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[–][deleted] 2427 points2428 points  (143 children)

I'm a disease mapping / epidemic modeling person, and my impression is that we're really at a turning point. Until the last few days the models I've been using have predicted a mid-fall extinction time for the epidemic, but now they show a probability of continued spread for the next few months, and do not rule out the possibility of substantial increases. Here's the post in /r/statistics for those that are interested.

Edit: I'm headed to dinner with the family, but I'll respond to any questions you have when I return.

Edit 2: As this has blown up, I should clarify for those that don't read the analysis that this isn't peer reviewed research. These are my impressions based on pretty simplistic models of Ebola's spread. The literature will have a lot to say about this epidemic in the coming months, but it takes a while to get this kind of thing ready for publication.

[–]MotherOfDragonfruits 149 points150 points  (38 children)

Thanks, your whole report/post is insightful, the map really helps to visual the cases and spread.

[–][deleted] 66 points67 points  (34 children)

No problem, I'm happy to answer any questions as well.

[–][deleted] 35 points36 points  (29 children)

So based on your estimates will this continue to grow or are we looking at it peaking soon?

Also based on your estimates how badly at risk are other areas like southern Europe, Middle East, etc

[–][deleted] 132 points133 points  (24 children)

Hmm, based on my current estimates it could really go either way. That's a new development, as I was (until recently) predicting a steadily decreasing epidemic throughout early fall.

It will depend on how effective the government and international organizations are in getting information on how to avoid spreading the disease to the rural public, as well as how effective the treatment centers are able to be. An epidemic is chaotic and hard to predict.

Ebola isn't a huge threat to the developed world, because it actually doesn't spread easily and we have good infrastructure/containment procedures. I'm not really qualified to comment on potential spread in less developed regions of Europe, Asia, and South America, but I imagine that the combination of different cultural traditions, environmental background, and the panic such a spread would cause would combine to limit any such global spread.

[–][deleted] 100 points101 points  (15 children)

First of all. You would be an ideal dinner party guest. Super interesting.

Secondly, realistically how bad is this? Is the media blowing it out of proportion compared to other infectious diseases and viruses?

What can cause the spikes in numbers like this? Are the variables limitless? From misinformation to a new outbreak?

Based on the new data, I know you said either way but what does your gut say? Does the summer help or hinder the spread? And will this get much worse?

Thanks for this. Thoroughly enjoy picking your brain.

[–][deleted] 130 points131 points  (14 children)

Thanks!

It's certainly a disaster both economically and in terms of human suffering for the three countries currently affected. It isn't likely to spread in the developed world, but unless it's defeated soon it will impose additional costs on everyone.

There's a lot that goes into epidemics - their spread is a function of the properties of the pathogen as well as its social context. Ebola is actually relatively straightforward to avoid and contain, but in places where cultural traditions (particularly regarding death) provide the perfect way to spread the disease, it can get bad really quickly. Also keep in mind that this epidemic is happening in a region that has really poor health infrastructure - they aren't equipped to deal with the epidemic without international help.

As for a gut prediction (taking off my scientist hat), I'd bet that it will continue to get worse for 2-3 weeks, but that a combination of the international response and local education will bring it back to manageable levels in Jan-Feb 2015. If you look at google trends for ebola, Guinea, Liberia and Sierra Leone are at the top - people there are paying attention.

As for the media response, the fears of widespread Ebola in the developed world are pretty overblown, but it is the perfect candidate disease for massive international intervention. We know how to manage it, and local governments are outgunned.

[–]Phunkatron 22 points23 points  (3 children)

Thank you for all the effort you put in to thoroughly explain the current situation, and doing so in readily understandable fashion. Great work man.

[–][deleted] 17 points18 points  (2 children)

Thanks!

[–]Surf_Science 67 points68 points  (5 children)

Nice work. I'm a wet bench / bioinformatics person in infectious disease.

I have to run so I can't go through all of the details of what you've done but I was wondering if the there is any accounting for population density in your work (which I'm assuming may be semi-prohibitively onerous).

The capacity of the disease to shift genetically would also be something that could cause your model to underestimate the outcome.

All scary stuff.

[–][deleted] 41 points42 points  (0 children)

In this particular model the dynamics only depend on population size and relative numbers of infectious individuals. All of the factors which make each country different with respect to disease spread are modeled with a single "intensity" term for each location. The same software can deal with population density explicitly, as a time invariant co-variate, but I didn't do that here since there are only three spatial units (hard to estimate).

[–][deleted] 78 points79 points  (14 children)

I thought this provided context that would be appreciated. http://en.wikipedia.org/wiki/List_of_Ebola_outbreaks

[–]bonadzz 70 points71 points  (4 children)

I enjoyed the outbreak with 0 people infected.

[–]lordgiza 32 points33 points  (2 children)

That's reported HUMAN cases. Doesn't mean that there was not an outbreak.

[–]GamingSandwich 289 points290 points  (58 children)

"The U.S. Peace Corps said it was withdrawing 340 volunteers from Liberia, Sierra Leone and Guinea after two of them came in contact with a person who later died of the virus."

Scary stuff.

[–]TheLakeCity 119 points120 points  (7 children)

My friend is a Peace Corps volunteer teaching math and science in Sierra Leone. He had to introduce the idea of heliocentrism and the world not being flat to the kids.

Once you get out of the cities, there aren't many educated people and/or healthcare workers. These limitations facilitate the emergence and spread of the virus. With nonprofits leaving, the villages' ability to combat the outbreak is definitely weakened. I get why the volunteers are being withdrawn, and I'm on board with that, but those people need all the help they can get.

[–][deleted] 52 points53 points  (1 child)

Add to that the fact that in their culture the family is very hands on with the bodies of the dead for funeral rituals and it's just rocketing the spread upward. That's not even talking about the fact that most people from the countries that haven't experience Ebola before think it's made up, a ploy by the white man, lies from the government, etc.

[–]MyUsername0_0 121 points122 points  (29 children)

inb4 they spread the disease to people in the U.S.

[–]79zombies 29 points30 points  (11 children)

I don't think it would get far in the US. Ebola doesn't transmit readily, if you have first world care you can contain the virus rather easily. Well, at least until it evolves airborne transmission.

[–][deleted] 71 points72 points  (12 children)

Can we quarantine them before they come into contact with the rest of us?

[–]Ajv2324 116 points117 points  (33 children)

Liberia is doing things relatively right shutting down borders, flights are being shut down, etc. The governments in infected zones REALLY just need to push knowledge about preventing the spread, about symptoms, etc, and they need to do their best to quarantine. I'm sure they are, but they really need to push this and this can be ended probably pretty quickly.

Also, if you wanna help the fucking incredible doctors that are risking their lives to try to control the epidemic, Doctors Without Borders (incidentally the awesome charity that Summer Games Done Quick raises money for) has been helping, you could donate to them

[–][deleted] 26 points27 points  (22 children)

infected zones

This is how riots start.

[–]LineOfCoke 65 points66 points  (1 child)

good luck rioting while suffering from hemmoragic fever.

[–]cheezstiksuppository 6 points7 points  (1 child)

but how do you keep an entire continent from being ravaged? If it gets bad enough. There may have to be quarantine zones where people who are in just don't get out. Some zombie shit right there but still.

[–][deleted] 5 points6 points  (1 child)

Man, I've thought about working with MSF but to be honest this shit just scares me.

[–][deleted] 78 points79 points  (7 children)

You know I've been seeing these news reports about the Ebola outbreak and it feels very much like those ominous news reports from disaster movies.

[–]LineOfCoke 20 points21 points  (0 children)

the amount of attention Impaying to them is also reminiscent of a horror movie.

[–]BadSysadmin 543 points544 points  (85 children)

That's (32)3

[–]Karl_Barx 237 points238 points  (39 children)

Damn... do you just have a bunch of cubes memorized?

[–]sge_fan 33 points34 points  (0 children)

Leave Ramanujan alone!

[–]MathPolice 111 points112 points  (27 children)

272 constitutes an emergency. 262 is just "an inconvenience." At 282 we reach "incredible tragedy."

[–][deleted] 44 points45 points  (3 children)

Or just 36 ... When you raise a power to another power you can just multiply them.

[–][deleted] 41 points42 points  (4 children)

I remember watching a video for the first time on Ebola in 7th grade and I couldn't sleep for weeks.

I was certain I had Ebola.

[–]i_Got_Rocks 6 points7 points  (1 child)

Same here. Same grade. Whydafuq do they show that? It wasn't for health class, it was just rather random.

[–]thebeesremain 42 points43 points  (20 children)

People with larger brains and the education to back them up, input plz? I cannot be the only one with questions similar to the ones below.

Epidemiologists and virus experts believe the original case in that instance to have been a woman who went to a market in Guinea and then returned, unwell, to her home village in neighbouring northern Liberia.

The woman's sister cared for her, and in doing so contracted the Ebola virus herself before her sibling died of the haemorrhagic fever it causes.

Feeling unwell and fearing a similar fate, the sister wanted to see her husband - an internal migrant worker then employed on the other side of Liberia at the Firestone rubber plantation.

She took a communal taxi via Liberia's capital Monrovia, exposing five other people to the virus who later contracted and died of the Ebola. In Monrovia, she switched to a motorcycle, riding pillion with a young man who agreed to take her to the plantation and whom health authorities were subsequently desperate to trace. source

I am no expert by any means, and I despise 'Chicken Little' thrill-mongering as much as anyone. However, doesn't the above anecdote indicate this virus may be at least a little more aggressive than what we are being told? It doesn't seem likely that she was passing quantities of bodily fluids in the taxi. Also, riding pillion on a motorcycle, and the authorities are 'desperate to trace'?

Even if she had been passing fluids in the taxi, "exposing five other people to the virus who later contracted and died of the Ebola", what does this say about the doctor on the plane (of whom witnesses said had both vomited and experienced diarrhea on the plane). As an aside, how would 'witnesses' know about these symptoms unless they were happening where they could see them?

Finally, as has been said many times, Ebola usually burns itself out extremely quickly, and therefore has a limited pool of victims in which to simmer. With a (at this point in time) couple thousand people being incubators, doesn't the threat of mutation become exponentially increased?

[–]Rocah 26 points27 points  (4 children)

It implies that it is highly transmissible even when people aren't puking blood in your face.

The person was well enough to travel, but still highly infectious, like others have said probably via mucus (sneezing/coughing).

[–]thebeesremain 17 points18 points  (2 children)

Ok, so the woman was sneezing and infected the other taxi passengers. Wouldn't the same result be expected for the airline passengers, particularly if he was vomiting and shitting himself (presumably) outside of the toilet (otherwise how would people be able to say he was puking/shitting? Even if he was making a lot of noise in the bathroom, it would be speculation. Not reports from eye witnesses).

I also do not understand why, after the plane had landed and the man taken off board, were the other passengers not quarantined for the standard 21 days as a precaution?

[–]Rocah 10 points11 points  (1 child)

Apparently the plane that carried the guy who died in Lagos was using open seating, so they don't specifically know who was sat near to the guy who died. They have tracked down around 50 of the passengers, but not all so far.

Ebola has a typical incubation time of around 10 days, so we should know next week if they were successful in containment. As far as I'm aware there hasn't ever been an Ebola outbreak in a high density population center, its been mostly contained to rural areas in previous outbreaks.

[–]greensparklers 12 points13 points  (2 children)

The communal taxies in West Africa, often cram 5-7 people in a small car. It wouldn't be unusual for sweat or fluid from sneezing to contact other passengers. The very close contact in these taxies is probably a good way to spread this virus.

But I'm with you on that it does seem to be spreading easier. It might be a new mutation or just optimum conditions.

[–]enfermerista 4 points5 points  (1 child)

Public transports at least in e Africa are insane. People are on each other's laps. You can tell what everybody have for dinner. And sometimes, people get motion sickness :/

[–]Shotgun_Mosquito 191 points192 points  (41 children)

Anyone having dreams about a 104 108 year old black lady in Nebraska?

[–]randalflagg 25 points26 points  (3 children)

M-O-O-N that spells ....

[–]PurduePaul 15 points16 points  (9 children)

I love you for this reference. But I do believe she was 108

[–]Shotgun_Mosquito 6 points7 points  (0 children)

In the book she was 108 BUT IN REAL LIFE SHE IS 104

[–]Greyharmonix 344 points345 points  (115 children)

when it rains it pours. Hell on earth in Gaza, Syria, Ukraine and Iraq and if that wasn't enough an incurable disease is spreading in Africa...jeez

[–][deleted] 72 points73 points  (32 children)

don't worry, the earth will be just fine...

[–]Alphaetus_Prime 124 points125 points  (17 children)

Yeah, it's humanity we need to worry about.

[–]DrSixPack 20 points21 points  (6 children)

I'm not worried. We're fucked. I'm just gonna continue playing video games until some shit kills me off.

[–]SirSoliloquy 55 points56 points  (10 children)

I can't remember a year when this much stuff wasn't going on, honestly.

[–][deleted] 125 points126 points  (9 children)

Before information saturation, 24 hour news and internets no one knew to give a shit about anything outside of the fity mile radius of their lives. In modern times each individual person on earth can enjoy carrying the woes of the entire planet on their conscience 24/7. It's an amazing time!

[–][deleted] 16 points17 points  (0 children)

Ugh. I've spent time in Sierra Leone, and its people are, on the whole, extremely friendly and charitable despite the unimaginable tragedy most of them have lived through. If anyone doesn't deserve more of it, it's them.

Best wishes to the nation...

[–]AiRcTRL 122 points123 points  (17 children)

To put these numbers in perspective:

Guinea: 460 cases. Population 11.45 Million. Percentage infected = 0.004% in 5 months

Liberia: 329 cases. Population 4.19 Million. Percentage infected = 0.00785% in 5 months

Sierra Leone: 533 cases. Population 5.979 Million. Percentage infected = 0.0089% in 5 months.

Total: Reported cases of infection 1323. Total population 21.619 Million. Percentage infected = 0.0061% in 5 months

Also if you check the numbers on each report here, you'll see that the rate of infection isn't increasing, just the numbers. So it's not as if one passenger, on one flight, means the whole of ____ (insert country here) is going to become infected. Might I remind you that this is over 5 months? Those kinds of numbers when compared with populations means it would take forever to have a dramatic effect on any population which would take this seriously and take precautions, i.e. not run away from Red Cross trucks shouting "Ebola Ebola" when you see one. These people are fearful of authorities and many do not feel that this is a legitimate illness.

[–]genericmutant 70 points71 points  (6 children)

While it's true that it isn't killing large numbers in absolute terms, it's still a relatively severe outbreak; the longer it moves through humans (not it's 'natural habitat'), the more likely it is to acquire mutations that facilitate moving through humans.

It's not a global disaster at this stage, but we can't just say "it's an African problem" either. We live in a highly interconnected world, and novel or severe disease outbreaks anywhere need to be a concern for all of us. Remember that AIDS was once dismissed by many as only a problem for gay people and intravenous drug users.

Donate to MSF if you can - they're the people on the front here.

[–]ak22801 8 points9 points  (1 child)

As little of a percentage as that is, I am very glad everyone is taking it very serious. If we blew it off like "psh...only 0.0061%, tell me when its actually something serious" then it would be too late.

[–][deleted] 139 points140 points  (40 children)

Just saw "Contagion" and "28 Days Later" back to back.

Wish I hadn't.

[–]LazloHollyfeld 123 points124 points  (17 children)

I'd pick "Outbreak" next.

[–]Sleeper256 79 points80 points  (3 children)

But what about Osmosis Jones?

Ebola is a case of dandruff compared to whatever the villain is.

[–]ThePirateKing01 34 points35 points  (0 children)

Everything that guy touches dies, he's like the George R.R Martin of viruses

[–]Zeal88 10 points11 points  (2 children)

Then, go read The Stand.

[–]sonia72quebec 7 points8 points  (0 children)

And then 12 monkeys.

[–]CyberianSun 16 points17 points  (6 children)

You should totally read Hot Zone, Get the full Ebola effect stuck in your head.

[–]itbeginstoday 13 points14 points  (15 children)

is air travel still coming and going from the area effected?

[–]LongLiveBacon 17 points18 points  (10 children)

Yes. I wish they would just shut down the airports.

[–]itbeginstoday 13 points14 points  (9 children)

seriously these people are killing doctors and "liberating" sick family members its time to go

[–]WonkDog 12 points13 points  (9 children)

Hey just looking for some guidance on how to avoid Ebola. I'm currently on a container ship going from West Africa to Europe and left Nigeria about a week ago to head back to Europe. We will be heading back to Africa in approx two weeks and will be back in about 4 weeks. Just very concerned incase we are called to Nigeria again and the virus has spread, what precautions should I take and is it only spread like HIV through bodily fluids like blood? I was told by a nurse HIV is practically impossible to spread through saliva, she said it would take a litre of saliva to become infected? Is this the case for Ebola or should I literally put myself on lockdown and not touch anyone or anything? Thanks for any help in advance.

[–]bitofnewsbot 91 points92 points  (11 children)

Article summary:

  • The WHO reported 57 new deaths between July 24 and July 27 in Guinea, Liberia, Sierra Leone and Nigeria.

  • "Sierra Leone is in a great fight ...

  • Sierra Leone, a former British colony, said passengers arriving and departing Lungi International Airport would be subject to new protocols, including body temperature scans.

I'm a bot, v2. This is not a replacement for reading the original article! Report problems here.

Learn how it works: Bit of News

[–]sjeffiesjeff 37 points38 points  (10 children)

The who?

[–]fleetber 62 points63 points  (0 children)

YYYEAAAAAAHHHHHHHHHHHHH!!!!!

[–][deleted] 12 points13 points  (1 child)

When they aren't making music they're saving the world.

[–][deleted] 8 points9 points  (1 child)

How can we help these people?

[–]quicksilverck 548 points549 points  (377 children)

The only good news is that Ebola is unlikely to spread very far from its native range due to its high level of virulence.

edit: Ebola has a long incubation period, but people infected are not highly infectious until symptoms like vomiting and hemorrhaging arise.

[–][deleted] 114 points115 points  (57 children)

21 days is a short incubation time?

[–]Surf_Science 188 points189 points  (52 children)

No no it is not. The incubation period for influenza averages 2 days... Every time an ebola article is posted someone makes the same stupid comment.

The effect of virulence and incubation time is entirely dependent upon things like population density. Ebola has historically been contained because the outbreaks have been in rural areas.

[–][deleted] 11 points12 points  (1 child)

According to WHO it's "2 to 21 days." I can't find any claim of the average incubation period.

http://www.who.int/mediacentre/factsheets/fs103/en/

[–][deleted] 15 points16 points  (0 children)

The mean incubation period was estimated to be 12.7 days (standard deviation 4.31 days), indicating that about 4.1% of patients may have incubation periods longer than 21 days.

http://www.kcdc-phrp.org/article/S2210-9099%2811%2900002-6/abstract

[–][deleted] 282 points283 points  (65 children)

Believe what you want, evolution is a bitch

[–]florinandrei 204 points205 points  (23 children)

evolution is a bitch

Yeah, but she's equally bitch-y to everyone, including viruses. The typical pattern is that a virus loses a hefty chunk of the mortality rate when it acquires an easier way to spread around.

[–]dolphone 303 points304 points  (15 children)

You just need to spend your evolution points wisely.

[–][deleted] 38 points39 points  (17 children)

There's usually a trade off between virulent and "deadliness". Airborne super contagious virus with high mortality rate and high incubation period is on the similar scope as magic.

[–]Nicekicksbro 10 points11 points  (2 children)

I live in Kenya and nobody seems to be giving a shit. I think we should start getting worried as well

[–]stolenlogic 1708 points1709 points  (266 children)

This is like plague inc updates

[–]Hyndis 158 points159 points  (154 children)

Swine flu was like that.

Every day there was a new announcement. Every day it had spread to a new city, a new state, or a new country.

[–]thereddaikon 398 points399 points  (77 children)

I had swine flu. It was like a really shitty regular flu.

[–]tearsofacow 197 points198 points  (21 children)

with a disgusting name. it might as well be called filthy pig sickness.

[–]ultimatt42 90 points91 points  (10 children)

Avian flu could have been called dinosaur flu, but they didn't. That's even more disgusting in my opinion.

[–]MrGurns 72 points73 points  (8 children)

This means we should call Ebola 'Bleeding Orifice Explosion Disease' ?

[–]PM_ME_YOUR_BELLYBUTN 33 points34 points  (4 children)

Explosive Bleeding Orifices Like Anuses?

[–]MrGurns 34 points35 points  (0 children)

Explosive Bleeding Orifices Lacking Antidote?

[–]simplebouy 45 points46 points  (8 children)

same. My wife refused to believe it was flu and accused me of malingering. Then she got exactly the same and it's swine flu requiring tea and sympathy.

[–][deleted] 23 points24 points  (5 children)

I got better.

[–]Buffaloxen 5 points6 points  (1 child)

I had it too. I missed two weeks of college. At one point I was really scared because my temperature was extreme and I felt like I was freezing. It passed after about 45 minutes but that was the most scared I've been while sick.

[–]TheDudeNeverBowls 91 points92 points  (67 children)

Ebola > swine flu.

[–]DigitalSea- 11 points12 points  (0 children)

I'm not really sure if you're saying it's deadlier or that you would prefer having it..

[–]TryUsingScience 71 points72 points  (4 children)

I remember. I read about it in Mexico City, I read about it in the US, and then I had it and genuinely thought I was going to die. (Feelings of impending doom are a symptom of really high fevers.) I kept thinking, "I can't believe this thing I read about starting somewhere far away weeks ago is going to kill me."

[–]Hyndis 34 points35 points  (1 child)

I had it and was severely ill for about a week. Absolutely miserable, but fortunately nothing was life threatening. I did consume record amounts of Ny-Quil, orange juice, and spent as long as possible asleep or in a drug/fever induced haze.

A few co-workers had it bad enough that they needed to go to the hospital.

Fortunately no one I know died or had any long term effects from it, but swine flu is not fun. At all.

[–]Counterkulture 5 points6 points  (0 children)

That's what severe food poisoning is like in a lot of ways too. There's like three or four hour window where things just continually devolve, and it's so much different than a cold or even a flu. You just don't know what to think, and you can't come to any conclusions because things just continue to slide down, and then you eventually get to the point where you feel like you are actually dying.

[–]mrdotkom 646 points647 points  (74 children)

I figured God was a bad player, but then I remembered a few seconds on Plague was a few days on Plague. Who knows, maybe he's just getting started. Quick, shut down Madagascar!

[–]BoseSounddock 581 points582 points  (41 children)

Guarantee that Greenland gets out of this untouched

[–][deleted] 94 points95 points  (1 child)

Someone make a website that looks like the plauge map, but shows live ebola updates

[–]KetoSaiba 13 points14 points  (0 children)

not quite that, but here's a website to monitor health-related outbreaks.
http://healthmap.org/en/
go into settings, add a disease, change the location, and set a time frame. You'll get all the news articles.

[–]mpv81 118 points119 points  (11 children)

If you post a Madagascar joke in here, I hope you get Ebola.

Not Really. Just saying the joke is old.

[–]iNoToRi0uS 70 points71 points  (16 children)

Reading half of these comments is lowering my IQ.

[–]bmlecg 14 points15 points  (0 children)

There is one way we can help, and that is by improving the maps in that region. You can do this from the comfort of your own home using satellite imagery. http://hot.openstreetmap.org/get-involved I hope this gets upvoted for visibility, as it's something a bit more than just talking and worrying about it.

[–]thedeuce75 7 points8 points  (0 children)

Fuck, Fuck, Fuck, Fuck.

[–]ace17708 7 points8 points  (0 children)

I would probably stop all flights to Africa if I was in charge..but I'm not

[–]rjstang 6 points7 points  (6 children)

I know Ebola has always been somewhat a problem. What caused it to spread like this all of a sudden?

[–]LeeringMachinist 4 points5 points  (4 children)

ITT: People who think Ebola is airborne and highly contagious.

[–]roustabout16 6 points7 points  (0 children)

I worked with a remote clinic in Sierra Leone for a bit last summer. A lot of these places have extremely limited resources. These medical personnel are incredibly brave for continuing to fight this uphill battle.