Replies to post #181917 on Biotech Values

[oldberkeley]

Would you agree that the African culture itself—still strongly infused with superstition—is playing no small part?

A belief that simply saying Ebola aloud makes the disease appear; that every death is triggered by enemies using witchcraft; that docs are deliberately killing patients and harvesting their organs; that Ebola is a punishment for sexual promiscuity, and more.

Of course, lest Westerners feel too superior, during Europe’s Black Death decades it was common knowledge that the plague was spread by the wind, caused by steam arising from the earth, a punishment from God for human sin, and the most popular: the Jews, aided by the devil, were poisoning the wells.

[zipjet]

It appears to me that it takes about three health care workers per Ebola patient.

Absent effective vaccination or treatment, it does not take long at the rate Ebola is growing to overwhelm the system.

Once that happens, containment and letting it burn out may be inevitable.

Does Africa have effective borders? I doubt it.

[iwfal]

Ebola - when evaluating the single arm (in many cases single patient) results of ebola treatments it will be important to keep in mind that the fatality rate varies *wildly*. E.g. Sierra Leone has had a 30 percent mortality rate in confirmed cases in this latest outbreak. Liberia has had 70 percent. Presumably a result of different standards of care since, until recently, Sierra Leone seemed to have a much better ability to get resources to their cases. And I'd presume that survival rates in the US would be substantially higher still.

Other notes:

1) it would be useful to know (e.g. when predicting resources, when predicting start of burnout, ...) what percent of close contacts (e.g. Family members) are infected but asymptomatic. And thus probably immune going forward. In locales where Ebola is endemic the percent of people with antibodies but who were never aware of the disease is surprisingly high.

2) note that much of the calculus about experimental vaccine use assumes there can be no harm if tested through ph 1. But it has happened in the past that a vaccine actually increases the rate of infection. E.g. The HIV vaccine that increased infection rate by 40 percent. Certainly not common. But something to be born in mind when combined with #1.