Firestone Stopped Ebola in Its Tracks

http://www.npr.org/blogs/goatsandsoda/2014/10/06/354054915/firestone-did-what-governments-have-not-stopped-ebola-in-its-tracks/

by mdturnerphys • 12 years ago

183 96 12 years ago

npr.org

Someone1234• 12 years ago

Honestly what it really boils down to is resources and money ("resource" can also be described as "money" therefore really money and money).

Up until very recently there were simply not enough hazmat suits, not enough burn-able bedding, not enough people (who wants to work with Ebola?), not enough disinfectant, and heck even clean water in SOME areas.

Then you have to consider how damn hot it is there, so a $5 hazmat suit may not cut it (this article covers that). Now you're dealing with suits costing tens of times more than that for basic AC, just to allow the people in them to work longer shifts.

You also have a lot of local population pushback. The hazmat suits scare people, and all locals see is Ebola patients go into treatment and die. There is a lot of suspicion that Westerners are getting people sick to kill them, so they hide away family members until they get infectious.

What can be done? Money, and resources. It isn't a magic bullet but if you train a metric ton of local people and give them everything they could possibly need it would at least slow the spread if not reverse it entirely...

PS - This article is exactly WHY I am not legitimately concerned about a wide-spread infection in the Western world. We are simply too rich, we have or can acquire the resources, and even your average Joe Smith on the street can Google how to protect themselves from Ebola exposure.

gohrt• 12 years ago

We also need to stop intentionally delivering fake medical care

http://www.scientificamerican.com/article/how-cia-fake-vacci...

and then wait decades to earn trust back.

chernevik• 12 years ago

That episode probably (hopefully?) hasn't much to do with the Ebola thing. Apparently it has been a huge problem for the polio eradication effort in Pakistan. A very, very serious error by the CIA.

tokenadult6• 12 years ago

Your comment is quite irrelevant to the topic of this thread, which is efforts to prevent deaths from ebola, a disease for which there is currently no vaccine.

ObviousScience4• 12 years ago

It's not like the US intentionally infected a bunch of people in a foreign country with a disease because they were curious about it, then waited 65 years to apologize for their crimes.[1]

And certainly the US government would never lie about treating people for a disease in a government program, and then just watch them die instead of actually helping them.[2]

Snark aside, have you ever considered that maybe there's a reason people don't trust the US government to act ethically or in their interests?

[1] http://en.wikipedia.org/wiki/Guatemala_syphilis_experiment

[2] http://en.wikipedia.org/wiki/Tuskegee_syphilis_experiment

adventured3• 12 years ago

You're referring to things that happened 60 or 70 years ago as a reference basis for trust, for a government who has as its President a man born 53 years ago.

There's a long list of warranted criticism to throw at the US Government, but I don't see how your examples are valid criticism of today's government. The US Government of 1950 no longer exists. Yet you're referring to it as though it does.

I guess Angela Merkel is not to be trusted because of what happened 70 years ago? Or Shinzo Abe?

tokenadult6• 12 years ago

Your comments too are quite irrelevant to the topic of this thread, which is about efforts to prevent the transmission of ebola.

snowwrestler2• 12 years ago

What's the international crime statute of limitations these days? Maybe Africans don't want U.S. or European help because those countries used to steal Africans and turn them into slaves.

Or--maybe Africans actually do want U.S. and European help, and have repeatedly asked for it, and have expressed thanks that it is now being mobilized.

http://www.nytimes.com/2014/09/13/world/africa/liberian-pres...

danieltillett15• 12 years ago

This article is exactly WHY I am not legitimately concerned about a wide-spread infection in the Western world.

Leaving aside the moral argument of preventing huge numbers of innocent people from dying Ebola if we can, there are two reason we in the west should be concerned:

1. There is a serious risk that Ebola will mutate to become more infectious. It is very unlikely to become airborne (this is about as likely as pigs becoming airborne), but it could relatively easily mutate to slow down its kill speed. At the moment Ebola kills so quickly that there is little time for a patient to spread it to other people. Ebola is under huge selection pressure to slow down the disease progression in humans. We could see a strain arise that takes a month to kill you where you are asymptotically infectious for a couple of weeks. Model this sort of virus and things look far less rosy for us in the west. The more people we let Ebola infect the more likely that such a strain will arise.

2. Once the number of cases get very large (25,000 a day by Jan 2015 according to the CDC) this is going to start disrupting international trade as countries close their borders. We already saw the sort of recession that can result from disruptions to trade when this happened in the GFC and the Asian crisis in the 90s. With interest rates at or near zero in most countries there is not much that can be done to buffer us economically.

AlexDanger• 12 years ago

You can bet Madagascar will be the first to close their borders.

phkahler4• 12 years ago

> There is a serious risk that Ebola will mutate to become more infectious.

Not likely. Survival of the fittest for a virus usually means allowing the host to live longer - in other words LESS lethal. It is not likely to become airborne, and if it did it would not be ebola any more. The symptoms of most diseases are not an accident, they are tied to the means of transmission: Colds make you cough and sneeze. Flu makes you cough, sneeze, barf and sweat. Rabies makes you crazy and want to bite. STDs some think may make people horny. Ebola makes you barf, shit, bleed, sweat.

The one scary thing is I once read that a single gene make Ebola hemoragic, and if that were to transfer to a flu, that would be very deadly. But it would also be less virulent due to that same deadliness and so would be selected against as our response to related flu vidii would wipe it out.

None of that is helpful short term, but this notion of the virus getting more horrible than it already is, I don't think so.

wobbleblob2• 12 years ago

Ebola is under huge selection pressure to slow down the disease progression in humans. We could see a strain arise that takes a month to kill you where you are asymptotically infectious for a couple of weeks.

The virus doesn't gave a goal, to kill the patient. The death of the host is just an unfortunate side effect that really harms the spread of the virus. The really successful viruses have mutated to a form where they don't kill the host, don't make you sick enough to stay in bed, and just make you go to work and cough and sneeze all over everyone at the office.

Shivetya• 12 years ago

the real threat is that this disease is going to come to more Westernize countries and fester amongst poor populations who already do not trust their local officials. combine this with a sense of entitlement far too many people have when it comes to travel and restrictions of such, already in the US there is push back from those being monitored who had contact with the Dallas patient. We even have protesters rallying because a dog was put down.

How do you contain irrational actions, the mutation of the disease may occur or not occur, but damn if a bunch of people aren't exercising self destructive behavior.

People love to ridicule the Africans suffering through this as backward and superstitious all the while ignoring that entitlement, arrogance, and such, will cause similar containment issues in supposedly better countries.

The fact that traffic hasn't been stopped already is criminal, its starting to read like World War Z. Europe will have it worse as they cannot easily control people getting in, the US has an ocean but air travel tends to mitigate that.

mcguire5• 12 years ago

"2. Once the number of cases get very large (25,000 a day by Jan 2015 according to the CDC) this is going to start disrupting international trade as countries close their borders."

This is what has me worried. It seems somewhat likely that overreactions will cause more harm (and possibly kill more people) than the disease itself.

DustinCalim• 12 years ago

I do agree that we(humans from other countries) should all just dump resources on the people there -

but I think the legitimate concern here is that while we squabble about resources and their cost, the virus spreads and mutates - and if it makes the jump to airborne, I think it will make the average Joe Smith pretty vulnerable.

sliverstorm2• 12 years ago

It's a prisoner's dilemma sort of thing. The best outcome for ME is if YOU dump lots of money into it, so I sit around on my hands hoping you take action, while YOU do the same waiting for ME to take action. As a result, we arrive at the worse outcome- nobody does anything.

robomartin6• 12 years ago

This article is exactly WHY I am not legitimately concerned about a wide-spread infection in the Western world.

I guess you have never been in a disaster in the western world. Well, I have. More than once. And I have seen what people can devolve into. I'll probably get voted down mercilessly for saying this:

The truth of the matter is that "civilization" is thin-skinned. It doesn't take that much for people to revert to cave-men behavior. The worst thing we can do, by far, is to adopt a smug "won't happen here" attitude in the "civilized", "educated" and "sophisticated" west.

The minute we don't attack this as the existential threat it is, we are simply setting ourselves up for a catastrophe of unimaginable proportions.

cturner• 12 years ago

It's not just resources, it's also about trust.

The government/foreign operations had basically shut down Ebola earlier in the epidemic. But there was an atmosphere of conspiracy theories associating the operation with the outbreak of the disease. Ebola cases went underground. The foreigners had started to pack up and go home when it reemerged.

saulrh• 12 years ago

Yep. Ebola is just not a very scary disease. Its incubation period is short and reliable, it doesn't become infectious until symptoms display, it's not particularly infectious in the first place, and its transmission mechanisms are downright pedestrian. 90% of the first world can make themselves completely safe by googling "Ebola Safety". The other 10% are homeless or hippies and will either get similarly informative pamphlets or are living in communes and won't infect the rest of us. And even if all of that fails, we have the industry to literally give every American a hazmat suit. Ebola may become a crisis, but it will not become a pandemic.

bane• 12 years ago

Well, it's one of those low-probability high-risk diseases.

You probably won't get it, but if you do there's a better than middling chance you'll die a horrible death and if you survive you're guaranteed it won't be any fun. Oh, and there's no cure and basically no treatment. You're on your own.

The treatment for it is basically "drink lots of fluids", "keep pumping blood into the patient" (since they're literally losing it all out of every hole in their body) and "pray real hard".

Even with all these resources the tale is pretty bad

Forty-eight were treated in the hospital and 18 survived.

Less than 40% survival rate.

adventured3• 12 years ago

A moderately effective treatment for ebola will come out of all of this.

There hasn't been a huge sum of money poured into ebola therapies, and we already have promising options. ZMapp or a similar treatment will be scaled up over time, and if ZMapp proves itself to work across a larger base of test patients, we'll simply begin keeping X doses available at all times to shut down ebola outbreaks in the future.

jeffdavis• 12 years ago

We're dealing with a living thing. Ebola has never been in a large enough human population to evolve much, but perhaps now it will. We've already underestimated the transmission rates.

Keep in mind how many medical professionals have become infected. These people have a lot more knowledge than somebody who just "googled" some safety tips.

There's a good chance that the active strains are more transmissible than we assume, and might become worse through natural selection.

danieltillett15• 12 years ago

There's a good chance that the active strains are more transmissible than we assume, and might become worse through natural selection

We actually have a very poor idea of what is going on the ground in most of the affected countries as the hospital system has effectively stopped admitting new patients. The CDC is using a correction factor of 2.5 (i.e. there are 2.5 case outside of the hospitals for every case in inside), but once you stop admitting new patients then you really have no idea how many infected people there are.

Detrus• 12 years ago

The first world had problems with the single patient in Texas. He was not quarantined white showing symptoms and came in contact with many people. Then those people were not immediately quarantined.

All it takes to get a pandemic going is to lose track of a few dozen infected people. That is easy to do.

You'll probably be very disappointed in the "first" world when you see how it responds if this outbreak spreads further. No one will give out hazmat suits in time, even if we have such an industry.

nathannecro• 12 years ago

Let me respond point by point.

Ebola is just not a very scary disease.

Ebola is a frightening disease. On a psychological point, I feel like the shock of the symptoms itself is lessened due to the fact that most of the infected have dark skin. End-stage Ebola leads to the patient bleeding everywhere. Not only is the patient bleeding from obvious places like the eyes, nose, mouth, ears, penis, vagina, rectum, the whole body becomes covered with bloody petechiae (http://en.wikipedia.org/wiki/Vasculitis#mediaviewer/File:Vas...). On lighter skin, the patient's agony is really apparent. Their bedsheets will be dripping with blood and their eyes swell up and turn a deep maroon color.

Its incubation period is short and reliable, it doesn't become infectious until symptoms display,

Yep.

it's not particularly infectious in the first place

I feel like that's a point that doesn't have nearly enough information. Previous outbreaks have generally been limited the virus burning its way through a small population before it can hit a major population center. Healthcare workers who are currently treating Ebola patients (who should know proper protocol), are being infected at a rate far higher than expected. (http://www.who.int/mediacentre/news/ebola/25-august-2014/en/)

its transmission mechanisms are downright pedestrian

I'll grant you that transmission by fluid is generally fairly easy to contain. However, when the patient is draining all of their bodily fluids out onto the floor, cleaning and containment becomes far harder. Not only that, there have been several incidents (at least before this current Mar 2014 outbreak) of patients infecting health workers by coughing and aerosolizing blood droplets into the mouth, nose, and eyes of their caregivers.

90% of the first world can make themselves completely safe by googling "Ebola Safety"

I don't think it's that simple. Currently, the CDC holds training sessions for:

"Currently licensed by a recognized professional agency to provide clinical care in some jurisdiction (e.g., hold a medical license to provide care in a state in the United States) and have recent (current or within the past 2 years) relevant experience providing direct care to patients. Participants should be licensed medical doctors (MD, DO, MBBS degrees), licensed nurses (RN, BSN, LPN, etc.), or other licensed clinical care providers (e.g., paramedics, physician assistants, and other clinical providers)."

These training sessions solely concern biohazard safety and last for three full days. Given that the target audience has already has extensive medical training, three full days of lecture, procedure, equipment, and technical training seems far above and beyond what we should expect from a normal citizen. Let me also point out that even with training and equipment, healthcare providers are still getting sick. (http://www.cdc.gov/vhf/ebola/hcp/safety-training-course/inde...)

The other 10% are homeless or hippies and will either get similarly informative pamphlets or are living in communes and won't infect the rest of us.

I don't even know where you get that 10% from. It's also facetious to state that people "living in communes" "won't infect the rest of us"...do people in communes live in outer space?

And even if all of that fails, we have the industry to literally give every American a hazmat suit.

I'd like to see how you arrived at that conclusion.

Ebola may become a crisis, but it will not become a pandemic.

I agree. Ebola may not become a pandemic, but it will still cause great suffering to a large amount of people. I'll also grant that until it becomes a real problem in western countries, no one will really make a move as generally, western pharma ignore diseases which don't hold the promise of profit (see schisto). However, there is a very real chance that we can help and reduce the spread of the suffering by taking violent action _now_.

This goes without saying, but the one thing that anybody can do is to donate to Doctors Without Borders or any other institution trying to quell the crisis.

http://www.msf.org/donate

danieltillett15• 12 years ago

You make a lot of very good points. The only things I disagree with you on is your final point.

This goes without saying, but the one thing that anybody can do is to donate to Doctors Without Borders or any other institution trying to quell the crisis.

The scale of the outbreak is now beyond what MSF or any NGO can handle. Only the military can now command the resources needed to get things under control. All donating to MSF is doing is delaying the point in which we activate the military.

serge2k• 12 years ago

Amazing what happens when western money has an interest in Africa.

taivare• 12 years ago

Anyone is free to use this Ebola awareness poster I made http://bit.ly/1vF1COO

dllthomas2• 12 years ago

Also, the UCSC ebola portal is worth a look: https://genome.ucsc.edu/ebolaPortal

danieltillett15• 12 years ago

All this story tells us is that what we have known since the mid 70s that if you can get and keep patients in a proper infection control facility that you can stop Ebola.

The problem we have right now is that we don’t have anywhere near enough functioning infection control facilities in the affect countries and we are not doing anywhere near enough to put them in place. The scale required is beyond anything ever attempted outside of a war setting.

swframe• 12 years ago

I think a "corporate micro-city" might be the solution for poverty in the 3rd world. I think a joint venture with google, facebook, apple, and 1st world governments etc to build a "hong kong/singapore styled city" next to a 3rd world capital could be the catalyst for transforming the country. I don't think providing internet access is enough. You need to break the cycle of poverty from birth to college. And you need a vehicle/brand that the 1st world can invest in/trust. I think you can avoid the obvious pitfalls by creating multiple independent neighboring "corporate mirco-cities" so there is competition for residents.

phkahler4• 12 years ago

> I think a "corporate micro-city" might be the solution for poverty in the 3rd world.

Funny, I was thinking it contributes to the problem. It clearly creates inequality which can be seen in this article. The company simply doing the minimum to exploit the resources in the area with no spill-over into the larger region. It would be more helpful to the locals if they were vertically integrated right there - producing tires. That would require building more infrastructure and more manufacturing capability and such. But no, they just want to grow the rubber there and keep the higher value stuff elsewhere.

To clarify, I'm not saying "companies=bad" just that companies only have self-interest and are not inherently good for the broader region they inhabit. This is abundantly clear from TFA which I don't think is the message they wanted us to take away.

briandh• 12 years ago

An idea along these lines is that of the Honduran ZEDEs: http://fee.org/the_freeman/detail/startup-city-redux

(I'd link to a less ideological source but libertarians and their fellow travelers are the ones giving them the most comprehensive coverage and the Wikipedia article is atrocious.)

BrandonMarc2• 12 years ago

Interestingly, that's similar to what Firestone did nearly a century ago - built a city in Liberia, and has been the major influence of the city ever since.

I'm not sure about Apple, Google, Facebook, et al (and even less hopeful about the success of building an ultra-modern city right next to an existing, poor-er [by comparison] capital) ... but ... there's a good notion here.

With a large plantation of rubber trees, it makes sense for Firestone. Rather than re-creating silicon valley in the jungle, finding and exploiting an economic resource there - and doing well by the locals at the same time - seems to be a great model to follow.

From the article:

Asked what's needed to turn that around, Flannery says, "More Firestones" — places that have the money, resources and unwavering determination to stop Ebola.

Maybe I'm oversimplifying, but this sounds like a situation where what we tend to call globalization turns out rather well for all sides.

dammitcoetzee• 12 years ago

Wow, a company that can handle a thing like this in stride has to make a good product. I will look at them next time I need tires.

innguest3• 12 years ago

Wow, someone that understands capitalism. :)

mcguire5• 12 years ago

Or is simply vulnerable to good marketing campaigns.

It's been a while since I used Firestone tires, but I'll bet anyone quite a lot that their product development and quality control have very little to do with their human resources practices in the third world. (Even though I think they sound really good, too.)

BrandonMarc2• 12 years ago

All I can do is scratch my head, wondering what the reporter isn't saying. Just what is it that Firestone is doing differently? It sure appears to be working, so it would be great to replicate if possible.

Marbel is a company town of 80,000 ... a city more or less owned and run by Firestone, benevolently it appears, for nearly a century.

Perhaps they're better at guarding and enforcing their border ... effectively keeping themselves mostly isolated from disease vectors coming in.

Perhaps that helps them avoid being outnumbered by the sick and, more importantly, the ignorant [1]. After all, it's easy to keep an eye on those exposed when they're comparatively few and you have reliable information ... which comes from having a literate, educated population you've been working with for decades.

Perhaps it's also easier to get honest [2], voluntary compliance when you're a close-knit community and the infected are usually coming from the outside (and, again, are few in number).

It sure is interesting that while Firestone has hazmat suits intended for dealing with chemical spills, that infected nurse in Spain [3] says the blame goes to her Level 2 biosafety suit since it wasn't the preferred Level 4. Please correct me if I'm wrong ... I get the sense Firestone's suits aren't comparable to Level 4.

Contrast this to the success (lack thereof) of the CDC, WHO, RSF, and other aid organizations. Sadly, they're either overwhelmed or incompetant. So what's needed is more Firestones, really? That's interesting.

-----

[1] Yes, ignorance is massively lethal. See this story from August, of a mob who decided it would be fun to ransack and rob and already-overwhelmed Ebola clinic, stealing everything and taking it home ... all while taking Ebola home with them.

http://pjmedia.com/richardfernandez/2014/08/16/man-without-a...

[2] As opposed to the diplomat who deceived his way into continuing on to a meeting of regional leaders ... thereby effectively causing the outbreak in Nigeria. And as opposed to the CDC today handing out fliers in airports and expecting voluntary compliance, in a sense informing travelers of how to lie in order to get into the USA where the good hospitals are.

[3] http://pjmedia.com/richardfernandez/2014/10/07/paradigm-shif...

danieltillett15• 12 years ago

All I can do is scratch my head, wondering what the reporter isn't saying. Just what is it that Firestone is doing differently? It sure appears to be working, so it would be great to replicate if possible.

They are doing nothing different than what has worked in all the other Ebola outbreaks which is catch the outbreak early and implement effective infection control.

A better question is why did this outbreak get out of control? The sad reason is incompetence. The WHO staff in west Africa appointed to watch out for Ebola outbreaks were, to quote Peter Piot [1], “[not] the most capable people but ... political appointees”. Some genius had also decided that gutting the department for hemorrhagic fever and the one responsible for the management of epidemic emergencies at the WHO was a great idea. This meant that there was no one around to respond. The outbreak was allowed to run wild for six months until it got so big that it overwhelmed the local health authorities (this occurred around August) and the case numbers took off exponentially.

[1] http://www.spiegel.de/international/world/interview-with-pet...

tjohns• 12 years ago

It sure is interesting that while Firestone has hazmat suits intended for dealing with chemical spills, that infected nurse in Spain [3] says the blame goes to her Level 2 biosafety suit since it wasn't the preferred Level 4. Please correct me if I'm wrong ... I get the sense Firestone's suits aren't comparable to Level 4.

As unfortunate as it is, it's more likely that the Spanish nurse was infected while removing her PPE.

Removing contaminated PPE is a non-trivial process. It requires practice, strict attention to detail, and ideally an equally trained buddy watching you while you're doing it. From what I've read, it sounds like they were just given 10 minutes of training.

Which isn't to say that better equipment and a proper decon shower wouldn't have helped. But the training is just as important as the equipment.

facepalm• 12 years ago

"They grabbed a bunch of hazmat suits for dealing with chemical spills at the rubber factory and gave them to the hospital staff. The suits worked just as well for Ebola cases."

I suppose having a rubber factory nearby helped a lot. Not to diminish their managerial achievement, but I imagine getting proper equipment might be a major obstacle in other parts of the country.

lotsofmangos6• 12 years ago

Donation pages for Médecins Sans Frontières:

http://www.msf.org.uk/make-a-donation

https://donate.doctorswithoutborders.org/

Send MSF money and we will see more successes like this.

Ebola can be beaten, but only if the resources are there.

peter303• 12 years ago

Nigeria has ended Ebola too. But its proximity to the main infections could mean reoccurence.

mcguire5• 12 years ago

"Forty-eight were treated in the hospital and 18 survived."

That's an interesting point on the actual lethality of the disease under more modern treatment conditions. Still, 60% is only slightly less scary than 90%.

Firestone Stopped Ebola in Its Tracks

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