Thursday, July 18, 2019

The ebola situation is bad

And from what the gentleman says, probably worse- maybe a LOT worse- than reported.
...As a result, the virus is now poised to break out into three or four new countries.  I'm taking bets that it will do so before long.  I know that area from personal experience.  Just look at this map (courtesy of the Daily Mail) of where the epidemic has spread, most recently to Goma, a city of at least one million people (according to informal estimates, double that).
Unless we're very lucky, look for Ebola to reach Burundi next, and from there, slowly but surely, all the way down the central African lakes and their connecting rivers to Zambia and Malawi.  Look at the blue areas on the map below.  That's how informal, local trade travels, and (like many others, such as the Black Death in Europe in the 14th century) this disease follows trade.  It will not be possible to screen all travelers using such routes.  It's physically impossible to intercept them all - and given their mistrust of graft-seeking officialdom (of which more below), they'll have every incentive to avoid checkpoints.  They'll simply take to the bush and walk around them, or sail past them.
And if one infected person gets on an airplane to another country...  Chances are against that starting a big outbreak, but anyone really want to take the chance?

And even without airplanes,
"Isolated cases" of Ebola have now been reported from Uganda and Kenya, with the latter subject to official denials.  (If you believe them, I have a bridge in Brooklyn, NYC, to sell you.  Cash only, please, and in small bills.)  Officials in surrounding countries are terrified of admitting to Ebola cases on their territory, because they may bring with them restrictions on travel, trade, and all sorts of things that may affect their economies - and, consequently, the graft, bribery and corruption they rely on to fill their wallets.  Can't have that interrupted, can we?  This is Africa, after all!  (That's how wealthier refugees from Ebola will evade travel restrictions, even though they may be carrying the disease.  A suitable bribe, and they'll be waved through.  How do I know this?  Because I've done it myself to evade travel restrictions, in more than one country in Africa.)  That being the case, distrust any and all official statistics coming out of the affected areas.  They may or may not be correct.  I'll trust Doctors Without Borders' figures before I trust those from any health ministry (or the World Health Organization).

One thing that will help here: I really doubt Trump would have any problem ordering "NOBODY from 'x' countries comes in without extensive screening.  And if you test positive you're not going home, you're going into a hospital to be watched.  With armed guards if necessary."


Dave said...

I hope to God you're right, Mr. Grant. If I was Trump I'd have CDC on speed-dial and I'd have Customs eyeballing ANYONE coming from Africa at this point.

Dave said...

Addendum: Why the hell did I think I was on Peter Grant's blog? Well, I guess there are worse people to be mixed up with, Firehand.

I think I may need to eat something.

KM said...

I really doubt Trump would have any problem ordering "NOBODY from 'x' countries comes in without extensive screening.
And the obvious knee jerk reaction from the ACLU and Dem mass media will be "RACIST!"
Hurry! Run down to the closest liberal judge and get an injuction ASAP!

markm said...

Ebola spreads mainly through an animal vector (probably fruit bats) and spreading through humans is self-limiting - although under African conditions, that's usually because everyone in the area died. It is not very contagious until the final stage when the victim's skin is dissolving, and that is several days after the victim was immobilized by the disease. And the virus only survives outside the body for a few minutes, even when it's in a pool of blood.

Consider the Dallas cases, which included two or three errors by the hospital - not realizing that he was a potential Ebola case, and some breach in the isolation and decontamination procedures that allowed two nurses to be infected in his final days. Duncan was exposed in Liberia on Sept 15, and arrived in Dallas Sept 20. He spent 5 days with family until the first symptoms showed. They sent him home with an antibiotic. He spent 3 more days with family, before he collapsed and was taken back to the same hospital by ambulance. In 8 days staying with family and out and about Dallas, the virus was not transmitted to anyone.

The hospital now realized that this was Ebola, and isolated him. Within a few hours, he was too weak to even get out of bed to use the toilet, and he died about 11 days later, on Oct 8. Two of the three nurses who treated him began showing symptoms on Oct 10 and 14. The second one had flown somewhere on commercial aircraft. She called the CDC when she came down with a low fever, and received permission to fly home. Nobody caught anything from either of them, they went into isolation and treatment, and survived.

Of course, in Africa they would not have received effective treatment, and in their last days probably would have been lying somewhere in the open, shedding blood from all their pores. That would only endanger those who actually came close to nurse them or to deal with their bodies. It's possible to do that safely, but you need gear that's uncommon in Africa, and most of all, you need to believe in germs rather than witches and do whatever you can to maintain isolation. So the epidemic spreads as long as the social contract holds so someone tends the dying or the dead - but it ends when everyone who is still well flees and leaves the ill to die alone.