How Ebola is Going to Get Your Ass

 A month ago I wrote Ebola, should we be scared?  I was afraid back then that Ebola might come to our country via air travel.  Well, it happened, and our country has developed a fear that Ebola is going to spread across our country starting with a few infected people arriving via planes. Obviously, possible, but cases that arrive this way are unlikely to overwhelm our medical capabilities. I was afraid of this a month ago, but I now realize my fear was focused on the wrong scenario.

 So, let's look at Africa and see how it is most likely to spread.  First, you many not realize that Africa has over 50 cities that have a million or more people.  Let that settle in as you look at some of them on this map:

Now another view of the major metropolitan areas in Africa.  The bigger the circle, the larger the population it represents:

Notice that Liberia, the country with 4000 plus Ebola cases by October is a small dot on this map with regard to population.  To get a flavor of what it is like in Liberia watch this video if you are up for it ... Ambulance Work In Liberia Isa Busy and Lonely Business.  Sierra Leone with 3000+ cases is a little bit bigger dot and Guinea with  1500 plus cases is even a little bigger dot of population in the map above.  Then a little further away, there's the big population center, Lagos in Nigeria.

In July a single person from Liberia infected 20 people via the airport in Lagos.  Nigeria jumped on it with both feet, isolating everyone, closing schools, etc.  Nineteen thousand homes were visited and temperatures taken. They have not had a single case since then, that they know of.  And they spent millions on educating the public. So, they successfully stopped Ebola spreading from ONE person.

 In the Ambulance Worker Video above, you will see angry people near panic and a lot of hopelessness from everyone.  Imagine in December when there are 10,000 new cases a week in our three small incubator countries.  What are they going to do?  Consider what has happened in Syria, where millions have fled across the border into Turkey and surrounding countries because of the threat of ISIS and the Syrian government -- in short, people flee to escape death.  How will those in infected countries respond when they fear death from ebola?

Ebola Refuges

I think the mathematical model for Ebola spreading can be formulated by simply asking what do people do when they are afraid they are going to die:  fight, flight, or freeze.  The eight health workers killed in Guinea over Ebola fears exhibited the first typical reaction, fight.  They blamed the health workers for bringing Ebola into their country, and as irrational as it is, the workers were killed. As the number of cases double every two or three weeks, the next reaction will be flight.  This is not complicated stuff.  Where will they flee is the only question. 

Overland Routes of Escape

The route of escape for most people in our Ebola incubator countries will be into Nigeria.  We are not talking about one person; 'we are talking about hundred of thousands of people, perhaps millions of people fleeing into the most populated city in Africa where 21 million people live.  Then just start connecting the dots as the Ebola spreads city by city toward Egypt, then the Middle East, Turkey, Pakistan,  Europe, across India to China.  

Across the Sea   

The other way to flee these countries is from the many seaports along the African coast.  While the number of refuges leaving by this mode of travel will only represent a few percent of the whole, they in theory can go anywhere.  The most likely place will be to other neighboring seaports such as Morocco to the north or Johannesburg to the South. But, some of them will make it to densely populated areas of South America, or the Caribbeans, or Mexico.  And again, just start connecting the dots from one densely populated city to the next.

  Panic Mode

As Ebola spreads from one country to the next across the globe, the number of cases increasing exponentially, panic will come faster as the fear outruns the reality.  I can imagine closed borders from one country to the next, none of it effective, as countries try to draw lines in the sand against a VIRUS.  And, what are the chances with millions of cases that the Ebola virus will not mutate at least once.  Who knows what that means, but it is probably not good news.

Isolating Ebola Victims

Ebola multiplies exponentially.  The supply of beds and doctors is limited. (See Malthus theory for population growth versus food supply, same mathematics.) What the math tells you is this: if you get behind on the supply of doctors and medical supplies you never catch up.  It seems clear to me that this has already happened. I don't see us starting to ship beds and health workers into Nigeria and other big cities near the incubator states ... if we really wanted to get ahead of the virus. 

We are not going to stop Ebola with the current strategy of isolating those that are sick and following all the people they have come in contact with, the math doesn't work.  In the U.S., the one person that came into U.S. with Ebola was in contact with more than 70 people.  Now imagine tracking 5000 people with the number doubling every two weeks.  Now imagine you're in a country with limited number of phone or modern communications.  I'm sorry, we are kidding ourselves that we are going to stop Ebola based on the method proposed by CDC. I suspect, THEY are afraid to tell us the obvious, we are not stopping the Ebola virus with Plan A.  They built their strategy based on stopping ebola in rural areas of Africa. They are using a model that does not work with Ebola inside of major metropolitan areas.

Plan B Make it to the Moon or Perish: Vaccine for Ebola

The mathematics say to me that the only humane way to stop Ebola is to develop a vaccine and distribute it ahead of the current wave of the Ebola typhoon.  Of course, it is already too late for millions of people that are going to die from Ebola.  But, being selfish, we probably have a year or so before the Ebola typhoon rolls up on our southern border.  That is probably enough time to create and test a virus and gear up production.  But, that is only if we pour a huge amount of money into it -- more or less a blank checkbook by the U.S. , China and European governments to scientists around the world.

In addition, we will have to put non-constructive competition between humans aside and realize it is humanity against a virus.  It sounds a little science fiction doesn't it?  And yet, look at the projections below for Ebola in the incubator countries alone:
  

And yes, that is a million cases by next summer.  And not shown, are 10 million cases by the end of the summer.  Of course, this is the scenario if nothing is done or if the effort is feeble versus the need.  And so far, our words have waxed long, our actions have been small and way behind the curve with regard to need.  These models all assume that Ebola radiates outward from a central core instead of being simultaneously seeded among all of humanity.  When people start fleeing the Ebola epidemic, it is possible the rate will increase - we don't know what fear will do to the rate at which it spreads.

Our Brother's Keeper

We posted a story about being a good country, a good citizen of the world last week.  I had hoped the Ebola epidemic in Africa would bring out the GOOD in us and that we would rise to the occasion with an open checkbook and an open heart.  But, it is not the US dying, and they are black and poor, and backward.  We act as if their lives are not as important as ours.  Instead we say,  let us close our borders and just let them die over there.  Besides being incredibly heartless, it is stupid and ineffective to think so SMALL and PETTY, especially if the model I am proposing is correct.

We have one chance to get this right.  We either think beyond ourselves or we will wake up with the wolf pounding down our door.  (I am going to work on the math and get back to you.)