms to other spaces.
      To my mind, it is stupidity on stilts to allow Ebola to enter the US as there is nothing to suggest that it can be contained.

    9. Jay Manifold Says:

      Prediction for Wednesday, November 5th: the Ebola panic-mongers will suddenly decide it’s not that big a deal after all, since sensible people got elected. And the defeated Democrats will say that the voters who threw them out were just scared of Ebola, not fed up with their failures in general.