Post #88,535
3/15/03 11:29:14 AM
3/15/03 11:55:50 AM
|
Scary
The one point that people are missing is that the WHO is not in the habit of issuing international alerts lightly. This is their first in a decade. For all of the publicity over Ebola, they don't issue this kind of alert for Ebola outbreaks.
We have an unknown highly contagious airborne disease without known cause (suspected viral - anti-biotics don't work and if it is new then treatments will take years to develop) which is frequently lethal and has spread to multiple countries. It has no problem infecting people whose immune systems are not compromised. It started in an area where diseases are known to cross over from animals to people. Hence the periodic worry about "bird flus" there. The last time a strain of flu made that cross-over was around WW I and the resulting plague killed more people than WW I. You see, a disease newly crossed over to people is poorly adapted to its host. A more informative description of a poorly adapted disease is highly lethal. Well-adapted ones walk the line between exploitation and killing. Poorly adapted ones either don't find that balance - if they manage to exploit at all they wind up killing far too often.
This outbreak may wind up contained fast. It may wind up infecting much of the world with most left knowing someone who died from it. The WHO alert is because they fear that there isn't much possibility of anything in between. And the worst case scenario, well historical plagues have been known to kill 25-90% of the population. (The Black Plague killed about a quarter. Estimates of deaths among the natives from flus brought by the Spaniards are in the 90% range.)
If this turns up reported in another 10-20 major cities around the world without any successful treatment being identified, it might be a good time to consider a long hike nowhere near major population centers. If it manages to achieve uncontrolled spread in one or two of those cities, get scared.
Lemme go see what the WHO have to say about this.
Their first alert:
[link|http://www.who.int/mediacentre/releases/2003/pr22/en/|http://www.who.int/m...ses/2003/pr22/en/]
They have an update today:
[link|http://www.who.int/mediacentre/releases/2003/pr23/en/|http://www.who.int/m...ses/2003/pr23/en/]
It has been reported in 8 countries so far. It has been identified on a flight from a 9'th country to a 10'th. The last flight in question originated this morning from the city where I live. Which means that it was at least in the airport. They want all airlines to be aware of the symptoms, and to immediately isolate any person spotted with them. No geographic region at present has sufficiently many cases to justify not travelling there.
That doesn't look good...
Ben
"good ideas and bad code build communities, the other three combinations do not"
- [link|http://archives.real-time.com/pipermail/cocoon-devel/2000-October/003023.html|Stefano Mazzocchi]
Edited by ben_tilly
March 15, 2003, 11:55:50 AM EST
|
Post #88,537
3/15/03 11:38:57 AM
|
CDC (typical conservative) response
[link|http://www.cdc.gov/travel/other/acute_resp_syndrome_eastasia.htm|http://www.cdc.gov/t...rome_eastasia.htm]
Many fears are born of stupidity and ignorance -
Which you should be feeding with rumour and generalisation.
BOfH, 2002 "Episode" 10
|
Post #88,543
3/15/03 12:36:19 PM
3/15/03 1:27:41 PM
|
How do you assess the risk?
If it is what the WHO fears, by the time you have positive proof, there is no way to contain it.
If you look at is as a disease, we have multiple reports of sick people, no identified disease organism or proof of mode of transmission, and only a handful dead. This is a crisis?
Given the potential consequences I am inclined towards the WHO's frame of mind. Theirs is the public health perspective, not the medical one. And I am minded of the fact that, publicity notwithstanding, public health has saved more lives than modern medicine. (Clean water supplies save more than antibiotics!)
Cheers,
Ben
PS D'oh. I got corrected by my wife. The CDC is a US organization, not a UN one. Both take a public health perspective. My speculation is that since the problem has not been reported in the US, the CDC has to trust that the problem will be contained, so their mandate is to avoid undue public panic and keep a good outcome having been seen as crying wolf. The WHO by contrast needs to motivate resources to achieve containment.
PPS My wife's comment about this is that what is reported so far is scary, and events in the next week are likely to be telling as to whether it dies down and will be succesfully contained or whether it will succeed in achieving a wider distribution.
"good ideas and bad code build communities, the other three combinations do not"
- [link|http://archives.real-time.com/pipermail/cocoon-devel/2000-October/003023.html|Stefano Mazzocchi]
Edited by ben_tilly
March 15, 2003, 01:27:41 PM EST
|
Post #88,549
3/15/03 1:47:09 PM
3/15/03 1:47:49 PM
|
Next week will tell the tale
We had a mini house council earlier. I live with a bunch of International students, including one from China and two from Korea... though they've all been here for at least two and a half months. OTOH, we've had five people go through the house who were in T.O. in the last week, including one of the tenants. It's extremely unlikely that any of them were exposed, but not impossible.
If we start seeing widespread infection in Toronto next week, it will be time to go from yakking to doing... if it's quiet by the end of next week (say, maybe a dozen or so more infections from contact with the initial family) then it might be OK.
... fixed typo. JT
--\n-------------------------------------------------------------------\n* Jack Troughton jake at consultron.ca *\n* [link|http://consultron.ca|http://consultron.ca] [link|irc://irc.ecomstation.ca|irc://irc.ecomstation.ca] *\n* Kingston Ontario Canada [link|news://news.consultron.ca|news://news.consultron.ca] *\n-------------------------------------------------------------------
Edited by jake123
March 15, 2003, 01:47:49 PM EST
|
Post #88,602
3/15/03 9:59:52 PM
|
I wouldn't worry about Toronto
If in the next week you continue to hear about isolated cases, but there is no sign in Hong Kong and Singapore of thousands getting sick, and there aren't a long list of cities popping up from which vectors seem to originate, then it almost certainly is contained.
I would personally be concerned if there is a city somewhere which is reporting thousands rather than hundreds. Or if the number of cities with outbreaks of a hundred or so keeps on growing. Either would indicate to me that despite public health efforts, it is continuing to grow towards a critical mass.
So if in a week there are 100 cases in Toronto but no new big centers of outbreak get reported, I would be comfortable. If in a week Toronto is clearly under control but Hong Kong is not, I would be worried.
Also I would like to note that being in a city of millions with an outbreak of hundreds is a small risk. Unless, of course, you are either working in the medical field or the outbreak takes off.
Cheers,
Ben
"good ideas and bad code build communities, the other three combinations do not"
- [link|http://archives.real-time.com/pipermail/cocoon-devel/2000-October/003023.html|Stefano Mazzocchi]
|
Post #88,637
3/15/03 11:41:58 PM
|
I'm not... yet.
As I said, the next week or so will tell the tale. It's been reported that the family that was sick made two separate visits to emerg before they were taken in; it was only on their third visit that they were admitted and put into isolation. If it's as infectious as it appears, that could mean major numbers of people have been exposed. OTOH, now that the health unit there knows what they're dealing with, they're taking all reasonable steps to find people who may have been exposed and bringing them in.
--\r\n-------------------------------------------------------------------\r\n* Jack Troughton jake at consultron.ca *\r\n* [link|http://consultron.ca|http://consultron.ca] [link|irc://irc.ecomstation.ca|irc://irc.ecomstation.ca] *\r\n* Kingston Ontario Canada [link|news://news.consultron.ca|news://news.consultron.ca] *\r\n-------------------------------------------------------------------
|
Post #88,539
3/15/03 11:50:34 AM
|
Yes, this is not good, not good at all
Just read today's WHO update. \r\n\r\n We're overdue for a "flu" outbreak... this could be it. \r\n\r\n The really bad news is that apparently the people in Toronto made it to their house before they got sick. Potentially, all the people they were in contact with, from passersby at the airport, transportation (bus, taxi), and, depending on how long they've been back in the country, any oother people they may have contacted since then. \r\n\r\n Even more disturbingly, it's also been reported in British Columbia. \r\n\r\n The [link|http://www.cbc.ca/stories/2003/03/15/pneumonia030315|news story on the CBC website] also mentions that the number of health care workers in Hong Kong who got infected from the US businessman on his arrival from Vietnam has now risen to over 50. It looks like this disease is highly contagious. --\r\n-------------------------------------------------------------------\r\n* Jack Troughton jake at consultron.ca *\r\n* [link|http://consultron.ca|http://consultron.ca] [link|irc://irc.ecomstation.ca|irc://irc.ecomstation.ca] *\r\n* Kingston Ontario Canada [link|news://news.consultron.ca|news://news.consultron.ca] *\r\n-------------------------------------------------------------------
|
