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Discussion topic: Why Outside Countries are Not Doing More about the Ebola Outbreak

Re: Discussion topic: Why Outside Countries are Not Doing More about the Ebola Outbreak

These military assets will most likely involve the the U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID) out of Fort Detrick.
 
Re: MSF request for military help exposes severity of Ebola outbreak - Obama commits "US military assets" for set-up & health care worker security

Re: MSF request for military help exposes severity of Ebola outbreak - Obama commits "US military assets" for set-up & health care worker security

Sending US military troops to support public health efforts to stop Ebola in W. Africa is going to be a tough sell to Americans who remain largely ignorant of the threat the virus poses to the region and the world in the coming months.
 
Re: Discussion topic: Why Outside Countries are Not Doing More about the Ebola Outbreak

Laidback Al said:
etudiant, I agree with JJackson's perspective. There are non-pharmaceutical interventions that can be implemented that could slow the infection rate. An important one is an education program to help local populations understand the nature of Ebola transmission.

JJackson, I appreciate your verbal imagery. "[Ebola] will just keep pushing tendrils into virgin territory."
Click to expand...

The problem with non pharmaceutical educational interventions was previously identified by another poster, one with very extensive local experience, who flat out said that education is such a slow process that it could not really help this situation. Absent pharmaceuticals, the influx of foreigners just adds more targets likely to expand the reach of the epidemic. A crash program for at least partially effective drugs is a must and a prerequisite.

A much more restrictive air traffic monitoring regime for the entire region would seem a logical first step in trying to limit the spread of this disease, but no action appears imminent and the 'tendrils' are still pushing out. Of course, the world health authorities have also stood by as Chikungunya spread world wide since its initial manifestation in Tanzania in the 1950s, so such restrictions are probably off the table.
 
Re: Discussion topic: Why Outside Countries are Not Doing More about the Ebola Outbreak

Laidback Al said:
An important one is an education program to help local populations understand the nature of Ebola transmission.
Click to expand...

I actually think that the local authorities have done reasonably well in terms of trying to educate the public.

A few hours on the African forums reveal the problem. The citizens simply don't believe the authorities, and for dang good reason. Many citizens have the craziest ideas you could ever imagine. Whatever some of them are smoking, I don't want any!

I'd add a #5 to the OP's post: For other nations to try to mitigate their situation, there is a sociological mountain to climb. It looks insurmountable to me.

Politics, tribal affiliations, burial customs, illness customs, extreme distrust of all authority, disbelief that Ebola even exists, belief that it's a plot for the government to get international aid for themselves: on and on. Certainly a person with awareness of the situation would consider donations as dropping money down a bottomless pit.

It looks like a perfect storm for getting our butts kicked in a most unpleasant way.
 
Re: Discussion topic: Why Outside Countries are Not Doing More about the Ebola Outbreak

I agree with Lynda and Etudiant... maybe help and education would work in stable conditions but I think in the middle of an epidemic like this it can't. Terrified people don't think rationally even in the western world.
 
Re: MSF request for military help exposes severity of Ebola outbreak - Obama commits "US military assets" for set-up & health care worker security

Re: MSF request for military help exposes severity of Ebola outbreak - Obama commits "US military assets" for set-up & health care worker security

Ray said:
Sending US military troops to support public health efforts to stop Ebola in W. Africa is going to be a tough sell to Americans who remain largely ignorant of the threat the virus poses to the region and the world in the coming months.
Click to expand...

If this were about educating the ignorant, there would be no problem. But I think the you more you educate, the more questions US citizens will have about who should foot the bill for security services.

http://www.theperspective.org/2014/0414201401.php
World Bank Wants Poor Countries to Monitor Flawed Contracts
By J. Yanqui Zaza
The Perspective
Atlanta, Georgia
April 14, 2014

...

Yes, under the watchful eyes of the World Bank, President Sirleaf canceled the Block # 13 oil agreement signed between Liberia and a Russian Company, and awarded a new contract to an American Company. The former speaker of the Liberian House of Representative, Edwin Snowe sought an explanation. In response, President Sirleaf stated that America did not want a Russian Company to be operated between two American Companies operating Blocks # 12 and Block # 14. Of course, the American Embassy in Monrovia refuted the explanation...
Click to expand...

http://nationalchronicleliberia.com/news/politics/940/neyor-refuses-to-shake-robert-sirleafs-hand/
17.07.2014 | 19:47 PM

...

The row, which has drawn in mega oil companies, such as ExxonMobil, the largest American oil company, and Gazprom, a Russian company, over the purchase of block 13 from the Canadian Oversea Petroleum Limited (COPL), led to the fierce business battle between Neyor and Robert Sirleaf.

Neyor, according to information, brought in the Gazprom to purchase the block, at a cost of US$125 million, which would have raised more revenue for the government. On the other hand, Robert Sirleaf chose to side with ExxonMobil to purchase block 13 for US$50 million. This caused the government to lose US$75 million in needed revenue, but kept the stability of the country. The sale, which went on the side of the Americans, brought relief to the country in many ways...
- See more at: http://nationalchronicleliberia.com...ke-robert-sirleafs-hand/#sthash.7fZ3Nuxk.dpuf
Click to expand...

So is the use of the military in Liberia part of the a promise to provide relief and 'stability' to Liberia in exchange for the $75 million loss they took on the Exxon deal?

Or maybe the obligation goes further back.

http://www.propublica.org/article/follow-the-money-payment-trail-reveals-challenges-of-ridding-liberia-of-cor
Follow the Money: Payment Trail Reveals Challenges of Ridding Liberia of Corruption

by Johnny Dwyer, Special to ProPublica , Feb. 22, 2012, 9 a.m.
This story was co-published with Foreign Policy.
...
No one has been prosecuted or charged with wrongdoing for the alleged bribes. According to a cache of U.S. diplomatic cables obtained by ProPublica under the Freedom of Information Act, both Sirleaf and the U.S. State Department pushed for the three allegedly tainted concessions to be sold to Chevron even after the allegations became public. ExxonMobil is now zeroing in on the fourth concession. These transactions give U.S. companies potentially rich new oil reserves, and the Chevron deal alone marks the largest concession in Liberia's history, according to one of the diplomatic cables. ..
Click to expand...

Back to the Exxon deal:

http://www.frontpageafricaonline.com/old/businesstech/marketfinance/5641-liberia-oil-block-13-set-to-seal-this-week-exxon-mobil-copl-in-ny-to-wrap-pact.html
Liberia Oil Block 13 Set to Seal This Week: Exxon Mobil, COPL in NY to Wrap Pact Written by FPA Staff Report Sunday, 31 March 2013 22:00
...

Once the discussions in New York are finalized this week, working interests in the block will be turned over to ExxonMobil as the key operator. As part of the deal, USD 50 Million will be received immediately upon ratification and printing into handbills includes USD21.25 Million, one of the highest Liberia oil block signature bonus yet.

“This amount of USD21.25 Million is also the largest ever upfront payouts to a non-producing country in the world. Up until now, it may interest you to know that the largest signature bonus Liberia has received for a single offshore oil block is USD3.33 Million The rest of the USD50 million is paid for taxes and transfer fees,” according to Randolph McClain, Chief Executive Officer of NOCAL.

Liberia’s negotiating team has also secured a 5% Citizen Participation Share in LB-13. “Simply put, if exploration and development in LB-13 are successful, revenues would be available to share with citizens. This will be at no cost to the citizens, NOCAL or to the Government of Liberia, after ExxonMobil and COPL have recovered their exploration, development and production costs the share could generate dividends to the citizens from the oil production. This is real profit for the people of Liberia.”
Click to expand...

I'm sure that deal will be profitable for a few people. It was an amusing coincidence that Exxon pledged a whopping $75,000 to fight Ebola in Liberia after saving $75,000,000 over the competing offer thanks to US intervention. :magnify:
 
Re: Discussion topic: Why Outside Countries are Not Doing More about the Ebola Outbreak

Shiloh said:
Article on US military assets that can fight an outbreak: http://www.examiner.com/article/u-s-troops-to-intervene-ebola-fight
Click to expand...

from the article:

The BBC reported Sept. 8 that the British military is sending troops to Sierra Leone as part of the efforts to combat Ebola. Combat engineers are expected to build a 62 bed hospital near Freetown for Ebola patients, and military medical personnel have been detailed to help staff the new hospital. The BBC states that the hospital is expected to be functioning in about six weeks.
Click to expand...
By my calculations in six weeks, if there is no decrease in the rate of infection, by the time the hospital is built there will be 400 cases a week in Sierra Leone. The hospital will be overwhelmed in days.
 
Re: Discussion topic: Why Outside Countries are Not Doing More about the Ebola Outbreak

Yes that 6 weeks bit caught my eye too. It smacks of a lack of understanding of situation on the ground. What we need is tent field hospitals that can be quickly erected and moved to new flash points a la MASH.
 
Re: Discussion topic: Why Outside Countries are Not Doing More about the Ebola Outbreak

etudiant said:
The problem with non pharmaceutical educational interventions was previously identified by another poster, one with very extensive local experience, who flat out said that education is such a slow process that it could not really help this situation. Absent pharmaceuticals, the influx of foreigners just adds more targets likely to expand the reach of the epidemic. A crash program for at least partially effective drugs is a must and a prerequisite.

A much more restrictive air traffic monitoring regime for the entire region would seem a logical first step in trying to limit the spread of this disease, but no action appears imminent and the 'tendrils' are still pushing out. Of course, the world health authorities have also stood by as Chikungunya spread world wide since its initial manifestation in Tanzania in the 1950s, so such restrictions are probably off the table.
Click to expand...
Education is tricky and needs to be done in parallel with everything else. Out-reach to community leaders/chiefs/religious leaders, who have the trust of their local population, must be attempted so they understand transmission and can guide others. National politicians and foreigners are not the best way to go. While some foreign HCWs will continue to get infected their overall effect will be to slow the rate of spread - which is what we need at present.

Air traffic is a problem for global spread and most of it into the core countries has already been stopped but it will not help much. Those who want or need to travel will find a way out to a neighboring country and travel from there. Screening of passengers will only find those who are beginning to be symptomatic but not those who are infected but not yet ill. These are the bigger problem as they will start with flu like symptoms and be infectious before they realise why they are becoming ill. Given the area most will probably think it is a malarial re-appearance until the symptoms get past that stage.

Drugs may help in the future but not on the needed time scale. Development of treatments in the pipeline is being accelerated but scaling up production to the required levels is not realistic unless we assume this is going to be spreading for years, which it will if we do not get on the ground in numbers with the procedures that we know work now. There is no current evidence that any of the pharmaceutical interventions have any benefit, outside of the animal models, and doing nothing until we have enough of them to find out if they work is a recipe for a global disaster.

Chick, Dengue/DHF and Malaria are all vector diseases, and consequently much more difficult to deal with, and not really comparable to an H2H epidemic.
 
Re: Discussion topic: Why Outside Countries are Not Doing More about the Ebola Outbreak

Re: PPE hoarding:

During H5N1, 3M became very deeply backordered on many items, especially masks. 3M dealers were price gouging, and shipments were being directed to "favored" accounts.

Other manufacturers had production backups, too.

The void was filled by "scammer" masks of the worse sort. They were without NIOSH approval or any semblance of quality.

I doubt those with inventory of these items are anxious to ship them off.
 
Re: Discussion topic: Why Outside Countries are Not Doing More about the Ebola Outbreak

The Ebola outbreak is different that a novel influenza outbreak. By definition, aerosol transmission is a key aspect of influenza infection. So far, there is no official evidence that individuals can be infected by aerosolized transmission of Ebola. Preventing contact with bodily fluids from an individual infected with Ebola will be far more effective than wearing an N95 mask.
 
Re: Discussion topic: Why Outside Countries are Not Doing More about the Ebola Outbreak

The line between a droplet and an aerosol is pretty thin, and a subject of controversy.

http://www.medscape.com/viewarticle/741245_3

If an actual aerosolized particle hits you in the mask, it might or might not work. If it's a droplet, the mask is pretty good.

Masks do a great job of keeping people from touching their face, too.
 
Re: Discussion topic: Why Outside Countries are Not Doing More about the Ebola Outbreak

"Osterholm commended groups like Doctors Without Borders but said uncoordinated efforts by individual organizations are no match for Ebola spreading swiftly through urban areas.

"This is largely dysfunctional. Nobody's in command, and nobody's in charge," he said. "It's like not having air traffic control at an airport. The planes would just crash into each other."

http://www.cnn.com/2014/09/12/health/ebola-airborne/
--------------------------------------------------------------------------------------------------------
"Not only neighboring countries but also Europe and the US will have to support the fight against the epidemic, WHO's Chaib demands.

Then it might be possible to win this fight.

The key to getting a grip on the epidemic is to stop the transmission of Ebola, especially in healthcare workers, she says.

Creating Ebola centers in the communities themselves will stop Ebola patients and their family members moving around and infecting other people."

http://www.dw.de/ebola-threatens-to-destroy-sierra-leone-and-liberia/a-17915090
 
Re: Discussion topic: Why Outside Countries are Not Doing More about the Ebola Outbreak

Laurie Garrett, a senior fellow for global health at the Council on Foreign Relations, said her initial reaction when told that the U.S. military would become involved was "Hallelujah ? the cavalry's coming."

However, she called the commitment of $22 million for a small field hospital "deeply disappointing. There is no organization on the planet that can mobilize or handle actual logistics better than the U.S. military."

"No one is better suited for the job" of providing support for combating a fast-spreading disease, Garrett said. "I'm deeply disappointed if this is the sum total of what the military is prepared to do."

I too am appalled at the miserly response of my country, especially when I think of just how much money the Congress was able and willing to hand over to the bankstas to avert a financial crisis, how quickly they did so and that it was done with almost no oversight or control.

It seems to me that the international community must come at this with a "worst case scenario" mindset and such a response might prevent that worst case notion from becoming a reality. I don't know if enough leaders have the courage to say that this is a challenge like no other that humanity has ever faced. I do know that I would not like to hear, after the fact of millions dead, "Oh, if only we had (known) (cared) (tried) etc.

My emails to my elected representatives may have been nothing more than a few wasted minutes on a Saturday morning but I hope not.
 
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