Yeah, I don’t get it either. More amazing chemistry GIF’s here.
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Liveblogging CDC Ebola Briefing October 14th
Live blogging.
Dr. Tom Frieden talking.
Don’t say “hand in glove!”
What the are doing in Dallas:
1) Site manager on the site in Dallas every hour of the day, checking protective gear use.
2) Enhanced training, including by experienced nurses with Ebola experience.
3) Limit number of care staff so they can be more expert.
Have been hearing concern from health care workers everywhere, working to minimize concerns.
Working to prepare all nurses and docs in all ER’s to ID Ebola, asking “where have you been in the past month/21 days”
Infections more likely to spread from someone not diagnosed.
Establish CDC response team to arrive within hours to any site where Ebola pops up. Equipment, management, expertise. I think most people thought they already had that but I guess not. They’ll assist in all aspects.
Also, for training, ramping up webinars, etc.
DALLAS CONTACT STATUS
Nurse remains in stable condition. Not severely ill now.
Index had 48 contacts, past 14 days, 2/3rds of risk period, highest risk period passed, decreasing likely that they will develop.
For the nurse only one contact. (because of active monitoring and not messing up)
Since nurse developed infection, possible other people who cared for Index patient could have been exposed… they are not in the 48.
ID’s 76 individuals in that group, all will be monitored daily for fever.
Relates his personal experience with thinking he might have Ebola; acknowledges freak out effect.
Now Dr. David Lakey, commissioner, TX dept of state health service.
14 days since first US case diagnosed.
Visited hosp. yesterday, visited CDC and state epi team, local health dept, and two emory nurses (brought in for training, checking system)
Reiterates 48 contacts past critical period.
One Patient 2 contact no symptoms.
Watching Nurses dog, the dog is fine.
Everyone remain calm. We’ll quickly announce any Ebola+ results. Those with self monitoring are all now on active monitoring.
QUESTOINS
NYT: How many of 76 were health care workers. Answer: all of them, all care takers for Index. (48 outside contacts, 76 or more possible in hosp contacts with him or his blood. still looking for more of those contacts)
ABC: Once a patient at some hosp is diagnosed, why not transfer them to a better facility. Ans: They might be.
NBC: Nurse had been certified in crit care 2 months ago. Is that enough experience. Ans: May not have mattered, we don’t normally treat Ebola (paraphrasing). Wish we had our response team we later thought of in place first. But from now on we’ll do that.
PHONE Question: CNBC: are you concerned about health care workers being concerned that they won’t come to work. Ans: we are concerned about htat, and about patients avoiding hospitals or clinics. We are trying to spread more knowledge about what to not worry about while at the same time doing a better safer job.
PHONE CNN. Clarify the 48 are unlikely to get Ebola. Ans: Yes, most cases would have happened by now, 21 days is on the safe side.
Newsweek: What has CDC learned from W. Africa from orgs like Doctors without borders. Ans: We work closely with them. African environment and US environment are different.
PHONE: CBS Dallas: Have you identified the breach in protocol. Ans: No. We review everything that occurred, nurse has helped a lot with this. We don’t always know what happened. Asks Lakey if he has ifo. Lakey: Have not identified a specific error. Looking closely.
So they don’t know. SO maybe there wasn’t one!
TIME: you wonder if you should have sent a team originally. Why? Ans: We did send a team, epis, to help with tracing, etc. We could have in retrospect sent a bigger more robust team and been more involved with hospital. Ebola is unfamiliar. Hospitals may even do unsafe things like using extra layers of protective equipment.
Phone question: inre 4 hospticals specialized with biocontainment. Why are there only four of them. If you transferred a patient there, how would it happen. Ans: The hosp with specialized facilities were created for totally unknown much scarier diseases that don’t exist yet. Ebola isn’t that bad if you do it right. Transporting is easy.
UNS: Some recover, some die, why? ans: We are not sure. Being healthy going in is better. Standard care makes a huge diff, doubles survivorship. Fluid balance. Also experimental treatments may or may not help.
Last question: Atlanta jour. cont: To what degree has team been sent at emory, has that become the model. Ans: Nebraska and emory have sound protocols, some are on site in Dallas.
Asks Lakey if he has concluding remarks. He says some stuff about how they are doing everything they can do.
Frieden final remarks:
1 we are focusing on supporting patient and hosp. in Dallas with robust expert team.
2 icreasing education and info to health care workers around the us
2.5 making a team to go anywhere needed within hours if there is another case.
3 working on contact tracing.
That concludes this liveblogging. Thank you very much you may return to your homes.
Blood meets hydrogen peroxide
Science Online Died. Why?
Science Online was an amazing annual unconference that started a few years back and grew and became part of the reshaping of public communication about science. This year, the people running the conference started out with the plan to move the conference to a new venue, Atlanta, and last week abruptly announced that the conference would not happen and the ScienceOnline organization would be shut down. Those who paid the registration fee would be refunded.
A few science writers and bloggers are writing about how great ScienceOnline was and how much it will be missed, and some are providing a few comments about why it had ended. I won’t bore you extensive thoughts about how great the conference was (a little at the end). I’ve written about that before, and since I did not attend the last two, I’m not really in a position to extol its wonderfulness at this point. Besides if you are reading this you surely already know what ScieneOnline was and how great it was.
I would like to know, however, why the project shut down. This is not morbid curiosity. ScienceOnline was a big, vibrant, powerful, a meaningful thing in my profession, and its sudden and unexpected (to me, anyway) demise can’t pass without some analysis. If All the Scientists one Friday morning got an email saying the American Association for the Advancement of Science would stop publishing Science Magazine and shut down all operations by Saturday, they wouldn’t just say “Oh, that was nice while it lasted. Oh well.” They would be compelled to discover why an organization central to their profession would shut down. Well, the demise of ScienceOnline is like that, but a couple of orders of magnitude smaller. Frankly I find the lack of serious consideration as to why ScienceOnline shut down in the few posts that mention it to be odd. Spooky even. Happy Halloween.
Here are my random thoughts on the matter.
ScienceOnline was growing, and there was no significant event or change in the nature of the science communication community that would suggest that such a successful project would not be able to continue. I think it is reasonable to say that it should have continued and it should not have shut down.
There have been suggestions that ScienceOnline was ruined by Bora Zivkovic, the former principle of the operation. Bora was accused, tried, and convicted of inappropriate behavior and forced to resign. The nature of that inappropriate behavior is up in the air, in the sense that people have labeled it with various legally meaningful terms that don’t actually apply, questions have been raised in the same venue as some of the accusations about the veracity of those accusations, and the entire exercise was riddled with posturing, hard feelings, look-at-me-too antics, and a certain amount of bullying, variously coming from some of the dramatic protagonists working from many different angles. There is a Standard Line that goes with the Bora Saga, and within a few weeks of the breaking of that story (almost one year ago, I believe) every one knew the Standard Line. At that point you eitherr towed it faithfully, objected to it anonymously, because questioning it openly felt like it would lead to your own trial and conviction. That was a mess, but I don’t think it had anything directly to do with ScienceOnline closing, because one entire conference happened AFTER that event, and after all, despite the always entertaining ability for so many professionals who operate on the internet to act like middle school students, in the end, most people eventually pull on their big kid pants and get real. Two years after a person involved in a conference leaves the process, the conference can move on.
There have also been suggestions that ScienceOnline was ruined by so-called “Feminazis” who had gone after Bora or used that problem as a means to do their evil work. This suggestion has been made to my knowledge only sarcastically, with the indication that “oh, any minute now the MRA’s (Mens Rights Activists) will be accusing the feminazis of bla bla bla….” I mention this here only so I don’t have to insert it later in an Updated version of this post, because I am perfectly confident the accusation will be made if it hasn’t been already. This possibility is just as absurd of an explanation as the aforementioned “Bora Ruined It” hypothesis. It requires no more consideration. It has been brought to my attention that some have read this paragraph as a suggestion by me that “feminazis” ruined the conference. Clearly, I am saying a) that didn’t happen, b) the idea is out there and c) the idea is stupid. Which is what I said. But now I said it again. AND DON’T USE THAT WORD FEMINAZI
There are two material differences between ScienceOnline 2015 and the previous conferences. One is the venue. The conference has always been held in the Research Triangle, and Scio 2015 would be held in Atlanta. Maybe everybody hates Atlanta. Maybe the Triangle offered a unique palatial charm not to be found many other places. I’m sure that latter aspect is true, but I find it hard to believe that this would cause ScienceOnline to tranmogrify form the “Un Conference” to the “NoWay Conference.”
The second material difference is the registration fee, which I think had gone up to something like $400 (it may have been less than $200 a few years ago). Also, the student price was something like 20 dollars off that, which I regarded as cynical when I first saw it. This could be a real effect.
I have heard that most of the sponsorship dropped out. Some have said this is because they were mad at Bora, but that seems incredibly unlikely for a number of reasons, including his total lack of involvement in the conference. I would like to know why so many sponsors dropped out and what the impact of that was. It may have contributed to the very high registration fee. These two things together may have been a problem.
I also heard that while in previous years there was typically a long waiting list to get into the conference to begin with, this years the number of attendees was way down, far lower than the expected amount (in the 200’s range instead of over 400?). I’d like to see the exact numbers on this. This could be a cause of the failure of the organization and conference; if 200 people fail to give you $200, that’s a lot of moola you didn’t get. Or it could be an effect. All those people who don’t like Atlanta, didn’t want to miss the Charm of the Triangle, and didn’t want to spend twice what they spent in a previous year opted out. Or maybe they were just still mad a Bora and needed to be in a snit, or maybe they were mad at the Bora Haters and needed to be in a snit. Hard to say. My guess is that the price drove a lot of people away.
Added: I’m being told that last year’s conference sucked. I had also heard t was great. But the fact that some people think it sucked matters.
There is one major effect which feels to me like the most likely reason. I may get the following bit a bit wrong in detail, simply because I don’t know all the details, but my understanding is that Karyn Traphagen, Anton Zuiker, an Bora Zivkovic were the three driving elements in prior versions of Science Online (not counting last year) along with a few others. Bora was the most visible face, having been a community organizer de facto or professionally on the Science Internet for years. The three of them made Science Online out of nothing, crafted it, expanded it, made it an incredible success. Then they were no longer involved. Then it shut down. One could hypothesize that the new organizers, and I have no idea who they ended up being, simply killed ScienceOnline because they didn’t know what they were doing. I suppose that question should be asked, but I have no reason to think it. But I do know that a rather amazing, perhaps even unlikely, kind of event was generated by a handful of people, most visible Bora, with Karyn and Anton very much engaged, and it may be that the magic worked only for them. What that magic was I can’t say. Maybe this moment in time … the moment when ScienceOnline 2015 was cancelled, happened every year but Bora, Anton and Karyn simply trudged past that and made it happen anyway. Maybe at this point in time there was always a shortage of interest by the online community but then the Three Conferenceoteers got in every body’s face and made them excited about the upcoming event. Maybe the project always lost its sponsors at this point, but then Bora, Anton and Karyn would show up on their doorsteps, begging or dressed in funny kitten suites or doing whatever they needed to do to bring them back in the fold. This does not imply a lack of will or ability on the part of the organizers that shut down the conference, but rather, an amazing ability that probably grew and developed every year as the project projected, on the part of the original organizers, that was lost when they were lost.
Keep in mind that the transition wasn’t smooth, as I remember. Last year’s conference was still going to happen on the grounds of momentum alone, Bora left, and pretty quickly his compatriots did as well, staying involved for various lengths of time. A smooth transition over a few years of the major players is quite doable. A wholesale housecleaning is dangerous.
For my part, I appreciated ScienceOnline and I’d like to retroactively thank Bora, Anton and Karyn, and others who may have been involved, for making that amazing thing happen. It was inclusive across several dimensions (gender, age, ethnocultural identity, professional level, nature of field). It included art and science. It was unconferencey (though for me that was less of a draw, I’ve been attending unconference style conferences for some time). It had the Charm of the Triangle. It was not in Atlanta! It was a good conference. Thank you three for making that happen. It is a shame to see the project end.
(Quick note added: I now see Karyn is still very much involved but Anton as an advisor. Perhaps it was more Bora originally if my theory of losing the founders as having been important is correct.)
Added: This is a good run down of possible reasons for the demise of Science Online. I haven’t seen anyone looking for “the cause” (I think most people in this community are beyond thinking so simplistically, we are science communicators and scientists after all) but most of the other points are worth checking out.
Mark Dayton on Ebola and Minnesota
First person in US to catch Ebola: The Meaning of Ebola Patient Two (updated)
The first person ever to catch Ebola in the United States is now in isolation at Texas Health Presbyterian Hospital.
Don’t panic, even if you live in Dallas. But also, don’t fall into the hyperskeptical trap of assuming that because scientific authorities tell you everything is fine that concern is irrational. There are very rational reasons to be concerned. But you need to be smart about what to be concerned about.
A couple of weeks ago, as you know, a man came to Dallas with pre-symptomatic Ebola, and became symptomatic there. This was the first case of a person being diagnosed with Ebola in the US. The case was botched. The hospital sent home a man with pre-Ebola symptoms who had come from West Africa. He was later admitted after he got a bit sicker and tried a second time to get treatment. There were other ways in which the case was not handled too well, mainly from a public relations and messaging standpoint, but the CDC and the hospital involved seemed to be doing a good job and getting their acts together.
Now, the situation has developed in a rather disturbing way. A health worker that had been caring for Patient 0 has now been diagnosed with Ebola. This happened overnight. The patient was under self monitoring, had a mild fever, went to the hospital, was tested, and the reasonably reliable preliminary test indicated Ebola. A second much more reliable test is being done now but it is expected to be positive.
I just watched the news conference and from this I gathered the following important bits about the new patient.
<li>The patient was in the low risk pool. Among Patient 0's contacts, there were higher risk and lower risk. Higher risk individuals were being isolated and/or monitored very closely, lower risk individuals were self monitoring. This patient was self monitoring.</li>
<li>The person cared for Patient 0 during his treatment prior to his death at Texas Presbyterian; there was no contact during the initial botched visit. </li>
<li>The new Ebola patient used protective procedures (gown, mask, gloves) in that care. The exact nature of the care beyond that is being kept secret at the moment owing to HIPAA rules. (But see below to see how absurd the HIPAA rules are in this case.)</li>
<li>The new patient seems to have lived with a second person who is now also in isolation.</li>
Hazmat suit wearing teams arrived during the night at the apartment complex of the new patient, and decontaminated public areas such as the lobby of the apartment building, and the interior of the patient’s car. It is thought that there is a pet inside the person’s apartment, but teams, as of this writing have not entered the apartment. They plan to do that soon. Local police doorknocked everyone in the “immediate area” to explain to them that they should not panic, did a “reverse 911” call for the area, and are re-door knocking this morning. So, the identity of the patient will be known any moment now because you can’t really do all that without that happening. (Which, frankly isn’t too relevant. I’m not sure if HIPAA rules should protect health care workers in quite the same way as patients, though they may in fact do so.)
So, what is the meaning of this all?
First it means that when hundreds of administrators, police, government officials, hospital employees, health workers, etc. are tasked with the job in the US of making sure no one gets Ebola from a person who has Ebola, and also tasked with the care of that person, a) one person gets Ebola anyway, and b) the first patient dies.
I very quickly add that this is a TINY SAMPLE SIZE OF N=1 and I’m being a bit cynical here. But it is still true that all these resources failed to prevent what every one feared, and what the authorities said would not likely happen.
Second, note that this new patient did not get Ebola from Patient 0 prior to his first visit to the hospital, or after that first botched visit. Again, small sample size, but it points out something important. When we say that a human with Ebola can spread the disease only when they are symptomatic, that probably doesn’t even count the initial fever period. Infectiousness is probably correlated to the severity of the symptoms. The family members or heath workers who deal with the bodily fluids randomly coming out of a person who is dying of Ebola, bed ridden and very sick, are at the highest risk, even those in the lower risk pool like this new patient. (This is why the HIPAA rules need to be set aside. We actually need to know what this person’s role in the process was, what this person did exactly. That is important information that the public has a right to know. If this reveals the name of the worker by deduction, then so be it. The person’s name has already been effectively revealed by deduction form the activities at the person’s home.) But, importantly, once a person is really infectious, they are really, really, infectious. See my quick note below on spread of Ebola.
Third, note that the medical authorities have said all along that following proper procedures minimizes risk. Note that even when following proper procedures one person was infected anyway. Note that at this morning’s press conferences, the authorities have not changed their story. This is partly your fault, members of the public, because collectively you seem unable to understand that Ebola is both very dangerous and manageable. Your collective insistence that your fear being ramped up is somehow proof that Ebola has gone airborne is an example of that. If you collectively stop being unmitigated morons about this, then the authorities can stop being alarmingly Orwellian about it. Maybe.
Fourth, think about this. A huge effort is made to avert a possible Ebola outbreak. The effort fails in a couple of ways, but we get lucky, those failures don’t cause too many problems other than, possibly, the death of the patient because care was not timely and proper drugs were not administered. But as far as the concern over an outbreak goes, the early screw ups did not cause one. So, proper and resource intensive procedures are in place and everything is going as well as it can be. Then somebody gets ebola anyway. This explains West Africa. Here, in the US, we have 200 people for every Ebola patient. In West Africa, you might have 1 person for every 100 (possible) patients out there. Those numbers are made up, but you get the point. In order to limit Ebola in West Africa we’d have to do what we can do here, and that proves to be of limited utility. Prior outbreaks were stopped because of the high ratio of health workers AND the disease burning out by killing almost everyone in some families or small villages so spread was stopped. So now we have a better sense of what is going on there. Imagine that every person in the US isn’t just someone who heard about Ebola in some other city. Imagine, instead, that everybody in the US lives in an apartment building in which one or two other people in the building have Ebola. And there are no hospitals.
So, collectively, that is all good news and bad news. One more piece of good news: We are near the end of the period during which someone who may have been infected might show up.
On the spread of Ebola
I’ve written about how Ebola is spread before and about the unlikelihood of it “becoming airborne” (see links below). But I keep hearing, again and again, that this or that vague observation someone has made proves that it has already gone airborne. Well, I’ve got a bit more to add to that discussion to help people put it in perspective. The truth is, pretty much every one who is saying it is already airborne or that it is likely to go airborne or that eventually it is inevitable that it will go airborne is an airhead. Sorry for the strong language, but at this point it is simply true that with so much information out there about this being utterly wrong is not acceptable.
Consider Norovirus. It is roughly as infectious as Ebola. Two years ago, for example, we had an outbreak of it here in the Twin Cities. Someone at my son’s daycare had it. Then my son, then everyone else at his daycare, and everyone in our family, and everybody. Had it been fatal, the entire region would be dead. It is not airborne, but it is a disease that there is a good chance all the people crowing about Ebola needing to be airborne have had, have seen in action. Next time you feel the need to insist that Ebola is airborne remember the last time everybody in your family, one by one, got the “stomach virus” (as it is often called). It wasn’t airborne. You got it because germs form someones’ poop or vomit got into your mouth. Perhaps you should not have been licking people’s anuses or drinking their vomit with a straw during that time. Oh, you claim you did neither of these things? OK, fine, you weren’t doing that. But you still got kooties that came from vomit or poop. The way bodily fluids get around, and the opportunities for contact, are much greater with Ebola. With the stomach flu, most of the time most people can make their own way to the bathroom to have diarrhea and vomiting. With Ebola, the sicker patients are lying in bed doing this in a closed room. Everything gets kooties on it. Maybe they were soiling themselves and puking for a few hours in a “taxi” waiting to get into a hospital. Touch touches stuff that touches stuff and bits of Ebola rich feces or Ebola laced vomitus are now on your hands.
Even the flu is only barely spread airborne, but mainly through direct or indirect contact. Ebola is more infectious because it does better with indirect contact.
UPDATE: Major Media is reporting, based on a Sunday AM show interview, that there was a “breach” in protocol in Dallas. But the doctor interviewed did not say that. He said, essentially, that there must have been a breach but they do not know what happened. This is important for media to get right, and it is the media’s job to get these things right. If there was no breach in protocol, then the existing protocol allows for Ebola to cross the boundary. If there was in fact a breach, and we know what it was and can confirm it, that is a very different situation. To be clear: The fact that protocol was in place and used and Ebola got across does NOT mean that Ebola is being transmitted by air or in some other unknown way. It could mean that protocol was breached, but without specific evidence we don’t know that to be true, and we don’t know what went wrong. In between these two is the very high probability that standard protocol has a weakness or two that could be shored up. Personally, based on my own experience (not with Ebola) and based on some reports from the field, I would suggest this has to do with how gowns, masks, and esp. gloves are handled. You have to use the same kind of protocol to remove these things as when you are using these things. Perhaps care workers should be demasked, degloved, and degowned by a masked/gloved/gowned coworker who has just suited up in a space away from the patient. (I don’t think that is done now.)
More on Ebola:
- Two Ways Hollywood and Literature Have Confused The Ebola Problem
- Ebola in Dallas Texas: Is our response adequate?
- Ebola Will Not Become Airborne And Here Is Why
- Has the Ebola Death Toll Surpassed Malaria in West Africa?
Pterosaurs by Mark Witton
Pterosaurs: Natural History, Evolution, Anatomy by Mark P. Witton is a coffee-table size book rich in detail and lavishly illustrated. Witton is a pterosaur expert at the School of Earh and Environmental Sciences at the University of Portsmouth. He is famous for his illustrations and his work in popular media such as the film “Walking With Dinosaurs 3D.”
The first pterosaur fossil was found in the late 18th century in the Jurassic Solnhofen Limestones, in Germany, the same excellent preservational environment that would later yield Archaeopteryx. They person who first studied it thought the elongated finger bones that we now know supported a wing served as a flipper in an amphibious creature. Not long after, the famous paleontologist George Cuvier recognized the winged nature of the beast. Witton notes that at the time, and through a good part of the 19th century, it was possible to believe that many of the odd fossils being unearthed were of species that still existed but were unknown to science. This is because most of the fossils were aquatic, and who knew what mysterious forms lurked beneath the sea? But a very large flying thing like this first pterosaur was very unlikely to still exist, unseen by European and American investigators. It had to be something major that was truly extinct. So in a way the history of extinction (the study of it, that is) was significantly shaped by this find. By the early 20th century there had been enough publication and study of pterosaurs to give them a place in paleontology, but not a lot else happened until the 1970s, when a combination of factors, including advanced technology that allowed more detailed and sophisticated study of fossils, led to much more intensive study of pterosaur anatomy and behavior.
Pterosaurs are part of the large taxonomic group that includes the lizards, dinosaurs, and birds, but they branched off within that group prior to the rise of the latter two. So, they are not dinosaurs, but cousins of dinosaurs. You can call them flying lizards, but not flying dinosaurs.
Witton explores this interesting history in some detail, and then proceeds to explore various aspects of pterosaur biology, starting with the skeleton, the soft parts (of which there is some direct but mostly indirect evidence), their flight, how they got around on the ground, and their reproductive biology. These explorations into pterosaurs in general is followed by several chapters devoted to the various groups, with a treatment of the evidence for each group, reconstructions of anatomy, locomotion in the air and on the ground, and ecology.
The resemblance of this layout to a detailed field guide for birds (or some other group) is enhanced by the use of color-coded bleeds at the top of each page, separating the book’s major sections or groups of chapters. The book ends with a consideration of the origins and endings of the “Pterosaur Empire.” It turns out that we don’t actually know why they went extinct. They lasted to the end of the Cretaceous, so going extinct along with their dinosaur cousins is a reasonable hypothesis, but they had already become somewhat rare by that time.
Pterosaurs are cool. Pterosaurs: Natural History, Evolution, Anatomy is a cool book.
Of related interest:
Paul Clements and Gary Peters for Congress in Michigan
This is an endorsement by Climate Hawks Vote, which I support.
Climate Hawks Vote announces endorsements of two Michigan Democrats: Paul Clements for Congress in Michigan’s Sixth District, and Gary Peters for Senate, because the Koch brothers and Big Oil need to stop using Michigan’s shores as a dumping ground for their pollution and Michigan’s politicians for their agenda.
Paul Clements is challenging none other than Fred Upton, chair of the House Energy & Commerce Committee – these days, the House Big Oil Lackey Committee. As the face of Big Oil, Upton was named the number one enemy of the earth. It’s into his pockets that Big Oil money goes – he’s among the top recipients of money from the oil, gas, and coal-fired electric utility industry. And when Big Oil spilled into the Kalamazoo River, Upton demanded answers for about a week, then went back to business as usual, pushing bills to gut the EPA.
Voting out Fred Upton piqued our interest… but Climate Hawks Vote won’t get involved in a race between a horrible Republican and a mediocre Democrat (we won’t name names, but our scorecard will). Luckily for the voters of southwestern Michigan, Paul Clements is a true climate champion. “Climate change is the greatest threat to Michigan and to the world in the 21st century,” he says. His new ad – watch it here – touts clean energy solutions.
We wouldn’t be endorsing if we didn’t think Clements has a chance; he’s considered to be Upton’s toughest challenger in years, and anything can happen to entrenched incumbents in a year in which Eric Cantor lost. The district begins as R+1, i.e. a very slight Republican edge that can be beaten by smart Democratic campaigning. Climate Hawks Vote aims to defeat Upton to send a clear message: Big Oil and Michigan waters don’t mix.
We’re also endorsing Gary Peters, running against Terri Lynn Land in an open seat for Senate. Like Clements, Peters is explicitly running on climate change and the effect it’s having on the Great Lakes. Peters fought the Koch Industries-created piles of petcoke in Detroit, and he’s been carrying a bill to boost electric vehicles – a classic made-in-Michigan solution to climate change.
As before, we’re backing up our endorsement with talons, er, boots on the ground for Peters + Clements voters. Our on-the-ground organizers helped Brian Schatz close the deal in the Hawaii Senate primary, and we helped Ruben Gallego defeat a coal-funded opponent in Arizona’s 7th Congressional District. We aim to win in Michigan.
Can Dogs Transmit Ebola? And, should Excalibur be put down? they put down Excalibur.
UPDATE: They killed the dog.
UPDATE: I’m adding this here because it is my current post on Ebola. Thomas Eric Duncan, the person who became symptomatic with Ebola in Dallas, had died at the Texas Health Presbyterian Hospital (according to news alerts).
A nurse’s assistant in Spain caring for Spanish nationals returned with Ebola from West Africa contracted the disease, gaining the dubious distinction of being the first person to be infected with Ebola outside of that disease’s normal range in West Africa, Central Africa and western East Africa. There is speculation that she contracted the disease by contacting the outside surfaces of her own protective gear, which is exactly what I’ve speculated to be a likely cause of infection in health care workers. This is not certain, however.
Members of her family and others, including additional health care workers, are in quarantine. There is evidence that the hospital procedures were inadequate to keep a lid on Ebola in this context, and nurse’s unions and others are protesting and demanding change.
Meanwhile, the Spanish government has claimed that there is “scientific evidence” that dogs can transmit Ebola, so Excalibur, the nurse’s family dog, will be euthanized and incinerated. People have gone to the streets to safe the dog.
So, can dogs get, or transmit if they get it, Ebola? Short answer: Yes, and probably not. Here’s my thinking on this, and some information.
1) Pick a random species, or to make it easier, pick a random mammal, and test to see if it can transmit a disease known in humans. It is unlikely to be the case because diseases are to some degree adapted to exist in certain hosts, and host vary, well, by species. So it seems unlikely.
2) On the other hand, Ebola seems to be able to infect a very wide range of mammals. Ebola resides in multiple species of fruit bats (though maybe not uniformly or equally well). A range of mammals seen to be suitable intermediates between fruit bats and humans. The mammals known to be able to harbor Ebola are diverse. It isn’t like only primates can be infected. So, it seems quite possible.
3) On the third hand, I’ve never heard of dogs being addressed as an issue in the current crisis in West Africa or during prior outbreaks. One would think that if dogs were a concern this would have been mentioned by someone some time.
4) On the fourth hand, dogs in Central Africa are less likely to be house dogs, hanging around with the family on the couch, and more likely to be working dogs that spend all their time outdoors. A Spanish family pet may have hung around on the sick bed with an ill individual. I don’t know about dogs in West African cities. By the way, you have to go look to see what the story with dogs there is, and it may within that context. I’ve noticed that westerners tend to have a rather monolithic view of how humans “elsewhere” (especially the “third world”) relate to their dogs, based on a concept we hold of them, not based on actual knowledge. How dogs fit in with humans from place to place and time to time varies.
5) I’ve read a good amount of the peer reviewed literature on Ebola and I can not recall anything about dogs.
5) But … A quick check of Google Scholar did come up with one study. From the abstract:
During the 2001–2002 outbreak in Gabon, we observed that several dogs were highly exposed to Ebola virus by eating infected dead animals. To examine whether these animals became infected with Ebola virus, we sampled 439 dogs and screened them by Ebola virus–specific immunoglobulin (Ig) G assay, antigen detection, and viral polymerase chain reaction amplification. Seven (8.9%) of 79 samples from the 2 main towns, 15 (15.2%) of 14 the 99 samples from Mekambo, and 40 (25.2%) of 159 samples from villages in the Ebola virus–epidemic area had detectable Ebola virus–IgG, compared to only 2 (2%) of 102 samples from France. Among dogs from villages with both infected animal carcasses and human cases, seroprevalence was 31.8%. A significant positive direct association existed between seroprevalence and the distances to the Ebola virus–epidemic area. This study suggests that dogs can be infected by Ebola virus and that the putative infection is asymptomatic.
I’ve not looked further at the literature. This study suggests, unsurprisingly (see point 2 above) that dogs can harbor the virus. However, they don’t seem to be symptomatic. Therefore, spread from a dog seems unlikely. I would think the dog could be kenneled for a few weeks, rather than being put down.
Interview with Michael Mann
Last Sunday, I interviewed climate scientist Michael Mann on Atheist Talk Radio. I do occasional interviews there on science related topics (see this list of previous shows).
You can listen to the interview here:
I’d like to take this opportunity to thank Minnesota Atheists for giving me the opportunity to do these science interviews, which are admittedly different from the usual topics covered by the show.
Prior to the show, I wrote a post indicating that we would be doing this interview, noting that people were welcome to past questions I might ask Mann during the interview. I tweeted that blog post, and Dr. Mann retweeted it, a couple of times. I promoted the show in a number of other places as well. There was a call in number and an email address to send in questions.
The show runs early in the morning on Sunday and the listening area of 950AM radio is fairly small (though it is possible to listen live on line using the Internet or other means). So, frankly, we don’t get a lot of live listeners. The usual number of call in or emailed questions we have (for my interviews, anyway) is usually about two. But, the podcast is much more widely listened to.
There have been some rather intense and lengthy discussions related to Michael Mann’s work on my blog here and here over the last few weeks (see: Steve McIntyre Misrepresents Climate Research History and I hope Judith Curry apologizes for this).
Putting all of this together, the several dozen people who have been tweeting at or about Mann or me over the last month about the Hockey Stick research, and those heavily and actively engaged in the conversations on my blog, must have known about the opportunity to ask specific questions about that work. What actually happened, though, was this:
Why? How is it that there can be so much yammering about Michael Mann’s research and the Hockey Stick graph, but when the opportunity arises to actually ask a direct question about it, the dozens of people making all that noise end up sounding like this:
Crickets. Crickets is all they’ve got, apparently.
Meanwhile, here is a talk Michael Mann recently gave at The Amazing Meeting in Las Vegas:
The Ebola Test: Civilization Fails
We really only know things work when we test them to the limit and see what it takes to make them fail, or nearly fail. All those air planes and space ships and regular shops and nice cars that usually don’t fail have a pedigree of prototypes or prototypes of parts that were pushed until they broke. Chickens fired into running Boeing 757 engines with a special Chicken Cannon. Crash dummies driving vehicles into specially built walls. Rocket engines exploding on test ranges. But many systems are never tested that way, and really can’t be. We build the systems and convince those who need convincing that they are stable, adaptable, appropriately designed, and ready. Then, real life comes along and pulls the fire alarm. It is not a drill. The system is stressed, and if it fails, that may be the first time we learn it wasn’t good enough.
Obamacare’s computer nightmare is a good example. It actually worked, ultimately, but at first it was one of the largest interactive computer services ever built and brought to so many users in such a short amount of time. There is general agreement that the system was built improperly and that is why it failed, but I don’t think that is necessarily the case. It may simply be that we can’t know that such a large and complex system is going to work when it is deployed, we should probably expect failure, and we should probably be ready to jump in and patch and repair and redo as needed. And, as a society, be a bit more grown up about the failure.
Three systems have been tested by the current Ebola outbreak and found wanting. One is the system of rational thinking among people. That is just not working very well. We have people in villages in West Africa thinking that health care workers who have come to help them are the cause of the scourge. We have tin-hat wearing Internet denizens insisting that that Ebola has already gone airborne, and that the US Government has a patent on the virus, and somehow it all makes sense, thanks Obama Bengazi! The failure of rational thought, which is a system supported by home grown culture and formal education, has been stressed and found wanting. We are not surprised, of course. I bring it up mainly because I want to point out that this is a general human failure, not just a failure among the victims in Africa who are so easily overtly blamed.
The global public health system has been tested and proved to be an utter failure. WHO and the CDC and all that have done a pretty good job with earlier, smaller, outbreaks of Ebola and other diseases, when they can fly in more people than even live in some remote African village, and most likely the hardest part of those missions is the logistics of getting to the field. That has been facilitated in the past by on the ground aid workers, missionaries, and in some cases, public health researchers who already knew the terrain. But they had a plan, they had gear, and it all mostly worked very well. We assumed the plan and gear and expertise and personnel was in place for a major outbreak. It wasn’t. That system has been tested and failed.
And now we are seeing a third system showing itself to be a failure, and it is actually kind of surprising. In speaking of the problem of screening for possible Ebola carriers coming in to the US on planes we learn that there isn’t a way to keep track of people flying to the US from other countries. From CNN:
“All options are on the table for further strengthening the screening process here in the U.S., and that includes trying to screen people coming in from Ebola-affected countries with temperature checks,” a federal official said… “It’s not as easy as it sounds. There aren’t that many direct flights from Ebola-affected countries to the U.S. anymore. Many passengers are arriving on connecting flights from other parts of the world, and then they come here, so that makes it more of a challenge.”
So, a couple of dozen well funded and well trained terrorists get on airplanes and destroy the World Trade Center and mess up the Pentagon, etc. This makes us consider more carefully the threat of terrorists attacking the US. We set up draconian laws and expensive systems that have the net effect of measurably removing freedoms for Americans, annoying people in other countries, and nudging us closer to a police state than ever before. We’ve even closed the border with Canada to anyone without passports, and even there, US and Canadian citizens can no longer assume they can freely travel back and forth. We fly drones over villages in other countries and blow people up (It’s OK, they were all bad) and we keep closer track of everything all the time everywhere than ever before.
But we can’t tell where a person getting off an international flight originated? Wut? I would have thought that would be the number one thing that would be implemented as part of the Homeland Security Upgrade. First thing.
Homeland Security in the US, the biggest shiniest newest system on Earth, fails the Ebola test.
In some ways, that is actually a bit comforting. But it is also terribly annoying.
The Ubuntu 14.10 Upgrade: What to do
The Ubuntu 14.10 Release October 23, 2014
Ubuntu 14.10 will be released shortly and I know you are chomping at the bit and want to know all about it.
There is some important news, for some, and there is some exciting news for others, and there is some boring news, and frankly, some bad news.
Before diving into the shallow pool of Ubuntu 14.10 (shallow in a good way) I want to go over some other ground first. I want to address this question:
“I have installed Linux and I don’t like the default desktop. How do I change that without ruining stuff?”
If you are a long time Linux user you know the answer has two parts. First, “Oh, hey, don’t worry, this is why Linux is so great!” and second, something like “sudo apt-get install yadayada, then log out and then log back in again with your new desktop” where “yadayada” is the new desktop. Easy peasy.”
Now, let is rephrase the question, and in so doing reveal the bad news.
“I have installed Ubuntu 14.04 and I don’t like the default desktop. How do I change that to gnome?”
The answer to the question is actually pretty simple, but has a very different form that I find deeply disturbing. Again, there are two parts. First, “Well, Ubuntu comes default with Unity, and Ubuntu with Unity and some other stuff under the hood does not actually allow you to just swap around desktops like you could in the old days without messing around a lot and depending on exactly how good the information you get on this is, and which desktop you replace Unity and all that with, you will probably break something.” Putting this another way, Ubuntu has broken one of the most important features of Linux, one of the features that makes Linux cool, and in so doing, Ubuntu has made Linux more like Windows. Ubuntu/Unity/Etc as a “distribution” is now vertically integrated across the usual layers to the extent that it is either take it or leave it (I oversimplify but not by much).
And of course, you can leave it. That is the second part of the answer. “You will need to essentially replace your current distro with another distro.”
How to replace Unity with Gnome on Ubuntu
There is a tool to do this, available from Ubuntu. This is actually a pretty amazing tool. It allows you to take a current distribution of Ubuntu and convert it to a different flavor. Ubuntu comes in many flavors. The default is with Unity and it is a desktop environment designed for the average user. Then there are alternatives that have either different desktops or that serve very different purposes, and mixing and matching is allowed to some extent. For example, Ubuntu can be a basic server, or a web server (called a LAMP server), or a mail server (or all three) perhaps without any desktop at all. Or, you can pick any of several distinct desktops like Kubuntu (uses KDE, which a lot of people like) or XFCE, which is what Linus Torvalds and I use, or Gnome 3, and so on.
The tool is called tasksel
You install and run tasksel (sudo apt update; sudo apt upgrade; sudo apt install tasksel; sudo tasksel) and you get a thingie that lets you pick a “Package Configuration,” which looks like this:
You then very carefully follow the instructions or you will ruin everything! But if you do it right, it should very cleanly remove Ubuntu’s default desktop and install Gnome 3 or whatever. HERE are the instructions and HERE is an excellent episode of the Linux Action Show that goes into detail.
Important additional information: First, this information is current in early October 2014. If you are reading this much later than that, re-research because things may change. Second, it is not perfectly true that Ubuntu does not let you install new desktops and use them. It is true, however, that this is not seamless, harmless, or even recommended. A clue to the seriousness of this is that if you use tasksel to remove Unity and install Gnome 3, you can’t then install Unity because Unity will not cohabit with the version of Gnome you’ve installed. There is too much stuff in the middle that does not work right.
I have installed multiple desktops on top of Ubuntu 14.04, including Mate, Gnome 3 and Gnome Panel. It was the first time for me that playing with desktops broke my system and I’ve been using Linux (and Ubuntu) for a long time, and I mess around with desktop a lot. This is the new normal (for Ubuntu). You will see instructions on what you need to do to switch around desktops on Ubuntu, but frankly, that boat may have sailed other than the use of extreme measures such as tasksel.
I will give you a recommendation below if you are confused or uncertain about what form of Linux you might want to install, based on my own experiences.
Now, back to what you need to know about Ubuntu 14.10.
The first thing you need to know is that Ubuntu 14.10 is almost exactly like 14.04. There are virtually no visible meaningful differences as far as I can tell. So if you are using Ubuntu and are sticking with Ubuntu, don’t expect pretty fireworks. This will not be an exciting upgrade.
Second, 14.10 has an updated version of the kernel, the deep guts of the operating system, and this is important. It is good to have a current kernel. Also, this kernel has some important new hardware support. Some Dell laptops have the ability to turn off your hard drive if it feels itself falling, so the drive is not running when your laptop hits the ground. The new kernel actually supports this feature so if you have a newer Dell laptop, you might want that. There is some improvement in the handling of Dell touchpads as well. The point is, you should absolutely upgrade to 14.10 for a number of unexciting but still potentially important reasons.
Want a better desktop, mate?
No, we are not in Australia. The third item is the big exciting news. If you think Unity sucks, and you liked the old fashioned Gnome desktop (back in the days of Gnome 2.0) you will find this cool. Gnome 2.0 was the best Linux desktop for most purposes, in my opinion. With the new approaches taken by both Unity and Gnome 3, and since forever with KDE, I get the sense that the purpose of the computer is to have a cool desktop. For me, the purpose of my computer is to run certain software and manage files. The purpose of the desktop is to facilitate that, ideally in a way that allows me some customization, but that stays consistent over time so an upgrade does not break my workflow or force me to relearn how to use the hardware, and often, that means just staying out of the way. For me, Gnome 2.0 was the sweet spot in meeting those requirements.
But Gnome has moved on. The current thing that looks and acts like Gnome 2 is called Gnome Panel. It kinda works but it has problems, especially (in my experience) on a laptop. It is not being kept up like it should be to be a current usable desktop. So, sadly, Gnome is no longer recommended for those who liked traditional Gnome. This not to say that Gnome 3 (or for that matter Unity) aren’t great. But they aren’t. Just sayin’
But then there is mate.
Mate is a fork of Gnome that intends to maintain Gnome 2 coolness. It has been around for a while now. It has been updated regularly, and the tradition seems to be to come up with the newest version of the mate desktop in sync with Ubuntu’s release schedule. I’ve tried mate a few times, and I’ve had mixed experiences with it, but in the end it is probably the desktop you want to install if you want Gnome 2-osity on any form of Linux.
This is a bit confusing unless you are already used to concepts like the difference between the terms “desktop,” “desktop,” “desktop,” and “desktop.” Mate is a desktop. Most desktops come along with software that is not strictly desktop but works with the desktop. There are two ways to get many (but not all) desktops. One is to install a “distribution” that uses that desktop, like installing Kubnutu to get the KDE desktop. The other way is to have some normal form of Linux on your computer, then you install the desktop onto that and later, you can chose to log into the newly installed desktop, or some other desktop that happens to be on your system.
Mate was available as an Unofficial Ubuntu Desktop. This means that the mate people would take the guts of a current Ubuntu distribution, and replace various parts with other parts so when you download and install the unofficial Ubuntu mate desktop you get Ubuntu with mate as your desktop.
Now, after a period of regular development, mate is an official flavor of Ubuntu. This means that you can do exactly what you could do before, install Ubuntu with mate instead of Unity or KDE or whatever. But it probably has other implications. I assume that being an official desktop enhances the degree to with an Ubuntu Mate distribution will install cleanly and function well.
It does not exist yet. I understand Ubuntu Mate as such will be released on October 23rd, the same day as Ubuntu. And it comes at a time when Ubuntu continues in the process of seriously downplaying the non-Unity desktops. If you go to the Ubuntu site and see what is there and download and install it, you can be forgiven for not ever knowing that you could have installed Edubuntu, Kubuntu, Lubuntu, Mythbuntu, Ubuntu GNOME, UbuntyKylin, Ubuntu Studio or Xubuntu. You have to dig through a couple of layers of the site and then you get to a scary page that most people will think is just for techies. In the old days, Ubuntu highlighted the diverse alternatives. Now, the bury them. That concerns me.
What you should do instead of automatically installing Ubuntu
There are a lot of Linux distributions out there, and you are of course free to mess around with them. But I’m happy to give you my current advice (subject to change frequently!) about what you might consider doing.
A given Linux distribution, which includes its own distribution materials, may or may not work fully and easily on a given piece of hardware. Considering that when you are looking at or working in a browser or your favorite text editor, the system you are using isn’t that important most of the time, the ease and seamlessness of the installation is really one of the most important features of a distribution. It is my belief based on recent experience messing around with installing several different distributions on five different computers (four laptops, one desktop) that Ubuntu, in one form or another, will generally install the easiest. This includes getting the install medium, doing the installation, and getting help when something goes wrong.
Having said that, installing debian, a traditional well developed form of Linux, on which Ubuntu is based (as are many other distros and most installations worldwide, I think) is pretty easy. Having said that, I quickly add that you probably really want to install one of the “extras” versions of debian, which includes “non free” material and is stored in a scary place and not so well documented.
So, my first piece of advice is this. Get two sets of installation media (this is not hard). One for Ubuntu, the other for debian. Try to install debian. If you run into trouble, switch to Ubuntu. You’ll get the job done. The installation process is not too time consuming or difficult, so this is not a big deal.
My second piece of advice is to figure out what desktop you like. If you actually like Unity, then by all means go over to the dark side and install default Ubuntu. Have a nice time communing with the devil. See you on Halloween!
But if you prefer a different desktop, like Gnome 3 or whatever, then follow my first piece of advice, trying debian than Ubuntu. If debian installs well, then go to town installing your preferred desktop if it wasn’t the default during your install. If debian does not work, then pick the flavor of Ubuntu that has your preferred desktop.
My third piece of advice I’m giving with an important caveat. The caveat is that I’ve not tried this yet so I have no business telling you to do it. But I am going to try this and I think it might be cool. If a Gnome 2 style desktop is your preference, then either install debian and then install mate on top of that, or install Ubuntu Mate 14.10 when it comes out. Just for fun. It might work great.
My fourth piece of advice is this. If you like the Gnome 2.0 desktop and you want to use a well tested and tried interface, consider using XFCE instead. XFCE is quite like Gnome 2 in many ways, but even less in your face. You could install Xubuntu, the Ubuntu flavor with XFCE as the default (or if you have Ubuntu Unity maybe you can use tasksel to switch, depending on things I don’t want to advice you on). Or, and this is probably the ultimate solution, you can instal debian with XFCE. Which, tellingly, is the default desktop for the canonical Linux distribution that is not Canonical. (See what I did there?@?)
And remember, there are only two things you need to keep your eye on. First, you need a computer that will run your software, and pretty much all of these solutions should do that equally well; the only difficulty here is the match between the distro and the hardware, and for a desktop computer, any Linux flavor with any desktop will probably work so you won’t be pounding your desktop in frustration. For laptops you may want to be more conservative and go with the herd (Ubuntu). Second, whatever you do, have fun. And there is nothing in the world more fun than repeatedly reinstalling your operating system, right????
Two Ways Hollywood and Literature Have Confused The Ebola Problem
According to popular literature (some fiction, some not) and movies, Ebola can cause havoc, infecting thousands of people, killing over half of them, and threatening an entire nation if it were to become airborne. Turns out that’s not true. Ebola can do all those things without becoming airborne. In several nations.
The confusion caused by this misconception is further enhanced in a more subtle way. Since the Hollywood version of Ebola (or some other similar disease) indicates that it is dangerous because it becomes airborne, we see constant claims today on the Internet that Ebola must be airborne because it is out of control in West Africa. And, of course, we see claims that it is only a matter of time before it becomes airborne. But an examination of the disease from an evolutionary perspective suggests that this is extremely unlikely. It is almost as though people have to believe that Ebola will eventually become airborne (or already is) to take it seriously. It wont’ become airborne. You must still take it seriously.
So that is the first area of confusion, about what Ebola is and what it does and does not do.
To this confusion, by the way, we may add the already mentioned hyperbolic reaction to Ebola, often of a rather tin-hat variety and the equally incorrect hyperskepticism that has made claims like Ebola is not that big of a deal because it is not malaria. That is also demonstrably false.
The second area of confusion is what is normally done when something like Ebola shows up in the US, as it has in Dallas, Texas. The Hollywood and Literature version is that a big silver truck shows up at the site, people with protective gear jump out of the back, individuals are taken away to Level 4 containment facilities that are handily available nearby, the site is sterilized using high tech devices (or imploded or burned down with flame throwers?), and if there are a lot of possibly infected people, everybody is quickly rounded up and moved in large green trucks to a containment camp run by the Army, with Morgan Freeman in charge whom you think at first is a nice guy but turns out to be evil.
Well, some of that is sort of happening, but slowly and clumsily and with no has-mat suits and no containment camp. As I write this I’m watching the live briefing on Ebola in Dallas. We have just learned that pretty soon some guys are going to go over to the apartment where the family of the patient lives. They will do the laundry when they get there because there might be Ebola kooties on the sheets and pillows. The CDC went grocery shopping for them, and they are being told they can’t leave. So in a way this is a little like what Hollywood says would happen, but with much, much lower production value and pretty much as a post-hoc set of reactions rather than a clear plan always in place just in case.
We are also learning at the news conference that there is not a current plan for where to take a second or third Ebola case. No playbook in place. Having said that, the authorities are confident that they can handle the problem.
None of this is surprising. After all, fiction is fiction. That’s why they call it fiction. What is also not surprising, but disappointing, is the low level of thought behind the questions the press are asking, and the highly unprofessional approach taken by some reporters. Pro tip: Don’t ask only dumb questions, or questions that have already been answered, then be all mad and stuff when the press conference ends sooner than you thought it should.
More on Ebola:
- Two Ways Hollywood and Literature Have Confused The Ebola Problem
- Ebola in Dallas Texas: Is our response adequate?
- Ebola Will Not Become Airborne And Here Is Why
- Has the Ebola Death Toll Surpassed Malaria in West Africa?
Ebola in Dallas Texas: Is our response adequate?
First, let’s look at the situation in West Africa, because that is way more important than anything going on in the US right now. The WHO has said two things about this. First, if there is not a full intervention, there may be hundreds of thousands or even millions of cases of Ebola several months from now (cumulatively). Second, with full intervention they can stop this epidemic.
What is full intervention? They say that full intervention is the development and manufacture of an effective vaccine, and the deployment of that vaccine to a very large percentage of the affected population.
Putting this another way, the current response has been inadequate, and while it can be improved, it can’t be made adequate. Things are pretty bad, are going to get enormously worse, and there is little hope for any other outcome, unless full deployment of a vaccine that does not exist over the next six months is realistic.
Now let’s look at the US. Public health officials and public health experts have been saying the same thing for months. Don’t worry about an Ebola outbreak in the US. We can handle it. We know what we are doing, and we have the systems in place to take care of this. So just don’t worry.
I’m going to tell you now why this is probably both true and untrue.
It is probably true at the large scale. We are not going to have an outbreak of Ebola in the US that involves hundreds of people getting the disease. Probably not even dozens. But, it is not true that we have the capacity to fully handle Ebola coming to the US in the way most people assume this is meant. It is very possible for Ebola to some to the US and make a bunch of people sick with about half of them dying. How many is a bunch? Five, maybe eight, something along those lines, but possibly a few times, in a few places, adding to a couple of dozen. (Totally guessing here, feel free to make your own guess.) That may not happen at all, but given the current situation it is absolutely possible. However, it is not necessary. If our public health system was truly able to handle an Ebola intrusion, the only people who would have Ebola in the US would be those who arrive with it, and possibly a very small number of additional people, not a bunch. In other words, unless changes are made, the inadequacy of our system, said to be fully adequate, will allow several people in the US to become ill, some will die, over the next year.
Here is why.
First, consider the travel problem, which is probably the smallest part of this. When Patient X came to Dallas with no Ebola symptoms, he was almost certainly not a risk. But he did get on an aircraft with the disease, and took a long trip the US. If this event happens 100 times over the next several months, how many times will the patient become symptomatic on the plane, possibly exposing others? 10% of the time? 5%? 20%? Hard to say, but often enough that over the next several months hundreds of travelers and airline workers will be exposed, but, the chance of them contracting the disease is low. So, with the current expanding outbreak and current policies, a very small number of people may get Ebola in a system that claims to be totally able to handle it. That’s small change compared to what is going on in West Africa, and it is probably the least of our worries here in First World Land.
Second, we have the problem of reporting and identification. Patient X became symptomatic and then for something like a day did not seek medical help, during which time various individuals were potentially exposed. Again, since Ebola is not airborne, the chances of them getting the disease is low, but it is real. The problem is that when people get sick, there is almost always going to be a window of time from a few hours to a couple of days during which the most prepared health care system in the world has no control over what happens because the person does not show up at a hospital or clinic. There may be no way to avoid this, but the risks can be reduced. If the West African epidemic continues members of the communities that overlap between the US and West Africa will be at risk, albeit low risk, of exposure to those who travel back and forth on a regular basis. What needs to happen is that those communities take special care to address this issue internally. All it is going to take is one or two Americans catching the disease from a person living part time in West Africa to shut down air connections between the two regions. If we want to avoid this, there needs to be self-monitoring in the communities.
Third, we have the unconscionable thing that happened in Dallas. A patient who had been in Liberia showed up with Ebola like symptoms in a hospital and was sent home. Holy moly. Why did that happen? Well if you’ve been recently in the hospital for anything that required testing and such, you may already know. Hospitals and clinics, but especially emergency rooms, are run like those steak houses that became popular back in the 1980s. You arrive at the steak house, and a nice person with a big smile seats your group. Then a server comes over and takes drink orders. A second server brings the drinks. A third server comes by for your meal order. A fourth server brings the appetizers, and a fifth server brings your meal. Eventually somebody comes by with the check. (Remember those?)
In an emergency room, there will probably be a physician taking care of you but all the tests that are run are done by different individuals, if there is some kind of treatment you need, the person who cues you in on that (tells you how to take the pill or use the device they are going to give you) is different still. The person who checks you out is different still. What is the possibility that a concern you address to the physical will be responded to by that physician later during your visit? It depends on how fast the person who check you out and sends you home arrives on the scene. Maybe 50–50.
That is probably how Patient X was let go with Ebola. The system has too many places to break. How likely is that to happen again in other emergency rooms or clinics in the US? Not zero.
So, the bad news is that our system does not really put the lid on Patient Zeros that may show up in clinics or hospital, reliably. The system we have been assured would not allow an outbreak probably won’t allow an outbreak, but it may well allow dozens of people to be needlessly exposed, among whom some may contract the disease.
Now here’s the good news. It is said (though the information is spotty) that between 80–100 people who may have had even minimal contact with Patient X are being checked twice a day for fever, and a smaller number are being looked at more closely, even quarantined. The several schools attended by some kids Patient X had contact with are being sterilized. And so on. Frankly, this is more than necessary, but that’s irrelevant. If you only have a few tiny “hot zones” (in this case, one, and not that hot) an abundance of caution is not overkill. If over-cautious reactions eventually emerge whenever an Ebola patient shows up in the US, the larger scale outbreak will be avoided. But the handful of people initially at risk will not be safe by virtue of our system.
Perhaps that is unavoidable, but I think most people will look at the Dallas event and say that sending the patient home clearly should not have happened, and now every hospital and clinic in the country will be extra cautious. Like, remember that one time a surgeon accidentally amputated the wrong leg, and after that one time, it never happened ever again anywhere?
What, you don’t remember that? Hmm… me neither.
(Also, consider this: Imagine implementing the level of caution now being implemented in Dallas in the affected areas of West Africa? Can you imagine implementing this only half way, or a quarter of the effort? That would a) stop Ebola and b) be impossible. That is why the outbreak continues there. We have a lot to be thankful here in the US.)
Conclusion: The communities that have regular interaction with the affected countries are already in many cases somewhat organized as communities. These communities need to develop humane and thoughtful ways of making sure travelers are properly watched after. Everyone who works in any clinic or hospital has to double check what they are doing and not mess up again. The initial conditions that led to the current situation in Dallas are going to become more common over time.
And, remember, so far everything in Dallas is under control, but it will take 27 days to be sure (the incubation period is about 27 days, despite the “21 day” number you keep hearing). Also, while Ebola can manifest in an infected patient as quickly as two days after exposure, it is more typical to show up 8-10 days later. So the first week to 10 days of October is a fairly likely time, perhaps, to see a second case in Dallas, if there is in fact, further infection.
More on Ebola:
- Two Ways Hollywood and Literature Have Confused The Ebola Problem
- Ebola in Dallas Texas: Is our response adequate?
- Ebola Will Not Become Airborne And Here Is Why
- Has the Ebola Death Toll Surpassed Malaria in West Africa?
I hope Judith Curry apologizes for this.
I’m not going to talk about Mark Steyn, other than to say that if you know who Rush Limbaugh is, Mark Steyn is a bit to the right and a tad more obnoxious, but not as smart.
You can find out more by clicking here, using the Climate Change Science Search Engine.
I’m also not going to say much about Judith Curry except that, unlike Steyn, she was a regular scientist who did climate science. Over time the material she has written, both in peer reviewed journals and on her blog, has become increasingly aligned with those who are highly skeptical that global warming is real. She has a theory that global warming is an artifact of models (even though we can see it without the use of models), and I’m pretty sure she’s been wrong about almost everything she’s done recently. But, that’s how science works. Sometimes a scientist is wrong. Some are not wrong very often. Some are wrong almost all the time. It’s a thankless job, but somebody’s got to do it. Maybe someday she’ll start getting more useful results with her work.
Anyway, Mark Steyn has recently aligned himself with the Mens Rights Movements, and Slyme Pit (you know who they are), in other words, antifeminist, pro harassment, not-too-concerned-about-rape crowd, in their cottage industry of giving me a hard time on the Internet. That fits since he is, after all, to the right of, and not quite as smart as, Rush Limbaugh.
And now, Judith Curry, has aligned herself with Mark Steyn and his systematic harassment of climate scientist Michael Mann, and to a lesser extent, me.
This is a tweet favoriting a tweet by Mark Steyn pointing to his own blog post in which he carries out obnoxious attacks on Mann and me. For my part, he points to this post on my blog, which he takes to be an indication that I stalked a particular woman. Go read the post. Tell me if shutting down a crazed graduate student who was harassing other grad students, an undergrad, and a few others, using standard procedures (telling mom and dad, in this case) is stalking. It isn’t. Also, tell me if Judith Curry’s favoriting of this tweet indicates her approval of Steyn’s methods. Does it?
This “favoriting” of Steyn’s tweet of his post by Curry seems to align Curry with the worst of the worst. Did she also “like” Rush Limbaugh’s assertion that Sandra Fluke needs to keep an aspirin between her knees, and that the tax payers should not be paying her to have sex? Or Rush Limbaugh’s comments making fun of kids who need help getting a simple lunch at school? I’m hoping, though, that Judith Curry simply was unaware of how much of a misanthrope Steyn is, maybe she’s never heard of him before and doesn’t know that he is this incredibly offensive person, and just saw someone taking a jab at Mike and clicked on the little “favorite” button.
It was after all, just a “favoriting” of a tweet by Steyn. Which means Curry can step back from this with a simple apology to Michael Mann and me. Then, no big deal, I’d move on. Up to her.
Or, she could not do that. But I really didn’t think she was that kind of person. But maybe she is.
(See also this response to Steyn’s tweet.)