ER life, from a nurse working as a lifeguard in the shallow end of the gene pool.
Tuesday, December 2, 2014
A Reminder: The Seven Stages Of Ebola Reporting
1. What Ebola?
2. EBOLA! RUN FOR YOUR LIVES!
3. Don't Worry, the Government has TOP. MEN. on the case.
4. The TOP. MEN. Are Idiots! RUN FOR YOUR LIVES!
5. Ebola is killing everyone handy in droves, but they're mostly "just Africans".
6. Continued Ebola Stories upset the editorial bias and the entrenched bureaucracy.
7. What Ebola?
Remember that governing paradigm as the stories on this outbreak wax and wane, while the number of infected and dead climbs inexorably, and right on track with any number of estimates.
There are only two or three pending milestones worthy of note:
1) Collapse of one or more of the three affected counties' governments;
2) Widespread outbreak outside the current 3 (or 4) affected countries;
(note that #1 leads inexorably to #2)
{nota bene that Mali is overripe for this, since their current mode is to assume that no one who dies or has died there anytime since September has Ebola until they're literally shitting their guts out, AND someone official deigns to take notice. Which worked out so well with Imam Ebola the Magnificent. }
3) Any cluster of multiple cases here (or elsewhere in the "first" world) >10 cases nearly simultaneously (because that's my ballpark guess on what would overwhelm anyone's management capability, unless they revert to the West African "no actual treatment" modality, in which case 80+% die) because that's the point when the previous rosy outlook all goes to shit, and reality probably starts to kick in at the level of the average person on the street.
Any one of those takes this up another DefCon level IMHO.
The rest is merely the outbreak continuing to chew its way to one of those eventualities.
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Is that why the FedGov has called for a palletized airborne isolation chamber capable of holding 12 Ebola patients for military transport? They seem to be just trying to hurry the problem into existence.
ReplyDeletehttp://pissinontheroses.blogspot.com/2014/12/company-near-ferguson-riots-awarded.html
Possible case in Boston:
ReplyDeletehttp://www.local12.com/news/features/top-stories/stories/possible-ebola-patient-boston-21534.shtml
HT POTR.
Here's an interesting round up of recent US Ebola news that starts with the Boston case; TL;DR: over 1,400 people in the US are currently being monitored after returning from West Africa, and "Ron Klain, the country’s Ebola “czar,” reported to the White House that hospital capacity increased from eight beds in three facilities to 53 beds at 35 designated Ebola [Magnet Center of Excellence] treatment centers across the country.
ReplyDeletePerhaps the most interesting thing about the latter is the paucity of total beds, and that some centers aren't volunteering more than one.
Where are all the cases?
ReplyDeleteAre they simply not able to count the dead bodies?
They are burying (or incinerating) dead bodies by the hundreds at least, but most of these are not counted as Ebola cases. In fairness, if someone dies in the street, it might not be Ebola, even if they had Ebola-like symptoms. Many of them certainly are Ebola deaths, but without a lab test to confirm it, it's just anyone's guess for any particular individual case. The problem is that testing the dead has never been a priority-- the testing labs have only so much capacity, and most of it goes to testing the living. Also there is, understandably, a lack of trust among the populace for government officials, and so many deaths (Ebola or not) go unreported. Everyone acknowledges that deaths have been grossly under-reported but no one knows by what factor. 3? 5? 10? More? No one can say for sure.
DeleteBut Liberia and Guinea managed to meet their "70%" target of patients isolated and safe burials because the WHO has changed its methodology on how to estimate those things. In the most recent WHO Sit Rep (Dec 3), this line appears:
"At present, it is difficult to measure directly the proportion of patients who are isolated. Usually, information from clinical investigation forms could be used to provide an accurate estimate, but inconsistencies in the way different clinical investigation teams interpret and define when and how a patient is hospitalized and isolated mean that this information is not reliable enough at present to draw any conclusions about isolation. The most robust method of estimating isolation currently available is to use the capacity to treat and isolate patients by geographical area as a proximate measure of the proportion of EVD cases who are isolated. This can be achieved by dividing the number of available EVD-treatment beds by the number of reported cases over a given period of time in a given location [...] Using this proximate measure of isolation at a national level, all three intense-transmission countries currently have the capacity to isolate all reported cases."
In other words, no one has any earthly idea whether 70% of Ebola patients have been actually isolated or not. But based on the number of beds available and the reported rates of new cases, the capacity exists for the target to have been met, and so the target was confidently said to have been met. With the bar lowered like this, these countries will have no trouble at all meeting the January 1 "100%" target either, assuming we don't see a huge wave of new cases that unravels their carefully-crafted rosy outlook. Their numbers shenanigans have pushed Ebola out of the front-page news for now, but the worse it gets, the harder it will be to keep up the charade.
I'm sure the boss will correct me but.
Delete'Cause of death' is a bit of a stupid thing.
Because 'death' is irreparable brain damage caused by lack of oxygenated blood to the brain.
Now, if you die, have Ebola symptoms, and test positive for Ebola, its easy enough to say you died of Ebola.
But what if you had Ebola, were shitting your guts out, and in a delerious state, walked in front of a bus and got splatted?
What if you test positive for Ebola, aids, cholera and get stabbed in a bar fight?
This person died with Ebola and died from Ebola are very different.
But we are getting the information in a roundabout way.
Some treatment centres are giving clear stats of their admissions and survivors, 90% fatality rate.
Others.
Well, if its an 8 day for survivor 1 to meet survivor 12 so they can hold a ceremony, that doesn't paint a picture of a lot of survivors.
I knew someone who was an internal bank auditor.
ReplyDeleteOne semi-clever fellow hacked his partner's access, and was able to self-verify funding transfers of <seven-digit sums (considered a "rounding error) in major financial institutions. So he simply shuffled larger and larger sums to cover the missing funds between several accounts, which worked fine until a three-day holiday triggered a 72-hour discrepancy report, and suddenly everything exploded.
This will go the same way: they'll be covering up the magnitude, when it explodes in multiple places outside the current perimeter, or within the country, and then the panic, both intra- and international, will start with renewed vigor.