Sunday, November 2, 2014

Ebola fever and the War with Spain

I write this post with some reluctance. As an issue, Ebola fever is being wildly overhyped. It would be better if people got a grip and paid attention to real issues. But people are not getting a grip, and it is the mission of RtO to praise greasy pork and restate the obvious, so here goes.

In 1898, when war with Spain was coming, there was a wave of press hysteria much like the press and (especially) television and radio hysteria we have enjoyed regarding the threat of Ebola coming into America. Back then, mayors of East Coast cities were panicked that the navy of Spain was going to bombard their harbors.

Each mayor demanded that the American navy station a battleship at his port, to protect the citizens. If this sounds exactly like, to take one example among many, Maine Gov. Paul LePage, that's exactly what it was like.

Never mind that if a Spanish fleet showed up, one battleship would not offer much resistance, nor that the proper use of a fleet is as a fleet, a powerful force that can dominate all the waters, not just one port. The American admirals, who were trying to concentrate their fleet somewhere near Cuba, were driven nuts by the amateur naval strategists, just as the communicable disease specialists today are being driven nuts by the instant experts (like Sarah Palin) who only want what's common sense protections for our vulnerable citizens. Lest anybody think I am picking on rightwing creeps (although I am), the Democratic prettyboy governor of New York, Cuomo, has been as bad (although the leftie mayor of New York City, DiBlasio, has demonstrated maturity and judgment that is hard to find elsewhere).

Anyhow, it all blew over and the fearsome Spanish navy was sunk (a topic we will have to return to later for historical revisionism).

Fearsome Spanish battleship, Reina Mercedes, with her sails furled


I still would not have stuck my oar in if two savvy, educated and cosmopolitan RtO readers had not revealed, in comments, that they do not understand the method of transmission of malaria, the greatest killer among infectious diseases of our time (unless it's TB). If two smarties like them don't know any more about infectious disease than that, imagine the level of misinformation among the professional ignoranti, like Limbaugh.

So there. The first step in public health is threat assessment. The CDC correctly evaluated the threat but misjudged, at first, the level of practice necessary to become skilled at dealing with it. Paderewski practiced the piano every day, whether he needed to or not.

It took a few days and only two tries to get up to speed, so nothing to worry about.

Now, let's examine both issues a little more deeply.

As a matter of fact, the United States Navy in 1898 was thoroughly incompetent and could have defeated only 2 other navies, Spain's and China's. Spain had only 2 modern ships and these had not had their guns mounted. China had good ships (bought from England) but crooked contractors had sold its navy shells filled with charcoal, cement and porcelain instead of gunpowder.

At the Battles of the Yalu (1894), Manila Bay and Santiago (1898), the Chinese and Spanish sailors fought with great courage but no hope. If you suspect the situation was much as it is today with the Iraq government that the United States created and continues to support, you are exactly right.

As to quarantines, it is incorrect to say -- as some of the people trying to douse the Ebola panic are saying -- that they cannot work. Sometimes they have been useful.

In the early 1970s, when cholera was introduced into West Africa (probably from south Russia), the international medical advisers thought that quarantines were hopeless and recommended something rather like the Doctors without Borders responses today: public awareness campaigns, changes in everyday behavior, isolation, treatment, prophylaxis.

The health director of one of the newly independent states set up a quarantine along his border. The white American and European advisers scoffed but the barrier held for seceral weeks, buying enough time for his nation to prepare. (I no longer recall which country that was, but a young American doctor, Pascal James Imperato, told the story in a series of articles in Natural History magazine.)

It does not follow that the quarantines being set up in Maine, Louisiana, New Jersey, New York, Canada and other backward places make sense today.

UPDATE: This is worth reading. Nut graf:

But why stay here when he was no longer sick? Isolation in a hospital is for sick people; quarantine is for people who have no symptoms but could be incubating a disease.




41 comments:

  1. You should rename this blog "Distorting the Obvious".

    Ebola is directly contagious, malaria is not.

    In epidemiology, if not at DtO, that is a huge difference.

    ... television and radio hysteria

    Really? How about a definition of the word "hysteria" and then some links to actual instance of newspaper, TV, and radio hysteria.

    There is a lot we don't know about ebola; we don't know its reservoir; we do know it is very infectious, but we don't know how contagious.

    And we do know that the Obama administration has handled this even more stupidly than was heretofore imaginable.

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  2. And malaria kills a thousand times more people than Ebola has. We know how to control malaria (at least in cities) and we know how to control Ebola (at least in rich countries).

    I really do not get your animus toward Obama. You did not use to react like this, not before you starting spouting the TP line. If the administration policies are so bad, where are the infected people?

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  3. Where, and a direct quote will be just fine, have I started spouting the TP line?

    My animus towards Obama is due to one basic fact: the man is completely incompetent. He has absolutely zero executive skill. Ebola is just the latest example. It was a very slow moving problem, with very obvious implications. Had he any leadership talent whatsoever, months ago he would have been sitting down with the CDC, DoD, among others to determine what our state of play is -- resources, training, policy, and, perhaps most importantly, how much do we actually know about the disease.

    Obama did none of those things. When Ebola showed up, he sounded exactly like what he is: a clueless tool. As a consequence, the administration in general was falling all over itself, and the CDC in particular looks to be a complete waste of money.

    Riddle me this: no quarantine at all for doctors and nurses coming back from West Africa, but our soldiers deployed there get 21 days.

    And I can't help but notice you have no examples of television and radio hysteria.

    And malaria kills a thousand times more people than Ebola has.

    What is it with progressives and math?

    Quantity and rate aren't the same thing.

    Pop quiz: what are the mortality rates for malaria and Ebola?

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  4. To your last question: just about the same.

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  5. Don't you get tired of being comprehensively wrong?

    Case fatality rates:

    Malaria: 3% (see page 5)

    Ebola: 71%

    If you think those two numbers are about the same, then your math skills are about par for the progressive course.

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  6. I did make a math error. Instead of a ratio of a thousand to one, it should have been 'more than 3000 to one.'

    There are wide uncertainties in the malaria deaths, but 3000:1 is the minimum. It might be 8000:1.

    Case rates are not the relevant measure, because of reinfection. Rates of death for first exposure are much closer.

    But since you didn't even know humans were malaria carriers, I am not surprised you don't get it.

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  7. No, no hysteria at all:

    http://nymag.com/daily/intelligencer/2014/11/kentucky-teacher-resigns-over-dumb-ebola-fears.html

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  8. None whatsoever:

    http://littlegreenfootballs.com/article/44022_Yet_Another_Bogus_Ebola-Obama_Conspiracy_Story_From_the_Dumbest_Man_on_the_Internet

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  9. I had not expected to give a chalk talk on malaria mortality in blog comments, but then I had not expected to be challenged by people who don't know humans are carriers either.

    In West Africa, the death rate among indigenes from malaria vivax is close to 0. The killer malaria is falciparum. Its intensity varies around the world; some varieties (in Malaita, for example) are close to 100% lethal among naive targets.

    In Africa, some people have some immunity to falciparum (from cell sickling), and survivors of first infection are somewhat resilient. But for naive patients (babies), the mortality is, as I said, about the same as for Ebola.

    It appears that with healthy adults who receive prompt and appropriate care, the mortality of Ebola is low. This is not so with falciparum.

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  11. I had not expected to give a chalk talk on malaria mortality in blog comments, but then I had not expected to be challenged by people who don't know humans are carriers either.

    I hadn't expected — fool that I am — to have what Bret and I actually said tortured beyond recognition.

    To reiterate:

    Bret October 31, 2014 at 7:49 AM
    Ummm. Isn't malaria carried by mosquitoes? In which case your title makes no sense?

    Bret October 31, 2014 at 2:29 PM
    I don't think you can catch malaria directly from another person short of having a blood transfusion.


    He clearly meant that mosquitos are the disease vector; therefore, completely unlike Ebola, malaria doesn't require any particular kind of quarantine or infection control because, completely unlike Ebola, malaria victims are not directly infectious to other people.

    (You either need to work on your reading comprehension, or stop prevaricating. Or, better yet, quote directly. That way it would be crystal clear to everyone that neither Bret nor I was the least bit confused about the malaria lifecycle.)

    That means, epidemiologically speaking, ebola and malaria are completely different.

    I followed your links.* Dr. Foege piece is a festival of fact free claims, false dichotomy, and sloppy reasoning.

    The screening of travelers is not simple and it is certainly not fool-proof. But again, public health recommendations have been tightened to improve the chances of finding people entering the country with the virus. Some of the same people critical of the public health approach seem very tolerant of politicians calling for a travel ban from affected countries or governors placing travelers in quarantine.

    Past experience indicates that people are clever enough to travel to other countries first if they really want to come to this country. And they will hide their exposure to Ebola patients if it means being placed in quarantine. That simply increases our risk. There is no evidence that such quarantine would be better than finding contacts and taking their temperatures twice a day to detect the first evidence of illness.


    False dichotomy: posing screening and travel bans as mutually exclusive.

    Fact without evidence: that a travel ban is less effective than screening. I go through passport control more often in a month than you probably have in your entire life. It is very difficult to hide countries you have visited, particularly if you didn't intend to do so in the first place.

    That's bad enough. Perhaps worse are the empty assertions, such as: "… public health recommendations have been tightened to improve the chances of finding people entering the country with the virus." Improve? What exactly are the units of "improve"? Couldn't "improve" also mean "better than awful, but still pretty bad?"

    Similarly, while it is true that "There is no evidence that such quarantine would be better than finding contacts and taking their temperatures twice a day to detect the first evidence of illness.", there is also no evidence that it isn't, either.

    * Speaking of fact free claims: You have twice said I never follow your links. How could you possibly know that? Oh, wait, you can't. Odds of you retracting a patently bogus claim are, based on previous performance, precisely zero.

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  12. Darn. I can't believe I missed the barking non sequitur. Some of the same people critical of the public health approach seem very tolerant of politicians calling for a travel ban from affected countries or governors placing travelers in quarantine. He clearly doesn't like some of the same people. That aside, it is entirely possible to find the CDC's exercise of what should be their core competence incompetent and also think that, given the level of his, and everyone else's ignorance, maybe waiting until the first sign of illness might not, after all, turn out particularly well.

    His reasoning would have applied equally well to AIDS. Imagine if you could wind back the calendar and quarantine patient zero, and everyone he had sexual contact with, even before they exhibited symptoms. Apparently he wouldn't have, nor would you.

    And the rest of us would think you absolutely nuts.

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  13. I had not expected to give a chalk talk on malaria mortality in blog comments …

    I hadn't, fool that I am, expected the goal posts to move so far, so quickly.

    I asked: Pop quiz: what are the mortality rates for malaria and Ebola?

    You answered with: just about the same.

    Fact: the CFR for ebola is nearly 25 times greater than the CFR for malaria of all kinds. CFR is CFR is CFR.

    The killer malaria is falciparum. Its intensity varies around the world; some varieties (in Malaita, for example) are close to 100% lethal among naive targets.

    Bollocks. Wrong:

    Standardized systematic procedures were used to collect clinical and laboratory data on 6,624 children admitted to hospital over a 1-year period in an intensely malarious part of Tanzania. Frequencies of signs and symptoms were calculated and their association with a fatal outcome was assessed using multivariate logistic regression. There were 72 deaths among 2,432 malaria cases (case fatality rate [CFR] = 3.0%); 44% of the cases and 54% of the deaths were in individuals less than 1 year of age.

    (emphasis added)

    Don't you get tired of being comprehensively wrong?

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  14. None whatsoever.

    Several right wing sites are already parroting the latest “Obama wants us all to die of Ebola” conspiracy theory …

    Going to the source:

    At the urging of the Obama Administration, the Associated Press and other news outlets have agreed not to report on suspected cases of Ebola in the United States until a positive viral RNA test is completed.

    Charles Johnson is either a liar or an idiot. But why choose?

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  15. 'He clearly meant that mosquitos are the disease vector;'

    I understood what he meant, but he was wrong. Just as to an egg, a chicken is just a method of creating another egg, to the plasmodium, a human is just a vehicle for getting into another mosquito.

    It is unlikely that malaria was ever transmitted across an ocean in a mosquito. They die too quickly. We were the carriers.

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  16. If you had read my link, you'd have known that Gateway Pundit wasn't the source. And in any case, that the Gateway Pundit is AKA 'Stupidest Man on the Internet.'

    The original source (which you'd know about if you followed my links) admitted an error, withdrew its misreporting and tried to explain how the error had occurred.

    Also, you seem to be having a serious case of confusing apples for oranges. The average number of malaria deaths is estimated at 500,000 to 1 million a year. That should suggest to you that not many of those people are being treated in hospitals.

    If you get a case of malaria or Ebola into a well-run hospital, the rates of deaths are comparable; and if you don't, the rates are also comparable but very, very different.

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  17. RtO has off and on had a Libertarian reader named Bronson Kaahui. I think he's absent just now. Bronson and I don't agree on policies that often, but I completely agree with his letter regarding what he calls "Google research."

    Of all the great killer diseases, malaria is usually accounted the most complex and hard to understand. In other words, just the subject in which a few Googled factoids would likely result in less than a clear understanding.

    Here is Bronson's letter:

    Googling for information is not same as research
    November 8, 2014
    The Maui News


    A Nov. 3 letter writer claims that there is no scientific consensus on the safety of genetically engineered crops. As evidence, she points to a petition of "scientists and legal experts" from EarthOpenSource, an anti-genetically modified organism website.

    Apparently, the letter writer doesn't understand what a scientific consensus is and how it is reached. It doesn't mean there is no disagreement. There is a petition of 671 scientists who reject evolution, a science that has been settled for over a century.

    I'm wondering if EarthOpenSource also rejects the consensus on climate change, given that a petition of tens of thousands of scientists is still circulating. Can you say selective skepticism?

    This is the problem with Google scholars, they are not trained either by education nor experience to conduct actual research on the Internet. They simply Google the information that confirms their worldview and repeat that information. This is a well-understood phenomenon known as confirmation bias.

    If the letter writer had conducted actual research, she would learn that the international scientific consensus is supported by the World Health Organization, the American Medical Association and the National Academies of Sciences of the United States, India, China, Brazil, Great Britain, France, Germany and basically every major country on this planet, including the European Commission, which represents the scientific bodies of all of Europe. All the same organizations which endorse the consensus on climate change by the way.

    Googling is not the same thing as research.

    Bronson Kaahui

    Lahaina

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  18. I understood what he meant, but he was wrong.

    No you don't, and no he isn't.

    He, and I, fully understand that the life plasmodium lifecycle requires both humans and mosquitos. You say Just as to an egg, a chicken is just a method of creating another egg, to the plasmodium, a human is just a vehicle for getting into another mosquito.. True. It is also true written the other way around.

    That isn't the case for Ebola.

    Your equating Ebola and malaria is foolish on multiple levels, as evidenced by your very next sentence. No doubt that malaria was carried across the ocean by humans. Just as there is no doubt that plasmodium found a congenial environment in New World mosquitos.

    However, this is exactly where you further demonstrate your incomprehension. There could not have been more malaria sufferers at the end of the voyage than began. Yet had there been just one Ebola case on board, it is entirely possible that it would have been a ghost ship before reaching the far shore.

    If you had read my link, you'd have known that Gateway Pundit wasn't the source.

    Had you read my comment, you would have realized I followed your link to Charles Johnson, and from there to the GP, whereupon it became readily apparent that Johnson had grotesquely mischaracterized what Gateway Pundit said. Kind of exactly like when you asserted "Tea Partiers chanted 'Let him die.'" (Although, to be entirely fair, you were just uncritically repeating what some idiot or liar at Think Progress said.)

    I followed, and reposted, the relevant links. I can't find anywhere that anyone retracted anything.

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  19. Also, you seem to be having a serious case of confusing apples for oranges. The average number of malaria deaths is estimated at 500,000 to 1 million a year. That should suggest to you that not many of those people are being treated in hospitals.

    The CFR in African hospitals is 71% for Ebola, and 3% for malaria. Therefore, under similar conditions, the CFR for Ebola is more than 20 times greater than malaria.

    Moreover, it is worth repeating, since you have somehow glossed over it, that your assertion of a 100% fatality rate for naive targets is more than 30 times greater than the actual rate.

    Just as nonsensical is your statement that statement that in a well-run hospital the rates are comparable, and not only in the trivial sense that 100% is comparable to 3%. Presuming you meant "similar" (otherwise, you are even further down the logic chopping road than you already are), the operative term is "well-run hospital". Compare the measures required to successfully treat, and prevent further infection, and Ebola patient vs. a malaria patient.

    On top of that you are prisoner of an implicit assumption based upon total ignorance. Consider what the term CFR means: it requires clinical presentation. Therefore, the CFR number is wholly ignorant of non-presentations. How many malaria cases are sub-clinical? How about Ebola? If there is a substantial difference between the two — and that would be a very good guess — then the CFR for malaria overstates the actual mortality rate of sufferers, whereas the CFR for Ebola is closer, and perhaps dead-on, the mark.

    Now I don't know the answer here, and you don't either, but you completely failed to even consider the possibility that the CFR for malaria is based upon a bias towards the worst cases, whereas the CFR for Ebola is based upon all the cases.

    Of all the great killer diseases, malaria is usually accounted the most complex and hard to understand. In other words, just the subject in which a few Googled factoids would likely result in less than a clear understanding.

    Oh for Pete's sake.

    You routinely traffic in pronunciamentos that collapse under even superficial inspection. You make claims about mortality rates that are glaringly wrong, and then SQUIRREL!

    Of course googling isn't the same as pure research, and of course mere googling can merely reinforce motivated reasoning.

    But when you assert something as fact, and disinterested entities such as the CDC state otherwise, then according to the CDC — not me — you are well and truly wrong. Your assertions are rubbish, and renders any argument you make on them dubious, at best.

    If you spent a little more time sourcing your pronunciamentos, then you wouldn't find yourself so often having to shout SQUIRREL!

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  20. Do you know what it means to 'follow links'? Evidently not, so I will quote the first part of the retraction, deletion and explanation:

    **CORRECTION: This piece originally and inadvertently suggested that The Associated Press and other news organizations were in agreement “not to report on suspected cases of Ebola in the United States until a positive viral RNA test is completed.” I regret this misinterpretation. In fact, AP is in no agreement with other outlets regarding news coverage. AP’s own position is that it will still report some suspected cases of Ebola if they cause enough disruption, even if there’s no confirmation the person has Ebola.

    To be fully clear, I am providing both the link to the October 17 AP advisory and the full text of the advisory, as follows:

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  21. Words have meanings. 'Well run' means well run, which is not an adjective that anyone would use to describe most of the overwhelmed hospitals in west Africa, although it applies well enough to some.

    If you stop and think about it -- as I asked you to do -- it would be evident, from the big spread in the estimates of malaria deaths, that most never saw a hospital. You keep harping on an elite group of patients. This is cherry-picking.

    As for 100% death rates for naive patients, these are achieved (as I said) in spots like Malaita. Malaita is across Sealark Channel from Guadalcanal, but it got to sit out World War II because the malaria there was insupportable to either Japanese or whites. This is not knowledge you'll find with Google. But it is in books.

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  22. Do you know what it means to 'follow links'? Evidently not, so I will quote the first part of the retraction, deletion and explanation:

    I apologize. I followed the link at the top of the LGF post entitled "Yet Another Bogus Ebola-Obama Conspiracy Story…"

    In doing so, I failed to go to the end, where the update was.

    That said, my characterization of Johnson stands: he is a toxic combination of idiot and liar. Nowhere did GP accuse anyone of a conspiracy; rather, GP arrived at the plausible conclusion that, based on a Forbes report, the Obama administration was more concerned about optics than facts.

    That isn't a conspiracy theory, even if the initial report was true. Johnson completely mischaracterized what GP said. Why does that happen so often with progressives? (BTW, I happen to think that it would be well within bounds for the administration to have not only asked that of news outlets, but even to do so publicly.)

    And if that is the closest you can get to hysteria, then you have miles yet to go.

    (Your link before it is no help either. You asserted television and radio hysteria, then used as an example parents with baseless fears. It don't fit.)

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  23. If you stop and think about it -- as I asked you to do -- it would be evident, from the big spread in the estimates of malaria deaths, that most never saw a hospital. You keep harping on an elite group of patients. This is cherry-picking.

    No, it isn't. It is a pure statistical fact that follows from a presumption about the nature of both illnesses. IF Ebola is always serious enough to require clinical presentation AND IF malaria isn't, then the CFR for malaria, by definition, will exceed the entire population's death rate from malaria.

    This is just as true of, say SARS. We know that there is a high CFR for SARS, but we have no idea what the total mortality rate is, because we have no idea how many SARS cases were not severe enough to clinically present.

    But even ignoring that, your assertion that the mortality rates of Ebola and malaria are similar is rubbish.

    Per the WHO:

    According to the latest estimates, released in December 2013, there were about 207 million cases of malaria in 2012 (with an uncertainty range of 135 million to 287 million) and an estimated 627 000 deaths (with an uncertainty range of 473 000 to 789 000). Malaria mortality rates have fallen by 42% globally since 2000, and by 49% in the WHO African Region.

    789e3/135e6 is just slightly less than 6e-3, or — at most — about 0.6%.

    According to the NIH the mortality rate of the current outbreak is merely 60%.

    I guess in progressive world, two orders of magnitude difference qualifies as similar.

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  24. As for 100% death rates for naive patients, these are achieved (as I said) in spots like Malaita.

    First off, substantiate your assertion.

    Second, even if completely true, the global mortality rate of malaria wouldn't see any change within 10 places right of the decimal point. Regardless of the truth of that factoid, it is completely irrelevant.

    Words have meanings. 'Well run' means well run, which is not an adjective that anyone would use to describe most of the overwhelmed hospitals in west Africa …

    Epic point missing. Or goalpost shifting, not sure which.

    The point is that successfully treating malaria is far easier in every respect than Ebola, and, unlike Ebola, does not put the health care workers themselves at risk.

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  25. You are not going to pay attention to anything I write, but you continue to demonstrate fundamental confusions about malaria. Please go find some other source (Margaret Humphrey and Robert Desowitz are both good), and learn about this diseases -- or better, these diseases.

    Start by understanding the difference between tertian and quartain agues.

    I notice that despite the heroic efforts that have reduced malaria deaths in late years, the total remains above the minimum estimate I used to derive the 3000:1 death ratio, even using your figures.

    In the 47 years since the outside world became aware of the African hemorrhagic viruses, the viruses have killed <10K. Malaria, somewhere upwards of 24M, maybe more than 50,000,000.

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  26. You are not going to pay attention to anything I write, but you continue to demonstrate fundamental confusions about malaria …

    In what regard? Direct quotes, please.

    You made the ignorant assertion that the mortality rates of both diseases are just about the same. They aren't, not even remotely. Worse, you make the mistake of comparing what has happened with malaria and ebola without recognizing that malaria is a devil we know, and ebola isn't. You have no idea how this ebola epidemic will play out.

    Worse, though is your insistence on comparing soup to nuts. In what way is a global bacterial disease that isn't directly infectious relevant to a (so far) localized extremely infectious viral disease?

    Your confusion on rate is clear enough, but it is no better with quantity. In 2014, so far, at least 3,000 people have died in Liberia from Ebola.

    It is hard not to laugh unkindly at progressive numeracy. A month ago, the WP had an article putting Ebola in perspective. Like you, the author ignores rate, and compounds the error by not understanding time, either:

    It's no malaria, which in Liberia killed 1,725 people and sickened more than 1.4 million in 2012. Cholera was responsible for 1,146 deaths in Liberia in 2011.

    So far this year, during the worst Ebola outbreak in history, the virus has killed about 900 people in Liberia. That puts it on par with other deadly, yet preventable ailments.


    Do you see the problem? (Other than restating the obvious about how wildly off the mark you were on mortality rates.)

    Let me help: 2012 was 12 months long. At the time of writing, "So far this year" amounted to nine months. Only a journalist would compare a quantity summed over 12 months to one summed over 9 without at least pro-rating. As I type "so far this year" is closer to a calendar year. Which makes ebola worse much worse than malaria and cholera combined.

    So you were wrong about rate, and when taken over a specific area and (nearly) identical time span you are wrong about quantity, too.

    Oh, BTW, when you ignore, or are ignorant of, rate, then you miss something else: the second derivative, which, for ebola deaths, is disconcertingly positive.

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  27. Read Desowitz.

    We know a lot about Ebola (and other African hemorrhagic fevers), with nearly half a century's experience in the West. The worst innumeracy was the CDC's extrapolation on a straight line of the case growth.

    I thought about blogging that but didn't have time. But the dullest form of prediction is that the future will be just like the present only more so. With epidemics of Ebola type this is especially silly, as people change their behaviors in ways that interrupt the skein of infection.

    At worst -- and we have seen versions of this already -- they wall up the sick and their families in their houses to die of plague or starvation. This is the Gov. Christie approach.

    Skipper, you also have a bad time problem. Ebola has been around for over 40 years, malaria for all those 40 years. In most of those years, the Ebola death toll has been 0 and until this year never more than a few score. In every one of those years, malaria has killed more than (probably much more than) 500,000.

    Talk about numeracy more. But don't cherry-pick your data.

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  29. The worst innumeracy was the CDC's extrapolation on a straight line of the case growth.

    Where?

    Oh, wait, I probably found it.

    As is so often the case, you mischaracterize what the CDC actually said. Perhaps you could comment on the number of cases that have occurred to date, compared to what the CDC predicted would occur.

    Also, while you are at it, you could explain to us just exactly which conditions for the CDC's prediction are invalid.

    Skipper, you also have a bad time problem. Ebola has been around for over 40 years, malaria for all those 40 years. In most of those years, the Ebola death toll has been 0 and until this year never more than a few score.

    Again, epic point missing. You made an assertion about mortality rates that is comically wrong. And compounded that error by goal post shifting: I did make a math error. Instead of a ratio of a thousand to one, it should have been 'more than 3000 to one.'

    A ratio is not a rate. When talking about relative mortality, ratio is completely inappropriate.

    Further, you are, in effect, saying that history guarantees future performance. That's risky enough in any event, but it is particularly risky when the current ebola epidemic is already unlike — and far worse — any in history.

    Over very nearly (there are no malaria stats for 2014) the same period and same locale, ebola is vastly more dangerous than malaria, and the rate of the rate of ebola infections is increasing. About this there can be no doubt, except among those for whom numeracy and logic weren't part of the J-school curriculum.

    Talk about numeracy more. But don't cherry-pick your data.

    Cherry picking, suppressing evidence, or the fallacy of incomplete evidence is the act of pointing to individual cases or data that seem to confirm a particular position, while ignoring a significant portion of related cases or data that may contradict that position.

    This is cherry picking: As for 100% death rates for naive patients, these are achieved (as I said) in spots like Malaita.

    Comparing mortality over relevant time periods, based upon the same area, population and health care conditions is not.

    Oh, and I can't help but notice you still haven't supplied any examples of hysterical reporting.

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  30. http://wonkette.com/566426/heres-the-best-ebola-freakout-montage-youll-see-all-day-video

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  31. I followed every one of the links in the link, and from that waste of time I know this: Doktor Zoom is, in addition to being an idiot and a liar, rabid.

    I really would like you to specify one thing that idiot cited that qualifies as "hysterical". Please stay within shouting distance of the dictionary definition.

    Not noted, unsurprisingly, was that the nurse was asked to self-quarantine after a doctor in NYC didn't either, and went about his merry way in NYC after becoming symptomatic.

    Also not noted, and equally unsurprisingly, is that from the outset the US military has imposed a 21 day quarantine on all personnel returning from Liberia.

    Are you sure Wonkette isn't a false flag operation?

    I also can't help but notice that when directly challenged, you never directly reply. And you still haven't supplied any examples of hysterical reporting. And, no, hysterically reporting "hysterical" reporting doesn't count.

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  32. You know what wasn't in any of those clips -- and hasn't been in any of their other broadcasts either: No cases of infection in US when CDC/MSF guidelines were used. No deaths in any case.

    It seems hysterical to me, along with the Solyndra meltdowns, which -- surprise! surprise! -- turned out to be equally bogus.

    The rightwing rage and disinformation machine chugs along, crazier and crazier.

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  33. I really would like you to specify one thing that idiot cited that qualifies as "hysterical". Please stay within shouting distance of the dictionary definition.

    I note that you didn't, so I presume you can't.

    Just like you couldn't here

    And just like Tea Partiers didn't actually, as it happens, chant "Let him die".

    But only the narrative matters, right?

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  34. I specify that I thought almost all of it was hysterical. But, who knows?, maybe it was merely dishonest political t3hater meant to inflame the rubes.

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  35. And you specified that Tea Partiers chanted "Let him die".

    About which you were entirely wrong.

    Absent being able to specifically cite an example of Ebola reporting, and describing how it was hysterical, then once again you are trafficking in nonsense.

    But for you, only the narrative matters, right?

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  36. Sometimes you have to choose, like between epidemiolgists who conquered diseases that had killed millions, on one side; and drunken clowns and trollops who have spent a total of 0 minutes and 0 seconds studying communicable diseases on the other.

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  37. I really would like you to specify one thing that idiot cited that qualifies as "hysterical". Please stay within shouting distance of the dictionary definition.

    I note that you didn't, so I presume you can't.


    Just to reiterate from your post:

    ... there was a wave of press hysteria much like the press and (especially) television and radio hysteria we have enjoyed regarding the threat of Ebola coming into America.

    A claim for which you have been able to provide exactly zero evidence. The only hysteria on offer is Doktor Zoom himself, in addition to his being the least attractive possible combination of idiot and liar.

    So the choice here isn't the non sequitur you propose (gee, which should I do today, take the bus to work or carry my lunch?). Rather, there is a credibility judgment to make. Doktor Zoom clearly has none.

    I suspect you cited that hard-left bloviator merely because it fit your narrative, not because there was any substance to be found.

    Please tell me you were a better journalist.

    ... drunken clowns and trollops ...

    Way to stay classy, Harry.

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  38. Just stating the facts about the hysterical. (You can find recordings of O'reilly's drunken phone calls on the innertubes if you care to.) If you don't think closing the borders was hysterical, I cannot help you.

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  39. Just stating the facts about the hysterical.

    From your post:

    In 1898, when war with Spain was coming, there was a wave of press hysteria much like the press and (especially) television and radio hysteria we have enjoyed regarding the threat of Ebola coming into America.

    Here are the facts you have provided about "television and radio hysteria":

    [crickets]

    You can find recordings of O'Reilly's drunken phone calls on the innertubes if you care to.

    I have no idea what this has to do with anything. But never mind that, what is so hard about providing a link yourself? Hmmm … I think I know. Because you can't.

    If you don't think closing the borders was hysterical, I cannot help you.

    The borders weren't closed, so I can't think something that never happened was hysterical.



    Let's do a little thread review:

    You were so confused about the epidemiology of malaria that you thought it directly contagious. You confused quantity with rate, then compounded that mistake by calculating a ratio both useless and ridiculous, thereby reproving, as if further proof was needed, progressive innumeracy.

    You had no idea what the relative mortality rates of malaria and ebola are. You don't understand case fatality rates, nor the extent to which CFRs might overstate mortality. You cherry picked a tree completely clean. You cited as definitive a column written by an epidemiologist who, no matter his professional excellence, cannot write 750 words without committing several barking logical errors and trafficking in completely empty statements.

    You were wrong — by a factor if at least 30 — about malaria fatality rates. Your assertion about how malaria got to the new world was both true, and completely irrelevant. You repeatedly make completely unsubstantiated assertions that, upon examination, implode. You badly mis-characterized a CDC position paper on ebola case growth.

    That has to be some kind of internet record.

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  40. I think I'll stand by my own facts because they are, you know, facts. And while the borders were not closed it is true that hysterical drunken clowns demanded it on a national network.

    It now turns out that the only slightly less hysterical governors have quietly abandoned their mini-border quarantines: From Sunday's Times:

    The absence of quarantines is striking, not only because both governors emphatically defended the policy as a necessary precaution, but also because most people returning from Ebola-stricken countries arrive in the United States through John F. Kennedy and Newark Liberty International Airports. Several aid organizations have American health care workers in West Africa, a handful of whom return every week. But New York and New Jersey officials say no one coming through the two airports since Ms. Hickox has reported direct contact with Ebola patients.

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  41. I think I'll stand by my own facts because they are, you know, facts.

    You mean like this one? You can find recordings of O'reilly's drunken phone calls on the innertubes if you care to.

    Not unless libel now counts as a fact. What does count as a fact, though, is that you will memhole that vile claim.

    And while the borders were not closed it is true that hysterical drunken clowns demanded it on a national network.

    Not until you provide proof, they weren't and didn't. And you won't, just as you haven't before on this thread (among others), because you can't.

    The absence of quarantines is striking ...

    Particularly striking in West Africa.

    Although far less striking here.

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