The first world is probably safe from Ebola, but at this point, it seems like Liberia is facing an existential crisis.
The international relief effort is notable, but this is all happening in a country of about 150-200 doctors, some of whom are now falling to the outbreak, and the relief effort seems to be constantly lagging behind the virus:
This is not even factoring all thosepeople who think Ebola is a lie and refuse to go to treatment centers because of some nefarious scheme.
Beyond the disease itself, Liberia is also now contending with increased food and supply prices, as shipments have slowed down and many companies, airlines, and other entities are cutting off or drastically reducing contact.
The world is mobilizing to some extent to deal with these problems, but the scale seems to be too limited (or at least not swift enough) to actually contain the crisis before it’s an unmitigated disaster. The experts seem to still be somewhat optimistic (20,000?!), but other estimates are now being made as well.
Am I missing something? Are there actually any reasons to be optimistic here, or are we indeed looking at hundreds of thousands dead and a country in ruins?
Liberia recently had a couple civil wars that left hundreds of thousands dead. Ebola will kill a few thousand. Maybe tens of thousands, though that’s at the high end of your estimates. I mean, that’s on the same order as malaria deaths (about 3000 a year, as near as I can tell). It’s a human tragedy, but it’s not a particularly nasty one compared to what this part of the world has experienced recently.
Since there’s no effective treatment, is a lack of doctors/hospital beds really an issue? I guess hospitalization might help contain the disease, but since it sounds like Liberian hospitals are a source of a lot of new infections, I’m not sure that’s the case either.
This is not true, the simple access to having the hydration and supports has great impact on the survival. The elevated death rates of the ebola are as much from the poor medical care in the areas where it has occured as from the virus. People in the west forget that a diarrhea from food poisoning still kills in rural Africa, where for you it is only an inconvenience.
This is confusing the effects. The lack of the doctors and the lack of the basic resources are causing much of the transmissions.
Of course to be put in the hospital that is a hospital in the name only and has no resources, this is of limited usefulness.
I’m pretty sure people in the West are in fact aware that medical care in many African countries is less then stellar, for diarrhea and other things. Not sure of the relevance though. So far as I know, diarrhoea isn’t a symptom of Ebola. Just because a person with diarrhea would fair better with medical care doesn’t mean the same is true of Ebola.
But I’m hardly an expert, which is why my previous post had question marks. Does hospitalization in the average Liberian hospital decrease the mortality of Ebola victims? If those hospitals doubled in size, would we expect mortality to decrease?
No I think you are not really aware as it comes again and again in these threads that it is not understood how the lack of the stable electricity, of the running water that is clean and is not contaminated, of the simplest things like the gloves and the chlorine to decontaminate water and walls, etc etc…
It is relevant because people die of things that in the West are only annoyances, from the dehydration and from the weakening of the body. It is simply you no longer understand what grave dangers these simple things can be to the weakened body.
Of course it is true as we know this even from the persons who simply have had access to the proper medical care. Of course the weakened person who is suffering from the bleed out and from the diarrhea and is not being rehydrated has much greater fatality rate even if we ignore the mortality of the virus.
All these factors have great impact although in the West it is no longer noticed and it is taken for granted to the point of even being questioned.
As has already been said, the conditions in the Liberia for the medical care are terrible, they are in fact among the worst in all of the West Africa region.
There is not the stable electricity for pumps, there are not enough of the gloves, of even the chlorine bleach. These things are needed and yes, if they were doubled, it would improve.
If you are taking of taking a building with no resources and doubling it and calling it a hospital without the doctors or the nurses with the gloves, the aprons, the clean water and all those things the people in the west assume automatically is in the hospital, then well it will not expect the mortality to decrease.
According to some virologists it has to burn-out in Liberia and Sierra Leone. That doesn’t mean everybody will be infected, just that those that are going to be infected will be infected and there’s not a lot we can do about it either way.
Anyway, no big worry. There are dozens of other diseases that kills a lot more than Ebola not to mention things like traffic deaths, etc., and Ebola - given the way it infects, and how fast it kills, is not likely to spread far or become a serious concern in the First World. Also the risk of it changing infection method, and for instance become airborne, is next to nothing.
It isuseful to read this account of a truly very brave American medical volunteer in the Liberia to understand how the Liberian situation is causing death, it is more than the virus, it is the Liberian situation. It is not hard to know why the Guinea Conakry, although being home to the province where this outbreak of the ebola began, is doing better than the Liberia. They have a functioning system of government, and never had a horrible civil war.
It is less the virus than the human systems break down.
More importantly, though, a Liberian Ebola patient in a hospital isn’t sharing a bed with a family member, which is something that happens quite a lot for patients treated at home. The hospital is as much useful just as a quarantine area as it is a treatment area.
That was kind of the thought I had; Liberia’s an awful place in most ways to begin with, and was ripe for some sort of calamity like this. And the situation that makes it ripe for something like this also tends to make it more severe and harder to deal with.
Yes it is again why if you look at West Africa, it is these two countries, the Sierre Leone and the Liberia, both of which have had their societies and their government systems destroyed in the terrible civil wars of which only ended just about ten years ago that are suffering the worst catastrophe. It is not only the poverty, it is also the social collapse that they have only just begun to recover from.
Ebola is a real disease. It is not a Michael Crichton novel or a mirror for your own anxieties. It’s a real disease with real properties, and real limitations. And like all diseases, from heart disease to typhoid, who gets sick is a not just biological, but involves all kinds of risk factors from lifestyle to how your city is constructed. And those are risk factors we can influence.
Ebola is treatable. Basic life support leads to an enormous improvement of outcomes. And Ebola is survivable. Furthermore, Ebola is preventable, and hospitals are a huge part of that prevention. There absolutely is a need to bring resources in to Liberia.
We don’t know how treatable Ebola is in modern hospitals, but it is no doubt better than in understaffed and underresourced ones. We do know how well it can be prevented in modern hospitals, because we contain outbreaks all the time and are quite good at it, with the arguable exception of blood born diseases with very long incubation periods.
Yeah, but the others have been rural outbreaks and contained fairly quickly. The size of this outbreak is unprecedented (for Ebola).
I don’t think anyone’s getting hysterical in this thread - I think we all agree that Ebola has no real shot to make inroads in a first world country. But the tragically shitty conditions in Liberia combined with the disease make it seem like this will be a humanitarian disaster of epic proportions.
Yeah, the First World is fine, but I guess my concern is that it WILL burn out unopposed in Liberia (and maybe Sierra Leone). The death toll from the disease and other factors like starvation will be massive, if that were the case.
No one has really addressed my question. Is there any real hope to prevent a massive massive humanitarian disaster at this point? I haven’t seen any indications, but I hope I’m mistaken. Or, as I fear, are 100,000s gonna die of Ebola, other diseases, starvation, etc.?
The CDC has quietly issued detailed checklists (PDF warning) to all US hospitals to prepare for Ebola. It appears CDC is past “if” and moved on to “when” Ebola reaches the US.
“To pay for the mission, the administration is asking for $88 million be added to the CR; $175 million has already been dedicated. The Defense Department has requested the reprogramming of $500 million in unobligated funds to be put towards the Ebola response.”
That is actually an encouraging sign that someone’s willing to spend some serious resources on this. I didn’t expect Obama to step up, but am glad he is.
How fast can this money be put to use? It seems like the logistics crisis in Liberia is half the problem, but if US military gets sent to build shit, that shit will probably get built. The US military may be shitty peacekeepers, but their logistics capability is still pretty damned impressive. Does the prognosis for Liberia change in any significant way, or is it already too late?