Congo gov. says it's 'on alert' over mystery flu-like disease that killed dozens
158 points
20 days ago
| 7 comments
| ctvnews.ca
| HN
cmriversepi
20 days ago
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I’m an epi professor and longtime HN lurker. I wrote a short essay yesterday about how to think about these mysterious outbreaks [1]. Briefly, the most common outcome is they are determined to be an endemic disease. Less likely is an emerging infectious disease. The most concerning possibility is something novel or highly unexpected.

[1] https://caitlinrivers.substack.com/p/understanding-mysteriou...

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tptacek
20 days ago
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This is a great article, and for anyone that wants a cheat sheet for the thread (and to double check my read):

* The "endemic disease" bucket describes things like cholera and known influenza strains, and what we're seeing is hazy reporting of flare-ups that happen in low-resource areas around the world on the regular.

* The "emerging infectious disease" bucket describes stuff like Ebola, which is scary but we've got something like a reasonable history of responding and containing to it, if we take it seriously.

* "Novel" is C19, or the first outbreaks of Ebola at the time, the point presumably at which we'd start thinking about novel precautionary measures applied preemptively.

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itsaride
20 days ago
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The article says it's an area where malnutrition is endemic, couldn't it just be a flu variant that's killing already vulnerable people?
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gosub100
20 days ago
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Starving people are more likely to eat bush meat, which is one way viruses can jump from one host species to another.
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etiam
20 days ago
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Are you willing to hazard a guess how long it will take to get material analyzed to determine which of your categories this is in?
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cmriversepi
20 days ago
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The first round of test results should come in Friday or this weekend. The longer it goes undiagnosed, the more we tip into categories 2 and 3.
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etiam
20 days ago
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Thanks.

So basically, if it's any of numerous reasonably well-known but very local diseases a fluid's probably going to go colored in some field test kit and say which one, else it could be something known (and often of known substantial concern for large-scale contagion) but too rare or understudied to have cheap robust quick tests yet so that has to be shipped to a real lab (probably with very high biosecurity rating), and if the lab doesn't recognize what they're seeing in their electron microscope and has to do fundamental research first to get a good biochemical profiling it's something truly expanding the boundaries of known infectious pathology?

Something like that?

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jonny_eh
20 days ago
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> Less likely is an emerging infectious disease. The most concerning possibility is something novel or highly unexpected.

What's the difference between an emerging and novel disease?

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JumpCrisscross
20 days ago
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> What's the difference between an emerging and novel disease?

Novel is new. Never before seen. SARS-Cov-2 was a novel virus.

Emerging means identified but changing [1]. The Covid variants were EIDs. So are antibiotic-resistant strains.

[1] https://en.wikipedia.org/wiki/Emerging_infectious_disease#Cl...

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etiam
20 days ago
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I don't exactly want to dispute that, but I would like to remark it's not entirely clear-cut.

SARS-CoV-2 response could be as rapid as it was in no small part because two decades of research on SARS-CoV more or less was applicable, and looking at genetic similarity alone contemporary variants of SARS-CoV-2 are now more different from the original strain isolated in Wuhan than that strain is different from SARS-CoV.

So was the threat from pathogenic Coronaviruses really novel? To a degree, and depending on what aspects one chooses to emphasize maybe.

Also, I'd say the pathogen itself doesn't necessarily need to do the changing in the context of emerging diseases. I'd take it to mean they have potential to become more prevalent or have a more significant impact, but that could easily also be due to changes in conditions, including human behavior.

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JumpCrisscross
20 days ago
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> I would like to remark it's not entirely clear-cut

Are you saying this as an epidimeologist? (I'm not an epidimeologist. I've only studied the math.)

> looking at genetic similarity alone

Epidimeology is the study of disease in a population. You can't look at the virus alone.

The dividing line between emerging and novel is brighter than between emerging and existing. It has to do with whether the population has pre-existing immunity. SARS-CoV infection conferred no immunity to SARS-CoV-2. Getting infected with the Alpha variant, on the other hand, conferred immunity to Omega.

> I'd say the pathogen itself doesn't necessarily need to do the changing in the context of emerging diseases. I'd take it to mean they have potential to become more prevalent or have a more significant impact, but that could easily also be due to changes in conditions, including human behavior

Literally in the Wikipedia. "EIDs may also result from spread of an existing disease to a new population in a different geographic region, as occurs with West Nile fever outbreaks."

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losteric
20 days ago
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So as I understand it:

- Panzi is an isolated, hard-to-access area where malnutrition, prior epidemics, and seasonal flu have already weakened the population.

- Poor healthcare infrastructure and delayed medical intervention have amplified deaths.

- There is no evidence of rapid or widespread transmission. (see first point).

- Samples have been retrieved for testing. At this point, there is no information on transmission vector (assuming it’s even a disease)

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giarc
20 days ago
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300+ cases is quite a few when you consider that many will not be reported.
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hvenev
20 days ago
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Despite the sad context, this seems refreshing -- an alert is raised due to a real and serious concern.
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autoexec
20 days ago
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It is nice that things aren't so bad that nobody is even keeping an eye out for things like this. There's some comfort in knowing that somewhere smart people are looking into it.
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whalesalad
20 days ago
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autoexec
20 days ago
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We watched it live in 2020 and we failed so hard that this is probably the worst time for any new pandemic, especially one that can be described as being in any way "flu like". We've learned from experience that no matter how many people start dying, huge parts of the population will not take it seriously and that governments will only care about keeping the workers busy making money for their employers even while those employers refuse to provide them with PPE or sick time. Nobody trusts the CDC as it is, and that will only get worse with the coming administration.

I'm just hoping that this isn't anything new, and that it doesn't spread very far.

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NotSammyHagar
20 days ago
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I disagree about trusting the CDC, I have no reason not to trust them. They'll do their best job to understand threats, avoid making confusing statements. But if there is a threat and people are dying in hospitals in large numbers without much information, they'll do their best to make health safety precautions, but they will probably make some mistakes. This is pretty common in science too.
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autoexec
20 days ago
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The CDC never had the trust of many people to start with, but their repeated failures at communication didn't do them any favors. They also repeatedly allowed themselves to be bullied and manipulated. For example, they changed the recommendation to stay home 5 days after testing positive, but that change wasn't based on any new evidence that would contradict their old recommendation.
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lispisok
20 days ago
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Cause the "experts" did such a good job last time.

I learned from the last pandemic that the so called "experts" were in fact incompetent at best and power tripping political ideologues at worst. It was crazy watching the last 100 years of germ theory and infectious disease get thrown out and start over from scratch

1. The virus isnt real it's a conservative conspiracy

2. The virus is real but isnt spreading human to human (it obviously was at this point)

    Bonus: Thinking the virus came from a lab doing research on that exact virus in proximity to the first cases was a conservative conspiracy instead of an obvious first guess
3. The virus is spreading human to human but not through the air (it obviously was highly probable given respiratory symptoms)

4. Masks dont work

5. Masks do work

6. Masks do work and you should always wear outside your house but not needed at BLM protests

7. The social distancing rules had zero scientific backing

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bdangubic
20 days ago
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this sounds exactly like the scientific discovery(ies) of something unknown. you are scrambling in this case to figure things out and you want to do it as fast as possible because you know - the government has decided to lock everyone up. so you go about trying to figure it out. but science is not dogma, if you first believed that masks do work and then get a proof that they don't after enough people start wearing them and you perhaps see that that shows otherwise, you pivot. this is exactly what you want, you don't want "experts" to sit and go "shit, we told everyone to wear masks, we now have this new data which shows limited utility but shit we can't say we were wrong, lets have everyone keep wearing masks... maybe even double-down and say you should wear masks alone in the shower cause virus might be in the water too..."
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incrudible
20 days ago
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We did not have new data on masks when the messaging on masks changed. The science said masks do not protect you and that is why experts initially said so. Then, they figured that this is not what people wanted to hear. People wanted to be told what to do to be safe and would not take “we do not know” as an answer. Politicians latched on this, the media latched on to this, and somehow it became a partisan issue. The path of least resistance was to just shut up, wear a mask and wait for the hysteria to subside.
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NotSammyHagar
20 days ago
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Yes, good points. Politicians and the public and all of us can have trouble when it's a rush situation with deadly consequences and the experts make their best prognosis based on previous times in some part - then they revise best practices as they gain knowledge.

This happens all the time but it's not usually so visibly combined with conspiracy theories about controlling people and all that kind of crazy stuff. America is so influenced by foolish postings on social media and popular, but not fact-based TV networks.

There was the realization that covid spread in a different way than the flu and the discovery of things spreading through the air was a bit surprising and unexpected, compare with traditional flu issues.

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bdangubic
20 days ago
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> and somehow it became a partisan issue.

this wasn't a partisan issue in the beginning. it only became a partisan issue when 50% of the population started getting the "scientific information about efficacy of wearing masks" via Mary from Pennsylvania on "X"

same with the vaccines. the loudest pro-vaccine politicians (e.g. DeSantis) after seeing posts on "X" from our PA/MT/MO experts decided it would be super beneficial to their political career to make that a partisan issue as well :)

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southernplaces7
17 days ago
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>it only became a partisan issue when 50% of the population started getting the "scientific information about efficacy of wearing masks" via Mary from Pennsylvania on "X"

Really? Only then? No partisan aspect to official narratives about masks and virus origin being practically imposed upon the public via all narrative-sympathetic media and social media channels?

No partisan aspect to the blatant hypocrisy of BLM protests being no problem in terms of mass gatherings, while any other type of mass grouping was considered wrong, and something only done by ignorant covid-deniers?

Not to even mention the whole "don't use masks you selfish pig, no wait! use masks, yes, use them you ignorant bumpkin!" debacle...

I guess none of these wonderfully varied and acrobatic narratives in the least bit created good reason to make large numbers of people start mistrusting the hell out of a whole range of politicians and media personalities.

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lawls
20 days ago
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Just in time for the holidays.
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jimbob45
20 days ago
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Epidemiological experts are in the region to take samples and investigate the disease, the minister said...

“At the current stage, we cannot speak of a large-scale epidemic, we must wait for the results of the samples taken,” health minister Kamba said regarding the mystery flu-like disease.

Not really "on alert" then, just waiting to see if what we're seeing is novel or what.

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uoaei
20 days ago
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That's exactly what "on alert" means.
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gorgoiler
20 days ago
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Hmmm. What is “ctvnews.ca”? I do not have any prior reason to trust this news source but would welcome some kind of hints.

Edit: I show my ignorance of north of the border! It is a major Canadian news station. Thanks for the replies.

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ceejayoz
20 days ago
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eddsolves
20 days ago
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It’s fine to not know, but why not google and check? It’s surely quicker than asking
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Kye
20 days ago
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I see people here in the US take The Beaverton seriously. I see people in Canada take The Onion seriously. It's hard to evaluate things like this from the outside.
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zymhan
20 days ago
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> It's hard to evaluate things like this from the outside.

No, it's not.

https://en.wikipedia.org/wiki/The_Beaverton

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taysix
20 days ago
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One of the largest Canadian news broadcasters

https://en.m.wikipedia.org/wiki/CTV_News

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