Sunday, November 23, 2014

Why Ebola Is Different

(Reuters) - An outbreak of the plague has killed 40 people out of 119 confirmed cases in Madagascar since late August and there is a risk of the disease spreading rapidly in the capital, the World Health Organization (WHO) said on Friday.So far two cases and one death have been recorded in the capital Antananarivo but those figures could climb quickly due to "the city's high population density and the weakness of the healthcare system", the WHO warned.
"The situation is further complicated by the high level of resistance to deltamethrin (an insecticide used to control fleas) that has been observed in the country," it added.
Plague, a bacterial disease, is mainly spread from one rodent to another by fleas. Humans bitten by an infected flea usually develop a bubonic form of plague, which swells the lymph node and can be treated with antibiotics, the WHO said.
If the bacteria reach the lungs, the patient develops pneumonia (pneumonic plague), which is transmissible from person to person through infected droplets spread by coughing. It is "one of the most deadly infectious diseases" and can kill people within 24 hours. Two percent of the cases reported in Madagascar so far have been pneumonic, it added.
Which, on the surface, would appear almost 10 times worse than Ebola in Mali.

And it would be, except for one thing:

You can hand somebody with bubonic plague about $25 worth of doxycycline, and send them home, (presuming they're not already on death's doorstep) and they'll be fine in about 10 days or so.
Problem solved.

Ebola, OTOH, requires a bit more in terms of resources for maybe 4 chances out of 5 to survive.

$500,000 and up/patient

This is why the US has saved 8 out of 10 Ebola patients (and will, as long as we don't get more than a paltry few at a time) and why West African nations lose about 75% of theirs, which is just about how many would live and die if they did absolutely nothing.

Because absolutely nothing is the amount of resources they have there 24/7/365/forever.

That's how Liberia, with a population half the size of NYC, has already lost more people to Ebola this year than the total casualties we suffered in 10 years of war in Iraq and Afghanistan combined.

And if the number of our victims ever starts to cut into the resources we can devote to their care, our death toll is going to start looking a lot more like the ones in Africa.

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