Gates: Large Epidemics Need a More Agile Response

jones_supa writes: Writing in the NY Times about the recent Ebola crisis, Bill Gates says this disease has made the world realize we are not properly prepared to deal with a global epidemic. Even if we signed up lots of experts right away, few organizations are capable of moving thousands of people, some of them infected, to different locations on the globe, with a week's notice. Data is another crucial problem. During the Ebola epidemic, the database that tracks cases has not always been accurate. This is partly because the situation is chaotic, but also because much of the case reporting has been done first on paper.

There's also our failure to invest in effective medical tools like tests, drugs and vaccines. On average, it has taken an estimated one to three days for test results to come back — an eternity when you need to quarantine people. Drugs that might help stop Ebola were not tested in patients until after the epidemic had peaked, partly because the world has no clear process for expediting drug approvals. Compare all of this to the preparation that nations put into defense, which has high-quality mobile units ready to be deployed quickly.

Comments

So when's the first scrum?

[BarbaraHudson]

n/t

Re:So when's the first scrum?

[Carcass666]

Yeah, that was my first thought, followed by involuntary cringing. It's sad how something that was supposed to bring hope to developers buckling under the yoke of waterfall development has instead become associated with every unreasonable request made by every airline-magazine reading executive.

Re:So when's the first scrum?

[Anonymous Coward]

And the stan-up, where we may all do some self-criticism, as in the good old communist countries?

Moving Infected People

[Cpt_Kirks]

I don't think infected individuals should be moved, or at least not moved far.

The number one concern is to limit contamination, so quarantine should be as absolute as possible.

Hard hearted? Maybe, but definitely practical.

Re:Moving Infected People

[oodaloop]

So when they're found in an airport, they should be quarantined there instead of going to, like, a hospital or whatever? Are you going to quarantine an entire flight of people at once in an airport?

Re:Moving Infected People

[Penguinisto]

Agreed.

While yes, the act of moving someone to an advanced care facility would be preferable for the person involved, I would counter that maybe, just maybe, that advanced care facility (or as much of it as possible) should be relocated to where the infected are. The absolute last thing you want to do is to start flying infected people outside of the infection zone to other places.

I already know the problems presented: The infected area is usually in some third-world shithole with little-to-no infrastructure, much of the equipment is big, heavy, and expensive, etc... but much of it can be made portable with sufficient engineering, and a good chunk of it doesn't even have to be brought along, or can be minimized (e.g. the ventilation/filtering systems that the centers here have to keep quarantine).

If Bill Gates wants to do something with all that cash, maybe he can hire a few engineers an medical types to build a deployable care center that can be flown out to $3rdWorldShitHole in less than 24 hours, and be put to use immediately when an epidemic strikes. Hell, build a bunch of them, include a big pile of needed supplies with each, then pre-position them in or near areas that are most likely to see recurring epidemics.

Re:Moving Infected People

[Cpt_Kirks]

As I said, not moved far.

Take that as "moved as little as possible".

If they are in a city, move them to the closest hospital IN THAT CITY.

With the last ebola mess, they were flying obviously infected people all over the place.

Re:Moving Infected People

[Penguinisto]

Are you going to quarantine an entire flight of people at once in an airport?

Not to be a heartless dick, but it's not that hard to do if someone shows symptoms en route. The airplane is a somewhat sealed metal tube, and an airport has a lot of acreage that can park that plane out far enough away from everyone else....

Re:Moving Infected People

[Anonymous Coward]

So when they're found in an airport, they should be quarantined there instead of going to, like, a hospital or whatever? Are you going to quarantine an entire flight of people at once in an airport?

I hope you were not serious with this question, for the airplane itself IS your platform to not only contain, but also transport.

Quarantine the whole damn thing and FLY it to wherever decon or containment efforts are ideal.

Re:Moving Infected People

[Wycliffe]

a deployable care center that can be flown out to $3rdWorldShitHole in less than 24 hours, and be put to use immediately when an epidemic strikes. Hell, build a bunch of them, include a big pile of needed supplies with each, then pre-position them in or near areas that are most likely to see recurring epidemics.

This is exactly what the summary is talking about. We have "high-quality mobile units ready to be deployed quickly" for military but
we don't have the equivalent on the medical side. It was insane that we did not have deployable quarantine units that could be sent to
the location so instead we attempted to fly them to a quarantine unit elsewhere. To add to the insanity, the only plane that was
capable of transporting an ebola patient could only transport ONE passenger at a time. I'm pretty sure that's the definition of being
grossly underprepared for an epidemic when the solution is to fly people halfway around the world one at a time.

Re:Moving Infected People

[ShanghaiBill]

With the last ebola mess, they were flying obviously infected people all over the place.

For a disease like ebola, that is no big deal. It is important to keep a grip on reality. There was a lot of scare-mongering over ebola, nearly all of it misplaced. Ebola can easily be stopped dead in its tracks by soap and/or hand sanitizer. It spread in Liberia, Sierra Leone, and (especially) Guinea, because those three countries have basically no health infrastructure, deep mistrust of outsiders, very low literacy, and little understanding of the germ theory of disease. Ebola was never able to gain a foothold in neighboring countries, such as Senegal, Ghana, or Nigeria, which have higher literacy and at least rudimentary health care systems. To think that ebola could spread in first world countries like America, or Europe is not realistic.

Re:Moving Infected People

[itzly]

Depends on the symptoms. Are you going to quarantine an entire flight when a passenger has a fever or is throwing up ?

Re:Moving Infected People

[ColdWetDog]

Exactly this. Ebola was a boon for the media and a disaster for the people involved but it was never a threat to the first or second world.

Not quite as hard to catch as HIV, but much harder to catch than influenza or measles. A bit aside from Gate's issue which seems to be predicated on some nonsensical idea that these places in deep, dark Africa without even clean (much less running) water, without even soap and without even a concept of the germ theory of disease - much less electronics and computers - can benefit from his brand of Windows centric data collection and a first world rapid response team.

All things considered, the world really did deal with Ebola fairly well. Certainly there are improvements to be made - least of all a commitment to get the local areas up to the very basic of sanitation, but Gates is just jacking off in his mansion and getting feel good points.

Re:Moving Infected People

[ShanghaiBill]

The number one concern is to limit contamination, so quarantine should be as absolute as possible.

Many health professionals think this is one of the dumbest things you can do. Strict quarantine policies discourage people from reporting infections, and cause people to flee at the first sign of trouble, so they can get out before the quarantine cordon is in place. During the ebola outbreak, some quarantines were imposed, and, in hindsight, they are regarded as a mistake. As people flee, they are crammed onto crowded buses, deprived of sleep, exposed to the weather, and dispersed far away from the health workers that know how to treat them.

Re:Moving Infected People

[ColdWetDog]

You do realize that Medicine Without Borders was able to contain the Ebola epidemic with not much beyond plastic sheets, gloves, goggles and bleach. If they had a couple of C17's with pallets of that stuff and the buy in from locals who are still stuck in a witchcraft-based culture they could have done much better. High tech pods really weren't needed.

Pretty much all of the epidemic infectious diseases can be treated similarly. What is needed is a long term commitment to the issue and some way to get the indigenous population out of the tenth century.

Re:Moving Infected People

[ShanghaiBill]

Depends on the symptoms. Are you going to quarantine an entire flight when a passenger has a fever or is throwing up ?

No, because you are not going to know about it. What possible incentive does a stewardess have to report that illness, when she knows that she will be quarantined along with the passengers, and possibly left to die on a sealed airplane? The problem with draconian solutions is that they incentivize counter-productive behavior.

Re:Moving Infected People

[itzly]

My question was a rhetorical one, but since it got moderated "-1 don't understand", I'll rephrase it in a more direct way.

Not to be a heartless dick, but it's not that hard to do if someone shows symptoms en route

The problem is that most symptoms that are developed en route are going to be simple things like a fever or vomiting. These aren't clear enough to be recognized as a symptom of a dangerous disease. Taking a blood or mucus sample, and running a real test could take hours, if not days, and that's too long to keep a plane full of people waiting.

Re:Moving Infected People

[Anonymous Coward]

Fear mongering indeed. There was a school district near where I live that wouldn't let 2 Kenyan kids go to school over ebola fears. That's like saying Canadian kids can't go to your school because of those nurses in Dallas.

Re:Moving Infected People

[jedidiah]

Running a real test will not "take days". However, a blood test may not be helpful for days. The last doctor we imported for treatment was like this. Despite the fact that he was starting to exhibit symptoms, blood tests didn't indicate he had Ebola.

Properly quarantining people is problematic enough when it's just one obnoxious nurse. Forget about an entire plane full of entitled 1st worlders.

Re:Moving Infected People

[Anonymous Coward]

For a disease like ebola, that is no big deal. It is important to keep a grip on reality. There was a lot of scare-mongering over ebola, nearly all of it misplaced. Ebola can easily be stopped dead in its tracks by soap and/or hand sanitizer.

This is what they told us this year. In previous years, they were telling us that breathing the same air as someone with Ebola was enough to contract it. In the early 2000's, it was revised to "touching someone with Ebola". In the 80's, the possible airborne aspect is what made it so frightening compared to any other flesh-eating diseases -- because health workers that were in cleansuits were dying. Back then, if you had a headache, they would quarantine you. They would send food into your tent/hut, and not accept anything that came out. When you died, they burned down the tent/hut, and yet people were STILL becoming infected.

It's almost impossible to know, anymore, whether you're getting a "Keep Calm and Carry On" message from your government or a "EVERYONE IS GOING TO DIE UNLESS THE WHO GETS 10 BILLION DOLLARS TO FIGHT THIS" message. Both are dishonest.

Re:Moving Infected People

[Anonymous Coward]

Tell that to the nurses in Dallas ?

Re:Moving Infected People

[moeinvt]

Interesting. I was not aware that there was a debate about the practice of quarantine. The idea of "moving" infected, or possibly infected people certainly seems counter-intuitive.

Re:Moving Infected People

[DerekLyons]

I already know the problems presented: The infected area is usually in some third-world shithole with little-to-no infrastructure, much of the equipment is big, heavy, and expensive, etc... but much of it can be made portable with sufficient engineering, and a good chunk of it doesn't even have to be brought along, or can be minimized (e.g. the ventilation/filtering systems that the centers here have to keep quarantine)

If Bill Gates wants to do something with all that cash, maybe he can hire a few engineers an medical types to build a deployable care center that can be flown out to $3rdWorldShitHole in less than 24 hours, and be put to use immediately when an epidemic strikes.

Let's see... the existing system uses minimal investment (mainly in transportable isolation units) to transport a small number of exposed or critically ill people to locations where an existing army of people and mountain of equipment already exists and has supporting infrastructure in place. Your proposed system has us spending tens of millions of dollars (if not more) to transport a (currently non existent) army of people and (currently non existent) mountain of equipment to a place without supporting infrastructure and requiring massive (and currently non existent) logistics pipeline to maintain to support a small number of exposed or critically ill people.

Other than the clueless paranoia displayed in this sub-thread, why on earth would you propose such a back-asswards system?

You, and the OP, are confusing two different problems. The first, moving the most critically ill people to treatment and isolating exposed individuals, is largely a solved problem. The second, quarantine and minimizing the spread of disease among the local population is a very different problem... and even so, it can be largely handled with existing systems. The problem with the Ebola outbreak in Africa was failure to recognize the problem followed up by a "too little, too late" response from the West, combined with cultural issues and behaviors which facilitated the spread of disease. You can't fix either by simply throwing money at them.

Re:Moving Infected People

[Anonymous Coward]

"To think that ebola could spread in first world countries like America, or Europe is not realistic."

If you are under the impression that the rude Paris waiter washes his hands after a bathroom break, think again.

Re:Moving Infected People

[ShanghaiBill]

Interesting. I was not aware that there was a debate about the practice of quarantine.

You didn't hear about the political backlash over the NY and NJ quarantines, that were imposed to deal with the zero infections that occurred there?

The idea of "moving" infected, or possibly infected people certainly seems counter-intuitive.

They idea that broad and draconian quarantines cause more people to move, also seems counter-intuitive, but it is true. Limited quarantines of actually infected people, that are being effectively treated, usually makes sense. Going beyond that is generally counter-productive.

The best way to stop ebola is soap, not draconian quarantines.

Re:Moving Infected People

[Shadow of Eternity]

That's the point everyone keeps missing. We don't need some high tech pod with a billion circuits and electronics, we need modular low-tech pods with diesel generators, solar panels, and sanitation facilities. People keep trying to throw technology at places like Africa... this isn't star trek. We don't have replicators and magic wave-this-to-fix-it beams that can maintain high tech stuff without any local support infrastructure. Anything going to something like the Ebola outbreak needs to be fixable with duct tape and wrenches.

Re:Moving Infected People

[mspohr]

I think they should model it on the Red Cross which has extensive protocols for equipment and people to respond to a disaster. They also have pre-positioned supplies in areas where they have a likelihood of disaster.
The WHO is not prepared or organized to do this but the Red Cross (just down the street in Geneva) is so perhaps the WHO could take a walk down the hill and learn from them.

Re:Moving Infected People

[Tamerlin]

Add to that the fact that with most infectious diseases, the symptoms that would make it evident that they are ill are unlikely to manifest just on the flight. Most of the time, there's a gestation period of a few days to a week before the person who caught shows symptoms, and in some cases they can pass it on before they become symptomatic.

That's the biggest problem with relying on quarantine. Either you always quarantine every incoming international flight until you make sure that no one on board has something nasty, or you just wait until you detect it naturally, in which case you already have a pandemic. We were lucky that this one was a disease that doesn't travel well from host to host.

ebola

[itzly]

The major reason why ebola was able to grow was simply poor basic health care practices in some countries. Simple rules, like not touching dead or sick people, and washing your hands regularly would have helped a lot more than "databases" and "global warning and response systems".

Re:ebola

[Anonymous Coward]

No, we must pour all money from all coffers and allocate at least many trillions of dollars towards Almighty Systems Which Will Never Fail. For it is better to entrust an Almighty system built by a contractor like Lockheed-Martin for quadrillions of dollars--which can never fail because the cubicle gophers who run it will certainly always know how to run it--than it is to think through the problems and have the necessary precautions of the low-hanging fruit taken care of.

Re:ebola

[moeinvt]

Washing hands? These primitive savages still haven't figured out that you should keep human waste in a central location far away from your water supply and that you shouldn't bathe in water that you're later planning to drink.

Re:ebola

[gnujoshua]

Simple rules like not touching dead people or sick people? Simple rules, like not touching dead or sick people, and washing your hands regularly would have helped a lot more than "databases" and "global warning and response systems.

It is not reasonable to expect people to not touch dead or sick people and it is absurd to think that proper hand washing would prevent the transmission of Ebola. Ebola is primarily a caregivers disease because the people most likely to get it are those caring for someone near the end of their life. A person walking around with Ebola is unlikely to spread it to another person. And a person who is near the end of life and severely sick with Ebola is unlikely to be walking around. In most places on Earth, a person with Ebola would go to a hospital when their symptoms were very strong. When there aren't hospitals, though, then it will be family members that will help care for a person who starts to spike a fever and is becoming dehydrated due to the explosive diarrhea or projectile vomiting (or both) that they are having. And, people should care for one another, because most of the time, the symptoms of Ebola are indistinguishable from other common ailments a person might have. For some patients, at the very end of life, there might be other signs that are peculiar to Ebola, such as lesions, but this isn't always the case. But in any case, even in a hospital setting, if a person is projectile vomiting or having explosive diarrhea, then often it is not just simply a matter of properly washing ones hands to prevent infection. Lastly, if when a person dies of such conditions, they are likely covered in their own vomit and excrement and may on occassion even have open lesions on their skin. Properly cleaning the area of a sick person and preparing their body for burial is something that trained professionals with proper equipment should do. But, again, such professional services do not exist throughout much of rural West Africa, and so the job of cleaning, preparing a body, and burying a body falls on shoulders of the members of the family and household.

As Paul Farmer said: "The only formula we’ve come up with is the following: you can’t stop Ebola without staff, stuff, space and systems. And these need to reach not only cities but also the rural areas in which most people in West Africa still live."

Re:ebola

[Anonymous Coward]

"The major reason why ebola was able to grow was simply poor basic health care practices in some countries."

Think of it as evolution in action.

Re:ebola

[itzly]

It is not reasonable to expect people to not touch dead or sick people

If the consequence is that you'll catch the disease and end up with a serious chance of dying yourself, it's a very reasonable request. And when people refuse to follow such basic advice, there's little hope that a "global warning and response systems" can save them.

Re:ebola

[khallow]

It is not reasonable to expect people to not touch dead or sick people and it is absurd to think that proper hand washing would prevent the transmission of Ebola.

Sure, it's reasonable. And proper hand washing doesn't have to completely prevent transmission, it just has to help reduce new transmissions to below the point where exponential growth in infections occurs. Through these means, exponential growth of Ebola has ceased in West Africa.

Re:ebola

[Anonymous Coward]

Lagos has 10 million people and no sewer system. What would have happened if people had started getting infected there?

Now let's collect money to build them a sewer system. It's the Christian thing to do, they are our brothers in Christ.

Re:ebola

[Anonymous Coward]

Other than calling them primitive savages, is there anything in this post that is particularly incorrect?

Gates?

[Anonymous Coward]

Why do people give credence to anything this guy says, beyond Microsoft, or more generally, microcomputers, I'll never know.

Re:Gates?

[Anonymous Coward]

Because there are a lot of $resources behind what this guy says.

Re:Gates?

[Anonymous Coward]

Perhaps because gates primary focus has been charity and philanthropy for almost as long as he was in the microcomputer game.

Re:Gates?

[kwiecmmm]

Why do people give credence to anything this guy says, beyond Microsoft, or more generally, microcomputers, I'll never know.

Maybe because of the vast amount of charity work he has done in the past two decades. His work (not specifically himself but experts that work for him) on malaria, HIV, vaccines worldwide, and other huge issues here and in the third world.

Even if you hate Microsoft, why would you completely ignore his charity work?

Re:Gates?

[Anonymous Coward]

Forgive me if I don't celebrate a person trying to make up for all of the shitty things he did to the industry to get to where he can give a bunch of the money away. Sure, it's better that he is now philanthropic. And that makes him better than some of his peers. But his ruthless activities shoving his monopoly down everyone's throats and destroying viable competitors by exploiting his monopoly aren't something that one should easily forgive.

Re:Gates?

[Wycliffe]

Perhaps because gates primary focus has been charity and philanthropy for almost as long as he was in the microcomputer game.

Why was this flagged -1? Bill Gates is president of one of the largest organizations helping to fight disease in the world.
He has as much validity as the president of Red Cross or any other large relief organization. This is why his opinion
matters. He's also uniquely positioned where he can help bankroll what is needed if necessary where most other large
relief organizations would have a much harder time changing their focus.

Re:Gates?

[Anonymous Coward]

Let me guess that you also carry a grudge regarding the SonyBMG rootkit scandal.

Re:Gates?

[Anonymous Coward]

Sorry to burst your bubble but I don't know anything about that. I was around long before Windows was even a thing. And over the years I saw company after company being targeted by Microsoft in their attempt to monopolize the desktop. The tactics that were used were despicable abuse of monopoly power. And many very good, viable, and competitive companies with far superior products are now long gone because of the the tactics used by Microsoft.

Re:Gates?

[ColdWetDog]

Perhaps because gates primary focus has been charity and philanthropy for almost as long as he was in the microcomputer game.

Yeah, and his efforts have been similarly helpful....

Re:Gates?

[chthon]

It is mainly to trick gullible people like you into believing that doing charity is a positive trait. The kind of people that are most loathable are the robber barons who then try to cover up their past tricks with doing things 'for the good'.

And US charity is paternalistic, it is always done with disdain for those who receive it.

Re:Gates?

[maliqua]

-1 disagrees with established opinion

You can't point out the good qualities of a perceived villain here without down mods

Re:Gates?

[jedidiah]

No. We just don't buy the whitewash. It's a really old trick. It's like anything else the guy ever did. He just copies things that other people have already done. He usually does so badly.

Re:Gates?

[maliqua]

so then we should discredit any good he tries to do simply because HE is the one trying to do it?

Re:Gates?

[jedidiah]

Not "discredit", apply a suitable amount of skepticism.

He's a medicore talent at best in his own chosen field. He is mostly notable for being more business oriented than his rivals and being much more ruthless.

He is by no stretch of the imagination an "expert". He's more of the typical "pointy haired boss" or the PHBs boss.

At best he's a figurehead and real leadership comes from elsewhere.

Re:Gates?

[mean pun]

Perhaps because gates primary focus has been charity and philanthropy for almost as long as he was in the microcomputer game.

Yeah, and his efforts have been similarly helpful....

Agreed, both are very respectable efforts, although not perfect in hindsight.

Re:Gates?

[Anonymous Coward]

You are an anachronism, even around this place. You sound like a complete fucking idiot. Seriously, you should listen to yourself carrying on like this sometime, you fucking insect.

Many just don't take it seriously.

[HalAtWork]

Not to mention all the coverups and stupid mistakes being made. Is there no SOP for all of this?

Re:Many just don't take it seriously.

[Penguinisto]

Probably not. Consider that most countries in Africa are run by some very corrupt mofos, up until recently Ebola was something that only happened in some isolated village, and logistics can be a nightmare when the port/airport authorities all want bribes before they allow you to bring your stuff in past their little checkpoints...

Wait: BillG hates America?

[cellocgw]

He clearly suggested spending less on Defense Dept and more on socialist anarchist anti-American [[sarcasm]] !

We can't have that now, can we?

Why should we care?

[Anonymous Coward]

I am going to post a devil's advocate question, because there are people who will ask this:

Why should we care about an epidemic/pandemic in some other area of the globe? The US economy is still quite flaccid, the only reason unemployment statistics are down because the definition of who is unemployed gets changed, and capital flies overseas due to tax inversions and other loopholes, as opposed to staying in the US or being lawfully taxed to actually help things. The US is getting into total debt to China, and it may have to be repaid in land (think a reverse Louisiana Purchase.) This may be something that is "nice" to have in better economic times, but not something doable now.

This isn't my personal view at all, but this will be a question posed to any pandemic research and will need to be answered, especially with the political shift to the right in the US.

Re:Why should we care?

[Penguinisto]

I am going to post a devil's advocate question, because there are people who will ask this:

Why should we care about an epidemic/pandemic in some other area of the globe?

Two words: Global Travel. Some dude wanting to flee that epidemic may have just enough resources to hop a plane ride or two, to get to safety with his relatives in the US... ...and we get to find out that even he didn't know he was infected until he landed and started spreading the love on US soil.

It's already happened once (that we know of) during this last one.

Re:Why should we care?

[petermgreen]

because the larger an epidemic grows the more expensive it is to deal with and the greater the chance of an infected person escaping and starting an outbreak elsewhere. The ebola epidemic got big enough to suck badly for the three main countries involved and there were a few minor outbreaks in other countries but fortunately the outbreak was contained in time to avoid any signficant outbreaks in the rest of the world.

Re:Why should we care?

[Anonymous Coward]

Why should we care about an epidemic/pandemic in some other area of the globe?

To make the world a less shitty place for people. I'm sure we can look a bit farther than just our own navels.

When it comes to fast moving stuff...

[Anonymous Coward]

People need to put on their big boy pants and act! Quit twiddling your thumbs waiting for some magical approval and do something.
"because the world has no clear process for expediting drug approvals"

No clear process huh...Great. That means If I have a drug that is potentially effective at stopping X and I have folks willing to take it...guess what...They're getting it approval be damned. Arrest me after the plague is contained.

If only Bill Gates was a Billionaire

[Anonymous Coward]

If only Bill Gates was a Billionaire, then he could spend money to implement his ideas instead of criticizing others.

His Billionaire buddies make the laws in the USA, maybe he should be directing his criticism at them instead of the powerless masses who are just trying to eat and find shelter.

Of course we can all just sit around and think, 'what a good idea', or 'what a shame we aren't doing that', but that would be a waste of energy.

Re:If only Bill Gates was a Billionaire

[mean pun]

If only Bill Gates was a Billionaire, then he could spend money to implement his ideas instead of criticizing others.

I fail to see why he deserves this. He is asked what he thinks went wrong with the Ebola crisis. He gives a very sensible answer. That's called discussion. It is essential for a functioning society, and there is far too little of it, as opposed to scare-mongering and partisan sniping.

Perceived and real evils from Mr. Gates' past are irrelevant to this discussion. The man has a sensible opinion, he is in a position to know about the subject, so his contribution to the discussion is valuable. If someone disagrees he should refute the arguments rather than the person.

Re:If only Bill Gates was a Billionaire

[Anonymous Coward]

OK, I will grant you that post microsoft Gates is a bit better than he was before.

I don't see how his opinion really matters much. He created monopolies and sucked as much money into his bank account as he could. Now he reads, is trying to be 'good'. He is really trying. He seems to read a lot and has informed opinions etc.... I have not seen him take even a rudimentary class on anything to do with medicine.

In a microsecond I would consider the opinion of a representative of 'Doctors Without Borders' over Bill Gates on this discussion. We only care about Mr. Gates because of his vast wealth.

Why don't we value the opinion of a hard working doctor who is in the trenches trying to fix this problem? (Answer)They have no money and no name.

Personally I would care about the opinion who dedicated their life to something (Doctors without borders) than to a hobbyist, armchair quarterback like Bill Gates on this discussion.

If Mr. Gates really cared, he would seek out a good representative doctor and back him up with the foundation and with money.

He seems to just want to scrub away all of the filth that he accumulated along with his fortune. I really don't care about him one way or the other.

I would die laughing if in ten years a Super Rich Doctor who cured Cancer was giving advice to Microsoft on how to build their Operating Systems.

Re:If only Bill Gates was a Billionaire

[Anonymous Coward]

If Bill Gates REALLY cared about this, he would fix it. He and his buddies have all of the power. Who cares about talk? Talk is for poor chumps like us.

With apologies to programming-motherfucker.com

[Anonymous Coward]

Medicine, Motherfucker

Do you practice it?

We are a community of motherfucking clinicians who have been humiliated by pseudoscientific quackery for years. Do you know what they call alternative medicine that works? Medicine, Motherfucker.

We are tired of antivaxxers, homoeopaths, naturopaths, chiropractics, acupuncturists, faith healers, and anyone else getting in the way of Medicine, Motherfucker.

We are tired of being told we're money-grubbing idiots who need to be manipulated to work in a Allopathic Medicine chain gang without any time to explore the natural healing powers of measles and whooping cough because none of the 10 insurance companies that are responding to customer demand for acupuncture coverage can do... Medicine, Motherfucker.

We must destroy these methodologies that get in the way of...Medicine, Motherfucker.

They claim to value / They really value / We fucking do:
Individuals and interactions / Tons of billable hours / Medicine, Motherfucker
Removing toxins and chemicals / Tons of pointless tests / Medicine, Motherfucker
Health Freedom / Bleeding patients dry / Medicine, Motherfucker
Fighting the Establishment / Paranoia and conspiracy theory / Medicine, Motherfucker

We think the shit on the left, is really just the con in the middle, and that we really need to just do the thing on the right... Medicine, Motherfucker.

Signed,
Anon. C. Owhard.
And the Medicinal Motherfuckers.

Re:With apologies to programming-motherfucker.com

[ColdWetDog]

You sound angry. Perhaps some nice Cognitive Behavioral Therapy.

Or just a nap.

Re:With apologies to programming-motherfucker.com

[Anonymous Coward]

I'm sure there are really are many medical practitioners who are trying to help people. I just doubt it is possible to know how to accomplish that in this day and age of endless volumes of pseudo-statistics based "science" advising you. So how do you do it?

"We are quite in danger of sending highly trained and highly intelligent young men out into the world with tables of erroneous numbers under their arms, and with a dense fog in the place where their brains ought to be. In this century, of course, they will be working on guided missiles and advising the medical profession on the control of disease, and there is no limit to the extent to which they could impede every sort of national effort."

  Fisher, R N (1958). "The Nature of Probability". Centennial Review 2: 261–274.

Re:With apologies to programming-motherfucker.com

[BarbaraHudson]

I'll stick with my medical practitioners, thanks. So far, they're batting 1,000.

Re:With apologies to programming-motherfucker.com

[Anonymous Coward]

I'd be interested in what problems and treatments you specifically experienced success with. Of course that is personal. I do not mean to be invasive/rude, so I do not at all expect a reply.

Re:With apologies to programming-motherfucker.com

[jedidiah]

That's a bit optimistic. Some of them are total schmucks that couldn't find their way out of a wet paper bag. Some of them can't even manage as well as some of the quacks.

I kid you not. The first doc I saw regarding my current condition missed obvious stuff that a genuine quack managed to see.

A lot of people in a similar situation are mired by "professionals" who don't do well enough to understand what's going on even if they do manage to catch the obvious physical symptoms.

Like anything else, Sturgeons law applies. Let the patient beware.

You could be harboring a nasty surprise yourself...

Re:With apologies to programming-motherfucker.com

[BarbaraHudson]

I'd be interested in what problems and treatments you specifically experienced success with. Of course that is personal. I do not mean to be invasive/rude, so I do not at all expect a reply.

Yes, it is personal, but in the interest of debate, here's why I trust my doctors:

• Juvenile Diabetes - insulin (otherwise I'd be dead.)
• Knee - surgery (otherwise I'd be crippled for life)
• Double Pneumonia - xrays that confirmed (even to my untrained eye) that my lungs were pretty full, lots and lots of different (and painful) antibiotic IVs (considering I had been hallucinating for a couple of days before being admitted, and could barely move, I would have died if there had been much more delay)
• Unknown Infection - 3 weeks in the hospital, all sorts of MRIs, xrays, blood tests, IVs, other stuff that I don't remember. (Doctor told me either be admitted immediately or go home and probably die - I was REALLY sick, so no complaints, but we'll list this as unknown outcome)
• Double hernia - (otherwise I'd be crippled for life)
• Flesh eating disease - 6 surgeries, 7 CT scans, temporary colostomy, a ton of antibiotics, lots of other treatment - (otherwise I'd be dead)
• Proliferative Diabetic Retinopathy - about 4,000 laser burns on each retina over the course of 3 years to help stop bleeding and delay when I will eventually go blind (otherwise I'd already be completely blind)
• Blind in one eye - a vitrectomy (that's where they stick 3 big needles in your eyeball and drain the accumulated blood and clots, as well as removing the membrane growth atop the retina (otherwise, I'd be totally blind in my left eye)
• Male-to-Female Transsexualism - too much to list in one little post, but you can find out way more than you wanted to know by searching on the web :-), (otherwise I'd be dead)
• Post-Traumatic Stress Disorder and Major Depressive Disorder - medication, complete psychological evaluation, therapy

Obviously I see my endocrinologist 2-3 times a year for blood tests to monitor the HRT and insulin therapy, my retinal ophthalmologist twice a year to monitor and treat my retinas as required, and my psychiatrist either every six months, or as required when things go bad.

So to summarize, I'd be dead, crippled, dead, inknown, crippled, dead, completely blind, blind in one eye, dead, and once more, dead.
(NOTE: this list may not be conclusive)

When my doctors say jump, I jump. They've always been good to explain what they're doing and why, and thanks to them I'm still alive and kicking. I trust them with my life, obviously. Now, your turn :-)

Re:With apologies to programming-motherfucker.com

[Anonymous Coward]

Thank you for sharing. It would require more detail to say for certain (not that I expect you would known or remember all of it), but at least the basis for all of the procedures seem to have been established pre-1980. That is approximately the year medical research seems to have "gone bad" according to my investigations. No doubt the exact procedures have been modified somewhat since then, but that degree of detail (eg what antibiotics) is too much for this forum.

Thank you again.

Re:With apologies to programming-motherfucker.com

[BarbaraHudson]

I don't think that anything I've posted here is a secret on slashdot, so sharing it one more time is no big deal. However, a lot happened after 1979.

The term PTSD didn't even exist until 1980, and its acceptance took time. Before that, the symptoms were known under different names, such as "battle fatigue." That it could be present in children and adults who had never gone to war was a new concept. Effective treatment is the only reason I didn't kill myself.

The invention of OCT (optical coherence tomography) to take 3d scans of my retinas is from the '90s. Better diagnosis means better treatment.

The "no-suture" surgical technique for draining the detrius from my eye and removing the membrane was first done in 1996. From what I saw in the OR, nowadays there's a lot of hi-tech gear involved. Without this, I would be blind in my left eye.

While photocoagulation has been around for a long time, today's lasers are way different - different frequencies, better positioning of each burn, smaller individual burns, the ability to do bulk "raster patterns" in various patterns, depending on the goals.

When I got laproscopic inguinal hernia surgery (which was invented in the early '90s) it was still experimental. When I asked the surgeon (he taught the procedure to doctors at a university hospital) I asked him how many he'd done, and he said "a few - all on pigs". I took his advice to be a subject because of the much shorter time to heal, and he was right.

Genetically modified insulin only became available in the '80s. The elimination of having to dip a test strip in a sample of urine to test blood sugar levels only became possible later, thanks to developments in portable electronics.

New methodologies for treating transsexuals are continuously being developed.

Thanks to newer technology - otherwise I'd be crippled, completely blind in one eye and mostly blind in the other, stuck using pig insulin (not an exact match) and peeing in a cup several times a day (and since I'd be blind, someone else would have to do the test and match the color to a chart).

Now what have been your experiences that make you so negative on modern medicine? There's got to be some reason.you're down on modern medicine. Let's hear it :-)

Re:With apologies to programming-motherfucker.com

[BarbaraHudson]

Considering that they saved me from being permanently crippled (twice), blind, or dying (6 times), I'm going to continue trusting them. Then again, I only deal with specialists, not GPs, so ... ymmv.

More about that here in response to another poster who thinks medicine went downhill after the '70s.

Re:With apologies to programming-motherfucker.com

[Anonymous Coward]

I've seen the research side from within (specifically drug development), I find it very difficult to imagine the process I observed has produced much of actual use. However, I do not have direct experience with the surgical and engineering aspects which likely have a different culture.

Re:With apologies to programming-motherfucker.com

[Anonymous Coward]

I'm not the previous poster, but I'll chime in with a couple of examples. I had a co-worker who had a large lump on the side of his face. Swollen in a big way, like he had been hit in the jaw with a bat. He saw 3 or 4 doctors over several months who dismissed it (one said sinuses, I don't recall the others). Eventually diagnosed as cancer, had half his jaw removed.

My wife's friend's husband who complained about stomach pain after surgery. It was dismissed for weeks by several doctors. Eventually they took him seriously, looked into it, realized a 13 inch instrument was left in his body after surgery.

My aunt had swollen lymph nodes in her groin last year. Diagnosed as a bladder infection. It only took her 3 doctors before they decided it was anal cancer.

I could go on. I'm not condemning all aspects of modern medicine, I've certainly had friends and family with apperently successful diagnosis and treatment, but my experience with doctors has been that they are generally batting .100 at best.

Re:With apologies to programming-motherfucker.com

[BarbaraHudson]

Those are pretty bad. My condolences.

Re:With apologies to programming-motherfucker.com

[BarbaraHudson]

Oops - 7 surgeries for necrotizing fasciitis, not 6. (If there were more, I was in no shape to remember them, never mind give consent).

Re:With apologies to programming-motherfucker.com

[dkman]

And that's the thing. If it's a well known well understood thing then medicine / doctors work great.

If it's something rare or not well understood then doctors are very hit and miss.

Chiropractic and Acupuncture have worked much better than doctors in my case, but I certainly know that doctors have their place.

Re:With apologies to programming-motherfucker.com

[Anonymous Coward]

Awesome! Here's why I DON'T trust doctors.

Diabetes : I was determined to be diabetic based off of 1 blood sugar test. I was later determined NOT to have diabetes based off of 1 blood sugar test.
Diabetic medicine : Medicines made things worse
Gastric Paresis : Misdiagnosed
Reglan : Prescribed for stomach issues. When I asked the doctors about the warnings against prolonged use, they told me not to worry, and continued to prescribe it to me for years while I was sick.

When my doctors say jump, I question them until I'm satisfied that jumping is the best viable option. I don't trust those fuckers any more, for the same reasons that you DO trust them. We've both had experience dealing with them, you had good experiences, and I had multiple misdiagnoses. AFAIC, putting doctors on some sort of pedestal is ludicrous, and their capabilities are only slightly higher than a faith healer or a witch doctor.

Also, I should add that while you certainly seem to be sure that you'd be dead, dead, dead, without these doctors, I believe that you really don't have any certainty with that. Might I also add that maybe these doctors that you see so regularly have been giving you these "unknown infections" and "flesh eating diseases". That supposition has just as much probability as your "I'd be dead" statement. There is nothing to back either statement up.

In other news

[Black Parrot]

He's considering changing his name to N. S. Sherlock.

FDA-as-disease-process

[Impy the Impiuos Imp]

"partly because the world has no clear process for expediting drug approvals."

The vast majority of drugs should be fast track. The number of deaths that occur with letting a drug out early (before full problems are realized) is vastly smaller than the numbers of deaths that occur because drugs are held up ten years.

The FDA is built on a mathematically false premise. But you konw, a dead guy from some drug, boy can those politicians decry "unconscionable profits".

How many are standing up to decry the ten million worldwide not saved becaise some good heart drug was delayed 6 years?

Re:FDA-as-disease-process

[BarbaraHudson]

There are times that a drug looks promising in small trials, but after larger trials, shows no significant benefit. Premature release means a lot of waste AND a lot of people who will have a false sense of security. Then there's DES (Diethylstilbestrol) and Thalidomide ...

Re:FDA-as-disease-process

[gewalker]

DES was approved by the FDA, so clearly the FDA was not helpful in preventing the drug from reaching the market.

Thalidomide was not approved by the FDA primarily due to bureaucratic delay. While the FDA doctors would not approve it as they were waiting for evidence it was safe and effective, they would have approved it eventually were it not for the birth defects that starting showing up in other countries. Drug testing protocols simply did not test pregnant women. I.e., the US was largely spared thalidomide babies because the approval process was slower than in other countries as there was nothing in the testing to date that would have prevented approval.

When you read a headline that FDA approves new drug able to prevent 10,000 deaths annually, rest assure this also means the FDA has been blocking a drug that would have prevented 10,000 annually, most likely for quite a few years.

The drug companies have considerable incentive to market new and expensive (non-generic) drugs. But the expense to bring new drugs to market is also very high, at least in part due to FDA rules. The very high costs tend to kill-off promising developments that would simply not be economical to develop. Real life can be a bit complicated.

Re:FDA-as-disease-process

[BarbaraHudson]

There are cost-sharing programs for "orphan drugs".

W. Africa needs: hospitals, physicans, equipment

[gnujoshua]

One way to be more agile is to have more hospitals, equipment, and trained acute care physicans and nurses available to respond. It is much easier to have digital record systems if you have properly equiped hospitals and clinics that are connected to each other. Every nation should have properly equiped hospitals and on-site training programs—facilities that can emergency and critical care type situations, as well as mortuaries. Here are a couple of quotes from a recent article by Paul Farmer, one of the founders of Partners in Health that explains a little about the health systems of countries in West Africa:

Both nurses and doctors are scarce in the regions most heavily affected by Ebola. Even before the current crisis killed many of Liberia’s health professionals, there were fewer than fifty doctors working in the public health system in a country of more than four million people, most of whom live far from the capital. That’s one physician per 100,000 population, compared to 240 per 100,000 in the United States or 670 in Cuba. Properly equipped hospitals are even scarcer than staff, and this is true across the regions most affected by Ebola. Also scarce is personal protective equipment (PPE): gowns, gloves, masks, face shields etc. In Liberia there isn’t the staff, the stuff or the space to stop infections transmitted through bodily fluids, including blood, urine, breast milk, sweat, semen, vomit and diarrhoea. Ebola virus is shed during clinical illness and after death: it remains viable and infectious long after its hosts have breathed their last. Preparing the dead for burial has turned hundreds of mourners into Ebola victims.

He concludes the article stating:

Fifth, formal training programmes should be set up for Liberians, Guineans and Sierra Leoneans. Vaccines and diagnostics and treatments will not be discovered or developed without linking research to clinical care; new developments won’t be delivered across West Africa without training the next generation of researchers, clinicians and managers. West Africa needs well-designed and well-resourced medical and nursing schools as well as laboratories able to conduct surveillance and to respond earlier and more effectively. Less palaver, more action.

run the course

[AndyKron]

I think we should let them run their course. There are too many people here as it is.

Re:run the course

[Anonymous Coward]

That's not terribly ethical way to think. Imagine if the cards were shuffled and you were an Ebola patient in a poor country.

tired of hearing about Ebola

[frovingslosh]

I'm tired of hearing about Ebola. And the Obama administration's response to it, which has been to send improperly trained people who volunteered to fight in the military to pretend to be medical staff and treat a disease. And, of course, to bring people (who deliberately exposed themselves to the disease and demonstrated that they were bad at taking the precautions that would prevent the spread of the disease) back to this country, where others would be at risk. More people die in this country of the flu virus each year than die of Ebola globally. And the flu is air-born. We are being told that Ebola is much harder to spread and that you pretty much have to go to infected areas of the world and expose yourself to get it. Yet I have not seen Obama call out the Marines or the National Guard to help fight the flu outbreak in this country. If we had all of our own domestic problems solved them maybe there would be some logic in us going over to Africa and trying to fight diseases in people who refuse to take proper precautions, including our own "missionary doctors". But we don't. More people are dying here of the flu than worldwide of Ebola, and those people are Americans who are unwillingly being exposed to an air-born disease. It is indefensible to let them suffer and die and instead joy-ride around the globe to fight diseases that affect a smaller group.

Nor will we ever be

[ilsaloving]

We will never be prepared for a global epidemic as long as anti-scientific morons are able to influence and/or dictate policy.

For example: The vaccination efforts of the last century have effectively been wiped out thanks to the idiotic anti-vaxxer movement, causing measles cases to surge, and are continuing to increase. I'm planning on talking to my doctor about the possibility of a measles booster just to keep my family safe.

And then there's the whole Thimerosol thing, which single-handedly destroyed our ability to easily distribute vaccines en masse. All because some assholes with zero chemistry knowledge freaked out because there was a mercury atom in the molecule. It doesn't occur to these people that if they took common table salt and consumed their component elements, your body would dissolve, punctuated by explosions.

So no, I expect that we are going to see more and more small epidemics of various diseases, and it's probably going to get significantly worse, all thanks to uneducated morons who think their ignorance has the same weight as hard-won knowledge.

Re:Nor will we ever be

[Anonymous Coward]

The vaccination efforts of the last century have effectively been wiped out thanks to the idiotic anti-vaxxer movement, causing measles cases to surge,

Citation? On any and all counts? The west has a small anti-vaccine movement, but retains very high vaccinations rates across population. Measles is hardly "surge"ing either, the vaccine continues to have a higher mortality than the disease in first world countries. Things like pertussis and the flu are far more dangerous. The varicella vaccine has almost eradicated endemic chicken pox in the US in the span of about 10 years.

There's one example I can think of where your claim makes any sense - the polio vaccine was within arm's reach of victory when the taliban started a nasty campaign for propaganda purposes to claim that it would sterilize children. Their main goal was to sow seeds of distrust with westerners, and get in the way of advantageous medical advancement for their feudal subjects. Polio continues to be wild in afganistan and pakistan as a result, but with any luck we can still make it extinct, since it is spread only by the fecal-oral route, so travelers to the first world aren't particularly good at spreading it.

Re:Nor will we ever be

[jedidiah]

While it's terrible that there still measles cases out there, they still remain statical NOISE. They are few and far between even when compared to obscure diseases you have never even heard of.

The overall goal of vaccination is still in effect. For the VAST majority of people, anti-vaxxers are IRRELEVANT because pretty much all of the rest of us are vacinated. Those vaccinations don't just innoculate us from the disease but they also innoculate us against the stupidity of the anti-vaxxers.

That's why I see little reason to get so upset about them. The victory of science and common sense with the population at large ensures that this fringe element has little impact.

It's just that the current information age and nature of commercial journalism means that ANY event will be blown way out of proportion.

Really worried about an anti-vaxxer? Make sure you're currents on your shots.

Re:Nor will we ever be

[Anonymous Coward]

Calling people idiots when he/she can't even name one blinded RCT of a measle's vaccine.

Re:Nor will we ever be

[Anonymous Coward]

Measles is hardly "surge"ing either

We went from 5-10 to 800-1000 per year in the early 2000s to now. It would not take much to take that number higher. This happened in under 3 years.
http://www.cdc.gov/measles/cases-outbreaks.html

Even if the current vaccination was 99% effective and 100% of the population got it. That leaves ~3million people who could get it. The actual rates I have heard are 95% to 98% depending on which paper you look at and a growing population of not getting it.

We went from eradicated in the US population and only brought in. To self hosted.

I think you underestimate how virulent measles is. From what I have been reading it is pretty much a 99% chance of getting it if you are in the same room as someone who has it.

Ever go to the pool? Notice how they make you wash BEFORE and AFTER you swim and the massive amounts of chlorine? There is a reason for that. Its called the measles and polio. Swing by a retirement home and ask the people there what they think of not getting a vaccination. They will tell you tales of their dead siblings and childhood friends.

Re:Nor will we ever be

[Anonymous Coward]

"And then there's the whole Thimerosol thing, which single-handedly destroyed our ability to easily distribute vaccines en masse. All because some assholes with zero chemistry knowledge freaked out because there was a mercury atom in the molecule. It doesn't occur to these people that if they took common table salt and consumed their component elements, your body would dissolve, punctuated by explosions."
-- ilsaloving (1534307) - Slashdot
This is going into my personal fortune file.

Re:Nor will we ever be

[Anonymous Coward]

I dunno, there are still ~25k cases of measles-like illness each year. At least in 1982 it wasn't common to "confirm" with a lab test, it definitely is now. Also, the lab tests do not agree with each other or doctor diagnosis very well (if at all). I wish I could be more confident in those vaccines, but the data is weak either way. I don't think anyone knows how well they work.

Serologic confirmation of diagnosis, while highly desirable, is rarely carried out in a large proportion of cases. In addition, the people that are tested probably do not represent a random subset of illnesses in the community but rather are selected on the basis of prior vaccination
status, atypical clinical presentation, and/or ease of obtaining a convalescent serum specimen.

http://www.ncbi.nlm.nih.gov/pubmed/6751071

“As only approximately 7% of the clinically-diagnosed cases of measles reported locally turned out to be measles by laboratory testing, there is a need for laboratory confirmation of measles to avoid misidentification of cases and improve disease surveillance.(2)”

http://www.ncbi.nlm.nih.gov/pubmed/17609829

" Indeed, an average of only 100 cases of measles are confirmed annually [32], despite the fact that >20,000 tests are conducted [28], directly suggesting the low predictive value of clinical suspicion alone. "

http://jid.oxfordjournals.org/content/189/Supplement_1/S185.full

"Our data demonstrate that regression analysis shows only limited correlation between NT results and the ELISA values. This is in agreement with other reports [4]. Similar limitations in the correlation were also reported for other viruses like Cytomegalovirus (CMV) [10]. In case of the gamma globulin samples, the low correlation might reflect the wider spectrum and heterogeneity of the involved or measured measles antibodies."

http://www.ncbi.nlm.nih.gov/pubmed/17308917

Re:Nor will we ever be

[Anonymous Coward]

As someone else pointed out, the increase in US measles cases is still statistical noise.

Re:Nor will we ever be

[ilsaloving]

What citations could you possibly need? Haven't you read the news at any point in the past several years?

Large swaths of North America have had almost zero cases for a couple of decades. And in the course of the last decade or so, we've gone from that to vilifying disneyland for being a disease vector, and clumps of outbreaks have been appearing in various major population centres, especially around those where the anti-vaxxer movements have been highest.

I'm not going to waste my time spoonfeeding you information when you're literally one google search away from finding it yourself.

Re:Nor will we ever be

[ilsaloving]

http://lmgtfy.com/?q=rct+mmr

Anything else, smartass?

Re:Nor will we ever be

[Anonymous Coward]

Did you read the top hits (the cochrane review)? There is no blinded RCT for mmr and measles. Further, they found the cohort studies to be crappy.

"Measles
Evidence from cohort studies
Effectiveness against measles was investigated in three cohort studies (Marin 2006; Marolla 1998; Ong 2007)...
There was a lack of adequate description of exposure (vaccine content and schedules) in all cohort studies. Another recurring problem was the failure of any study to provide descriptions of all outcomes monitored. A lack of clarity in reporting and systematic bias made comparability across studies and quantitative synthesis of data impossible."

http://www.ncbi.nlm.nih.gov/pubmed/22336803

Please cite a specific paper, or sentence from a review referencing one. Otherwise, stop calling people idiots.

Deployed quickly?

[tomhath]

Deploying any kind of sizable mobile force (military or otherwise) takes months. The ebola epidemic had pretty much run it's course by then.

Re:Deployed quickly?

[Anonymous Coward]

Actually, You can deploy a well prepared medical force in less than 2 days.
http://www.dsls.usra.edu/education/grandrounds/archive/2012/20121023/102312.pdf

Madagascar closes its borders ;)

[Anonymous Coward]

Yes. It's a very effective solution to the problem. If the disease is bad enough I will accept it even if I'm on that plane. In fact if necessary, it's probably easier to kill us more painlessly while we're in a plane (fill it with nitrogen gas or similar). Most diseases don't have such a high kill rate though.

For large scale epidemics you need lots of food and water supplies so that quarantines can be done without too many people dying of thirst and starvation (or rioting on the streets and breaching quarantine). Sending people to hospitals only works if there are few infected. After a certain number, hospitals would become overwhelmed and maybe even spread disease (nurses and doctors get infected).

The more you let people move about, the higher the risk of other people getting infected.

A big problem would be a disease that is highly infectious but asymptomatic for many days or even weeks AND eventually deadly or crippling.

Re:Moving Infected Machines

[Anonymous Coward]

I don't think infected Windows machines should be moved, or at least not moved far.

The number one concern is to limit contamination, so infected Windows machines should be quarantined from the Internet as soon as possible.

Hard hearted? Maybe, but definitely practical.

Crater airfields

[Anonymous Coward]

There will be times when quarantine will have to be enforced with extreme prejudice.
As in, cratering airfields to prevent egress. Snipers sans frontieres.

Or, we could just have 'patch tuesdays' everyone gets the latest vaccine in the mail as a skin-sticker...

But

[MitchDev]

With the help of Microsoft Surface Tablets running Microsoft Windows, connected to Microsoft Windows Servers and running Microsoft Windows Apps will fix everything, trust Bill, just spend the money and he will magically fix everything....

Money is the real epidemy

[Anonymous Coward]

And has no cure.

Moving people? WTF?

[moeinvt]

"...few organizations are capable of moving thousands of people, some of them infected, to different locations on the globe"

Why in the hell would you want to move infected people to different locations on the globe? Furthermore, why would you move '1000's of people together when some of them might be infected? Putting a few sick people on a crowded bus or a plane is a great way to spread disease.

The typical response to a disease outbreak is quarantine because you want to keep the infection localized and to keep sick people away from others. I can understand how you might want to have resources in place to quickly transport medical professionals and other experts along with necessary equipment to respond to an outbreak. but moving infected people? That doesn't make much sense.

So they need to have a daily scrotum?

[Anonymous Coward]

I swear agile is the biggest fraud since Smegma Sex. All my developers do now is have group scrotums and whine about being blocked. Well take a fucking laxative you morons. Agile is just an excuse to do nothing. In the three years with Agile, we haven't done a single major release. Back when we actually planned, we did almost one a year. Saying you want to kill people by making the response ineffective is morally wrong. Gates is an asshole for trying to shove this down our throats.

SCRUM

[Anonymous Coward]

I fail to see how standup meetings will prevent the spread of illness.

Well if anyone knows about Viruses...

[Anonymous Coward]

...it should be him.

How in the world has Gates become an expert?

[QuietLagoon]

Is this article little more than more self-promotion in yet another attempt by Mr. Gates to have history view him in a better light?

Resources would help

[lhowaf]

The US recently paid a scrapper 1 cent to cut up a retired aircraft carrier for scrap. Just imagine the resources you could pack onto an aircraft carrier. Fully staffed and outfitted hospital, housing, power generation, decon facilities, communications, transportation. It doesn't even have to be self-powered - it could be towed to where it's needed. What a waste.

Re:Resources would help

[MrL0G1C]

I bet the maintenance(and fuel) cost of an aircraft carrier is 10x what is would cost to set up and maintain emergency sites in 99.9% of the world.

Re:Resources would help

[jedidiah]

A towed mega boat. Not the most efficient means of travel. Certainly not something you want to wait on when you are trying to get ahead of something quickly.

Re:Resources would help

[Anonymous Coward]

Actually, aircraft carriers are among the fastest when they pick up speed. Their front surface area relative to the amount of space on board for propulsion systems makes them very efficient. However, they do expend a lot of fuel to get to that speed.

Look up records of carriers outpacing their accompaniment of smaller ships for more info.

Re:Resources would help

[david_thornley]

US fleet carriers are not tremendously fast. There's been a tremendous amount of nonsense written about it. The reactors aren't that powerful, and no matter how much stuff you put in the hull all that energy has to be transmitted through the screws into the water. Look at the propellors, folks, because that is a genuine bottleneck. They don't expend fuel as such, being nuclear powered.

What they can do is maintain nearly full speed pretty much indefinitely, while other ships would spend a tremendous amount of fuel to keep up.

They also could accelerate a lot faster than conventional steam vessels, which means they could zoom out of a formation while the escorts struggled to catch up. This is the source of a lot of the stories.

Re:Moving people? WTF?

[Anonymous Coward]

To spread the disease. He has already managed to get the virus "Windows" onto almost every PC -- for this he has also shipped thousands of infected CD-ROMS across the globe.
Now his next target are humans.

Re:Moving people? WTF?

[Anonymous Coward]

"...few organizations are capable of moving thousands of people, some of them infected, to different locations on the globe"

Why in the hell would you want to move infected people to different locations on the globe?.

This is how to deal with an outbreak that threatens millions of lives: https://www.youtube.com/watch?v=lO2-YxWkRxk
Realism, motherfucker!

Bill Gates sponsors quackery

[Stormwatch]

Speaking of epidemics, there is that HIV epidemic in Africa. And how does the Gates Foundation help? By promoting male genital mutilation, aka circumcision -- which is damn well proven to be completely useless to prevent HIV infections.

Re:Bill Gates sponsors quackery

[MrL0G1C]

And he's a giant hypocrite, he invests his money into bad companies that f**k the world up and then acts the saint trying to make the world a better place with the interest.

Re:Bill Gates sponsors quackery

[mspohr]

Your circumstitions.com website belongs with the anti-vaxers and flat earth societies.
Please, try a Google search and pick a reputable web site such as this:
http://www.who.int/hiv/topics/...
From the WHO:
"There is compelling evidence that male circumcision reduces the risk of heterosexually acquired HIV infection in men by approximately 60%. Three randomized controlled trials have shown that male circumcision provided by well trained health professionals in properly equipped settings is safe. WHO/UNAIDS recommendations emphasize that male circumcision should be considered an efficacious intervention for HIV prevention in countries and regions with heterosexual epidemics, high HIV and low male circumcision prevalence."

Re:Bill Gates sponsors quackery

[Stormwatch]

Now here is an explanation of why that study is simply worthless, why that "60%" number is meaningless, and how, even if it was absolutely correct, it would mean 56 circumcisions would be necessary to prevent a single case of HIV infection, and it would still fail to prevent another case -- whereas giving everyone condoms instead would have prevented both cases.

those anti-vaxer idiots

[frovingslosh]

Yea, it is a shame that there are anti-vaxer idiots out there. By the way, did you know that our government runs the National Vaccine Injury Compensation Program (Public Law 99-660)? And that a tax of $2.25 is applied to every measles-mumps-rubella vaccine (as well as taxes on all other vaccines)? Of course, the fools that want to protect their own children from the dangers of vaccines are just idiots and no harm ever comes from vaccines, so don't question why the government is collecting hundreds of millions of dollars into a compensation fund.

Re:those anti-vaxer idiots

[itzly]

Of course, the fools that want to protect their own children from the dangers of vaccines are just idiots and no harm ever comes from vaccines, so don't question why the government is collecting hundreds of millions of dollars into a compensation fund.

Instead of adding it all up, you should consider that it's still only $2.25 per shot, which puts a limit on what they expect to have to compensate per child.

Re:those anti-vaxer idiots

[ilsaloving]

Actually, there IS a very good reason. It's called insurance, because shit happens. There will be a small segment of people who react badly to vaccines, because there are small segments of people who react badly to all sorts of ridiculous things, from onions to sunlight.

Unfortunately, a majority of these people don't even know until AFTER they've already been exposed and go into anaphylactic shock or worse.

But the benefit to getting the entire population vaccinated is so overwhelmingly great that the idea of NOT vaccinating people is just ludicrously irresponsible, so this little insurance fund was set up to help those that draw the short stick.

We could do better

[wcrowe]

As much as I hate to agree with Bill Gates, I do think we could do a better job when it comes to handling epidemics.

BTW, a "global epidemic" is called a pandemic, but perhaps that's splitting hairs.

Anyway, an epidemic can turn into a pandemic pretty quickly these days, so we need to be more nimble.

uhhh....good?

[JustNiz]

>> few organizations are capable of moving thousands of people, some of them infected, to different locations on the globe,

Isn't that a good thing? I mean Quarantining is a good idea right?

Narcissism and Sociopathy

[Princeofcups]

Narcissism and sociopathy are probably the most harmful diseases currently known to man, leading directly to wholesale slaughter, destruction of the environment, rampant poverty, etc. The sooner that we can put people like the referenced into a controlled medicated environment where they can no longer have such a negative affect on the world the better.

Why I admire Bill Gates

[Anonymous Coward]

I admire Bill Gates because he was a wealthy brat kid who bullied his way into a whole lot of money.

Now he wants to be 'Loved and Respected'.

Maybe he should have worked harder. I care much more about the Intel legacy than parasites like Microsoft and Bill Gates.

I wonder....

[Anonymous Coward]

I wonder how much Gates will profit from this. That's what his activism is all about - personal power and profit. How can he modify IP laws to his advantage in the variuos countries he's working with...

Carnegie Built Libraries and Foundations

[Anonymous Coward]

Carnegie also exploited the work of hundreds of thousands of people. Any one of those hundreds of thousands of people could have contributed more to society than Carnegie did.

The failing of Carnegie and Gates is that they didn't care about human potential and in empowering individuals. They wanted to exploit, exploit, and exploit until the well went dry and then they want to be remembered as the 'Good Guys'.

The fact is that if they empowered individuals, let free enterprise run it's course, and were not so damn greedy our civilization would have advanced much farther than it did, and we are all worse off for it.

Now we all worship at the feet of the 'Gods' of capitalism, just because they were greedy, selfish, jerks who want to remembered as the 'Good Guys'.

Do any of us really have a choice?

Realities of life in an LDC

[Anonymous Coward]

I think that many people who grew up in developed countries want a simple, direct solution to epidemics like Ebola. And there isn't one.

No, scratch that. Describing the fundamental problem and it's solution is easy. Implementing is what is hard. The problem is that life in a Lesser-Developed Country is a struggle. The entire array of life is in a difficult state, just name the area of concern: Education, economics, public health, housing, good governance, roads, communications, sanitation, the list is endless. It's not uniformly bad you understand, but the typical state for the median citizen is dilapidated, old and frequently absent altogether. Real improvement that's sustainable involves advancements right across the board. Something that even when done well takes decades and billions of dollars.

Many of these countries have had wars (civil or international, it makes little difference). The wars degrade the infrastructure to the point of uselessness. They also traumatize the victims and enable the perpetrators. War is one of the scourges of the LDCs, and is probably right up there with disease as a root cause preventing advancement. And the most problematic diseases aren't Ebola. Instead they are diseases like malaria, yellow fever, sleeping sickness, guinea worm, cholera, etc.

If you really want to make a dent, education and public health are a good place to start. But you need to build that capacity with locals involved and running the show.

The do the right thing!

[Anonymous Coward]

Build mobile hospitals in containers powered by Air pressure.
Its time.

You know what this means

[Anonymous Coward]

No more bad mouthing Bill Gates about Microsoft - It looks like he has distanced himself far enough away that we can no longer blame it all on him.

Med

[Anonymous Coward]

Where did Gates get his medical degree?

Worst pandemic of all

[vandamme]

Microsoft Windows. Solve that (AKA Linux bug #1) and the world will be a better place.

Stick to what you know, Billy

[Anonymous Coward]

Gates should stick to what he knows, the disease known as Microsoft, and leave medicine to those who are qualified in that area.

Gates in NEJM

[UncleJosh]

Longer piece on same topic for different audience in the New England Journal of Medicine.