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Ebola

HBirdman80 said:
I'm not going to call out any particular posts on here because I don't want to embarrass or belittle people, but some of what I've read has been just astoundingly bad and reckless 'science', and frankly scary that we are descending into the same type of culture that prevails in western Africa.

Of course this is America and everyone has the right to free speech and to state their opinions (it's what I'm doing after all). But please, on topics like this, take pause before you use that right to free speech. Don't post as fact that which is just your opinion. Ask questions instead of making statements. There are plenty of people on this board who actually do know and understand this topic and I'm sure many would be willing to contribute their knowledge to the discussion.

You can all hate away now :flowers4u:
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I don't claim to be an expert on anything :) I honestly follow a lot of these posts for the education because there are quite a few very knowledgeable THPers on various topics including yourself, so thanks.
 
moosejaa said:
This makes me think it may be more easily spread than they have said up to this point.
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If the report that said 70 people cared for the man is true, then protocols need to be rewritten.

Having that many people exposed to an infected person is asking for trouble.
 
moosejaa said:
I don't claim to be an expert on anything :) I honestly follow a lot of these posts for the education because there are quite a few very knowledgeable THPers on various topics including yourself, so thanks.
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Hey I'm happy to answer any questions I can (my background is in biochem and I work with pharma companies in drug development) and if I cannot answer them I'm happy to check with some of my resources (molecular biologist, a couple government research scientists, multiple docs and chemists) to find an answer.
 
Rhyno said:
If the report that said 70 people cared for the man is true, then protocols need to be rewritten.

Having that many people exposed to an infected person is asking for trouble.
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You would be surprised at how many people are responsible for your care when you are admitted to the hospital, especially for long term, critical care.
 
3 false alarms in Vancouver over the last few days.

It occurs to me that we are simply not prepared for this at all.
 
ArmyGolf said:
3 false alarms in Vancouver over the last few days.

It occurs to me that we are simply not prepared for this at all.
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The only reason I would say that we are unprepared for this is because the population, at large, is not scientifically versed. They don't fully understand the disease and are freaking out. I guess I can't blame them, the disease can be quite horrific. Then there is an element of the population that refuses to trust those "in the know", and it's problematic because they tend to be the s**t stirrers and conspiracy spreaders.
 
deuce said:
You would be surprised at how many people are responsible for your care when you are admitted to the hospital, especially for long term, critical care.
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True, but in situations like this having 70 caregivers is horribly irresponsible, especially if the allegations that they did not have proper safety equipment and did everything ad hoc are true.
 
HBirdman80 said:
True, but in situations like this having 70 caregivers is horribly irresponsible, especially if the allegations that they did not have proper safety equipment and did everything ad hoc are true.
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I would say a goodly number of those caregivers have to be from the ER before they knew his diagnosis.
 
HBirdman80 said:
True, but in situations like this having 70 caregivers is horribly irresponsible, especially if the allegations that they did not have proper safety equipment and did everything ad hoc are true.
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Isn't that a direct reflection back to the CDC about how unprepared they really are? They have no universal protocol about how to deal with an outbreak like this? I know hospitals deal with their own internal bacterial infections and diseases that are brought into the hospitals and have their own protocol but it seems like they are leaving the providers flying in the wind to deal with this in their own way?
 
Nate said:
Isn't that a direct reflection back to the CDC about how unprepared they really are? They have no universal protocol about how to deal with an outbreak like this? I know hospitals deal with their own internal bacterial infections and diseases that are brought into the hospitals and have their own protocol but it seems like they are leaving the providers flying in the wind to deal with this in their own way?
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I agree. I think the greatest chance of this spreading is in the hospitals. Look at what has happened with this Duncan guy...no one in his family has shown signs of the disease yet, but 2 caregivers have it. Almost as if the family was more prepared more than the hospital.
 
Nate said:
Isn't that a direct reflection back to the CDC about how unprepared they really are? They have no universal protocol about how to deal with an outbreak like this? I know hospitals deal with their own internal bacterial infections and diseases that are brought into the hospitals and have their own protocol but it seems like they are leaving the providers flying in the wind to deal with this in their own way?
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Here's the thing. People hate when the gov't meddles, and I bet there would have been any number of politicians pulling the CDC into the Capitol to ask why the CDC is forcing hospitals to practice protocols on diseases which have never been isolated here in the United States because it's a waste of time and money. Training doesn't happen overnight, it takes time and practice. I wouldn't be surprised if this hospital also has higher rates of other nosocomial infections (MRSA, etc) because their infectious disease protocols are lacking.

The CDC already has protocols in place, reasonable protocols. They've been utilized elsewhere and work effectively. Every lab in the United States that works on Ebola in a laboratory setting uses those protocols and no one has turned up infected, despite years of working directly with the virus. Yet, are they now going to have to come up with "Infectious Disease Control for Dummies" protocols? Looks like it.

Mind you, no one wound up getting infected at Emory when they treated the two doctors brought back to the US. They used the same protocols outlined by the CDC.

INgolfer said:
I agree. I think the greatest chance of this spreading is in the hospitals. Look at what has happened with this Duncan guy...no one in his family has shown signs of the disease yet, but 2 caregivers have it. Almost as if the family was more prepared more than the hospital.
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No, not because the family was more prepared. It was because Duncan was in his most infectious state in the hospital and that he was receiving direct care which meant more exposure to blood and body fluids.

It's a very dangerous thing to say that this will spread more in hospitals. That leads people to believe that they're better off staying away from hospitals and trying to self-treat. That will result in a larger spread of the infection. Avoiding an epidemic is predicated on people reporting their symptoms and seeking treatment.
 
deuce said:
Here's the thing. People hate when the gov't meddles, and I bet there would have been any number of politicians pulling the CDC into the Capitol to ask why the CDC is forcing hospitals to practice protocols on diseases which have never been isolated here in the United States because it's a waste of time and money. Training doesn't happen overnight, it takes time and practice. I wouldn't be surprised if this hospital also has higher rates of other nosocomial infections (MRSA, etc) because their infectious disease protocols are lacking.

The CDC already has protocols in place, reasonable protocols. They've been utilized elsewhere and work effectively. Every lab in the United States that works on Ebola in a laboratory setting uses those protocols and no one has turned up infected, despite years of working directly with the virus. Yet, are they now going to have to come up with "Infectious Disease Control for Dummies" protocols? Looks like it.

Mind you, no one wound up getting infected at Emory when they treated the two doctors brought back to the US. They used the same protocols outlined by the CDC.

No, not because the family was more prepared. It was because Duncan was in his most infectious state in the hospital and that he was receiving direct care which meant more exposure to blood and body fluids.

It's a very dangerous thing to say that this will spread more in hospitals. That leads people to believe that they're better off staying away from hospitals and trying to self-treat. That will result in a larger spread of the infection. Avoiding an epidemic is predicated on people reporting their symptoms and seeking treatment.
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Totally understand. Once this thing is over and contained (God willing) I'm sure there will be more "behind the scenes" of what really happened with the protocol's and where the breakdown occured. I still can't get over the Dr. letting him go home in the first place even after he told everyone where he just came from.
 
Nate said:
Totally understand. Once this thing is over and contained (God willing) I'm sure there will be more "behind the scenes" of what really happened with the protocol's and where the breakdown occured. I still can't get over the Dr. letting him go home in the first place even after he told everyone where he just came from.
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Yeah, that fact is breathtaking. Patient history is a critical element for care and why that didn't raise any alarms is beyond me. Someone obviously dropped the ball there.

I don't think there is any defense for what happened at the Dallas ER, but I will say this. The ER is one of the most overworked and crowded areas of a hospital. A considerable segment of the population uses the ER for basic - non-emergency - care, and because of our laws, no one is allowed to be turned away from an ER without being seen. An overhaul of the medical system needs to happen ... doubt it will happen ... but it is yet another thing that this incident exposed and I bet it's never addressed.
 
I find it reprehensible that we knew this thing has popped up before and haven't put all hands on deck & allocated all the resources necesssary to come up with a cure. It's always been said that the thing that will eventually do in the human race won't be war, won't be a meteorite, won't be aliens ... it will be a virus. I'm not saying this with respect to ebola, but it's mind boggling that adequate resources weren't allocated to this years ago last time it surfaced ...
 
As of October 8th, the CDC has confirmed that 4033 people have died from Ebola, 8400 cases total.

In 2003-2004 influenza killed 48,614 (or was a factor in the death of)

Ebola is scary, but it hasn't been something that's killed a lot of people.
 
inthehole said:
I find it reprehensible that we knew this thing has popped up before and haven't put all hands on deck & allocated all the resources necesssary to come up with a cure. It's always been said that the thing that will eventually do in the human race won't be war, won't be a meteorite, won't be aliens ... it will be a virus. I'm not saying this with respect to ebola, but it's mind boggling that adequate resources weren't allocated to this years ago last time it surfaced ...
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Amen.

Why has a cure not been properly funded*? Politics. Politicians go through research budgets with a fine tooth comb, and have made many a press release when they thought funds were not being properly spent. They claim it's a duty to their constituents, to ensure that money is being spent in an effort to give them a better quality of life. Hence, that's why most money is spent to study heart disease, and cancer, and diseases that are endemic to the US. Putting significant resources into finding a cure for a disease a half a world away doesn't matter ... it doesn't affect us ... until it does.

*Research on Ebola does occur in academic, industrial, and military settings. Could it stand to have more resources put into it. Definitely. Then again, that could probably be said for most diseases here and abroad.
 
deuce said:
The only reason I would say that we are unprepared for this is because the population, at large, is not scientifically versed. They don't fully understand the disease and are freaking out. I guess I can't blame them, the disease can be quite horrific. Then there is an element of the population that refuses to trust those "in the know", and it's problematic because they tend to be the s**t stirrers and conspiracy spreaders.
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Expecting everyone in the country to have a degree in infectious diseases is a bit much.

Also, expecting people to blindly trust those who are "in the know" is a bit much too, as we often find out those "in the know" either don't know as much as they thought, or make mistakes. The CDC should be the authoritative expert on this subject and there should not be mistakes. As you say, this disease has been thoroughly studied since the late 70's. But the CDC is admitting mistakes and changing their protocols. I'm quite sure the higher-ups at Texas Presbyterian told the staff there that there was no danger, or at least there was little danger. But we know that wasn't true. Where was the CDC in all this? Why didn't they immediately take over the case of Thomas Duncan and transport him to one of the hospitals which is trained to deal with this?

Given all these mistakes, is it really a surprise that people aren't exactly comforted by the "nothing to worry about" claims?

Note that I'm not refuting the basic premise of your post. It is a good thing we have experts in this stuff and we do need to listen to them. I'm simply pointing out why people panic.
 
inthehole said:
I find it reprehensible that we knew this thing has popped up before and haven't put all hands on deck & allocated all the resources necesssary to come up with a cure. It's always been said that the thing that will eventually do in the human race won't be war, won't be a meteorite, won't be aliens ... it will be a virus. I'm not saying this with respect to ebola, but it's mind boggling that adequate resources weren't allocated to this years ago last time it surfaced ...
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It takes on average 12 years and a gazillion dollars to develop a new drug. Putting aside the difficulties of FDA testing and approval with Ebola, why would any company go to that expense and investment for a treatment for a disease that has infected fewer than 10,000 people ever? That's how our system works.

The NIH has funded a joint project with GSK to come up with a vaccine and it is in Stage 1 testing on an expedited basis, but Stage 2 and 3 testing will be difficult.
 
How and when are politicians allocating dollars towards specific research? Honest question.

Also, it certainly makes sense to me why there would be a massively higher amount of dollars and time spent on heart disease vs. ebola, regardless of how scary one sounds.
 
Hawk said:
How and when are politicians allocating dollars towards specific research? Honest question.
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This stuff happens all the time. They meddle like fiends. It starts as soon as they start working on the budget, proposing cuts down to the agency level. Here is the first hit that popped up on Google-Fu where one Representative put forth an amendment to cut 1.2 billion from the NSF budget and barring that, to prohibit them from funding political science research. http://www.aip.org/fyi/2012/074.html

Then there is the Wastebook that was put out annually by Dr. Tom Coburn R-OK. Yes, there is waste in federal spending, but honestly the discretionary spending portion of the budget is a fraction of the overall budget. If he (and others) spent time working on solving the mandatory spending element, they'd save much more money for the taxpayer. Of course, it puts their jobs in jeopardy because people like their entitlements.
 
Hawk said:
How and when are politicians allocating dollars towards specific research? Honest question.

Also, it certainly makes sense to me why there would be a massively higher amount of dollars and time spent on heart disease vs. ebola, regardless of how scary one sounds.
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The vast majority of drug development is done privately by major corporations. This is why you see ads for drugs out the ying yang, the mega corps are making up their investment plus a profit plus a risk premium. If there isn't enough potential profit they won't get involved. You do not want to know how this sausage gets made, it is astonishing.

The government does fund some projects. Research universities do a lot of the groundwork while the NIH and military (DARPA) also play large roles. Most of this is at the early discovery stage. But to go from that through actual implementation is glibly known as the "valley of death" because it is hard, expensive, and risky, and many manufacturers don't want to do it unless it will be a 'blockbuster'. Ebola drugs aren't blockbusters because the market is too small. Sometimes you can get a foundation to step up and bridge this gap, but their contributions are smallish and generally not enough to bridge the gap.

As for what projects the government helps with, same way as everything else, pork and lobbying.
 
Well we can't have it both ways. If the disease is controllable, generally not fatal in the US or west with advanced healthcare, is hard to spread and has never occurred in the US, why wouldn't we spend our money finding cures for the diseases that actually impact us every day?
 
tequila4kapp said:
Well we can't have it both ways. If the disease is controllable, generally not fatal in the US or west with advanced healthcare, is hard to spread and has never occurred in the US, why wouldn't we spend our money finding cures for the diseases that actually impact us every day?
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Correct. Ebola is, essentially, what we refer to as an orphan disease.
 
deuce said:
Amen.

Why has a cure not been properly funded*? Politics. Politicians go through research budgets with a fine tooth comb, and have made many a press release when they thought funds were not being properly spent. They claim it's a duty to their constituents, to ensure that money is being spent in an effort to give them a better quality of life. Hence, that's why most money is spent to study heart disease, and cancer, and diseases that are endemic to the US. Putting significant resources into finding a cure for a disease a half a world away doesn't matter ... it doesn't affect us ... until it does.

*Research on Ebola does occur in academic, industrial, and military settings. Could it stand to have more resources put into it. Definitely. Then again, that could probably be said for most diseases here and abroad.
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We haven't had to worry about Ebola.

Why worry about a disease that has a low transmission rate while other diseases are killing morw people and spreading faster?

Ebola isn't even the most worrying hemorrhagic fever, Marburg is deadlier, and it had no known treatment.

55,000 deaths a year by Rabies in Africa, 100% fatal if untreated and treatment must be administered quickly.

Creutzfeldt-Jakob diseases 100% fatal. No know cure, we don't even understand it. (Luckily it extremely rare)

H5N1 and H7N9, these two are about on top of everyone's we are screwed list should they come into wide circulation.

MERS.

HIV/AIDS
Tuberculosis
Pneumonia
Maleria
Infectious Diarrhea

All these things have been prioritized over Ebola and for good reason, they either have deadlier survival rates, high transmission rates or kill more people.

And none of them have cures (to my immediate knowledge) either.

It's a question of what do you focus on, this deadly disease or that deadly disease.

If research is done in an area not effected by one disease while another has effected it how does it change the priority of the diseases.

Add in the vast numbers of things that kill and have no cures, or treatments that are ineffective, add in Cancer and all of its types, ALS, Parkinsons, Alzheimers, heart diseas.

There's simply not enough money.
 
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deuce said:
This stuff happens all the time. They meddle like fiends. It starts as soon as they start working on the budget, proposing cuts down to the agency level. Here is the first hit that popped up on Google-Fu where one Representative put forth an amendment to cut 1.2 billion from the NSF budget and barring that, to prohibit them from funding political science research. http://www.aip.org/fyi/2012/074.html
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Well that's a little different than ebola vs. heart disease, but I'll take you for your word.

Still though, I agree with the concept that we'd pour more money into diseases that actually have meaningful impacts on the health of the nation as a whole. Regardless of ebola being a hot topic at the moment, you can hardly compare the two. For now at least.

HBirdman80 said:
The vast majority of drug development is done privately by major corporations. This is why you see ads for drugs out the ying yang, the mega corps are making up their investment plus a profit plus a risk premium. If there isn't enough potential profit they won't get involved. You do not want to know how this sausage gets made, it is astonishing.

The government does fund some projects. Research universities do a lot of the groundwork while the NIH and military (DARPA) also play large roles. Most of this is at the early discovery stage. But to go from that through actual implementation is glibly known as the "valley of death" because it is hard, expensive, and risky, and many manufacturers don't want to do it unless it will be a 'blockbuster'. Ebola drugs aren't blockbusters because the market is too small. Sometimes you can get a foundation to step up and bridge this gap, but their contributions are smallish and generally not enough to bridge the gap.

As for what projects the government helps with, same way as everything else, pork and lobbying.
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Good insight. Thanks.

Wouldn't they be looking towards vaccine more than 'cure' at this point just because it's a virus? I know they've made strides in anti-virals, so maybe that's more of a possibility than I think.
 
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