20% Chance Of Ebola In USA By October; 277,124 Global Cases By Year-End, Model Predicts

Tyler Durden's picture

"There's nothing to be optimistic about," warns the professor who developed the Global Epidemic and Mobility Model to assess outbreaks, "if the number of cases increases and we are not able to start taming the epidemic, then it will be too late. And then it requires an effort that will be impossible to bring on the ground." As FredHutch reports, the deadly Ebola epidemic raging across West Africa will likely get far worse before it gets better, more than doubling the number of known cases by the end of this month, predicting as many as 10,000 cases of Ebola virus disease could be detected by Sept. 24 – and thousands more after that. “The cat’s already out of the box – way, way out," as the analysis of global mobility and epidemic patterns shows a rougly 25% chance of Ebola detection in the UK by the end of September and 18% it will turn up in the USA. "I hope to be wrong, he concludes, but "the data points are still aligned with the worst-case scenario."

 

Via FredHutch,

The next three weeks will be crucial to determining whether the Ebola outbreak is tamed or rages out of control, the experts agreed.

 

...

 

WHO officials have predicted as many as 20,000 cases of Ebola and laid out a “road map” for the outbreak response that calls for stopping the outbreak within six to nine months. But that’s only if a “massive” global response is implemented.

 

The scenario modeled in the new paper suggests that the actual number of cases could far exceed the WHO estimate – and far sooner. Vespignani said he and his colleagues are calibrating the model every couple of weeks to see whether there’s any change. So far, the answer is no.

 

“The data points are still aligned with the worst-case scenario,” Vespignani said. “It’s a bad feeling. I hope to be wrong.”

 

That’s a sentiment echoed by Longini, who said that he and other disease modelers are dismayed by what they see.

 

“There’s nothing to be optimistic about,” he said. “It’s frustrating. It feels like there should be a more concentrated international effort to help these countries.”

The latest counts Monday from the Centers for Disease Control and Prevention, which include WHO and Ministry of Health reports, put the total at 4,061 cases and 2,107 deaths.

The deadly Ebola epidemic raging across West Africa will likely get far worse before it gets better, more than doubling the number of known cases by the end of this month.

 

That’s the word from disease modelers at Northeastern University and the Fred Hutchinson Cancer Research Center, who predict as many as 10,000 cases of Ebola virus disease could be detected by Sept. 24 – and thousands more after that.

 

“The epidemic just continues to spread without any end in sight,” said Dr. Ira Longini, a biostatistician at the the University of Florida and an affiliated member of Fred Hutch’s Vaccine and Infectious Disease and Public Health Sciences divisions. “The cat’s already out of the box – way, way out.”

 

It’s only a matter of time, they add, before the virus could start spreading to other places, including previously unaffected countries in Africa and developed nations like the United Kingdom -- and the U.S., according to a paper published Sept. 2 in the journal PLOS Currents Outbreaks.

 

There’s a roughly 25 percent chance Ebola will be detected in the United Kingdom– and as much as an 18 percent chance it will turn up in the U.S. – by the end of September, the analysis of global mobility and epidemic patterns shows. The new paper includes the top 16 countries where Ebola is most likely to spread.

 

Though concerning, a spread to Western nations is not the biggest threat. At most, there would be a cluster of a few cases imported to the U.S., probably through air travel.

 

...

 

“We are at a crucial point,” Vespiginani said. “If the number of cases increases and we are not able to start taming the epidemic, then it will be too late. And then it requires an effort that will be impossible to bring on the ground.”

*  *  *
As we noted previously, this is anything but "contained"

*  *  *

As another epidemiolgist (and federal advisor) - Dr. Michael T. Osterholm of the University of Minnesotta - warns:

I’ve spent enough time around public health people, in the US and in the field, to understand that they prefer to express themselves conservatively. So when they indulge in apocalyptic language, it is unusual, and notable.

 

When one of the most senior disease detectives in the US begins talking about “plague,” knowing how emotive that word can be, and another suggests calling out the military, it is time to start paying attention.

There are two possible future chapters to this story that should keep us up at night.

The first possibility is that the Ebola virus spreads from West Africa to megacities in other regions of the developing world. This outbreak is very different from the 19 that have occurred in Africa over the past 40 years. It is much easier to control Ebola infections in isolated villages. But there has been a 300 percent increase in Africa’s population over the last four decades, much of it in large city slums…

 

The second possibility is one that virologists are loath to discuss openly but are definitely considering in private: that an Ebola virus could mutate to become transmissible through the air… viruses like Ebola are notoriously sloppy in replicating, meaning the virus entering one person may be genetically different from the virus entering the next. The current Ebola virus’s hyper-evolution is unprecedented; there has been more human-to-human transmission in the past four months than most likely occurred in the last 500 to 1,000 years. Each new infection represents trillions of throws of the genetic dice.

And finally, as Wired reports, the professor extrapolates:

In a worst-case hypothetical scenario, should the outbreak continue with recent trends, the case burden could gain an additional 77,181 to 277,124 cases by the end of 2014.

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HobbyFarmer's picture

Hey Miffed, I'm curious...how does the lab work get to you?  Say a sample of blood is taken from somebody in Seattle....is there a special carrier that transports this to your lab (or the CDC)? 

Or is it sent via USPS first class, this side up, handle with care?

Thanks!

Miffed Microbiologist's picture

I work in a clinical lab. We serve the patients that come to our hospital. If a doctor requests a test be done that we don't perform, the patient's specimen ( blood, tissue, body fluid) is sent to a reference lab that does the test. This can be in state or out of state. I send most to Texas and Utah to large reference labs, mostly for identification by sequencing or unusual antibiotic susceptibilities. So the specimens are often on planes, packaged by DOT protocols depending how lethal the specimen is. They are sent there by courier companies that have DOT certification. No, you can't just drop it off at the corner mail box and wave good bye. Probably a smart thing, huh.

Yes, I've sent bioterrorist agents I've isolated from patients on planes for analysis in other labs. If I keep it I house, I must provide proof I have destroyed it when I'm done so it doesn't fall into unsavory hands. Quite funny actually. If some shit head idiot wanted to make a bioterrorist weapon out of the things I have work with, he'd probably kill him first unless he had proper equipment to handle it. Even properly aerosolized, it would disperse rapidly to reduce its kill zone.

Newly emerging viruses are usually handled by State Public Health. If not, they go to the CDC. I would refer to the CDC representative to what to do at my local public health. Everything of that nature would have to be shipped out to a reference lab. Hospital labs are unequipped to deal with newly emerging pathogens and must defer to the research labs.

Miffed;-)

q99x2's picture

Oh man. Its been a long weekend without a ZH article on Ebola. Thought I wouldn't make it.

That's pretty scary but considering it is the best publicly available bio-weapon due to its accessability and shelf life is something even more scary that nobody is mentioning.

At least not while they have the M"Fn US/Mexican border wide F'n open.

Impeach Obama. Try him for war crimes. Arrest Jamie Dimon and Loyd Blankfein. Arrest the queen and hang her by her cloven hooves.

layman_please's picture

... and then? 

you actually named no-one of any significant importance. 

lakecity55's picture

Ring Ring!
Hello?
Agent HAffblack, is the border still open?
Yes, but look, all that's happened is a bunch of Mexicans.
Well, we have been brewing something up. Just a while longer...
OK
*click*

limacon's picture

Stay out of hospitals .

Even in normal times it is scary , See stats from CDC below.

http://www.cdc.gov/hai/surveillance/

Based on a large sample of U.S. acute care hospitals, the survey found that on any given day, about 1 in 25 hospital patients has at least one healthcare-associated infection. 

 


yogibear's picture

Many doctors don't wash their hands between patients.

Miffed Microbiologist's picture

And those are the proven cases. In reality, it's probably higher. Resistant aggressive microbes and a sick diabetic population is a disastrous combo. It makes for great job security, unfortunately.

Miffed;-)

Not Too Important's picture

I watched a live feed of a stenosis operation from a very prestigious hospital, and the doctor, one of the most respected experts in the field, bragged about it being so easy, he didn't even have to wash his hands between patients, and actually went from one patient to another to perform the operation while we watched.

A hundred bio-tech engineers were gasping. This fucker didn't give a shit about nothing, and certainly not about the health of his patients.

Even psychpaths can get through med school.

yogibear's picture

That should crush consumer demand.

Eateries and public places empty.

Avoid bars, elevators and getting close to other people.

knukles's picture

So the great wide open fresh air of the golf courses are safe!

(sarc)

Holy shot.  If this gets out of hand, can you imagine the television and radio.  Even Internet thingamajigge.  24/7/365 Fear Porn, stoke the fear, consolidate more power at the federal level, Lock-down America!  Ain't enough police and troopies (including the DHS) to keep order.  Best places to be will be middle of fuck all nowhere or next door to a Congresscritter... or with him in a DUMB

Not Too Important's picture

No football games, basketball, baseball, kid's sports, people's private space will extend to half a mile.

 

yogibear's picture

ISIS want to give the give the Christmas gift that keeps on giving to others. How many infected with ebola will cross into the US?

FieldingMellish's picture

The machines will continue to buy the S&P long after the last human drops dead. Mission accomplished.

Tenshin Headache's picture

Someone may have already posted, but the US has called a UN Security Council meeting for Thursday. Subject: Ebola.

Not Too Important's picture

The outcome has already been determined by those that control the UN. Everything from here on out is nothing but optics for the useless eaters.

Gotta get to 500 mil, stat.

joego1's picture

I'm a volunteer Firefighter, It would be a very tough thing to wiegh the risk of responding if this hit the US. I'm thinking there may not be emergency services at all in some places. .

IridiumRebel's picture

My wife was an ER Nurse and now runs a clinic....you'd see little show to work if this got going.

Jena's picture

A patient was admitted to a hospital in Ghana over the weekend with a fever and a diagnosis of rule/out Ebola. The staff promptly abandoned the facility and the rest of the patients.

http://www.ghanaweb.com/GhanaHomePage/NewsArchive/artikel.php?ID=325800

I wonder how healthcare workers here would respond if we had Ebola patients in most facilities and more coming through the ERs. Maybe many would continue to show up for their shifts but I am confident we'd see an attrition rate. An I wouldn't blame them.

Not Too Important's picture

99% would quit. There's always the 1% that want to commit some selfless act, even if it means suicide.

The barely sick will be all that's taking care of the really sick.

And once the healthcare system breaks down, people will just shelter in place until they survive or die. No point running through the streets looking for help no one wants to give. Or get shot.

 

MsCreant's picture

From the History Channel: After Armageddon

Takes us through a hypothetical pandemic flu outbreak through the experiences of a family. What was useful about it was they had a nutritionist, a sociologist, psychologists, epidemiologists, survivalists, and others, commenting as we moved through the "story" of what the worst case could look like.

https://www.youtube.com/watch?v=Eym4PwHmUvI

Oliver Klozoff's picture

I actually watched that this weekend. They should have taken the drama out of docudrama.

MsCreant's picture

I told my husband it was cheesey, but that we would have good conversation/planning as a result of seeing it together. You have to take it in that spirit, but I agree with you.

IridiumRebel's picture

It's subprime....it's contained.

 

blu's picture

Note to Tylers: nobody cares about this anymore.

IridiumRebel's picture

you forgot the sarc tag

HobbyFarmer's picture

nobody cares....because like subprime, it is contained?

blu's picture

Nobody cares because it's just another conspiracy thing anyway. Scary .GOV TLA thing from DHS and the CDC UN NWO WHO trying to drum up moar moneez for their algore climate hockeys. Or some random noise I cant keep track of.

 

ANNNND back to lurkville until some serous SHTF. But yeah you guys have fun.

Urban Redneck's picture

Of course, nobody cares when the first properly qualified calculation of R0 is done, and they come back with a projection of 77,181 to 277,124 cases in 2014 with the qualification that if they miss, it is because their estimations are low due to under reporting... because everybody is exhausted from reading all the crappy studies done previously.

http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20894

Our analysis is not exempted of limitations. First, the epidemic is ongoing in multiple geographical locations, and no simple mixing matrix can capture the complex geographical patterns of spread in the region. Second, cases may be under-ascertained, and hence reported cases may represent only a portion of the total number of infected individuals. However, our estimates of the reproduction number *[and only the repoduction number]* are not affected whenever the diagnosis and reporting rates have not dramatically changed over time. Third, the reporting delays are known to induce a downward bias in incidence in the latest observation, which can complicate real-time analyses. Several studies have successfully addressed this bias [19-22], but we were unable to incorporate this delay into our analyses due to a lack of empirical data to characterise the reporting delay distribution.

Cthonic's picture

Nice catch.   Here I thought the biostatisticians would be using statistical methods to estimate heteroscedasticity, undercounting and reporting delays, and make projections therefrom.  Also, you think they could round the number of significant digits in their projections.  77,181 to 277,124 really?  Is that supposed to sound 'more accurate' than 200k ± 100k !?  Not.

Urban Redneck's picture

Back in the Dark Ages when I hung around a few institutions of higher "learning" - if you wanted to write at a postgraduate level, the ground rules were fairly simple (regardless of field or specialization).

1) If the words are important, they better be in there.

2) If the words are not actually important, remove them.

If a calculation (much less the entire focus of a paper) is based off an assumption, which if it does not hold to be true, renders the calculation meaningless, it's pretty damn important. One sentence is not too much to ask for, except in an idiocrasy.

MsCreant's picture

Blu titted effigy bait.

blu's picture

Consider it a public service.

Oh and one of these days remind me to tell you about my theory of collective delusion and the importance of mental blind spots. Until then please try not to die. 

snblitz's picture

Ebola is already "transmissible by air".  Lookup the definitation of "airborne" as it pertains to desease propagation. Droplet size matters.  And even if you want to accept the definition used by "doctors" I would not want to bet my life on a 50% roll of the dice.

Quaderratic Probing's picture

 You mean we could die before we get to nuke each other. 

knukles's picture

They're taking everything away from us!

Dead Man Walking's picture

Bring out your dead...

Everybodys All American's picture

ekm1: So instead of banker's suicides it would apear as though the choice is to kill off all the customers and confiscate their assets with a widespread epidemic of Ebola.

Not Too Important's picture

The people that put up the Georgia Guidestones weren't the poor type. No, that took some coin, and they're coming after yours.

Lost Word's picture

Everybody ... Ebola, It is Too slow a method.

Try Instant death ... Nukes.

foodstampbarry's picture

Clearly are southern border should be wide open to slow the spread... Clearly.

Not Too Important's picture

And give them birthday cakes as they come across:

'AZ Sheriff: Border Patrol Baking Birthday Cakes' http://www.breitbart.com/Breitbart-TV/2014/09/11/AZ-Sheriff-Border-Patro...
p00k1e's picture

As long as Apple doesn’t have your fingerprints in their database….

Once people start dropping like flies from Ebola, we will be able to switch identities.  We can have this self die as an Ebola victim and pick-up the identity of an Ebola victim. 

Think about the moola, etc.... 

Lost Word's picture

Are you going to take their ID off their dead body?

Dre4dwolf's picture

How can we make $$$$ off Ebola?

-Short Health Insurance companies?

-Long Medical Equipment and Hazmat gear manufacturers? 

-Long Linen Textiles?

-Short financials

-Long gold/silver

-Short BTC

-Short Cruise Liners

-Short Airlines

-Long Remote Real-estate

-Long Coffin Manufacturers