I'm surprised there's been no thread about this...

[Guinevere]

We all made a mistake in thinking this was an African, or a Liberian, problem instead of a global health problem and we're paying for it now.

Looking ahead I hope we can learn from this and do better the next time.


yrs,
rubato

I think that's exactly right. We can and should do better.

[Jarlaxle]

Absolutely right-west Africa should have been quarantined a LONG time ago!

[oldr_n_wsr]

I think everyone leaving those affected nations should be hooked up to an oxygen tank and then wrapped up in saran wrap (or bubble wrap, or shrink wrap like they do to winterize boats). When they get here they can be unwrapped in quarentine. No exposure to airline passengers or crew, no exposure to people on the street....

[Jarlaxle]

All commercial flights should be stopped, period.

[BoSoxGal]

All commercial flights should be stopped, period.

From those west African countries, or all commercial flights in general?

I mean seriously, talk about a way to create an instantaneous worldwide economic whammy - and a HUGE overreaction to a disease that thus far has killed not even 1/3 of the number of people, in Africa, that influenza kills in the US every year! A disease which has yet to kill a single American, or to my knowledge, European.

[Jarlaxle]

West Africa...which would have been crystal clear had you actually read my previous post!

[rubato]

We all made a mistake in thinking this was an African, or a Liberian, problem instead of a global health problem and we're paying for it now.

Looking ahead I hope we can learn from this and do better the next time.


yrs,
rubato

I think that's exactly right. We can and should do better.

The 'internationalization of everything' happened a while ago and our understanding is struggling to keep up with it. Witness the witless comments above.

The globe is almost completely interdependent. Other than N.Korea, who shows very graphically what walling yourself off looks like, what happens anywhere happens to us as well, as often as not. Culturally, Economically, Religiously, Militarily, Politically, we are interconnected. We are only attending to our own self-interest when we act to improve health care in Africa or social justice in Latin America.


yrs,
rubato

[wesw]

yet you say ISIS is far away and doesn t have the power to hurt us here....

[rubato]

You are indulging in your habit of making things up again.

spew


yrs,
rubato

[Gob]

A US nurse held in quarantine in New Jersey after treating Ebola patients in West Africa says she will challenge her confinement in a federal court.

Kaci Hickox said she was made to feel like a criminal after returning from Sierra Leone last Friday.

Her lawyer says the case has raised "serious constitutional and civil liberties issues".

The White House and mayor of New York have expressed concerns over new strict quarantine orders in several US states.

The new rules in New York, New Jersey and Illinois require a mandatory 21-day quarantine period for all health workers who have had contact with Ebola patients in West Africa and just returned to the US.

On Sunday New York Governor Andrew Cuomo announced an easing of the quarantine restrictions in his state.

Under the latest guidelines, returning health workers who have displayed no symptoms can return to their homes for the quarantine period, where they will be monitored twice daily. Compensation will be offered for loss of earnings.

Governor Cuomo was later quoted by Reuters as saying that the state wanted to encourage health workers to go to the Ebola outbreak zone.

[liberty]

We all made a mistake in thinking this was an African, or a Liberian, problem instead of a global health problem and we're paying for it now.

Looking ahead I hope we can learn from this and do better the next time.


yrs,
rubato

I think that's exactly right. We can and should do better.

The 'internationalization of everything' happened a while ago and our understanding is struggling to keep up with it. Witness the witless comments above.

The globe is almost completely interdependent. Other than N.Korea, who shows very graphically what walling yourself off looks like,
yrs,
rubato

I disagree Ru, if I follow you correctly you are implying the problem with North Korea is that it is isolated rather than communist.
Their problem is not isolation; the people of an isolation nation could live reasonably well provided they had adequate resources available, a common sense government and a motivated population. The people of the Incan Empire lived reasonably well considering the times. The problem with communism as practiced by the Marxist states of the twentieth century is that is a brutal and inefficient. It is inefficient because it is brutal. In such a system the safest thing for one to do is exactly what one is told to do, no more or less. Do I need to point out that is not a very effective way to manage a society?

[rubato]

Do you always have this much trouble following the point of a discussion?


yrs,
rubato

[wesw]

at least he was civil towards you.

[oldr_n_wsr]

talk about a way to create an instantaneous worldwide economic whammy

Didn't we stop flights to and from Isreal when they were having their latest "to do" with hamas?

[Econoline]

Ebola: The Real Reason Everyone Should Panic

Our Global Institutions are Broken

Zeynep Tufekci on Oct 23 / Updated Oct 26

The conventional (smart) wisdom is that we should not panic about Ebola in the United States (or Europe). That is certainly true because, even with its huge warts, US and European health-care systems are well-equipped to handle the few cases of Ebola that might pop up.

However, we should panic. We should panic at the lack of care and concern we are showing about the epidemic where it is truly ravaging; we should panic at the lack of global foresight in not containing this epidemic, now, the only time it can be fully contained; and we should panic about what this reveals about how ineffective our global decision-making infrastructure has become. Containing Ebola is a no-brainer, and not that expensive. If we fail at this, when we know exactly what to do, how are we going to tackle the really complex problems we face?

Climate Change? Resource depletion? Other pandemics?

So, I have been panicking.

Pandemics have long been among my favorite topics to teach sociology with, not because the subject is cheery, but because they contain so many of the lessons about our modern world.

But this year, it feels like a lesson in despair, about everything that’s broken.

There are dozens of textbooks for introduction to sociology, but they all have a similar chapter order. Somehow, globalization always ends up around chapter seven, the middle of the semester, when the novelty of sociology as a topic has worn off, and the class starts to drag.

But chapter seven would always be a turning point in my class: that’s when many students would sit up and realize that this, more than anything, was their generation’s core problem.

We always started with pandemics: Ebola or the Flu.

Why should you care about the state of health care infrastructure, I’d ask, in Laos or in Gabon, besides the obvious: shared humanity?

Many would offer altruistic reasons: because we care. Of course, I’d say. Of course we should care. Of course. But, imagine you are trying to convince an uncaring organization, a bureaucracy, a self-interested power, people with money who do not want to part with their money, or people who simply don’t care?

Can you convince them they should care?

First, do you know what has killed more people than all of World War I at the end of World War I? Not the war itself. The Spanish Flu, the pandemic that swept the world thanks to increasing transportation technologies, the close quarters of barracks, and discharged soldiers who took it back to their communities.

I’d start with network theory, and our small world. In our increasingly connected world, every virus is but a hop or two away: almost all humans are close enough to someone who flies — maybe except the isolated tribes in the Amazon.

If some people fly, any virus can get to any country. In a historical experiment, social psychologist Stanley Milgram challenged people to send packages around the world only through personal contacts — it took about six hops for most packages to find their way home. (This inspired the famous play and movie “Six Degrees of Separation”, which later inspired the “Six Degrees of Kevin Bacon” game.) Today, this would likely be a smaller number because of “hubs” and bridges, people who connect otherwise disconnected clusters, have proliferated.

So, lesson number one: many divides separate us in the world, but we are all connected, very closely. It is truly a global village, of sorts. We are divided, but also united.

Viruses — which we can only vaccinate against and cannot cure like we can with bacterial infections and antibiotics — also thrive when they come across bridges: between the human and the animal host. Historically, the most dangerous viruses are ones that jump between animals, domesticated or not, and humans. The flu that jumps between poultry or swine, and humans; the filovirus that can survive in the fruit bat, but also jump to a person. Many such viruses thrive at poorer places, especially those where the original, rich ecoystem is intact. And it is poor people who will be the ones who bring their chickens into the hut in the winter, the only place with enough warmth to survive, or hunt in the bush for meat, because they can’t buy it in a supermarket.

Jumping hosts sharpens the skills of a virus to spread and kill more effectively— and few of us have immunity to such new viruses, especially those with heightened abilities.

Lesson number two: there are certainly hotspots for natural emergence of deadly pandemics, and many of them reside in the world’s poorest regions.

The final piece of the puzzle is how epidemics work. Epidemiologists talk of “r nought”, R0, the most basic epidemiological number. It is, simply put, the number of new infections each ill person generates. If it is less than 1, R0 < 1, the infection will tend to die out. Each ill person is not replaced by another ill person. Bigger than 1, every ill person infects multiple people, it will grow exponentially.

It’s like that game: put a single grain of rice into the first chess block. Double it in the next one: two grains of rice. Double it again: four grains. There are 64 blocks in a chess board. Once you go through all 64, you will have 18,446,744,073,709,551,616 grains of rice or about 636,094,623,231,363 pounds. As in trillions.

That’s how exponential math works. It gets big, very quickly.

The only way to stop this is to stop it very early. Otherwise, the avalanche becomes uncontainable.

Lesson three: exponential growth is powerful, and best countered very, very early.

By now, we are in the middle of the class of the middle of the lesson in the middle of the semester, the most dangerous time in terms of losing a student.

But I’d already see some of them start putting all this together, and sitting up.

There is no “r nought” independent of connectivity. The more connections, the more possibilities, the bigger this number.

Globalization, in essence, means we really are one big family, in sickness and in health.

The more connected we are, the easier it is for a virus to spread wide and deep, before we get a chance to contain it.

And that is partially why Ebola is now ravaging through three countries in West Africa: it broke through in cities and large-enough settlements, and due to an accumulation of reasons, including recent civil wars, at a time when they were least equipped to handle it.

Containing an outbreak requires circumscribing the outbreak (isolating and treating the ill, tracing their contacts, isolating and treating them as well) so that it can no longer find new hosts, and healing those who are ill, or mourning those who die. Circumscribing an outbreak is easier when the cases are a few, or a few dozen, or a few hundred.

In fact, we know from previous Ebola outbreaks which parameters brings down the dreaded transmission rate: “the rapid institution of control measures.” It’s that simple.

After thousands of cases, this gets harder and harder.

After millions, it is practically impossible.

That’s what is happening now, in Sierra Leone, and in Guinea, and Liberia. There are almost 10,000 cases in those three countries, and half of those people are already dead. In some places, the fatality rate is up to 70%.

On the other hand, Paul Farmer of Partners in Health, one of my favorite organizations in the world, who just returned from Monrovia, Liberia, estimates that 90% of those who receive proper hydration care should survive. The numbers could well work: of the seven people who were treated in the US, only one has died, and his treatment was delayed. Four are already out of the hospital, and two are reportedly doing well.

And crucially, as with all viruses, survivors of Ebola gain immunity, at least to this strain.

In fact, countries with even slightly better health-care, not at the US level, can control this epidemic by circumscribing it: On October 17th, WHO declared Senegal free of Ebola. Later, Nigeria, too, was declared free. Ebola, because of the speed with which it kills, and the short incubation period, is not that hard to contain if contained early — Ebola has a weakness as a virus: it doesn’t have too long to reproduce before it kills or is beaten by its victim, hence its “r nought” is not that high, compared with other viruses which take a longer time lying stealthily in the body. Ebola’s speed and deadliness, paradoxically, gives us an advantage for containing it—if we act early.

On the other hand, at the current level of meager, vastly under-resourced effort in the core countries, the WHO estimates 10,000 cases per week in just a few months. Cases in Liberia are still doubling every two weeks.

There could be a million cases, CDC estimates, by the end of 2014.

Let that sink in. A million Ebola victims in just a few months.

At that point, we end up with another endemic virus, similar to other ones that still survive like polio (so close to being wiped out but wars keep interfering), measles for which we have vaccines, and HIV and malaria (a parasite) for which we don’t have vaccines and which kill millions every year.

What I just summarized in fewer than 2,000 words or so isn’t even basic epidemiology. It is the basics of basics of basics of epidemiology, and this is something every policy maker on the planet should understand after talking for 10 minutes to an expert of their choice in their own country.

A few weeks ago, the United Nations Secretary general Ban Ki Moon asked for about $1 billion to contain this epidemic, in 2014, before it settled for good. (Travel restrictions work if the affected are small numbers, and will not work when we have millions of cases — a few will get out within the incubation period and remember — this disease does not just travel on dark-skinned people.)

Further, the longer we allow Ebola to experiment on us, the more dangerous it may get. A version with a slightly lower fatality rate along with a longer incubation period may be very, very hard to contain.

One billion dollars. About 1/16th of a WhatsApp. One blockbuster movie.

This is but a rounding error for the global economy. It is a meager amount needed, to forestall having to lose much, much, much more later.

And the United Nations reported that it had received about $100K deposited (you read that right) and only about $250 million were made in commitments, that may or may not arrive in time. (There are other sources of funds but the response is clearly, unequivocally inadequate. Liberia is lacking gloves and plastic buckets. The basics.).

Every day we let this pass as is, the harder it will be to eventually exterminate it — not to mention the unacceptable human misery. And cruelly, the disease is ravaging caregivers most, because as people become more sick, they shed more and more of the virus through their bodily fluids.

Ebola kills the most human of us, first, those who are unwilling to abandon the ill, the dying.

And there is so much to do, so so within our reach.

We can send massive amounts of protective equipment. Liberia doesn’t even have enough plastic gloves — they reportedly asked for 110,000 because they just have 2,100. When Centers for Disease Control first went to Liberia in August, when there were only a handful of cases, it found that the hospitals had no gloves. This situation should be unthinkable. Unfortunately, it’s not.

Survivors of the disease acquire immunity, at least to this strain, and there are thousands of them now in the most affected countries — poised to be hired and trained, with proper equipment, so that the newly infected can also be cared for properly, and hence also survive in much larger numbers. Many organizations, from Doctors Without Borders to Partners in Health, are very good at providing community based care, by hiring and training locals, so that epidemics can be contained and treated.

Letting Ebola take root would not just cause more deaths we can prevent, but also would require taking away resources in regions already stretched thin. The spikes in hunger and infant mortality are almost inevitable.

By the end of that sociology class, my first-year college students would all get this basic math, and the basic humanity. The course we must take is a no-brainer, from every point of view: a sense of humanity, and if you cannot be moved by that, by a sense of self-interest and rationality.

It’s 2014.

We have one chance to stop this awful disease in its tracks, this year.

In 2015, that option will be gone.

Mass media is too busy generating the wrong panic — the infinitesimal chances of Ebola in the US now, rather than how to roll it back it in West Africa.

The UN is reduced to begging and being ignored.

There is heroic NGO work. Partners in Health — which specializes in hiring and training locals — and Doctors Without Borders — experienced at moving resources quickly and operating at challenging environments — are both phenomenal organizations — and I’m donating to both what I can this year. I don’t really believe in framing “charity” as a solution at this scale, but I believe in solidarity. However, this should not come down to whether or not a few people donate — our collective institutions should collect and organize these resources, and direct this effort. While PIH and MSF can and will do a lot, this cannot be on their shoulders alone.

So I panic and despair, about what this lack of response says about us, our institutions, our humanity.

How can we make our institutions work, for us, at a global scale? That remains the core challenge of 21st century, without which we will fail at many more tests, at great suffering.

source

[rubato]

Our Global Institutions are Broken[/b][/center]

I don't think they are broken so much as they never were developed very well. Ebola and global warming are two very good examples of it.

'Climate Change: Lessons for our Future from the Distant Past'

David Hendry at Vox EU:

Climate change: Lessons for our future from the distant past, by David F. Hendry: Summary Climate change has been the main driver of mass extinctions over the last 500 million years. This column argues that current evidence provides a stark warning. Human activity is producing greenhouse gases, and as a consequence global temperatures and ocean heat content are rising. Such trends raise the risk of tipping points. Economic analysis offers a number of ideas, but a key problem is that distributions of climate variables can shift, invalidating stationarity-based analyses, and making action to avoid possible future shifts especially urgent.

His conclusions:

Economic analysis offers many insights – externalities need to be either priced or regulated, and climate change is the largest ever worldwide externality. All approaches are affected by the possibility of abrupt changes and the resulting unknown uncertainty when distributions shift, making action more urgent to avoid possible future shifts. Adaptation is not meaningful if food, water, and land resources become inadequate. Conversely, mitigation steps need not be costly, and could stimulate innovation. International negotiations are more likely to succeed if the largest players act first in their own counties or groups – also creating opportunities for their societies as new technologies develop.

Planet Earth will survive whatever humanity is doing – the crucial issue is the effect of climate change on its present inhabitants. It is a risky strategy to do nothing if there are potentially huge costs when the costs of initial actions are small. The obvious time to start is now, and the obvious actions are the many low-cost implementations that mitigate greenhouse gases (see Stern 2008 for a list) – just in case.

[See also "U.N. Climate Change Draft Sees Risks of Irreversible Damage - Scientific American".]

http://economistsview.typepad.com/econo ... -past.html




yrs,
rubato

[Gob]

Sierra Leone has condemned Australia's decision to suspend entry visas for people from Ebola-affected countries in West Africa as "counterproductive" and "discriminatory".

The move has also been criticised by Amnesty International.

And UN Secretary General Ban Ki-moon has said travel restrictions will severely curtail efforts to beat Ebola.

Nearly 5,000 people have died from the virus, the vast majority of them in Sierra Leone, Liberia and Guinea.

The Australian government announced on Monday that it was cancelling non-permanent or temporary visas held by people from the affected countries who were not yet travelling, and that new visa applications would not be processed.

Permanent visa holders yet to arrive in Australia must undergo a 21-day quarantine process before departure.

Immigration Minister Scott Morrison told parliament: "The government's systems and processes are working to protect Australians."

But Sierra Leone's Information Minister Alpha Kanu described the move as "too draconian", insisting that measures put in place at Sierra Leone's Freetown airport had successfully prevented anyone flying out of the country with Ebola.

"It is discriminatory in that... it is not [going] after Ebola but rather it is... [going] against the 24 million citizens of Sierra Leone, Liberia and Guinea. Certainly, it is not the right way to go," he told Reuters news agency. "This measure by the Australian government is absolutely counterproductive."

[Long Run]

This is a tough issue, with no good answer on the travel ban question. But how is this statement true?

"This measure by the Australian government is absolutely counterproductive."

I get that the ban injures the economy of the African country and limits its citizenry from traveling, most of whom are non-carriers. It also makes it more difficult to get aid to the African countries because everything has to go by charter. These are the main drawbacks of the ban and need to be weighed in making a decision on the subject. But the goal of the ban is to prevent the virus from arriving in Australia. How is the ban counterproductive to that goal?

[Crackpot]

because it effectively cuts off aid workers who are needed to combat the problem in the effected countries the longer those countries are breeding grounds for the disease the more chance for the problem to get even more out of control.

[Guinevere]

Pretty much what CP saId - which is what the NEJM said today. The best possible thing to do is get more health workers into West Africa to help stop the spread of the disease. Otherwise it will become a world-wide problem.