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Gates: Large Epidemics Need a More Agile Response

Posted by Soulskill on from the looking-to-hire-The-Flash dept.

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.

81 of 140 comments (clear)

  1. So when's the first scrum? by BarbaraHudson · · Score: 2, Insightful

    n/t

    --
    "Transparent" is a shit show that trades on every stereotype going. A man in drag is NOT a transsexual.
    1. Re:So when's the first scrum? by Carcass666 · · Score: 1

      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.

  2. Moving Infected People by Cpt_Kirks · · Score: 2, Insightful

    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.

    1. Re:Moving Infected People by oodaloop · · Score: 2

      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?

      --
      Tic-Tac-Toe, Global Thermonuclear War, and relationships all have the same winning move.
    2. Re:Moving Infected People by Penguinisto · · Score: 3, Interesting

      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.

      --
      Quo usque tandem abutere, Nimbus, patientia nostra?
    3. Re:Moving Infected People by Cpt_Kirks · · Score: 4, Insightful

      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.

    4. Re:Moving Infected People by Penguinisto · · Score: 2, Insightful

      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....

      --
      Quo usque tandem abutere, Nimbus, patientia nostra?
    5. Re:Moving Infected People by Wycliffe · · Score: 2

      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.

    6. Re:Moving Infected People by ShanghaiBill · · Score: 4, Insightful

      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.

    7. Re:Moving Infected People by ColdWetDog · · Score: 1

      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.

      --
      Faster! Faster! Faster would be better!
    8. Re:Moving Infected People by ShanghaiBill · · Score: 2

      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.

    9. Re:Moving Infected People by ColdWetDog · · Score: 1

      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.

      --
      Faster! Faster! Faster would be better!
    10. Re:Moving Infected People by ShanghaiBill · · Score: 4, Insightful

      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.

    11. Re:Moving Infected People by itzly · · Score: 2

      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.

    12. Re:Moving Infected People by jedidiah · · Score: 2

      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.

      --
      A Pirate and a Puritan look the same on a balance sheet.
    13. Re:Moving Infected People by moeinvt · · Score: 1

      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.

    14. Re:Moving Infected People by DerekLyons · · Score: 2

      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.

    15. Re:Moving Infected People by ShanghaiBill · · Score: 2

      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.

    16. Re:Moving Infected People by Shadow+of+Eternity · · Score: 1

      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.

      --
      A bullet may have your name on it but splash damage is addressed "To whom it may concern."
    17. Re:Moving Infected People by mspohr · · Score: 1

      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.

      --
      I don't read your sig. Why are you reading mine?
    18. Re:Moving Infected People by Tamerlin · · Score: 1

      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.

  3. ebola by itzly · · Score: 5, Insightful

    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".

    1. Re:ebola by moeinvt · · Score: 1, Troll

      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.

    2. Re:ebola by gnujoshua · · Score: 2

      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."

    3. Re:ebola by itzly · · Score: 1

      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.

    4. Re:ebola by khallow · · Score: 1

      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.

  4. Many just don't take it seriously. by HalAtWork · · Score: 1

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

    --
    Twinstiq, game news
    1. Re:Many just don't take it seriously. by Penguinisto · · Score: 1

      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...

      --
      Quo usque tandem abutere, Nimbus, patientia nostra?
  5. With apologies to programming-motherfucker.com by Anonymous Coward · · Score: 4, Funny
    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.

    1. Re:With apologies to programming-motherfucker.com by ColdWetDog · · Score: 2

      You sound angry. Perhaps some nice Cognitive Behavioral Therapy.

      Or just a nap.

      --
      Faster! Faster! Faster would be better!
    2. Re:With apologies to programming-motherfucker.com by BarbaraHudson · · Score: 1

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

      --
      "Transparent" is a shit show that trades on every stereotype going. A man in drag is NOT a transsexual.
    3. Re:With apologies to programming-motherfucker.com by jedidiah · · Score: 1

      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...

      --
      A Pirate and a Puritan look the same on a balance sheet.
    4. Re:With apologies to programming-motherfucker.com by BarbaraHudson · · Score: 1

      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 :-)

      --
      "Transparent" is a shit show that trades on every stereotype going. A man in drag is NOT a transsexual.
    5. Re:With apologies to programming-motherfucker.com by BarbaraHudson · · Score: 1

      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 :-)

      --
      "Transparent" is a shit show that trades on every stereotype going. A man in drag is NOT a transsexual.
    6. Re:With apologies to programming-motherfucker.com by BarbaraHudson · · Score: 1
      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.

      --
      "Transparent" is a shit show that trades on every stereotype going. A man in drag is NOT a transsexual.
    7. Re:With apologies to programming-motherfucker.com by BarbaraHudson · · Score: 1

      Those are pretty bad. My condolences.

      --
      "Transparent" is a shit show that trades on every stereotype going. A man in drag is NOT a transsexual.
    8. Re:With apologies to programming-motherfucker.com by BarbaraHudson · · Score: 1

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

      --
      "Transparent" is a shit show that trades on every stereotype going. A man in drag is NOT a transsexual.
    9. Re:With apologies to programming-motherfucker.com by dkman · · Score: 1

      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.

      --
      I refuse to sign
  6. Re:Why should we care? by Penguinisto · · Score: 3, Insightful

    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.

    --
    Quo usque tandem abutere, Nimbus, patientia nostra?
  7. FDA-as-disease-process by Impy+the+Impiuos+Imp · · Score: 2

    "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?

    --
    (-1: Post disagrees with my already-settled worldview) is not a valid mod option.
    1. Re:FDA-as-disease-process by BarbaraHudson · · Score: 1

      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 ...

      --
      "Transparent" is a shit show that trades on every stereotype going. A man in drag is NOT a transsexual.
    2. Re:FDA-as-disease-process by gewalker · · Score: 1

      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.

    3. Re:FDA-as-disease-process by BarbaraHudson · · Score: 1

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

      --
      "Transparent" is a shit show that trades on every stereotype going. A man in drag is NOT a transsexual.
  8. Re:Gates? by kwiecmmm · · Score: 1

    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?

  9. W. Africa needs: hospitals, physicans, equipment by gnujoshua · · Score: 2
    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.

  10. run the course by AndyKron · · Score: 1

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

  11. Nor will we ever be by ilsaloving · · Score: 2

    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.

    1. Re:Nor will we ever be by jedidiah · · Score: 1

      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.

      --
      A Pirate and a Puritan look the same on a balance sheet.
    2. Re:Nor will we ever be by ilsaloving · · Score: 1

      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.

    3. Re:Nor will we ever be by ilsaloving · · Score: 1

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

      Anything else, smartass?

  12. Re:Gates? by Wycliffe · · Score: 4, Insightful

    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.

  13. Deployed quickly? by tomhath · · Score: 1

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

  14. Re:Why should we care? by petermgreen · · Score: 1

    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.

    --
    note: i'm known as plugwash most places but i screwd up registering that here somehow in the past and now can't register
  15. Re:Gates? by ColdWetDog · · Score: 1

    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....

    --
    Faster! Faster! Faster would be better!
  16. Re:Gates? by chthon · · Score: 1

    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.

  17. But by MitchDev · · Score: 1

    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....

  18. Re:Why should we care? by Anonymous Coward · · Score: 1

    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.

  19. Moving people? WTF? by moeinvt · · Score: 1

    "...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.

  20. Re:Gates? by jedidiah · · Score: 1

    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.

    --
    A Pirate and a Puritan look the same on a balance sheet.
  21. Re:Gates? by maliqua · · Score: 1

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

  22. Re:Gates? by jedidiah · · Score: 1

    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.

    --
    A Pirate and a Puritan look the same on a balance sheet.
  23. How in the world has Gates become an expert? by QuietLagoon · · Score: 1

    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?

  24. Resources would help by lhowaf · · Score: 1

    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.

    1. Re:Resources would help by MrL0G1C · · Score: 1

      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.

      --
      Waterfox - a Firefox fork with legacy extension support, security updates and better privacy by default.
    2. Re:Resources would help by jedidiah · · Score: 1

      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.

      --
      A Pirate and a Puritan look the same on a balance sheet.
    3. Re:Resources would help by david_thornley · · Score: 1

      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.

      --
      "When you have eliminated the unacceptable, whatever is left, however improbable, must be the truthiness" - Holmes
  25. Re:Moving people? WTF? by Anonymous Coward · · Score: 1

    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.

  26. Bill Gates sponsors quackery by Stormwatch · · Score: 1

    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.

    --
    Circumcision is child abuse.
    1. Re:Bill Gates sponsors quackery by MrL0G1C · · Score: 2

      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.

      --
      Waterfox - a Firefox fork with legacy extension support, security updates and better privacy by default.
    2. Re:Bill Gates sponsors quackery by mspohr · · Score: 1

      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."

      --
      I don't read your sig. Why are you reading mine?
    3. Re:Bill Gates sponsors quackery by Stormwatch · · Score: 1

      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.

      --
      Circumcision is child abuse.
  27. Re:Gates? by mean+pun · · Score: 1

    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.

  28. those anti-vaxer idiots by frovingslosh · · Score: 1

    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.

    --
    I'm an American. I love this country and the freedoms that we used to have.
    1. Re:those anti-vaxer idiots by itzly · · Score: 1

      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.

    2. Re:those anti-vaxer idiots by ilsaloving · · Score: 1

      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.

  29. Re:If only Bill Gates was a Billionaire by mean+pun · · Score: 1

    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.

  30. We could do better by wcrowe · · Score: 1

    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.

    --
    Proverbs 21:19
  31. uhhh....good? by JustNiz · · Score: 1

    >> 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?

  32. Narcissism and Sociopathy by Princeofcups · · Score: 1

    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.

    --
    The only thing worse than a Democrat is a Republican.
  33. Worst pandemic of all by vandamme · · Score: 1

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

  34. Gates in NEJM by UncleJosh · · Score: 1

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