Talk:Western African Ebola virus epidemic/Archive 7

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A note about how wonderful your work is

Yesterday I was being interviewed on Sky News in the UK. The interview was supposed to be about a conference that I'm attending here in Dublin (One Young World) but took an unexpected (for me) turn into discussing ebola. The interviewed quite confidently challenged me on the importance of ebola with the claim that "only 4 people per day are dying of it". I was astonished and challenged back and she cited The Economist and insisted on the number and tried to move on. I stopped her right there and said look, if The Economist says that, then they are wrong. I said that people should come to this article and look at the table where we have a meticulous table with exact reference to the authoritative data. Later, on twitter, she appeared to be continuing to push the line by tweeting a screenshot of something from the Economist - dated early August. Sheesh.

Anyway, I was very proud to know that our article is very good, and that we are doing something that unfortunately talking heads on television can't or won't do: responsibly and thoughtfully working very hard to get high quality information out to the world. This journalist didn't turn to us, but we know that thousands of journalists do. Your work is meaningful to the world, and I thank you for it.--Jimbo Wales (talk) 09:10, 19 October 2014 (UTC)

Thank you! It means a lot to hear this. AmericanXplorer13 (talk) 13:22, 19 October 2014 (UTC)

may God bless you and help those in west Africa and elsewhere --Ozzie10aaaa (talk) 13:28, 19 October 2014 (UTC)

It's our Armed Horses that make the difference ;) (inside joke). Gandydancer (talk) 13:44, 19 October 2014 (UTC)

I still can't believe I did that. AmericanXplorer13 (talk) 13:49, 19 October 2014 (UTC)

I thought it was very funny, and if the truth be known very sweet when you said, "Sorry guys...". It is good when we lighten up and have a little fun. Gandydancer (talk) 14:21, 19 October 2014 (UTC)

Gandydancer, I can't find the archived talk section where I told everybody what happened. AmericanXplorer13 (talk) 18:03, 19 October 2014 (UTC)

Found it Art LaPella (talk) 21:35, 19 October 2014 (UTC)

Thanks Art. Deleted because it was "non-serious", eh? It seems that the editor who deleted it (who has not spent any time working on the article, BTW) does not consider a discussion of physics as important. Until this moment I was not aware of the four horses of physics because the section was deleted before I had a chance to read the science input from the IP. Gandydancer (talk) 14:59, 20 October 2014 (UTC)

Glad to know that all the hard working editors here can help to inform the world and be appreciated. It makes it all worth the while.BrianGroen (talk) 13:37, 20 October 2014 (UTC)

Yes, I thank Jimbo for his appreciation as well, but enough of this off-topic discussion and back to work. If you want to have any fun, instead watch this clip from the Conan show a few nights ago: [1]  :) Gandydancer (talk) 15:06, 20 October 2014 (UTC)

(WP attempts at humor can easily be misunderstood - I'm just kidding about "off topic - back to work", etc.) Gandydancer (talk) 18:09, 20 October 2014 (UTC)

US section

Two substantial paragraphs have been added to the section, bringing the total to four rather than two. I think that the additional info would be best put in the US article rather than here. What do others think? Gandydancer (talk) 13:37, 19 October 2014 (UTC)

agree, should be put in u.s. article(rather than here)--Ozzie10aaaa (talk) 21:22, 19 October 2014 (UTC)

Thanks Ozzie. No objections - I will delete the detail. Gandydancer (talk) 18:11, 20 October 2014 (UTC)

Nurses allegations in Dallas

LA times is now reporting the Dallas nurses' allegations. http://www.latimes.com/nation/la-na-ebola-dallas-20141014-story.html#page=1 The claims are being made under unusual circumstance (according to LA times). Not sure how to write this in a balanced way (if at all) since the story seems to be that the allegations are being made by a 3rd party not directly involved. Something to keep an eye on. Greenbe (talk) 02:29, 16 October 2014 (UTC)

• I would say relegate this to the US sub-article. It has little relevance to the actual area where 99% of the cases of the disease are, and that is placing the number of cases elsewhere too high. Liberia, Sierre Leone and Guinea have over 99% of all cases, closer to 99.9%John Pack Lambert (talk) 04:39, 16 October 2014 (UTC)
  • I second that. But somebody reverted it back in with a new USA Today reference. I found the USA today article irresponsible, because the 3rd party claims can not be independently verified even with confidential sources (which LA times pointed out). Even for a US article we should be very careful of this until it becomes an established fact of some kind. That said, CDC does have published guidelines for protection of healthcare workers on the web (seems to go back many years). It is a valid question why these don't seem effective in Africa where healthcare workers are the most vulnerable to infection percentage wise, and have been since the 1976 outbreak.Greenbe (talk) 23:55, 16 October 2014 (UTC)

The article currently contains one sentence re the nurse's allegations: Nurses at the hospital who were assigned to care for Duncan claimed they did not receive the proper training or personal protective equipment.

Exactly what is your complaint? This information is reported at numerous news sources. We don't need to establish as a fact that the nurses are correct, we only need to establish as a fact that the nurses claimed that it is a fact. Or do you disagree? Gandydancer (talk) 00:56, 17 October 2014 (UTC)

""Many of the comments we have seen or heard in the media are only loosely based on fact, but are often out of context and sensationalized. Others are completely inaccurate," the hospital said - right from CNN a few hours ago. http://www.cnn.com/2014/10/15/health/texas-ebola-nurses-union-claims/index.html This story is moving fast and what is out there is changing. I think the only fact right now is that there is a controversy. The original claim a few days ago was not made by a nurse from the Dallas hospital but rather a union rep for a union that does not represent anyone at the hospital and had not been there. Only today it seems Briana Aguirre has gone public (she says she treated Ebola patients), but exactly what she is claiming I haven't looked into.

I agree this should be moved to the US article, this is only one situation compared to hundreds of health care workers that have already died in Africa so in context of the global focus of this article probably best not spend space on. I think care should be taken not to over-sensationalize this until some facts have been corroborated. I am not against mentioning the controversy in the US article Greenbe (talk) 05:47, 17 October 2014 (UTC)

This article takes special care to not ignore the infections of the hundreds of health care workers who have willingly exposed themselves to Ebola disease, and in fact we have devoted a section to that information. Regarding the mention of the allegations of the US nurses, I can hardly see that a one-sentence mention of their views would be considered over-sensationaling their accusations. As the main Ebola epidemic article, we are following the WP guidelines by mentioning the main points that are elaborated on in the splits. This issue has become a major issue in the US split; it has become one of the top news stories on every major US news source. Gandydancer (talk) 16:21, 17 October 2014 (UTC)

Agree with Gandydancer. Mentioning what the nurses have said was their experience, especially given that two of them have now contracted the virus, is definitely not 'sensationalising' it in any way. Also these are not allegations by the nurses. That's politicized language. The sources use, 'said' as in the 'the nurses said.' Dr. Gupta used the term 'claim' wrt the nurses' union statement, which could be seen as a claim, since they were not directly involved. The nurses actually involved in Duncan's care, went to the nurses union to ask the union to speak up for them because they feared losing their jobs if they came out directly. The hospital used protective gear based on the CDC guidelines which were inadequate. This explains why two of the nurses have contracted the Ebola virus. That's not an allegation, btw, that's a medical fact. SW3 5DL (talk) 16:58, 17 October 2014 (UTC)

Please assume WP:AGF before you imply I am politicizing something that will not need any help in that regard from me. The word "allegation" came directly from the LA Times article, which I thought did the best job of explaining the Nurse union claim/allegation. "The allegations, made under unusual circumstances, provided the first detailed portrait " - LA Times. The word "allegation" does not appear in the main WP article, only in Talk. I am fine with "claim" or "says". As for the substance, I watched the whole Briana Aguirre interview now. She is claiming/saying many very specific things that could be easily corroborated if someone investigates. Why more people aren't coming forward, including Nina Pham, is unclear. I expect that will change. This topic is covered in detail in the US article and I still think in this article no more is needed than "a controversy has erupted in the US over whether the Dallas hospital and CDC is responding adequately to the Dallas cases." Let's not get US centric, that is my opinion.Greenbe (talk) 01:30, 18 October 2014 (UTC)

Keep an eye out on new guidelines for from the CDC for protection.[2][3]. i will add it later today when i get back from hospital... /New guidelines on protection No skin may be exposed and some additional protection issues...BrianGroen (talk) 05:51, 20 October 2014 (UTC)

I'd be interested to see your take on that. I read the CDC guidelines last week (they seem to go back a few years), my take is that they were actually a bit vague. They never said you need to be covered in head-to-toe impermeable covering as much as I could tell but I'm not a professional in the field I could not interpret. WHO seems to quote the same text. If these guidelines are wrong, is this one factor in the 100s of healthcare worker deaths in this outbreak? I read the research on the original 1976 Zaire outbreak, and reuse of needles was proved as a major factor in propagating the infections. And all the guidelines prohibit reusing needles, but maybe they have been too lax on the PPE?Greenbe (talk) 21:10, 20 October 2014 (UTC)

Norway

Here is the section on Ebola virus epidemic in West Africa#Norway:

"On 6 October, MSF announced that one of their workers, a Norwegian national, had become infected in Sierra Leone. Special facilities at Oslo University Hospital are being prepared for any Ebola cases.

On 7 October the Norwegian woman arrived in Norway and is being treated in the Ullevål University Hospital by a team of 23 specially trained nurses and two doctors. She is currently in stable condition and has shown signs of improvement. The Public Health Agency of Canada sent ZMab, a precursor of ZMapp used for testing in laboratory animals, to Norway, and it may be used to assist in her treatment.

On 20 October, MSF and Ullevål University Hospital announced that the woman had been successfully treated and was discharged. Her identity was also released."

Considering the information that was just added in the third paragraph, I think the other paragraphs may need updating, specifically:

• First paragraph: Even though it's a different hospital, don't you think the special facilities at Oslo University Hospital have already been set up? Perhaps "are being prepared" can be changed to "have been prepared".

• Second paragraph. Perhaps the second sentence can be deleted now that she has recovered and been released from the hospital, and the third sentence, about what was used in her treatment, can be updated, to perhaps "was used in her treatment". CorinneSD (talk) 15:53, 20 October 2014 (UTC)

Thanks Corinne. I rewrote the section. Gandydancer (talk) 18:13, 20 October 2014 (UTC)

Corinne, thanks for copy editing my rewrite and you certainly need never think that I might be offended. My writing is passable but far from really great. We've all worked very hard on the article, and want to be proud of it. IMO you and Art are the ones who have turned a good article into a great article, and I am very grateful. Gandydancer (talk) 13:01, 21 October 2014 (UTC)

HE he i think CorinneSD pulls her hair out when she see my bad English here...BrianGroen (talk) 17:43, 21 October 2014 (UTC)

Thanks, Gandy. Brian, I liked your edit summary, "Oopops fixing". I know it was a typo, but it was cute. (Maybe "oopops" is the plural of "oops".) You're doing a great job updating all those details. CorinneSD (talk) 20:55, 21 October 2014 (UTC)

guinea numbers

cases DECREASED from 14th to 17th? — Preceding unsigned comment added by 162.119.232.104 (talk) 20:14, 21 October 2014 (UTC)

It's probably best to view the WHO data as an estimate. It's most likely somewhere between what they report and 2x that. | How many Ebola cases are there really? Snd0 (talk) 01:11, 22 October 2014 (UTC)

Numbers due sometimes fluctuated especially interim reports..BrianGroen (talk) 06:23, 22 October 2014 (UTC)

Perhaps it is best to remove the data of 14 October altogether as the data from both Guinea and Liberia are suspicious, and as we have 12 and 17 October anyway. --Voorlandt (talk) 12:47, 22 October 2014 (UTC)

For the weekly graphics I need the values from Sundays, if there are no Sunday values I have to interpolate them. As long as not 12 October is removed, I can live with removing 14 October. Malanoqa (talk) 14:10, 22 October 2014 (UTC)

Thanks, I have removed 14th now. Numbers were obviously way off (at least inconsistent with the 12th and the 17th)Voorlandt (talk) 20:19, 22 October 2014 (UTC)

Hi Voorlandt thanks for removing, was to off for me as well.. Besides Liberia only had one days figures.. BrianGroen (talk) 08:08, 23 October 2014 (UTC)

Article structure once things die down?

We might be a long way off from this, but what changes do you guys anticipate we'll need to make to the page once the outbreak either dies down or becomes a series of events that go beyond the scope of this particular page? MrHassanSan (talk) 03:41, 23 October 2014 (UTC)

HI MrHassanSan we'll cross that bridge if /when we get there... best call..(on the armed horses) greetings BrianGroen (talk) 11:35, 23 October 2014 (UTC)

I concur, one does not know which way this could go--Ozzie10aaaa (talk) 15:49, 23 October 2014 (UTC)

It is hard to know, neigh impossible to know... Gandydancer (talk) 16:42, 23 October 2014 (UTC)

Nigeria section

On 9 October the European Centre for Disease Prevention and Control (ECDC) acknowledged Nigeria 's positive role in controlling the effort to contain the Ebola outbreak in this country. "We wish to thank the Federal Ministry of Health, Abuja, Nigeria, and the staff of the Ebola Emergency Centre who coordinated the management of cases, containment of outbreaks and treatment protocols in Nigeria." Nigeria's quick responses in isolation all cases within three days were of particular importance in controlling and limiting the outbreak according to the ECDC.

[cite web|url=http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20920%7Ctitle=TRANSMISSION DYNAMICS AND CONTROL OF EBOLA VIRUS DISEASE OUTBREAK IN NIGERIA, JULY TO SEPTEMBER 2014 |publisher=European Centre for Disease Prevention and Control|date=9 October 2014|accessdate=18 October 2014]

I think this is worth a mention as the swift reaction of Nigeria halted the spread with great care.. THE European CDC credits them for that... thoughts.. BrianGroen (talk) 05:08, 19 October 2014 (UTC)

Agreed. The Nigerian response was absolutely astounding: a country with only a fraction of the resources found in the West, dealing with an outbreak in a densely populated urban area with significant poverty, reacted with what should now become a textbook example of how to contain an outbreak and stop it from becoming an epidemic. Perhaps the Nigerian public health planners (and their advisers such as the Special Adviser on Public Health for the Lagos stage government Yewande Adeshina) should now be invited by the CDC to help them in the U.S. -- The Anome (talk) 12:03, 19 October 2014 (UTC)

Hey, guys. As of today, Nigeria has been declared Ebola-free, could someone note that? — Preceding unsigned comment added by 73.34.74.251 (talk) 12:39, 20 October 2014 (UTC)

done Art LaPella (talk) 14:27, 20 October 2014 (UTC)

Let's not get too exited with these temporal, ephemeral pieces of good news -- this outbreak is far from over, and if the disease enters Mali and especially the Ivory Coast (likely at this point), Nigeria will soon be dealing with it again, and this time on a scale it cannot begin to address.--Froglich (talk) 18:12, 23 October 2014 (UTC)

New PPe guidelines

The CDC have released the new guidelines.. it is a big change but i will attempt to get to it (will add it to EBV main page...More relevant)..Just need to summarize it all.. Also new travel guidelines...only 5 US airports allowed to receive west Africa flights..Will add that here BrianGroen (talk) 06:49, 22 October 2014 (UTC)

I question the addition of US travel restrictions since we are not currently reporting the travel restrictions of other countries - though I could have missed it... Gandydancer (talk) 18:35, 22 October 2014 (UTC)

Hi gandy Gandydancerdecided to add it there on us page...GreetingsBrianGroen (talk) 11:33, 23 October 2014 (UTC)

OK, good. Gandydancer (talk) 16:47, 23 October 2014 (UTC)

Travel restictions are a nuisance, there are 196 countries in the world and I expect every one of them has some kind of restriction by now. Covered (very briefly) in the "Responses" page.Robertpedley (talk) 20:15, 23 October 2014 (UTC)

Archiving

This article is set to archive every four days. That seems too quick to me. Thoughts? Gandydancer (talk) 14:21, 22 October 2014 (UTC)

once a week,maybe better?--Ozzie10aaaa (talk) 16:32, 22 October 2014 (UTC)

I've slowed the archiving pace.--Froglich (talk) 20:52, 23 October 2014 (UTC)

RfC: Is Senegal still relevant in table or can i drop it

Should the Senegal total s still remain in Timeline table or can i clear this section since the outbreak is declared over. Just add a general note omn top. I think keeping it for one case is not worth it. Comments will be appreciated. I can use this space for confirmed cases instead. BrianGroen (talk) 06:02, 18 October 2014 (UTC)

Do we need an RfC for this? Just ask the question and there should be plenty of response here. - Floydian ^τ _¢ 07:24, 18 October 2014 (UTC)

Hi Floydian thought rfc better way so i can get consensus to add lab confirmed cases to table. greetings Brian BrianGroen (talk) 10:05, 18 October 2014 (UTC)

Remove both Senegal and Nigeria -- put the data somewhere else, but not in this article. Both of these countries have stable situations. Shii (tock) 15:56, 18 October 2014 (UTC)

drop it (Senegal); though it might be useful as a reference --Ozzie10aaaa (talk) 17:00, 18 October 2014 (UTC)

The table is currently titled "Casualties", which implies all Ebola-related deaths will be tallied there. Either Senegal should stay (and be marked as "Outbreak ended" or something, and other countries can go there if their outbreaks end), or the table should be renamed "Active outbreaks". Xqxf (talk) 17:14, 18 October 2014 (UTC)

The article is about the whole outbreak in West Africa in 2014, and is as much about the history of the outbreak as it is about its current status. The tables show how the total number of cases and deaths associated with the outbreak have progressed over time. This information will be relevant to the article even when the outbreak is over. The Senegal statistics, small though they may be, will remain part of that history. If the Senegal entry were removed now, there would be no reason to retain any of the other columns in the table either once the outbreak was over. But doing so would remove a significant part of the historical record. For the time being, I believe the Senegal (and other quiesced) columns should be retained, perhaps in another table and/or perhaps just in the Archived section as and when that is extended. Kirbett (talk) 21:37, 18 October 2014 (UTC)

• Keep Senegal possibly revisit later. It's data, so deleting it doesn't seem right. Later, if Senegal/US/Spain terminate but many other countries pop up, then we might make an other countries column. In a way, Nigeria and Senegal are reassuring columns because the disease was controlled/stopped in parts of W. Africa. Adding confirmed cases to the table is a separate issue that needs more thought. I considered doing it a couple months back when I was trying to sort out inconsistent numbers, but didn't because it was more detail with little impact. The table sort of corrected for it later when the number of cases declined (not so true now because the numbers are larger and mask declines, but note Sengal dropped from 3 cases to 1 case). The question is how significant is the confirmed case distinction? I don't know. Glrx (talk) 17:02, 19 October 2014 (UTC)
  • How about moving the columns with less than 30 cases to a separate table? Simply so our poor readers don't have to scroll around as much when reading. Shii (tock) 20:00, 21 October 2014 (UTC)

I went and done it. Shii (tock) 22:28, 23 October 2014 (UTC)

NYC doctor tests positive for ebola

http://www.nytimes.com/2014/10/24/nyregion/craig-spencer-is-tested-for-ebola-virus-at-bellevue-hospital-in-new-york-city.html — Preceding unsigned comment added by Rsskill (talk • contribs) 00:43, 24 October 2014 (UTC)

Confirmed case in Mali

http://www.bbc.com/news/world-africa-29750723 looks like another country must be added 84.52.48.213 (talk) 21:47, 23 October 2014 (UTC)

It should be listed as an index case, as there has not yet been any transmission within Mali. — Preceding unsigned comment added by 129.59.122.15 (talk) 00:16, 24 October 2014 (UTC)

It seems Mali has been added already. Supersaiyen312 (talk) 03:51, 24 October 2014 (UTC)

Nigeria + Senegal clear as of "29 October 2014"?

Following a 42-day waiting period, both countries were declared disease-free as of 29 October 2014.

Surely this date is wrong? Evercat (talk) 12:40, 24 October 2014 (UTC)

I've fixed this. Mark M (talk) 18:43, 24 October 2014 (UTC)

cases table, division

is it wise to split the cases table in two, whatsmore splitting them into major and minor ?--Ozzie10aaaa (talk) 22:22, 23 October 2014 (UTC)

Move it entirely to the sub-article created for this purpose. ZeLonewolf (talk) 02:12, 24 October 2014 (UTC)

Jimbo was using this article for the cases table though. :) The table was too big Shii (tock) 03:23, 24 October 2014 (UTC)

I think the split was wise; there is a huge gulf between the worst country which had local transmission (Nigeria) and the three countries where the epidemic is more or less uncontrolled. Titanium Dragon (talk) 21:41, 24 October 2014 (UTC)

Treatment section

A very large map called "Ebola virus disease in West Africa" has been placed in the treatment section. I can't see how it has anything to do with treatment. Could this be moved, please? Gandydancer (talk) 10:56, 25 October 2014 (UTC)

Someone (Brian?) made the map smaller - this does help. Gandydancer (talk) 15:21, 25 October 2014 (UTC)

why are Doctors Thomas Frieden and Anthony Stephen Fauci not mentioned anywhere in this article?

they have been very deeply involved in this 2014 crisis and situation, and both testified in the United States Congressional hearing on the Ebola crisis (on October 16th 2014). Why is there zero mention of these two doctors, Dr Frieden and Dr Fauci, in this article? Arguably there should be, at least something. Given their heavy involvement in this matter. Regards. Gabby Merger (talk) 19:46, 16 October 2014 (UTC)

Hi Gabby Merger agree will see what i can do tomorrow... Night time buy me..greetings Brian. BrianGroen (talk) 20:17, 16 October 2014 (UTC)

For now, Frieden is already mentioned at Ebola virus outbreak in the United States. Art LaPella (talk) 20:34, 16 October 2014 (UTC)

That's fine, Art, but Frieden should be mentioned somewhere in this article too. And Dr Fauci also, who is not even in the "United States" article. Fauci has been in interviews galore regarding this, is a well-established immunologist etc, and testified in the Congressional hearing today regarding this. Regards. Gabby Merger (talk) 21:19, 16 October 2014 (UTC)

In my opinion, they should not. The article, as of now, is about the West African outbreak. Yours is an American perspective.

Given that the US political silly-season is upon us, I would just as soon not see Frieden (or other Obama-appointed bureaucrats & critics assorted) mentioned, as it would attract a certain species of editor to the article like flies to manure. (So, agreed, albeit for different reasons.)--Froglich (talk) 18:23, 23 October 2014 (UTC)

Zezen (talk) 21:57, 16 October 2014 (UTC)

The problem with your position, Zezen, is that it forgets that the "American perspective" STEMS from the West African situation, since the spread of the disease ORIGINATED from West Africa to begin with. Plus the fact that this is a GLOBAL WORLD...and with speedy travel and communications, etc, every nation is in some way inter-connected. The "American perspective" is not from some isolated thing out of nowhere. But from the outbreak in West Africa, in the first place. Duncan came from West Africa, somehow got to America, and infected a few others in America. It's all related. Regards. Gabby Merger (talk) 04:13, 17 October 2014 (UTC)

We have plenty of articles about various aspects of Ebola. This specific article is about the epidemic in three West African countries, Gabby Merger, which involves roughly 10,000 cases. Those two physicians certainly deserve to be mentioned in our coverage of the (as yet) very small Texas outbreak, but how, precisely, are they significant to the story of the main West African epidemic? Should we also mention the leading public health physicians in the several other countries in Europe and elsewhere, that have a handful of Ebola cases, in this article about West Africa? If so, why? Cullen³²⁸ Let's discuss it 04:49, 17 October 2014 (UTC)

Support sorry personal opinions of "American perspective" aside, these two doctors were the main reason we have a massive influx of US help in Africa, and defiantly deserve a mention..BrianGroen (talk) 05:01, 17 October 2014 (UTC)

I strongly agree with Gabby and Brian. Gandydancer (talk) 06:48, 17 October 2014 (UTC)

I agree that mention of Drs. Fauci and Frieden is appropriate here, but mention should be confined to the specifics about their efforts in West Africa. Any info on them wrt the U.S. outbreak belongs on that article.

Will get on it, let me just do research on their African input. Any USA info i will add there...BrianGroen (talk) 19:38, 17 October 2014 (UTC)

Please do mention fAUCI AND fRIEDEN. But not to bame drop integrate it into the text. Yes they are big players in the African scene, they meet WP:NOTWikidgood (talk) 00:39, 18 October 2014 (UTC)

1) Americanization. 2) Plenty of other guys working hard in Uk, France, Geneva etc to mobilise support. 3) This page is obout the epidemic, not the doctors, not the political lobbyists, not the drug companies. Fauci & Freeden, if they are worth their salt, would agree. Robertpedley (talk) 20:11, 18 October 2014 (UTC)

Sorry, Robert. They should at least have PASSING mention somewhere in this article. America and the UN are the MAIN entities helping out in West Africa. More than France or Switzerland. The UK is the only other country that comes close. So Brits should be mentioned here too. England, America, and the United Nations. It's a global thing, and there's heavy involvement. Regards. Gabby Merger (talk) 23:56, 18 October 2014 (UTC)

• !

This discussion got archived, but I dont think it is over. Gabby has now added 2 extened paragraphs about Fauci & Frieden nto the page, well out of proportion to the general content in this article. Opinions were

• Pro - Gabby, Wikidgood, Gandy, Brian
• Against - Robert, Art, Cullen, Zezen

It looks like a draw to me, so I shall revert the edit due to lack of consensus. I would not have objected to a sentence or two but the current content is way too long. Does anyone know how to et up a dispute resoultion process? Robertpedley (talk) 09:44, 22 October 2014 (UTC)

I pointed out where Frieden was already mentioned. I don't consider that an oppose. Art LaPella (talk) 13:52, 22 October 2014 (UTC)

Please strike what I may have said - too late at night or too early in the morning? IMO that info is better put in the US article than this one. Note also, that I opened a new thread re this info and only one editor replied. After 24 hrs I took that to mean agreement and deleted the detailed info. Gandydancer (talk) 14:03, 22 October 2014 (UTC)

Sorry, Gandydancer I'm on holiday, missed your other thread. Not sure if Art is in favor or abstaining, but I think the score now is

• Pro - Gabby Merger, Wikidgood, Art LaPella, BrianGroen
• Against - Robert, Gandydancer, Cullen328, Zezen

Still no consensus - and no comment here from Gabby - so I shall remove it again. Robertpedley (talk) 17:49, 22 October 2014 (UTC)

And Ozzie agrees on removal as well. Robert you have been reverted, I will go back to the previous version. The US article is in very good shape and well-able to cover this sort of information. Gandydancer (talk) 18:23, 22 October 2014 (UTC)

It's NOT a "draw". There's more that support than oppose. Because Art, by his own words above, said that he was NOT "opposed", just because he said that "Frieden" was somewhere. So it's more like

:*Pro - Gabby, Wikidgood, Gandy, Brian, Art

:*Against - Robert, Cullen, Zezen, Gandydancer

Also, to the point about "too long", that's fine, so Wikipedia policy and recommendation is to TRIM OR MODIFY, and to not necessarily wholesale remove. So even with that, the total deletion was arguably not really warranted. But overall, in this section and thread, more editors support than oppose. Regards. Gabby Merger (talk) 19:44, 22 October 2014 (UTC)

I did mean "abstain", as I habitually don't take sides in this kind of Wikipolitics. Art LaPella (talk) 20:04, 22 October 2014 (UTC)

Fair enough. So I'll modify what's going on with this (sighs and double facepalm, since this should NOT warrant all this what-to-do...and I can't believe that it is...since the Frieden and Fauci stuff could have been TRIMMED instead of totally removed, etc)....

:*Pro - Gabby, Wikidgood, Gandy, Brian

:*Against - Robert, Cullen, Zezen, Gandydancer

:*Abstain - Art

The point is that if there was overall support or at the very least a strong draw, etc, tie should go to runner, as in baseball, and the Fauci and Frieden stuff should stay (albeit in maybe modified or trimmed form). Regards. Gabby Merger (talk) 21:10, 22 October 2014 (UTC)

I just read the above exchanges. I don't understand how this got to be an either-or situation -- either remove everything Gabby Merger wrote or leave it all in. I think a brief mention of Dr. Fauci, Dr. Frieden, or both would be appropriate if it fits in with the rest of the content of the article and has a connection with the epidemic in West Africa. I just looked at the two paragraphs in question. The information about Dr. Frieden seems more specific to the United States; it is about what happened at the Dallas hospital so seems more appropriate for the other article. The information about Dr. Fauci is more pertinent since it deals with screening of people wishing to travel to the U.S. from West African countries. Let's face it, the epidemic has spread, even if only slightly, outside of West Africa, so to argue that, if information is not specifically about West Africa it doesn't belong in the article, is wrong. I can also understand the other point of view: if top experts in other developed nations are not mentioned, the article could be seen as being American-centered. The relative amount of support being supplied by each country should not be the only criteria. Relevance is more important. Would anyone go along with including some information about Dr. Fauci? I'll copy the paragraph here so you can look at it:

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said "discussion is underway right now" and "all options are being looked at." Dr Fauci told CNN that clear-cut screening is being implemented on the exit end, referring to the Ebola-affected countries' practice of screening outbound passengers before they leave. The current U.S. discussion, he said, centers on "what kind of screening you do on the entry end. That's something that's on the table now." On 16 October 2014, at a United States Congressional hearing regarding the Ebola virus crisis, Dr Fauci warned that drug companies were still some distance from producing sufficient quantities for widespread trials.

If you look at this paragraph, overall it is not a very cohesive paragraph. You'll see that the first sentence is a bit vague and general; perhaps that could be left out. The second part is about screening, which I think is relevant, and there may be more up-to-date information about that. The third part is about the availability of drug treatments; that seems relevant, but perhaps belongs in another section. So, in sum, a little information, the most relevant, about Dr. Fauci, placed in the right place in the article, seems appropriate to me. CorinneSD (talk) 00:59, 23 October 2014 (UTC)

I have been through this article many times as the disease has progressed from a few hundred cases to thousands of cases. As more important information emerges, information of lesser importance obviously needs to be cut or the article would grow to an unacceptable length. I have come to the point where I have cut the names of everyone except Margaret Chan of the WHO and the names of presidents of their individual countries when I come across them in a review. I see no reason to include Dr. Fauci's or Dr. Frieden names. I don't think it's needed and I also don't think it's right to appear to suggest that one country's head of this or that health department is more notable than that of another. As for the info on screening, we have a good US article that is well-kept and up-to-date, thus there is no need for that info in this article which, IMO, would also seem to suggest that the US was special and we needed to discuss its travel restrictions while not including that info in the other country articles that have splits. That is not to say that IMO it could not be included under "Travel restrictions and quarantines", but that would take a fair amount of work/time to get it done right - besides the concern about the length of the present article. I did use the Dr. Fauci source and add info to the Treatments section. While IMO it was not needed, I think that it improves the section even though (IMO) it only says the obvious. I want to make something very clear: I do NOT like to delete the work of others - I hate it. It is not any fun at all to suggest that I know better than another editor what this article needs and what it doesn't need. Sometimes rather than delete I go through the ref and see if I can improve what I may find fault with, but there is not always time for that. In this case I felt that the info was either not appropriate for this article or already covered. I'm sure that there is plenty of room to improve this article, but on the other hand there is not plenty of room to fit it all in. Gandydancer (talk) 12:18, 23 October 2014 (UTC)

O.K. I have been persuaded that you are right. CorinneSD (talk) 19:40, 23 October 2014 (UTC)

First of all, Gandydancer, America IS ahead (at least in certain ways) in taking the lead on this matter. Whether you happen to like that fact or not is irrelevant. It happens to be (in many ways) a fact. But even if it wasn't, what is so wrong in giving at least brief or trimmed mention to Frieden and Fauci in this article, since they definitely were involved in all this? The whole thing is CONNECTED, since it originated in West Africa. And America is definitely heavily involved. Arguably (in a way) more than other countries. Against, whether Gandydancer personally likes that fact or not, is immaterial. It is what it is. And again, even if that wasn't so, they are still definitely heavily involved...and it stems from the West Africa situation. It didn't have to be all or nothing, like you kept uptightly doing. (To be frank.) You could have modified, changed it, or trimmed it. Instead of wholesale removing it. WP suggestion is really to NOT do what you did. But to modify, alter, or touch up, or trim. Good day. Gabby Merger (talk) 23:16, 23 October 2014 (UTC)

Gabby, I think the other editors have carefully considered your suggestions and they have either given respectful alternatives, or given good reasons for not accepting them. Please remember that Wikipedia works on a principle of consensus WP:Consensus. Robertpedley (talk) 21:16, 24 October 2014 (UTC)

Robert, there IS NO CONSENSUS "against" having those names in the article somewhere to any degree. It's a DRAW. Count the numbers. It's even and equal. So what do you mean by "consensus" exactly? There's no majority against with this. It's even...a draw. So you don't need to lecture me. Learn to count. There's no "consensus" with this matter. Thanks. Gabby Merger (talk) 23:46, 24 October 2014 (UTC)

Comment: I oppose inclusion of about 95% of the trivial cruft in this article (to include names of lesser-notables, and the nitty-gritty of who got sick when/where/why)....for the simple reason that over the course of the next two years (which is my OR guess as to how long this plague is going to run, at minimum) they're all going to be eventually junked anyway as a greater volume of bigger-ticket items crowd them out. In the end, the page will be similar to the 1918 flu pandemic article.--Froglich (talk) 10:09, 25 October 2014 (UTC)

Comment: I agree with User:Froglich User:Gandydancer User:CorinneSD and other and oppose inclusion of the Nurses union story, Dr. Fauci and other peoples names other than other than a handful of the initial case patient names as has been included for all countries. CDC does have a large role (maybe outsized role?) along with various organizations in many countries in the initial discovery of Ebola, isolating several of the virus species, and ongoing containment efforts. Yet IMO day-to-day pronouncements are not relevant unless they are crucial to understanding the situation in areas where >99.9% of the cases occur. All such day-to-day and US controversy is exceptionally well covered in the US article.Greenbe (talk) 17:44, 25 October 2014 (UTC)

Gabby Merger, are you now persuaded by the arguments of User:Gandydancer, User:Froglich, and User:Greenbe? Let's preserve a sense of collegiality. Don't feel ganged-up upon; you're part of the group. What do you think? CorinneSD (talk) 19:21, 25 October 2014 (UTC)

??? "Ganged up on"? That would be the case if I was the only one who had this position. But I'm clearly not. I was making the point that it seemed fitting that at least SOME mention of Frieden etc should be somewhere in this main article, because of their heavy involvement in the overall matter. I'm not persuaded otherwise, because it's simply a fact. Stop assuming. This has gotten ridiculous. And you notice that I have not put anything back onto the article in days and days now, because I don't really care much anymore. It's NOT worth all this hassle. I kind of moved on already in that sense. I just find it silly that there's this what-to-do goof-tarddery over something so minor, and so obvious. Frieden and Fauci should have at least passing brief mention, in this article, period. For the reasons I stated above, which please re-read. Gabby Merger (talk) 21:13, 25 October 2014 (UTC)

Gabby, People aren't exhibiting 'gooftarddery.' You were telling people to learn to count bc if they could add they would see your opinion was in the majority, but you incorrectly included Gandy in the Pro column, and even if he were (which he wasnt), you were not ahead; so even at that point the majority was against you. I agree with others like Greenbe, so now the count is 8 to 3 against your opinion.JustinReilly (talk) 22:16, 25 October 2014 (UTC)

Yeah, the Gandy inclusion was a mistake. That's true. But I did not say recently (if you read all my comments carefully) that there was recently "more" on my side. I said clearly in my last few remarks the last few days that it was a DRAW. But ALSO, even if it's not, the point stands (which I'm NOT even pushing anymore as far as actual edits, for a while now), that arguably some mention should be made of Frieden and Fauci in this article, where the USA is mentioned. It seems a bit incomplete in a way that they aren't. But of course I respect consensus. Even when it's wrong. Cheers. Gabby Merger (talk) 22:31, 25 October 2014 (UTC)

Map key colour consistency

Is it possible to have consistency in the map key colours?Akinsope (talk) 20:30, 25 October 2014 (UTC)

The colour scheme in the main map at the top is unclear. However there is a much better key in the global map further down the page.

Would it be possible to use the key structure from the global map i.e. the one showing the following: 1) Widespread transmission, 2) Local transmission, 3) initial cases - deaths, 4) initial cases no deaths, 5) medical evacs death, 6) medical evacs no deaths, 6) Ebola free. For the purpose of the map key in the first map perhaps certain key categories could be omitted if they are not applicable to the countries indicated.

A lot of people are referring to this page around the world and are not really reading further down the page to see the current factual status. This is impacting people's lives as the media spreads misinformation.

A clearer key on the first map people see or even a better presented map could make a huge difference.

Akinsope (talk) 20:29, 25 October 2014 (UTC)

Perhaps, keep it simple: one color for countries active cases, and another color for countries that have contained the outbreak. In any case, if we're going to use color, please for sanity's sake can we have a legend? ZeLonewolf (talk) 21:09, 26 October 2014 (UTC)

And we made the news

To All here, rthis credits all the editors on a job well done...Wikipedia Is Emerging as Trusted Internet Source for Information on Ebola [4] BrianGroen (talk) 05:47, 27 October 2014 (UTC)

Bold-Revert-Discuss cycle regarding the exceptional character of the epidemic

So having noticed that one of the notable characteristics of this outbreak/epidemic cycle was not mentioned in the article, I put in a line to the effect that the current epidemic was notably not in a geographic zone in which previous outbreaks outbreaks had occured. This is of course a paramount and notable feature and its lack of mention was a normal oversight as people hustled to put quality information up onto mainspage. And I would add that overall a remarkable job has been done. I have had a number of edits go through on this and related pages and there has been some in depth discussion related to issues of framing, nomenclature and stigmatization.

Here I am seeking some feedback on this edit cycle. I am pleased to see that the point about the epidemic being notably in a new geographic zone has survived at least had survived and as far as I know is still in mainspace, as well it should be. But I think that there needs to be some kind of adjective so that lay readers who are not following epidemic history understand that this is not a bland unimportant fact.

There was a partial revert which is actually somewhat amusing. This edit left my main point unmolested, to wit, that the epidemic is widespread and in unprecedented areas etc. But the editor took out the phrase used to alert readers to the heightened importance of that factoid. Admittedly there are better was to state it, and I will go ahead and try something else, per WP:BRD, and this section serves the"D" function if anyway cares to make suggestions.

Please note that there are RS's who have characterized the epidemic as alarming, disturbing, unprecedented and so forth. So it is not "editorializing" on my part to so assert. It might have been more appropriate to put a "Citation needed" tag after the word I chose, which is that this is "disturbing" in that these areas had heretofore not been considered to be at risk of Ebola. But it is obviously not just a dull factoid of no importance. The fact that some factor, be it fruit bat flight patterns, air travel, monkey meat marketing or "the swamp gas/space aliebs/flouridated water" - something different has happened to activate pathogenic EBV in these areas. This is prima facie alarming, disturbing and unprecedented as tons of WP:RS attest.

So while I understand the intent of the reverter and of course WP:AGF, I will have to proceed per WP:BRD to have the mainspace reflect the RS. Let's not pretend that the proliferation of Ebola disease is somehow NOT unprecedented, alarming and disturbing. It is not our job to sensationalize but neitheris it our job to take a vital concern of our times and render it as a dessicated topic like programming assembly language, therules of civil procedure, or air conditioning repair. The Ebola epidemic is an epic drama of heroism and sacrifice and the fate of nations lies in the balance. It is not "editorializing" to present Wikipedia content in a neutral, truthful and reliable manner reflecting the humanitarian concern at the heart of the Ebola response. Wikidgood (talk) 22:52, 19 October 2014 (UTC)

I have not been adding content to the article as others have, but I can speak to the choice of words. The guideline is at WP:EDITORIALIZING, which I will copy here:

"The use of adverbs such as notably and interestingly, and phrases such as it should be noted, to highlight something as particularly significant or certain without attributing that opinion should usually be avoided to maintain an impartial tone. Words such as fundamentally, essentially, and basically can indicate particular interpretative viewpoints, and thus should also be attributed in controversial cases. Care should be used with actually, which implies a fact is contrary to expectations; make sure this is verifiable and not just assumed. Clearly, obviously, naturally, and of course all presume too much about the reader's knowledge and perspective and are often excess verbiage. Wikipedia should not take a view as to whether an event was fortunate or not.

More subtly, editorializing can produce implications not supported by the sources. Words such as but, however, and although may imply a relationship between two statements where none exists, perhaps inappropriately undermining the first or giving undue precedence to the credibility of the second."

I have placed in bold face type what I think is the pertinent sentence. One can substitute "disturbing" for "fortunate" in that sentence. I think words that convey emotion such as "disturbing" and "appalling" are not appropriate. However, words such as "unprecedented", "unusual", "highly unusual", and "unexpected" might be appropriate because it is possible to support these with facts. The best course, I think, would be to quote or paraphrase an expert or the WHO here. I agree with your point that this unusual aspect of this outbreak should be mentioned. I'm sure things have been said about the very thing you wish to highlight. CorinneSD (talk) 23:32, 19 October 2014 (UTC)

Calling something "disturbing" is a value judgment which should not be made in Wikipedia's editorial voice. This is another case of the "Hitler was evil" rule -- yes, we know Hitler was evil, but it's not our job to make that observation directly, and you won't find it in that article: we just report the facts that lead to that conclusion. The same applies to this epidemic: we should report the facts about it, of which there are many that are indeed really disturbing, and let the reader form their own judgment.

On the other hand, we can certainly quote other significant sources describing it as such per WP:NPOV, and as CorinneSD says above, words like "highly unusual" or "unprecedented" would be fine to say in Wikipedia's editorial voice, because they can be backed up with factual references, -- Impsswoon (talk) 13:26, 20 October 2014 (UTC)

I reviewed the lead and I think all the text in there is fine. But I would vote to reorder the second paragraph first to emphasize the severity of the outbreak, which is the most important thing about it to a new reader. Specifically take "is the most severe outbreak of Ebola since the discovery ...." from the 2nd paragraph and precede and insert as second sentence 1st paragraph as "It is the most..." and continue with the rest of the 2nd para and make 1st paragraph second. I wouldn't change anything else but to me that way it flows better. Greenbe (talk) 02:47, 21 October 2014 (UTC)

OK, I did a trial lead change using Greenbe's suggestion and I really think it's a great improvement. What do others think? I did leave out the "by September the number exceeded all previous..." since we already said it's the worst, we don't need to repeat that fact. Gandydancer (talk) 12:20, 21 October 2014 (UTC)

(1) Just a quick questions regarding this clause: "since the identification of ebolaviruses in 1976". Were several ebolaviruses discovered in 1976, or was one ebolavirus discovered in 1976 and others after that? Normally, one thing is discovered for the first time -- ie., the ebola virus -- with the discovery of specific strains following that discovery. What is the case here? Just thought the singular/general "the ebola virus" would sound better, but if that's not correct, we'll just leave it as it is now. CorinneSD (talk) 21:08, 21 October 2014 (UTC)

Answer: 2 species (members) of the genus Ebolavirus caused the 1976 outbreaks. The Sudan specie in south Sudan, the Zaire specie in DRC (which was called Zaire at that time). It was two separate outbreaks barely a month or two apart in 1976, and about 1000km apart. The details of the separate species was only known later. If you read older literature on this it is very confusing because the taxonomy naming was changed in the last 10 years, and the names of the places after which everything was named also changed, and it took many years to figure out the details, and the word specie and strain are mixed up since it was all codified much later. Zaire species is the one responsible for this outbreak, and for most of the more deadly outbreaks. My understanding is there are sub-strains of Zaire in 2014, which do not get their own taxonomy, and that the two sub-strains caused two separate outbreaks in 2014. Late news is there is a new outbreak in DRC in August, also Zaire, and unknown which sub-strain until genetic mapping is done.Greenbe (talk) 18:30, 25 October 2014 (UTC)

(2) I made a few small changes to the wording. Hope everyone approves. I have a question about this sentence in the lead:

"Cases of secondary infections of medical workers in the United States and Spain have occurred, neither of which has yet spread to the general population."

Since the title of the article is "Ebola virus epidemic in West Africa", I wonder whether this sentence is appropriate for the lead. If it is important, then I wonder whether a few words could be added to the sentence to show the connection to West Africa. The way it is, the sentence gives no clue as to how they got a disease from a West African epidemic. Or perhaps it is felt that if a reader wants to know more, the reader can read on. CorinneSD (talk) 21:40, 21 October 2014 (UTC)

Corinne, re question #1 about viruses: Re the use of "the", see below:

• According to the rules for taxon naming established by the International Committee on Taxonomy of Viruses (ICTV), the name of the genus Ebolavirus is always to be capitalized, italicized, never abbreviated, and to be preceded by the word "genus". The names of its members (ebolaviruses) are to be written in lower case, are not italicized, and used without articles.

To go on:

• The genus Ebolavirus is a virological taxon included in the family Filoviridae, order Mononegavirales.[Kuhn, J. H.; Becker, S.; Ebihara, H.; Geisbert, T. W.; Johnson, K. M.; Kawaoka, Y.; Lipkin, W. I.; Negredo, A. I.; Netesov, S. V.; Nichol, S. T.; Palacios, G.; Peters, C. J.; Tenorio, A.; Volchkov, V. E.; Jahrling, P. B. (2010). "Proposal for a revised taxonomy of the family Filoviridae: Classification, names of taxa and viruses, and virus abbreviations". Archives of Virology. 155 (12): 2083–2103. doi:10.1007/s00705-010-0814-x. PMC 3074192. PMID 21046175.</ref> The members of this genus are called ebolaviruses.] The five known virus species are named for the region where each was originally identified: Bundibugyo ebolavirus, Reston ebolavirus, Sudan ebolavirus, Taï Forest ebolavirus (originally Côte d'Ivoire ebolavirus), and Ebola virus, formerly called Zaire ebolavirus. Both the Ebola virus and the Sudan ebolavirus were discovered in 1976 in separate outbreaks in Zaire (as it was then called) and in Sudan.

As for the wording in the lead, I'm not very good at wording and struggle to no end when I make my own edits. But I would have used different wording, and it would not contain "has not yet spread to the general population". (I believe that both the Spain and US outbreaks should be called "outbreaks" as part of the ongoing epidemic that began in Africa.) Gandydancer (talk) 02:48, 23 October 2014 (UTC)

Thank you Gandydancer +1 like to the structure of the new lead I think it reads much better. IMO it should stay as is and we can make minor tweaks as new info develops. Speaking of which, I think you need to add a short mention of the new DRC outbreak in the lead paragraph 2. http://www.cdc.gov/vhf/ebola/outbreaks/drc/2014-august.html which is a long distance from the other outbreaks.Greenbe (talk) 18:40, 25 October 2014 (UTC)

Greenbe, I think the lead is pretty good too but it does oddly jump into saying we have "Cases of secondary infections of medical workers in the United States..." without ever actually mentioning the US index case (and now we have a second person that caught the disease while in Africa)... I've tried to figure out a simple and short way to put it and have not been able to figure anything out... CorinneSD do you have any ideas? Re the DRC, it was in the lead while there was so much concern that it might be related but one no longer hears anything about it. I did't take it out but tend to agree with whoever did. You could bring it up for discussion if you feel strongly about it. Gandydancer (talk)

Greenbe I think it looks fine the way you did the DRC. I did change Mali back... Gandydancer (talk) 02:53, 28 October 2014 (UTC)

Should we back-bench the WHO as a RS?

Despite what I just said a few days ago, I think that in light of the following corruption, we should explore authoritative alternative sources to the WHO for casualty statistics, among other things. Additionally, this "Nero fiddled while Rome burned" behavior probably warrants mention (if it's not already in this, or another, article already).--Froglich (talk) 06:15, 27 October 2014 (UTC)

Well, A) tobacco kills more people than Ebola does, by several orders of magnitude, and B) by the sounds of it, it was them trying to get people to give them more money. It takes money to make money, as they say, and they can't just slide money around freely in many cases - most likely, the money was already apportioned out for the event. Plus, you know, people love to complain.

Calling it a "crisis" is a bit silly; it is typical media nonsense. And WHO ultimately gets their numbers from various other national organizations. A lot of people are fundamentally pretty ignorant about how organizations function; most organizations have budgets and other things and plan out stuff like this months in advance, and, as I noted, most likely it was an attempt to get more money for themselves for the cause of tobacco related deaths. People lose perspective on stuff; Ebola has killed fewer people - ever - than the US has die every year of the flu. It isn't that it isn't important, but... Titanium Dragon (talk) 06:26, 27 October 2014 (UTC)

This is an exponentially expanding epidemic with 70% (or greater) lethality for which no vaccine exists; there is absolutely no comparison to low CFR diseases such as the flu (for which vaccines do exist), let alone non-contagious habit-forming substances such as tobacco. And "It takes money to make money" is an axiom applicable to capital-investment, not bureaucratic corruption. In any event, the currently-used numbers suck anyway (even the WHO now says so).

-- Does MSF or anyone else on-site regularly publish estimates?--Froglich (talk) 06:43, 27 October 2014 (UTC)

I've seen quite a few folks making a similar comparison of Ebola with the deaths caused by Malaria - ignoring the exponential growth Ebola poses. And then I saw this quote "The “collapse” of healthcare systems in West Africa because of the Ebola outbreak could lead to thousands more people dying from malaria and other diseases, a leading expert has said, with the additional death toll from malaria and other diseases likely to exceed that of the outbreak itself..."[5] How then to assess casualty statistics ascribable to Ebola? Kirbett (talk) 14:08, 27 October 2014 (UTC)

Said "experts" don't know how to do math. The CFR of Ebola is 70% or higher. The CFR of malaria is 0.03%. To kill a million people with malaria, 333 million of them have to be infected. For Ebola to kill a million people, it need only infect 1.4 million. Given an exponential doubling time of three weeks and a current extrapolated actual estimate of cases of 25,000 (i.e., 2.5 x latest WHO), there are 50,000 cases in 21 more days, 100k in 42 days (Dec 9), 200k on New Year's Day, 800k mid February and 1.6 million by early-March. And that's assuming the actual doubling time remains only three weeks instead of reducing (since said doubling times represent the averaging of rapid blow-ups with "caught-it-in-time" medical smothers -- however medical logistics are a finite commodity whose efforts dwindle to an infinitesimal once an outbreak passes, well, about the current level of infection). Suffice to say that an out-of-control Ebola outbreak is a depopulationist's wet-dream.--Froglich (talk) 07:29, 28 October 2014 (UTC)

Its not a matter of WHO being RS or not. Good data on this epidemic just doesnt excist. Its not getting properly collected. Affected countries gobble something together and forward it to WHO. WHO sums it up, adds a note that the numbers are not exactly adding up and hey presto - sitrep. Cant find better source for data that doesnt excist.217.71.47.78 (talk) 21:16, 27 October 2014 (UTC)

@217.71.47.78: is correct in his view; there simply aren't better sources available for the data. WHO is collecting data as best they can, and there's no sign that they're unreliable in this instance. We know that the data is unreliable, but the source itself is reliable and is reporting that the data is unreliable, but it is the only data they've got. Titanium Dragon (talk) 23:31, 27 October 2014 (UTC)

IMO I agree with Titanium Dragon that for a combination of "only data we have" and no evidence to indicate they are have often been a materially wrong source in the past we need to stick with WHO (and CDC for that matter). If we later find another conflicting source we should discuss how to present it at that time. All points above well taken. The one thing we can and should do IMO is to try our best to add perspective. It's not malaria, typhoid or even measles as a killer, but it alarms people because they know how to protect themselves against those. Fact is unless you walk into the room of a known Ebola patient, statistically you are best off to spend your time worrying about lightning next time you see a cloud. Greenbe (talk) 02:22, 28 October 2014 (UTC)

I couldn't confirm the lightning statistic; you may have used different assumptions. 24,000 or 6,000 deaths worldwide per year from lightning. Using the higher figure, about 65 per day. Our table shows about that many Ebola deaths per day for the last few weeks. It also says the real figure is 3 times higher. And even that figure doesn't count people dying at home, to my knowledge, leaving me wondering if their professional pride allows them to give up and say "We don't know how many". And that's for the last few weeks, not the future. Maybe the epidemic is leveling off, maybe it will grow another order of magnitude or two, and just maybe an exponentially growing apocalypse is coming (yeah I know, they say you have to touch someone to get it, but several infections have happened under unexplained circumstances, and politics dictates keeping people happy for now.) Art LaPella (talk) 03:06, 28 October 2014 (UTC)

Reminder: only WHO (or other govt.) tallies for totals

Recently an editor has been attempting to include, as a source, a Liberia "sitereport" dated the 19th but submitted as from the 22nd. Request other editors get in habit of, every so often, hovering their mouse arrow over the "cases/deaths" refs under the upper-right image to ensure that only WHO or other government sources are listed.--Froglich (talk) 19:42, 24 October 2014 (UTC)

Latest available data from government health ministries:

Sierra Leone: 3896/1281 [6] as of 22 Oct

Liberia: 4744/2737 [7] as of 20 Oct

Individual government reports come out in advance of WHO reports, presumably due to aggregation. There is no reason not to update the numbers as they come available from WP:RS sources. ZeLonewolf (talk) 13:47, 25 October 2014 (UTC)

I was referring to the BIG total.--Froglich (talk) 17:04, 25 October 2014 (UTC)

There is a very good reason not to update the numbers as they come in from different sources: it's not statistically valid to do so. Ideally, the numbers used in the article should use a consistent source, or if more than one source is used, the model used to produce the combined number should be consistent across the whole table and published in the article somehow. The most recent number published in the article is a good example of this: it appears that there's been a huge jump in case numbers between 19-24 October (>2000, to ~12008), but the WHO situation report for 25 Oct says that the total case number is 10114, which would be more in line with expectations given the current status. The discrepency comes from the inconsistent use of different sources for the numbers. This is important, because even if the WHO numbers are an under-report, it's a consistent error and so the trends will be easier to spot Jonth (talk) 11:35, 28 October 2014 (UTC)

Incubation period defined further and changed

I have been reading news about 95% of cases incubate within 21 days and 98% within 42 days. I think this is vital information and I am going to try and carefully incorporate it into the page. However, exactly how is a question. For example. When there is a sentence that PERSON X will be quarantined for 21 days. Do we followup with a sentence that states this catches 95% of cases? http://currents.plos.org/outbreaks/article/on-the-quarantine-period-for-ebola-virus/ http://www.forbes.com/sites/jonfortenbury/2014/10/15/21-days-not-a-long-enough-quarantine-for-ebola-according-to-new-study/ Pbmaise (talk) 03:25, 17 October 2014 (UTC)

That's a single study representing the conclusions of that researcher. I don't see that this study represents the consensus of published sources. If lots of medical sources start reporting that a 21 day quarantine is inadequate, we can reconsider. Cullen³²⁸ Let's discuss it 05:14, 17 October 2014 (UTC)

Dear Pbmaise you already stated a discussion for this topic on Ebola virus disease, it helps us, if you inform us in that case, so that we do not discuss it twice. The information is also not new, the readers new about this when they completely read all references given for the first two sentences of this article. In the moment it is reference 6 of this article. You find it in , see for instance page 1487 and 1489. With kind regards, Malanoqa (talk) 06:32, 17 October 2014 (UTC)

References

Dear Pbmaise I looked at both talk pages. I read and searched all 3 articles, Haas (PLOS), Forbes, and NEJM. I could not find the text "98%" or "42" at all in any of them. Is there another ref for that I missed? Haas suggests 31 days but says it needs to be checked against cost/benefit. NEJM (WHO research team) says "approximately 95%" had symptom onset with 21 days of exposure, but later concludes "The measured duration of the incubation period, and its variation, imply that the advice to follow case contacts for 21 days is appropriate." Note Haas is reviewing available data and models from several older outbreaks, but WHO is using data collected during the 2014 outbreak up to mid September. NEJM is clearly a good source (respected peer reviewed journal), Haas is just one Civil/Environmental engineering professor. I don't know it seems slim another primary ref would be good (not just press citing these articles). Greenbe (talk) 02:11, 21 October 2014 (UTC)

WHO said in a recent report that 21 days was the maximum time to symptoms. In the next sentence, it said that 95% have symptoms by day 21 and 98% by day 42. So I guess they are nominally adopting both positions; but really it's just more incredible sloppiness from WHO so I guess they should just be ignored because once again they are not a reliable source, although they are a "Wikipedia Reliable Source."JustinReilly (talk) 22:25, 25 October 2014 (UTC)

Dear JustinReilly "WHO said in a recent report" can you please provide the link? I would like to read it. I kind of vaguely remember seeing this a while back but cannot find the actual ref. My only direct WHO reference is embedded in the NEJM paper, which was written by a WHO team. But the text "42" is not in NEJM based on my search. I totally assume WP:AGF and you have seen this text somewhere but please provide a pointer if you can. This thread is spread on two talk pages I did my best to gather up all links. I am not saying we should discard WHO as a reliable source. 42 days would have big implications if it bears out to be accurate.Greenbe (talk) 01:58, 28 October 2014 (UTC)

Greenbe, I couldn't find the 98% number in the WHO NEJM article either. Here is the WHO report I was referencing. See section called "Incubation Period."

http://www.who.int/mediacentre/news/ebola/14-october-2014/en/JustinReilly (talk) 02:53, 28 October 2014 (UTC)

One possibility is that the WHO aren't blithering idiots, but are simply misunderstood. From an epidemiologist's point of view, if people develop symptoms within 21 days 95% of the time, that's the incubation period (this may or may not reflect the biological incubation - stay with me...). If person X has an exposure to Ebola and develops symptoms 30 days later, does that mean the actual biological incubation period is 40 days, or is it possible that person X and Y were both exposed at day 0, and only person Y got infected (with symptoms by day 15) and transmitted to person X (maybe there was even a person Z, and all 3 had an incubation of 10 days). Epidemiologic data cannot tell these apart, generally, because not every person in the population is sampled (and humans don't volunteer for inoculation studies). These incubation periods (e.g. 98% by 42 days) are used to determine when a country like Nigeria is Ebola-free (i.e. when 42 days had elapsed since the last case, they were confident that every known case's contacts had had a chance to manifest infection with 21 days, and even if they missed one or two, their contacts are also past the incubation period) and may not represent what would happen in a controlled experiment. -- Scray (talk) 03:27, 28 October 2014 (UTC)

JustinReilly Thanks for the link. Interesting reading. I was only ever aware of "42" in context of a country being declared Ebola free eg. Nigeria. I had assumed it was just double the maximum 21 day incubation, in case someone either recovers or dies without being diagnosed you have double the maximum and 3-4 times the mean. And indeed this very reference supports my theory stating "42 .... is twice the maximum incubation period". But then goes on to up-end the 21 days by saying "98% have an incubation period that falls within the 1 to 42 day interval." and 95% 21 days. What is interesting is these exact numbers appear in NEJM but the conclusion drawn in same paper is that there is no need to monitor beyond 21 days. What I don't know is whether the 95% probability stems from the lack of confidence or accuracy in the raw epidemiological data, or is a clinical/biological fact. They don't say. Nigeria was very effective in quashing it in Lagos (20 million people) after the highly infectious index case by being very aggressive in monitoring a large number of contacts (more aggressive than the US as far as I read) ... but only up to 21 days. My understanding from reading some of these epidemiology studies going back to 1976 is that the mean is around 8-10 days depending on outbreak, and that actually if you are symptom free for 2 weeks past last contact you most likely will not get it but the third week is for insurance. I have not read of any proven confirmed case with symptom onset longer than 21 days past last contact. They studied this in great detail in the initial outbreaks back to 1976 including a nurse that had a needle stick so they knew exactly when she was infected. My impression was the raw data is case-by-case and they delete or otherwise lower weightings on unknown outcomes. IMO any implication in WP that you could possibly incubate longer than 21 days has to be well supported (in data and conclusion by several sources) since it would definitely cause new consternation.Greenbe (talk) 22:33, 28 October 2014 (UTC)

Projections of future cases

In the second paragraph of the section Ebola virus epidemic in West Africa#Projections of future cases is the following sentence:

"According to a research paper released in early September, in the hypothetical worst-case scenario, if a BRN of over 1.0 continues for the remainder of the year we would expect to observe a total of 77,181 to 277,124 additional cases within 2014."

This is the second in a list of estimates of future cases of ebola virus that counter the estimate offered by the WHO. This is the only one that does not specify who made or published the study. It is not clear whether this study was made and/or published by the person/group in the previous statement or by a different person/group. It's a bit ambiguous in this regard. It would improve clarity and consistency if the researcher or research group were mentioned. CorinneSD (talk) 17:17, 18 October 2014 (UTC)

Yes, it would. I see a PubMed study is used for the source. Most of us are not able to read the PubMed sources because one must either pay or have a free subscription. In my experience I generally just accept that the info is accurate when it seems reasonable. In this case I would not be concerned, however I believe that Brian has access and perhaps could help here. Gandydancer (talk) 17:50, 18 October 2014 (UTC)

Hi Gandydancer, CorinneSD i have added a diferent paper with the same source info for every one to read.. free from ECDC ..greetings Brian BrianGroen (talk) 18:45, 18 October 2014 (UTC)

Thanks, Brian. I continue to have the same concern as I expressed above, that the name of the person or group of researchers who conducted and/or published the study is not mentioned. Thus, it is slightly unclear as to whether this person or group is the same person/group mentioned in the previous sentence. One has to read the reference in order to discover that, and it's the only item in the list for which one has to do that. I think the name of the researcher, group of researchers, or research center needs to be named after "According to a research paper released in early September". What would you suggest?

Also, I glanced at the reference. Is there really a research center called "Eropian Centre..."? CorinneSD (talk) 21:36, 18 October 2014 (UTC)

@Gandydancer:, @BrianGroen: Could someone please look at the reference note for reference #244, which starts, "Nishiura, Chowell"? I see Eropian Centre. I just wonder if that is correct. CorinneSD (talk) 16:51, 19 October 2014 (UTC)

Now it's #249. The number keeps changing, but it's still there. I mean, is it really "Eropian"? Not "European"? CorinneSD (talk) 21:45, 21 October 2014 (UTC)

I don't get anything for that, but it was published in Eurosurveillance BTW, yes - when we use a single scientific study it should say "one (or a) study" and include the date (month/year). The name of the researchers/institution is not necessarily needed unless it is significant for some reason. Gandydancer (talk) 01:24, 19 October 2014 (UTC)

Hi CorinneSD,Gandydancer the ECDC do exist and the authors are the same for the first paper published. Eurosurveillance is a spin off site for their main site and is listed right at the top of the article. I added it to the external links but some one deleted it.. ECDC also list breakout numbers from Africa and developments. I added the authors name to link. Greetings Brian BrianGroen (talk) 04:59, 19 October 2014 (UTC)

Link to ECDC ebola page [8] BrianGroen (talk) 05:51, 19 October 2014 (UTC)

Note that BRN (aka Ro) varies over time, often denoted Rt or R(t). I've seen conflicting data from recent weeks in 2014 outbreak. Eurosurveillance seemed to show Rt declining close to 1 in the longer running sub-outbreaks, NEJM seems to show Rt in a range of 1.7-2. Clearly if they are right the large number of cases seems likely. http://www.nejm.org/doi/full/10.1056/NEJMoa1411100?query=featured_home#t=article Greenbe (talk) 02:34, 21 October 2014 (UTC)

Greenbe - I'd guess that Ro also varies geographiclly - outbreaks in well prepared areas trend to <1, in poorly prepared areas >1. Outbreaks which are extinguished (Dallas, Nigeria) eventually come down to zero. The problem with this outbreak is that the statistical measures are all unreliable. Robertpedley (talk) 21:02, 21 October 2014 (UTC)

Agreed it will vary with many factors, geography, virus strain, reaction (Nigeria was very aggressive in contact monitoring). My understanding is you don't need to get to 0, just <1 for it to be extinguished. If it stays >1 it becomes endemic. I don't know that the conclusion to draw is that the statics are unreliable. They have a large amount of data this time around and they have ways of averaging out the uncertainty in the source data. Also, the 1.7-2 is in the range of past outbreaks which were studied in detail long after they had ended (long term seems to be 1-2 range). My point is that R(t) appears to be a time-window calculation so it depends on the window you choose. Naturally you will get a higher answer for a longer window in a declining situation. What we all want to know is the instantaneous rate today "R(today)" but we don't have that answer because we don't know how the countermeasures have changed since they operate in the future by definition.Greenbe (talk) 22:57, 28 October 2014 (UTC)

Time-frame for article rename

Given that all heavily involved countries now have their own pages, with this article now acting as an umbrella over the rest, it's time to consider renaming again after several weeks. (And especially so with the disease poised to spill eastward through the unstable if not war-torn infrastructure-poor regions of the Sahel, thereby taking it out of western Africa.) Suggest 2014 Ebola epidemic for a title. This should serve for a long time, and perhaps permanently (if the disease remains largely confined to the one continent). I realize the outbreak began in very late 2013, but the massive upswing didn't occur until this summer. I submit November 1 as a potential change date, as that will give us the better part of a week to weigh options.--Froglich (talk) 10:42, 27 October 2014 (UTC)

oppose - I suggest that this topic be closed. There is no reason to go through yet another long, time-sucking discussion about the title. It is fine. Gandydancer (talk) 11:17, 27 October 2014 (UTC)

The article has sections for Spain and the United States; it has a world map -- "West Africa" is no longer a sufficient title descriptive. As the outbreak continues to expand, the current title will degrade from mildly inapplicable to badly unrepresentative.--Froglich (talk) 11:48, 27 October 2014 (UTC)

agree i think its time for a title change--Ozzie10aaaa (talk) 11:29, 27 October 2014 (UTC)

strong oppose - We have discussed this multiple times, and we are going to stick with what the WHO told me until they change the name of the epidemic.AmericanXplorer13 (talk) 16:18, 27 October 2014 (UTC)

I emailed my WHO contact about whether we should keep the name "Ebola virus epidemic in West Africa". This is what she said:

“ Alex, Yes. West Africa remains the hotspot of intense virus transmission. WHO has declared outbreaks in Senegal and Nigeria over. Mali will likely have more cases but counts as part of West Africa. Onward transmission in US and Spain is very low transmission. Hope this helps. ”

AmericanXplorer13 (talk) 16:55, 27 October 2014 (UTC)

Be that as it may, Wikipedia is not obligated to honor WHO naming conventions, particularly when, as noted above, the page has already segued into an umbrella article linking all the various national pages. Going forward, the article will eventually have a date associated with it anyway, e.g., the 1918 flu pandemic, etc.--Froglich (talk) 22:04, 27 October 2014 (UTC)

I was referring to the dating in title names of historical disease outbreaks, not the word pandemic (though that may come to pass as well at some point).--Froglich (talk) 12:01, 28 October 2014 (UTC)

If you can find a source that refers to this as a pandemic that meets the criteria for a WP:RS better than the WHO, then sure.--Taylornate (talk) 22:30, 27 October 2014 (UTC)

• Oppose - The ebola epidemic is called such by WHO. It isn't an epidemic anywhere outside of West Africa. Ergo, the correct name for it is what the article is called today. We may eventually add a date to the epidemic article, or it may end up with some generally recognized name in the future, ALA Black Death. It isn't our place to speculate on what the name will end up per WP:CRYSTAL; we're reporting on what the name is right now. WHO calls it such, people refer to the epidemic as being in West Africa, and it is in West Africa, so I'm not really sure why we would change the name. I don't see any WP:COMMONNAME issues with the present article name, and the article name doesn't have NPOV issues, so there's no reason to change it. Titanium Dragon (talk) 23:35, 27 October 2014 (UTC)
• For with mod - I liked using 2014 to distinguish from the past. But it's still >99% West Africa. I am for 2014 Ebola epidemic in West Africa. This will serve us until January (I sincerely hope).Greenbe (talk) 02:45, 28 October 2014 (UTC)
• Oppose -- as said above, it's only epidemic in West Africa -- the very limited cases in other countries outside West Africa do not even remotely constitute an epidemic. This is not Plague Inc., and we should think very carefully before exaggerating the scope of this serious situation. -- The Anome (talk) 22:38, 28 October 2014 (UTC)

I'd like to think we could get by with only two more renames (assuming that at some point Ebola hops continents): one rename as it expands out of western Africa ("2014 Ebola epidemic" being IMO ideal, as it's also applicable to the present situation as well), and then epidemic->pandemic later if necessary.--Froglich (talk) 00:30, 29 October 2014 (UTC)

I'd hope that the public health initiatives to contain this succeed, and we don't have to rename the article at all. -- Impsswoon (talk) 10:49, 29 October 2014 (UTC)

Froglich also hopes that containing the epidemic succeeds. He said a grim title would be ideal, not the disease. Neither optimism nor Froglich's pessimism is incompatible with good intentions. Art LaPella (talk) 14:12, 29 October 2014 (UTC)

Another vaccine

I didn't see any mention of the Johnson and Johnson experimental vaccine in the article[9]. I couldn't find a technical name of the vaccine. Rmhermen (talk) 19:57, 25 October 2014 (UTC)

at the risk of sounding generic,,,J&J vaccine ??[10]--Ozzie10aaaa (talk) 22:47, 25 October 2014 (UTC)

Yes please add it! Robertpedley (talk) 22:35, 29 October 2014 (UTC)

latest WHO numbers

http://www.who.int/csr/disease/ebola/en/  Situation report - 29 October 2014--Ozzie10aaaa (talk) 23:16, 29 October 2014 (UTC)

New numbers

Hi all , just a small note.. on the time line and lead there are added section details. If anyone update numbers please shift the "section begin" and "section end" up as well. It cross reference with the EBV page and automatically update that page.. save time and editing that way.. And as special thank you to all helping on this great article.. greetingsBrianGroen (talk) 11:46, 23 October 2014 (UTC)

Just noting the numbers for the map graphic deaths is over 5000 for oct 24 yet the 29th october deaths is less than 5000 — Preceding unsigned comment added by 14.202.101.6 (talk) 03:19, 30 October 2014 (UTC)

leap to 12,000

was their an unusual contributing factor to the latest "sitrep" which made it leap more than 2000 cases? also the fatalities for Liberia seem to not have changed on the "cases/fatalities" table?--Ozzie10aaaa (talk) 12:33, 28 October 2014 (UTC)

It looks like there was a significant step change to the Liberian reporting and classification procedures between their Oct 21st SitRep and their Oct 22nd SitRep which provided much higher case counts for most of their counties. At the same time, their fatalities data switched from being cited as "Total death/s in confirmed, probable, suspected cases" to just "Cumulative deaths" taken from individual-level data from Case Investigation forms. Their latest Oct 25th SitRep actually now cites 2106 "cumulative deaths", compared to the >=2704 shown in the wiki table. I don't know if this makes their data more consistent with that from the other countries. Maybe the next WHO report will shed more light on those changes. Kirbett (talk) 16:20, 28 October 2014 (UTC)

Hi Ozzie10aaaa,Kirbett it looks like a new agency has taken over in liberia to report..but yes it was a huge jump but it did stagnate for a few days.. but apparently hundreds of new cases were counted in the capital region over the previous days. The death rate is questionable .. there is a error of 1000 from previous report so i stuck with the latest WHO report on that .. but that being said it is going to jump by nearly 500 in the next day or two with Sl already reporting 200+ new cases in one/two days. BrianGroen (talk) 20:45, 28 October 2014 (UTC)

I updated the graphics I care for with the leap to 12,000. Malanoqa (talk) 21:31, 28 October 2014 (UTC)

The leap isn't real; it is a data artifact. The Liberian numbers have long been considered to be especially under-reported by WHO, and it appears that the new numbers are an attempt at correcting the issue. Titanium Dragon (talk) 22:20, 28 October 2014 (UTC)

It's certainly an artifact. Histograms with reasonably-sized binning (like Malanoqa's) will be more helpful than line plots to absorb some of this. With Aylward saying that it could jump from 1000/week to 5000-10000/week in the span of two months [11], it seems possible that these corrections will become more frequent, given how far the WHO numbers have already fallen. Snd0 (talk) 23:30, 28 October 2014 (UTC)

If this is the reason, a note in the article will be necessary. Someone please find a reliable source regarding the increase, please. SYSS Mouse (talk) 01:45, 29 October 2014 (UTC)

Reduction in Liberia cases is weird, WHO sitrep 29oct figure 2, past 3 weeks - probable cases continue to do their own thing, but weird is that confirmed cases fall to flat zero, especially in the capital area where there are 3 labs that are doing tests all the time. This looks like a serious reporting problem. Actual cases might have or might have not fallen, but if data is clearly bad it cannot be used as a reference.194.126.122.67 (talk) 10:06, 30 October 2014 (UTC)

Need to Condense

I realize that this is very much a work in progress, with raw data flooding in daily, but the epidemic isn't projected to slow down any time in the near future; the page is already quite long, even with some of the data having pages of their own. I'm wondering when and how to go about condensing this page, or what can be put where. Thoughts? Scoottz (talk) 01:08, 27 October 2014 (UTC)

You are right and thanks for the feedback. Which sections do you feel are the most/least important? I'll give a few of my thoughts:

• The "Experimental treatments" section - Could we cut this back to a short introductory para with a direct to the main disease article where they are all listed? Gandydancer (talk) 03:34, 27 October 2014 (UTC)

• The Guinea, Sierra Leone, and the Liberia sections now all have their own articles. Could we retain the overall coverage "Outbreak" section with directs to the individual country articles at this point (as has been planned but waiting for the articles to be improved)? Gandydancer (talk) 03:40, 27 October 2014 (UTC)

• The DRC also has its own article. I'd suggest we get rid of the map/count diagram and reduce the information further. Gandydancer (talk) 03:55, 27 October 2014 (UTC)

A lot of stuff should be transferred to the secondary pages, if it isn't there already.

• I trimmed "Travel Restrictions & Quarantines" about 6 weeks ago by consensus. The new material here is US related so it should move to that page. Most of this has been added by Hello32020 who's putting a lot of effort into it - sorry, mate!
• "Experimental treatments" - Gandydancer - could lose the biochemical stuff (some of which is incorrect), but I think it is helpful to keep reporting on progress of the various vaccines etc through clinical trials in West Africa & elsewhere so that the reader can get an idea of how each is progressing and how useful they are likely to be.
• Suspected cases - strike completely. There are dozens, every day, in various parts of the world.
• Contained Spread - both Sengal & Nigeria can now be trimmed back. Did either of them get their own page?

Nigeria redirects to West Africa, and Senegal was not created.. Nigeria could use it's own page, however Senegal with a single "Imported" case did not have a local infection at all, should stay, in full, in the main article (unless future infections occur)..Gremlinsa (talk) 09:21, 29 October 2014 (UTC)

• Medevacs - contains superfluous detail about airplanes etc, could be cut back.
• Projections - each new projection supersedes the previous one, so we only need report the latest

I should get some free time for some of this in a day or two. Robertpedley (talk) 23:37, 27 October 2014 (UTC)

Not really a problem, I've just been transferring updates from the U.S. page. If it's too much, feel free to condense. Hello32020 (talk) 23:40, 27 October 2014 (UTC)

Robertpedley Yes, I agree on TR&Q. While I thought that the US stuff was excessive I thought to just look the other way for a few days since the US reactions were so beyond anything I could have ever even dreamed of (such as the tent outside of the hospital for a nurse with no symptoms what-so-ever...etc....). (She's from Maine BTW - so am I ;) ) Re the Treatment (drugs etc>) section - do what you want as I know you know more than I do in that section. (BTW, did you note the ZMapp recent edits?) Re Nigeria, no there is not a split and I'd suggest we not add one due to the history of the difficulty of upkeep. I'd hate to see much more if any cut since it seems good to keep a good historical record. Senegal, I know I've been cutting all along and it was my feeling that I'd cut back as much as I was happy with last time. I did cut way back on Spain since there is a split article. I agree on cutbacks on Medevacs. Yes projections is long...but on the other hand, oh boy does it ever make an interesting read to see the progress....no? Gandydancer (talk) 01:24, 28 October 2014 (UTC)

I added the information on planes to the medevac section, I thought it was relevant because there are really only two planes capable of doing it. Lack of medevac facilities is discouraging places like Canada from sending people. Siuenti (talk) 17:30, 28 October 2014 (UTC)

Hi Siuenti - Medevacs are small in number relevant to the main outbreak. We considered striking them completely a few weeks ago - but they attract headlines. The medevacs in Europe have been managed using military transport places temporarily adapted with biocontainment kits (... yes, the military have this equipment ready in case of biological warfare).

One section of the US Ebola facility in Liberia be dedicated to high quality care for medical workers - I think the objective is to remove the need for medevac completely, although this has not been stated as an explicit policy. Robertpedley (talk) 21:26, 29 October 2014 (UTC)

It's true that Britain and Spain evacuated their own people but there are also reports like "[German Defense Minister] has admitted in the past weeks that neither the German military nor any other EU countries have aircraft suited to the task. Only the United States has access to two specially equipped planes, belonging to the Georgia-based company Phoenix Air, which have also been used to transport Ebola patients to Germany." [12] If the aim is to condense the main article, perhaps medevacs could be split off? Siuenti (talk) 12:39, 30 October 2014 (UTC)

Case fatality rate

I altered the CFR figure from "70.8%" to "approximately 70%": Gandydancer altered it back on the basis that "approximately 70.8%" is not what the source says. But the actual words used by the source are "70.8% (95% confidence interval [CI], 69 to 73)" (see http://www.ncbi.nlm.nih.gov/pubmed/25244186). "70.8%" is not a good way to represent this figure: it gives a false sense of precision by omitting the confidence interval and suggesting a precision to within a 0.1% interval, instead of the much wider interval the source suggests. I suggest that we either say "approximately 70%", or use the entire quoted words -- "between 69 and 73" won't cut it by itself, because that's not actually how CIs work. -- The Anome (talk) 19:26, 27 October 2014 (UTC)

Agreed; "70.8" represents a False precision fallacy. (There are alarming indications that CFR might, in fact, be considerably higher than 70% due to reticence in various regions for listing Ebola as a cause of death.)--Froglich (talk) 22:16, 27 October 2014 (UTC)

What does 95% confidence interval [CI], 69 to 73" mean? Gandydancer (talk) 23:12, 27 October 2014 (UTC)

@Gandydancer: A confidence interval is a measure of statistical confidence; basically, when you say there is a 95% confidence interval, there is a 95% chance that the true value of the thing that you are measuring is within that range. So there is a 95% chance that the true case fatality rate is between 69% and 73%, according to the data set used; we don't know the exact value more precisely than that. So 19 times out of 20, the true value of the CFR is between those two numbers; 1 out of 20 times, it would be outside of those bounds. Titanium Dragon (talk) 23:37, 27 October 2014 (UTC)

Reasonable, but it diminishes readability. As an aside, the 70.8% stat was obtained in treatment centres, it's not representative of the CFR for people who can't get to them. Robertpedley (talk) 23:17, 27 October 2014 (UTC)

I've just noticed that the same stat is quoted 3 times in total differently as 70% or 70.8% or 71%. Robertpedley (talk) 23:42, 27 October 2014 (UTC)

If this idea were extended to the rest of the data in the article, we'd have to put either "approximately" or "(95CI: XX to XX)" all over. The # of cases, beds, physicians, incubation period, transmission rate, etc. That's correct for a paper, and is more precise, but not so fun to read or edit. But as Robert pointed out, it should be the same throughout. Snd0 (talk) 23:44, 27 October 2014 (UTC)

Considering that 70.8 should be rounded to "about 71" and that is what the CDC uses, I'm going to change it to "about 71". Gandydancer (talk) 00:53, 28 October 2014 (UTC)

I found the last 70.8 and changed it to "about 71". All three references match now.... consistency is our friend.Greenbe (talk) 02:54, 28 October 2014 (UTC)

I think they should all go to 70% -- given how horrible the statistics gathering has been of late, it's arguable that even the *first* digit (the 7) is an actually unknown quanta, and that being the case, the next digit (the 1) is pure fantasy. So, to avoid false precision, "approximately 70%" is preferably to 71% (even though, in this case, it's likely to be more correct as I think CFR out in the boonies is probably over 80%).--Froglich (talk) 07:45, 28 October 2014 (UTC)

@Froglich: We really have no idea what the CFR is like outside of the hospitals. It is interesting to note that Nigeria had a CFR of only 40%. The US has had 8 people who have completed their run with Ebola, of whom only 1 has died; of the 9 victims in Europe, only 3 have died. That is a significantly lower CFR than what we're seeing in the three hardest-hit countries, so it may be that the CFR in those countries is already taking into account the fact that many of the patients are not getting adequate medical care. How many of the patients in that data set went untreated in medical facilities? The CFR could be either an over or under-estimate; it could be an underestimate because of all the untreated people out in the boonies, or an overestimate because it only counts people who actually get reported to the authorities, who are most likely to be the most sick - someone who gets sick and recovers on their own is less likely to be counted. Only if you were to count everyone who got sick would you really get a good estimate of the CFR, and that's fairly unlikely under the circumstances. Titanium Dragon (talk) 09:38, 28 October 2014 (UTC)

Great post Titanium Dragon and I agree. Now if we could only get a good RS to say this... Gandydancer (talk) 19:13, 28 October 2014 (UTC)

The Nigerian and US experiences so far represent too small of samples for valid statistical extrapolation. I would expect CFRs to remain modest when a handful of cases are quickly discovered and dealt with. But when the number of active cases exceeds the capacity of medical infrastructure to cope (or where none exists in the first place, e.g., the two EBOV Congo outbreaks in which cases exceeded 300 had mortality rates of 81% and 88%) -- then CFR goes up and basic reproduction number goes up, and consequently exponential doubling time goes down. In other words, the disease will spread faster and be more lethal. Once panic sets in, doubling time will reduce even further. IMO, Ebola is going to "bomb" over the next few months, and CFR will likely be 80%+ (whether any agency is around, and capable, of counting such massive casualties is another matter).--Froglich (talk) 10:26, 28 October 2014 (UTC)

I have changed the number back to "about 71%". I have not taken stats but basic math tells me that 71% is closer to 70.8% than 70%. Apparently the CDC agrees as they say, "about 71%" which is more accurate than what a group of Wikipedia editors may feel to be correct. Gandydancer (talk) 16:31, 28 October 2014 (UTC)

@Froglich: The problem is that we don't actually know if 70% is an underestimate or an overestimate; as I noted, we have things which push in both directions. Some people are keeping their Ebola secret to avoid cremation (which would lower the recorded death rate from Ebola as people kept it a secret) while others are not reporting their Ebola because they recovered from it, possibly not even realizing that they had Ebola in the first place (which would increase the recorded death rate from Ebola because it excludes people who recovered). In the countries where 100% of Ebola cases have been identified, the CFR has varied from 0-40%, but obviously the statistical significance for predicting future cases is low (though note that the CFR in Nigeria actually is 40% by definition, as that is a total count of all cases). Those countries obviously have vastly better data than the most badly struck countries, and thus are picking up all the Ebola patients, even the ones who would have recovered on their own from the disease. As such, we know that Nigerian and American numbers are complete while the numbers in the hardest-struck countries are not. That doesn't necessarily mean that they're better for estimating the CFR, but it is problematic to assume that the CFR is being underestimated when there is potentially a large population of people who get sick and recover and never report having Ebola in the first place. The people who are most likely to be recorded are the ones who seek medical care, who are disproportionately likely to be very ill (hence why they sought treatment) and thus more likely to die than someone who gets ill but doesn't reach the point where hospitalization is required. We're not sampling from a random population, whereas a whole-population sample is always going to give you the "correct" number. We will likely never have a full-population sample from those countries unless we get "lucky" (i.e. a whole village gets Ebola). Titanium Dragon (talk) 22:16, 28 October 2014 (UTC)

And it's also likely that the CFR is substantially different in the case of patients who are completely without medical care in poverty-stricken rural villages, compared to those receiving care in field hospitals, or still yet those in modern state-of-the-art western facilities receiving 24-hour intensive care and specialist treatments such as zMapp. -- The Anome (talk) 22:32, 28 October 2014 (UTC)

Absolutely -- as previously noted, past EBOV outbreaks in excess of 300 cases have resulted in CFRs >80%, and were contained only through the fortuitous circumstance of those outbreaks being in remote, low-population regions. The current epidemic is already orders of magnitude beyond the ability of all of the world's medical professionals (if hypothetically transported to west-Africa right now), so I have little reason to assume actual CFR is less than 80%. (But, anyway, I still dislike 71%; we should be saying "over 70%" to avoid false precision.)--Froglich (talk) 22:39, 28 October 2014 (UTC)

I like "about 70%" or "around 70%" myself. I don't think it is 80% this time but I guess time will tell. Note the species and strain of the virus may have something to do with CFR but they have never been able to prove that (independent of poverty or remote rural location). One outbreak was 25%. Greenbe (talk) 23:11, 28 October 2014 (UTC)

That was not an EBOV outbreak. --Froglich (talk) 06:37, 29 October 2014 (UTC)

Nope that was BDBV. But there are EBOV documented at 45% but small outbreak total cases <50. I looked over the table again and interestingly if you remove all outbreaks <100 cases, EBOV CFR seems to be 70% or above. My point about strain/species is more subtle. For some reason each outbreak comes with its own CFR and there is quite a bit of variance. One obvious source of difference is the species (formerly called strain in a lot of literature since species were classified more recently). But within the current species definition my understanding is there are strains (ie more than one strain of EBOV). But biologically I don't know if they have proved one or the other strain is more deadly. It could just be chance ie the circumstance of the outbreak maybe the next BDBV outbreak will be 90% (and there are BDBV outbreaks with higher rates). All the reports seem to suggest early detection and hydration treatment and age affect the CFR but again no solid proof yet afikGreenbe (talk) 21:39, 29 October 2014 (UTC)

Hi Greenbe - this is moving into the realms of speculation, but I'm guessing that patients who are already weakened by other factors - TB, malaria, HIV, malnutrition, pregnancy etc will have a worse prognosis. Therefore the CFR will be affected by the demographic of the population or the community where the outbreak occurs. Western medical health workers have a stronger start position, in addition to receiving serum transfusions & experimental drugs.Robertpedley (talk) 22:04, 29 October 2014 (UTC)

Robertpedley I agree with you, speculation aside. The health status, age and demographic seems to play a part according to reports but I have not seen hard data on that. I would be very curious to see data that tries to figure out the inherent deadliness of a strain/species after trying to control for these other factors. The only other idea I have seen independent of the starting status of a patient is the idea that early detection and maybe aggressive hydration and support for organs like dialysis may improve the odds. None of the serums and experimental drugs have been proven effective yet in humans but I believe there are ongoing empirical studies. That all said, it seems to me that Zaire (EBOV) in general must have an inherent CFR north of 50%, probably 60-70% simply because that was the result over so many outbreaks over time and geography that probably tend to net out some of these other factors. Unknown if early detection and aggressive treatment can get the CFR well under 50%. But this is purely opinion I have not seen any article that addresses the inherent CFR of the virus thoroughly.Greenbe (talk) 16:27, 30 October 2014 (UTC)

The New York Times: Wikipedia Emerges as Trusted Internet Source for Ebola Information

• Cohen, Noam (October 26, 2014). "Wikipedia Emerges as Trusted Internet Source for Ebola Information". The New York Times. Retrieved October 28, 2014.

Might be a useful source for use in this article. — Cirt (talk) 03:08, 28 October 2014 (UTC)

Oppose -- Including it sans notability constitutes self-promotion. (I could see it eventually being part of Wikipedia's article about itself, but not articles concerning other subjects.)--Froglich (talk) 22:45, 28 October 2014 (UTC)

I agree with Froglich here. Wikipedia is notably, verifiably awesome, but it doesn't belong in this article. -- The Anome (talk) 22:49, 28 October 2014 (UTC)

I thought that was intended as a joke ;)

Can we do smileys here? Robertpedley (talk) 19:20, 30 October 2014 (UTC)