Why Ebola will not stay in Africa.

56 thoughts on “Why Ebola will not stay in Africa.”

1. I was wondering if CB would have a post on this. From much of the news lately, I have come to believe the world has gone medieval.

2. Not only will it not stay in Africa, it will be here soon. A couple of days ago the Federal government [read that Buraq Hussein] stated that there would be no ban on air travel to and from countries where the epidemic is raging.

   Then there is the matter of our deliberately open southern border. Once again, a couple of days ago they released a breakdown of who they had caught crossing so far this year. We have caught 71 nationals from Liberia, Guinea, and Sierra Leone. Now that Nigeria is in epidemic status, you can add whatever number of Nigerians were caught.

   Now factor this in. We normally only catch a small percentage of those who try to cross. Granting, that does not hold at this moment for Hispanics, because if they surrender they are getting free entry. But eventually someone with Ebola is going to enter from the south.

   I will also note, that the epidemic is spreading. And that Guinea is a Muslim country. Sierra Leone is 70% Muslim. Liberia is 30% Muslim. Nigeria is over 50% Muslim. The Hajj starts October 1, 2014 with every Hajji walking around the Ka’aba seven times. It takes all day to get the 2 million plus through it.

   http://www.boltaunsa.com/wp-content/uploads/2014/01/Hajjfileafp.jpg

   All 2 million scatter to the winds back home at about the same time.

   Pessimism = Realism

   Subotai Bahadur

3. Can Ebola be transmitted through tears?

4. In 1645 there was an outbreak of plague in Leith, the port of Edinburgh. 50% of the town’s population died. What might Ebola achieve?

5. Dr. Kennedy,

   We have something new in the BELMONT CLUB thread you cited:

   One of the things I do is evaluate returning travelers and arriving refugees who are ill. Occasionally, this involves specialized testing at CDC.

   I can absolutely guarantee that the number of “rule out Ebola” tests that the system can provide are inadequate to our present circumstances. First of all, there are probably only one or two individuals who can do the work. Reagents (testing materials) are “home-brew”, non-commercial products and are now undoubtedly in short supply.

   For at least the last few years, refugees being resettled in the USA are arriving sick in unprecedented numbers. When I started working in 1976, and for many years, strict screening at point of departure was always applied. This no longer appears to be the case.

   With regard to the Mt. Sinai case – EVERY arrival from West and Central Africa who has a fever now has to be tested – even if you can prove malaria, for example (because they could have both). This means that dozens or even hundreds of people/week will need testing. The “system” almost certainly cannot do volume like this – and that’s the probable explanation for the hush-hush.

   As an aside, this means that the number of patients in isolation for possible Ebola (most of whom, or all of whom, don’t have it) will rise, and the refusals to work will rise as well.

   I don’t see a short-term fix other than a travel ban, which we know will not happen.

   Interesting times.

   Can you speak to the testing issues he identifies to confirm or deny?

   Subotai Bahadur

6. Tom Friedan, head of the CDC seems adamant that Ebola, even if it got to the US, would be easily controlled. I’m mildly inclined to believe him, since the CDC and the broader US Public Health System did a remarkably good job controlling SARS, which was an airborne virus that doesn’t even require contact.

   That said, I suppose FEMA was considered ready to respond to any hurricane that could possibly land on US shores until Katrina hit. For that matter, it was also inconceivable that the vaunted CIA and US Military would let a full US Ambassador get killed by terrorists without even trying to mount a rescue op…

   Respectfully,
   Vamsi Aribindi

7. The rainy season is beginning in Africa now and malaria will spike, further confusing the issue as the early symptoms are similar.

   Too bad Ellis Island is only a memory, and only for those of us who bother with history.

8. We have grown accustomed to being safe, and complacent in our belief that it will always be so. Across the globe, there are many places with medical systems which would quickly collapse when confronted with a plague this virulent.

   The influenza epidemic after WW1 killed many millions. Travel is much easier and faster now, for people and germs.

   It’s very unfortunate the current regime is so utterly incompetent. A competent, pro-active response by adults might have saved a lot of lives. Instead we have fools and immature ideologues.

9. It could be a good thing.

   Ebola will savage two populations. Those living in dense cities (progressives) and those who are reliant on the government for sustenance (progressives).

   People outside of the cities will look after themselves as they always have and will keep strangers away with rifles. The problem will self-correct after a few weeks.

10. Mr Black,

    You are delusional.

    Ebola is no respecter of political beliefs.

    Besides that, you are missing the implications of wide spread hard quarantines.

    The economic costs to shutting down the world air traffic system will kill the just in time economic model for the duration of the shut down.

    In addition, we are looking at the bankruptcy of every major air line world wide simultaneously. Boeing Airbus and the Brazilian regional jet manufacturers won’t be far behind.

    The trucking system won’t be far behind the airlines.

    The disruption from that is great depression class in effect.

11. The US govt shut down air travel to Israel, a tiny country, for 36 hours and it caused tremendous disruption. Imagine the economic ramifications of prolonged international flight bans.

    That said, I’m guessing it doesn’t get that bad here, because we have better medicine, better communications and more wealth than do the countries now suffering the epidemic. The conventional wisdom is that Ebola’s short incubation and high lethality have retarded the spread of epidemics. Maybe that’s right. OTOH Ebola has some of the characteristics of the 1918 flu. We shall see.

    The person who thinks it could be a good thing for the epidemic to spread among his political opponents in dense cities is a depraved fool.

12. No one is going to shut down international flights. What will happen, at worst, is that flights from Africa are shut down, and that will not impact anyone significantly. Further to that, travellers may need a medical clearance to fly from other countries. If it got to the point where the entire air industry shut down, it’s too late and humanity is in serious, serious trouble everywhere. Economics and business interests will be the least of our worries.

    Western populations will handle an alert just fine, except for the previously mentioned welfare slugs who will have to congregate in order to receive food aid. They are no loss.

13. Jonathan Said:

    >>That said, I’m guessing it doesn’t get that bad here, because we have better medicine, better
    >>communications and more wealth than do the countries now suffering the epidemic.

    That would be a bad guess. See this article:

    Int J Exp Pathol. Aug 1995; 76(4): 227–236. PMCID: PMC1997182Lethal experimental infections of rhesus monkeys by aerosolized Ebola virus.
    E. Johnson, N. Jaax, J. White, and P. Jahrling

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1997182/

    Abstract
    The potential of aerogenic infection by Ebola virus was established by using a head-only exposure aerosol system. Virus-containing droplets of 0.8-1.2 microns were generated and administered into the respiratory tract of rhesus monkeys via inhalation. Inhalation of viral doses as low as 400 plaque-forming units of virus caused a rapidly fatal disease in 4-5 days. The illness was clinically identical to that reported for parenteral virus inoculation, except for the occurrence of subcutaneous and venipuncture site bleeding and serosanguineous nasal discharge. Immunocytochemistry revealed cell-associated Ebola virus antigens present in airway epithelium, alveolar pneumocytes, and macrophages in the lung and pulmonary lymph nodes; extracellular antigen was present on mucosal surfaces of the nose, oropharynx and airways. Aggregates of characteristic filamentous virus were present within type I pneumocytes, macrophages, and air spaces of the lung by electron microscopy. Demonstration of fatal aerosol transmission of this virus in monkeys reinforces the importance of taking appropriate precautions to prevent its potential aerosol transmission to humans.

    This EBOV viral hemmoragic fever that is spreading out of West Africa, as opposed to Ebola Zaire, has a 23-day infectious period in dried blood and the exposure of 1 mm of eyes, nose or mouth tissue to sneeze droplets is enough to give you a clinical case of EBOV.

    See this comment was on that Wretchard “Viral” thread about that —

    “middle c

    A friend of my daughter’s was a physician treating Ebola earlier this year. Her team had to be flown out under military protection in March when the inhabitants tried to kill them. The report is that whole villages are gone, families annihilated – and I was told with some vehemence that the Ebola virus is indeed airborne, via droplets at the least and dust particles at the worst.

    The virus lives for 23 days on a surface – a plane seat, a door handle, a gas pump, a grocery cart, mail, cash. The notion that it can be contained arises from denial, same as the natives running away into the bush rather than submit to quarantine.

    In fact, a big piece of the story is that identified contacts are running away and hiding even as they succumb. Now it is in Saudi Arabia, with the hajj imminent. Countless African students will be winging their way to universities around the world this month.

    As Mr. Isaacs told the Congressional sub-committee, one millimeter of unprotected skin is all it takes to be infected. Prepare now, while you can, for at least 3 months of sheltering in place – where nothing and no one goes out, and nothing and no one comes in.

    The reported rate of infection is about 1.86 per patient (ie, each Ebola victim infects nearly 2 more) – and that rate may be artificially low due to poor reporting. But even at that rate, 4 billion will have been infected by 2016. Wake up!”
    —

    and it has the following implications —

    EBOV is showing lethal persistence that rivals VX persistant nerve gas (three weeks) and high self-replicating virulence.

    That is a civilization destroying pandemic risk.

    There is no way that any Western hospital can deal with a blood/mucus/saliva born disease that can infect with a 1 mm square eye/nose/mouth/skin contact from a sneeze and remains infectious in dried blood for three weeks.

    The Ebola EBOV variant is spreading across the African roads to the population of African long distance truckers and their prostitutes — “blood born” also means sexually transmitted — to everywhere in Africa. In a matter of weeks we will be seeing prostitute vector Ebola showing up with village headmen and African government officials across equitorial Black Africa.

    In short, we have already lost rural equatorial West Africa and the West African cities are dying.

    And It will be in Arab North Africa and Southern Africa in three weeks by road, if it hasn’t made it there by airplane already.

    It is now a question of limiting the damage.

    Nothing short of a hard shut down of the world wide air transport system and air-sea-land blockade _right now_ with a shoot to kill enforced quarantine is going to stop this.

    Once it gets into America anywhere, we will have to shut down interstate travel for at least three months.

    Follow this twitter feed for the latest —

    https://twitter.com/hashtag/EVD?src=hash

14. One more point, the key public health deception happening right now is that the various government talking heads are all carefully trying to conflate

    1. “exhalation” transmission with,

    2. “inhalation” transmission, to deny the existence of

    3. _Airborne transmission_.

    IOW, If it ain’t “exhalation transmissible,” _it ain’t airborne transmissible_…

    …even though it can be contracted by inhaling dried saliva and dried bodily secretions without the protection of a N95 respirator class breath mask and full body slime suit.

    And the media will believe them, or at least say they do.

    See this link —

    http://www.tfmetalsreport.com/comment/423181

    and in particular this most interesting post, No. 228:

    @ssj
    I think the discussion section of the article you posted suggests that Ebola is more likely to be transmitted via aerosol at lower temperatures and relative humidities than are usually present in sun-Saharan Africa. They mentioned they did their experiments at 24C and <40% relative humidity. What I meant by "thriving" was merely that virion would have a longer stability on surfaces in conditions that are more similar to our autumn than Nigerian summer.

    My personal take on transmission is that the ability of the virus to be transmitted is being vastly underestimated. While not strictly "airborne", it is clearly very transmissible with very few particles via mucous membranes – recall Ken Isaacs statement about the eye. Droplets, even microscopic, from respiratory or other bodily secretions (sweat, urine, blood, feces) can apparently act very effectively as agents of transmission when landing on fomites (inert surfaces like table tops, seats/chairs, clothing).

    It appears from the clinical observations in West Africa that the virus is exquisitely capable of being expelled onto fomites, transferring to another person (via the hands or garments) and then infecting the person through the most minute exposure to a mucous membrane like the eye or the oral mucosa or the respiratory tract.

    Remember that only a very few microscopic virion particles could effectively cause an active clinical infection. This spread would then appear to be like airborne transmission while not strictly fitting that definition.

    I suspect the Nigerian and CDC “authorities” are aware of this, and are hiding behind semantics so as to not cause panic but nevertheless not be guilty of overt lying.

15. This is the next key “Tell” to watch for in the spread of EBOV —

    Keep an eye on the following oil companies, Shell, ExxonMobil, Chevron, Total, and Eni, to see if they announce employee evacuations and the shutting down of oil operations in Nigeria.

    You won’t see this on the broadcast news, but only in the oil market reports citing ‘lower nigerian production’ and indirectly via gasoline price spikes.

16. Many uncertain probabilities here. Probabilities aren’t additive. Are airline stocks falling or biotech/pharma and medical supply mfr stocks rallying? If not, why not? The extreme predictions may be right but I don’t think that’s the way to bet. We will know soon enough in any case.

17. Jonathan,

    Federal reserve automatic buy programs, and the ability to print money electroically means for an industry as small as the airlines, means that we just can’t tell.

    Oil is several orders of magnitude bigger.

18. Jonathan,

    This is definative —

    http://www.msdsonline.com/resources/msds-resources/free-safety-data-sheet-index/ebola-virus.aspx

    Ebola virus
    PATHOGEN SAFETY DATA SHEET – INFECTIOUS SUBSTANCES

    SECTION I – INFECTIOUS AGENT

    NAME: Ebola virus

    … SURVIVAL OUTSIDE HOST: The virus can survive in liquid or dried material for a number of days (23). Infectivity is found to be stable at room temperature or at 4°C for several days, and indefinitely stable at -70°C (6, 20). Infectivity can be preserved by lyophilisation.

19. Remember that the health care workers were infected by urine directed randomly. It might be time to read Tom Clancy’s book, “Executive Action” about Ebola as a weapon.

20. Jonathan,

    It is now time to stay away from hospitals and diagnostic health facilities handling blood tests.

    See:

    http://www.cdc.gov/vhf/ebola/hcp/clinician-information-us-healthcare-settings.html

    Text excerpts below —

    BILLING CODE: 4150-37
    DEPARTMENT OF HEALTH AND HUMAN SERVICES

    Declaration Regarding Emergency Use of in vitro diagnostics for detection of Ebola Virus

    AGENCY: Department of Health and Human Services, Office of the Secretary

    ACTION: Notice.

    SUMMARY: The Secretary of Health and Human Services (HHS) is issuing this notice pursuant
    to section 564 of the Federal Food, Drug, and Cosmetic (FD&C) Act, 21 U.S.C. § 360bbb-
    3. On September 22, 2006, then Secretary of Homeland Security, Michael Chertoff, determined
    pursuant to section 319F-2 of the Public Health Service Act, 42 U.S.C. 247d-6b, that the Ebola
    virus presents a material threat against the United States population sufficient to affect national
    security.

    On the basis of this determination, on August 4, 2014 the Secretary declared that circumstances
    exist justifying the authorization of emergency use of in vitro diagnostics for detection of Ebola
    virus pursuant to section 564 of the FD&C Act, subject to the terms of any authorization issued
    under that section.

    >Snipped<

    III. Declaration of the Secretary of Health and Human Services

    On August 4, 2014, on the basis of the Secretary of Homeland Security’s determination that the
    Ebola virus presents a material threat against the United States population sufficient to affect
    national security, I declared that circumstances exist justifying the authorization of emergency
    use of in vitro diagnostics for detection of Ebola virus pursuant to section 564 of the FD&C Act,
    subject to the terms of any authorization issued under that section.

    Notice of the EUAs issued by the FDA Commissioner pursuant to this determination and
    declaration will be provided promptly in the Federal Register as required under section 564 of
    the FD&C Act.

    Dated: August 5, 2014.
    _______________________________________
    Sylvia M. Burwell,
    Secretary

21. It is time to lay in three months of supplies for a “shelter in place” situation in a safe location.

    Expect power and water to be unreliable after the first month.

    Good luck on getting those supplies, because we all have very little time before the panic buying hits.

22. The New Republic | has the latest word on what to do about Ebola.

    ” we all need to work to correct the harsh injustice of a continent where health care is inaccessible for too many; where fresh, running water is scarce; and where electrification and modern roadways are problematic.”

    Yup. Problem solved.

    Does the left have any other solution to problems of civilization ? Remember that Osama bin Laden was “building schools,” according to Senator Patty Murray.

23. Trent, I agree that it’s a good idea for individuals to be prepared. However, I don’t think anyone knows what the odds of an Ebola epidemic in the industrialized world are. Maybe the worst-case predictions are accurate. OTOH, maybe Americans would respond to an epidemic in ways that greatly reduced its severity.

    The point about stocks is that a widespread epidemic, or fear of an epidemic, would cause a lot of economic uncertainty that would affect the markets. We haven’t seen that. Maybe we will see it, but until we do I’m guessing that the threat of an epidemic here is overblown.

24. Jonathan,

    For the Left, and the high end financial traders are now predominently left of center, this is so completely outside their frame of reference that they don’t believe in it and the government types they talk to don’t believe in it either.

    The problem is that disease does not care whether you believe in it or not.

    I saw a similar problem with Democratic Party National Security talen versus their Health care policy talent during the First Clinton Term.

    Then Secretary of Defense deignate Les Aspin Aspin found an utter lack of young, smart, & flexible minds to fill those positions. He was left hiring Carter Administration re-treads, and his House committee staffers, for those slots because all the best Democratic Party minds had gone into health care issue related think tanks or policy positions during the 12 years of Reagan-Bush41.

    The last of the real hawkish Democrats, who beluieved in foreign enemies, and foreign disease threats like Ebola, went down in the 1982-1984 Nuclear Freeze movement. After that, they all either retired; became defense contractor lobbyists & retired; or became Republicans.

    Sen. Sam Nunn’s vote on the 1991 Gulf War killed the last of that senior policymaker rear guard in the Democratic Party and Aspin’s hiring effort gave them their retirement pensions.

    The since 1992 Democrats have invested too much into single-payer national healthcare for them to abandon it. This is a party self-identification issue, which is why you see all the issues wuth Obamacare that is currently killing their Party in the 2014 elections.

    The problem is that people so tied around the axle for American national healthcare just don’t believe that the rest of the world is real and that there are deadly threats, other than domestic ones like Republicans or “Teabaggers.”

    Hence the Obama failure with Benghazi as well as ISIS in Syria and Iraq.

    Those Obama Democrats are the same people the Market traders talk to about Ebola.

25. “Hence the Obama failure with Benghazi as well as ISIS in Syria and Iraq.

    Those Obama Democrats are the same people the Market traders talk to about Ebola.”

    I absolutely agree. Politicians, and staffers are politicians in utero, have very limited horizons. For example, after the 1994 election, I was just finishing a year at Dartmouth on health policy and was highly motivated to do something with the new Congress. I would have worked for nothing as I had a secure income. I went down to DC and talked to some serious people, aided by some help from Senator Gregg’s office. I was told that the health policy shops were being staffed with tax lawyers and there was no interest in a physician contribution. That’s what Republicans do.

    I was just reading an interesting article about Andrew Cuomo and the risk he is running of going to prison.

    Serious matters are not the concern of politicians. The Japanese practically waved flags to warn us of Pearl Harbor. Al Qeada was giving warnings for several years with escalating attacks. If you read Heart of a Soldier , Rick Rescorla and his SF buddy predicted 9/11 after 1993. Rescorla was running evacuation drills for years for his employer. On 9/11, he got everyone out and went back to look for stragglers that weren’t there. The Port Authority was telling everyone to stay at their desks. He defied them.

    The financial meltdown in 2008 looked so much like 1929 that it was amazing that no one noticed.

    As some Hollywood producer once said, “Nobody knows anything.”

26. Trent,

    What you’re arguing is unrealistic. Traders aren’t politically monolithic, and even if they were they wouldn’t throw away money. They are going to pay close attention to any hint of a developing epidemic. The uncertainty caused by a US Ebola outbreak on the scale you’re describing would cause a lot of market volatility, and probably a major sell-off until the scope of the damage could be assessed. You are talking about events that would significantly lower US GDP. That would take a chunk out of share values no matter what the Fed did.

    Or to put it another way, people in general tend to have limited horizons, but markets are very good at analyzing publicly available information. If there is going to be an epidemic here the first warnings may come in the form of unusual market activity. So far we haven’t seen anything. The situation may change, but at the moment it looks like the most frightening predictions are unlikely to be realized.

27. May we all live in interesting times

    I wonder if the Chinese are quarantining the thousands of workers they have all over Africa as they come home for visits. An Ebola outbreak in the tremndously crowded cities there would be horrific.

28. ” Traders aren’t politically monolithic, and even if they were they wouldn’t throw away money. ”

    Why did so few see 2008 coming ? A couple of traders did but not most of them.

    In the investment world, there are several anecdotal evidences showing that some investors made a lot of money and profited from understanding key functions and relationships in financial economics. In the past, George Soros profited from predicting the UK currency collapse. The most recent example is John Paulson, who profited from betting on the burst of subprime mortgages at the heart of the housing bubble and 2008-2009 economic crisis.

    There are also at least three documented cases of experts who foresaw the financial crisis and warned about its impact on the economy. To others, they seemed lucky, but the evidence suggests that these professionals knew something that others didn’t and they believed in it to the point of risking their reputation and careers.

    More saw 1929 coming, including Calvin Coolidge, but it didn’t help. The Panic of 1907 led to the establishment of the Federal Reserve, which in turn probably contributed to the 1929 crash as interest rates were kept too low for too long. At least Benjamin Strong had the excuse that he died in 1928. Alan Greenspan had no such excuse.

29. Jonathan,

    I was Civil Defense at the height of the Cold War. What scares me is the impact on retail food distribution of contamination of inert surfaces by dried secretions from Ebola victims remaining infectious for days and weeks. Plus only a small viral load is required to create infection. That makes effective quarantine measures just about impossible in the event Ebola really gets going here.

    This sort of insight is not available to financial traders. It is outside their frame of reference. I doubt current federal planners have considered this problem.

    IMO the odds are about 4-5 to 1 that 20-30 million people, almost entirely in Africa, will die in the next six months from the worst epidemic since 1918 Flu. The results here will be a quarantine-caused recession of about 2008-2009 magnitude. There is about a 1 in 3 change that several hundred million people will die in the next year from Ebola and its spinoff factors, with a world-wide Depression magnitude event from the necessary quarantine measures plus panic.

    IMO there is currently about a 1 in 20 chance that 10-15 million Americans will die of Ebola and related causes in the next three years, which would certainly collapse the US economy, at least wipe out all equity holdings in the financial community with their bond-holders becoming the new equity holders, etc. This scenario entails at least a billion deaths overseas from Ebola and related factors, with the poorest and most backward areas being disproportionately impacted.

    It is remotely possible that 50+ million Americans will die of Ebola and related factors in the next three years, with several billion fatalities abroad. I doubt civilization could be wiped out everywhere even in a worst-case scenario because of defensible countries like Japan, Chile, Singapore, New Zealand, Switzerland, etc.

30. Jonathan said —

    >>What you’re arguing is unrealistic. Traders aren’t politically monolithic…

    Recent campaign contributions to the politcal parties by Wall Street financial firm senior management argues differently.

    >>and even if they were they wouldn’t throw away money. They are going to pay close attention to any
    >>hint of a developing epidemic…

    See Tom H regards the Financial/Fed “frame of reference” issues.

    The traders and the Feds they talk to won’t believe Ebola will be happening here until it does, and then they will panic.

    This is commonly known as a market crash.

    >>Or to put it another way, people in general tend to have limited horizons, but markets are very good at
    >>analyzing publicly available information. If there is going to be an epidemic here the first warnings may
    >>come in the form of unusual market activity.

    If the on-coming event is outside your analysts frame of reference, it is an “Unknown, Unknown.”

    Or to put it another way —

    “It’s not what you don’t know that kills you, it’s what you know for sure that ain’t true.”

    ”• Mark Twain

31. Tom Holsinger Says:
    August 12th, 2014 at 10:36 am

    I would tend to give a higher probability of the 10-15 million American casualties than your 1 in 20. The refusal to restrict access for direct flights from African cities where Ebola is running wild is one thing. The deliberately unprotected southern border where the “catch and release” process does not include any health screening, and the presence of West Africans mixed into the invaders makes that more likely.

    Another factor not discussed here yet is what the political reaction to an American Ebola outbreak would be. So far, in Africa, the reaction at first has been denial and deception. Look at the American government, even before Obama. Given the reaction so far, I know what I would bet.

    Then when denial is no longer possible, what will the reaction of the government be? Realistically, can anyone imagine an American government NOT taking advantage of the crisis to seize power that it will not ever give back? Regardless of political party. Because Angelo Codavilla is right about the Governing Class. And we are right about their bipartisan lack of competence.

    That will not occur in a vacuum. The reaction will be anything from absolute submission to absolute resistance; and probably a combination at different times and places. That will have a definite bearing on the effectiveness of the scope and intent of any public health measures.

    Case in point, the ZMapp serum which is the only known treatment and of unknown effectiveness. It is also experimental and in short supply. How will it be allocated and on what basis? How will that be enforced? And what will the reaction be to whatever allocation plan is made? We do not have the social, cultural, and political cohesion we once had.

    Interesting times.

    Subotai Bahadur

32. “How will it be allocated and on what basis? How will that be enforced?”

    Politicians first, of course. I hope it does not get away from us.

    I was rereading my section in my medical history book. There was a polio epidemic in Los Angeles in 1934. There were 3000 cases and 200 doctors and nurses became ill. I cannot imagine the effect of an epidemic of that size in a major American city today.

    I lived through the early years of the AIDS epidemic in an area heavily affected. Politics was dominant. There were laws passed to ban testing and isolation. What if Ebola appears here in the black population ?

    St Louis will be nothing.

33. The fatal problem I see is retail distribution of food during quarantine periods. The retail grocery stores will have floor, shelf and even food container contamination issues due to dried blood, mucus and saliva secretions of victims of the current Ebola virus remaining contagious through _skin and eye contact_ for days and weeks. Only a tiny viral load is required to infect new victims.

    Every time someone newly contagious with Ebola comes into a store, and they won’t know they have Ebola yet, let alone are contagious, some of their normal mucus and saliva will end up in the store, dry and stick around for a while, and infect new victims.

    Retail grocery outlets simply CAN’T be decontaminated like hospitals, and they have far more foot traffic than hospitals due simply to how they operate.

    I am aware through my civil defense background that most homes have at most a week’s supply of food, about half frozen and half on shelves. In 1977 most retail grocery chains had about a week of food in their stores or in local distribution storage. See:

    _Availability and Shipment of Grain for Survival of a Nuclear Attack_, by Carsten M. Haaland, American Journal of Agricultural Economics; May 1977, Vol. 59 Issue 2, p358.

    These days retail groceries have significantly smaller local food stocks – perhaps 3-4 days – due to “just-in-time” delivery systems.

    The food distribution system will back up during an Ebola crisis due simply to slower national and regional transportation. Less food will be available at the retail level, not more, just as the population, particularly in urban and suburban areas, will be trying to hoard food to get through any quarantine period.

    This is a prescription for a disaster even if quarantine is never implemented.

    There simply is no way for there to be an effective quarantine period of even a week due to local food stock issues. There will be mass panic in the US as soon as any Ebola quarantine of any sort is publically announced here, however local it may be.

    The _Journal of Civil Defense_ published an article by me about 25-30 years ago describing how something like this, i.e., the public heading for the hills en masse from fear of nuclear attack, would render any conventional war mobilization impossible.

    The US does not have enough food stocks available in homes and the local retail level to allow an effective quarantine period before mass panic impedes distribution of new stocks. The means of distributing replacement food stocks in areas with significant Ebola infections will be GONE due to Ebola contamination of retail grocery stores. This is a deadly combination.

    Certainly it is possible that things won’t get that far. I hope they don’t. We’ll need a combination of Ebola mutating to less lethality as 1918 Flu did, vaccines, new drugs for treatment, and a lot of public trust.

    The government continuing its pattern of lying to the public will destroy what little trust the American people still have in government.

34. In the 1970s and 80s, during the last survivalist scare, I still had my boat. That was my refuge with food and water. Not now.

35. Tom,

    This sort of insight is not available to financial traders. It is outside their frame of reference. I doubt current federal planners have considered this problem.

    If you believe that, you should consider buying the shares of biotech and other companies that would do well as a result of an epidemic.

36. “If you believe that, you should consider buying the shares of biotech and other companies that would do well as a result of an epidemic.”

    If you are an optimist. If not, maybe the makers of survival gear and freeze dried food. I do know, for example, the son of the guy whose investor letter I read for 30 years has bought a farm in rural Oregon and is raising his own food. That investment letter was very astute. I wish I had taken every bit of his advice I neglected.

37. Jonathan,

    Buying several months worth of non-perishable foods and putting them in a safe location with water would be a better investment.

38. Tom Holsinger Says:
    August 12th, 2014 at 2:10 pm

    The obvious corollary is that it would be prudent to have at least a 3 month supply of food [y’all can live a long time on beans and rice and a few other things] and medications on hand. And the means to acquire and purify water. A year is better. Two years best, assuming that you have agricultural or barter possibilities. Barter being conducted at a distance and with appropriate barrier/isolation/sterilization procedures in force, after Ebola dies down a bit. If after a year things are still raging, we are scrod.

    If you have those items, prudence would also dictate discretion. Best of all would be a community [not necessarily co-located, but able to render support so long as the disease has not broken out] of like minded individuals. And the means to mutually defend such from two and four-legged predators.

    And there will be predators, some infected, some just examples of the common Nova Americanus Habenae Cliens; and they will run in packs. As will the Nova Americanus Habenae Bureaucrat Armatus.

    Subotai Bahadur

39. Mike, note the resemblance to certain John Ringo books, starting with the opening of _Under a Graveyard Sky_:

    “AlasBabylon Q4E9,” the text read.
    …
    “I finally got to pull up the code sheet,” Steve said. “Biological, viral, latent, wide-release, previously undetected, currently no vaccine, hostile activities parameter.”

    “I got all of that except latent and hostile . . . Wait! Zombies?”

    We got all of that here except substitute “3-week inert surface secretion contamination” for the zombies. Ringo describes the disaster prepper differences between planning for physical/social disaster vs. a widespread lethal plague in that book.

    Plus consider Ringo’s comparison of his _Last Centurion_ plague effects in high-trust rural areas with low-trust urban ones with my comment above that Ebola will disproportionately impact “the poorest and most backward areas”, i.e., those with the least social trust and cohesion. We talk about the same thing. This applies to poor, i.e., black, urban areas in the US in the event Ebola hits here. They simply can’t get out of where they are and are the most susceptible to panic, disorder and food shortages.

    The Obama administration might face the awful choice between a very low probability of saving most of America’s black population and significantly greater risk of losing most Americans, or abandoning most of America’s black population to have a significantly better chance of saving most Americans. This is the sort of moral dilemma which makes great plots for novels.

    I’d rather not be living in a John Ringo novel, but he is ****ing prescient.

40. Jonathan,

    I’m one of the people who won’t survive a breakdown in medical services. Consider how old I must be to have been a civil defense volunteer during the Cold War.

41. The best way to describe the 10% of Ebola deaths (roughly 170 out of 1700 deaths) in West Africa being medical professionals is “Throwing logs on the fire in an attempt to smother it” with the logs being health care workers.

    Medical professionals are less than 1% of the American population and tend to follow the leader more than most. Any Ebola outbreak will disproportionately kill the medically trained simply because of that follow the leader culture.

    An Ebola case load of 20 million in America will statistically wipe out every doctor in the country.

    what that means for the surviving populatiopn with AIDS, coronary heart disease, and a series of other ailments can only be imagined.

42. BTW, Jonathan, your response is identical to that of the lefties who contended that conservatives who advocated being beastly to poor misunderstood terrorists should immediately enlist or be proven cowards.

    It translates as “I got nothing substantive to say so I’ll just be an ***hole.” Congratulations.

43. Trent, M.D.’s are less than 1% of the population. Nurses (particularly nurse “practioners”), some physical therapists, and lots more health care workers have certifications and degrees which qualify them as medical professionals and, together with the M.D.’s, constitute more than 1% of the population.

    You are quite correct that a significant Ebola outbreak in the US would way disproportionately kill medical professionals. See:

    http://pissinontheroses.blogspot.com/2014/08/cdcs-lesser-of-evils-double-standard-on.html

    and

    http://emergency.cdc.gov/coca/transcripts/2014/call-transcript-080514.asp

44. I think it’s a good idea to be prepared. There could be an epidemic here. I don’t think it’s as likely as the rest of you seem to, but maybe I’m wrong.

45. BTW, Jonathan, your response is identical to that of the lefties who contended that conservatives who advocated being beastly to poor misunderstood terrorists should immediately enlist or be proven cowards.

    Nope. I’m saying that I read the odds differently than you do, and I’ve given a reason why based on experience as an observer of markets. I’ve also acknowledged that I may be wrong. The point about buying stocks isn’t that I think your argument is invalid if you don’t do as I suggest. It’s that people who risk their own money for a living aren’t making the bet that they should make if you are right, and the fact that they aren’t suggests that an epidemic is less likely than you think.

46. The time to activate escape plans is getting closer, but is snot yet here. The CDC has admitted that Ebola is transmissible by inhalation. See:

    http://www.health.gov.ng/doc/Ebola%20Fact%20Sheet.pdf

    How is Ebola Virus Disease spread?

    The manner in which the Ebola virus first appears in a human at the start of an outbreak has not been determined. However, Ebola VD could be spread through the following:

    … 6. Inhalation of contaminated air in hospital environment;

    I found this at:

    http://www.tfmetalsreport.com/comment/423799#comment-423799

    See my prior explanation of the very important distinction between transmissibility by inhalation vs. exhalation at:

    http://pjmedia.com/richardfernandez/2014/08/09/minority-report/?show-at-comment=831104#comment-831104

    Exhalation transmissibility is what is traditionally meant by “airborne transmissibility”, i.e., you can catch it by breathing the exhaled air of victims. Inhalation transmissibility means here that people can contract Ebola by inhaling particles in the air of dried mucus, dried saliva and possibly dried mucus of Ebola victims, not by mere breathing of their ordinary exhalation. This is the difference between bad and apocalyptic.

    My description above of how dried blood, saliva and maybe mucus of Ebola victims can be infectious for days or weeks on inert surfaces is very bad, but not apocalyptic.

    It appears that the CDC has decided to be honest about these fine distinctions, rather than using them as a vehicle to mislead the public. Hopefully they are trying to maintain public trust.

47. Jonathan, you have proven your reasoning abilities too. You said earlier, “If you believe that, you should consider buying the shares of biotech and other companies that would do well as a result of an epidemic”, and just repeated now, “The point about buying stocks …”

    Both these fine statements were made in response to my comment that a 10-15 million fatality Ebola outbreak in the US would:

    “… collapse the US economy, at least wipe out all equity holdings in the financial community with their bond-holders becoming the new equity holders, etc.”

    This is terminal failure to understand the concept.

48. There are two separate issues here. One is what might happen in the context of a worst-case or nearly worst-case Ebola epidemic. The other is the odds that such an epidemic will occur. You keep saying that a big epidemic would be very bad. I don’t disagree. However, I don’t think it’s as likely to occur as you do.

    On stock valuations, an epidemic on the scale you anticipate would do tremendous economic damage and probably tank the stock market, but that doesn’t mean that some stocks, like those of vaccine manufacturers, wouldn’t do well, at least for a while. Of course if half of the people in the country die in the epidemic then probably stocks are not the best long-term investment, but you have to weigh the outcome by the odds of its happening and I don’t think the extreme outcomes are very likely.

49. Speaking of stocks and traders, Forbes is weighing in .

    Given the scope of the Ebola outbreak unfolding in Western Africa, it seems possible that a case will eventually emerge in the U.S. We could even see an isolated cluster of infections in an American city.

    Considering the nature of the Ebola virus, and the medical infrastructure we have to combat its spread, the diagnosis of some cases on American soil shouldn’t be reason to panic. We have a plethora of tools and public health practices to readily combat its spread. Yet because the virus is so dangerous, and feared, its arrival in America would likely to trigger a robust response from our public health establishment.

    For most Americans, it may be the first time they glimpse the tools that our government has staked out over the last decade, as preparation for public health emergencies like a pandemic flu, or even bioterrorism. Some of these authorities are wholly necessary. Others will prove controversial and worthy of closer scrutiny.

    Unfortunately, they have a few things wrong.

    It’s highly infectious because someone stricken with Ebola is very likely to get sick (and harbors a lot of virus particles that they can readily transmit to another person, given the right conditions). But the virus itself is fragile, and does not easily spread. So it’s not very contagious. In short, Ebola is harder to contract than many other viruses.

    The Ebola virus can only be spread by direct contact (through broken skin or mucous membranes) with the blood, or other bodily fluids or secretions (stool, urine, saliva) of infected people. Infection can also occur if the broken skin of a healthy person comes into contact with environments that have become contaminated with an Ebola patient’s infectious fluids (such as soiled clothing).

    If it is airborne, we are in trouble but they don’t see that.

    Also I wonder how places like Ferguson, Mo. are going to react. Not with cooperation, I suspect.

50. It is remotely possible that 50+ million Americans will die of Ebola and related factors in the next three years, with several billion fatalities abroad. I doubt civilization could be wiped out everywhere even in a worst-case scenario because of defensible countries like Japan, Chile, Singapore, New Zealand, Switzerland, etc.

    Don’t forget about Madagascar!

51. Madagascar is too close by Dhow to Africa to survive.

    Tom,

    There are a lot of other issues besides food distribution. The latest MSDS sheet for Ebola lists a 23 day infectious period for dried blood —

    http://www.msdsonline.com/resources/msds-resources/free-safety-data-sheet-index/ebola-virus.aspx

    That is a longer lethal period than VX persistent nerve gas for a pathogen that has a very low viral loading required to cause another clinical infection. What that means when Ebola contamination gets into the American retail food distribution infrastructure is a horror that will require a great deal of civil defense planning to deal with.

    Also very important are the host of second order infection threats that the CDC has not addressed that the 23 day latent infection period represents.

    Ebola infected housing in areas near “low trust/high crime” areas are another facet of the Ebola epidemic that needs adressing.

    For example, most middle class American people shower after the vomit on themselves. They throw their soiled cloths in a washing machine and dryer afterwards. Neither a shower nor a wash with less than 2.5 PH bleach water will kill the EBOV virus.

    So, this middle class individual in a family home with a spouse and two kids gets sick. He or she vomits in the rest room, cleans up in a shower. The billowing steam droplets get out of the rest room off the master bed room into the mater bed room proper and get on the TV.

    Later the individual and the family are taken away for a medical quarantine as the disease progresses.

    The house is left vacant, perhaps with police evidence tape around it and signs. Later that night an IV drug used breaks in. Sleeps off the latest hit, steals the TV from the master bed room to score the next hit.

    Best case is that he or she is caught by the police, who use proper protocol, and is quarantined without infecting anyone else.

    Worse case is that he or she takes the TV, trades it to a drug dealer for the next hit, and shares his hit and needle with another IV drug user for sex. Then they spread it to others before Ebola is discovered.

    This “Druggie breaks in and sleeps in your house, then steals the TV” story is a personal one.

    I had it happen with a several months vacant house I had for sale in Rosenberg Texas, a suburb of Houston, during the 2007-2008 housing market crash.

    The CDC needs to get more people involved able to deal with the Ebola decontamination issue. It has to be non-medical people, because there won’t be enough of those if we get a real Ebola epidemic.

    People who know how to take sub-90 IQ people and train them to the point of muscle memory in proper decontamination procedure.

    The name for those people are the US Army Chemical Corps.

    The CDC needs to get with the Chemical Corps, put together a US Army decontamination team, send it to Africa and decontaminate Ebola contaminated medical facilities there. Particularly in Monrovia, Liberia. They have to learn by doing, learn by dying.

    That will be the only way that that skill can be learned, equipment and proper reclamation procedures developed and enough non-medical people trained up to standard for the role before Ebola breaks out in the West.

52. We just had a “It could only have happened by casual contact on an airliner” Ebola death confirmed.

    Jatto Asihu Abdulqudir, 36, a protocol assistant, who was travelling to an Ecowas function with Liberian Patrick Sawyer just died in Nigerian quarantine.

    See:

    http://www.tfmetalsreport.com/comment/423799#comment-423799

    ———————

    Sit Rep: Nigerian Case Count – caution is merited
    @TF and @Cris

    Reliance on the case count as an indicator is cautioned. As I have previously written in this thread, the behavior of the virus is related to contagion. The undiagnosed health issues suppressing immunity can impact susceptibility to Ebola and survival.

    I concur with Cris regarding his conjecture that the Nigerian case count is likely undercounted.

    For the past week, I have been waiting for disclosure of the secondary cases from the index case. It is these secondary cases that we were not seeing discussed between July 26 to present. This absence of clinical discussion is detrimental to the international relief effort.

    Clinical discussion is a requirement for peer review journals such that the broader medical community can evaluate the progression of the disease in the population.

    Our suspicions regarding these types of cases appears to be bearing out in some respects.

    CDC writes this morning that the Nigerian Ministry and WHO reported 13 suspect cases and 2 fatal cases as of 9 Aug 2014. The two fatal cases were the index case (PS) and the nurse who took care of PS.

    However, in the last 5 hours, this story appears:

    http://www.rte.ie/news/2014/0813/636773-ebola/

    A member of the West African regional body Ecowas has become the third person in Nigeria to die of Ebola fever, Ecowas said this morning.
    .
    Jatto Asihu Abdulqudir, 36, a protocol assistant, was travelling to an Ecowas function with Liberian Patrick Sawyer, the man who brought Ebola to Nigeria last month.
    .
    Mr Abdulqudir had been under quarantine.

    In the WHO’s epidemic case count statement of 11 Aug 2014, WHO’s data shows on-going new cases in Guinea, Liberia, and Sierra Leone. The data reflected information gathered between 7 and 9 Aug. Nigeria reported no new cases over those two days.

    However, the case count for Nigeria moved from 10 to 13. I went back and reviewed the WHO report for 6 Aug 2014 and noticed that Nigeria’s “new case” column now was 4 new cases and 1 death listed. I did not recall seeing that when we looked several days ago. Andrea posted that table in the first message on this page. It shows “0” new cases. I can only surmise that the UN WHO changes the data in the table retroactively. Retroactively changing the data in a previously published statement is not a good accounting practice.

    With the evidence now showing contagion, infection, illness, and death of 2 contacts (1 being a healthcare worker and 1 being a travelling associate), it is clear that the virus is transmitting to casual contacts.

    I think this is the first time we’ve been able to demonstrate this “casual” contact equating to illness and death in the entire thread and during our entire analysis.

    CDC and Health Ministry officials in the field need to become far more proactive in disclosing case presentations from the epidemic.

53. Here’s a bit more on food distribution problems during an Ebola outbreak.

    Grocery cart handles would be arguably the primary vector of Ebola transmission. Stores already offer handi-wipes for those because of the many nasty germs on the handles. The country doesn’t have enough nitrile gloves and cloth grocery bags to deal with this means of transmitting Ebola.

    My wife, her mother and I were on the Princess Cruise liner which had norovirus outbreaks on four successive voyages in 2011. My wife and I, but fortunately not her 85 year-old mother, contracted norovirus and were quarantined to our cabin for two days each, but not simultaneously. News accounts said 10% of the passengers on our voyage were infected. My credit card company said 10% of its customers on that voyage made refund claims.

    I saw the liner staff constantly scrubbing the stairway handrails and door handles to public rooms.

    Consider how door handles, elevator buttons, plus handrails in stairways and escalators in public areas, stores, churches will become Ebola transmission vectors.

    Plus, as Trent noted, criminals and drug addicts won’t care about Ebola contamination. Drug addicts in search of drugs and things to steal will, for all effective purposes during an Ebola outbreak, act identically to fictional zombies in terms of contracting and transmitting the disease. They care for nothing except their next fix, are irrational by definition, and act heedless of their own safety. They’ll be secreting Ebola fluids while staggering around dying while trying to break into homes, stores and other buildings, and those dried secretions on inert surfaces in buildings they break into will contaminate new victims for weeks after the addicts are dead.

    And the only way to stop them from doing that will be to shoot them from a safe distance. Or nuke them from orbit.

    When my wife first came down with norovirus on our 2011 cruise, she didn’t know it was norovirus and left our cabin with a fever to see a movie. She had vomited and had a diarrhea episode when we got up that morning, and initially stayed in our cabin while I took her mother in the next room up to breakfast, but had left to see the movie when we returned. Without leaving a note.

    I went to the purser’s office to report this, learned of the norovirus outbreak from them (Princess had concealed this from most passengers – never go on a Princess Lines cruise), and was told that my wife must stay in our room for the next two days.

    I did a careful Peter Falk in _Columbo_ imitation in gratitude for all this, walked away for a few steps, turned and LOUDLY said, in front of a dozen other passengers, “Oh Miss? One more thing – if you hear of a 60-year old lady biting people, it’s probably my wife. A zombie epidemic on a cruise liner could be very bad.”

    This was two years before John Ringo published _Under a Graveyard Sky_.

54. I really, really, really, hope that the following is the ground truth on this Ebola outbreak.

    However, the continued lack of a air travel ban from infected areas after the Patrick Sawyer incident is frightening to say the least.

    ========================
    Report from WHO tonight – Sit Rep on Ebola Epidemic

    Epidemiology and surveillance

    Between 10 and 11 August 2014, a total of 128 new cases of Ebola virus disease (laboratory-confirmed, probable, and suspect cases) as well as 56 deaths were reported from Guinea, Liberia, Nigeria, and Sierra Leone.

    Contact tracing in Guinea, Nigeria, and Sierra Leone has resulted in a range between 94% and 98% of contacts of EVD cases being identified and followed-up. In Liberia, efforts are underway to strengthen contact tracing, but help is needed in this area. The Liberian Army has also recently placed a third province under quarantine as part of the ongoing effort to stop transmission of EVD.
    —
    On the operational side, WHO is finalizing its strategic operations response plan and expects to share this with countries and partners in the coming days. Mapping is also underway to develop an operational picture in order to coordinate and move people and materials to areas of greatest need.

    WHO does not recommend any travel or trade restrictions be applied except in cases where individuals have been confirmed or are suspected of being infected with EVD or where individuals have had contact with cases of EVD. (Contacts do not include properly-protected health-care workers and laboratory staff.)

55. An update today from Belmont Club .

    Included are a few items.

    Politics also had a role in bringing Ebola to Nigeria. The Premium Times describes how Liberian government ministers intervened to get Sawyer on the plane, despite strong suspicions that he was afflicted with the disease.

    The Liberian Government was aware that Patrick Sawyer, its citizen who brought the Ebola virus into Nigeria, had possibly contracted the virus from his late sister, yet cleared him to travel to Nigeria for a conference organised by the Economic Community of West African States [ECOWAS], PREMIUM TIMES can authoritatively report today.

    Documents obtained by this newspaper showed that Mr. Sawyer’s employers, ArcelorMittal, an iron mining company, suspended him from work and isolated him after it became aware that he had contact with his sister who died of the virus on July 8”¦.

    And this”¦

    Because politics trumps germs, right? Maybe not. Ebola is having its revenge. The Nigerian government guidelines on handling Ebola now regard Ebola as being transmissible by air to a limited extent. Enumerating the of modes of transmission, it lists as number “6. Inhalation of contaminated air in hospital environment”. Five days ago ECOWAS closed their Lagos office and suspended its regional meetings. The ministers are in full flight.

    The shut down of the office, located within Victoria Island, is to enable health officials fumigate the buildings and the entire compound, Nigerian health officials said, adding that they were also fumigating the vehicle used in evacuating the late Patrick Sawyer, a Liberian-American who was the first victim of the disease in Nigeria.

    Meanwhile, ECOWAS has suspended all its regional meetings, unless such meetings are “absolutely necessary” ”¦ the ECOWAS building would remain shut until the fumigation process had been concluded satisfactorily.

    Does this mean Ebola is airborne in the true sense? Probably not. But this strain is perhaps more contagious than previous ones. Wait of course, for the official determination.

56. Another Ebola update, this one ” You are not nearly scared enough about Ebola”

    Last week, my brilliant Council on Foreign Relations colleague John Campbell, former U.S. ambassador to Nigeria, warned that spread of the virus inside Lagos — which has a population of 22 million — would instantly transform this situation into a worldwide crisis, thanks to the chaos, size, density, and mobility of not only that city but dozens of others in the enormous, oil-rich nation.

    Control by quarantine is failing.

    Nigerian health authorities announced that a nurse who had treated Sawyer escaped her quarantine confinement in Lagos and traveled to Enugu, a state that, as of 2006, has a population of about 3 million. Though the nurse has not shown symptoms of the disease, the incubation time for infection, which is up to 21 days, hasn’t elapsed.

    Another shoe will drop.

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