Ebola

[Robin Hood]

I received an email from Avaaz saying it is estimated that 1 million people will be affected from it. I have seem many comments from some mean-spirited Westerners (particularly Quebecers) who suggest closing the borders and barring the people currently in West Africa from coming here, so that we don't get infected because Africans are sub-humans for these people...), my question is: if we were to bar anyone from West Africa from coming to the West, will we be safe from Ebola? Thanks!

 

BTW, even if I were a physician, I wouldn't have gone to West Africa to treat the infected people living there, too chicken for that.

[Falling]

This is my opinion as a pre-med:

 

If we ban flights in and out of that region to Western Nations, Western nations cannot send aid to countries hit by Ebola. No western health workers (physicians, nurses, volunteers) and no supplies.

 

Lack of Western Aid => No improvement in Ebola in those countries.

 

If Ebola continues to spread in this countries:

1) More people will die

2) More likely that it spreads throughout Africa, or other parts of the world.

 

So, the way I see it, you'd have to 100% ban any travel in or out of these regions that are hit with Ebola, and the ban must apply to any state. No one from anywhere in the world could enter or leave the regions where Ebola is prevelant.

 

This doesn't seem feasible, and it would basically sentence incredibly large numbers of people in these regions to death.

[starryskies]

I think that if a strict travel ban were to be imposed it would certainly stop help the spreading if the disease in other countries, however that could possibly entail that  professionals who are working there as well as citizens of the countries imposing the ban could be excluded from receiving a higher standard of healthcare if infected. An infected Canadian would have rights to receive healthcare here in Canada, and a blanket ban doesn't address this. Also, by not intervening as a global society to stop this epidemic within West Africa, the affected areas would have a large likelihood of exponentially increasing, which would make it even more difficult to contain and by extension more likely to be spread to other parts of the globe.

 

I don't know if it's just people being mean when they want a more strict ban on who is allowed entry to counties facing contagious disease epidemics. A lot of the reactions may be knee jerk and done when one is feeling very emotional and vulnerable as the media is constantly running stories on how ineffective strategies have been to contain it. It's also what may seem the most intuitive reaction to many people, because that's how we tend to deal with other contagious ailments like the flu for example (we isolate ourselves from the rest of the society).

 

I don't think the "answer" is as simple as enforcing a ban. In order for West Africa to properly contain the spread of the disease, it requires more advanced infrastructure and increased awareness/ education amongst it's population. As the current health care system within many of these countries is incapable of dealing with these factors, they require outside help.

[Birdy]

I think imposing a travel ban would just result in it being harder to identify potential routes of entry since people would not necessarily volunteer that they'd been in an affected area recently if it could result in them being barred from entering the country. Say someone travels to Nigeria from an affected country before travelling to Canada. As it is now, we know who is coming from affected regions and we can screen them and ensure they have information on what to do if they show symptoms. My university has a fairly large number of students from Africa and there are posters up about it.

 

Given our health infrastructure, I think it is unlikely Ebola could get a foothold here (which is the opinion of the actual experts, last I checked) and while we might deal with a few imported cases I doubt we'll see much if any domestic transmission even if the numbers get very high in Africa. That's just my inexpert thinking on the matter, anyway.

[ralk]

Cutting off all travel from those countries would work in the same way shooting a shotgun at a spider would work to kill it. It does the job, but there's some significant collateral damage and simpler, more effective means are available.

 

Ebola is a deadly, incurable infection, but it's not overly contagious. Say one person with the infection comes here: we should still be able to contain it fairly easily, though it's impossible to guarantee it won't spread to a small handful of people. That's far from ideal, but more people in Canada will die of influenza this year and no one's freaking out about that. Even the US case is fairly non-alarming. The disease spread to only one person in the initial patient's infectious period and they were promptly identified - that's not the makings of an epidemic.

 

The best way to attack Ebola - really the only way - is to hit it in Africa. Right now the situation there is spiraling out of control. There health care systems were weak to begin with and they're getting progressively weaker. The more people infected there, the more likely it'll spread to other countries. As I said, if an infected person gets to here or a country with a modern health care system, the chances of it becoming anything more than a small cluster of infected individuals is fairly remote, but countries without those systems are much more vulnerable. Nigeria is the immediate concern, with its massive, concentrated population. It already has some cases, but appears to be handling them well enough. Let's hope that doesn't change. Longer term concerns are India and China. These are big population centres, each with cultural, social, and/or economic ties to the region, and with questionable health care systems. China at least has proven capable when it wants to make a concerted effort to solve a problem (yay autocracy!), but India has demonstrated that it's usually slow to respond to crises. We can realistically cut off travel from West Africa, but we couldn't cut travel from India. And the more people and countries affected, the higher our chances are of having an Ebola case - or multiple Ebola cases - here in Canada.

 

West Africa is like an abscess, a source for infection that's currently contained but will not cease to be a problem until it's handled directly. The affected countries mostly they need supplies. The way to stop Ebola is to use basic protective equipment and sanitary measures. It's hard to gown, glove, and put on a mask when treating potential Ebola patients when you've only got one set of each for the entire hospital. If we want to stop Ebola here, we have to stop it there, and that means money, lots of it, right now. Countries so far have been extremely reluctant to provide this sort of aid, but it's the only real solution. Instead, we do asinine things like check for fever at airports, a policy that'll catch a ton of people without Ebola, would miss many individuals who did have Ebola, and will cost a ton of time, money, and energy in the meantime.

 

Ebola shouldn't be that scary for countries like Canada. But our response to the problem is terrifying.

[Robin Hood]

Cutting off all travel from those countries would work in the same way shooting a shotgun at a spider would work to kill it. It does the job, but there's some significant collateral damage and simpler, more effective means are available.

 

Ebola is a deadly, incurable infection, but it's not overly contagious. Say one person with the infection comes here: we should still be able to contain it fairly easily, though it's impossible to guarantee it won't spread to a small handful of people. That's far from ideal, but more people in Canada will die of influenza this year and no one's freaking out about that. Even the US case is fairly non-alarming. The disease spread to only one person in the initial patient's infectious period and they were promptly identified - that's not the makings of an epidemic.

 

The best way to attack Ebola - really the only way - is to hit it in Africa. Right now the situation there is spiraling out of control. There health care systems were weak to begin with and they're getting progressively weaker. The more people infected there, the more likely it'll spread to other countries. As I said, if an infected person gets to here or a country with a modern health care system, the chances of it becoming anything more than a small cluster of infected individuals is fairly remote, but countries without those systems are much more vulnerable. Nigeria is the immediate concern, with its massive, concentrated population. It already has some cases, but appears to be handling them well enough. Let's hope that doesn't change. Longer term concerns are India and China. These are big population centres, each with cultural, social, and/or economic ties to the region, and with questionable health care systems. China at least has proven capable when it wants to make a concerted effort to solve a problem (yay autocracy!), but India has demonstrated that it's usually slow to respond to crises. We can realistically cut off travel from West Africa, but we couldn't cut travel from India. And the more people and countries affected, the higher our chances are of having an Ebola case - or multiple Ebola cases - here in Canada.

 

West Africa is like an abscess, a source for infection that's currently contained but will not cease to be a problem until it's handled directly. The affected countries mostly they need supplies. The way to stop Ebola is to use basic protective equipment and sanitary measures. It's hard to gown, glove, and put on a mask when treating potential Ebola patients when you've only got one set of each for the entire hospital. If we want to stop Ebola here, we have to stop it there, and that means money, lots of it, right now. Countries so far have been extremely reluctant to provide this sort of aid, but it's the only real solution. Instead, we do asinine things like check for fever at airports, a policy that'll catch a ton of people without Ebola, would miss many individuals who did have Ebola, and will cost a ton of time, money, and energy in the meantime.

 

Ebola shouldn't be that scary for countries like Canada. But our response to the problem is terrifying.

 

 

Two things I have remarked:

 

1. Many people imagine it's going to be the End of the World.

 

2. And that's sickening, and I hope to be wrong, but racism seem to have really spread in Quebec.

[Arztin]

??????????? @ Robin Hood

[Leon]

A message from Docs without Borders. These people have taken their healthcare role to a level that most of us can only ever hope to aspire to. Please consider commenting on the relevant post, to boost their morale and bring encouragement to those battling to save Ebola patients in deplorable conditions that we can't even begin to imagine.

"Doctors Without Borders is asking our supporters to leave messages of encouragement for our staff working in Ebola projects in West Africa. Most are national staff who come from the countries and communities where the disease is taking an enormous toll, and they are experiencing the devastating effects of Ebola at home, as well as at work. Let them and all of our staff know you support their efforts and please SHARE this post. Photo by Caroline Van Nespen/MSF"

https://www.facebook.com/msf.english

[Harvey Specter]

I thought ebola was fake so we can steal Africa's resources?

[StriveP]

First of all, preventing people from traveling will decrease the spread of the disease but it will not abolish it. There are a few vaccines that are being developed that are very promising including: rVSVs and ZMAPP. Look up ZMAPP, it has cured 2 U.S. healthcare workers already. The only issue with ZMAPP is that there is such a low supply and since it was recently developed they didn't make enough for a 2nd round of testing. Its going to take months for them to make another batch and then they will have to do human trials with those. Oh and they tested it in rhesus monkeys with the first batch they had and 11/12 survived when given ZMAPP. The only 1 that didn't survive was particularly susceptible to EBOV for some reason, at least that's what the study suggests.

 

Source of original paper: http://www.nature.com/nature/journal/vnfv/ncurrent/pdf/nature13777.pdf

[Falling]

First of all, preventing people from traveling will decrease the spread of the disease but it will not abolish it. There are a few vaccines that are being developed that are very promising including: rVSVs and ZMAPP. Look up ZMAPP, it has cured 2 U.S. healthcare workers already. The only issue with ZMAPP is that there is such a low supply and since it was recently developed they didn't make enough for a 2nd round of testing. Its going to take months for them to make another batch and then they will have to do human trials with those. Oh and they tested it in rhesus monkeys with the first batch they had and 11/12 survived when given ZMAPP. The only 1 that didn't survive was particularly susceptible to EBOV for some reason, at least that's what the study suggests.

 

Source of original paper: http://www.nature.com/nature/journal/vnfv/ncurrent/pdf/nature13777.pdf

 

The monkey that died seems to have had much worse symptoms than the rest. The results look promising, but the sample size is 13. Cannot really draw any inferences from that.

[Life_Sci_Guy]

http://www.nytimes.com/2014/10/24/nyregion/craig-spencer-is-tested-for-ebola-virus-at-bellevue-hospital-in-new-york-city.html

 

 

Doctors Without Borders physician comes back from West Africa and tests positive with ebola...

[Garfas]

For me personaly Ebola is a artificialy created panic in population. 

[medhope15]

Back in the day, plagues were contained by barring a village, burning huts with sick people inside them. Thanks to your ancestors you are here today (seriously if you think about those facts, thanks to harsh methods of containment hundreds and thousands of years ago, some of us may have survived through). I'm not saying we continue these practices, but the logic of the matter is, commercial / vacation travel should be banned from conflict regions. Not saying that aid should stop, but IMO the WHO should have their own outfit of airplanes that can travel into such high risk regions (ie. think military aircraft which are used for transport of wounded soldiers). Aid should come it via WHO airlines from Europe, but "american airlines" shouldn't be flying over with tourists or unnecessary personnel during an outbreak. Contain the spread by closing a border and sending aid IN and having ill people contained in treatment centres.

We do the same thing in the US when there is a hospital outbreak. We contain the patients on the unit, don't allow new admits, limit visitors from entering.

I am shocked that Docs without borders outright said that it is "stupid" to try to logically contain the outbreak and prevent sick people from travel in and around half of africa, when we all know that the continent is not properly equipped to help the sick in areas outside of large cities. The smart thing to do is have a strong presence ready to set up "tent hospitals", educate people to immediately seek help in a centre and not wonder off for hundreds of miles.