Aviation and the Ebola epidemic in West-Africa

[sn-remember]

@Inquirer
You are right. So I said "reaffected for that purpose
Meaning sanitary measures like individual bedrooms and bathrooms, just a common canteen, meals served on individual plates?
It would need the supervision of specific healh services to detect the first symptoms.
It's mainly when first symptoms emerge that the sick person should be sent to a hospital special unit .
As you must know , contagion is considered low risk during the AP.
Also I would (cautiously) suggest affecting 10 such units (around 150 bedrooms each) , each sdedicated for each arrival . So no mixing with potentially different satge of the disease.(I know arguable and it's not the main point)
..
But I don't pretend this is the best way to organise it at all ..
Any better suggestion ?

[Flanker2]

The problem is that each room would require its own sanitation facilities. This is not the case at most military establishments where the sanitation facilities are often shared, even if rooms are separate. Sanitation is important, people need to wash, poo, pee, etc...
If you visit the military facilities, you can also see that most are pretty old, in bad shape and not comfortable. I think that comfort should be good, so that people can go along with it.
Reaffecting those would cost more and take more time than fully booking the Holiday Inn at BRU.

You also need facilties that can prepare and provide food, facilities that are easy to clean and collect as many "patients" as possible within one establishment so it can be done efficiently, avoiding that doctors and nurses would have to move around the country.

There should be no direct contact, so each person would need his room with his own sanitation facilities.
Group contact is obviously not acceptable, as it would spread Ebola if someone does have it.

Collecting garbage would be the nastiest part, but it can be done.

120 pax, 6 times a week is not realistic, hence such operations should be stopped and reduced to scheduled charter operations using government lift (Government Gulfstreams etc...) for aid workers only, at a rate of 20 per day, 6 times a week.
That way, a facility with 360 rooms would be able to handle the inflow and outflow of isolations.

This would cost much less than isolation and quarantines all over the world, which cause aircraft to be delayed, trains to be cancelled, people to be inconvenienced. It saves also a lot of hysteria.
And it avoids unnnecessary deaths, which is the main prize.

Obviously all other borders of the Ebola-3, maritime or ground should be closed, so that authorities can organise a Blitz on Ebola to contain it and eradicate it within months.
This is the only way to stop it at this level, so that economical activities, flights and lives can resume as soon as possible in the Ebola-3. It's short pain, long gain.

At this scale, Ebola is no longer going to diffuse by itself, so action is required, and spreading it to the rest of the world is the unthinkable. It's a form of terror, as people are going to experience fear.

[Passenger]

OK thank you Passenger. However I was talking of some 120 pax on a 6 weekly basis. Lets stick to that ?

It's no quarantine then: it's just a Lotto quick pick: "Take some of the risk flights, isolate some of the passengers". Doing so, you will not eliminate that a passenger with ebola virus in him escapes the net. And after all, shouldn't that be the end result of a missive quarantine: zero limit?

[sn-remember]

@Passenger : you still didn't answer my question
@ Flanker : my post and yours mihjt have collided . Did you read through?
Especially the contamination risk I mention ?

[sn-remember]

Reaffecting those would cost more and take more time than fully booking the Holiday Inn at BRU.

You may have a point there ..
However you would need 10 such 120 b/r hotels booked for that purpose .. Of course better select the cheapest ones. So lets say 50 eur/night *10=500 euro to charge in addition to the ticket price..
It seems to me feasable. But I am still not considering the health service cost in that bill.
If I remember well, Sabena when operating at lad during the war was charging something like 500 euro extra to the normal ticket price for insurance purpose.

[airazurxtror]

https://yahoo.skynet.be/actualites/belg ... ls-airport

Les syndicats de Brussels Airport ont fait part de leur satisfaction après que Charles Michel eut annoncé, sur RTL-TVI, que les voyageurs en provenance des pays africains actuellement touchés par la fièvre Ebola seraient "screenés" à leur arrivée à l'aéroport belge.
Erika Vlieghe doit présenter dans le détail, ce dimanche après-midi, les nouvelles mesures qui seront prises contre Ebola à Brussels Airport.

http://www.lalibre.be/actu/belgique/ebo ... 2e50907028

Le Premier ministre Charles Michel a annoncé dimanche sur RTL-TVI que "dès demain, les voyageurs en provenance des pays touchés par Ebola seront screenés lors de leur arrivée en Belgique" à l'instar de ce qu'ont déjà décidé plusieurs autres pays.

Brussels Airport unions have expressed their satisfaction after Charles Michel has announced on RTL -TVI, that the travelers from African countries currently affected by Ebola would be " screened " upon arrival at the airport, from tomorrow.
Erika Vlieghe must disclose in detail, this Sunday afternoon , the new measures that will be taken against Ebola at Brussels Airport

[Passenger]

@Passenger : you still didn't answer my question

Think I did:

Putting only 120 pax on a 6 weekly basis in isolation is no qurantine: it's just another measure to reduce an already low risk. Quarantine should result in zero risk.

[Flanker2]

Apparently they're starting to organise a little bit:

http://www.hln.be/hln/nl/957/Binnenland ... land.dhtml

Finally Ebola screenings, a much needed first line of defense that already rules out that symptomatic people would come into the country and the rest of the world.
----------------------------------------------------------------
But this measure can't catch everyone, so they shouldn't stop here.

The government should move to buy out all SN seats and allocate them exclusively to aid workers who will submit to a regimen of isolation upon return, if returning before Ebola is contained in the Ebola-3.
"Unfair competition" is ruled out as it's a global emergency and the EU will approve it as a temporary state aid measure, if revenues per flight remain the same.

SN-remember, you would need 18 x 120 rooms for 21 day isolation regimen.
Although many countries like the U.S. do have 1000+ room hotels, this is not the case in Belgium or in Europe in general.

I think that people who don't need to travel shouldn't travel.
So maybe if they sell 5.000 EUR tickets, with a 21-day isolation vacation included, it could be acceptbale. That way only people who really need to travel will (such as people who have to go back for their job, etc...), and the rest will be aid workers.

This way we also protect the friends and families by avoiding unnecessary VFR travel, like Duncan.

[sn-remember]

@passenger (and Flanker)
Indeed it's not strictly quarantine .. Rather it is isolation from the ROW in order to react quickly and neatly should some symptom occur.

[sn-remember]

Apparently they're starting to organise a little bit:

http://www.hln.be/hln/nl/957/Binnenland ... land.dhtml

Finally Ebola screenings, a much needed first line of defense that already rules out that symptomatic people would come into the country and the rest of the world.

But it can't catch everyone, so we shouldn't stop here.

The government should move to buy out all SN seats and allocate them exclusively to aid workers who will submit to a regimen of isolation upon return, if returning before Ebola is contained in the Ebola-3.
"Unfair competition" is ruled out as it's a global emergency and the EU will approve it as a temporary state aid measure, if revenues per flight remain the same.

SN-remember, you would need 18 x 120 rooms for 21 day isolation regimen.
Although many countries like the U.S. do have 1000+ room hotels, this is not the case in Belgium or in Europe in general.

I think that people who don't need to travel shouldn't travel.
So maybe if they sell 5.000 EUR tickets, with a 21-day isolation vacation included, it could be acceptbale. That way only people who really need to travel will (such as people who have to go back for their job, etc...), and the rest will be aid workers.

This way we also protect the friends and families by avoiding unnecessary VFR travel, like Duncan.

OK on second reading the govt is just doing nothing yet .. right ? (On first glance I thought the whole of your post was a govt statement). Screening is not effective .. more symbolic than anything

[Flanker2]

It's good news indeed, but I think that they shouldn't stop here to give a false sense of safety, and should go a step further.

Despite what people here think, well-informed hln readers have already identified that this is only a half-measure, and continue to call for an end to the flights. (and I don't know any of those people before you accuse me). It's just plain common sense.

http://www.hln.be/hln/nl/942/Economie/a ... show=react

I can live with continuation of flights if only restricted to aid workers against Ebola and a 21 day paid holiday in a hotel, hospital or any type of suitable isolation facilities upon return, even if we, the public have to pay it with our goddam taxes.
I don't care if I have to pay 100 euro more taxes this year, as long as we avoid unnecessary deaths and don't need to worry about coming in contact with other people.

Other people who want to travel can also do it, but isolation costs should be at their own expense.
And not only SN, but also RAM and AF, otherwise there is no meaning.

[sn-remember]

Despite what people here think, hln readers have already identified that this is only a half-measure, and continue to call for and to the flights.

http://www.hln.be/hln/nl/942/Economie/a ... show=react

I can live with continuation of flights if only restricted to aid workers against Ebola and a 21 day paid holiday in a hotel upon return, even if we, the public have to pay it with our goddam taxes. I don't care if I have to pay 100 euro more taxes this year, as long as we avoid unnecessary deaths.
And not only SN, but also RAM and AF, otherwise there is no meaning.

Of course they should go for the complete measure.
And, like the HLN readers, I completely agree and support your post here.
+1
I am still UNhappy SN are NOT YET doing things cleanly (I AM amazed how they CAN defend such a dangerous operation) and so UNhappy our govt is NOT doing things COMPLETELY professionally YET!

[Flanker2]

.

OK on second reading the govt is just doing nothing yet .. right ? (On first glance I thought the whole of your post was a govt statement). Screening is not effective .. more symbolic than anything

I edited to make it a bit more clear, indeed. It was bit confusing there.
Like you, I'm glad though that the first steps are being taken and that it can ultimately lead to something productive.


Let's also remind ourselves that ebola is in a totally different category of epidemics:
-H1N1 mortality rate 1.5%
-SARS mortality rate 10%
-Ebola mortality rate 70%

Ebola has already surpassed SARS in number of cases and has already 5 times more deaths, so this is not a joke.

[Passenger]

Yep. The forum on HLN.be runs. And it will be fun, as usual:

Ik vermoed dat het virus al in het land aanwezig is, maar dat het er al zoveel worden dat ze het niet meer kunnen stilhouden

Translated: I think that the ebola virus is already in Belgium, but that so many people are infected by now that it became impossible for them to cover it up.

Men moet de ebola-onkosten in ons land verhalen op de landen waar het virus vandaan komt.

Translated : Belgium should recover its ebola expenses from the countries from where the virus comes from.

Fact is that most of those HLN forum posters disagree with the basic principle of the fight against ebola: a constant and spreaded flow of western aid workers is the only way to stop ebola in West Africa, and stopping ebola in West Africa is the only way to avoid that ebola becomes a worldwide pandemy.

[Inquirer]

Let's also remind ourselves that ebola is in a totally different category of epidemics:
-H1N1 mortality rate 1.5%
-SARS mortality rate 10%
-Ebola mortality rate 70%

Ebola is also extemely difficult to get since it can't be passed on through the air, like the 2 others.

As a well informed HLN reader yourself, I am sure you read that one has more chance of being killed by a flatscreen falling over, than by Ebola.

A second screening on arrival seems like a low key measure to take: in combination with a pre-departure check, this will re-assure everybody flying on the plane as well as all staff having to work on it afterwards, that there was indeed nobody contagious onboard. If no contagious Ebola patient boarded the plane and no contagious patient deboarded the plane in BRU, there logically can't have been one on it and so the hysteria can stop.

Other than that, the best possible quarantine is our own individualistic Western European way of living: the average household is just 1 or 2 persons: one can't be living much more isolated than that almost.
Since you can't get it from just sitting next to somebody with Ebola for instance you really have to share bathroom and other stuff as a very minimum, let's just combine our natural social quarantine with sensibilization to join a hospital as soon as you have fever developing.
Bring your partner with you in that case and we're done.
It worked pretty well in the USA or Spain.
Just common sense really.

[Squelsh]

Let's also remind ourselves that ebola is in a totally different category of epidemics:
-H1N1 mortality rate 1.5%
-SARS mortality rate 10%
-Ebola mortality rate 70%

When discussing epidemic and/or pandemic and especially the category of it, not the mortality rate takes upper hand, it's the infection rate that matters. This is basic logic

An HIV virus on speed... ok, saliva, sweat & snot to be added to the list of fluids..

If having to spend time in public transport, whether it be planes trains or busses, I prefer this one to be on the loose than any airborne virus, less or more mortal..

[Homo Aeroportus]

Gentlemen,
I appreciate your in-depth analysis and search for solutions but let’s not be over-optimistic and superficial here.
What about the crews? They should be put in quarantine as well, no?
Of course it may create a rostering problem if a crew cannot perform more than one rotation every 3 weeks but we cannot take risks. Maybe flight crews could be exempted though thanks to sterile cockpit procedures but then SN must provide them with diapers or block the forward toilet to their sole use.

I am also afraid that you are taking all this a bit lightly when you envisage a quarantine limited to only 21 days.
Please keep in mind the WHO warning as per Fact sheet N°103 Updated September 2014 :

People remain infectious as long as their blood and body fluids, including semen and breast milk, contain the virus. Men who have recovered from the disease can still transmit the virus through their semen for up to 7 weeks after recovery from illness.

So quarantine must be seven weeks at least, or 7 weeks after the last case became symptomatic and some bunga-bunga took place while in quarantine.

Let's hope a thorough solution will be found quickly.

H.A.

[sn-remember]

Other than that, the best possible quarantine is our own individualistic Western European way of living: the average household is just 1 or 2 persons: one can't be living much more isolated than that almost.
Since you can't get it from just sitting next to somebody with Ebola for instance you really have to share bathroom and other stuff as a very minimum, let's just combine our natural social quarantine with sensibilization to join a hospital as soon as you have fever developing.
Bring your partner with you in that case and we're done.
Just common sense really.

You forget the households with kids and babies it seems ...
And from the moment you are symptomatic you are VERY contagious, even if the virus is not airborne stricto senso it can still be EASILY transmitted in multiple ways of the daily life, arguably also though droplets expectorated while coughing or sneezing.
SO, every step from first symptoms to special care unit is EXTREMELY dangerous.
Everybody should know these facts, you the first who pretend to judge HYSTERICAL those who raise justified concerns over the spread of the virus and the reponsability of SN and govts in that spreading.
And you should NOT advise to direct those patients to the first hospital nearby but to a special hospital that can handle these cases. And the way they are conveyed theer is NOT simple either, taking a taxi or a public transport is NOT recommended at all.
ANd finally you should remember that even the asymptomatic phase is PROBABLY NOT completely without contagion risk (See Dr Beutler's analysis developped on P27 of this thread)
Etc etc, We can't correct every false statement, but please ...
That's why I say with many other qualified people that quarantine measures are indeed necessary.

[airazurxtror]

Le vol Air France pour Conakry a été annulé samedi à cause du cas suspect d'Ebola détecté lors des premiers contrôles sanitaires sur le sol français. L'avion a dû être "désinfecté en vertu du principe de précaution", a expliqué un porte-parole de la compagnie.
"La mise en oeuvre des vérifications imposées par les autorités sanitaires à une heure proche du départ s'est révélée incompatible avec le temps de service de l'équipage", a t-on précisé chez Air France. L'avion n'a donc pas pu décoller samedi après-midi comme prévu, "il est reparti dimanche à midi de Roissy".
http://www.lefigaro.fr/flash-actu/2014/ ... samedi.php

The Air France flight to Conakry was canceled Saturday because of suspected Ebola case on the previous flight from Conakry. The plane had to be " disinfected under the precautionary principle ," said a spokesman for the company.
" The implementation of the checks required by health authorities near the take-off time proved incompatible with the duty time of the crew . The aircraft was therefore unable to take off Saturday afternoon as planned, " he left Sunday noon."

It seems that it's always the same planes that fly between Paris and Conakry - no to risk infecting the whole fleet.

"S'il faut attendre qu'un de nos collègues ramène le virus Ebola pour stopper les vols commerciaux vers Conakry, ce serait un vrai drame", s’alarme Charlotte Marchand, hôtesse de l'air et membre du syndicat SNGAF. "On est 80 % de la population navigante à refuser ces vols", insiste-t-elle. Plusieurs compagnies européennes ont déjà décidé de ne plus desservir les destinations à risques, contrairement à Air France qui a maintenu sa liaison Paris-Conakry.
http://www.francetvinfo.fr/replay-jt/fr ... 23801.html

If it takes one of our colleagues to come back with Ebola in order to stop commercial flights to Conakry, it would be a real tragedy " , warns Charlotte Marchand, air hostess and member of SNGAF union. "We're 80% of the flight crews to refuse these flights," she insists. Several European companies have already decided not to serve destinations at risk, unlike Air France which has maintained its Paris - Conakry link.

[Inquirer]

You forget the households with kids and babies it seems ...

On average, the Belgian household is not even 2 persons.
I think you'll find the average heathcare worker's household to match this statistic fairly well, I'd think?
If not, well then bring your partner as well as your kid(s), done.

That's why I say with many other qualified people that quarantine measures are indeed necessary.

I have no right to judge the qualifications of anybody on this matter, yet I can't but notice that none of those qualified persons you refer to have made it to a position which allows them to even remotely influence -let alone take- the decisions you are convinced would be appropriate here in any of the countries dealing with this, so either these's an odd global mechanism at work here which systematically prevented those qualified people to rise to the many positions where their qualifications could have been useful, or these people were not picked to hold any of those positions in the past because even more qualified people were systematically available.

In the end we're luckily talking about a disease which isn't very likely to be spreading easily in Europe due to the rather intimate way in which it gets transmitted, so our western society is a good enough place to serve as both natural quarantine environment for the few cases that will come our way over time as well as a good social supervisory mechanism to contain any further spreading here quickly.
Albeit scary at first, such mechanism worked well in Spain and in Texas, didn't it?
Have a little faith in how it all gets done, especially since we're no experts at it.

The worst that can be done is often when amateurs take over, willing to implement more radical solutions and yes there's IMHO a lot of hysteria surrounding all this, as basically eveybody with a brown skin who's feeling a bit sick and risks vomiting is seen as a potential Ebola patient these days.
At some point in time, the sense of realism is to return and it better be quick or we'll have loads of false Ebola cases around the beginning of December, when drunk 'Zwarte Pieten' are going to be knocking at our doors.