Ebola Summary of Cases, Deaths, Discharges, and CFR (8,756 cases and 4,579 deaths as of ~10/8/14)

[JimO]

Re: Ebola Summary of Cases, Deaths, Discharges, and CFR (5,391 cases and 2,628 deaths as of 9/13/14)

Re: Ebola Summary of Cases, Deaths, Discharges, and CFR (5,391 cases and 2,628 deaths as of 9/13/14)

Someone has pointed out that the table I have been updating could be misleading regarding the actual CFR, so I wanted to provide some qualifications regarding the numbers I am reporting.

Sierra Leone - They regularly report the number of cases, deaths, and discharged patients; however, not all the data is updated in every report, so there are times when the number of deaths, for example, might come from a WHO report because that number is highest, while other data comes from the MoH reports. However, the most glaring problem with their data is the number of cases that have to be listed as "In Treatment" because that is what remains when I subtract deaths and recovered cases from total cases. I don't believe they have the capacity to treat 800+ patients. Most of those are cases with no outcome. However, the number listed as "In Treatment" are not used to calculate the CFR.

Liberia - Liberia's data is not very reliable. For example, between situation reports 116 and 118, the total number of deaths decreased by 70 while the number of cases listed still increased. Although Liberia reports the number of cases in treatment in their situation reports, the number varies widely and has been as low as 49 in recent reports. We know that sick people are being turned away and that their treatment centers are over capacity. Therefore, the number of cases "In Treatment" is likely underestimated. Because they don't report discharged cases, the only option for estimating a CFR is to assume that discharged cases are total cases minus both deaths and cases in treatment. Thus, discharged cases will be overestimated if the cases in treatment are underestimated.

Guinea - Guinea probably has the most accurate numbers for several reasons. First, they began detailed tracking of cases at the outset. Second, a higher percentage of their cases have outcomes. And, third, they report total cases and deaths (most of which are confirmed), and the number in hospital. The number listed in hospital seems reasonable compared with their capacity.

The bottom line is that the overall CFR I have calculated is underestimated and should be considered a minimum. The true CFR is probably at least 70% (which is consistent with recent oubreaks in other areas). CFRs reported by others, including the WHO, divide the number of deaths by the number of cases, which assumes all cases currently in treatment will survive. So, I do not believe that the data suggest in any way that this strain of ebola is less virulent than in past outbreaks or that there is a decrease in its virulence over time within the current outbreak.

One final qualification - I am not a professional epidemiologist, virologist, immunologist, or even biologist. I am actually a professional hydrogeologist. I'm simply trying to report the most current and most accurate data that I can find, but I want everyone to understand that the data being published isn't always accurate and that the most accurate CFR can only be determined after an outbreak is over and all outcomes are tallied.

 

[sharon sanders]

Re: Ebola Summary of Cases, Deaths, Discharges, and CFR (5,391 cases and 2,628 deaths as of 9/13/14)

Re: Ebola Summary of Cases, Deaths, Discharges, and CFR (5,391 cases and 2,628 deaths as of 9/13/14)

Thanks Jim. It is widely understood that the WHO and other official ebola counts are understated. There is no way to know the numbers of people who have avoided the (lack of) health care systems. I think the "real" numbers could easily be double the official counts. I also agree with Jim that the case fatality rate is very high.

If you look at the 4 known ebola cases that were evacuated, so far 3 have lived and 1 has died. This is a 25% death rate with the very best treatments, and in the very best conditions. So what is the rate in the countries with no treatments and less than optimal conditions? Very, very high.

 

[kondor]

Re: Ebola Summary of Cases, Deaths, Discharges, and CFR (5,391 cases and 2,628 deaths as of 9/13/14)

Re: Ebola Summary of Cases, Deaths, Discharges, and CFR (5,391 cases and 2,628 deaths as of 9/13/14)

Not only was the care they were given exceptional, the people themselves were not really a good test bed.

Health workers going off to foreign countries usually are up to date with inoculations, have no serious pre existing medical conditions and have passed medical fitness exams for insurance purposes. So the group was somewhat exceptional as was the care they received.

However, keeping in mind that the first challenge is to get the meds into this very same group, we might see some good results and that would be a really good thing. Many people may need their help, so they need every percentage point they can get, to help the publics chances to improve too.

 

[JimO]

Re: Ebola Summary of Cases, Deaths, Discharges, and CFR (5,391 cases and 2,628 deaths as of 9/13/14)

Re: Ebola Summary of Cases, Deaths, Discharges, and CFR (5,391 cases and 2,628 deaths as of 9/13/14)

In this update, I've included the 358 cases and 265 deaths reported to have been discovered in Sierra Leone during the 3-day investigation. I have not had any accurate numbers for recovered cases in Liberia and was simply calculating it as the difference between total cases and patients in treatment + deaths. However, the following article from the 18th reports that only 300 patients have recovered tiphat: HenryN).

http://www.thenewdawnliberia.com/in...-ebola-in-liberia&catid=25:politics&Itemid=59

I believe this to be a more realistic representation of the minimum CFR, which is likely close to 80% overall. Even though Guinea has had better data, with the recent resurgence of cases, I believe the listed CFR is low. Numbers in red are uncertain and are either estimated based on media reports or calculated using reported data.

Please note that the listed values for CFR are not from official reports, but I have calculated them by simply dividing the number of deaths by the sum of deaths plus recovered cases.

 

[JimO]

Re: Ebola Summary of Cases, Deaths, Discharges, and CFR (8,169 cases and 3,874 deaths as of 10/1/14)

Re: Ebola Summary of Cases, Deaths, Discharges, and CFR (8,169 cases and 3,874 deaths as of 10/1/14)

Numbers in red are associated with the notes at the bottom of the table. Data in the table reflect the WHO situation report dated 10/3/14 and the most recent report from the Liberian MoH&S dated 10/1/14.

 

[JimO]

Re: Ebola Summary of Cases, Deaths, Discharges, and CFR (8,169 cases and 3,874 deaths as of 10/1/14)

Re: Ebola Summary of Cases, Deaths, Discharges, and CFR (8,169 cases and 3,874 deaths as of 10/1/14)

In August, I created a simple spreadsheet that predicted ebola deaths based on an R0 of 1.80 and a reproduction period of 21 days. I started with 1 death in early December and calculated predicted deaths through June 2105. I've been plotting actual deaths versus predicted deaths and have created the following charts. The first one is through late October for predicted deaths and shows how actual deaths have plotted from March through the end of September. The next chart shows predicted versus actual through the end of the year and the third chart shows predicted versus actual through June 2015. Given the dramatic increase in predicted deaths in the spring, the current data is barely discernable in the last chart.

 

[Sharky]

Re: Ebola Summary of Cases, Deaths, Discharges, and CFR (8,169 cases and 3,874 deaths as of 10/1/14)

Re: Ebola Summary of Cases, Deaths, Discharges, and CFR (8,169 cases and 3,874 deaths as of 10/1/14)

Jim -- I really appreciate these charts and graphs. Looking forward to the next update.