Saturday, 11 October 2014

Ebola Screening

Ebola Screening
(The need for education)

The World Health Organization (WHO) data show that the Ebola epidemic is spreading exponentially in West Africa. Using WHO data (reported in Wikipedia) it can be seen that the total number of cases shows a doubling time of 29 days (tx2 of deaths is 30 days).

Containment and education

This rate has remained depressingly steady from 1st May till the last week in September, showing that essentially nothing was learnt about containment (protection, how to handle the cases, and the corpses) between May and 25th Sept. If the present doubling time remains steady it means the 7,492 cases on 1st Oct would become 14,984 by 29th Oct (the 3439 deaths would become 6878 deaths by 30th Oct). And that would imply that we have still learnt nothing about containment.
Education must be speeded up. New methods of handling infected material must be evolved (e.g. perhaps remote handling machinery would be more effective than rubber gloves which are presumably removed at mealtimes). New social and religious practices regarding disposal must be worked out and inculcated.
Please tell us all, in simple words in large letters on a A5 poster, how to avoid infection; and what to do with suspected cases. Everyone in Sierra Leone should know these instructions by now.

Screening and tracking

The small amount of anecdotal evidence available in the press suggests that the delay between irreversible infection and overt symptom of fever (the incubation period) is well over 2 weeks and may be 3 weeks. This means that screening at point of boarding and leaving a plane will do very (very) little to prevent the spread of the disease from West Africa. However, as it is very easy to do, it might as well be done. (We did this with SARS in Taiwan in 2003; on entering any public building or aeroplane we filed past a remote thermosensor.)
However, what seems absolutely vital is that the whereabouts of every person leaving an infected area be known and tracked for 28 days. It is essentially pointless to take the temperature on entry into Britain if we then lose the traveller into the population.

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