Ebola - A perspective you might need to hear.

CDC just confirmed the first case, Guys READ THIS THREAD, IT'S IMPORTANT.

ebola will do nothing.

I knew that this was going to happen. It's predictable, knowledge of how the healthcare system works can tell anyone about how this will play out. This patient went to the ER symptomatic, and was sent home. Just like I said. American emergency medicine would treat this like the flu, or a cold, and that's exactly what they did. Basically he exposed everyone on the plane, everyone at the airport, everyone at his home, everyone at the ER twice.

Now CDC is in crisis mode. WHEN, this happens in my hospital, I will give you all an honest play by play on this thread, so look for it. In the meantime, don't forget what I said here, and feel free to ask me any questions you like.

US infrastructure is not what it once was.

Roads are failing, systems are failing, people don't do as good of a job as they once did. This includes hospital staff.

People are dirtier than they used to be and there are many areas in the US resembling the 3rd world.

Ebola will have better success in the US than it would have say, 20 years ago.

Just because it may not kill us down to the last (wo)man doesn't mean it's not going to blaze a trail of suffering here.

As soon as the relative of someone you know dies from ebola and you see the pain to the families yourself you will stop viewing it so objectively, "like a movie" and realize even dozens or hundreds, thousands dead is STILL tragedy.

Cant we just nuke Dallas?

Guys listen, this shit is scary. I get it, ok? I do. The human population of this world has always been kept in check by viruses, or some other method of sheer destruction. The Flu, Polio, Smallpox, you name it, these things have a purpose in nature. They keep populations under control.

Since the dawn of the industrial age we began to outsmart them all. We Vaccinate against the flu, we all but eradicated Polio in this country. We had beaten our enemies into near submission, and as a result, the worlds population has exploded. But our Genius is beginning to catch up with us. Anti-biotic resistant bacteria is on the rise, the flu is devising new ways to counter attack our defenses. And Ebola, well, lets just say it's doing what all viruses do. It's trying to survive, it's trying to find a way to use our own immune system against us. Think about this for a minute...

The Flu infects you, your body goes into defensive mode, realizing that it must expel the invader. So your own body fills your lungs with mucus and fluid, which forces you to cough. This is the real genius of the flu. It actually depends on your immune response to spread itself. And it doesn't have much time to do it either. Because your body begins to increase it's own temperature. Yes, having a fever is an immune response, not caused by the flu, rather it is literally your body attempting to make you so hot that the protein coat protecting the flu virus breaks down, allowing your white cells to attack.

This is what all viruses do. ALL of them. They find a way to exploit your natural immune responses to propagate themselves.

Ebola.... once just a hemorrhagic fever on steroids, now is a bona-fide menace. I work in a hospital laboratory at a major hospital in a major Metro Area. My wife works clinical micro for the same company. I'm very well versed in just about everything a STAT lab in a hospital can, and does do. My wife on the other hand, actually majored in micro, with emphasis on virology. So I wanted you all to know a few things about this outbreak that became apparent to us as it began to spread.

#1. Something has changed. This virus used to have a much shorter incubation period. And it would kill within a week. The mortality rate was much higher once upon a time. However, this is not the case anymore. Based on the sheer number of infected, the virus it seems, may have found a way to transmit itself easier. Typically when a virus "evolves" it gains in one area, while giving ground in another. It makes sense to me that Ebola gave up alot of it's lethality, for the ability to spread itself easier, and incubate much, much longer.

#2. Africa is a mess. There is no way to tell how many are infected. Once upon a time Ebola would strike a village and wipe everyone out, and that was it. It would kill so fast that it could not spread out of the hotzone. Because of what I said above that is not the case anymore. On a continent where borders still mean very little to the native population, it is a scary mix. Even if the CDC or the WHO wanted to get accurate numbers, it would be hopeless due to the unknown number or people that distrust western medicine, refuse to get help, or wander around from village to village. The infrastructure simply does not have the same capabilities we do in the west.

#3. Even in the United States, out of all the various hospitals I have worked at, there is no hope of containing anything like this. One of the largest hospitals I worked at only had two reverse flow isolation rooms. TWO, let that sink in for a minute. If this thing goes as bad as some think it will, we are, quite literally, screwed. Patients only show up to the hospital when they go symptomatic. So by the time they get there, they've already infected their entire family, their work group, and anyone they got within a few feet of on the way to the hospital. When they get there the ER nurses would treat it either like Flu, or Sepsis. But the whole time the patient is infecting all of them. And all of them, in turn, begin to infect everyone else in the exact same way. If this is as virulent as the WHO thinks it might be, by the time people realize what is going on, there will be more sick people than there would be beds available at every hospital in the US combined.

#4. Testing blood for anything is not as simple as looking under a microscope. And hospital labs are not set up for exotic virology. We run basic Chemistries, Cardiac enzymes, blood counts, sed rates, drug levels, bacterial cultures, all the basic hands on shit. The kind of things that old people usually present for, blood loss, infection, and cardiac events. Anything exotic gets sent out. Sometimes to the State lab, most of the time specimens get sent across the country to Quest Diagnostics, or to other organizations actually set up for it. Your average city hospital is pitifully, laughably, not ready for anything of this nature. Sure, running a CBC can tell if you are dehydrated, it can tell of you are loosing blood, it can tell if you are fighting "something" off. It just can't tell what. A sed rate can determine if you have excess inflammation, but it can't tell you why. A Lactic Acid level can indicate Sepsis, but it can't tell you from what. The point is, at the early stages of an outbreak, people will get treated for run of the mill things. Because nothing a hospital can test immediately will be able to tell anyone that you are carrying the most deadly hemorrhagic fever currently known. Honestly, if a person came into a busy ER with a fever, the triage nurse would put them in the waiting room until a non urgent room opened up in the back. They simply have no way to know who is carrying what.

I'm not saying we're all gonna die. This thing could fizzle out. And everything could be fine. What I am trying to illustrate here is that just because a lab exists in a hospital, does not mean that it can tell you everything. There are triage algorithms that work for everyday field medicine, but nothing for an outbreak. Thinking that living in a developed nation will curb the spread is ridiculous. If anything, it makes it worse. Our commute, our workplaces, our homes, our methods of entertainment, all of those things that we love so much about living in the the west, are the things that viruses depend on to spread.

If this virus truly has found a way to transmit easier, the healthcare system would be completely overloaded with something they simply can not handle.

Anyway, I'm not trying to scare anyone, I just hope people can be realistic about the capabilities of hospital containment, hospital laboratory testing, and the fact that the healthcare system, in ANY country, could not handle a massive outbreak.

So don't expect miracles from front line hospital staff, we don't have the tools, and we certainly do not have the manpower. Ask anyone in the medical field how much overtime they could work if they felt like it, don't even get me started on how thinly stretched people in the industry are. Though I suppose if this does turn into something, that will become apparent very, very fast.

Good luck, don't freak out, wash your hands, be prepared, hug your kids.

That is all.

I remember reading this thread in early August, then looking up the Wikipedia "2014 Ebola outbreak" page...

I put the data of cases vs. deaths in Excel and fitted an equation to the graph... with an R value of like 0.97 or something close. Which means this shit has reached close to exponential growth. (I'm not a statistician) but when shit doubles in size in 23.73 days it's exponential at some level.

I thought shit, why isn't there a graph on Wiki about this? The next day I swear there was a nice statistical interpretation on Wiki about the topic... and I did not write it.

The next number that comes into mind is the statistically significant number of cases (not deaths). This number is about 30 cases. When you reach 30 cases in any area you will need a super quantum computer to figure out all the connections/infections/links/contacts/future cases etc in the given area. Look up "6 degrees of separation" to learn more. A good example of this is Liberia, which was able to contain the Ebola virus under about 25 cases (I say 25, but I don't know the real number....)

Bottom line is this:

If we hit around 30 case in the US, you better have tomato plants in.

This guy got admitted to the ER twice. He's already exposed more than 30 people. Now it it's just a matter of how many contracted it. He didn't kust magically appear ar the ER. He passed people along the way, probably went for a brisk walk right when he started to feel bad.

30 cases? In a place like DFW, that's pretty conservative.

ebola will do nothing.

Guys listen, this shit is scary. I get it, ok? I do. The human population of this world has always been kept in check by viruses, or some other method of sheer destruction. The Flu, Polio, Smallpox, you name it, these things have a purpose in nature. They keep populations under control.

Since the dawn of the industrial age we began to outsmart them all. We Vaccinate against the flu, we all but eradicated Polio in this country. We had beaten our enemies into near submission, and as a result, the worlds population has exploded. But our Genius is beginning to catch up with us. Anti-biotic resistant bacteria is on the rise, the flu is devising new ways to counter attack our defenses. And Ebola, well, lets just say it's doing what all viruses do. It's trying to survive, it's trying to find a way to use our own immune system against us. Think about this for a minute...

The Flu infects you, your body goes into defensive mode, realizing that it must expel the invader. So your own body fills your lungs with mucus and fluid, which forces you to cough. This is the real genius of the flu. It actually depends on your immune response to spread itself. And it doesn't have much time to do it either. Because your body begins to increase it's own temperature. Yes, having a fever is an immune response, not caused by the flu, rather it is literally your body attempting to make you so hot that the protein coat protecting the flu virus breaks down, allowing your white cells to attack.

This is what all viruses do. ALL of them. They find a way to exploit your natural immune responses to propagate themselves.

Ebola.... once just a hemorrhagic fever on steroids, now is a bona-fide menace. I work in a hospital laboratory at a major hospital in a major Metro Area. My wife works clinical micro for the same company. I'm very well versed in just about everything a STAT lab in a hospital can, and does do. My wife on the other hand, actually majored in micro, with emphasis on virology. So I wanted you all to know a few things about this outbreak that became apparent to us as it began to spread.

#1. Something has changed. This virus used to have a much shorter incubation period. And it would kill within a week. The mortality rate was much higher once upon a time. However, this is not the case anymore. Based on the sheer number of infected, the virus it seems, may have found a way to transmit itself easier. Typically when a virus "evolves" it gains in one area, while giving ground in another. It makes sense to me that Ebola gave up alot of it's lethality, for the ability to spread itself easier, and incubate much, much longer.

#2. Africa is a mess. There is no way to tell how many are infected. Once upon a time Ebola would strike a village and wipe everyone out, and that was it. It would kill so fast that it could not spread out of the hotzone. Because of what I said above that is not the case anymore. On a continent where borders still mean very little to the native population, it is a scary mix. Even if the CDC or the WHO wanted to get accurate numbers, it would be hopeless due to the unknown number or people that distrust western medicine, refuse to get help, or wander around from village to village. The infrastructure simply does not have the same capabilities we do in the west.

#3. Even in the United States, out of all the various hospitals I have worked at, there is no hope of containing anything like this. One of the largest hospitals I worked at only had two reverse flow isolation rooms. TWO, let that sink in for a minute. If this thing goes as bad as some think it will, we are, quite literally, screwed. Patients only show up to the hospital when they go symptomatic. So by the time they get there, they've already infected their entire family, their work group, and anyone they got within a few feet of on the way to the hospital. When they get there the ER nurses would treat it either like Flu, or Sepsis. But the whole time the patient is infecting all of them. And all of them, in turn, begin to infect everyone else in the exact same way. If this is as virulent as the WHO thinks it might be, by the time people realize what is going on, there will be more sick people than there would be beds available at every hospital in the US combined.

#4. Testing blood for anything is not as simple as looking under a microscope. And hospital labs are not set up for exotic virology. We run basic Chemistries, Cardiac enzymes, blood counts, sed rates, drug levels, bacterial cultures, all the basic hands on shit. The kind of things that old people usually present for, blood loss, infection, and cardiac events. Anything exotic gets sent out. Sometimes to the State lab, most of the time specimens get sent across the country to Quest Diagnostics, or to other organizations actually set up for it. Your average city hospital is pitifully, laughably, not ready for anything of this nature. Sure, running a CBC can tell if you are dehydrated, it can tell of you are loosing blood, it can tell if you are fighting "something" off. It just can't tell what. A sed rate can determine if you have excess inflammation, but it can't tell you why. A Lactic Acid level can indicate Sepsis, but it can't tell you from what. The point is, at the early stages of an outbreak, people will get treated for run of the mill things. Because nothing a hospital can test immediately will be able to tell anyone that you are carrying the most deadly hemorrhagic fever currently known. Honestly, if a person came into a busy ER with a fever, the triage nurse would put them in the waiting room until a non urgent room opened up in the back. They simply have no way to know who is carrying what.

I'm not saying we're all gonna die. This thing could fizzle out. And everything could be fine. What I am trying to illustrate here is that just because a lab exists in a hospital, does not mean that it can tell you everything. There are triage algorithms that work for everyday field medicine, but nothing for an outbreak. Thinking that living in a developed nation will curb the spread is ridiculous. If anything, it makes it worse. Our commute, our workplaces, our homes, our methods of entertainment, all of those things that we love so much about living in the the west, are the things that viruses depend on to spread.

If this virus truly has found a way to transmit easier, the healthcare system would be completely overloaded with something they simply can not handle.

Anyway, I'm not trying to scare anyone, I just hope people can be realistic about the capabilities of hospital containment, hospital laboratory testing, and the fact that the healthcare system, in ANY country, could not handle a massive outbreak.

So don't expect miracles from front line hospital staff, we don't have the tools, and we certainly do not have the manpower. Ask anyone in the medical field how much overtime they could work if they felt like it, don't even get me started on how thinly stretched people in the industry are. Though I suppose if this does turn into something, that will become apparent very, very fast.

Good luck, don't freak out, wash your hands, be prepared, hug your kids.

That is all.

The OP is right in his assessment sadly. We are seeing the biginning of a pandemic of the likes never seen in this generation.

My opinion as well. Although if th incubation period is real, then we'll all find out about it in a few weeks.

ebola will do nothing.