Doing the Math on Ebola

Adding up the numbers while I pick the beans.

Adding up the numbers while I pick the beans.

This continues to bother me, that the things we are seeing in the latest ebola outbreak do not match what we should see if it is the old Ebola Zaire. I’ve read that the second wave of this epidemic was a surprise, since it occurred more than 21 days after the last known case emerged. Once the incubation period passes with no new cases, the epidemic can be considered over. It didn’t happen that way, and that is the problem.

Patrick Sawyer’s death gives us some insight into how this happened. What we are now told is that he helped care for his sister during her illness, and that no one knew it was ebola until later. Her illness resembled malaria, and about half the cases do that. People affected in that way don’t show the classic profuse bleeding and can be misdiagnosed with other illnesses.

Suppose that the kill rate of this virus is sixty percent, not ninety, and that forty percent of those stricken survive with or without professional care. Traditional supportive care might be nearly as effective. Those who are misdiagnosed or who never seek official treatment and do recover remain infective for up to seven weeks. Add 49 days to the 21 day incubation period, in those cases, then add another 21 days to cover those instances where an infected person infects someone else at the end of his illness, that’s 91 days.

Three months after the last reported case, this epidemic might be over. Maybe not, if some victims evade the net. Whatever we do, the virus will still be out there in its animal hosts, and the next time it invades humans, it will act in new ways.

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Green Beans and Ebola

DCIM100MEDIA

Great year for beans and ebola.

The most pleasant part of gardening or for that matter any type of traditional manual labor is that you have plenty of time to think. Just set the body in motion for the task at hand and the mind can roam freely. Even though no one pays any attention to me I do enjoy thinking about important things like the Ebola epidemic in Africa while I’m picking the green beans. It’s been a fantastic year for green beans and I’ve been canning them like crazy, almost like I’m preparing for a famine or a plague. I suppose that might be true, because I don’t think we are looking at the current ebola outbreak in a sensible way. What I’m seeing in the news does not match the official view of what ebola does. There must be a lot of professional people thinking the same thing.

Alice and I have been emailing each other about the latest ebola news and for us it seems much like many of the pandemic disaster movies we’ve seen except that it’s actually happening. I’d prefer to trust what the CDC says about the disease, that it isn’t easily transmitted from person to person if you take simple precautions and it’s unlikely to spread in developed nations with good health care systems. However, all this makes me remember our last visit to the emergency room at the hospital in Greencastle, Indiana, when Alice had a bout of food poisoning that was likely due to contaminated spinach purchased from a supermarket here. Our health professionals told us that salad greens were almost never the source of pathogens. A week later the supermarket recalled all their spinach.

As we were waiting for permission to leave, I noticed some activity on the emergency room’s examining table. The table was infested with fleas.

Well, that’s our health system for you, doctors who think they know what they are doing and fleas in the emergency room. I’m betting that ebola could survive pretty well in this country. What I’m reading about ebola lately doesn’t make me comfortable at all, because how the beast currently acts doesn’t quite match the description we’ve been given. This is supposed to be Ebola Zaire, one of the deadliest strains. Its 90 percent kill rate makes it burn out rather quickly, since victims die in small clusters without spreading the disease far and wide. Quick reaction to outbreaks stops them quickly. According to the CDC, the ebola currently working through western Africa is a 97 percent match for Ebola Zaire. Apparently everyone working the epidemic thinks that means it is Ebola Zaire.

Actually all this means is that this virus evolved from Ebola Zaire. Three percent change is a lot of difference, and might mean we are dealing with an entirely new animal that doesn’t play by the old rules. Three percent difference could be significant if that difference causes the virus to spread more efficiently. When I read about the three percent difference in this ebola’s genome, I got curious and began to research the problem a little more carefully, looking for any reason to think we have a new bully in the playground. I did not find comforting information that proves me wrong.

This virus shows a very different kill rate than Ebola Zaire, fatal to 60 percent of its victims rather than 90 percent. Officials explain this as a result of better health care for those infected, but that isn’t the only possible explanation. An equally plausible explanation is simply that it’s a different strain. Many victims are avoiding the health care system in Africa. We hear about those who die, but if others recover without professional care we would not hear about them. Only half the victims show the dramatic symptoms of ebola, the profuse external bleeding that people associate with the illness. The rest bleed internally, and the illness in those people resembles malaria or typhoid. When those people recover they remain a source of ebola virus for up to seven weeks. Potentially we have 4 out of ten infected people who avoid the health care system remaining in the population to spread the disease. If the kill rate of this virus actually is 60 percent regardless of health care, it’s not the old Ebola Zaire.

Ebola Zaire was relatively easy to control by quarantine and good sanitation. It spread to family members who cared for the sick people or who washed or touched their bodies after death. In west Africa, touching the dead is normal behavior at funerals, and the dead remain infective for some time. Ebola Zaire spreads when body fluids find a break in a new victim’s skin, but not simply by breathing the same air as the infected person. There’s no cloud of airborne virus to inhale, as there is during a flu pandemic. Flu lives for a long time outside the human body, and Ebola Zaire does not.

We’re seeing some differences in this epidemic that should be a wake-up call for governments and health officials. This ebola spreads more effectively than the old ebola. Several doctors working the epidemic caught the disease even though they followed all the recommended procedures and wore all the safety gear. Did they all make the same mistake that allowed Ebola Zaire to gain a toehold? or does that three percent difference in the ebola genome include a better means of transmission, one that can bypass all that gear? Different experts give different opinions on this, but no one really knows.

Many of the strains of flu that I have caught in the past traveled in a very simple fashion, moving from infected person to me in a fraction of a second rather than lingering on some handy object for hours or floating about in the air waiting for me to inhale. If someone coughs in your face you inhale spit droplets or they splash in your eyes. There’s a reason the doctors treating ebola victims wear all that gear including respiratory masks and eye shields. Ebola can make the jump. Ebola Reston, a form that killed a warehouse full of caged lab monkeys in Reston, Virginia, does not require direct, immediate contact for transmission. It’s good enough that it can float through a room to get you, but fortunately it does not cause illness in humans. Indirectly it remains a danger, because many types of wild game as well as monkeys, humans and domesticated pigs can harbor the different forms of ebola. If an individual contracts more than one form, the viruses can mix and mutate. Effective mutations result in better skills for the virus. Ebola once was a disease of the deep forests in remote areas such as the Congo. Modern human culture spread the virus far beyond its old borders. Even pigs in the Philippines have tested positive for ebola antibodies. The mixing pot now favors the production of new strains. We notice the ones that kill people, not the strains that don’t, but even the benign strains present a real danger, warehousing new methods of infection that someday might jump to lethal strains.

Maybe it’s time the people in charge over there started thinking of this in an open-minded way. Sometimes the worst-case scenario is the right one. Anyone in contact with an infected person should be isolated from the general population until they pass the incubation period without illness. That includes the health care workers and doctors. We are not seeing that level of response as yet. Everyone thinks it’s the old beast, Ebola Zaire, and we’re fighting it under the old rules. This could be a new beast, one we haven’t named as yet, playing a different game.

Had to wonder today whether I should give the neighbors any of my food, because it’s a great year for gardens as well as for ebola. I don’t expect ebola to erupt in this country, but if I did I’d be doing the same thing I’m doing now, working in the garden and putting up food for winter. I decided I could spare some food and gave away some beans and squash. No reason to get crazy about all this, but we should be doing things that make sense.

 

 

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The Hammock I Actually Take Camping

In the early 70′s I took a jungle survival course taught by a Green Beret sergeant with a couple of tours of experience in Vietnam, and one of the practical things he suggested I include in my kit was a nylon mesh hammock. That’s what I still take with me when I go camping, and I define camping as living outdoors with a vehicle (either boat or car) as a base. I don’t take a hammock backpacking because a string and a stuff sack will do what I need done. Food goes in the bag and I haul the sack up a tree limb out of reach of bears and chipmunks. Hammock isn’t needed for that.

When you camp, you can take stuff that makes life more pleasurable. I love to camp by canoe, and a canoe has lots of room, so I can take things I wouldn’t dream of taking with me if I carry everything in a pack. I lash my Coleman two-burner camp stove under a canoe seat and I pack a mosquito net and a hammock in my kit. My training sergeant suggested the hammock because he had found it very practical when stuck in the bamboo swamps overnight. Other people in his squad, he recalled, squatted in the muck and the leeches through the dark hours, while he swung above the mess in his two dollar hammock. They do cost more now, but they are still the cheapest way to comfort in a base camp situation.

When canoe camping on a river or lake here in the midwest, I prefer sleeping in a tent, but the hammock still comes in handy for holding all the gear you need to keep above the damp. Just pile it in there, lash a tarp over it, and everything is fine even if there’s an unexpected storm. You could sleep in one of these mesh hammocks with as much comfort as in a more expensive ripstop nylon version, but you’d still need a mosquito net and some rigging skills. I prefer tents. On gravel bars, I use my tactical shovel to scoop the top six inches of gravel off the tent site, so I get down to where it’s cool. Nothing quite like a cool bed of river gravel for a good night’s sleep. Wiggle your hip into it and you’re fine.

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