Read my last response which is fairly focused on countries like the USA that at worst will only get the odd one off case(s). Managing & containing that is fairly simple as showcased by Nigeria & Senegal. You’re worrying about a non issue since Ebola will never have a general outbreak in the US unless it’s weaponized, and I think we all know who has a penchant for weaponizing biological pathogens. You should be concerning yourself with the real issues you have stateside such as obesity, Enterovirus & school shootings than a marginal exotic tropical disease that will never get a foothold on your shores.
I note you change your phrase. Capable, very capable. Capable is not even defined.
I have already noted that the Lagos hospital center once they realized it was Ebola seems to have had recovery rates nearly identical
Waving the flag of the undefined abstraction of capable does not help understand the pretended question.
Capable and resourced, even is a continuum.
We have the potential answer in the Lagos instance, it needs more investigation for detial, capability and resources.
You again change, why not simply put in the words you want to use?
It is not a question of being equal to the USA, the question was capable. The disdain for any answer not matching an unstated preconception becomes palpable.
Ramira, capable was defined in the OP as Western, not to be confused with West African “compromised” hands no matter how competent their capability may be outside of the hot zone. This is just another flag waving Yankee who wants affirmation that the hospital he works at is superior to African ones, debacles of Ebola protocols at Dallas notwithstanding.
No, it is not a case of the flag waving yankee. You can search on the discussions here on this board Africa, genetics and inferiority to obtain further information for this context. I understand the coding.
According to news stories today, the Ebola epidemic has peaked and the number of new cases is going down in the three countries where it was at an epidemic level.
It is a question of reduction of transmission, which is different than the question of treatment that was posed.
If we discard a prejudiced view that will hold automatically that black and african means incapable in skills and perhaps genetically inferior by assumption, and take an analytical view of the situation for the question, there are two components to the question
(i) the physical capacity to achieve the result, which is the result of the infrastructure that enables achieving it, as whatever human knowledge capacity you have, if the basic infrastructures are absent, then it often becomes impossible. I see this frequently ignored in discussions of all natures, as in about post apocalypse because almost all the westerners have almost no real experience with infrastructure collapse, particularly the sustained infrastructure collapse or absence. It is a blind spot, natural but …
(ii) the human capacity in the awareness, the knowledge and the specific skills. In this we can see even from the results of highly human capable results from MSF, which attracts very high calibre and very highly motivated medical professionals, due to its good reputation and good organization, that without (i) to some level of threshold, one cannot utilize for best results (ii). If there is not clean water or even no equipment for rehydration, the knowledge of the practice does no good.
I have pointed to the learning, which is the best answer that is possible now, from details of how the Lagos Nigeria incident progressed, as the incomplete information that is available seems to tell us that Nigerian (black) doctors once they understood it was the Ebola disease, and in an African urban hospital context in a lower middle income African country were able to achieve significantly better treatment outcomes which if we knew well the timeline of when the patients received treatment once the Ebola disease was properly identified, seem to have come close to the developed (rich) country results in treatment.
As the GQ answer, it seems to me that with the medical staff that is aware and trained on the Ebola treatment AND having a certain baseline of infrastructure to draw on, even in Africa, can achieve very significant reductions of the mortality and even achieve levels that are close to ideal (zero).
At the moment we do not have a medical history insight on when the rehydration insight was achieved (despite certain prejudiced comments making assumptions). The adoption quickly of this by the Lagos doctors suggests they were aware of it immediately. It must have been known.
The anser to survivability seems to be from this mixed data that it is likely that with even reasonably available medical care in a well-organized African country, if it is timely, that the Ebola disease is actually survivable, and the story of the Ebola disease is maybe the story of the horror of disease in the deep rural areas of Africa - or in the very badly organized and systematically broken countries. This describes well the DRC, the Liberia, the Sierre Leone. Even now there are reports in Liberia, which is the beating heart of reinfection, of corrupt agents stealing and reselling the ebola medical equipment. But I can say also the Liberia has for several years a bad reputation in terrible corruption and bad behaviour. It is a society very much broken by the civil war.
This is the analytical view.
Indeed Wendell. Over the weekend it had been reported that Sierra Leone seemed to have turned the corner because they were burying less dead. There was a spike in new cases in the capital yesterday (my time) but in the rural areas it looks like the worst may be over.
Ramira I guess your pal may have to roll up Dixie for now as the pandemic he needed to answer the OP may not be forthcoming after all. If the curtains are coming down on the West African outbreak it begs the questions where will those millions of dollars pledged by the International community go if they’ve been disbursed already? Will the 3,000 troops deployed to Liberia by Obama leave the now cooling hot zone or is there another reason Uncle Sam saw it fit to send grunts while the rest of the world sent medics? Either way there’s tough days ahead for the hot zone. With economic activity stalled and farming stunted for almost a year, the three countries will no doubt face a new set of challenges going forward.
I am sorry but I think the answer is beyond this. While the OP as a certain point of view behind assumptions and questions that can be clarified in searching on the opinions about africa, genetics and inferiority on this board, the general question is a valid one, and goes beyond the control of the outbreak.
It appears to me that there needs to be a epidemiological study that is aware of the timing of awareness and access to treatment.
I keep insisting that the Nigeria case can tell us interesting information, if studied in a time-line fashion, because it tells us a potential result for local capable and realistically with resource result.
If we drop prejudiced comments that have conclusions already decided, this is interesting because both for the local outbreak when it occurs in a place
It also teaches lessons about the trade off of human capacity and infrastructure capacity. This, as I know as a person in business, is not a condition that is binary, and it is a naive and ignorant analysis that does not look at this as variables separate.
It is very interesting to answer the question
If the curtains are coming down on the West African outbreak it begs the questions where will those millions of dollars pledged by the International community go if they’ve been disbursed already? Will the 3,000 troops deployed to Liberia by Obama leave the now cooling hot zone or is there another reason Uncle Sam saw it fit to send grunts while the rest of the world sent medics? Either way there’s tough days ahead for the hot zone. With economic activity stalled and farming stunted for almost a year, the three countries will no doubt face a new set of challenges going forward.
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Given concern is that it jumped a fire line when it hit even a single urban area, news that rural areas of X country (SLeone) turning a corner doesn’t really hearten, except of course for the individuals who live in such places. The R0/r nought rate is estimated (and that’s all they can do) at 1.5 to 2. With a general fatality rate of 70% v. up to 90% in prior outbreaks, hard to know what’s due to the mutation and what’s due to better medical care.
WaPo article as of October 9:
"But experts caution against reading too much into small fluctuations that may simply reflect an increase or decrease in surveillance or a reappraisal of older data. This cautious attitude toward lower numbers particularly applies to a reported drop in new cases in Liberia in the past three weeks, which the WHO said is ‘unlikely to be genuine’ and more likely reflects ‘a deterioration in the ability of overwhelmed responders to record accurate epidemiological data.’ ”
I don’t know where the U.S. military is in terms of goal of 17 treatment centers that hold 100 beds a piece (as of early October); Liberia and Sierra Leone had 924 beds BETWEEN them, and need(ed) over 4,000. Who knows whether the curve of predicted 1.4 million infections by January has been bent due to recent response. We shall see.
We do not learn anything from this relative to the question posed.
Where has a single person said that in this thread?
But this is EXACTLY what we’re talking about when we talk of:
We get it! It’s the lack of infrastructure, of modern medical tools and people with the knowledge and willingness to apply them. It’s the facilities, not the residents, which are sub-par in the countries with the worst outcome rates. It’s not because Liberians or Sierra Leoneans et al are stupid, or inferior…although I will stick by the view that there *are *some cultural - not racial, *cultural *- contributing factors, including the attacking doctors with machetes and handling/kissing of dead bodies that weren’t helping. But it’s also my understanding that these practices are dwindling with more public education, which is great news, and another sign that those people aren’t stupid, they just didn’t know before, and now they do.
I’m not sure if there’s a language barrier issue or if you just can’t see past that chip on your shoulder, but I just don’t see the racism you’re accusing here.
And while the news that ebola infections are going down in the three hardest hit countries is good news, there’s also this news going around today, which is very worrisome:
Thousands Break Ebola Quarantine to Find Food in Sierra Leone
Again, this is *not *a racial critique. This is an infrastructure problem, and a big one. You can’t expect people to keep quarantine if they have no one bringing them food, I don’t care what country they live in or what color their skin is.
Also remember that 88.3% of statistics that are cited were actually made up on the spot. 22.5% of Americans know that.
Ramira I would caution against using the Nigerian example as a model of sound Ebola treatment because (1) the authorities at the airport dropped the ball by not red flagging a visibly ill Patrick Sawyer from the hot zone, (2) hospital staff initially didn’t see the need to treat the foreigner as a potential Ebola case, & (3) in a state of delirium Sawyer is alleged to have urinated on an unspecified number of medics who were attending to him. There is no way to know how these initial gaffes contributed to spiking the number of deaths upwards in the country as we will not know how many medics were thus affected until an epidemiological study is released. That said, their recovery towards containment was remarkable.
Fallen, whether the introduction of the 3,000 US ground forces and emphasis on providing “stuff” as opposed to staff as other countries did with dozens to hundreds of medics is the million dollar question.
WhyNot, I don’t think there’s a language barrier here than a communication one. Several examples of successful treatment in West Africa which can be used by extrapolation to determine what a first world medical response could play out like. The contemptuous manner in which these examples are dismissed as irrelevant is the bone of contention. After all, if Senegal knowing they were dealing with Ebola dealt with it robustly and contained it without a single loss of life or an accidental infection of a medic, does one really expect any country on the planet to better that record? The best all can hope for is it can be replicated, elsewhere except for America & Spain which with fatalities & accidental contaminations will never match Senegal, all things being equal.
You mention the cultural issues such as kissing & washing of the dead which the OP callously put as “rubbing up against our viral laden dead”. I would imagine such practices were stopped some months into the outbreak. Little attention is paid to the natural and human response of caring for the living since the exotic and strange rituals of caring for the dead (which knowing Africa cannot be a blanket practice but most likely localized in a particular area) sounds more “sexy”. CNN had a remarkable story on about a young Liberian lady who cared for her parents, sibling and young male cousin by treating them in separate rooms using improvised PPE made up of plastic bags on her hands, boots, a long coat, hat & mask. She saved everyone except her cousin who died.
The group of people that were killed were lay volunteers not doctors. I’m not condoning the crime. Just saying.
One cultural trait you didn’t mention was the West African habit of consuming bush meat and its role in contributing to the outbreak. Well watching the news last night I was surprised to learn that Patient Zero, a young girl in a village in Guinea was actually the victim of a bite from a bat & not the other way around that she was eating the bat. Again, exotic habits, sexy, the truth, not very interesting. There has been a condescending tone throughout this thread that cannot be denied perpetuated by the poster of the OP.
Hunh…
And here I thought I was just wondering if there is any good data on Ebola survivability when the medical care is capable.
So far, it looks as if the survival difference between the US and african countries is marked. You are correct that I have inferred from that that either:
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African countries are not very capable at taking care of Ebola, or
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That US cases have been very very lucky
I was curious if any Dopers here had any inside scoop on what the survivability of Ebola is thought to be in capable hands.
So that’s why I asked the question.
But if you want to insist that it’s just a secret ploy to make the US seem “superior,” enjoy your view of the world.
Actually that should be your view of the world. My point remains that the US has already proved that even with robust facilities your medics are just as prone to mess up like any other medics. First by turning away an asymptomatic patient & secondly by having not one but two accidental contaminations. Hey you’re human after all. Live with it…
There were several people who were diagnosed with Ebola in Europe during past epidemics and treated there, and they too had a very high rate of survival. There have also been a few people who contracted it in lab accidents, and most of them lived as well.
I also do not believe that this is the first time we’ve had Ebola cases on American soil. With international travel being as prevalent as it is, I do believe that we’ve had them before, and the person either recovered or died without getting a correct diagnosis.
That’s not entirely accurate. In the first outbreak back in 1976 at what is now the Democratic Republic of Congo along the shores of the Ebola River (hence its name, EVD) the Belgian nurses who contracted it & were evacuated to Belgium all died. The only previous documented case in the US occurred in a lab in Reston, Virginia when a lab technician accidentally infected himself. Prompt treatment, because everyone from the patient on, knew exactly what they were dealing with saved his life from what was eventually called Ebola Reston strain.
Breaking down jargon, “hypovolumia” and “volume” refer to body fluid volume, especially blood. So the problem is diarrhea and vomiting kicking fluids out and not allowing fluids in, meaning your electrolytes get out of whack, which triggers organ problems. Couple that with the rampaging virus that attacks body cells.
Treating the volume and electrolyte balance issues keeps the organs able to function better, but still dealing with the rampaging virus eating cells. But that supports your body’s immune system response in making macrophages tuned to the virus.
Pumping in blood serum is an attempt to jumpstart the macrophage level.
As pointed out, the US issue is not race or socio-economic status per se. Rather, it has to do with an unexpected/uncaught case that progressed really far before treatment began versus cases that were diagnosed early and began full/extensive therapy and support.
HIV is a poor analogue, because HIV attacks the immune system itself.
Er, what?
I think it would depend upon how ravaged you became before treatment, and how effective your body was at fighting off the infection. How much damage did your body accummulate before the infection was defeated?
No, it makes perfect sense in English. “Teach your grandmother to suck eggs” is an old expression about being a novice trying to teach an expert how to do something. She just extended the metaphor with the eggs being rotten.
This is an uneducated and prejudiced view. If you wish to continue holding that view, it’s your right, but don’t think it makes you sound reasonable.
Have you bothered to actually read this thread, and the supplied links? How could you miss the statements that show that the “capable healthcare systems” have too few numbers for reasonable statistics and the countries with high numbers don’t have capable healthcare. However, doctors who have been there treating it state they feel the virus has an 80 - 90% survivability rate with capable health care.
Obama sent military because that’s what he has the authority to mobilize, and because they are being used as logistical support to get supplies and health care stations set up. It’s not like Obama can activate doctors and nurses, pull them from their day jobs, and send them overseas.
Chief Pedant’s unwillingness to read, stubbornness in his characterization of Africa, combined with his posting history in GD all contribute to that opinion.
It’s inherent in Chief Pedant’s dismissal of all African healthcare as a universal block, as well as his reputation from GD. I don’t see a chip on Ramira’s shoulder. I see her dealing with a difficult poster. Though you are correct about the comments on infrastructure and that they have been addressed in this thread.
nm for now (need more time to edit)