Yale Scientists Conclude Best Chances of Eradicating Ebola – Report

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A recent study by Yale University has found that isolating Ebola victims within four days of symptom onset could achieve disease elimination in Liberia. Setting out to determine how to best use scare resources to combat the Ebola outbreak overwhelming West Africa, and after analyzing the incidence and case fatality of the outbreak, the team concluded that the best hope for ending the spread of Ebola was isolation of Ebola victims very early in the progression of symptoms–although the time window suggested by the research was smaller than current time to hospital reporting in West Africa.

“The Ebola outbreak in Western Africa is spiraling out of control. The need to determine how to deploy scarce resources to end this crisis is urgent,” Dr Dan Yamin, Postdoctoral Associate in Epidemiology at Yale School of Medicine and lead author of the report, framed the study.

Dan Yamin
Dr Dan Yamin, lead researcher on the study

The goal of the study was to “evaluate the contribution of disease progression and case fatality to transmission and to examine the potential for targeted interventions to eliminate the disease,” according to the report.

The team used both clinical and epidemiological data–incidence and case fatality records–from the Liberian Ministry of Health and Social Welfare, and found that secondary infections occurred during the infectious period of an Ebola victim at an average rate of 1.73. That is, each infected person passed on Ebola to 1.73 healthy individuals.

Isolating Ebola Cases Best Chance of Eradicating Ebola - Report
Distribution of secondary cases per infected individual among survivors and nonsurvivors

Ebola victims who did not survive passed the disease on to 0.66 people, while nonsurvivors passed the disease on to 2.36 people. Survivors of Ebola, the study found, infected at least one healthy person in 32 percent of cases. Nonsurvivors infected at least one healthy person with a 67 percent probability rate.

“Consequently, nonsurvivors, who made up 63% (CI, 60% to 64%) of the population, were responsible for 86% (CI, 63% to 98%) of transmissions,” the researchers found.

Left alone, “the number of newly reported cases will be doubled every 20 days,” Yamin told The Speaker, pointing out that the number of newly reported cases should not be misconstrued to be the total number of cases.

The conclusion reached by the team was that isolation of infected individuals offered a chance of eliminating the disease. Isolation of 75 percent of nonsurviving infected individuals within four days after symptoms began created a 74 percent chance of disease elimination. Isolation of all infected people offered a marginal reduction beyond the 74 percent. Isolation of asymptomatic people, however, made no practical sense, the researchers found.

“There is no medical sense in quarantining asymptomatic people,” Yamin told us. “All evidence shows that asymptomatic people (and people that were exposed and are in the “incubation period”) can’t transmit.

“Isolating all individuals before symptoms onset is not practical,” said Yamin, noting that, of course, it “would obviously lead to disease elimination.”

Isolating Ebola Cases Best Chance of Eradicating Ebola - Report
Average number of secondary cases per day of symptomatic disease

The most pragmatic way to actually combat Ebola in West Africa, Yamin told us, was isolation of only those people who were already symptomatic.

“In the absence of sufficient isolation units, our model emphasizes that targeted isolation of those who are mostly responsible for transmission may be the most efficient way to contain Ebola. Specifically, because infectiousness increases greatly with disease progression we found that that isolating 75% of infected individuals (particularly, the more severe cases) within four days of symptom onset has a high chance of eliminating the spread of the disease.

The researchers found that the current average period from symptom onset to hospitalization in Liberia was approximately 5 days–significantly beyond the requirements suggested by the study.

The researchers also evaluated the effectiveness of self-quarantine–a pragmatic strategy in areas where there were not sufficient isolation units. Self-quarantine of 75 percent of all infected could eradicate Ebola with 78 percent probability.

“Effectively, we tested self-quarantine by contact reduction of an infected person beyond what was currently reported,” Yamin told us. “The data provided by the Liberian Ministry of Health suggests that, an infected individual contacts, on average, with 6 people–this

Isolating Ebola Cases Best Chance of Eradicating Ebola - Report
Probability of disease elimination for different intervention strategies and coverages

number seems to be substantially lower than the number of contacts of a healthy person.

“Our results suggest that to achieve 78% for elimination, additional 60% reduction in contacts should occur following the first day from symptoms onset. Practically, implementing even this strategy seem to be challenging, which highlights the importance of increasing isolation units in Liberia.”

The conclusion of the researchers was that the massive international support directed at helping in West Africa “should be directed towards expanding the capacity of hospitalized case isolation.”

“Targeted isolation may offer the best hope of ending the Ebola epidemic.”

The report, “Effect of Ebola Progression on Transmission and Control in Liberia,” was authored by Dan Yamin, PhD; Shai Gertler; Martial L. Ndeffo-Mbah, PhD; Laura A. Skrip, MPH; Mosoka Fallah, PhD; Tolbert G. Nyenswah, MPH; Frederick L. Altice, MD, MA; and Alison P. Galvani, PhD, was published in Annals of Internal Medicine, and was funded primarily by the National Institute of Health.

By Andrew Stern

Photo: International Federation of Red Cross and Red Crescent Societies

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‘Joujou’ is another name for hope in the Brazilian wetlands

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A male jaguar named Joujou has returned to his home sweet home in the wild.

In Brazil he has become a symbol of the efforts of environmentalists, volunteers and firefighters to protect and restore a much affected strip of the Pantanal, the world’s largest tropical wetland area, which was ravaged by the fires last year.

Little by little, vegetation returning to the Serra do Amolar, a chain of mountains considered an environmental treasure because of the large number of species it houses.

Before the fires, 62 jaguars had been monitored in the region. Today, researchers are unable to say how many have survived and how many have returned to their habitat, which was scorched in the worst sequence of fires in 14 years. Between January and September of 2020, 2.3 million acres have been on fire, an area which is two times as big as the city of Rio de Janeiro.

Joujou the catJoujou has become a symbol of hope because he was shown on national TV with his paws burned. Some Brazilians said they cried in front of the screen when they saw the big cat suffering so much. In November, two jaguars were rescued. They could barely move. One of them didn’t make it. Joujou was taken to a center for housing and treatment of wild animals in the city of Campo Grande, capital of the state of Mato Grosso do Sul.

After months of intensive care, this example of the Americas’ biggest feline has recovered entirely and was flown back to Pantanal. Joujou now has a tracking collar and will be monitored for a year. He reached the hospital weighing just a hundred pounds. He now weighs almost 180 pounds.

Many other animals – including anteaters, armadillos, snakes, alligators and other jaguars – did not survive the blaze. However, Joujou, beautiful and strong, has been returned home safe and sound.

By Jorge Valente

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The priest who left no sharp stones

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SAO PAOLO, Brazil – One of the most iconic figures in the fight for the homeless in the city of São Paulo has been in the spotlight since the beginning of February.

Father Julio Lancelotti learned that the City Hall’s authorities had decided to cover the ground under a bridge with pointed stones, a move to prevent the homeless from sleeping underneath.

A reputed advocate of human rights, father Lancelotti had no second thoughts about the line of action he was about to take.

With a sledgehammer in hand, he took to the streets and positioned himself right below the bridge. And then attacked and destroyed furiously what he considered another serious breach of human rights in a city already plagued by many other violations.

On social media he later posted a picture showing the result of his action and wrote, “Outrage against oppression”.

São Paulo is believed to have more than 24,000 homeless living below the poverty line, according to a 2019 survey. But Human Rights Watch groups say this number skyrocketed during the pandemic.

City Hall authorities said that the decision to put the stones under the bridge was an “isolated action” and had already fired the employee who was in charge of the task.

Father Lancelotti, however, was skeptical about this take on things, and said another similar action had already been done, commenting, “It’s inhuman, looks like a concentration camp.”

By Jorge Valente

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Tourists damage 1500-year-old Gate of the Sun and rock monoliths in Bolivia’s ancient city of Tiwanaku

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Four women and one man from the eastern city of Santa Cruz were charged with damaging the carved stone relics of the civilization that flourished for five centuries on the site, forerunner of the Inca empire. The pre-Columbian ruins are part of the country’s most important archaeological treasures.

After seeing what they described as “suspicious activity,” caretakers said the group splashed the structures with an oily substance that stained surfaces and that experts say would attract gases into the stone, causing internal changes and deterioration.

By Milan Sime Martinic

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Myanmar university students rally near Chinese embassy, protest SEAFOOD

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YANGON, Myanmar – University students in Yangon rallied near the Chinese embassy Feb. 27 and called for the Chinese government not to cooperate with the Myanmar military.

Protesters in Myanmar suspect that China is transporting hardware devices to build a firewall for controlling the internet in Myanmar. When the protesters asked the question, the embassy told them that China was sending SEAFOOD to Myanmar. “SEAFOOD” is defines as Software Engineering Approaches for Offshore and Outsourced Development.

There are three main telecommunication companies in Myanmar: MPT, Ooredo and Telenor have provided faster internet connections since 2014.

At present, there is an internet blackout between 1am to 9am daily throughout Myanmar, and when it is available, internet connections are slower than before the military grabbed power from the democratically-elected government.

By Htay Win
Featured image credit: Sit Htet Aung

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Japan’s ruling party to allow women to watch its board meetings, but no talking

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Japan’s Liberal Democratic Party will invite up to five of its female members of parliament to board meetings, but they should not speak. This was announced by the party as it took what it said was a step toward equality.

“It’s important to fully understand what kind of discussions are going on,” said Toshihiro Nikai, the LDP general secretary. “Look. That’s what it’s about.” Nakai added that women should not have a say in the proceedings but can submit suggestions in writing after the meetings have concluded.

The party’s action has sparked criticism from the opposition, which charges male chauvinism and discrimination against women is ingrained in the LDP, which depends on the voices of Japan’s strong nationalist circles with their traditional role models. They are tentative in grappling with women-friendly ideas, according to women’s groups, and progress is slow. The party’s make-up is 40% female, but women only hold 10% of its parliamentary seats, a figure far below the 25% global average.

According to the World Economic Forum 2020 report, Japan ranks 121 out of 153 countries in its gender parity global ranking.

By Milan Sime Martinic

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