As I said earlier, I’ve been collecting links on the Ebola outbreak. Slate has published a post from Tara C. Smith, “associate professor of epidemiology at Kent State, studies zoonotic diseases and blogs at Aetiology”, who does a much more professional job of aggregation than I can aspire to, in “Here’s Where We Stand with Ebola“:
It’s nine months into the biggest Ebola outbreak in history, and the situation is only going from bad to worse. The outbreak simmered slowly in West Africa from December 2013, when the first case was retrospectively documented, through March, when it was first recognized by international authorities. It began gaining momentum in June and throughout July. Now, terms like “exponential spread” are being thrown around as the epidemic continues to expand more and more rapidly. Just last week, an increase of 700 new cases was reported, and the case count is now doubling in size approximately every three weeks.
Already, the number of cases (approximately 5,300 as of Sept. 18) and deaths (2,630) has dwarfed the total number of cases and deaths from every reported Ebola outbreak in history—and those are only the cases that we know about…
…[W]e do know that the risk that this outbreak may spawn an airborne Ebola virus is still incredibly tiny. Virologist Vincent Racaniello sums up the history of viruses mutating to a novel route of transmission, noting, “There is no reason to believe that Ebola virus is any different from any of the viruses that infect humans and have not changed the way that they are spread,” and that “the likelihood that Ebola virus will go airborne is so remote that we should not use it to frighten people.”
Even without an airborne form of Zaire Ebolavirus, we still have plenty to be concerned about. Models have suggested that this outbreak could go on for several more months at a minimum. The worst-case situation suggests that half a million cases are possible before the outbreak is finally brought under control. New research proposes that the current outbreak is so different from past Ebola epidemics that modeling is simply not informative, and “as a result, we are not in a position to provide an accurate prediction of the current outbreak.”…
And yet, there are heroes… (to be continued in another post)
Is it just me, or are the two statements about the infinitesimal chance of airborne transmission and that past modeling isn’t informative kinda self-cancelling?
I put my 1996 copy of The Hot Zone on top of the corner trash can and it was gone by the time I got back from lunch.
I hear you loud and clear… there has been some discussion of transmission via “aerosol“.
While it is important not to give panicked messages, sweeping confidence is also not justified. Maybe saying things like ” we are optimistic that Ebola will not develop a true airborne route of transmission”…
I think that Camus’ The Plague also comes to mind
Fox will find some way to blame this on Obama.
I can’t tell if this is overhyped. Malaria kills half a million people a year, every year, doesn’t it? Is the ‘exponential spread’ just part of the natural ‘life cycle,’ sort of, of a new epidemic?
Which isn’t to deny the horror to those affected. I’m just having a really hard time lately discerning between real threats and small-world panic.
Now I’m regretting the fact I just finished binge-reading The Newsflesh cycle this weekend…
@Snowwy: The physical means of transmission could be unlikely to change (not going to physically change and go aerosol) while the social / etc means of transmission — the patterns of diffusion, contagion could change a lot with scale. Past models with rates of infection could be totally off because people are panicicky, fleeing further while contagious so spreading it further, faster. Moving people further to better medical facilities could do,the same thing. (I’m blueskying a bit here, medical geography is not my primary area.) Even simple transportation networks are likely to be different and those are condiuts for contagion as well. stressed people, people lacking food, may catch it easier. Fair number of unknowns that change with scale.
I think that’s what the article that AL posted a few days ago was positing: basically, it had never made it into urban areas before, so you had inexperienced medical personnel who didn’t realize they were dealing with ebola rather than something more common (like cholera) and those kinds of mistakes helped it spread faster.
ETA: And then there’s the whole distrust of government part, which makes me quite nervous when thinking about the possible effects of a contagious outbreak here in the good old US of A. I don’t see the anti-vaxxers and doomsday preppers reacting much better than the villagers in ebola-affected areas.
ETA2: Not that I think ebola is on its way, but even a good flu breakout could cause major issues for us.
OK, that does tend to reconcile the two, and I thank you for your reply.
I found this blogpost from August to be useful: “Ebola virus may be spread by droplets, but not by an airborne route: what that means.
Although the outbreak continues in Guinea, Liberia and Sierra Leone, the Ebola outbreaks in Senegal and Nigeria appear to have been contained. I think Nigeria is “lucky” in the sense that the people first infected were medical professionals treating a Liberian diplomat fresh off a plane, and they mostly knew what to do. Here’s an account from a young Nigerian doctor who survived Ebola. Her colleagues weren’t so lucky.
Since survivors of a particular strain of Ebola have a lifelong immunity from that strain (but probably not from other strains), researchers are saying that antibodies from survivors’ blood can be used to protect others. Hope that works out well.
Not really. The first statement is talking about the pathology of the illness itself and the chance of it mutating into an airborne form. The second has to do with modeling of the epidemic’s geography. The two things are not totally separate but there isn’t that much connection between them.
@kindness: if only we had intervened in Benghazi, then we could have kept Ebola from spreading and killing all those people we refuse to give humanitarian aid to.
Yeah, so this is an issue. Patterns of logging in West Africa is outside my expertise (understatement of the year), but I know that it’s happening, and on a large scale that impacts the available proteins for villagers, such as the patients whose preparation of bat meat seems to have been among the first of this Ebola epidemic.
However, in the geographically and politically similar parts of SE Asia (triangle north of Bangkok that is govern by 4 failed corrupt dictatorships), a factor shaping disease transmission and mortality for the past 5 years is unchecked destruction of the habitat for larger game animals nearby existing villages.
That is, people are going farther from home to hunt, coming home with smaller mammals, and eating less–all 3 of which increase the transmission of [other] viral diseases. Because you’ve got more person-to-person contact, more bush meat of species that carry different viral loads requiring increased and different prep to be safely eaten, and on top of it infected people has no reserves because they’re hungry.
tl;dr: Climate change may NOT in fact drown or grill us all.
A slight quibble with the conclusions at the end of the block quote. The paper and blog post on are more accurately summarized (IMHO) as saying that recorded Ebola outbreaks are highly variable. The estimated ‘reproductive ratio’ (a measure of transmissability) is close to one with a large standard error, which would mean that the typical Ebola outbreak is always on the knife edge between dying out or getting bigger, and an Ebola outbreak can either flare up and burn itself out quickly, or spread to an epidemic. Chance events, and very small differences seem to make a big difference in the size of the outbreak.
I don’t see the final link, the blog post as saying anything much more than this Ebola outbreak is the biggest and most widespread, than ones in the past and no really knows why.
@jl: My point being is that, from what I read, this one could be really bad just because random fluctuations and small differences (for example, as mentioned in comments above, relatively small changes in physical condition of population and susceptibility to infection) as some important genetic change in the virus.
@jl: And, to correct an error in my comment, in the framework of the second to last link of blockquote (the House article) ‘standard error’ is not the right term. What they did was closer to estimating a probability distribution for observed reproductive ratios over recorded outbreaks. My apologies to Bayesian BJers.
@jl: Even the simple possible happenstance of getting it into a larger urban. environment can change things. The moment of people between towns and cities (especially) tends to be faster (different modes of transportation) so you start seeing hierarchical diffusion (think outbreaks popping up in physically different places connected by the connections between cities) in addition to the garden variety contagion which is the more compact version of face-to-face spread that looks like spilt wine on a tablecloth. So, if you’ve a finite number of specialists and resources now trying to combat a disease popping up in different locations, it’s going to be a problem. The task of quarantine gets trickier.
So yes, still reading, though I in no way qualify for Bayesian status.
Lit match, meet house of straw.
@scav: Neither do I qualify as anything other than a very amateur Bayesian. I wonder if small changes in travel patterns could make a difference. Which would be bad news if there has been a secular trend towards more frequent or higher prevalence of travel between towns and cities that are further apart. Could imply much larger outbreaks on average in the future, if that research is correct.
@scav: Not clear to me whether the paper is trying to estimate a probability for a single unknown parameter (which does not make much sense in terms of the article’s causal interpretation of the results), or a probability distribution of random realizations of a reproductive ratio over different outbreaks. So, sort of like difference in classical statistics between confidence interval for parameter and an individual observation. Been a long time since I did this kind of research, and having problems connecting the math model with the statistical method.
@jl: Well, travel patterns have mattered since forever, classic examples being the plague (follow those ships and rats!), HIV/AIDS (the so-called patient one left a really specific geographic pattern of hierarchical diffusion that could identify his likely job). Think of all the examples already about people getting on airplanes and getting sick at the other end, surrounded by doctors unlikely to know what that exact bug is. But, then again, the beginning of Dickens Little Dorrit has people sitting in ships for quarantine. So, yes, it’s changing, as the speed and ubiquity of travel (especially long distance) becomes more prevalent, but luckily, the means to combat diseases are also evolving — it’s unlikely medical teams could have been mobilized as quickly, information, drugs and staff mobilized, let alone a national lockdown (well see how that worked) enacted as efficiently in the past. So, all still complicated. But I’m pretty sure it’s been accepted for a while that the increasing frequency of travel between formerly generally isolated areas with different disease pools (especially those not yet well understood) was likely to be a mess (even then, think of the exchange of diseases between the “new” and “old” worlds post Columbus et al. — just speed it up.).
@jl: And my expertise is more entirely in the models of geographic patterns of interaction / transmission (which are not limited to medical geography) and not the hard-core stats themselves. So, I found it baffling in that nowhere were the outbreaks discussed, the specifics of the instances discussed. They seem to have added time, but all the guts of what actually impacts actual transmission are ignored. I can see why the general question is interesting for predicting size but as far as I’m concerned, a lot of the important stuff is missing — a part of that is likely the geographer talking, but where matters. A lit match next to the steering wheel is nothing like a lit match next to the gas tank.
The other avenue of treatment might be convalescent serum — or the serum (and antibodies) from those who have survived infection. Not sure how quickly this can be used after infection and whether or not it works against Ebola. I haven’t read much conclusively.
The social dynamics of larger and more mobile populations have clearly played a large role. Also, populations that clearly distrust government and “outsiders” as well other social behaviors.
Clearly, this is tearing apart several countries both socially and economically, and it is clear that the interventions are not in place to stop this, though I hear that a few countries (Nigeria, Senegal) have been able to halt new cases for now…
@Elie: I found a Journal of Infectious Diseases paper from 1999 through PubMed titled “Treatment of Ebola Hemorrhagic Fever with Blood Transfusions from Convalescent Patients.” The outbreak was in the DRC in the 1990s and relatively small compared to this one, but the use of transfused blood with Ebola antibodies but no active Ebola showed promise.
Thanks for the shout out that I am being histrionic..
I surely hope that Ebola will not become airborne. The link actually says that droplet nuclei are not transmitters of Ebola but does discuss other factors. Its not a bullshit link like the one you provided.
By the way, I wouldn’t want to receive a face full of mucus and blood from a sneeze from an Ebola victim. That is not airborne per se but transmission from infected body fluids to mucus membranes in the nasopharynx. I think that the line of what we call “airborne” is a bit hazy… most of this, however, can be avoided by appropriate isolation gear which includes the big face shield or mask and goggles
I hope this is true. We would have to get the facilities in place to 1) identify the survivors, 2) harvest serum ONLY after no virus in blood of recovering person and 3) a means to administer to the sick —
We have to be cognizant that the serum may contain HIV or malarial parasites — so would have to screened for at least those …
Its a tall technical order for countries that have trouble with basic enforceable isolation techniques right now…
@scav: Seems to me the author believes himself to be estimating a marginal distribution of realizations of the reproductive ratio, integrated over a lot of chance and random factors, and factors unique to individual outbreaks that have not been consistently recorded, or at least not for enough outbreaks to get a stable estimate, or maybe not recorded at all. I think that is what is implied by the underlying causal model the author has in mind. Need more details to know if that is really what was calculated.
@jl: Well, at least I need more details. Maybe somebody who can connect the contagious disease modelling and stats better than I can will come along and tell me.
Based on the large number of infected healthcare workers, the fact that this has a transmission rate of 2 rather than the more typical 1, and comments like this from the Nigerian doctor linked above:
I have to say I think this Ebola is different and substantially easier to spread than earlier ones. Obviously it’s not spreading like the flu, but it could certainly have mutated to enter mucosa more easily or survive dessication better.
Also, while serum from surviving patients might well help in individual cases, it’s not epidemiologically of much help until the epidemic is already under control. As long as it’s doubling every 3 weeks with a mortality rate exceeding 50%, the infected will always greatly outnumber survivors. You just can’t get enough serum from the survivors.
I feel like we are talking at 30,000 ft.
What we need is people to care for the sick and for those who are sick to allow themselves to be isolated and treated. Both require enormous faith and trust. We don’t have enough care givers because people are scared and the people who are sick are unsure that the caregivers will give them help rather than hurt them more or give them more disease.
This is our dilemma…. We all want it to be fixed without any major sacrifice of either money or exposure to disease… we keep looking for the cure – the vaccine or medication…
@jl: based on 25 outbreaks.
ok. totally out of my universe where we’d run hundreds and thousands of iterations to evaluate model performance. At work, we may have bumped into the millions (certainly hundreds of thousands) for some critical features. have to trust them to know their needs and constraints.
@Fair Economist: @scav: The House paper notes that previous estimates of the reproductive ratio for Ebola outbreaks have ranged from 1.34 to 3.65. So, this paper’s estimates, to the extent they are comparable, are lower.
I think we are going to have to have major “incentives” (financial or other meaningful payments), to get the scale of care givers needed. Right now, the risk is perceived as too great to leave it to just humanitarian impulses. Offering a 100K payment for providing care for 3 months will attract a lot of experienced care givers across the world. We need a effing ARMY of caregivers to flood the affected countries. We could also offer awards from 25 – 50K for other support workers as well.
No bullshit. We have to get serious about raising people power very fast. You wlll not get it from enough volunteers fast enough. We need well trained and well compensated mercenaries to get it under control. First. Then we can talk about altruism and volunteers. Time to do the job using what we know will work to get the right number of people on the job.
To buttress my mercenary argument, Medicines sans Frontieres said that they are swimming in money, but they need care givers.
Lets link A with B.
We need to get the countries where this is out of control into control asap. If the workers need military support… we give them military support (with the approval of the governments). Mercenaries to treat and to protect the treaters.
If this is a threat to the world, maybe we need to act like it
@Elie: Ask Mr. Prince. He says he and his troops are very brave :).
@jl: Not to forget the demonstrated capability of Halliburton et al in running an efficient, useful, low-cost and working logistical efforts in our partially outsourced adventures in Iraq! Showers are trickier than isolation hospitals, right? Our ambassadors of goodwill will be greeted with open arms.
I’m not sure about your asides, but I think we need a different approach than waiting for volunteers.
It would be great to not rely on mercenaries (paid workers from other countries)… Medecins sans Frontieres and Unicef have been overwhelmed and I don’t see lines of volunteers queing up to serve an altruistic purpose. Understandably, it is scary and no one has bonds to these people. Other countries in Africa have not responded. In that context, you can make fun of Haliburton — but if they offer real help — even at a price… I am not going to poke fun from my living room couch. Are you?
@Elie: Cuba is sending 165 medical personnel, almost a third of the 500 non-local health workers the WHO is asking for.
There are local volunteers in the affected countries but obviously not enough.
I think that, in a situation like this that is very fraught with danger for the healthcare workers, you have to ask for volunteers BUT I don’t have a problem offering incentives for people to volunteer, perhaps through the WHO or CDC. At a minimum, the travel costs of the volunteers should be paid, along with a salary at least equivalent to what they would get at their day job. But I don’t think it would be ethical to tell people in unaffected areas that they have to do the work.
So past models are not helpful in predicting. Sigh. I guess.
Meanwhile the particular virus evolves at a rate much quicker than multicelled organisms evolve. Color me kinda bummed.
Well, if you believe that its a universal problem, then we all own the decision and action, right?
Volunteers are great if you can get enough to get job done….My question is whether as a world society we can count on that for enough and timely care. I believe in altruism but I am a practical person. Lets see how we can get this done — and not sit around waiting to see if maybe we can get it done.
We don’t have time. I was just looking at a conference on C-SPAN about Ebola. These people are scared and anxious.
The time for volunteer niceties is passing quickly.
I am thinking of 200,000 folks on the ground with medical, public health and logistic expertise. However we can get them asap.
what will they do: Implement isolation and treatment of those affected while feeding same and sustaining their unaffected families. They will also have to treat and support all those with the other major illnesses such as HIV, TB and Malaria while supporting pregnant women and providing critical vaccinations. In other words, provide the missing public health infrastructure in three or more countries.
And when are you getting on a plane to Monrovia? They don’t need skilled workers right now, they just need people to do basic patient care. You could probably do most of what they need.
IMO, it’s immoral to force people to risk their lives. I think that organizations should be sending a lot more medical personnel and recruiting more, but I don’t think it’s moral to tell a CDC doctor that s/he has to be on the next plane to Liberia or they’re fired.
I think we can offer large incentives to get more volunteers. Why? Because we need to have enough people to do what is necessary. It is taking too long.. Are you ok with that?
I am thinking about it (going), every day. Every day.
And speaking of morality — is what is happening now, moral? Are you fine with sitting on the couch tsk tsk ing about “someone elses” problem?
What are YOU going to do?
@Elie: Was busy. Two points I was hoping to make. First and perhaps least important
A) Halliburton and the contract labor we sent along with suitcases into our last little adventure put up infrastructure that sometime electrocuted the people using it and I wouldn’t characterize them as efficient methods of getting money to the people that need it either. Like them or not, I’d rather trust the actual military to actually manage the infrastructure construction.
BUT, and this has my second point wrapped into it.
B) Neither the external military and probably especially mercenaries are necessarily going to go in with the goodwill or trust of the local populace. A lot of those people don’t even trust their own military or police forces, and now some Oyibos in uniform shows up telling them things? Yes, mercenaries can help with the external attacks on medical bases, but I’m not entirely sure they be a net positive in getting the average local on the street to eagerly cooperate with all the things needed to get the general situation under control . Uniforms plus strangers are not exactly the best introductions. And then there could be long term consequences and some other lingering issues involving trust and outside medical “help”. Medical groups giving vaccines are already tainted by being associated with the CIA etc., plus all the rumors of plots and bad drugs etc already floating about — so there’s a hell of a lot of complex issues to be thought about.
So YES for the external help but I’m not sure that simply hiring mercenaries is the way to go and even the military might need some thought about how and where best to manage it most effectively and who (nationally even) to do what where. There’s a bit more to be thinking about. A real problem is we needed to be thinking about a lot of this earlier because building that trust etc. takes time, something we don’t exactly have. So, cobble as best we can now but then keep thinking about it for the future.
the only reason that I cited using mercenaries was to adopt a vehicle to get a lot of people on the problem quickly. All of what you say may be true but we can’t afford the time to make it all better before we wade in.
I am a nurse. If someone is bleeding out from a cut to the femoral artery, you use whatever you have on hand to stop the bleeding from your bra to a belt or rope. I see it very plainly: We have to get people in action doing things to isolate and then treat patients… with protection for them while they do it. I am respectful of people’s suspicion which is many times justified, but we don’t have time. Really. So while it is less than ideal, we have to make sure that care givers are protected and maybe other things too to make sure food and water, etc are distributed correctly.
@Elie: Yes, I entirely understand the need for speed, but containment is going to require the cooperation of large numbers of locals, to manage and commit to the isolation and containment. We’re talking isolation of entire populations, populations that know the local environment thoroughly. They will outsmart foreigners patrolling perimeters who lack that local knowledge. Local buy-in can’t be omitted, it’s not a nice to have. Landscape scale quarantine is a bit tricky.
I’m going to keep sending money to Doctors Without Borders and other relief organizations, because I have zero expertise in patient care. But I’m also not the person arguing that we should force people to work with Ebola patients if there aren’t enough volunteers. To me, that’s like arguing that firefighters should be allowed to pull civilians off the street to help them put out big fires rather than calling in more firefighters.
I’m fine with offering large incentives. I think we should be doing that right now rather than relying solely on altruism.
What I’m arguing against is the idea that we should force people to go there if they aren’t willing to go even with large incentives. I have no problem with sending even more military personnel than we’ve already sent because those are people who signed up to risk their lives, but I would have a major problem with telling civilians (including doctors and nurses) that they’ve been chosen to be shipped off to the Hot Zone and too bad if they don’t like it, which is what it sounds like you’re advocating for.
ETA: Also, I think there probably are a lot of doctors and nurses who would be willing to volunteer to go, but there’s no one organizing it. So I don’t think we need more people who are willing to volunteer, I think we need better organization.
Wait a minute. Somehow you got that I am for forcing people to work with Ebola patients. I argued for incentives and mercenaries — not conscripts!
I would never argue for coercing that kind of service. I am not sure how you got that from what I wrote.
Yes, this is urgent. I am thinking through what I can do besides what I have already done which is sending money. Please understand, I am NOT for coercing caring for Ebola patients for anyone but who willingly either volunteer or accept the work for their own incentives, such as payment.
Okay. I hear you now…
What I struggle with is how to get the urgency enough to get strong enough payment or other reward for care givers to do this thing — me included (though money could never be enough alone for me)
I am a nurse. I am also a health consultant nearing retirement. This would be so meaningful and yet I am hesitating… So many things to think about but I do want my life to count for something …and I am pullled to the suffering and the need that I see in front of my eyes and in my heart
I was using the good ole American logic that if you offered enough money, you could get more people to do something. Again, not sure how you got to my believing in conscription or coercion to serve. Maybe you misread “mercenary” to mean “conscript”.
All I meant was that if you pay enough, you can get more people to do something high risk more quickly than waiting for volunteers. We have lots of money from all the donations etc– Seems a good way to spend it to get the most bang.
But hearing the reports on the ground, it sounds like the problem is not volunteers, exactly — it’s organization and coordination. Right now, they need people who can set up tent cities for refugees and create Ebola wards in existing buildings far more than they need medical personnel.
Unfortunately, the US really sucks at organizing that kind of thing. I think our soldiers and Marines would be great at taking orders and doing the necessary physical work, but our military commanders don’t have the skill set needed to organize it. I’m not sure what country or organization is capable of doing it, frankly.
@Elie: People may have confused two sense of the word “volunteer”: it can mean unpaid workers (or at least not-paid-extra workers), but when used in reference to the “volunteer military” it means “people who are not conscripts”.
I do not agree with you about the logistical ability of the army. If we are talking about setting up sites where people can treat and care for people, they are actually excellent doing that… On what are you basing your opinion that they can’t? Its part of the reason that the army is called in for logistical support after disasters. You also forget the very efficient and well constructed field hospitals that have physically saved thousands of soldiers and people. These are set up quickly with all necessary supplies and provisions. Seriously. You are just wrong.
They can set things up, but they need direction about where to set them up and you then need personnel to run them — having soldiers nurse patients is a waste of everyone’s resources.
Like I said, from everything I’ve been reading, what’s lacking right now is planning and coordination, not willing volunteers.
While I agree on the lack of overall coordination across the multiple players (organizations and countries) involved in the effort, your assertion that the military does not know how to do medical set up logistics is incorrect. They have also provided (though maybe will not be asked to do so here), major clinical support (medical, nursing, medics, OR techs, – everything). Clearly, this has mainly been for traditional conflict related injuries, but these people are good and know what they are doing in terms of all traditional related treatment and surgery. I keep coming back to correct you because you are still not correct in asserting that they need to be “told what to do” in the sense of not knowing about medical care. That is just not true. Sure, they may need to update their processes for this kind of infectious disease and isolation treatment, but these people are fully trained and capable and are part of the Army. Any hospital that does not treat large infectious disease outbreaks would need similar updating of their processes. Please stop making statements like they are a bunch of folks who just have military skills. You don’t know what you are talking about in this case.
I will add that these locations will need to “backfill” a lot of primary care treatment for HIV, tuberculosis and maternity care. The actual treatment of the Ebola patients can be done by aides and techs who can provide supportive care and treatment to keep people hydrated, their secondary infections treated and kept clean, fed and dry. Yes, someone needs to coordinate that. They will also need to start setting up and planning for vaccination teams. That is a way aways, but they will have to get to know the landscape and the people in the villages. This would be mostly handled by the CDC and WHO working with the people
Time to step in and put a grinding screeching halt to the incipient panic.
The number of annual traffic fatalities in America vastly dwarfs the number of people who die from infectious disease.
The number of people who die from malaria annually in the third world makes the total likely final death toll of this ebola epidemic negligible by comparison.
At least two orders of magnitude more people die in America from slipping and falling in the bathtub every year than from exotic diseases like ebola.
If you want to be scared of something, be scared of (a) driving a car; (b) slipping in the shower or falling off a ladder at home, and (c) eating too much junk food and clogging your arteries up with cholesterol so that you become a risk for coronary artery disease.
Annual worldwide deaths from malaria: 1.2 million people.
Annual traffic fatalities in America: 33,561 (as of 2011)
Annual deaths from slipping and falling at home: 13,322
Annual U.S. fatalities from heart disease: 596,577
CDC estimates Ebola death toll “could reach 550,000 by January.”
If you live in the developed world, your chances of dying from this ebola outbreak are significantly less than the chance that you’ll get killed by a meteorite.
You seem to have mistaken our compassion and empathy for fear. Somehow, I’m not surprised.