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This Train Doesn't Stop There Anymore
Sep. 24th, 2014 12:13 amLet's get existential. As in, potential existential threat.
Part of the classwork for Biology for Population Health requires us to develop a portfolio on a particular disease or ongoing health concern. I selected ebola virus disease, and put my request in quickly - EVD's pretty sexy right now, and I expected that it'd be a popular choice, and with the ongoing West African outbreak, there would be plenty of material and information to work with. Along with my individual work on EVD, I'm working on a group project to develop and defend a quarantine program to slow or stop the spread of the disease in a large city - specifically, Lagos. It's going pretty well - just from CDC sources, I have what can be best described as an embarrassment of riches.
The current outbreak is scary. Since the outbreak began in December 2013, approximately 3400 cases have been confirmed, with 1700 confirmed deaths. Suspected numbers are closer to 6200 and 2900, respectively. EVD was identified in 1976, and between that date and November 2013, the combined number of cases from all outbreaks totals just over 1700. 1700 cases in 37 years, versus 3400 in ten months. There's something very different about this one - it's happening in areas of denser population, for starters.
This morning's reading included a scary projection from CDC. If the current rate of infection continues, there will be at least 8000 cases, and as many as 21000, by the end of September. Barring changes in behavior in the affected populations and a significant increase in medical interventions, the projections for Liberia and Sierra Leone combined are between 550000 and 1.4 million by mid-January. Those two countries have a combined population of about 10 million, so we're looking at somewhere between 1/20th and 1/7th of the population infected. Serious? Yes. Very.
One of the discussions going on with CDC and WHO is, like my group project, what happens if the outbreak spreads to Lagos? Cases have been reported and confirmed in urban areas of Liberia (and the attempt at forced quarantine in Monrovia did not go well at all), and the spread in that environment is much, much faster than in the countryside. A large fast-moving outbreak in Lagos has real potential to spread the infection globally, very possibly overwheming existing medical resources in many nations.
Quick comparisons! Liberia's population and land area are very close to those of Kentucky; thankfully, the Commonwealth's medical resources are much greater than Liberia's. The WHO estimates that Liberia has about 65 doctors. Sixty-five. For a population of four million. In addition, there are about 5000 healthcare workers of varying degrees of competency and training in the country. The hospital system attached to the University of Louisville employs over 600 MDs, and it's nowhere near the largest component of the healthcare structure in the Louisville Metro area alone. Hey, speaking of Louisville ... Just shy of 400 square miles (combined city-county government figure) and about three-quarters of a million people (again, combined city-county). Lagos is 385 square miles, and a population close to 21 million. A single large outbreak, or numerous scattered small ones, would be, bluntly, devastating. Lagos sees about 15 million passengers a year pass through its primary airport alone, and FSM alone knows how many land and sea passengers pass through the city.
Development and implementation of a vaccine is unlikely, no matter how many white people are infected. A containment and intensive treatment system has to be developed and implemented. This thing is frightening.
Part of the classwork for Biology for Population Health requires us to develop a portfolio on a particular disease or ongoing health concern. I selected ebola virus disease, and put my request in quickly - EVD's pretty sexy right now, and I expected that it'd be a popular choice, and with the ongoing West African outbreak, there would be plenty of material and information to work with. Along with my individual work on EVD, I'm working on a group project to develop and defend a quarantine program to slow or stop the spread of the disease in a large city - specifically, Lagos. It's going pretty well - just from CDC sources, I have what can be best described as an embarrassment of riches.
The current outbreak is scary. Since the outbreak began in December 2013, approximately 3400 cases have been confirmed, with 1700 confirmed deaths. Suspected numbers are closer to 6200 and 2900, respectively. EVD was identified in 1976, and between that date and November 2013, the combined number of cases from all outbreaks totals just over 1700. 1700 cases in 37 years, versus 3400 in ten months. There's something very different about this one - it's happening in areas of denser population, for starters.
This morning's reading included a scary projection from CDC. If the current rate of infection continues, there will be at least 8000 cases, and as many as 21000, by the end of September. Barring changes in behavior in the affected populations and a significant increase in medical interventions, the projections for Liberia and Sierra Leone combined are between 550000 and 1.4 million by mid-January. Those two countries have a combined population of about 10 million, so we're looking at somewhere between 1/20th and 1/7th of the population infected. Serious? Yes. Very.
One of the discussions going on with CDC and WHO is, like my group project, what happens if the outbreak spreads to Lagos? Cases have been reported and confirmed in urban areas of Liberia (and the attempt at forced quarantine in Monrovia did not go well at all), and the spread in that environment is much, much faster than in the countryside. A large fast-moving outbreak in Lagos has real potential to spread the infection globally, very possibly overwheming existing medical resources in many nations.
Quick comparisons! Liberia's population and land area are very close to those of Kentucky; thankfully, the Commonwealth's medical resources are much greater than Liberia's. The WHO estimates that Liberia has about 65 doctors. Sixty-five. For a population of four million. In addition, there are about 5000 healthcare workers of varying degrees of competency and training in the country. The hospital system attached to the University of Louisville employs over 600 MDs, and it's nowhere near the largest component of the healthcare structure in the Louisville Metro area alone. Hey, speaking of Louisville ... Just shy of 400 square miles (combined city-county government figure) and about three-quarters of a million people (again, combined city-county). Lagos is 385 square miles, and a population close to 21 million. A single large outbreak, or numerous scattered small ones, would be, bluntly, devastating. Lagos sees about 15 million passengers a year pass through its primary airport alone, and FSM alone knows how many land and sea passengers pass through the city.
Development and implementation of a vaccine is unlikely, no matter how many white people are infected. A containment and intensive treatment system has to be developed and implemented. This thing is frightening.
