Risk perception has a high degree of personal decision-making and choices. For instance, I choose not to ride on the back of a motorcycle or handle rats in a lab without wearing gloves---that's me. I leave risk analysis to the actuarials.
What I worry about is a cavalier attitude and statistics leading to a conclusion on such a small sample size of Ebola infected people within this country. Yes, we have better sanitation methods than African countries so we will probably not have the lethal percentage of Ebola cases here in the USA but we do have a dense population in NYC with its own unique methods of transmitting potentially contagious diseases (ie subways, theaters, etc).
As you very we'll know, viruses vary greatly regarding their timeframe of contagiousness, shedding, hosts' immunity vs susceptibility, and so on. They are unique critters & tend to mutate.
And I'm certain you have the utmost of respect for their uniqueness and adaptability. My question to you is not about risk or exposure......my question to you is not about interpretation , politics, defusing panic for whatever reasons, etc, etc---
or risk analysis but rather on the qualities of the actual virus itself. ***Lets talk details of the virus itself***
I think it should be handled more aggressively than what I've seen occurring. A comprehensive pro-active, coordinated approach is key.
Remember, at the end of the day, doctors trained and properly suited came down with the virus.
Moo
Risk perception drives behavior, as you have pointed out, and is a key part of public health policy and decision-making. It is not just for actuaries.
Regardless, I do not think it is reasonable to state that I have a "cavalier attitude" because I have pointed out that the risk of dying from influenza is vastly greater than than the risk of dying from Ebola and provided data demonstrating this.
Further, I did not draw any conclusions whatsoever from the current case fatality rate in the US. I don't know why, to date, it is so low, and neither do you. It is a fascinating set of data, however. Personally I look forward to the identification of the reason(s) for this, particularly if it continues, and I suggested one possibility, which is that Ebola may not have as high a CFR when properly treated than was previously thought. Unlikely, but not impossible.
I used a comparison to cholera, which when left untreated has a CFR of 50-80%. When properly treated it is more like 5%. This was quite unfortunately apparent after the Haiti earthquake. The docs there knew what they needed to treat it, but they did not have access to rehydrating salts or IV fluids. Approximately 100,000 people die of cholera each year worldwide, even though we know how to treat it. Another possibility includes that every patient in the US had a "mild" strain of Ebola, which seems unlikely given the different exposures of each and the statistical unlikelihood that approximately 90% of the patients brought here just happened to have it. Unlikely, but not impossible.
You had also talked about mutations, etc. I have seen no evidence that this virus is mutating in either direction--to be more or less fatal or transmissible. As you say mutation rates for viruses tend to be high, but as you also know they tend to be neutral. If you have data to present that indicates otherwise, please let me know where I can find it.
Lastly you state that a comprehensive approach is needed, but you also said that you are not interested in talking about risk or exposure, which implies otherwise. As I see it, with Ebola exposure is
everything.
anic:
