Monthly Archives: October 2014

View 847 Friday, October 24, 2014

“I have observed over the years that the unintended consequences of social action are always more important, and usually less agreeable, than the intended consequences.”

Irving Kristol

“Transparency and the rule of law will be the touchstones of this presidency.”

President Barack Obama, January 31, 2009

For summaries of what is believed or known about strains of Ebola, see the messages from Stephanie and Brian below.

We do not yet know what strain of Ebola Dr. Craig Spencer has, nor are we really sure we know how Ebola is transmitted. In most cases the transmission mechanism is direct contact with bodily fluids – sweat, sputum semen, blood, mucus – of someone showing at least some symptoms of Ebola. In those cases infection rates appear to be very high

We have anecdotal stories of infection through other means, but those are stories fro the plague zone with no confirmation.

We can be fairly certain that there is no risk of catching Ebola from physical contact with a recently recovered Ebola patient; recovered Nurse Nina Pham was admitted to the presence of President Barrack Obama, and was given a Presidential hug in the Oval Office.

Apparently it is not so certain whether you can catch Ebola from a pet; Miss Pham’s Spaniel, Bentley, will be held in quarantine for another ten or so days before being allowed to come home, but Nurse Pham, a now recovered Ebola victim, will be allowed to play with him and give him a hug while remaining in quarantine from those not known to be immune to Ebola. We suppose that once Nurse Pham recovers sufficiently, she will be a source of plasma with anti-Ebola enzymes, which we will need if there are further outbreaks in the United States.

Given current policies such are nearly inevitable. Dr. Spencer, known to have been exposed to Ebola, came home and was not quarantined. He went to restaurants, rode subways, and went bowling. The cost of his failure simply to stay home and avoid contact people needlessly is estimated to be in the millions of dollars. Some officials have called for his prosecution for his behavior upon his recovery.

Nurse Vinson, who like Nurse Pham contracted Ebola while treating Thomas Duncan, is said to be recovering, and now has a positive prognosis. Duncan, who came from Liberia after conducting a dying Ebola patient in a vain search for a hospital that would admit her, died a few days after exhibiting Ebola symptoms. Prior to that he slept with his fiancé, and associated with many people, none of who appear to have contracted Ebola, even though two of his caretakers did come down with it within days of his death. http://www.myfoxdfw.com/story/26880079/family-friends-of-thomas-duncan-protest-outside-hospital

We may conclude that the Duncan strain of Ebola is not very contagious up to and even into the first stages of exhibiting symptoms. So far as I know we have no evidence to support similar hypotheses regarding the strain that Dr. Spencer exhibits. Doctors Without Borders does not require that its physicians remain in isolation for any period of time after they cease to treat patients and before leaving the plague zone. As a US citizen Dr. Spencer had every right to return to the United States. New York City had every right to require him to remain in self-quarantine so as to minimize the number of people with whom he would have had contact, thus saving millions of dollars in investigations of his contacts immediately before he developed symptoms; but nothing of the sort was imposed, and Dr. Spencer was left to his own devices. Apparently he was so certain that he had not been exposed and could not be contagious that he roamed the city, running in the parks, eating in public restaurants, probably shopping in local food markets, riding the subways, and going bowling. The assumption is that his (unknown) strain of Ebola is similar to that of Mr. Duncan, contagious only after symptoms have been fully developed. We may all hope that this assumption is true; evidence against it is anecdotal and comes from survivors in the plague zone.

Dr. Spencer’s timeline from Guinea to diagnosis of Ebola is given here: http://www.cnn.com/2014/10/24/health/new-york-ebola-timeline/index.html 

I have asked for a summary of what is known about Ebola strains and their degree of contagion abilities, and we’ll report on that when I get it,

Nigeria, through a very strict enforcement of quarantine, has managed to emerge from being a plague zone. The United States has not implemented any such policy. So far there have been only two cases of Ebola in the US contracted from someone imported from the plague zone. At the moment we are winning the bet that Ebola won’t spread in the US.

From the October 17 View: 

Nine Doctors Without Borders physicians, all equipped with the best of isolation and prophylactic gear, have died of Ebola.  Of the  physicians and nurses who have died of Ebola in this epidemic, most (more than 60%) had what was considered more than adequate protective gear and were instructed in its use. The US Military being sent into the plague zone have had four hours of instruction. https://www.jerrypournelle.com/chaosmanor/a-new-ebola-czar-military-deploys-to-plague-zone-competence-in-government/

I have errands. Back later this afternoon.

Far Cries

Dear Jerry,

You’ve talked about the new publishing and I wanted to let you know I’m plunging in with both pedal extremities. My backlist is handled by Open Road Media, the biggest e-publisher in New York, but I am trying to put out new stuff on my own, via Kindle Direct Publishing. The trouble is, you cannot, as in days of yore, sit back and leave everything to the publisher. You have to promote your stuff. There are various mechanisms for that sort of thing, but it’s all a new universe to me. So I am flogging my new collection of short stories.

Far Cries – Kindle edition by John DeChancie. Literature & Fiction Kindle eBooks @ Amazon.com. <http://www.amazon.com/Far-Cries-John-DeChancie-ebook/dp/B00O2PLT54/ref=sr_1_11?ie=UTF8&qid=1414181338&sr=8-11&keywords=Far+Cries>

I can pretty well guarantee that no one will have seen the likes of these stories before.  Finally an answer to the question of why Presidents would keep the alien prisoner a secret…

Transmission of Ebola

You have stated that Ebola is non transmissible after recovery.

That appears to not be the case. I have read that patients that recover are still shedding virus for several days after ending symptoms. It may be a short time but anyone who plays with death is a fool, cutting the isolation time to zilch is a risk no sane individual should attempt, even if it is for political points.

Earl

Actually I have not said that, except in irony: the evidence being that Nurse Nina was permitted into The Presence just after she was pronounced ‘cured’ of Ebola. It is clear that this is the official view, else she would not have been permitted in The Presence, much less the recipient of a hug.  Perhaps the Ebola Czar, formerly chief of staff to Vice President Biden, has not heard that the Oval Office may now be contaminated?  Or there are more factors at work?  It does seem clear that our ever competent government is certain that no harm can come from allowing a very recently recovered Ebola patient to touch the President.

I asked Stephanie to summarize what we now about strains of Ebola.

There are now 6 known strains, counting the one that has been dubbed Guinea:

Guinea ~70% fatal –> research papers in April of this year identify this with the current West African outbreak; general death rates seem to corroborate this Zaire ~90% fatal Sudan ~70% Bundibugyo ~35-40% Reston ~0% Tai Forest/Cote d’Ivoire ~~mostly animal; some researchers have developed it; human fatality rates not known; does not always present with hemorrhage

These have different fatality rates, with the most serious being Zaire, at 90% fatal. Reston appears not to infect humans, or at least not to be symptomatic in humans. Reston may also be airborne. Guinea is also in a different clade from any of the other strains. (clade: http://en.wikipedia.org/wiki/Clade) Classification is order Mononegavirales, family Filoviridae, genus Ebolavirus. Related to the Marburgvirus; may have diverged from a common ancestor. Mutation rate only about 25% of e.g. influenza virus.

If I read the papers correctly, Guinea developed separately from the other strains. This may or may not mean that it mutated from the original ancestor of the Ebolavirus and Marburgvirus independently of the other Ebola strains, which IIRC are all in the same clade.

Symptoms per CDC:

* Fever

* Severe headache

* Muscle pain

* Weakness

* Diarrhea

* Vomiting

* Abdominal (stomach) pain

* Unexplained hemorrhage (bleeding or bruising)

The UV as presented by the Sun would be insufficient to kill Ebola dried on a surface, and wholly insufficient to kill Ebola in liquid suspension, because next to no UVC reaches past the atmosphere. A UV light at a distance of 6-12" will kill the majority of Ebola, which is more sensitive to UVC than models indicated, but there will be 3-4% residue that is UV-resistant. Other solar wavebands may be as, or more, effective, but I’ve not been able to find research on it.

Symptoms may appear anywhere from 2 to 21 days after exposure to Ebola, but the average is 8 to 10 days. There is some evidence that indicates that some strains, in some people, have an incubation period up to some 42 days, or twice the maximum. This has, to my knowledge, not been proven.

Internally, victims’ tissues begin to break down, resulting in widespread hemorrhage. This hemorrhage escapes the body through available orifices (mouth, eyes, ears, nose, rectum, and any puncture wound such as provided for an IV). As the disease progresses, explosive diarrhea and projectile vomiting can be complicated by seizures. The waste material temporarily aerosolizes the virus present in the feces and vomitus, making anyone in the vicinity susceptible to contamination. The numbers I’m hearing most bruited about indicate that infection is possible if only 1-10 viruses are introduced into the body.

Insofar as is known, the Zaire strain, at least, is not a true aerosol virus. It is aerosolized during vomiting and defecating in the same fashion as one might aerosolize a liquid in a pump spray bottle; it will eventually settle out onto local surfaces. This does, however, naturally "weaponize" the virus (though not as effectively as, say, a fine powder of anthrax). One way to truly weaponize the virus would be to take a victim’s blood, dry it, and powder it to a sufficient level of fineness that the particles can become suspended in air, then disperse it in air in a population-dense area. [I’m not sure you want to publish that last bit though.]

This is all I can think of at the moment.

I want to emphasize that my degrees are not in biology, let alone epidemiology. However, by dint of the broad range of degrees I have, I was at one time my organization’s resident expert in what was then called NBC (Nuclear Biological Chemical) weapons tech and effects. (I think they call it CBRN now: Chemical Biological Radiological Nuclear.) So I know enough to be able to interpret the papers, by and large, and determine the implications and effects thereof.

Stephanie Osborn

Interstellar Woman of Mystery

http://www.Stephanie-Osborn.com <http://www.stephanie-osborn.com/>

And see the summary by Brian below.

We have often recalled Kipling’s Gods of the Copybook Headings on this site, starting actually in BIX days in the 1980’s.

Sarah Hoyt

Two excellent essays,

one the God of the Copybook Headings with modern footnotes and a study in voter fraud.

http://accordingtohoyt.com/

Direct links in case they cycle down the page http://accordingtohoyt.com/2014/10/24/theyre-baaaaaack/

http://accordingtohoyt.com/2014/10/23/will-you-also-tolerate-this/

My friend Sarah Hoyt has gone me one better, with links at nearly every line.  Worth your attention.

And the sophisticated climate debate continues:

Child Armies of the Night 

Dear Jerry

Let it not be said that either side in the Climate Wars has a monopoly on the bizarre.

While Climate Communicators have begun publishing peer-reviewed protocols for brainwashing Girl Scouts,

http://vvattsupwiththat.blogspot.com/2014/10/when-you-finish-washing-my-brain-train.html

their opposite numbers have dragged Cthulhu into the debate :

http://vvattsupwiththat.blogspot.com/2014/10/well-at-least-its-change-from.html

—

Russell Seitz

Fellow of the Department of Physics Harvard University

Thanks

Ebola Virus

Dear Dr. Pournelle,

You asked for a summary of Ebola. Regrettably, the real information is behind a paywall (http://jid.oxfordjournals.org/content/147/2/264.full.pdf)

but here is what I have been able to determine from freely available sources, such as Wikipedia and the very readable ‘Hot Zone’ (http://www.amazon.com/Hot-Zone-Terrifying-Story-Origins-ebook/dp/B007DCU4IQ/ref=sr_1_1?ie=UTF8&qid=1414247042&sr=8-1&keywords=hot+zone)

So far as I can tell, there are at least five known related viruses of this type:

1. Bundibugyo virus (http://en.wikipedia.org/wiki/Bundibugyo_virus). Mortality rate: 50%. Cause of spread: Eating monkey meat infected by the disease.

2. Ebola Sudan (http://en.wikipedia.org/wiki/Sudan_virus). Mortality rate: 50%.

3. Tai Forest virus (http://en.wikipedia.org/wiki/Ta%C3%AF_Forest_virus). Mortality rate: 0%. A killer among monkeys, but it had little impact on the human researchers investigating the deaths. One scientist was hospitalized, but recovered completely.

4. Ebola Zaire (http://en.wikipedia.org/wiki/Ebola_virus_disease#Classification) Mortality rate: 90%.

5. Ebola Reston (http://en.wikipedia.org/wiki/Reston_virus). Mortality rate: 0%. First observed in Reston, Virginia. While an absolute killer of Macaques, it had no effect whatsoever upon infected humans — which we discovered afterward, when blood tests showed that various members of the team sent to control it had become infected. This is, so far as I know, the only airborne version of the virus and can be spread just like the common cold. It killed pretty much every chimp that came down with it, but had no effect on humans. Thanks be to God.

I should also mention Marburg (http://en.wikipedia.org/wiki/Marburg_virus), which is not an Ebola variant but has similar qualities. Mortality rating: 25%.

All of these diseases share similar traits of being too successful: The virus multiplies too quickly, destroying so many cells that the internal organs fail. Dehydration, internal bleeding are also constants,resulting in high mortality. The victim becomes contagious with the onset of symptoms, 21 days after infection. Infection is primarily through contact with body fluids — the most dangerous of which is the ‘vomito negro’, the black vomit, which is practically all virus (http://www.life.illinois.edu/bio100/cindyk/ebola/symptoms.html).

I don’t believe there is any known treatment — the best that can be done is to make the patient comfortable. And, of course, inject them with antibodies from other survivors.

I believe it is unlikely that the doctor in NY will pass on the disease to any of the people he encountered — unless this is a mutant strain such as Reston which can spread through the air. I point out , however, that the patient in Dallas likewise was in contact with many people, and the only people who became ill were those who were actually working with his waste, post-infection.

I was forced to listen to a talk-radio host yesterday insisting on a travel ban to West Africa — why aren’t we doing this? So far as I can tell, the reasoning is as described in this link;

http://www.vox.com/2014/10/13/6964633/travel-ban-airport-screening-ebola-outbreak-virus

Essentially, the belief appears to be that a travel ban is futile, as a similar closing after 9/11 did nothing to prevent the propagation of influenza via air travel. It does, however, make it harder to treat the problem at its source — west Africa — and because people start lying on forms it becomes even harder to form a clear picture of what is going on.

I’m not sure I agree with the reasoning, but that is the theory.

At any rate, Nigeria is now Ebola-free (http://www.foxnews.com/health/2014/10/21/nigeria-declared-ebola-free-holds-lessons-for-others/). The solution there appears to be careful surveillance, rapid communication and tracking, and quick quarantine of cases. As opposed to Liberia, where tribal customs , lack of sanitation, superstition, and overcrowding have combined to turn the large cities into Ebola hothouses. (http://www.telegraph.co.uk/news/worldnews/africaandindianocean/sierraleone/11001610/Ebola-outbreak-fight-against-disease-hampered-by-belief-in-witchcraft-warns-British-doctor.html).

I believe the deployment of hospitals and educational personnel are just what is needed to stem the outbreak there. As to the US itself, so long as the disease does not mutate into an airborne variant, I do not believe we will see an epidemic here so long as patients can be quickly detected, diagnosed, and quarantined. This implies we will need to make sure there ARE medical facilities up to the task of imposing such quarantine, as Dallas Presbyterian apparently was not.

Respectfully,

Brian P.

Thanks to Brian and Stephanie, I think we have a good summary of what is known or at least believed on the subject. Stephanie’s summation is above.

Freedom is not free. Free men are not equal. Equal men are not free.

View 847 Tuesday, October 21, 2014

“I have observed over the years that the unintended consequences of social action are always more important, and usually less agreeable, than the intended consequences.”

Irving Kristol

“Transparency and the rule of law will be the touchstones of this presidency.”

President Barack Obama, January 31, 2009

We continue to upgrade all the systems here at Chaos Manor. Today we worked on the Mac systems upgrading one of them to OS X Yosemite. Haven’t done the Mac Book Pro yet, but we’ll get to it quickly. And I haven’t got the Mac Book Air her new battery, but that will come shortly as I look into iPhone 6 and the newest iPad. All that will be in the next column, which I have started on.

The pledge drive went so well that I used up a good bit of time recording all the subscriptions. I should automate the process, since there are a great many of them, but I like to be familiar with at least a good sample of those who subscribe and support this place. Thanks to all of you.

Charles Murray has an interview marking the 20^th anniversary of The Bell Curve and it is worth your time. Couple the conclusions of The Bell Curve – that the modern world tends to group intelligent people together so that there is a big inequality in smart between the places where the elites live and the rest of the country – some predictions become obvious. There is also the problem of jobs, not for the lowest and highest intelligence people, but those in between.

Add to that observations many including me have made about the effects of Moore’s Law on the need for humans at many jobs, including many health care jobs; the growing tendency for government to be incompetent; and the trends become even more interesting.

Murray suggests that we need some kind of distributism plus relegating a great deal of local government and other functions to local communities, which would make more people relevant and needed. Perhaps so. When I first read The Bell Curve (and if you have not read it perhaps you should; it is an important book, and it’s not about what you have probably been told it’s about) I thought of Moore’s Law and that sent me to looking at the old distributists, Chesterton and Hillaire Belloc; and lately Pope Francis I has seen some of the implications as well. More on this another time.

We are ramping up on commands to the healthcare workers, coupled with a bit of information and possibly the distribution of some equipment for dealing with Ebola. Recall that all that equipment is subject to a 20% Federal Excise tax. All medical equipment from crutches to scalpels, hemostats and wheel chairs, splints and stethoscopes, all of it is subject to a 20% excise tax, presumably to help finance affordable health care although how making medical equipment more expensive is supposed to do that is not clear to me. This raises the cost of protective gear a considerable amount.

And we are sending troops into the plague zone. We have not yet closed the gates to those coming in from the plague zones, and apparently there is no intention of doing so. Update 1100 22 October: the Administration is about to require that all those entering the country from plague areas do so at one of five designated airports.  This will, it is hoped, allow us to detect those already infected and quarantine them in suitable locations.  Of course we must hope that there are not many, since there are fewer than two score beds in proper condition to allow quarantine and treatment of Ebola patients.  Were I infected with Ebola or even afraid I might be, and I were in a plague zone, I would pay everything I had to get on an airplane to one of those five hospitals in the United States, and pray that I was hearty enough to get on that plane.  After that  I would be in the hands of a medical establishment that might save me.

Nigeria, largely through strict quarantines and not allowing anyone to enter the country from plague zones, has managed to achieve Ebola=free status.

Of course the real danger is that the plague will enter the Middle East and South America. That is a danger real indeed, but it is not clear that the 101^st Airborne is well trained or equipped to do it, and with four hours training for each soldier – although the military is in general much better trained at sanitation procedures than the general public – it is possible that some soldiers won’t get it right.

Sir:

I am Cpl. Mike Lawson USMCR. I spent 7 1/2 years in the Marines, most at 4thMarDiv 4thC.E.B (Combat Engineer), Delta Company (Knoxville, Tn). During my time there I was the Assistant NCOIC (non-commissioned officer in charge) of the company’s N.B.C. (Nuclear, Biological, Chemical) response.

Let me assure you, even as a reservist, the amount of training the average Marine (or soldier as it may be) has received in NBC procedures throughout their enlistment to include donning/doffing/Decon is more than enough for this mission. The 4 hour training is SPECIFIC to Ebola. The training we had was for threats that make Ebola look like child’s play (i.e V.X, Mustard gas, Anthrax) You need not worry about the safety and capabilities of the military sent over there. We know our stuff.

Thank you.

Sincerely yours:

Mike Lawson

My own experience is that any time there is a company of soldiers in place, a fresh dose of gonorrhea will show up on the morning report even though it would seem physically impossible for the trooper to have contracted it; but I cheerfully admit I am long out of date on such matters. I hope these paratroopers will be careful.

Here’s an interesting article from 2013 about the Viking colonies on Greenland, and how as the climate changed and became colder ca. 1300, they adapted.

http://www.spiegel.de/international/zeitgeist/archaeologists-uncover-clues-to-why-vikings-abandoned-greenland-a-876626.html <http://www.spiegel.de/international/zeitgeist/archaeologists-uncover-clues-to-why-vikings-abandoned-greenland-a-876626.html>

Note that per one method of dating the Little Ice Age, it began roughly ca. 1350AD, but certainly began no later than about 1550.

Wolf Minimum (extended solar minimum) ca. 1280-1350 (definite, but not as deep as others)

Sporer Minimum ca. 1460-1550 (significantly deeper than Wolf)

Maunder Minimum ca. 1645-1715 (deepest extended minimum)

Dalton Minimum ca. 1790-1820 (shallower than Wolf)

Also note that (as we have been seeing for the last ~2 decades) there was a gradual taper-off — both in solar activity, and in temperatures.

SIDE NOTE: This was brought on by research into Stonehenge, and the notion that Britain was "Hyperborea," "Beyond the North Wind," and that Stonehenge was the purported "spherical temple to Apollo" as purported by Hecataeus of Abdera as preserved by Diodorus Siculus. However, that same description also describes the Sun as moving around the horizon, which would place Hyperborea above the Arctic Circle. Ptolemy and Marcian both place Hyperborea in the North Sea.

Stephanie Osborn

Interstellar Woman of Mystery

http://www.Stephanie-Osborn.com <http://www.stephanie-osborn.com/>

Dear Dr. Pournelle,

I hope things are well with you. For myself, I am finding this book on the reconstruction of Iraq very fascinating.

http://www.amazon.com/gp/product/B004ULOJA2?btkr=1

It is titled "We Meant Well" — but it was nonetheless a failure.

Why?

Essentially, the fundamental issue to all of the problems recorded is the assumption that with nine women you can get a baby a month. A LOT of money was spent — it was the one thing the author says he was never short of — but most of it was wasted.

Case in point: There are a couple of different lines of effort [LOEs] that the state department would sign off on. One example was a chicken plant , built to give jobs to Iraqis and rebuild the infrastructure. Problem: Most Iraqis ate chicken imported from Brazil at a cost of 2880 dinaris for the equivalent of a bird. Chicken feed was not grown naturally in Iraq — it had to be imported. The result was that a *live* chicken sold for 3000 dinaris. After processing, the finished product went on the market at 4000 dinars — more than twice the price of the original chicken. The plant could not operate profitably, so it ran solely on American subsidies, for the benefit of ‘war tourists’ from the Green Zone.

The author explained that when he tried to shut down one of these wasteful programs, he received a poor performance review. His higher ups had careers to think about, and that means they needed to show as many dollars as possible spent on LOES [care for widows, rebuild infrastructure, revitalize economy] , preferably with pictures demonstrating success. The field grade officers in the Army were in much the same predicament — interested in quick, photogenic results which would burnish their careers.

The result is that a lot of careers were made, and most of the money was wasted.

Rebuilding a country is evidently not something you can do quickly, even with literal tons of money, and it is not best accomplished by people who are on short time to another assignment with scant knowledge of Arabic or the society. If we are to properly rebuild a country, we are going to require long-service professionals. Those are hard to come by in the modern world. In the 19th century, Englishmen LEFT England to spend their lives in these other places. But I can’t think of many moderns who would live in a third world country for any time at all if they could possibly help it.

Respectfully,

Brian P.

Confidence in the competence of government is often misplaced.  The military is often extremely competent at what it can accomplish; but when given the wrong objectives and tasks it was never designed to do, the results are not so predictable.

Jonah Goldberg

http://www.nationalreview.com/article/390606/putting-o-ebola-jonah-goldberg

On page 3, Jonah presents an unavoidably crude but accurate reason why we absolutely want to keep Ebola out of India.

(Unless, of course, this actually IS a conspiracy of the UN nutters who want to reduce global population 85+% – and rule the

survivors as an allegedly benign elite.)

Hi, Dr. Pournelle –

This might add a bit to your discussion of the Ebola crisis. If you have seen it, sorry to be redundant!

How Did Nigeria Quash Its Ebola Outbreak So Quickly? <http://www.scientificamerican.com/article/how-did-nigeria-quash-its-ebola-outbreak-so-quickly/>

Authors of a paper published October 9 in Eurosurveillance <http://eurosurveillance.org/ViewArticle.aspx?ArticleId=20920> attribute Nigeria’s success in "avoiding a far worse scenario" to its "quick and forceful" response. The authors point to three key elements in the country’s attack:

* Fast and thorough tracing of all potential contacts

* Ongoing monitoring of all of these contacts

* Rapid isolation of potentially infectious contacts

Chuck Ruthroff

Thats where I read about this before!

Jerry,

I knew I’d seen this story before. In the 6th grade reader, Jason and the golden fleece. Jason and the heroes are sent on an impossible quest by someone who secretly hopes they don’t come back. Today, a few thousand US military heroes are sent to "go fix Ebola", at a time where American safety protocols are also known to fail. That’s a pretty long time, but sure enough history repeats itself. I wonder if this iteration will be written down and remembered. I’m not sure even the Bay of Pigs was this coldly calculated, but the selection of a political assassin as the Ebola Czar is a pretty clear indication that the federal government’s decision process surrounding Ebola is 100% political.

http://washington.cbslocal.com/2014/10/17/obamas-new-ebola-czar-does-not-have-medical-health-care-background

Serving Officer

I am sure that cannot be the intent.

: New CDC Experts on Ebola –

Hi Jerry,

Normally I don’t forward jokes/images, but this one is too good to pass up.

Cheers,

Doug

<https://scontent-a-dfw.xx.fbcdn.net/hphotos-xaf1/v/t1.0-9/10610870_778460848857244_2418749490250592028_n.jpg?oh=e7179e4cf92a96f4773b76a234838aea&oe=54AE8776>

Freedom is not free. Free men are not equal. Equal men are not free.

View 846 Friday, October 17, 2014

“I have observed over the years that the unintended consequences of social action are always more important, and usually less agreeable, than the intended consequences.”

Irving Kristol

“Transparency and the rule of law will be the touchstones of this presidency.”

President Barack Obama, January 31, 2009

“We had been told, on leaving our native soil, that we were going to defend the sacred rights conferred on us by so many of our citizens settled overseas, so many years of our presence, so many benefits brought by us to populations in need of our assistance and our civilization.

“We were able to verify that all this was true, and because it was true, we did not hesitate to shed our quota of blood, to sacrifice our youth and our hopes. We regretted nothing, but whereas we over here are inspired by this frame of mind, I am told that in Rome factions and conspiracies are rife, that treachery flourishes, and that many people in their uncertainty and confusion lend a ready ear to the dire temptations of relinquishment and even to vilify our actions.

“I cannot believe that all this is true, and yet recent wars have shown how pernicious such a state of mind could be and to where it could lead.

“Make haste to reassure us, I beg you, and tell us that our fellow citizens understand us, support us, and protect us as we ourselves are protecting the glory of the Empire.

“If it should be otherwise, if we should have to leave our bleached bones on these desert sands in vain, then beware the fury of the Legions.”

Centurion Marcus Flavinius, Second Cohort, Augusta Legion to his cousin Tertullus in Rome.  No date given.

http://www.jerrypournelle.com/archives2/archives2view/view414.html#Fury

The premise of the liberal philosophy is that good intentions are the most important qualification for government office, and government is more competent to solve social problems than any other institution. Today President Barrack Hussein Obama appointed a political operative to be “Ebola Czar.”

Obama to Tap Former VP Chief of Staff Ron Klain as Ebola ‘Czar’

President Barack Obama will appoint Ron Klain to head up efforts to address the Ebola threat, a senior administration official tells NBC News.

Klain is a former chief of staff to both Vice President Joe Biden and former Vice President Al Gore. He left the vice president’s office in 2011. He is now the president of Case Holdings and serves as the general counsel for Revolution, an investment organization.

"It’s not solely a medical response," White House press secretary Josh Earnest said. "That’s why somebody with Mr. Klain’s credentials — somebody that has strong management experience both inside government but also in the private sector; he is somebody who has strong relationships with members of Congress; and obviously strong relationships with those of us who worked with him here at the White House earlier in the administration. All of that means that he is the right person."

http://www.nbcnews.com/storyline/ebola-virus-outbreak/obama-tap-former-vp-chief-staff-ron-klain-ebola-czar-n228151

I cannot resist wondering whether his association with Al Gore was thought to be qualification for a post involving scientific observations. Chief of Staff to Al Gore and Joe Biden.

Ebola Scare at Pentagon After Woman Who Was Recently in Africa Vomits on Tour Bus

http://washington.cbslocal.com/2014/10/17/ebola-scare-at-pentagon-after-woman-who-was-recently-in-africa-vomits-on-tour-bus/

Around 9:10 a.m., a woman began vomiting in the Pentagon parking lot while on a bus tour, according to Pentagon spokeswoman Lt. Col. Valerie Henderson. The woman indicated she has recently traveled to Africa.

DC Dept Health Director says woman who got sick on bus had been to Sierra Leon.

That one, at least, is not a problem: she has since confessed that she has not recently been in Africa, and physicians are confident that she does not have Ebola.  Of course the Pentagon would not be a target of Ebolized jihad.

Belize Confirms Patient With Ebola Symptoms On Cruise Ship Off Its Coast

http://belizean.com/belize-confirms-patient-with-ebola-symptoms-on-cruise-ship-off-its-coast-1814/

Six Reasons to Panic

By JONATHAN V. LAST

http://www.weeklystandard.com/articles/six-reasons-panic_816387.html?nopager=1#

As a rule, one should not panic at whatever crisis has momentarily fixed the attention of cable news producers. But the Ebola outbreak in West Africa, which has migrated to both Europe and America, may be the exception that proves the rule. There are at least six reasons that a controlled, informed panic might be in order.

(1) Start with what we know, and don’t know, about the virus. Officials from the Centers for Disease Control (CDC) and other government agencies claim that contracting Ebola is relatively difficult because the virus is only transmittable by direct contact with bodily fluids from an infected person who has become symptomatic. Which means that, in theory, you can’t get Ebola by riding in the elevator with someone who is carrying the virus, because Ebola is not airborne.

This sounds reassuring. Except that it might not be true. There are four strains of the Ebola virus that have caused outbreaks in human populations. According to the New England Journal of Medicine, the current outbreak (known as Guinean EBOV, because it originated in Meliandou, Guinea, in late November 2013) is a separate clade “in a sister relationship with other known EBOV strains.” Meaning that this Ebola is related to, but genetically distinct from, previous known strains, and thus may have distinct mechanisms of transmission.

Not everyone is convinced that this Ebola isn’t airborne. Last month, the University of Minnesota’s Center for Infectious Disease Research and Policy published an article arguing that the current Ebola has “unclear modes of transmission” and that “there is scientific and epidemiologic evidence that Ebola virus has the potential to be transmitted via infectious aerosol particles both near and at a distance from infected patients, which means that healthcare workers should be wearing respirators, not facemasks.”

In August, Science magazine published a survey conducted by 58 medical professionals working in African epidemiology. They traced the origin and spread of the virus with remarkable precision—for instance, they discovered that it crossed the border from Guinea into Sierra Leone at the funeral of a “traditional healer” who had treated Ebola victims. In just the first six months of tracking the virus, the team identified more than 100 mutated forms of it.

Yet what’s really scary is how robust the already-established transmission mechanisms are. Have you ever wondered why Ebola protocols call for washing down infected surfaces with chlorine? Because the virus can survive for up to three weeks on a dry surface.

How robust is transmission? Look at the health care workers who have contracted it. When Nina Pham, the Dallas nurse who was part of the team caring for Liberian national Thomas Duncan, contracted Ebola, the CDC quickly blamed her for “breaching protocol.” But to the extent that we have effective protocols for shielding people from Ebola, they’re so complex that even trained professionals, who are keenly aware that their lives are on the line, can make mistakes.

By the by, that Science article written by 58 medical professionals tracing the emergence of Ebola—5 of them died from Ebola before it was published.

(2) General infection rates are terrifying, too. In epidemiology, you measure the “R0,” or “reproduction number” of a virus; that is, how many new infections each infected person causes. When R0 is greater than 1, the virus is spreading through a population. When it’s below 1, the contamination is receding. In September the World Health Organization’s Ebola Response Team estimated the R0 to be at 1.71 in Guinea and 2.02 in Sierra Leone. Since then, it seems to have risen so that the average in West Africa is about 2.0. In September the WHO estimated that by October 20, there would be 3,000 total cases in Guinea, Liberia, and Sierra Leone. As of October 7, the count was 8,376.

Given that this is in the neoconservative magazine Weekly Standard I doubt if Mr. Klain has read it, but perhaps someone on his staff with access to the Czar will encounter it. The rest of the article is worth your time. Five of the 58 medical professionals involved in the Science Magazine study died of Ebola before the paper was published.

U.S. Soldiers Get Just Four Hours of Ebola Training

http://www.thedailybeast.com/articles/2014/10/17/u-s-soldiers-get-just-four-hours-of-ebola-training.html

As the U.S. military rushes to combat Ebola in West Africa, soldiers are receiving on-the-fly instructions on how to protect themselves against the deadly virus.

American military operations to fight Ebola in Africa are unfolding quickly—forcing the military to come up with some procedures and protocols on the fly.

Soldiers preparing for deployment to West Africa are given just four hours of Ebola-related training before leaving to combat the epidemic. And the first 500 soldiers to arrive have been holing up in Liberian hotels and government facilities while the military builds longer-term infrastructure on the ground.

For soldiers at Fort Campbell and Fort Bragg preparing for their deployments to West Africa, Mobile Training Teams from the United States Army Medical Research Institute of Infectious Diseases (USAMRIID), based out of Fort Detrick, have been tasked with instructing them on Ebola protocols.

A team of two can train as many as 50 personnel over that four-hour time frame, USAMRIID told The Daily Beast. The training includes hands-on instruction on how to put on, remove, and decontaminate personal protective equipment, followed by a practical test to ensure that soldiers understand the procedures.

“All training is tiered to the level of risk each person may encounter,” said USAMRIID spokeswoman Caree Vander Linden.

The training process sounds daunting: One USA Today report described soldiers being told that Ebola “basically causes your body to eat itself from the inside out” and that Ebola is “worse” than what soldiers encountered in Afghanistan. Others reportedly heard that the disease is “catastrophic” and “frightening… with a high fatality rate,” though the chances of contracting it are low.

“I’ll be honest with you,” one soldier told the newspaper. “I’m kind of scared.” [emphasis added]

* – * – *

Soldiers based in Liberia have their temperature measured several times per day, and are not permitted to shake hands.

The military maintains that American service members have only limited interactions with locals on the ground. But some American soldiers are working with the Armed Forces of Liberia on a day-to-day basis, and others are training health-care providers on how to combat the virus.

Further, the military acknowledges that it is currently sharing hotels and businesses with foreign nationals.

"We are here with the permission of the Liberian government and we do not clear out local hotels and businesses during our stay," said an Army spokesman. "We chose hotels with the safety of our service members in mind, and the hotel staffs monitor all employees and guests and allow us to conduct safety inspections of their facilities to ensure they meet our safety criteria."

Instead, the military spokesman focused on the precautions that they are already taking: Soldiers based in Liberia have their temperature measured several times per day, and are not permitted to shake hands. They are also are required to frequently wash their hands with a chlorine solution. Some locations even employ chlorine mats that service members are required to wipe their feet on in order to enter.

“The facilities that we’re in have been vetted by our doctors. [They] have gone through the facilities to make sure that they’re safe for our soldiers,” Army spokesman Lt. Col. Michael Indovina said. “We’re very confident. We’ve had very good luck from the time when we’ve arrived on the ground.”

Congress has been slow to give the green light to funding for military operations combating Ebola in Africa, in large part due to initial skepticism over whether there was a sufficient plan for protecting American service members in Liberia.

In mid-September, the Obama administration submitted a $1 billion request for Ebola funding. The request was for a movement of leftover funds from an overseas war spending account, requiring a sign-off from several key congressional figures.

When the Obama administration briefed staffers of the Senate Armed Services Committee on Sept. 19, it was criticized for not adequately explaining what steps the military would take to ensure soldiers’ health.

“If they had bio-security procedures in place, they weren’t adequately articulating them to Congress,” said an aide to Sen. Jim Inhofe, the top-ranking Republican on the Senate Armed Services Committee. “When they first came over, they were not able to answer a lot of questions about what procedures were in place.”

Of course it was not long ago that high government officials assured us that any decent hospital in the United States would be able to care for Ebola patients. Yesterday Nina Pham, the first American known to have contracted Ebola in the United States, was taken out of her hospital where, as a nurse, she contracted Ebola, and was sent to Bethesda. Her condition, previously reported to be “good” has now been downgraded to “fair”. Unlike typhus and cholera, Ebola basically turns internal organs to liquid and expels them through diarrhea. There is no known treatment, although there is empirical evidence that the plasma of Ebola survivors can be effective. Experimental drugs but not plasma was given to Mr. Duncan, from whom Ms. Pham contracted Ebola; he subsequently died.

Chaos Manor Reviews, and The View from Chaos Manor, operate on the Public Radio model: they are free, but we are supported by patronage and subscriptions. If you have not subscribed, this is the week to do it. If you have subscribed but can’t remember when you last renewed this would be an excellent time to renew. KUSC asks for $10 a month. My costs are much lower so I don’t need that much, although some of you generously pay that and even more. My thanks. . How to subscribe is described here: PAYING FOR THIS PLACE.

Once the Sixth Grade Reader of what was considered the world’s best public education system: California in 1914.  Recommended to home schools up to 9th grade.

Nine Doctors Without Borders physicians, all equipped with the best of isolation and prophylactic gear, have died of Ebola.  Of the  physicians and nurses who have died of Ebola in this epidemic, most (more than 60%) had what was considered more than adequate protective gear and were instructed in its use. The US Military being sent into the plague zone have had four hours of instruction.

The U.S. military’s plan to deal with Ebola in Africa

http://www.usatoday.com/story/news/world/2014/10/17/ebola-military-pentagon-reservists-liberia/17426929/

The U.S. military is prepared to provide up to 3,000 troops to help deal with the Ebola crisis in West Africa.

There are 547 U.S. troops there, primarily in Liberia though some are in Senegal, according to the Pentagon. Their assignments include building 17 treatment centers in Liberia, training local professionals in how to handle Ebola patients and conducting tests to verify diagnoses of the virus.

U.S. forces will not treat Ebola patients directly, but medical personnel will be trained to care for and transport American service members back to the USA if they contract the disease.

All branches of the military contribute to the effort:

•Navy "Seabees" (Construction Battalions) build the treatment centers, and Navy medical personnel conduct lab testing.

•Army soldiers from the 101st Airborne are being sent to West Africa, and others are already on hand, performing civil engineering and logistical duties.

•Airmen coordinate military flights in and out of the country.

Thursday, President Obama signed an order allowing reservists to be called into active duty to support the Ebola effort. "The authorities that have been invoked will ensure the Department of Defense can properly sustain the military operations required in this effort," Obama said in a letter to House Speaker John Boehner.

The Pentagon said the order allows flexibility to draw on the reserve force for specialists in areas of technical engineering, communication systems, logistics, comptroller duties and religious specialties.

The reservists provide special skills not available among active-duty forces and can augment or replace personnel sent to Africa, the Pentagon said.

The military is good at breaking things and killing people. They are not particularly well trained for managing contagious disease outbreaks.

Kobani may fall to militants, top U.S. officer says

WASHINGTON — It is "highly possible" that the besieged Syrian city of Kobani could fall to Islamic State militants, the commander of U.S. military forces in the Middle East said Friday.

Army Gen. Lloyd Austin, who leads Central Command, said Islamic State fighters have made Kobani their "main effort" in a move to expand the territory they hold in Syria and Iraq. Austin said attacks by the militants on Kobani have given the U.S.-led air war opportunities to blast the terror group — also known as ISIL or ISIS.

In his first remarks on the air campaign that began in August in Iraq, Austin said progress is being made and called for "strategic patience." The U.S.-led effort is designed to allow security forces to secure Iraq’s borders, then retrain, re-equip and retake ground lost to Islamic State fighters, he said.

http://www.usatoday.com/story/news/world/2014/10/17/is-iraq-syria-air-war/17429941/

A regiment of Marines with air support could accomplish wonders in this battle. For that matter, selected units of the 101^st Airborne could, on 24 hours notice, completely change the course of the war against the Caliphate. Whether that would be a good use of the troops can be debated; but if saving Kurds is an American goal, this would be a more appropriate use of troops than sending them into a plague zone.

The question is not the competence of the troops, nor of their officers; but one can question the competence of their civilian controllers, both civil service and political. And perhaps our new Ebola Czar can reconsider whether sending them into a plague zone is the best use of our Army. No, that won’t work. But he reports to Susan Rice, National Security Advisor; perhaps her expertise as a diplomat has determined that sending soldiers to Liberia and not sending help to the Kurds is good national policy.

After all, the premise is that government is competent.

But I do wish I heard a bit more about objectives, not merely in Syria/Kurdistan/Iraq, but for control of the Ebola outbreak in the United States.

Lawmakers urge an Ebola travel ban, Obama opposed

http://www.usatoday.com/story/news/nation/2014/10/17/ebola-travel-ban-obama-cdc-faa/17433901/

House Dems side with Obama, oppose Ebola travel ban

http://www.theblaze.com/blog/2014/10/16/house-dems-side-with-obama-oppose-ebola-travel-ban/

I remain unrepentantly in favor of quarantining dangerous contagious diseases.  I hope the new Czar shares that belief, but I have no real hope that he will.

Boots

http://www.defenseone.com/ideas/2014/10/what-could-us-boots-ground-do-iraq-and-syria/96515/

The author is correct, "boots on the ground" is a capability. Thus, US troops in Iraq could be used much as the 1st Marine Provisional Brigade was used in defense of the Pusan Perimeter during the Korean War; as a ‘fire brigade’ to shore up, reinforce, and exploit successes of the Iraqi army/militias.

David Couvillon

Colonel, U.S. Marine Corps Reserve, Retired.; Former Governor of Wasit Province, Iraq; Righter of Wrongs; Wrong most of the time; Distinguished Expert, TV remote control; Chef de Hot Dog Excellance; Avoider of Yard Work

What Could US Boots on the Ground Do in Iraq and Syria?

In discussions of America’s current conflict with the Islamic State of Iraq and the Levant (ISIL)—which, like the Vietnam conflict, Washington does not consider an official war—a phrase heard frequently is “boots on the ground.” It is a direct challenge to those who believe wars can be won by airpower alone. Critics of the current air campaign in Iraq and Syria argue that boots on the ground—the physical presence of soldiers on the battlefield—is a prerequisite to military success. But how many?

There are currently somewhere around 2,000 American military personnel deployed in Iraq, protecting the U.S. Embassy, helping the Iraqi forces coordinate military operations and assisting the air campaign. They have no direct combat role, although some may engage in special operations, such as attempting to rescue hostages. Strategists outside of government have suggested the need for 10,000 or 25,000 American combat troops.

Boots on the ground represent a capability, not a strategy. The question is, what would 25,000 American ground forces do that nearly 300,000 Iraqi soldiers cannot do?

They could bolster local defenses in critical areas, reinforcing Iraqi or Kurdish forces that are hard-pressed by ISIL fighters. This is not just a matter of added firepower. Their presence on the ground could also enhance the effectiveness of the air campaign. And with American combat units at their side, Iraqi units might fight harder—or they might fight less, leaving it to the Americans to do the bloody work.

American combat forces could also be used as a mobile strike force to follow up the bombings or destroy concentrations of enemy forces. In this kind of deployment, the combat units would be moved from place to place to exploit opportunities, rather than to hold terrain.

A more ambitious and costlier task for American forces would be to drive ISIL forces out of the cities and towns they now hold. Urban warfare, especially against dug-in defenders, chews up armies. As we have seen on numerous occasions, from the battle of Hue in 1968 to the second battle of Fallujah in 2004, urban engagements can become ferocious fights. More than 13,000 American, British, and Iraqi forces were engaged in Fallujah, and they suffered nearly a thousand casualties.

http://www.defenseone.com/ideas/2014/10/what-could-us-boots-ground-do-iraq-and-syria/96515/

There is considerably more, all worth your time if the subject interests you.  Needless to say the point of the story is you must have objectives in mind or choose them when you have assessed the situation; simply putting forces into an area doesn’t accomplish a lot.  Armies are good at breaking thing and killing people.  They are also good at building roads and temporary bridges. In disasters military people are useful at first because they are versatile: but their primary skill is in breaking things and killing people.  It’s what they do. The important thing, then, is to choose wisely the things to be broken and the people to be killed. That is usually known as strategy, and the first principle of military strategy, at lest as taught at West Point for decades, is The Principle of the Objective.  Before you break things, it is well to have a good grasp on what you will gain from having them broken. 

Chaos Manor Reviews, and The View from Chaos Manor, operate on the Public Radio model: they are free, but we are supported by patronage and subscriptions. If you have not subscribed, this is the week to do it. If you have subscribed but can’t remember when you last renewed this would be an excellent time to renew. KUSC asks for $10 a month. My costs are much lower so I don’t need that much, although some of you pay that, and have my gratitude. How to subscribe is described here: PAYING FOR THIS PLACE.

http://www.weeklystandard.com/articles/six-reasons-panic_816387.html

So my earlier research was correct — this is indeed a separate strain of Ebola from the Zaire strain some have claimed it to be. Which also explains the different level of fatality percentages. And if it happens to be more like the Reston strain, then it may well transmit airborne.

…Oh $#!^. And it’s mutating. Fast.

"In August, Science magazine published a survey conducted by 58 medical professionals working in African epidemiology. They traced the origin and spread of the virus with remarkable precision—for instance, they discovered that it crossed the border from Guinea into Sierra Leone at the funeral of a “traditional healer” who had treated Ebola victims. In just the first six months of tracking the virus, the team identified more than 100 mutated forms of it…By the by, that Science article written by 58 medical professionals tracing the emergence of Ebola—5 of them died from Ebola before it was published."

…And spreading.

"The latest WHO projections suggest that by December 1 we are likely to see 10,000 new cases in West Africa per week"

Epidemic: (of a disease) affecting many persons at the same time, and spreading from person to person in a locality where the disease is not permanently prevalent.

Pandemic: (of a disease) prevalent throughout an entire country, continent, or the whole world; epidemic over a large area.

(Dictionary.com)

"In September, the CDC ran a series of models on the spread of the virus and came up with a best-case scenario in which, by January 2015, Liberia alone would have a cumulative 11,000 to 27,000 cases. That’s in a world where all of the aid and personnel gets where it needs to be, the resident population behaves rationally, and everything breaks their way. The worst-case scenario envisioned by the model is anywhere from 537,000 to 1,367,000 cases by January. Just in Liberia. With the fever still raging out of control."

Liberia’s population is only about 4.3 million. Worst case, that’s 12.5-32% of the total population.

"…if the four pillars—contact tracing, case isolation, safe burial, and effective public information—fail, no one seems to have even a theoretical plan for what to do."

I have an idea or two but it isn’t pretty, nice, or politically correct. It may wind up being expedient.

Who the hell ARE these people?!?

"A travel ban is not the right answer. It’s simply not feasible to build a wall—virtual or real—around a community, city, or country. A travel ban would essentially quarantine the more than 22 million people that make up the combined populations of Liberia, Sierra Leone, and Guinea.

When a wildfire breaks out we don’t fence it off. We go in to extinguish it before one of the random sparks sets off another outbreak somewhere else."

That is EXACTLY what you do! A quarantine confines people who may or may not be infected, to keep everyone ELSE safe, until it can be determined if they ARE infected, and what to do about it! And you don’t go in to extinguish a wildfire! You set up FIRE BREAKS — effective WALLS around the fire — to deprive it of fuel!

I’ve just located a paper studying Ebola’s susceptibility (when dried on surfaces) to UV. There’s a lot of people out there believing that if the victim, e.g. throws up on the sidewalk, if you just expose it to the sun for a day, it’s safe. I have my doubts, especially if it is capable of staying around for 3 weeks. I’ll pass on the paper in a minute; I’m trying to get the gist of the important parts.

Stephanie Osborn

Interstellar Woman of Mystery

http://www.Stephanie-Osborn.com <http://www.stephanie-osborn.com/>

I would have thought that avoiding the importation of new infection sources would be a first order of business. It’s hardly sufficient, but I would think it necessary.

Quick Tests Versus Effective Procedures 

Jerry,

Earl misreads my statement that quick tests "are an essential part of any effective Ebola entry-prevention policy"

My point in emphasizing the need for such tests, since it apparently wasn’t obvious the first time, is that cheap, quick, local finger-prick tests are far more useful (far easier to use early and often, and thus more likely to be so used) as part of an overall entry-screening process than current tests that require drawing a vial of blood, sending it to a lab, then waiting two to three days.

I had not been aware that Ebola virus detectability could lag visible symptoms by days; my thanks to Earl for pointing that out. CDC seems to think that the lag is "up to three days" for their tests (see

http://www.cdc.gov/vhf/ebola/hcp/interim-guidance-specimen-collection-submission-patients-suspected-infection-ebola.html)

and I’d be interested in pointers to any info on the reasons for this delay and on how likely it is to apply to the new fast tests. But yes, this would obviously complicate screening procedure design.

Worth noting here is that one study I previously cited on asymptomatic Ebola infections (http://www.ncbi.nlm.nih.gov/pubmed/10881895) clearly indicates that both the antibodies and the viruses themselves can be tested for and identified in asymptomatic individuals. The problem may then not be fundamental, and some possibilities may exist for higher-sensitivity quick initial screening tests.

My understanding is that other viral initial-screening tests tend to go for extremely high sensitivity, and deal with the accompanying high false-positive rate with more precise follow-ups tests. If such an approach is currently difficult for Ebola, I’d be curious to see more about why.

Porkypine

This is not really the place to debate specific procedures and quarantine practices.  Those are generally left to be decided by locals familiar with their resources and the people involved: the best may not be good enough, and in fact often the best is the enemy of the possible.  Developing and employing such procedures is truly a matter for experts, which does lead me to wonder what led to the appointment of the current Czar; I would have thought it better to appoint a technical expert and someone like Klain as his/her chief of staff. 

Ebola quarantine

Jerry,

Anyone willing to put down odds on an Ebola quarantine being put into effect just in time for the first deployed US military Ebola case to become the political football "proving" that we need to have an open door policy to let in Ebola patients? I ask because the lack of training and cavalier attitude the govt and CDC has towards Ebola pretty much guarantees multiple Ebola infections among our troops deployed to the Ebola zones.

Newt Gingrich pointed out on Hannity something that I think is in one of the articles you linked – Of the 25 Ebola specialists who authored a thoroughly comprehensive medical paper about Ebola, 5 of them are already dead from Ebola. Think about that. In a group of 25 doctors who may be regarded as the most knowledgeable experts in the world on Ebola, who can be expected to have 100% adherence to ALL protocols and safeguards, 20% still contracted and died of Ebola. Only an idiot would say we shouldn’t be terrified by this, even if our govt was doing everything right.

It is the height of arrogance and ignorance for ANYONE to say "we got this", expecting that the magic of American medicine is an effective and reliable countermeasure against Ebola.

The question remains, why would our govt, in the face of global astonishment at how childishly ignorant and dangerous our Ebola response is, continue down this path of suicide. One cruise ship has already been denied port rights due to a single American on board, because Belize things we’re a bunch of suicidal idiots and they don’t want to have anything to do with anyone from the US who has had anything to do with Ebola, symptoms or not. Belize is utterly correct – we’re dangerously incompetent and any government who cares about its people probably ought to implement a 100% ban on travel from the US because we’re the only country on the planet who thinks its ok to transport Ebola patients around the globe as if its nothing worse than the common flu.

Plus, the update from the world health organization… 70% fatal, 42 day incubation. That’s horrible, but why is that more scary than 50% fatal and 21 day incubation given that you can travel around the world 5-6 times and interact with thousands of people in dozens of countries in 21 days, let alone 42? The world has every right to be terrified of American travelers at this point.

Serving Officer

Ebola Czar

Dr Pournelle

RE: https://www.jerrypournelle.com/chaosmanor/a-new-ebola-czar-military-deploys-to-plague-zone-competence-in-government/

The fact that President Obama named Ron Klain as "Ebola Czar" rather than fill the empty post of Surgeon General tells me he wants not a medical solution but a political solution.

Live long and prosper

h lynn keith

Ebola and Luck

In Ringworld the Puppeteer Nessus tells Louis Wu that the Puppeteers have bred humanity to be lucky as they saw no other hope for the long term survival of humanity. And, they did like humans.

After reading about how we are dealing with Ebola and this link

http://www.huffingtonpost.com/2014/10/15/obama-ebola-nurses-atlanta_n_5990584.html?ncid=txtlnkusaolp00000592

I wonder if the puppeteers haven’t started earlier than documented in Ringworld.

Peter Wityk

God protects fools, drunks, and the United States of America.  Of course we were a much more devout nation when Bismarck made that observation.

Freedom is not free. Free men are not equal. Equal men are not free.

View 846 Thursday, October 16, 2014

“I have observed over the years that the unintended consequences of social action are always more important, and usually less agreeable, than the intended consequences.”

Irving Kristol

“Transparency and the rule of law will be the touchstones of this presidency.”

President Barack Obama, January 31, 2009

This is an exemplar of many letters I have received recently.

Lockheed – Commercial fusion in 10 years?

Hi Dr. Pournelle,

After all the decades of disappointments, is the era of fusion power now actually within reach? Lockheed sounds very confident in this article:

http://www.theguardian.com/environment/2014/oct/15/lockheed-breakthrough-nuclear-fusion-energy?CMP=fb_gu

They expect to have a commercial 100 MW deuterium-tritium reactor that will fit on a truck in 10 years. I’ll go out on a limb and predict that if they do, the “environmentalist wackos” will find some reason to oppose it.

Bill

I intend to look into this: clearly if it were true, it would change the world. Science fiction writers and academic futurists have speculated about the consequences of cheap energy. One of the earliest was Heinlein. I have written about the Second Industrial Revolution: the First made energy available for manufacturing. One consequence was big cities, because much of the big energy of that revolution was centralized and concentrated, and required large capital investment before you could make use of it. The Second Industrial Revolution, which I call “the quarter inch drill”, came about with the development of widely distributed low cost high energy devices that could be used nearly anywhere and which were affordable by nearly anyone.

Both these Revolutions – and they truly were – depended on energy production and that remained dependent in turn on great industries: mining, transportation, drilling, refineries, power plants and distribution grids.

Cheap distributed energy production from low capital devices would be another Revolution.

For most of the history of mankind, something like 90% of mankind lived at the edge of survival. Historians call this the Malthusian Era. Most of the population worked in agriculture and the distribution of agricultural produce. Peasant had perhaps one change of clothing, and labored six days a week (seven in cultures uninfluenced by the Bible) relieved only by holidays. There was no science of medicine. Lives tended to be short. Food consumption was not much above survival rates.

As Gregory Clark observes in A Farewell to Alms, “The average person in the world of 1800 was no better off than the average person of 100,000 BC. Indeed, the bulk of the world’s population was poorer than their remote ancestors.” This condition prevailed across the world. “Jane Austen may have written about refined conversations served over tea in china cups. But for the majority of the English as late as 1813 conditions were no better than for their naked ancestors of the African savannah. The Darcys were few, the poor plentiful.”

The industrial revolution changed all that. Mr. Darcy was wealthy, but even the poorest in America have, or can have if they take the trouble to work the system, television, access to transportation, more than enough to eat along with some discretionary income for cigarettes and liquor, and some access to medical care that the very wealthiest could not have afforded before 1930. Mr. Darcy had little of this.

All this change was brought about by the various industrial revolutions.

Cheap energy widely available, plus human initiative, added to the Computer Revolution, will have similar effects – or potentially could. Of course the likelihood that all the good will be absorbed by bureaucracy and the effects will not happen is reasonably good.

The history of civilization has this thread: more and more of the output of the society is converted into structure. The structure is controlled by rent seekers who become a bureaucracy. The Iron Law of Bureaucracy prevails. Sometimes – the discovery of the New World, the inventions that inspired the first three Industrial Revolutions – productivity is so great that the structure is evaded. The bureaucracy doesn’t have the means to control and regulate and redistribute. That happened in the Computer Revolution, but it appears that the regulators will gain control of that, too.

Look for the Iron Law to assert itself if small cold fusion becomes possible.

Of course none of this applies if the technology is not there.  The Lockheed effort is not the only possible “small fusion” effort. http://www.extremetech.com/extreme/191754-cold-fusion-reactor-verified-by-third-party-researchers-seems-to-have-1-million-times-the-energy-density-of-gasoline

I do wonder why there is not a larger ferment within the scientifically cognoscente press.  Most of that press is controlled by the regulatory aristocracy, but surely there are some independents. We can hope.

Ebola

Ebola

Dear Mr. Pournelle;

I don’t want to minimize the danger of Ebola — I’ve suspected for some time that a pandemic might be sufficient to collapse our civilization. But I do want to ask: is it the responsibility of the Federal Government to prevent its spread? If so, how far does that extend? Should the CDC have not only advisory but enforcement authority? Should the Federal Government dictate procedures to all hospitals anywhere near an airport?

Granted there are less intrusive measures already available to Federal authority. However, it has seemed to me on more than one occasion that when something frightens or enrages us, we are prone to demand that The Authorities fix it — using powers which, in saner moments, we never gave them.

If we want a non-intrusive government, it seems to me we will also need to find ways to respond to genuine emergencies which don’t require government intrusion.

Yours,

Allan E. Johnson

I would say that it is the responsibility of the federal government not to import Ebola, since the states don’t have the authority or the ability to control international travel.  So far as interstate travel is concerned, that has to be federal again; the states are not permitted to erect immigration barriers against other states.  Should they be? The Constitution gives interstate commerce to the Congress.

I would suppose that a wise federal government would try to avoid direct regulation and responsibility for hospitals within the states (other than federal facilities such as the VA), but I have little expectation of wisdom from the current bureaucracy and even less from the administration.

I would presume that the Federal excise tax on medical equipment (20%) would impose a moral obligation on the federal government, but I doubt anyone feels that.

Have any of you noticed the elephant in the room?

We have two nurses infected and sick with Ebola.

We have a family that was in contact with Duncan while he was getting sick even after his temperature spiked to 103.5. So far none of them are sick.

While I am sure this is premature one tentative conclusion I draw is that the patient is not particularly contagious until well into the "I’m sicker than hell" state. It’s worth thinking about.

{^_^}

True of his strain. Not of other strains. [JEP]

At the moment the head of the CDC is adamantly testifying that Ebola is both undetectable before they are symptomatic and can not transmit Ebola during the period they cannot detect it. They are currently defining 100.4 degrees (If I recall correctly) as a critical temperature. So the nurse with a 99.5 fever probably would not be a danger to people around her. At 101.5 she’d be a danger to people around her if, for example, she stumbled and somebody tried to help her by grabbing her to steady her.

But, then, we do have the families that are not affected (so far) even with the patient spiking to a fever of 103.5 and nurses over exposed due to inadequate protection early on to consider. This hints you really have to try hard to become infected. West Africans with their funerary procedures seem to go out of their way to be exposed to Ebola. Doctors and nurses are in intimate contact with patients which puts them in extreme danger, God bless them every one!

With that as a background, I am inclined to the opinion that the media are toning this to panic the populace and sell their newsware rather than provide the word that the danger really is minimal if the responses of the medical profession are carefully considered and well trained. It is actually rather difficult to transmit Ebola, at least this strain and probably all five strains.

I also rather like the CDC’s advisory role. "We advise you not to fly and we are notifying the airlines of this. It will be up to the individual airline to let you fly or not. If they do not our warning will shield them from lawsuits over refusing to let you fly." Inform the public if a person advised not to fly actually is allowed to fly after the warning. The public tries and convicts the airline "for free."

If the CDC does maintain stocks of materials both written and equipage that can be requested by states or medical facilities on short notice, that is also a very good thing.

Our Constitution should prevent the CDC from moving in and taking over on its own initiative.

{^_^}

By the way – I take issue with what I’ve read of the protocol for taking off the medical moon suits. I suspect they need to rethink it for Ebola at least. I suspect duct tape and Velcro are your friends here. The Velcro is to allow the suit to part at the shoulders so it can be peeled (and rolled) down the body with the contaminated surface in side. That allows the hood to come off first over the head while the wearer leans forward and pulls a tab connected down to the lip of the head gear’s cowling. Expose skin only to the inside surfaces.

Once the cowling and hood is off pull on the suit below the shoulders to pop the shoulder Velcro loose. Pull the hands partway out of the gloves that are duct taped to the sleeves of the garment. Peel the suit off like a condom rolling the contaminated surfaces inside. Once it is down step out of the booties. Only uncontaminated insides should be exposed at this time. Have tabs off the front of the shoes maybe an inch or so to allow the wearer to step on one tab with the other foot to free the feet from the booties.

Then take off the inner layer of protection that’s not normally called for.

Then toss everything into a barrel of chlorine water using long tongs or whatever.

{^_^}

I would suppose that there have been engineering studies of this, or at least of removing protective gear contaminated with corrosive substances; but that supposes more competence than I am finding in examining the health care bureaucracy. There are competent people in the bureaucracy, but the Iron Law still prevails, and it has worked its will on administration and bureaucracy alike; or appears to have. Why does the chap who told us all the hospitals are ready for Ebola still have a job? And who is the supervisor of the people who told Nurse Amber that it was all right to fly with a 99.5 F fever even though she had probably been exposed to Ebola? Is that person still employed and answering health questions?

But then we have been led to expect competence in many parts of this administration

But then I tend to take an engineering approach to problems.  First you have to define an objective.

http://www.foxnews.com/politics/2014/10/16/cdc-considers-adding-names-people-monitored-for-ebola-to-no-fly-list/

The move is being considered as a response to Wednesday’s disclosure that Dallas nurse Amber Joy Vinson was cleared to fly on a commercial airliner earlier this week despite having been exposed to the Ebola virus while treating Thomas Edward Duncan at Texas Health Presbyterian Hospital.

On Monday, a CDC official cleared Vinson to fly from Cleveland to Dallas on board Frontier Airlines Flight 1143 despite the fact that she had called and reported having a slight fever, one of the common symptoms of the Ebola virus. Vinson’s reported temperature — 99.5 degrees — was below the threshold of 100.4 degrees set by the agency and she had no symptoms, according to CDC spokesman David Daigle.

Problems Quarantining Ebola

Jerry,

My thanks to reader Earl for his pointer to the WHO release that mentions 5% of recently studied Ebola incubation periods not (I’m stating this carefully) provably falling within the nominal 21 days.

The actual wording in the WHO release (at

http://www.who.int/mediacentre/news/ebola/14-october-2014/en/) is "Recent studies conducted in West Africa have demonstrated that 95% of confirmed cases have an incubation period in the range of 1 to 21 days; 98% have an incubation period that falls within the 1 to 42 day interval."

(It’s easy to take the missing 2% and infer those cases incubated for even longer than 42 days. Note though that any such study necessarily will include some uncertainty as to when infection actually first took place; some or all of the missing 2% might also be that. Regardless of that uncertainty, the 3% of cases WHO does specify at 22-42 days incubation is alarming enough.)

Also worth noting is another recent study (story at

http://www.naturalnews.com/047281_Ebola_symptoms_incubation_period.html)

which says that between .2% and 12% of recent cases may still not show symptoms 21 days after infection. That’s quite a wide range of uncertainty, but FWIW the median 5.9% is quite close to WHO’s overall 5% non-21-day cases.

There are also studies showing significant numbers of individuals infected with Ebola who have remained asymptomatic indefinitely.

http://download.thelancet.com/flatcontentassets/pdfs/PIIS0140673614618390.pdf?id=aaadpDXSyNZVP5Qg76oKu,

and http://www.ncbi.nlm.nih.gov/pubmed/10881895.

The now-known longer-than-21-days incubation periods (plus the real possibility of transmission by asymptomatic individuals) may well account for a problem I’ve seen reported from the current West African outbreak: Localities that were thought to be past their crisis with sharply declining infection rates have seen renewed outbreaks.

Meanwhile, the implications for US quarantine attempts are clear – simply waiting 21 days will not work. Further, it’s not clear that there is any practical quarantine length that will be effective.

The immediate conclusion I’d draw is that fast-turnaround (minutes not days, on-the-spot not lab) tests for virus presence are an essential part of any effective Ebola entry-prevention policy.

The immediate policy implication is that mass-deploying such tests (in the works from at least two different sources, http://khon2.com/2014/10/14/tulane-doctor-developing-faster-ebola-test-detection-in-minutes/

and

http://denver.cbslocal.com/2014/10/14/colorado-test-for-ebola-could-speed-up-diagnosis-to-10-minutes/)

should be a crash priority.

It’ll be, uh, interesting to see how long it takes the CDC and White House to reach the same conclusion. Or, more likely, be forcibly led to it… Whatever works.

Porkypine

Never waste a crisis.  If this one causes some reforms of the bureaucracy it may increase the competency of an important federal agency and our confidence in it.  I fear I do not have high hopes for this.  The Iron Law is pretty implacable.

There are several flaws in the fast tests mentioned by Porkypine

First. Present data indicates that a victims will not test positive to Ebola for as much as 4 days after frank symptoms. One shudders at the thought of a Real Case of Ebola being turned away because of a quick negative result, free to cough all over folks on the bus or subway.

Second> WHO defines a negative result as TWO tests taken 48 hours apart. This is quite different from the sloppy results that CDC is pushing. A quick test would not provide any advantage except to point out the obvious positives. You would still need 48 hours (or the 4 days after symptoms) to safely pronounce a negative result. This was a point where the bureaucrats at WHO castigated the bureaucrats at CDC as not being careful. (such a delightful image – bureaucrats facing off with automatic weapons at 2 paces and may God protect the Right )

Earl

Ebola Visas

Jerry:

Regarding State Department protocols permitting visa issuance: I am a retired Immigration Officer. State can (and has) revoked visas that have already been issued. It would be a fairly simple matter to cancel all visas issued at consulates in the affected countries. Normally, people who reside in those countries must receive visas only from their own consulates. I suppose exceptions would have to be made for diplomatic visas.

The mechanism whereby this would be implemented would be to notify all common carriers of such cancellation. The carriers would be liable for substantial fines for allowing persons with such cancelled visas to board a flight to the US. This would be more effective than stopping direct flights, since it is easy for people to connect through another location such as Brussels.

Best Regards,

Greg Fiorentino

Why is this not being done?

In this: http://www.foxnews.com/politics/2014/10/16/lawmakers-grill-health-officials-over-ebola-response-resistance-to-travel-ban/

Is this quote: "But health officials continued to downplay the need for flight restrictions for flights to and from West Africa, arguing that officials still would have a difficult time tracking where travelers have been. "

Having just been through customs in two countries, that’s a non-starter. If it’s an electronic passport, just check the records – and if not, check the date on the customs stamp! This is not rocket science. Sure it’s not perfect, but it’ll be a darn sight better than nothing. There’s another agenda here, and I wonder just how much of the information we’re being fed is truth and how much is spin.

Doug

I would think that not importing new strains would be a high priority move.

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