Life as an Extreme Sport

OutbreakChat: A Livetweet of a Movie That Gives People Nightmares,…

November 12, 2014 Kelly ...and everything else, Bioethics, Pop Culture

…and probably not for the reason you think. Outbreak is one of those movies people seem to either love or hate (or possibly love to hate); almost everyone I know who has anything to do with public health, infectious diseases, or virology tends to swear up a blue storm when the movie comes up.

So naturally, a group of us are going to watch it in real-time tonight, drinking and live-tweeting our thoughts on Twitter. This will include fact-checks, snark, and almost certainly questions and answers from the crowd-at-large. Who is doing this? Well, you might remember David Shiffman (@whysharksmatter) from my Virtually Speaking Science interview a few months ago; while he might seem like an odd choice to organize this, remember he has significant experience with pop culture/movie portrayals of sharks, mermaids, and other scientifically incorrect portrayals of the ocean.

Tara Haelle (@tarahaelle) is a freelance journalist probably best known for her excellent article that debunks flu myths. She’s written extensively on science and the need for accuracy in media imagery and discussion.

Nicholas Evans (@neva9257) is a post-doctoral bioethicist at the University of Pennsylvania’s Department of Medical Ethics and Health Policy, based in the Perelman School of Medicine. He specializes in biosecurity, bioterrorism, and the ethics of pandemic preparedness, and recently wrote a piece for Slate explaining why Ebola is not a bioweapon, despite media myths. (He’s also my husband.)

And what am I (@rocza) doing involved in this? Well, aside from spending much of the last couple of months educating Twitter about Ebola, blogging extensively about Ebola, and doing Justice Putnam’s “The Morning After” radio show to talk about the ethics of science journalism and Ebola coverage, I once upon a time was pursuing a PhD in bioethics and philosophy, looking at how popular media portrayals of medical issues affects our medical-decision-making (a continuation of my undergraduate thesis on autonomy and medical ethics). I’ve taught courses through pop culture (Stargate and Applied Ethics), and one of my most popular and invited lectures was on why we watch reality TV. I also have a weird affinity for Ebola; I once intended to become a virus hunter, and I’ve been studying Ebola, outbreaks, and the research for going on 20 years.

We are, of course, hoping more people will join in the viewing party-both experts and lay people alike. So pop up some popcorn, grab your favourite beverage of choice, and join us at 8pm ET tonight (#OutbreakChat) to see firsthand what set the foundations for the Ebolanoia that has raced through the world these past few months.

Edited to add: Bingo cards are available on Twitter.

Know Your Variants: Kikwit vs Gueckedou

November 11, 2014 Kelly ...and everything else

This is an update of an earlier post, Know Your Species: SUDV vs EBOV.

When last we discussed the Democratic Republic of Congo outbreak of Ebola, it was presumed that it was actually an outbreak of the genus Ebolavirus, species Sudan ebolavirus (SUDV), largely because that’s what initial reports indicated. It hasn’t yet been clarified why there were reports of a positive test for SUDV and a positive test for a SUDV/EBOV mix (although I’ve heard speculations about earlier outbreak exposure), but what we do know is that on 2 September, the World Health Organization released the results from their virological analysis, showing that while the Ebola outbreak in the DRC was actually EBOV (Zaire ebolavirus),See Maganga G, Kapetshi J, Berthet N, Ilunga B, et al. Ebola Virus Disease in the Democratic Republic of Congo. NEJM 2014;DOI: 10.1056/NEJMoa1411099. it also was not linked to the on-going epidemic in West Africa.I say “was” because there is currently no known active transmission occurring, and the country is in the cool-down period, waiting for 42 days to pass in order to be declared virus-free.

This brings us back to my last post illustrating Ebola with kittehs.The language of the internet. For a quick refresher, all ebolaviruses are the family Filoviridae and the genus Ebolavirus. There are five different species within that genus: Reston ebolavirus (RESTV); TaÃ¯ Forest ebolavirus (TAFV); Bundibugyo ebolavirus (BDBV); Sudan ebolavirus (SUDV); Zaire ebolavirus (EBOV).

And then we have a obligatory illustrative cute cat picture, because this is just likeWell, with significantly less cuddles. how cats are members of the same family (Felidae) and the same genus (Felis), but have a variety of different species.

Bv48v2KIQAAFYEE

But what does it mean when we learn that, in fact, it’s the same species of ebolavirus, but different variant? Simply put, it just means being even more specific: variant fits inside species fits inside genus fits inside family.Are you having flashbacks to biology class yet? (Inside order. Viruses stop at that point; for the curious, the family Filoviridae is part of the order Mononegavirales.)

Variants are written out in a specific way that tells you the virus name, the isolation host-suffix, country of sampling, year of sampling, variant designation, and isolate designation. It looks like this:

For more information on all of this, see: Kuhn J, Bao Y, Bavari S, Becker S, et al. Arch Virol. Jan 2013; 158(1): 301—311.

The current epidemic started with, it is presumed, a Guinea variant GuÃ©ckÃ©dou,The NEJM article discussing contact tracing back to a December case in GuÃ©ckÃ©dou. which would be written like this:

Ebola virus H.sapiens-wt/GIN/2014/Gueckedou-XXXXX

This tells us that it’s an ebolavirus infecting homo sapiens (that’s us humans), wild type (it hasn’t been cultured), that it was sampled in Guinea in 2014, and that the variant is GuÃ©ckÃ©dou.There is a brief post on Virology Down Under about this, too. (Don’t worry about the isolate. That’s basically an individual code that’s given per sample, hence the name.)

Clearly, at this point, it becomes harder to do a one-to-one correlation between viruses and kitties, because kitties don’t break down into variants and isolates, but work with me a bit here. What cats do break down into is year they were born, litter, and even what they look like. So we do have ways we tell each individual Felis catus apart, even though we recognize them all as belonging to the genus Felis and species catus.

DifferentVariants80Per

In theory, we could roughly write these two cats out like this, utilizing their species, country of origin, year they were born, where they were born, and their name:

F.catus-wt/USA/2005/Philadelphia-Zeus

Yes, Toledo is from a place in Washington called Cougar. Honest.

Just as we can all look at Zeus and Toledo and see that they’re different domestic cats (but still clearly domestic cats, all the same), researchers can look at the virus they isolate from individuals and see that they’re different variants of the same strain. In the case of the outbreak in the DRC, it was a variant most closely related to the 1995 Kikwit Zaire ebolavirus outbreak.

So why does this matter? In an era of ebolanoia, it’s important to understand what it means when there’s an epidemic of Ebola in one area of the world and a new outbreak in another. People are quick to panic and assume that all outbreaks are connected to the epidemic, and equally quick to forget that ebolavirus has been cropping up sporadically for nearly 40 years in other parts of Africa. Knowing how scientists differentiate between strains and variants within viruses is another tool in being an educated and informed media consumer.

Help Stop Ebola with this One Simple Trick!*

August 27, 2014 Kelly ...and everything else, Bioethics

I mean, other than donating to aid organizations that desperately need help, that is.

See, yesterday, it was revealed there was yet another Western person being treated with ZMapp. Yep, that experimental drug that the world supposedly ran out of last week. Except, apparently, when there’s a Briton involved, in which case, someone checked behind the couch cushions, NIH thought to look in an unused cold storage closet, or who knows—because that’s the problem. The world now knows British man Will Pooley received at least one dose of ZMapp and will receive more, and no one has explained how the Royal Free Hospital happened to stumble across these doses that theoretically didn’t exist. In fact, all they’re saying is

[T]he team treating the nurse had sourced the drug through its clinical networks with the help of international colleagues.

Well, that’s not at all suspicious. Clinical contacts? International experts? Sure, that doesn’t sound at all sketchy.

See, the thing is, we’re going back to risk communication, international relations, and the people who are dying en masse in affected countries who’ve been told that there is just no drug left. When you say “nope, sorry, no drugs left, we are all and completely out of ZMapp” and then manage to suddenly find some when a white British guy needs it, you foster a climate of mistrust—something that’s already a huge issue that doesn’t really need further fuel on the fire.

Which is why, at this point, when these random unaccounted for surprise stores of ZMapp are discovered, there needs to be transparency about where it came from, why we didn’t know about it, and why it was suddenly found. Because otherwise, it sure looks like the double standard of treatment for Westerners vs. native Western Africans is continuing to happen.

(*How does this help to actually stop Ebola? Right now, one of the bigger issues being seen in countries like Liberia and Sierra Leone is a complete lack of trust in Westerner health care workers who are trying to help. Reinforcing the idea that there is a cure for Westerners when people in Liberia, Sierra Leone, and Guinea have been repeatedly told there isn’t a cure for them is going to continue to emphasize this lack of reason to trust, and that trust is an extremely crucial step to all of the very basic things that need to be done to stop this outbreak from spreading any further. At this point, I’m leaning pretty hard on it being unethical for doctors or journalists to report on ZMapp use without also identifying the source of the drug.)

Know Your Species: SUDV vs. EBOV

August 25, 2014 Kelly ...and everything else

Last night, it was confirmed that at least some of the hemorrhagic deaths in a remote area of the Democratic Republic of Congo are from an ebolavirus—but it looks like it’s species Sudan ebolavirus (SUDV), rather than the one ravaging Sierra Leone, Guinea, Liberia, and trying to get a foothold in Nigeria: species Zaire ebolavirus (EBOV). Technically, EBOV is the only member virus within the species Zaire ebolavirus, but let’s keep it simple. …simpler.

In other words, while the two outbreaks involve members of the same family (Filoviridae) and the same genus (Ebolavirus), they are not the same species.

It might help to think about cats.Ian Mackay uses cars, and goes into much more detail. But frankly, it’s the internet. Cats are the obvious go-to. Like these guys:
Bv48v2KIQAAFYEE

While these cats are both members of the same family (Felidae) and the same genus (Felis), their species are different. In fact, black-footed cats and the common domestic house cat look similar enough that it’s often hard to tell them apart without either being an expert or getting a genetic test.

Which is pretty much how it works with SUDV and EBOV, too.

So keep that in mind when people start sky-is-falling about Africa: there are currently two species of the genus Ebolavirus in (probable) outbreak, and there is no known link between the two. And, for what it’s worth, this isn’t the first time both SUDV and EBOV have occurred at the same time. As a matter of fact, the very first known outbreak of both overlapped.More than one person, myself included, has wondered if we might be seeing some sort of weather- or animal migration-related pattern emerging.

Aid Organizations Working in Ebola Regions

August 17, 2014 Kelly ...and everything else, Politics

Last night, Ian Mackay posted this very disturbing logistics/supply chain chart, showing that some personal protective equipment stock in countries battling Ebola are at “zero” – and have been for a while. Articles from the and New York Times bleakly illustrate just how bad the situation has become.

Donation box. Note: Cats are not needed at this time.

Because, contrary to popular opinion, humans don’t always suck, people seeing these posts immediately started asking what they can do to help and began brainstorming ways to crowd-fund supplies. However, as Twitter user Macrophagic so succinctly put it, the best thing to do right now is use established supply lines.For more information on why this is the case, read Harvard professor Calestous Juma’s excellent Al Jazeera op-ed on how the lack of infrastructure in the affected region and how this affects all public health.

In support of both people’s inclination to give, and to have that giving filter through established supply lines, here is a list of trustworthy organizationsTrustworthy as defined by me, based on research, name recognition, and Charity Navigator if possible. Vague, I know, but I wanted to get an international-as-possible list up as quickly as I could. that, as of Sunday, August 17, are still operating in Sierra Leone, Guinea, and Liberia. I’ll update this list as I come across more information, or as people enter/leave the affected region(s). Feel free to add your suggestions in comments.

Please check to see if your workplace does matching donations for charity.

The CDC Foundation
The CDC Foundation is an independent, nonprofit organization that connects individuals and the private sector with CDC’s expertise and distribution channels. The Fund’s Global Disaster Relief Response Fund is only activated during extreme emergencies, and has been activated for the Ebola crisis. They are providing personal protective equipment, communications equipment, emergency operations equipment, and funds for public health campaigns. The CDC Foundation received a rating of 96.07 from Charity Navigator. Donations are accepted worldwide.

The International Federation of Red Cross and Red Crescent Societies
IFRC is the world’s largest humanitarian network. Their donation page currently has a Syria crisis appeal, but if you select “donate,” the second option is for their Ebola campaign. You can also make a donation to your specific Red Cross or Red Cresent; here is the link to the American Red Cross website; that donation is tax-deductible. (I would recommend donating directly to the IFRC website, as that is guaranteed for Ebola efforts.) The American Red Cross receives an 85.25 rating from Charity Navigator.

Updated 21 August: Here’s the link to the Australian Red Cross donation page. They’re helping with awareness, contact tracing, medical treatment, and burial.

Direct Relief
Direct Relief is coordinating with doctors on the ground in Sierra Leone and Liberia to provide personal protective equipment and other supplies, which are being sourced directly from manufacturers. You can direct your donation to their Ebola efforts; they accept international donations. Charity Navigator gives Direct Funds a pretty amazing 99.71 rating.

AmeriCares
AmeriCares is organizing air shipments to hospitals in Liberia that have no necessary personal protective equipment, including gloves, gowns, and masks. They are accepting contributions for future shipments. AmeriCares receives a rating of 92.89 from Charity Navigator. Donations are tax-deductible.

Medecins Sans Frontieres/Doctors Without Borders
MSF has been pushed to its limits in the outbreak region, and vocal about it. What they need right now, however, is not more supplies, but more people. Their current fundraising campaign for Ebola is listed as fulfilled, and they are requesting that donations be made to their general fund for a more flexible response. MSF anticipates being in the West African region for at least six more months, so it’s entirely likely that they will re-open fundraising for that region. That said, given the extended timeline, it’s plausible general funds will be used. However, they are working in multiple regions of the world, so there is no guarantee that donations to the general fund will be used in West Africa. MSF/Doctors Without Borders receives a 92.03 rating from Charity Navigator. Donations are tax-deductible.

Added 21 August
World Food Programme
With quarantine (quite literally cordon sanitaires) enacted in many of the Ebola-affected regions, food supplies are becoming critical. The World Food Programme is ramping up efforts to feed people caught in the Ebola quarantines. You can read more about that here, and donate at this link. World Food Programme is 100% funded by donations, and the US arm of the organization receives an 89.11 from Charity Navigator. US residents who would like their donation to be tax deductible can donate here.

Added 25 August
UC San Francisco: Support the Emergency Ebola Response
UCSF clinician Dan Kelly has returned to Sierra Leone to operate a nationwide distribution network for emergency medications and supplies from their international partners; support the Ebola isolation and referral center at Kono’s Public Hospital; implement strict screening and control measures at the UCSF facility in Sierra Leone; coordinate emergency referrals to Ebola treatment centers in Kailahun District; collaborate with the District Health Management Team to implement effective contact tracing and sensitive community engagement. There is a matching gift opportunity here; every gift of $250 or more will be matched up to $50,000 total, through 30 September, thanks to the generosity of an Anonymous Donor. International donations are accepted, and US donations are tax-deductible.

Added 2 Sept
UNICEF
UNICEF is working in Nigeria to help quell their Ebola outbreak. Those in the United States can make a tax deductible donation at this link. If you’re an international donor, go here to find your country. The United States Fund for UNICEF is rated 93.69 by Charity Navigator.

Elizabeth R Griffin Research Foundation
The Griffin Foundation is working in Nigeria; you can find donation information here. I don’t know much about the group, but the foundation was formed in memory of a woman who died after contracting macaque-born B virus. The foundation works worldwide to promote safe and responsible practices for handling biological materials. So, you know, seems like they’re pretty useful right now. This foundation has not been rated by Charity Navigator.

Hospitals for Humanity
Hospitals for Humanity provide quality and affordable health care in disaster areas and people in the developing world. In addition to providing care, they also provide medical training and education to the local population. You can help by either volunteering for a medical mission or donating. Hospitals for Humanity has applied for 501(c)(3) status, but not received it yet. They are not rated by Charity Navigator.

Added 8 September
Global Giving Ebola Epidemic Relief Fund

Ebola continues to spread across West Africa, with the number of those affected continuing to rise dramatically. The latest report from the World Health Organization counts 3,069 cases of Ebola in the region and 1,552 deaths from the disease so far.

Global Giving’s Ebola Epidemic Relief Fund focuses on getting grant money on the ground fast, so that rapid responses to changing situations can be made. They are in the middle of a 400,000 fundraising appeal. Here is a full list of grants to date:
-Â BRAC (Sierra Leone) — $10,000
– DEVELOP AFRICA (Sierra Leone) – $26,000
-Â DOCTORS WITHOUT BORDERS (Sierra Leone) — $5,000
-Â FOUNDATION FOR RESTORING WOMEN’S HEALTHCARE TO LIBERIA (Liberia) – $18,000
-Â GBOWEE PEACE FOUNDATION (Liberia) — $5,000
-Â GREATEST GOAL MINISTRIES (Sierra Leone) – $20,000
-Â IMANI HOUSE (Liberia) – $30,000
-Â INTERNATIONAL MEDICAL CORPS (Sierra Leone) – $10,000
-Â INTERNEWS (Guinea) — $10,000
-Â LIFELINE ENERGY (Liberia) — $5,000
-Â WEST POINT WOMEN FOR HEALTH AND DEVELOPMENT (Liberia) — $10,000

Global Giving is a charity fundraising web site that receives an impressive 97.94 rating from Charity Navigator. An anonymous donor is matching all new recurring monthly donations to the Ebola Epidemic Relief Fund. Donations are tax deductible for Americans.

Category: …and everything else

OutbreakChat: A Livetweet of a Movie That Gives People Nightmares,…

Know Your Variants: Kikwit vs Gueckedou

Help Stop Ebola with this One Simple Trick!*

Know Your Species: SUDV vs. EBOV

Aid Organizations Working in Ebola Regions

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