6 ms·

Day 7: Brutal Triage – Freetown, Sierra Leone

19 points by hblanks 12y ago

hblanks 12y ago
These are the numbers in Sierra Leone from Les Roberts, WHO Foreign Medical Team Coordinator. Les is a long-time epidemiologist and sanitation engineer; he's served in dozens of outbreaks and conflict situations including both of the cholera epidemics in Goma following the Rwandan genocide.
danieltillett 12y ago
I wish I had someway to up vote this post to the top of HN. I feel like I am in a theatre on fire and everyone is ignoring it and just complaining that the smoke is blocking their view of the stage.
mturmon 12y ago
From the OP, which is worth reading in its entirety: "[...] this is not about treating the ill as much as it is about minimizing infections. [...] We are primarily trying to facilitate people to die without infecting others. Very little of this logic beyond the ORS [oral rehydration supplement] is about treatment."
- danieltillett 12y ago
  There are so many unanswered questions. Why would any family bring a loved one to one of these ECUs? You are basically abandoning someone you love to die alone in great pain. Who is going to volunteer to work in one of these ECU as they will be basically unprotected and at great risk? Even if everything go according to plan they will be worse in a months time than they are now?
malandrew 12y ago
" We are about to assist thousands and thousands of people to die an excruciating death at home without even the most mild of pain relief." I simply don't understand this. Why isn't humane assisted suicide an option considered in this scenario? If I were one of the people who was going to be left to die an excruciating death, all I would want is one syringe with a super potent does of heroin... i.e. enough to slip into a warm coma and then shut down my breathing and nervous system. How hard can it be to repurpose seized drug shipments for such a purpose if shit is truly hitting the fan. The longer the host stays alive, the longer the virus has to multiply in the host and get caretakers sick.
- d0mine 12y ago
  50% survive.
  - malandrew 12y ago
    The number I've seen is 30% and I've haven't seen anything written on the quality of life afterwards... But either way, a 50% survival rate under circumstances where I am more likely to infect those I love the longer I'm alive makes it a much easier choice. At an R0 of 2, I'm statistically likely to take one other life, who will go on to take one other life etc. At an R0 of greater than 2, I'm going to result of many more people. Only at an R0 less than 2 is it even reasonable to consider trying your chances to stay alive.
    - d0mine 12y ago
      50% is for the current outbreak in West Africa. Total Cases: 9937 Total Deaths: 4877 http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/index.html http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/inde...

19 points by hblanks 12y ago

These are the numbers in Sierra Leone from Les Roberts, WHO Foreign Medical Team Coordinator. Les is a long-time epidemiologist and sanitation engineer; he's served in dozens of outbreaks and conflict situations including both of the cholera epidemics in Goma following the Rwandan genocide.

danieltillett 12y ago

I wish I had someway to up vote this post to the top of HN. I feel like I am in a theatre on fire and everyone is ignoring it and just complaining that the smoke is blocking their view of the stage.

mturmon 12y ago

From the OP, which is worth reading in its entirety: "[...] this is not about treating the ill as much as it is about minimizing infections. [...] We are primarily trying to facilitate people to die without infecting others. Very little of this logic beyond the ORS [oral rehydration supplement] is about treatment."

danieltillett 12y ago
There are so many unanswered questions. Why would any family bring a loved one to one of these ECUs? You are basically abandoning someone you love to die alone in great pain. Who is going to volunteer to work in one of these ECU as they will be basically unprotected and at great risk? Even if everything go according to plan they will be worse in a months time than they are now?

malandrew 12y ago

" We are about to assist thousands and thousands of people to die an excruciating death at home without even the most mild of pain relief." I simply don't understand this. Why isn't humane assisted suicide an option considered in this scenario? If I were one of the people who was going to be left to die an excruciating death, all I would want is one syringe with a super potent does of heroin... i.e. enough to slip into a warm coma and then shut down my breathing and nervous system. How hard can it be to repurpose seized drug shipments for such a purpose if shit is truly hitting the fan. The longer the host stays alive, the longer the virus has to multiply in the host and get caretakers sick.

d0mine 12y ago
50% survive.
- malandrew 12y ago
  The number I've seen is 30% and I've haven't seen anything written on the quality of life afterwards... But either way, a 50% survival rate under circumstances where I am more likely to infect those I love the longer I'm alive makes it a much easier choice. At an R0 of 2, I'm statistically likely to take one other life, who will go on to take one other life etc. At an R0 of greater than 2, I'm going to result of many more people. Only at an R0 less than 2 is it even reasonable to consider trying your chances to stay alive.
  - d0mine 12y ago
    50% is for the current outbreak in West Africa. Total Cases: 9937 Total Deaths: 4877 http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/index.html http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/inde...