Ebola Virus Disease (EVD) logarithmic chart update – 15 December 2014

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Ebola monthly cases, Ebola monthly deaths, Ebola update, Medical efforts are working!, Possible hopeful signs

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This logarithmic chart updates to December 15, 2014 the deaths from Ebola and compares them to deaths from Flu, AIDS, Plague, WW2, Mongols, and others. Click chart to make it bigger.

This chart is based on WHO’s published data and it shows both a continuing tragedy and a clear hope for the immediate future. The tragedy is that since the last update on November 26, 2014 there have been 1,152 deaths attributed to the West African Ebola outbreak, (6,841 minus 5,689). The hopeful sign is that when described on a logarithmic chart there is a clear sign that the present huge efforts are working. With a continued effort at the present level there may be a substantial drop in Ebola victims. However, the great effort should be continued until there are zero cases of this disease. This is the type of disease that can be totally eliminated from the human population, and when there are no more cases there will be no more human sources of infection. There is the probability that Ebola will still be lurking in some wild animal population, but that source hasn’t been identified yet, and there may be several wild reservoirs. The transfer to humans is rare, but when it happens it can spread before it is recognized and can be devastating. The chart above shows how quickly Ebola can grow. It went from one death in December 2013 to over a thousand in three weeks in late November through early December 2014.

TIME magazine has designated its Person of the Year 2014 to be The Ebola Fighters.

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Ebola Virus Disease (EVD) logarithmic chart update

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Ebola monthly cases, Ebola monthly deaths, Ebola update, Medical efforts are working!, Possible hopeful signs

[Click here] for all of Probaway’s EBOLA Posts arranged by date. The recent posts will be at the top.

This logarithmic chart compares Ebola to deaths from Flu, AIDS, Plague, WW2, Mongols, and others. It shows past cases and deaths and monthly statistics. Click chart to make it bigger.

This monthly update of the Ebola epidemic in west Africa is sad because of the large number of deaths it represents, but it is strangely positive too. The surprising thing shown by the logarithmic type of presentation is a drop in monthly cases and deaths. This can be seen by comparing the December 1st number of Cases, shown in a red letter C to the letter C in earlier months. The black Ds represent Deaths. Although the total cases and deaths continue to rise the number of patients and deaths per month has been dropping for two months. There were still over a thousand deaths in November, but that is only half of two months ago in September.

Another positive indicator is that the large amount of money and personnel being invested on stamping out Ebola is now beginning to show. If the epidemic doesn’t explode, for some unexpected reason, the efforts now being deployed may bring this epidemic under control before next summer. That hasn’t happened yet, but if the huge effort can be maintained for a few months it might be ended. But it must be maintained at this high intensity for a while for that to happen, and any let up at this time could bring on another wave of disaster. There is another possibility that must be dealt with, and that is someone with the Ebola virus disease might have gone to another country totally remote from west Africa, and is at this moment already infecting others. A traveler might start another outbreak that might not be noticed until it had grown to where it needed another major effort to bring it under control.

How many days for Ebola to become symptomatic and infective?

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Charting Ebola, Ebola infectivity, Ebola symptoms, Eliminating Ebola, Protecting the US from Ebola, Telephone monitoring of potential Ebola carriers, Tracking potential Ebola carriers

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This chart presents an estimate for how long it takes Ebola to become symptomatic, given various levels of the number of viruses entering the body. The virus’s doubling time is about eighteen hours; thus if a single Ebola virus entered the body, at that rate it takes about thirteen days before the first fever strikes. A person infected with a large number of viruses, because they touched some virus-laden bodily fluids and then touched their own eyes, nose, mouth or open skin irritation, would display symptoms in only four days.

Until a person is displaying symptoms they are exposing the world to few if any viruses. The viruses only survive in a wet environment, and healthy people generally don’t spew wet particles, except when they sneeze. However, when the victim has an abundance of viruses in their body, they become sick and feverishly sweating, vomiting or having diarrhea they are exuding huge numbers of viruses in a wet material. When the viruses are wet they can survive for a long time. Even when an Ebola victim is dead their body is still being consumed by the viruses and their body is still exuding live viruses. That is why the funeral practices where the survivors touch the body puts those loving people at great risk of contracting the disease.

The time in days for Ebola to manifest serious symptoms and become highly infectious is dependent on the number of viruses they begin with.

The numbers on this chart are flexible, but they demonstrate why it is necessary to track all people who have been exposed to the Ebola viruses. Even a single virus can cause the disease, but it takes many days before it manifests any symptoms. People who are working with sick patients should be tracked very carefully, and the easiest way to do that is by issuing a cell phone and a thermometer to every exposed person. They could then be phoned a few times per day to check their temperature and general health. To help maintain their cooperation they should be told when issued the cell phone that they will be treated for any disease they contract in the next thirty days free of charge. There will be people who contract some disease and fail to mention it, but when they can not answer their phone, or refuse to do so, a person can be sent to the cell phone’s location. This procedure should discover nearly all victims, and only expense to the public is the price of a cell phone, a thermometer and a person monitoring their phone and temperature.

Ebola is a disease that can be totally eliminated from the human population, and usually it remains gone until it is reintroduced from some wild animal source. Since it has recently entered highly populated areas it has become more difficult to isolate, but that must be done. There isn’t much danger of Ebola getting totally out of control in advanced countries with fully functioning health care systems, but in those densely populated areas with poor medical facilities there could be a massive outbreak. Any major city slum anywhere in the world is presently at risk, and so this disease must be eliminated as quickly as possible. Until it is gone, a disaster is lurking for billions of people. West Point, Monrovia, Liberia had some Ebola cases, but this tightly packed slum hasn’t gone epidemic yet, so there is hope that the disease can be controlled.

A good medical overview of Ebola is found at Up To Date.

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A hazmat suit for Ebola or entering a hospital for voluntary surgery.

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Extreme hazmat protection, Hazmat suits, Hospital infection avoidance, Protection from Ebola

Two ways of surviving hospital induced infection was published in 2008, where there is a picture of a Tyvek suit. The idea was to put on a germ-resistant suit at home before going to the hospital for voluntary surgery. The surgeon would only open the suit at the point of incision. This would prevent germs getting into the wound, and thus avoid hospital induced infections.

At the moment the CDC is purchasing special kits to have instantly available to send to hospitals where they have an Ebola patient. The suit pictured below would not be sufficient protection for working as a nurse for this disease.

Tyvek coveralls

There are more total covering suits, like the Lakeland Interceptor Fully Encapsulated Front Entry Level A Vapor Protective Suit, Disposable, Blue.

Lakeland Interceptor Fully Encapsulated Front Entry Level A Vapor Protective Suit, Disposable, Blue

Today there are ads on Google for protective suits that are intended to protect the wearer from external infections. The white suit pictured above isn’t as completely covering as some of the newer models like the blue one. The head, hands, and feet are exposed, and the zipper may not be totally sealed, but the new ones are better. DuPont TY122S Disposable Elastic Wrist, Bootie & Hood White Tyvek Coverall Suit 1414, Size XLarge, Sold by the Each

In a short term desperate situation you could make a hazmat suit out of garbage bags and duct tape.

How to monitor potential Ebola carriers fairly but effectively.

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Protecting the US from Ebola, Telephone monitoring of potential Ebola carriers, Tracking potential Ebola carriers

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My friends were discussing the Ebola epidemic in West Africa, and I was bringing to the conversation some of my ideas for coping with it. There is a problem of talking about this subject because any response at all is thought of as hysterical. After all more people die here in America of almost any disease that has a name than have died of Ebola. So far there has only been one death, Duncan, and he wasn’t admitted into the hospital until he was deathly sick. Had he been admitted two days earlier when he first came to the Emergency ward, he probably would have been saved. Rehydration, both orally and intravenously, appears to be the critical factor for saving lives if it is begun as soon as symptoms appear.

The problem that people worry about is contagion. The official reports have stressed that an Ebola victim can not spread the disease until they are feverish, violently sick, spewing vomit and diarrhea. That seemed unrealistically optimistic to me, and I got into a heated discussion last week, when one of my friends got adamant about the official CDC reports. However, since then it was reported, rather quietly, that the CDC has changed its policy minimally from it can not be communicated until the victim is violently sick to it is unlikely to transmit. Another subtlety is the official declaration that a person does not have Ebola if they don’t present symptoms by 21 days after possible encountering some Ebola fluids. That period of time was defined by them as meaning 99% will show symptoms before 21 days, but their own data suggests perhaps one per thousand may not exhibit symptoms for 28 days. Also, the data shows that men’s semen may carry testable particles of Ebola for 90 days. These may or may not be infectious, but why take a chance with something so deadly?

Disturbing facts come to the fore when discussing these things with people, especially about medical staff returning from obvious contact with Ebola victims. The examples of nurse Kaci Hickox and doctor Craig Spencer are disturbing, because the nurse has refused to cooperate with attempts to limit her interaction with the public. The doctor, upon returning from a West Africa tour of treating Ebola patients, had in fact contracted Ebola, but was traveling all over New York City right up to coming down with symptoms. He is reported to be doing well, but that is because he got to the hospital promptly on presentation of symptoms. However, some person he contacted who doesn’t know they have been exposed to Ebola might continue going to work, or school, on public transportation even though they were very sick. They might become a super-spreader.

How can we hope to cope with this situation? How can we be fair to these people who have risked their lives to save people in West Africa, and yet protect our people here at home? I first suggested using those radios that are sometimes attached to the ankles of probationary convicts, but this brought about a howl of disapproval. I am not too enthusiastic about that method either, so I suggested issuing cell phones to people coming from Ebola-stricken areas. They would be given the phones and informed that they would be tracked for two months, so if they did develop Ebola there would be some information on who they contacted and who would be at risk. Also, they would be issued a thermometer and contacted a few times per day to check their temperature and general condition. This could all be done for fifty dollars per person, so the expense wouldn’t be great. Cooperation should not be a problem because it is minimally invasive, just carry a cell phone which most people do anyway, also take one’s temperature daily, which many people do routinely. Apparently, those of us who carry cell phones are already being tracked, so this is nothing new.

Millions of phones and thermometers are available and only a few thousand would be needed to do this form of monitoring.

The problem at present is that if someone becomes a super-spreader there won’t be any way of warning those most at risk, and a general alarm will go out, and then there will be hysteria.

How we can help Post-Ebola syndrome sufferers.

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Coping with Ebola, Ebola, Ebola home treatment, Ebola survivors, Preventing Ebola, Survivors can help others

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Surviving Ebola isn’t enough. The survivors are still at risk of other severe health problems and social rejection. ABC News reports “We are seeing a lot of people with vision problems,” Dr. Margaret Nanyonga, a psycho-social support officer for WHO, said at a conference in Sierra Leone last week. “Some complain of clouded vision, but for others the visual loss is progressive. I have seen two people who are now blind.” How can a newly blind person find a job and survive for long? They will probably die soon, and not even be counted as Ebola victims.

Even before they were deathly sick with Ebola many of these people were desperately poor, and after three weeks of not being able to make a living they will be beyond desperate. What help will come to these survivors when they return to their communities, where they are now outcasts and will not get much support? These are the people the WHO policy paper condemns; in Use of Convalescent Whole Blood or Plasma Collected from Patients Recovered from Ebola Virus Disease for Transfusion, as an Empirical Treatment during Outbreaks, paragraph 2.2, we read, “Potential donors should be informed that there will be no payment to them for their blood or plasma donation.” The survivors have no one to turn to for a job, or even for a handout, and now the representatives of the wealthy world of WHO are even refusing to pay them for their life blood. A rich person in New York who caught Ebola in the subway would give half their wealth for a pint of these outcasts’ blood.

WHO is promoting a terrible policy! Last week I wrote, “Ebola survivors are the most valuable people on Earth today.” These people can do many things that no one else on earth can do, because they are now immune to Ebola. They may be weak, but they have what it takes to survive Ebola. Most of the things these survivors can do don’t require a doctor’s degree, or a moon suit, and so these survivors should be well paid heroes, rather than outcasts.

Caring for a desperately sick person with Ebola is dangerous work for any other person, even in a moon suit, but an Ebola survivor can do that and should be well paid, not shunned, even by WHO. The Ebola emergency hospitals should be staffed with their recently recovered patients. They know the procedures after being there for a couple of weeks, and would require little training.

We must support Ebola survivors by giving them well paid work that only they can do safely.

Projecting the future of Ebola from November 2014 into 2015

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An 18 month Ebola projection, Ebola, Ebola projections, Ebola vaccine, flu, Plague, World War 2

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This logarithmic chart compares Ebola to deaths from Flu, AIDS, Plague, WW2, Mongols, and others. It projects the vaccine effectiveness in bringing the disease to zero. Click chart to make it bigger.

How does Ebola compare to other historical diseases and wars? This chart illustrates the risk to humanity of disease and wars, and demonstrates that there is little risk to humanity from Ebola at this time. It is unlikely that it will become as dangerous as the 1919 influenza epidemic that killed an estimated seventy million people.

The chart’s red and black lines are based on data publicly available from the World Health Organization (WHO). The yellow and red disks and the black Xs are based on published data. This data when plotted on a logarithmic chart forms a strikingly straight line. What I have done on the chart is to take the data point from 1 April 2014 and draw a straight line through it to the data point on 1 October 2014 and continued that line for double that time until 1 October 2015. That was done for the case line in red, and the death line in black. Those lines are totals to their dates labeled at the bottom, and when the epidemic is over those lines will become horizontal.

Below the red and black lines are red disks for cases and black Xs for deaths. These represent the number of cases for the preceding month. As the epidemic comes to an end these red disks and black Xs will trend toward zero. I have colored these projected possibilities in lighter colors, and shown them as trending upward until a vaccine is provided in quantity. When that happens the disease will trend back to zero quickly. The sooner an effective vaccine is available the sooner the trend line will roll over and dive to zero. Only when they reach zero and stay there can we relax our efforts to end the epidemic.

If Ebola went from a single case to ten thousand in ten months it has the potential to do that again, if it can get started. Hopefully the vaccines now in development will provide an effective protection for the public, and Ebola will become a disease of humanity’s history.

The flu is easy to catch, because it transmits easily through moist air, but Ebola usually requires physically touching an infected person’s bodily fluids, and that is easily avoided. Even so, being close to an infected person is dangerous, because it is easy to touch the virus-laden fluid and then touch your lips, and that is all that is needed to become infected. Until you have been vaccinated or actually survived the disease, the further away from an infected person you can stay, the less likely you are to catch Ebola.

Ebola is a deadly disease if the victim can not maintain bodily fluids because of diarrhea, but replacing fluids can be done in a hospital setting intravenously. That is why you want to get to a hospital immediately if you suspect Ebola disease. That intravenous procedure reduces the death rate to below ten percent. Home-bound victims can improve the chance of survival from near zero to probable by keeping hydrated. They can help hydrate themselves when sick by adding one teaspoon of salt plus eight teaspoons of sugar to a quart of water and drinking enough to maintain body weight. When a person is dehydrated they can not fight off infections and then they get much sicker and often die.

Until a vaccine is available – the only effective control of Ebola is the physical separation of the virus from people.

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Ebola traced to Meliandou, Guinea, and the carriers are revealed.

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Ebola, Ebola and flu confusion, Ebola dose related to survival, Ebola symptom progression, Ebola symptoms, Flu symptoms, Transmission of Ebola

EBOLA Response Roadmap Situation Report

WHO – 1st Chain of Transmission of Ebola: MELIANDOU chart showing Emile Ouamouno’s death as December, 28, 2013

This chart is new data from The World Health Organization, and I have gone back through my previous posts and changed the date of Emile Ouamouno’s death, gotten from earlier news sources, from December 4th to December 28, 2013. This new date comes from WHO and is likely to remain firm.

A surprising discovery shown by this chart from WHO is the high transmission rate of Emile’s grandmother, Koumba. She gave infections to the local city of Gueckedou, also to Dawa, Damdou, and to Meliandou, her home village of about 100 people, that now has a reported 14 deaths. That’s at least 9 people suspected to be infected by this one person. Although these people were from a remote village, they were travelers, and her nephew died in Conakry, a city of two million, over 300 miles away on dirt roads. He may be the source of the Ebola epidemic there. This is remarkable because the disease supposedly has a low transmission rate. The virus must remain in a carrier’s body fluid to survive. Koumba died only three days after onset of symptoms in the local hospital in Gueckedou.

The general assumption is that the disease is only transmissible during the fever, diarrhea, shock and dead stages, but in Koumba’s case that was only three days. It appears that people in this area don’t go to the hospital until they are very sick. If that is true then Koumba infected three people a day, and that seems like a high transmission rate, because the transmission rate must drop below one before the disease can be eliminated.

Until a vaccine is available – the only effective control of Ebola is the physical separation of the virus from people.

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Ebola survivors are the most valuable people on Earth today.

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Coping with Ebola, Ebola, Ebola home treatment, Ebola survivors, Preventing Ebola, Survivors can help others

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Ebola survivors can save humanity

1. Ebola survivors can save humanity from a worldwide epidemic.
2. Ebola survivors can give blood with antibodies that can help other people survive.
3. Ebola survivors can bring the Ebola epidemic back to zero new deaths.
4. Ebola survivors can begin essential cleanup work with little training.
5. Ebola survivors can safely work in Ebola clinics without PPE protections.
6. Ebola survivors can safely work with Ebola without extensive training.
7. Ebola survivors can leave a contaminated area with a complete wash and drying.
8. Ebola survivors can do work that is dangerous for others without supervision.
9. Ebola survivors can care for sick Ebola victims in their homes.
10. Ebola survivors can quickly go clean up effluvia from current Ebola sufferers.
11. Ebola survivors can immediately go bring Ebola victims to a hospital.
12. Ebola survivors can safely do the dangerous work of burying dead Ebola victims.
13. Ebola survivors can be studied for what helped them survive.
14. Ebola survivors can provide blood proteins for research on vaccines.
15. Ebola survivors can interview families with Ebola victims.
16. Ebola survivors can counsel family members who are at risk of having Ebola.
17. Ebola survivors can speak to the public to give them courage and suggestions.
18. Ebola survivors can distribute flyers to everyone and to risky areas.
19. Ebola survivors can distribute Ebola survival salt and sugar kits to sick people.
20. Ebola survivors can take food and necessities to Ebola sufferers.
21. Ebola survivors can test safely equipment for reliability and safety.
22. Ebola survivors can search for victims door to door, without causing moon-suit panic.
23. Ebola survivors can suppress the epidemic around before vaccines are available.
24. Ebola survivors can represent a cross section of a whole societies job resources.
25. Ebola survivors can be sources of survival rather than rejected as disease carriers.
26. Ebola survivors can be issued ID medallions so people know they are safe.
27. Ebola survivors can be well paid in money and honors.

In the World Health Organization (WHO) document Use of Convalescent Whole Blood or Plasma Collected from Patients Recovered from Ebola Virus Disease for Transfusion, as an Empirical Treatment during Outbreaks, paragraph 2.2, we read, “Potential donors should be informed that there will be no payment to them for their blood or plasma donation.” There are good reasons for that policy based on empirical observations in some first-world situations. It is a reasonable policy when rich people have idealist motivations for doing things. Their rewards will be a good feeling about their own self-worth and a community appreciation, and they will resent being given a small amount of money because it will degrade their idealism.

This Ebola epidemic is different and there may be no idealism available, and the only motive for a recently deathly sick person to let their blood be taken is to enhance personal physical survival. For the desperately poor places like West Point, Liberia, a few hundred dollars would be highly motivating and not thought of as demeaning. Also, they should be paid because there are many other diseases to which they are increasingly susceptible because they are in a weakened condition, and taking some of their blood weakens them even more. These Ebola survivors are risking their lives by giving blood, and should be greatly rewarded for doing so.

All of the categories of work listed above should be paid, and paid well, because they are doing things which no other people on Earth can do. The doctors and nurses and other trained people going over to West Africa may not be gaining anything monetarily, and they are doing it because they want to help. But their altruism and dedication will give them a tremendous boost emotionally and over the years they will have considerable status gains and that will lead to monetary ones, too. The previously sick people giving their blood will probably get no rewards other than the money, but they are giving a wonderful service to humanity by subduing the Ebola epidemic.

I would propose a world day of thanks, a Life Day, for all of those people who risked their lives to save humanity. Perhaps December 28th could be the combination day, a day of mourning for those lost their lives and a day of thanks for those who gave their help, and chief among these would be the people who gave their life blood so people will live whom they will never know.

Life Day – honoring those people who have risked their lives for humanity’s preservation.

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West Point, Monrovia, Liberia, responds to Ebola

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Ebola home treatment, Ebola salt sugar water, Ebola treatment kit

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Can Ebola be stopped where it already has a grip on a town? About a half square kilometer of sand called West Point will soon demonstrate to the world if seventy thousand people crowded together with few amenities can beat Ebola. There is a  poster campaign and plenty of word-of-mouth communication. The living conditions at West Point are poor for people, but they are ideal for Ebola.

Downtown Monrovia, Liberia, at the bottom and West Point peninsula at the top. 1km yellow line

West Point, Monrovia, showing the single road going the length of the peninsula. Seventy thousand people live here.

Central West Point has one road and very narrow passages between tiny homes. Center is at lat/lon 6.3274 -10.8060

For scale – there is a 10 meter yellow line to the right of the red roof in the lower right corner. There is a truck on the road at the bottom of the road, and a car at the top of it. Notice that there are no spaces between these homes because the roofs overlap.

From a sign posted in West Point:

 THE 10 COMMANDMENTS OF EBOLA

1. Thou shalt not HIDE ANY SICK person even family member or friend;
2. Thou shalt not SHAKE HAND or TOUCH someone with high fever who is very sick;
3. Thou shalt not TOUCH DEAD BODY even if it is your family member or friend who has died;
4. Thou shalt not PUT MAT DOWN for dead people not even your family member;
5. Thou shalt not EAT or DRINK from the same pan, place or cup with any family member, friend or anybody;
6. Thou shalt not allow anybody even family friend to spend time;
7. Thou shalt not HAVE SEX with strangers; be very careful of the person you have sex with, they could have the EBOLA virus — No sleeping around; Stick with the person you know very well;
8. Thou shalt not PEE PEE OUTSIDE, use a plastic bottle and wash your hands;
9. Thou shalt not TOILET OUTSIDE; use a plastic bag and wash your hands;
10. Thou shalt call this TELEPHONE NUMBER 4455 for Response Center #1 right away when you have a sick person or a dead body in your house.

What bothers me is that there is no mention of how to survive Ebola. The primary way a person not in a hospital can help themselves is to stay hydrated. Unfortunately, just drinking pure water doesn’t work because with severe diarrhea it goes right through. When a person has diarrhea they need to put 1 level teaspoon of salt and 8 level teaspoons of sugar into a liter of water. That water will stay in your system better.

Until a vaccine is available – the only effective control of Ebola is the physical separation of the virus from people.

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