This ain't Hell, but you can see it from here

Category: Reality Check

  • “Previews of Coming Attractions”

    People wonder just how bad the Ebola outbreak could get. Well, with a bit of understanding of the relevant mechanisms, knowledge of the math involved, and a spreadsheet, putting together a “quick and dirty” approximate model for the spread of that disease is relatively easy.

    What it shows may be somewhat hard to swallow. And it is a simplified model; reality will be somewhat more complex. But for the early stages of an epidemic – and we’re still in the relatively early stages of this one – I think this should be relatively close.

    First, a few known facts and/or best estimates for the current outbreak and about Ebola itself.

    1. Although the first case was reported 6 months ago, the current outbreak has actually been ongoing since Dec 2013. The index case infection(s) occurred in Guinea, in late Dec 2013. It simply wasn’t recognized as Ebola for around 3 months.
    2. The mortality rate (percentage of those infected with the disease who die) for a disease outbreak cannot be calculated until after the outbreak has run its course. However, an estimate – the current case fatality rate (CFR) – can be calculated. The CFR is a snapshot in time, and tends to rise during the course of an outbreak as more complete information becomes available and some of the patients sick at the time of last calculation die. For the current outbreak, data indicates that the CFR for the current outbreak is approximately 53%.
    3. The total number of reported Ebola cases during the current outbreak is believed to be only approximately 40% of the actual number of cases.   Roughly 60% of the cases (and deaths)in the current outbreak are believed to have never been reported – or in other words, multiply the current reported totals for cases and deaths by 2.5 to get the best guess at the true number.
    4. Facts and best estimates concerning Ebola virus disease.
    • The average Ebola incubation period seems to be about 10 days (min observed is 2 days; max observed is 21).
    • During incubation, patients are asymptomatic (without symptoms). Individuals are not in general contagious prior to becoming symptomatic.
    • At the onset of symptoms, patients begin shedding the virus in bodily fluids and become contagious.
    • Transmission of Ebola appears to be via human-to-human transmission through close contact and/or contact with contaminated fomites/surfaces. Contact with an symptomatic Ebola sufferer’s bodily fluids (sweat, urine, feces, vomit, semen, vaginal secretions, mucous, saliva, or blood) is believed to be the mechanism by which Ebola is transmitted from person to person. For that reason, shaking hands with or standing within 1 meter of an Ebola patient without PPE is considered close contact.
    • The virus appears to enter the human body through mucous membranes or open wounds.
    • Aerial transmission of Ebola does not appear to be a normal means of transmission from human-to-human. However, the possibility cannot be ruled out. Ebola Reston is believed to have spread between primates in different rooms of the famous Hazelton “monkey house” in Reston, VA, through the facility’s ventilation system. After analysis, aerial transmission through the facility’s ventilation system was determined to have been the most likely mechanism by which that Ebola variant spread.

    How epidemics work.

    An epidemic in an immunologically naïve population (e.g., one that has no previous exposure, and thus no natural resistance to the disease) works and can be modeled at a somewhat simplistic level as follows.

    1. A first case – termed the index case – becomes infected. This begins the first generation of the outbreak.
    2. The index case proceeds through the disease’s incubation period. For Ebola, this is on average 10 days. For Ebola, the individual is not contagious during the incubation period.
    3. The individual becomes contagious. For Ebola, this occurs with the onset of symptoms. Also for Ebola, the period during which a sufferer is contagious lasts until they either recover (average is approximately 16 days) or die (usually around day 10 after onset of symptoms). (One caveat here: the Ebola virus persists in certain organs of recovered Ebola patients for up to 90 days after clinical recovery. Though the recovered patient’s body does eventually rid itself of the virus, transmission to others after recovery can occur. In particular, sexual transmission of Ebola by a “recovered” Ebola patient several weeks after clinical recovery has been recorded.)
    4. Transmission to others occurs during the period while an infected person is contagious. During this period, the individual transmits the disease to some number of other individuals. The average number of persons to whom each sufferer transmits the disease is a critically important parameter, called the “reproduction number”. So long as this number is greater than 1, the number of people infected will continue to increase. It’s just a question of how fast.  For the current Ebola outbreak, the reproduction number is estimated to be somewhere between 1.5 and 2.
    5. The transmission to others referenced in step 4 begins the next generation of the virus. Steps 1 through 4 then repeat.

    That’s it. Until the numbers of persons with some type of immunity to the disease (either through survival or vaccination) in the affected population becomes significant, the above is a reasonably accurate – though somewhat crude – description of how an infectious disease propagates through a susceptible population.  It will hold until something (deaths, developed immunity, behavioral changes, whatever) changes the transmission cycle of the disease – usually by changing the reproduction number.

    Those familiar with calculus might be wondering if this is a process exhibiting exponential growth. The answer, unfortunately, is yes. Epidemics in fully susceptible populations are indeed exponential growth scenarios until “herd immunity” (the fraction of the population immune due to prior exposure or vaccination) becomes significant – or until the population dies out, or something else intervenes to reduce the reproduction number below 1.

    The Model.

    Here is a simplified spreadsheet model I’ve come up with for the current West Africa Ebola outbreak. As noted, it’s a rather crude, “quick and dirty” model. But it gives a reasonable idea of what may be in store; I don’t think it’s grossly in error.  Format is Excel 97-2003.  If anyone with more knowledge of the subject or the parameters in question has criticism or comment, I’m all ears. Getting it right is what’s important.

    Fair warning:  I would suggest you (a) sit down, and (b) get a cup of coffee (or something stronger) before you look at the model.  And I wouldn’t recommend do so immediately after or while eating.

    Assumptions used were the following.

    • Single index case in late Dec 2013.
    • 53% mortality rate.
    • Reproduction number of 1.57
    • Average incubation period of 10 days.
    • Transmission on average occurs (and thus begins the next generation of the epidemic) on day 5 after each infected individual’s symptoms begin.
    • Reported cases and deaths are each 40% of actual.
    • Estimates based on averages are reasonably representative of physical reality and will not be grossly in error.

    For 9 October – the start date of the model’s generation 20 of the outbreak – this model predicted a reported number of cases of 7,724 and a reported number of deaths of 4,090.

    Per the CDC website, on 8 October 2014, the reported number of cases was 8,011; the reported number of deaths was 3,857.

    On the “bright side” – if you can call it that – the model I developed doesn’t predict 1.4 million cases until late Feb/early Mar 2015. Without changes in the outbreak, CDC predicts that number of cases by late January.

    I guess I could say “Happy Halloween” at this point; the above is certainly scary enough. But I don’t see much to be happy about above.

    THIS is why we need to do everything possible to keep this sh!t out of the United States. Period.

    Are you listening, Mr. President?

  • Talk About Bad Timing

    Headline from the cover of the issue of Dallas Weekly magazine released on 25 September:

     “Taste of Africa Comes to Dallas”

    Seriously.

    Yeah, the timing on that one . . . kinda sucks.  They obviously didn’t have a working crystal ball.

  • Fifty Years Ago Yesterday

    On 10 August 1964, Public Law 88-408 was signed by the POTUS, and became effective.

    It’s better known today as the Gulf of Tonkin Resolution. That resolution was described by then-Undersecretary of State Nicholas Katzenbach as “the functional equivalent of a declaration of war.”

    The resolution was passed by Congress at the request of the LBJ administration in Joint Assembly of Congress on 7 August 1964.  A “pair” of “hostile fire incidents” in the Gulf of Tonkin involving US Navy ships – the destroyers USS Maddox and USS Turner Joy – on the nights of 1- 2 and 3-4 August 1964 were the stated reason for the LBJ administration’s request.

    The first incident involving the USS Maddox was legitimate. Best evidence indicates that the second “incident” involving both ships actually was not a hostile fire incident at all, but was due to sonar/radar reflections being misinterpreted as possible hostile vessels and torpedo tracks.

    In reality, there was no second “hostile fire incident”.  In 1999, Robert McNamara – SECDEF at the time of the incidents – publicly acknowledged that fact.

    The evidence also indicates that LBJ likely knew full well that the second incident was questionable, and probably had not actually happened. He chose to ask Congress for the resolution nonetheless.

    Why? LBJ was wary of appearing “soft on Communism”. His opponent in the upcoming 1964 Presidential Election – Senator Barry Goldwarter of Arizona – was widely viewed as the more strongly conservative, anticommunist candidate. Getting Congressional backing for stronger action in Vietnam would neutralize Vietnam as a political issue – particularly if LBJ reacted strongly to a “provocation”.

    Further, LBJ had been urged over 2 months earlier by his Foreign Affairs Advisor, McGeorge Bundy, to declare the defense of Vietnam “essential” to the US – and that a declaration of authority and intent to use force was desirable. And of course, there’s this statement by LBJ to the Joint Chiefs of Staff in December 1963 (some of whom were also pushing for more US involvement in Vietnam): “Just get me elected, and then you can have your war.”

    At the time of his statement to the Joint Chiefs, LBJ may well have been playing one faction against another – classic “backroom politics”, at which LBJ was a master. But by mid-1964, that no longer appears to have been the case.

    The resolution gave LBJ carte blanch authority to maneuver the US into Vietnam in strength – without further consultation with Congress. He did exactly that, by stealth, beginning in early 1965.

    After he’d been reelected.

    The Army Times has an excellent article today on the Tonkin Gulf Resolution. It’s worth a read.

    And afterwards, maybe also take a moment to remember those who didn’t come back from that questionable conflict.

  • Where do we get such men?

    I spoke with Soldier who not long ago completed his second tour in Afghanistan.   I knew him as a teenager who was unsure what direction to take his life. I know him as a man for whom I have the greatest respect and admiration.  I have seen first hand the growth and the pain he and his family have endured by his decision to become a Soldier.

    Six years ago he was sitting in his Grandmother’s house watching a video on YouTube. The end of the video asked what have you done to support our troops? Within a few days he had been to see a recruiter within a few months he was in the Army.  His first day of Basic was also his 20th Birthday, He celebrated his 21st in Afghanistan.  He wears his CIB with pride, he can also wear a Purple Heart that he does not think he should have been awarded, you see he was in an explosion and spent a few days in the hospital and a few weeks recovering from TBI, but, in his opinion that’s not the same as getting shot or otherwise wounded in action. These are the facts verified and vetted. The facts don’t always tell the truth of events.

    We live in a nation that has been at war for 13 years.  The average recent high school graduate has no memory of our nation at peace.  Anyone joining the Army in the last 13 years knew they were going to war, but they still joined. They knew that there was a good chance that not only could they be asked to give their life for our way of life but to take lives as well, But they still joined.  We tied yellow ribbons around tress and gave parades for those going to war and for those returning, in time our nation at war became our way of life. The ribbons were not as prominent and the send offs and return were not as well covered by the news.  They still came and went.  The truth is we have grown weary of war. Most people don’t understand why we still have troops deployed.  Public opinion changes with the political wind, but the truth remains. Our sons and daughters are fighting a war.

    The Soldier with whom I spoke had nightmares when he came home,  he relived time and again the pain and suffering he witnessed as well as endured.  When he spoke to me about the injury and death he had seen, it was with barely restrained tears. The emotion in his voice transcended time and space, he could have been any Soldier speaking about any battle in history.  But he was not just any Soldier and it was not just any battle.  He was talking about the death and injury of his people, while they may not be brothers in flesh,  they are brothers in arms. I know that sound cliche but I cant think of any other term.

    He thinks that the people at home look down on him and his fellow Soldiers. He thinks that admitting he has bad dreams, or no longer likes loud noises or crowds makes him weak in some way. He told me a few stories about friends getting injured by IED’s.  He told me about how he coped with taking a life.  He told me about the reality of war. The whole time he talked I kept thinking to myself “how do we get such men?”

    He talked about “getting blown up” – his words.  He has survived 3 IED explosions in close proximity.  He was injured slightly “took some shrapnel, bot not bad enough to worry about”  the first time and suffered TBI the last time. The second he doesn’t talk much about.  While he was not physically injured he will carry the emotional injuries for a long time to come.   I still ask myself where do we get such men?

    I know his experiences are average for any Infantry Soldier with two deployments.  They are not what the average 25 year old American males has dealt with.  I know I spoke with a professional soldier. He believes in what his nation stands for.  He doesn’t see himself as anything but a soldier, he cannot grasp how anyone could see him as a Hero.  I cannot grasp how anyone could see him or anyone else that has answered  the call as anything but Hero’s.  I thank God we have such men.

  • Memorial Day


    I can get a great deal on a car in the next few days.   Electronics are on sale.  Hotel’s are booked. It’s the beginning of summer!  All the big networks are wrapping up the TV viewing season.  Schools across the country are out or are counting the few remaining days.

    What I haven’t seen any place is the mention of a parade.  Not a word about honoring those that died in the service of our nation.   No words to the Gold Star families to let them know we have not forgotten.   It saddens me.

    Memorial Day was called Decoration Day as well as Remembrance Day,  no one really knows what town was the first to celebrate it,  several claim it as their own. What is known is that it came into being as an idea about the same time in several places in the late 1860’s.  The Nation was still mourning its dead on both sides of the Civil War.  In 1868 General  John Logan, national commander of the Grand Army of the Republic  issued an order that May 30 would be Memorial Day, for the First time the graves of Union and Confederate dead in Arlington were decorated with flowers.

    By 1890 all of the Northern States were celebrating Memorial Day on May 30th.  Most southern states still has different days of remembrance.  The division between the North and South Remained until after WWI when Memorial Day expanded to Include WWI dead as well.

    Memorial Day remained May 30 until 1971,  When Congress passed the National Holiday act, moving Memorial Day to the last Monday in May, giving federal employees a 3 day weekend. Several Bill have been introduced to move Memorial Day back to May 30, all have died in committee.

    I share the opinion that Memorial Day started to lose its meaning when it was moved.  Celebrations and Parades that used to be common place in small towns across the Nation became less common.  Adding to the problem was the perceived mood of the Nation in the years following Vietnam.   The inevitable commercialism  of all holidays has led to a Generation of Americans that only know Memorial Day for sales, a long weekend and a trip to the lake.

    There are a few notable exceptions. Since the late 50’s on the Thursday before Memorial Day, the Soldiers of the Old Guard place small American flags at each of the gravestones at Arlington National Cemetery. They then patrol 24 hours a day during the weekend to ensure that each flag remains standing. In 1951, the Boy Scouts and Cub Scouts of St. Louis began placing flags on the 150,000 graves at Jefferson Barracks National Cemetery as an annual Good Turn, a practice that continues to this day. More recently, beginning in 1998, on the Saturday before the observed day for Memorial Day, the Boys Scouts and Girl Scouts place a candle at each of approximately 15,300 grave sites of soldiers buried at Fredericksburg and Spotsylvania National Military Park on Marye’s Heights. And in 2004, Washington D.C. held its first Memorial Day parade in over 60 years.

    Many feel that memorial day is for remembering all that have died.  It is my belief that this day needs to remain sacred, and reserved only for those that gave their life for the Nation.

    In Flanders Fields

    Lt Col. John McCrea MD.

    In Flanders fields the poppies blow
          Between the crosses, row on row,
       That mark our place; and in the sky
       The larks, still bravely singing, fly
    Scarce heard amid the guns below.

    We are the Dead. Short days ago
    We lived, felt dawn, saw sunset glow,
       Loved and were loved, and now we lie
             In Flanders fields.

    Take up our quarrel with the foe:
    To you from failing hands we throw
       The torch; be yours to hold it high.
       If ye break faith with us who die
    We shall not sleep, though poppies grow
             In Flanders fields.

    In 1915, inspired by the poem  Moina Michael replied with her own poem:

    We cherish too, the Poppy red
    That grows on fields where valor led,
    It seems to signal to the skies
    That blood of heroes never dies.

    Whatever your plans this Memorial Day, please take a moment to remember those who gave everything so that we can know Liberty.

    ©2014 This Aint Hell

  • You Get What You Pay For

    The effects of Defense wide cuts is far reaching. As this US News Article discusses.

    “We’re an 11-carrier Navy in a 15-carrier world.” Army General Martin Dempsey said.

    According to Marine General John Kelly, his command is, “unable to get after 74 percent of suspected maritime drug smuggling.”

    Our budgets are being cut so tight that we are unable to accomplish the ever increasing global missions that we are being tasked to accomplish. This is an ultimate consequence of the success of our military and the generations that came before. They have established a sense of security within our borders that fosters the idea that we no longer need the military. That is a nice idea, and 9/11 should have been a reminder of that, but as a nation we have a short term memory.

    There will come a point when we as a nation are again reminded that the world is not a friendly place and we can’t solve problems by throwing money at them. Well, throwing money at other people, while failing to invest in ourselves, our infrastructure and our ability to defend it. The issues in Crimea are highlighting the failure of that thought process, and I hope that we won’t have to solve that problem with physical intervention. Stalin, however, does seem to be trying the west/America’s patience, just to see what he can get away with.

    At the rate we are going, however, with more budget cuts, we won’t have much left to fight with. Our military will be poorly equipped, understaffed and under trained. Hopefully, our enemies will just be happy that we keep developing new iPhones and still make great movies, and just leave us to our own devices.

     

  • Guest Article: Stolen Valor, Part 2: “Wayne and Earl – and Their Families”

    Here’s the second increment of Wesley’s work.  Once again:  high quality stuff.  (If you missed the first part, it follow this link to read it.)

    You might want to grab a tissue before you start reading.  However, if your family has suffered a recent loss, or you’re having a particularly bad day – maybe you might want to read it later.  Ditto if you have blood pressure issues and are having a bad day on that front.

    And Wesley – consider talking to Jonn about becoming a contributor to TAH.  Your work really is damned good.
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  • Guest Article: Stolen Valor, Part 1: “What it is”

    Wesley Wilson – who comments here as “Enigma4you” – has asked me to post this article on his behalf if I “felt it has merit”.

    Yeah, Wesley, it has merit – it’s damned good.  I’ve told Wesley I think that he should ask Jonn for an account, and post occasional articles as his time and circumstances permit.

    Without further ado, here’s Wesley’s article. I think you’ll like it.

    . . .

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