Friday, October 10, 2014

Blind Hog. Acorns. Assembly Required.

While I would normally hold most of the stuff written in the WaPo with an understandable amount of disregard given their editorial perversion, if they keep this sort of thing up, they may actually stumble back onto real journalism, provided the shock of the pure strain doesn't kill them outright.

When the experts describe the Ebola disaster, they do so with numbers.
Right now, the math still favors the virus.
 The number of Ebola cases in West Africa has been doubling about every three weeks. There is little evidence so far that the epidemic is losing momentum.
“The speed at which things are moving on the ground, it’s hard for people to get their minds around. People don’t understand the concept of exponential growth,” said Tom Frieden, director of the U.S. Centers for Disease Control and Prevention. “Exponential growth in the context of three weeks means: ‘If I know that X needs to be done, and I work my butt off and get it done in three weeks, it’s now half as good as it needs to be.’ ”

Thanks, Tom. Only 15 doubles out of 33 possible* along this road, it's rather nice of y'all at CDC to notice everyone's a tad bit behind the curve.

 The virus is still outpacing the efforts to contain it.“The situation is worse than it was 12 days ago. It’s entrenched in the capitals. Seventy percent of the people [who become infected] are definitely dying from this disease, and it is accelerating in almost all settings,” Bruce Aylward, assistant director general of the World Health Organization, told the group.
Aylward had come from West Africa only hours earlier. He offered three numbers: 70, 70 and 60. To bring the epidemic under control, officials should ensure that at least 70 percent of Ebola-victim burials are conducted safely, and that at least 70 percent of infected people are in treatment, within 60 days, he said.

For reference, they're at maybe half of the burials being conducted safely, 20% of the victims are in treatment, within any number of days, until they become a problem for the burial teams.

More numbers came from Ernest Bai Koroma, president of Sierra Leone: The country desperately needs 750 doctors, 3,000 nurses, 1,500 hygienists, counselors and nutritionists.

For some perspective on that, Sierra Leone had a total of 115 doctors total in their entire country before the Ebola outbreak hit. So all their president is asking for is six and a half times more doctors amidst an epidemic that's killed thousands than the total number they could muster when things were relatively peachy and stable.
And while you're up, we'd like world peace, the winning Powerball ticket, and a Shetland pony.

The numbers in this crisis are notoriously squishy, however. Epidemiological data is sketchy at best. No one really knows exactly how big the epidemic is, in part because there are areas in Liberia, Sierra Leone and Guinea where disease detectives cannot venture because of safety concerns.
The current assumption is that for every four known Ebola cases, about six more go unreported.
Put another way, the reported number of case and death totals are only 40% of the actual ones, we're therefore at more than 16 doubles out of 33 possible before the number of cases exceeds the world population , and thus Sierra Leone really needs 2,250 doctors, 7500 nurses, and 4500 hygeinists, counselors, and nutritionists. (And just to be fair, I'd also like to add the home phone number of this month's Playmate, and a Ferrari to my wish list.)

The U.S. military is building 17 treatment centers that can hold 100 people each, but the top military commander in Africa said Tuesday that they won’t be ready until mid-November. Liberia and Sierra Leone have a particularly keen need for more hospital beds. The two countries currently have 924 beds between them, but they need 4,078, according to the WHO.
But as Mssr. CDC Director Frieden pointed out, by mid-November, six weeks hence and two more doublings along, they'll be needing 16,312 beds. Less the 5709 patients that have died, and now need burial (8156 x 70% death rate) by the teams that can't keep up already with only a quarter of the work now that they'll have by then. So the 1700 new beds are going to come up juuuuuuuuuuuuuust a little short. 

In case I lost anyone with that math, imagine you start running as fast as you can now. In thirty seconds, I'll fly by you in an F-22 on supercruise. You keep running as fast as you can to catch me, while I fly along in a straight line at about 900MPH. Then, in 5 minutes' time, we'll see how much closer you are to catching me. Then we'll check again in 5 minutes after that. And so on. That's how exponential virus outbreak works in real life. Like now.

The latest data from the WHO show hints of progress in bringing Ebola under control in certain rural areas stricken by the disease earlier this year. Seven provinces in Guinea that previously reported Ebola cases saw no new infections in the most recent three-week period covered in Wednesday’s WHO update. Two districts in Sierra Leone and one in Liberia showed a decline in infections.
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.”

That's the "squishy numbers" they mentioned earlier. It's a bitch to try and gauge how well you're doing when people inconveniently die faster than your team can tally them, even using their fingers and toes to count. Welcome to West Africa.

But the best news:
As the number of infections increases, so does the possibility that a person with Ebola will carry it to another country. This is known as an export.
“So we had two exports in the first 2,000 patients,” Frieden said in a recent interview. “Now we’re going to have 20,000 cases, how many exports are we going to have?”
In case you missed that, that was the head of the CDC admitting out loud that we're going to have any number of additional Duncans, in multiple countries, doing the exact screenings we're doing now. Assuming no changes in any variable, 10 more at least on a straight extrapolation. Some (but not all) of whom will come to the US. the rest of whom will head for London, Paris, Rome, India, China, Pakistan, Indonesia, etc. And it could just as easily be 50 as 10; we simply don't know. We just hope.

And we're betting all the marbles there are that in every export case, we'll spot them immediately, isolate the infectious people flawlessly, and track down all their contracts swiftly. (Just not in the pooch-screwed manner it worked out in Dallas. And Madrid. And what looks to be the UK case(s) loose in Macedonia.) No one else will screw it all up every way possible, unlike what's happened every single time so far, because Magic Beans and Fairy Dust.

*(For those unclear:
Exponential Growth 101
1 patient "double" becomes 2, 2 becomes 4, 4 becomes 8, etc.
It takes 10 such doubles to get from 1 to 1,000, ten more to get from 1000 to 1,000,000, and ten more to get from 1,000,000 to 1,000,000,000. Three more doubles to get to 8,000,000,000. In a planet with only 7.7B people, 33 doubles from Patient Zero gets you to "Game Over". When you get to 16M, in about 15-18 weeks (each double is now taking about 21 days), you've reached the point where everyone in the three primary affected countries has Ebola, or died from it (because about 20M people live there). Long before then, governments there break down, people go every which way, and the process continues spreading outward like ripples in a pond. So you either stop it cold early, slow it way down, or become functionally extinct. We're at the halfway point, give or take, on that 33-step process, today. And losing. This is why Frieden and WaPo describe the math as "ominous".)


  1. "This wasn't an act of God, no, this was pure Human fuckery."
    Steven King The Stand

  2. Just for sheets and giggles, the mythical Captain Trips had a 99.4% lethality rate.
    7 billion population means there will be 6 billion, 958 million dead.
    That's 42 million survivors world wide.
    >The Marching moron's< Cyril M. Kornbluth Galaxy SciFi 1951
    Perhaps this is the elites plan.