I’d like to know everyone’s thoughts on the current ebola outbreak. I’m not the doomsdayer type but this seems like a much bigger problem than SARS, swineflu, etc. Potential impact on the markets? So far it doesn’t look like the growth rate has slowed in West Africa…
There are a few issues. One is that as more and more get sick then there are fewer people/medical staff to look after the population at large and new victims. Ebola will ultimately snowball out of control and it will no longer be possible to contain (more or less) the disease to West Africa due to sheer numbers. The incubation period is problematic and most people don’t want to wait 21 days in isolation before resuming normal activity. This is seen with the NY doctor going to west Africa to help then returning back to the USA. The biggest threat however is that given enough time, Ebola could mutate. Perhaps it will become airborne or the rules for being contagious will change. Who knows? But if this ever happens then all bets are off.
Steve
I don’t see this as pessimistic as market-neutral. Today they released nurse Pham - cured after only 13 days in hospital. If you have the flu it will take you longer to recover. She is now immune from further infection from Ebola. She did not transmit the disease to anybody else either. So as more and more healthcare workers get cured they will be able to help people who get Ebola. They don’t even have to put on protective clothing because they are immune. As the infection rate becomes less than the number people who have Ebola, then the sickness will eventually disappear. That is just maths.
As for the isolation period just announce in New York and New Jersey. This is counter productive - people will just fly to another airport. What the governors should have added is that people who are isolated will be accommodated in 5-star luxury hotels and paid $1,000 per day for being there. So anybody who arrives from West Africa who has been doing work trying to help people with Ebola will at least have $21,000 to show for their efforts when they have been in quarantine for 21 days.
This would be an incentive to get more health-care workers to Africa where they are desperately needed. But as it is, now nobody will go there to help if they know that they will be confined for 21 days when they come back. I guess the politicians were just pandering to their constituents.
My guess: It’s hell on earth in west Africa. My hope is that it doesn’t reach the India sub-continent. We’ll see limited isolated cases in the West. Eventually, WHO, MSF, CDC etc. will stop the outbreak. A vaccine will be developed within a year. Most of the effect has already been seen in the markets. Take a look at LAKE and APT.
Bill
Yesterday there was an hour long program on TV here in the Netherlands, with a bunch of experts. They say that Ebola is actually not very contagious at all. You have a high probability (50-60%) of dying a horrible death when you do get it, but you can only infect others through bodily fluids etc when you already have the symptoms (after the three weeks of incubation time).
With Western infrastructure, knowledge, and health standards, it should be easy to contain here. The reason it got out of hand in West Africa is because it wasn’t diagnosed as Ebola for a long time (it started Dec last year, only to be recognized as Ebola in March or something) and the cultural customs in West Africa happen to be such that Ebola can spread easily (touching dead people during a funeral was an example, when the chance of contamination is highest).
West Africa is indeed hell on earth now, and it will be for some time. But I’m not worried about Europe or the US.
I hope as everyone else does that Ebola will not spread beyond West Africa. But when experts start saying there is no cause for alarm then I really start to be concerned 
I am not an expert of course so everything I comment on should be taken with several shakers of salt but here are my thoughts:
- Ebola is an RNA virus, making it prone to a higher level of mutation than other types of virus
- Vaccines and other treatments have not progressed beyond phase 1 trials. There is no guarantee of an effective vaccine and if one is developed the virus may have evolved by the time the vaccine is released to the point where the vaccine is no longer effective.
- The death rate in West Africa continues to rise. Shortage of medical staff, facilities (including running water), handling of dead bodies, and the astigmatism associated with Ebola survivors are all a problem. With the WHO predicting that there will soon be 10,000 new cases of Ebola a month (or was it a week?), it is hard to see how this can be contained to west Africa without completely shutting down the borders.
- We have been lucky to date in that travellers to USA with Ebola have not shown symptoms on the flight, but afterwards. I doubt the general population will put up with entire airplanes being quarantined when Ebola symptoms start to occur on flights. This will eventually happen.
- Soon winter will be here along with the flu and colds which will cause further chaos. Can you imagine flying across the Atlantic with the person next to you showing signs of coughing, sweating or vomiting? Even if it is a simple flu this will cause riots.
- Since Ebola has previously been contained to Africa, we don’t have any experience as to how Ebola might mutate in a global environment, when mixed with other more common viruses.
- Even with the three week quarantine period, there is still a 5% chance that Ebola is present (something the experts aren’t telling us). This means that in one out of twenty cases it is likely that someone (medic or otherwise) may have been cleared, get symptoms and assume it is a cold or flu. Also, the virus also persists in semen for up to three months.
- Ebola is known to persist with no symptoms in animals such as dogs and pigs. Presumably dogs can transmit the virus even though no symptoms are present? I suspect this disease may end up being like rabies, where it will be present in wild animals in forests and present a threat to humans. Ultimately, it will possibly spread beyond Africa via animals, if not humans.
While Ebola has taken over the media, there is another virus with more immediate impact to North America, the “polio-like” enterovirus that is affecting hundreds of children. The reporting of this seems to be sparse but the number of cases are clearly growing.
Steve
It is VERY rare for a virus to change its transmission mechanism. If the virus protein mutates for the worse it might have to do with other factors but not a transmission mechanism change.
Steve,
I do not know the risk of spread to animals in North America but the virus would have died in Africa if it were not carried by the fruit bat. It took them forever to figure out that the fruit bat was the host between human epidemics
I don’t think it’s likely to mutate and become airborne, but that doesn’t mean it’s not potentially devastating. And I wouldn’t trust the reported numbers for infections and deaths. It’s probably far higher.
I agree with Bill. There are tens of thousands of Indians living in West Africa too. If the virus keeps spreading at the same rate eventually someone who’s infected will bring it to India.
Jrinne - the fruit bat is one host. There are others such as primates, pigs, dogs, etc. It is speculated that some breakouts may have started by eating contaminated wild animals.
ehensim1 - the disease was shown by experiment to be transmitted through air using monkeys. The reason why there is no observed airborne transmission in humans is not fully understood but likely there is insufficient virus in the lungs. In any case, the virus exists in human saliva, which can be thrown while talking (i.e. spit) and can end up in someone’s eye.
Anyways, this situation could break down very easily, even in the USA. Here are some articles:
http://www.theguardian.com/world/2014/oct/25/ebola-cases-10000-mali-death
“The international community badly misjudged the impact of the Ebola epidemic in its first few months and is compounding that error by failing to act quickly enough now.”
“The New York Daily News claimed that an unusually high number of hospital workers have reported in sick since Spencer’s arrival.”
Nurse returning from Africa … “I am scared that, like me, they will arrive and see a frenzy of disorganisation, fear and, most frightening, quarantine.”
http://www.newscientist.com/article/dn26354-ebola-could-never-spread-widely-here-could-it.html
Nigeria… “But to find the 20 people subsequently infected required 18,500 visits to monitor 900 people quarantined after coming into contact with infected people, and cost $30 million.”
“General John Kelly … , warned this week that if Ebola epidemics break out in that region (South and Central America), people may run for the US… Already … many West Africans are smuggled overland into the US.”
“There were just over 8000 cases of SARS worldwide, and by the end global supplies of surgical masks were exhausted.” Comment: there will potentially 10,000 new Ebola cases a week by January.
All:
Unlike flu or HIV, ebola doesn't mutate very rapidly. I'm pretty sure we will see a vaccine within a year or so. Also, ebola has been stopped several times before. I agree that this outbreak is on a significantly different scale; cases and deaths are under-reported. Still, I'm optimistic.
Bill
Can we short Ebola? I mean, 1/2 million children alone are dying this year from Malaria. I am saying that it will never be, but right now Ebola is not a societal problem in the Americas. The specter is what frightens us and the media has marching orders to sell that fear.
The virus will only be controlled when the vaccine gets released… Now it’s pretty much out of control and will go to other slums…
Also did you guys know the virus stays inside the sperm up to 90 days after testing negative? Ebola becoming a sexually transmitted disease is worrysome.
Here’s another way of looking at it: Even with a small probability of this outbreak becoming a worldwide pandemic, the cost of that outcome would probably be larger than anything we’ve ever seen in our lifetimes. If I had to take a wild guess on the spot, I’d put the chances of it happening at a few percent, considering how fast it’s currently spreading and how incompetent we’ve been at dealing with it so far. And I think that is still way too high to be comfortable about this situation. This could be a huge black swan to most people.
All:
It very well could be a black swan, but black swans are rare.
Bill
Black swans are things you don’t see coming. This is by definition not a black swan. One person dies and its broadcasted 24/7. Even Prez Obama has appointed a bureaucrat to oversee the virus.
In all probability it won’t amount to anything. But I have to disagree with the last statement: “Black swans are things you don’t see coming. This is by definition not a black swan.”
The point is that we are too complacent to “see it coming”.
Steve
People act on emotions, not on facts. A few facts…
Some years flu kills 50.000 people in the U.S.
Metabolic diseases that are linked to obesity and sh*t-food kill hundreds of thousands every year.
The 1918 Spanish flu virus killed about 3% of the world population in a few months at a time when there was NO airlines. Even with no vaccine and despite this virus was airborne (Ebola is not), the outbreak stopped. The mortality rate varied in a 30-fold factor across countries, in negative and almost linear correlation with the average income per capita (article published in 2006 in the Lancet).
Ebola is a disaster for Africa. If you want to invest against it, just send a gift to Doctors Without Borders, they are the best at treating this disease on the spot.
"The point is that we are too complacent to “see it coming”.
Even if you are not complacent, you would not see a black swan coming.
piard2 - I’m not sure what your point is.
- 3% of today’s US population is 9 million people. That is a tad more than 50,000 people.
- I don’t understand the comment “NO airlines”. A virus will spread faster with airlines, won’t it?
- There were three waves (mutations) of the Spanish flu. The first mutation was deadly. The second mutation was “incredibly deadly”. The third mutation less so. This is three mutations in a few months. I keep hearing the argument that Ebola won’t mutate as fast as the flu. How do we know this? Ebola is an RNA-virus which typically mutates fast. There are 5 variants of ebolavirus that we know of today. These variants range from no effect on humans to 90% death rate.
- Ebola is currently not arirborne. We don’t know what will happen once it enters a global environment (instead of isolated to small areas of Africa) and starts to mix with flus and other viruses.
- The cost for Nigeria to be Ebola-free was $30 Million. They have publicly stated that they cannot afford to do this again.
WERNER - I don’t understand your point, if there is one.
Steve