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The caveats to your comment are in my opinion as follows: Bundibugyo the current strain has not previously been responsible for material outbreaks, as such it h

by phyalow 24d ago

The caveats to your comment are in my opinion as follows: Bundibugyo the current strain has not previously been responsible for material outbreaks, as such it has therefore received significantly less scientific attention. Additionally Ebola (Zaire) has previously been shown to be potentially spread via aerosols. https://www.nature.com/articles/srep00811 https://www.nature.com/articles/srep00811, the CDC and associated institutions resolutely claim this is not possible, yet also insist on full respirator PPE. For any institution to claim we know much about this strain isnt true. An alarming fact to update ones prior is the current size of the outbreak and its rapid development compared to ALL previous outbreaks (yes conditions on the ground maybe confounding this), but the scientific approach would be to say, we simply do not have enough evidence to make any claims of significance. I am quite worried about the potential for this situation in the DRC (a country of ~116m people, ~55% rural) to 1) not burn itself out, 2) act as a smouldering viral reservoir where occasional spillovers occur to the western hemisphere. 2) Is interesting politically for Western countries, because even if a mass pandemic DOES NOT occur (this is my base case), the pressure of containing a handful of regularly appearing and likely high profile Ebola cases by public health authorities will be acutely felt politically and socially. It is very possible some sorts of lockdowns are implemented. Yes vaccines are in development, yes rapid antigen testing is possible. But this is no Covid, 50%+ CFR is a totally different beast! I think this is potentially close to some sort of worst case scenario from a social and political perspective even if the public health impact IS limited.

gucci-on-fleek 24d ago
> Additionally Ebola (Zaire) has previously been shown to be potentially spread via aerosols. https://www.nature.com/articles/srep00811 https://www.nature.com/articles/srep00811 Ah, I was not aware of this, so thanks for pointing that out. That does indeed look quite concerning, so let's hope that that won't apply to humans (although I'm struggling to think of a plausible biological reason for why it wouldn't). > I am quite worried about the potential for this situation in the DRC (a country of ~116m people, ~55% rural) to 1) not burn itself out, 2) act as a smouldering viral reservoir where occasional spillovers occur to the western hemisphere. I agree that this is bad in the sense that something absolutely horrific is happening to a lot of people; I was just trying to refute the point that we could also somehow wake up with Ebola a month from now.
- fakedang 24d ago
  Doesn't Ebola kill faster than transmission can be maximized? I believe Nipah in Asia also faces the same "issue".
  - colingauvin 24d ago
    In general the more severe a virus the less likely it is to spread into a pandemic. This is for a couple reasons: 1) really sick people are less likely to go spread it, 2) really sick people are easier to identify and isolate and 3) the time between virus shedding and death is very small. There are, of course, some exceptions (long incubation periods where you can shed virus but are totally asymptomatic) but those are rare and usually self limiting in some other factor. Smallpox was really the worst possible case and we have thankfully eliminated it. Big deadly pandemics (black plague level) are usually bacteria.
    - paimapi 24d ago
      >Big deadly pandemics (black plague level) are usually bacteria. that's not really true, is it? I'm thinking small pox and influenza are big ones with well-studied pandemics that had fairly high mortality rates
xienze 24d ago
> It is very possible some sorts of lockdowns are implemented. What drives me nuts, and the same thing happened with Covid, is all the things you mentioned are true and yet western countries don't even entertain the possibility of preemptively denying travel from these countries until things get under control. I think the US, Europe, etc. will manage to survive without travel from the DRC et al for an extended period of time. But will governments actually do it? Nah...
- thinkcontext 24d ago
  The US has travel restrictions, therefore you are incorrect that "western countries don't even entertain the possibility of preemptively denying travel from these countries until things get under control" https://www.cdc.gov/ebola/situation-summary/returning-travelers.html https://www.cdc.gov/ebola/situation-summary/returning-travel...
  - xienze 24d ago
    OK, guess I missed that one. Score a point for mean ol' Trump I guess. But, you're ignoring that it's also not exactly a blanket ban on travel from the DRC, just "within the last 21 days", which... does that make a meaningful difference? And, where are the other western countries doing the same? Kinda my point. If it's done at all, it's a day late and a dollar short.
    - AnimalMuppet 24d ago
      I believe that Ebola will kill you a lot faster than 21 days. It's not going to be latent in you for that long. [Edit: Arodex notes that it can remain dormant for years (at https://news.ycombinator.com/item?id=49418182 https://news.ycombinator.com/item?id=49418182). So, yes, someone could bring it back. It probably wouldn't be an active infection, though. But what is the alternative? Nobody who ever visits the DRC can enter the US ever again? That seems like overkill.]
    - gucci-on-fleek 23d ago
      > But, you're ignoring that it's also not exactly a blanket ban on travel from the DRC, just "within the last 21 days", which... does that make a meaningful difference? What's the alternative here though? It's not really okay to lock your own citizens out of the country indefinitely, so there has to be some way for people to be able to come back home eventually. Requiring an Ebola test on entry would be one option, but those Ebola tests would probably be better used on patients in Africa, so it would be hard to defend such a policy from an allocation of resources perspective.
timr 24d ago
> Additionally Ebola (Zaire) has previously been shown to be potentially spread via aerosols. …between inoculated pigs and monkeys, in a lab. Pigs infected with this strain, quite notably, do not become hemorrhagic, and as the article notes, manifest as a respiratory illness. So it isn’t fair to point at it and draw conclusions about humans. Moreover, from the article: ”We have also never observed transmission of EBOV from infected to naive macaques, including in an experiment employing the same cage setting as in the current study, where three NHPs intramuscularly inoculated with EBOV did not transmit the virus to one naive NHP for 28 days, the duration of the protocol.” They’re literally telling you that the thing you’re fear-mongering about was tested for, and not found to exist. > the CDC and associated institutions resolutely claim this is not possible, yet also insist on full respirator PPE. …for people working with late stage infections, in close quarters. Usually with many such cases. This is a case where “better safe than sorry” applies.

by phyalow 24d ago

gucci-on-fleek 24d ago

> Additionally Ebola (Zaire) has previously been shown to be potentially spread via aerosols. https://www.nature.com/articles/srep00811 https://www.nature.com/articles/srep00811 Ah, I was not aware of this, so thanks for pointing that out. That does indeed look quite concerning, so let's hope that that won't apply to humans (although I'm struggling to think of a plausible biological reason for why it wouldn't). > I am quite worried about the potential for this situation in the DRC (a country of ~116m people, ~55% rural) to 1) not burn itself out, 2) act as a smouldering viral reservoir where occasional spillovers occur to the western hemisphere. I agree that this is bad in the sense that something absolutely horrific is happening to a lot of people; I was just trying to refute the point that we could also somehow wake up with Ebola a month from now.

fakedang 24d ago
Doesn't Ebola kill faster than transmission can be maximized? I believe Nipah in Asia also faces the same "issue".
- colingauvin 24d ago
  In general the more severe a virus the less likely it is to spread into a pandemic. This is for a couple reasons: 1) really sick people are less likely to go spread it, 2) really sick people are easier to identify and isolate and 3) the time between virus shedding and death is very small. There are, of course, some exceptions (long incubation periods where you can shed virus but are totally asymptomatic) but those are rare and usually self limiting in some other factor. Smallpox was really the worst possible case and we have thankfully eliminated it. Big deadly pandemics (black plague level) are usually bacteria.
  - paimapi 24d ago
    >Big deadly pandemics (black plague level) are usually bacteria. that's not really true, is it? I'm thinking small pox and influenza are big ones with well-studied pandemics that had fairly high mortality rates

xienze 24d ago

> It is very possible some sorts of lockdowns are implemented. What drives me nuts, and the same thing happened with Covid, is all the things you mentioned are true and yet western countries don't even entertain the possibility of preemptively denying travel from these countries until things get under control. I think the US, Europe, etc. will manage to survive without travel from the DRC et al for an extended period of time. But will governments actually do it? Nah...

thinkcontext 24d ago
The US has travel restrictions, therefore you are incorrect that "western countries don't even entertain the possibility of preemptively denying travel from these countries until things get under control" https://www.cdc.gov/ebola/situation-summary/returning-travelers.html https://www.cdc.gov/ebola/situation-summary/returning-travel...
- xienze 24d ago
  OK, guess I missed that one. Score a point for mean ol' Trump I guess. But, you're ignoring that it's also not exactly a blanket ban on travel from the DRC, just "within the last 21 days", which... does that make a meaningful difference? And, where are the other western countries doing the same? Kinda my point. If it's done at all, it's a day late and a dollar short.
  - AnimalMuppet 24d ago
    I believe that Ebola will kill you a lot faster than 21 days. It's not going to be latent in you for that long. [Edit: Arodex notes that it can remain dormant for years (at https://news.ycombinator.com/item?id=49418182 https://news.ycombinator.com/item?id=49418182). So, yes, someone could bring it back. It probably wouldn't be an active infection, though. But what is the alternative? Nobody who ever visits the DRC can enter the US ever again? That seems like overkill.]
  - gucci-on-fleek 23d ago
    > But, you're ignoring that it's also not exactly a blanket ban on travel from the DRC, just "within the last 21 days", which... does that make a meaningful difference? What's the alternative here though? It's not really okay to lock your own citizens out of the country indefinitely, so there has to be some way for people to be able to come back home eventually. Requiring an Ebola test on entry would be one option, but those Ebola tests would probably be better used on patients in Africa, so it would be hard to defend such a policy from an allocation of resources perspective.

timr 24d ago

> Additionally Ebola (Zaire) has previously been shown to be potentially spread via aerosols. …between inoculated pigs and monkeys, in a lab. Pigs infected with this strain, quite notably, do not become hemorrhagic, and as the article notes, manifest as a respiratory illness. So it isn’t fair to point at it and draw conclusions about humans. Moreover, from the article: ”We have also never observed transmission of EBOV from infected to naive macaques, including in an experiment employing the same cage setting as in the current study, where three NHPs intramuscularly inoculated with EBOV did not transmit the virus to one naive NHP for 28 days, the duration of the protocol.” They’re literally telling you that the thing you’re fear-mongering about was tested for, and not found to exist. > the CDC and associated institutions resolutely claim this is not possible, yet also insist on full respirator PPE. …for people working with late stage infections, in close quarters. Usually with many such cases. This is a case where “better safe than sorry” applies.