The current Ebola outbreak, unlike others throughout history, is lasting a very long time; with cases now being reported on a variety of continents well outside of its equatorial African origin.

I’m not especially worried about Ebola striking me or my loved ones, for reasons I’ll explain in a moment. But I’m growing increasingly concerned about the government response to the outbreak.

So let’s spend some time understanding the nature of Ebola, specifically, and viral contagion, more generally. At the very least, Ebola can serve as an instructive reminder about how our society’s responses to a viral outbreak could prove to be at least as disruptive and damaging as the virus itself.


While very often cited as being 90% fatal once contracted, Ebola is rarely that lethal. In fact, it was only that lethal in a single isolated outbreak. A 50% to 70% mortality rate is more common. As of Oct 10 2014, the latest outbreak had afflicted 8,376 and killed 4,024 -- a mortality rate of 48%.

This places the Ebola strain responsible for the latest outbreak on the lower end of the Ebola lethality scale. Don’t misunderstand me: this is still a very deadly virus, to be sure. But it’s not a guaranteed death sentence, either.

Viruses come in a wide variety of types and shapes. But the general structure they all share is that they have some form of nuclear material, either DNA itself or RNA, housed inside of a protein capsule. Think of a peanut M&M, where the peanut is the genetic payload and the outer coatings serve both a protective purpose (while the virus is seeking a new host) and as the means of docking with a host’s cell.

That’s really all a virus is. A few proteins and some genetic material. No membranes, no sexual merging of genetic material, and no ability to replicate themselves all on their own. There are debates still ongoing today as to whether a virus should even be considered a living thing.

The life cycle of a virus is very simple. A virus particle will dock with a target host cell (most viruses are highly specific for the precise sorts of cells they will and won’t bind to), insert its genetic payload which hijacks the host’s replicative machinery, replicate the genetic payload wildly which codes for both new genetic material and protein capsule subunits, and then reassemble lots of intact virus particles which then escape the host cell to go and find other cells to infect.

Within a mammalian host, once a virus attack is recognized, an antibody response is mounted and the fight is on. As the virus particles escape the host cell (which is usually damaged or killed as a consequence of having been hijacked) it is vulnerable to being identified by a host antibody, itself a highly-specialized protein that will ‘dock’ with a virus particle more or less permanently (they bind together very tightly) and thereby incapacitate the virus’ ability to dock to a new host cell.

With lethal viruses, something goes wrong with this process. Either the virus replicates too quickly for the host to counter effectively, or the virus tricks the immune response into either too little or too much activity – both conditions which can end poorly for the host.

For example, the Spanish flu epidemic of 1918 preferentially killed those between the ages of 20 and 40. This was unusual because it’s exactly opposite the flu mortality patterns we normally expect, where the very young and the very old are the most susceptible.

The best prevailing explanation for this is that it was the very health and vigor of the patients that did them in. The Spanish flu (and other avian flu strains) cause the host body to unleash a ‘cytokine storm’ which is a very unhealthy, and sometimes lethal, positive feedback loop between immune cells and a class of attractor signaling molecules called cytokines. As more cytokines are released, say into the lung tissue, immune cells are attracted and can then release more cytokines, which attracts more immune cells, and so on. The place to which they are attracted becomes damaged by this overly-aggressive response of the immune cells and for the Spanish flu victims, this happened in the lungs, critically impairing respiration. Hence, the ‘healthier’ a host was, the more damage the Spanish flu virus caused.

In the case of Ebola, the virus preferentially targets the cells that line the inner walls of blood vessels (a.k.a. endothelial cells) as well as white blood cells, a fact which helps to spread the virus throughout the body fairly rapidly, as white blood cells actively migrate system-wide.

Through a variety of mechanisms, the Ebola virus causes the endothelial cells to detach from the blood vessels and die, which compromises blood vessel integrity. This targeting of the blood vessels is why the Ebola virus is classified as a hemorrhagic fever. The patient’s blood vessels literally break down. That leads to the many visible symptoms of an Ebola victim, not the least of which is various burst blood vessels all throughout the body.


Currently, it's thought that once exposed, an Ebola victim will incubate the virus for a period of up to 21 days before symptoms express. It's only once the victim is symptomatic that they themselves can transmit the virus and infect others.

This characteristic of Ebola, more than any other, is why I don’t fear it overly much as a pandemic risk. A far more worrisome virus would be one that’s infective during asymptomatic stages of its host cycle, as is the case with HIV.

Early symptoms of Ebola include the sudden onset of fever, intense weakness, muscle pain, headache and sore throat. Unfortunately, that pretty much describes any reasonably intense flu, which complicates screening procedures and causes unnecessary worry among those who merely have the flu but worry about the possibility of Ebola.

Nonetheless, authorities have no choice but to take every traveling passenger with these very ordinary flu symptoms as a possible Ebola case. It’s a safe bet we’ll hear plenty in the coming days and weeks about Hazmat-suited response teams escorting sickly passengers off of planes.

A tip : if you have a fever, don’t travel. You’ll worry a lot of people unnecessarily. And you may end up in quarantine, really throwing your travel plans off the rails.

The Short-Term Risk

While gruesome and heartbreaking, the actual number of deaths by Ebola as well as the total number of people infected is very, very low compared to other hazards out there.

Are you more worried about Ebola than driving to work? If so, you have those risks entirely inverted.


In the above chart, there are 27 years worth of data contained in each data point. That means that if the chart reads 2,700 for a given day, then an average of 100 people died on US roads on that day each year out of 27.

For the US, the above chart translates into ~33,000 vehicle deaths per year. Even in Africa where some 4,000 people have died from Ebola so far in 2014, America’s vehicle fatalities dwarf that current statistic.

Other communicable diseases such as HIV, tuberculosis, malaria, and diarrheal disease cause some 9 million deaths worldwide each year.

This is why I’m personally not that worried about Ebola striking me or my family here in the eastern US at this time. Nor would I be overly worried in Dallas, where the first two US-soil cases of Ebola command national attention. The odds of getting infected at this point are very low at the individual level.

The Longer-Term Risk

However, I do think that the reaction to Ebola, which could include ex- and inter-US travel bans and other economically and socially disruptive practices could be another matter altogether at this moment in time. While there is a small, but non-zero, chance that this Ebola strain could morph into something more virulent, there is a very good chance of a more Draconian government response developing.

In Part 2: Prudent Precautions To Take Now, we dive into not only what damage to our civil liberties and livelihood these heavy-handed and poorly executed government responses are likely to be, but we also address the actions that individuals can take today on important questions like:

  • Who is at risk of infection in the current ebola outbreak?
  • What's the likelihood the current strain will morph into a more virulent form?
  • What are the best steps to take today to reduce your vulnerability to a pandemic?
What Ebola reminds us of is that when a true pandemic arrives it will travel much faster than those in the past (thanks to air travel being an order of magnitude faster than dawning recognition) and that our complex, highly leveraged, just-in-time global economy is utterly unprepared for even a minor glitch in the flow of goods let alone the virtual lockdown that a true pandemic would require.

A small amount of preparing can make you much less vulnerable should (when?) that comes to pass.

Click here to access Part 2 of this report (free executive summary; enrollment required for full access)

This is a companion discussion topic for the original entry at https://peakprosperity.com/ebola/

There's some reason to believe that actual mortality rate is closer to 70%.  It's lower right now because the spread is mushrooming and many people are sick who have no yet died - but will.  


We are not seeing an exponential increase in auto accidents, so how can that be a valid comparison?  The risks are known and understood, and not doubling every 3 weeks. 
The plan such as it is, seems to be to let this pandemic burn out, which occurs as the sloppy replication of the virus causes it to lose its lethality in favor of transmission.  Spanish flu had a mortality rate of 2.5% and managed to span the globe before it burnt out.

A bit of fear, would be helpful in slowing the spread of ebola. 

You sound very disingenuous when comparing ebola against car accidents. Car accidents do not grow exponentially! I worry more that the government will downplay the risks and tell us what we want to hear. Indeed, they are already doing so. You heard the CDC director stating there was a breach of protocol before even evaluating whether the protocols are sufficient or consistent. My impression is that you are using this to grind a familiar axe.

I regularly like to keep things in proportion.  Ebola is still not yet anywhere on my personal worry list in terms of the disease potentially striking me.
Even if it is growing exponentially, the base is so small that it will take many doublings from here before any concern registers in my brain.

That's because I am versed in statistics and do not spend any time ingesting whatever fear du jour the media is peddling.

So far, what are your chances of dying in America from Ebola contracted here?  Exactly zero.

What are your chances of contracting Ebola at all?  So far one in 160,000,000.

What are your chances of contracting Ebola if you were not on the front lines treating a sick Ebola patient?  Exactly zero.

With all the things to actually worry about, why worry about something with almost zero chance of hitting you?  that's not an 'apologist's' stance, it is just by the numbers.

Here are some more numbers.

All unintentional injury deaths Number of deaths: 126,438  

Unintentional fall deaths Number of deaths: 27,483 

Motor vehicle traffic deaths Number of deaths: 33,783

Unintentional poisoning deaths Number of deaths: 36,280

I also have no concern about catching Ebola here today.  I'm much less sanguine about Ebola than you overall.  My concern is that Ebola is not being brought under control yet and the longer this continues the greater the risk of Ebola establishing itself elsewhere say India, Egypt, Brazil or any other number of highly populated places with weaker medical systems than ours.  That potential greatly raises the risk that we see significant numbers of infections here which would seem to have the potential to overwhelm our medical system and would certainly have significant economic impacts.
Until recently, the Fed was pumping $85 billion dollars a month into the financial system.  I think it would be worth it to provide whatever resources are needed to those countries that are currently trying to get this under control.  It would seem a true bargain to guarantee a good annual salary to any Liberian Ebola survivor for example who was willing to be trained to take care of the sick and dead to get this under control.  Allowing this to rage on and spread to other areas risks inviting the black swans I'd say.  The risks aren't where the situation stands today it's where it could go in 6 months.

Another thought, I know a woman who grew up in Africa and swears that her immune system is strong enough for her to travel anywhere and drink the water eat the food and never worry about being sick.  How would American immune systems fare having never been exposed to the stressors of the average African, better or worse?  Also, I imaging in Liberia the people are accustomed to being more self sufficient and wonder if our efficient market and transportation systems would prepare us to cope better or worse than them?



The early responses are exactly why I'm more concerned about fear of Ebola than I am of Ebola, itself. 
The CDC's role in disseminating information, as Chris has said, is dubious - to put things conservatively.
Nearly all their statements have been inflamed by the media, and now people everywhere are expecting millions of cases by this time next year, if not billions. 
The modeling that's been done is literally taking place in a "worst case" vacuum. We can't expect the rate of doubling in Africa to adequately represent the doubling time anywhere else. If Ebola were revealed to have a much higher rate of transmission than previously thought, that would be concerning, and, not particularly surprising. 

At present, however, we're left with the official channels assessment, the MSM's spin machine on 'full-tilt boogie' and our wild imaginations. It's worth remembering that the Bubonic Plague was less deadly than the fear it created.


If 8,000 cases seems statistically insignificant, how's 10,000 per WEEK? http://www.nytimes.com/2014/10/15/world/africa/ebola-epidemic-who-west-africa.html

Number of Ebola deaths this year = 4,447
Number of people on planet Earth = 7,000,000,000 (roughly)

4,447 / 7,000,000,000 x 100 = 0.0000635% mortality rate of Earth dwelling humans

Panic over

My more immediate threats are muggers, car users and alcohol poisoning

Now back to our regularly scheduled program

"The greatest shortcoming of the human race is our inability to understand the exponential function."
- Prof. Al Bartlett

You would refer you to the late Dr. Albert Bartlett's excellent youtube videos explaining exponential growth in layman's terms, or Dr. Martenson's excellent Crash Course video explaining exponential growth.

[quote=dryam2000]You would refer you to the late Dr. Albert Bartlett's excellent youtube videos explaining exponential growth in layman's terms, or Dr. Martenson's excellent Crash Course video explaining exponential growth.

Swine Flu, Bird Flu, SARS
To Paraphrase;

Swine Flu

Based only on lab-confirmed cases, the WHO official figures report that just under 18,500 people died in the 2009 flupandemic.

A new study by over 60 researchers from 26 countries suggests that the number of people who died in the 2009 global H1N1 "swine flu" outbreak is much higher than official figures show.

Writing in PLOS Medicine, they estimate the total respiratory deaths worldwide to be up to 203,000, some 10 times higher than the World Health Organization (WHO) official total, which is based on lab-confirmed cases.

Bird Flu

Since 2003, 650 human infections with highly pathogenic H5N1 viruses have been reported to the World  Health Orgranization (WHO) by 15 countries. About 60% of these people died from their illness.

In 2011, 62 human H5N1 cases and 34 deaths were reported from five countries—Bangladesh, Cambodia, China, Egypt, and Indonesia.  Six countries— Bangladesh, China, Egypt, India, Indonesia, and Vietnam—have widespread and ongoing infections in their poultry. Poultry outbreaks have occurred in other countries recently as well.



The SARS outbreak of 2003

According to the World Health Organization (WHO), a total of 8,098 people worldwide became sick with SARS during the 2003 outbreak. Of these, 774 died. In the United States, only eight people had laboratory evidence of SARS-CoV infection. All of these people had traveled to other parts of the world with SARS. SARS did not spread more widely in the community in the United States. See an update onSARS cases in the United States and worldwide as of December 2003.



Since 2004, there have not been any known cases of SARS reported anywhere in the world. The content in this Web site was developed for the 2003 SARS epidemic. But, some guidelines are still being used. Any new SARS updates will be posted on this Web site.

Paraphrase Ends.

"Fears are nothing more than a state of mind" - Napolean Hill

I really don't see it in my little circle. My doctors seem like they are a bit scared because they are front line but I have yet to witness panic.  Even my friends who work in ER's haven't been panicking.  MSM is getting their ratings though.
I am sorry to be nitpicky but it is unfair to accuse people of panicking when they are just trying to find out what is going on…

Very helpful writeup on the nuts and bolts of the virus.  Thank you as always Dr. M.

Inference on my part. Sorry, my apologies

The perspective I tend to trust is from those who are on the front lines of dealing with infectious disease, in particular nurses who deal every day with the good and bad practices in hospitals that deal with infectious diseases.  Mary Odum, at the Prosperous Way Down blog, is a professor of nursing with practical experience.  She has written some trenchant posts on the way the outbreak is being handled; here's her latest.  She's far less sanguine than Chris or most of the commenters here.  One of her main points is the disconnect between the doctors and nurses who are in the system, and the MBAs who run the hospitals and make the official pronouncements.
As to statistics, it seems to me that the most important one at this point is the rate of growth (deaths), which was still exponential last I saw, with a doubling time around 20 days (recent update from a commenter on Odum's site: "The case doubling time for Ebola appears to be close to its incubation time, about 21 days. With today's case load, we have about 27 doublings to reach over 7,000,000,000. That's about eighteen months.").

Certainly panic isn't called for, but neither is complacency.  We've been seeing lately how poorly our national-level systems deal with systemic issues (Iraq, anyone? Ferguson? Deepwater Horizon? Katrina? Peak oil?) – it looks like public health may be another example.

My wife is an ER nurse in the med center catty corner to Texas Health Presby Dallas (Ebola central).  Although her ER patient load has increased fivefold due to Presby being basically empty, she's not plussed about the virus at all.  However, she is concerned about having the correct protocol, training, buddy systems, etc if it does go nuts. Since Presby Dallas is pretty much a very large yet for all intents and purposes, closed facility, Med City and even Parkland (about ten miles away) are refusing ambulance patients; walk-ins only (Parkland is accepting ambulance delivered burns since they're a major burn hospital but that's all).  Texas Health Presby faced a mass exodus of staff when they drastically cut back hours.  So, because of the fear of losing most of their employees, they have been paying full component to their entire staff even though there are NO patients and it's a pretty huge facility.  How long they'll be able to keep that up is anyone's guess.  My guess is, not for much longer.  They make money by fixing broken people stuff, not by paying a few thousand people to watch their Facebook page all day.  So far, Dallas hasn't lit its hair on fire quite yet.  I asked my wife last weekend how many infected people will cause statewide severe sphincter muscle contraction.  She said, 30 and it's all over but the crying.  That's for Texas.  If you're in a state like Connecticut, where somebody who knows somebody who called somebody in Liberia who might have been infected, they might establish martial law. What's weird is that Ivory Coast, after closing its borders next to Sierra Leone and Liberia have had zero cases.  I wonder why that is.

Couldn’t agree more with Dwig that Mary Odum’s writing on the Ebola situation is very sobering stuff.
Essential reading, surely.

What are the chances that Ebola is not contained and becomes a true global pandemic?  What would the expectation be for the number of deaths if this were to run amok?
If there is a .0001 chance of this escaping to become a true global pandemic, you'd have an expectation of 7,000,000,000 x .0001=700,000 x .5(mortality rate)=350,000 deaths.  Maybe you think the odds are it would only impact half the population, so you'd have an expectation of 175,000 deaths.  Or maybe our odds of it being contained are much better than one in a million.  You can use your own judgment as to what is likely and I'm not sure how best to quantify that.

However you want to look at it, the consequence of not fully containing this is so large it should be addressed much more aggressively by the world community.  Even if the chance of it happening is low.


If you do the numbers, it looks like the doubling period for African Ebola is 23 days, not 20 as the media states. Do it for the US diagnoses, it’s 11+/- days.
Wait, you may say… the small sample size invalidates the estimate.
On the contrary, it brings out a worse point: that the exponential growth is not valid for early growth. Why? Because you aren’t just getting exponential caseload growth. You are getting exponential growth of the number of paths of transmission.
First, it was ebola patients coming in by jet: first one, then two moreg then two more again… Then, it was transmission by protocol-less hospital. But that transmission was actually three paths: skin-skin contact with patients, poor wast management with vomit-soaked rags piled up to the ceiling, and a problem with the cafeteria that they decline to describe.
Next it was transmission-by-jet, with a feverish patient knowingly taking a jet trip to and from Fort Worth.
As each path causes groups to be overwhelmed, transmissions within that path approach exponential growth, and then tail off.
But that’s not the worst. I’m going to posit that the number of available paths of transmission is a function of the size of the economy.
Liberia’s GDP is small; they have a few paths of transmission; so they quickly moved from an exponentially growing exponent constant, to a fixed exponential constant.
But the US GDP is large. So the number of ways people interact is huge. Therefore, our 11 days could become 8 days, then 5.3, then 4 days to double the case load.