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Replies to post #103406 on NanoViricides Inc. (NNVC)
11/08/14 9:38 AM
Dr. Luciana Borio, assistant commissioner for counter-terrorism policy at the U.S. Food and Drug Administration, told reporters in New Orleans Nov. 5 that experimental Ebola drugs must be vetted in a way that demonstrates efficacy.
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Recently, a group of scientists including Peter Piot, an Ebola expert who helped discover the virus, wrote in the journal the Lancet that this approach was unsuitable in the current crisis.
"We accept that RCTs can generate strong evidence in ordinary circumstances; not, however, in the midst of the worst Ebola epidemic in history," the authors wrote. They instead advocate the use of observational studies, conducted in parallel, at different locations.
Among other objections, the researchers said the use of placebos could further undermine trust in authority in a region where the social order is breaking down because of disease, poverty and the aftermath of civil war.
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"The bottom line is that we don't really know whether it helps and to what degree it helps, and logistically it's quite difficult to implement on a large scale," Borio said Wednesday. "Like any other therapeutic, ideally we'd be able to study them in an appropriately designed trial so that we can actually learn its benefits."
As experts continue to debate the terms of experimental drug use, an epidemiologist who has worked in Sierra Leone -- one of the three hardest-hit nations -- worried that there might not be adequate staff to conduct any trials in Africa.
"I think the linchpin on the ground for me is: We don't have local staff there that are showing up, that are given the same protection and the same benefits that people coming from overseas are also given," said Lina Moses of Tulane University's Ebola task force.
"Until we provide those assurances, we're not going to have people to deliver these vaccines or monitor people in these trials," Moses said.
During the panel discussion with reporters, Dr. Alan Magill, president of the ASTMH, addressed a controversial decision by Louisiana officials to bar people from attending the tropical disease conference if they had visited an Ebola-affected nation in the last 21 days - the incubation period of the disease.
Magill said 30 people did not attend the conference as a result of the advisory issued by the Louisiana Department of Health and Hospitals.
When asked if the tropical medicine conference would ever return to New Orleans as a result, Magill said:
"I think the first response from many individuals was a bit of an emotional one, which was to say, 'No we shouldn't come back,' " Magill said. "I think my leadership response is: We're going to have a great meeting while we're here and then we'll reassess the options as we go forward in the next several months as cooler heads prevail."
“Here’s why: Ebola cases are doubling about every 21 days, the amount of time a person can take to show symptoms after being exposed.
“You can start almost anywhere on any day since the outbreak began and then see that the numbers double every three weeks. That means that by the end of December, we should be looking at 300,000-400,000 cases, again with the number doubling within three weeks and then doubling again, etc. Even the Centers for Disease Control has predicted a worst-case scenario of nearly 1.5 million cases by the end of January.
“With a death rate that is probably running at least 70% (despite other numbers you may have read, Ebola cases are vastly underreported), it won’t take 300,000 new cases of Ebola to cause most countries to shut their borders.
Small clusters of Ebola would completely overwhelm US hospitals - AP investigation
A team of AP reporters evaluated multiple indicators of preparedness at hospitals, including levels of training, available manpower, funding, emergency room conditions, available supplies, and infection control and protection for health workers. They also interviewed dozens of top experts in the field to gather educated opinions on the matter.
The verdict? Virtually every available resource is currently too limited to handle an infectious disease outbreak, and especially Ebola. Besides the likelihood that many healthcare workers would likely refuse to treat Ebola patients based on its track record of mysterious infections, many hospitals, and especially smaller ones, simply don't have the infrastructure in place to deal with the virus.
NYC Ebola watch list explodes to 357 people
One piece of news that did slip out via a local NBC affiliate is quite telling. The CDC's "active monitoring" watch list of at-risk Ebola carriers exploded from 117 to 357 people in just the first two days of this week.
This is a clear indication that some new person with Ebola has potentially exposed hundreds of New Yorkers to the virus, yet there isn't a single news report about who this person is, how they got here, where they traveled, or who might be exposed.
At the same time, nearly all Ebola news is being officially censored in the press, the CDC, NIH and White House are actively dismantling isolation quarantines, opposing air travel restrictions and arguing against increased medical security at border crossings...
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As the U.S. National Academies of Science wrote in 2005: [4] (h/t to WashingtonsBlog.com)
In the United States, national and local government and public health authorities badly mishandled the [1918 "Spanish Flu"] epidemic [which killed up to 50 million people worldwide], offering a useful case study.
The context is important. Every country engaged in World War I tried to control public perception. To avoid hurting morale, even in the nonlethal first wave the press in countries fighting in the war did not mention the outbreak. (But Spain was not at war and its press wrote about it, so the pandemic became known as the Spanish flu).
The United States was no different. ...The U.S. government passed a law that made it punishable by 20 years in jail to "utter, print, write or publish any disloyal, profane, scurrilous, or abusive language about the government of the United States."
One could go to jail for cursing or criticizing the government, even if what one said was true.
Routinely, as influenza approached a city or town -- one could watch it march from place to place -- local officials initially told the public not to worry, that public health officials would prevent the disease from striking them. When influenza first appeared, officials routinely insisted at first it was only ordinary influenza, not the Spanish flu. As the epidemic exploded, officials almost daily assured the public that the worst was over.
Why are Australia and Canada following North Korea’s lead on Ebola?
Despite international bodies such as the World Health Organization declaring it a shortsighted and ultimately damaging tactic, the number of countries that are placing restrictions on travel due to Ebola has been rising.
Although precise numbers are a little hard to ascertain (countries are not always forthcoming with their policies), by WorldView's count there appear to be almost 30 countries imposing blanket or near-blanket bans on entry for residents from Ebola's West African epicenter: Liberia, Sierra Leone and Guinea. Many of these countries are also banning entry for their own citizens who have visited the epicenter recently.
Post-Ebola syndrome...
West Africans fortunate to survive Ebola may go on to develop what's being called "post-Ebola syndrome," characterized by vision loss and long-term poor health, a doctor told a World health Organization.
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