These notes were taken at the 2014.Dec.18 New England Complex Systems Institute Salon focused on Ebola. Sam, Willow, Yaneer contributed to this write-up, and 20 people were in attendance. We hope you’ll join us in future. We’ll have unstructured meetings each Wednesday from 18:00 to 20:00 (6p-8p) starting Jan 21st, with the fourth Wednesday of each month structured towards contribution towards a global challenge. The next such structured event will be on January 28th, on the subject of ethnic violence. You can see notes on this and potential future subjects here, and can register here.

About Ebola at NECSI [briefing by Yaneer]

NECSI has a history of studying Ebola models, and has predicted something similar to what is currently going on in West Africa for some time now. NECSI started with a model of pathogen evolution in which the most aggressive stable state has virus constantly passing slowly through populations, creating islands, dying out as people expand into areas with no disease.

Aggressive diseases plus long-range transport

Then if you add long-range transport, you get more and more aggressive strains. The more long-range transport you have the more aggressive the strain can be without dying out; and eventually could kill an entire global population. Paper published in 2006, mentions risk of Ebola.

As transportation becomes more pervasive, vulnerability increases.

Early warning and preparedness

Presented to the WHO in Jan ‘14. They were respectful and excited by the work. Discussed other public health issues faced by WHO, however didn’t return to pandemic models.

Since then: outbreak happened. Lots of discussion. Why don’t we engage in risks in a more serious way? Everyone thinks their prior experience indicates what will happen in the future.

• Look at past Ebola! It died down before going far, surely it won’t be bad in the future.
• Models of outbreaks look at existing conditions, which prove to be too limited here.

Example: with flu, people take exactly that disease and known circumstances, and simulate an outbreak, ignoring changes in the disease or in the conditions (and: nothing has to change in order to have huge risk). the same properties could remain, but a low-probability event could unfold, “fat tail distribution” – past experience isn’t necessarily a predictor of what will happen in the future.

Individual and community

Contract tracing, the standard public health method, doesn’t work well when there are more than just a few cases. Stop thinking about the contacts of the person, think about the community. Travel restrictions so new communities aren’t infected. Now that people go door to door for symptom screening, the cases have decreased dramatically in Liberia.

People were saying: “The beds are empty!” Authorities responded: “We can’t figure out why. We think people are still sick!” Why are the hospitals and authorities waiting for the sick to show up? Going door-to-door in the neighborhoods shows what’s going on, and is what is effective.

Once you know the right question, the answer is clear.

Interests

We then stated our interests – each person said one thing about the topic or intro talk they’d be interested in diving into more during breakout groups Continue reading →