By Michaael Fumento in Vol. 1, Issue 1 of Inference Review, October 2014:
There have
been far fewer cases of, and deaths from, Ebola Virus Disease
(hereinafter “Ebola”) during the period of the recent outbreak than from
numerous other endemic diseases that primarily afflict Africans, such
as malaria, tuberculosis, HIV/AIDS, and childhood diarrhea.
Yet there is a widespread sense, in the media and among the public,
that particularly urgent measures must be taken to combat Ebola. This is
owed in large part to estimates of future cases produced by
the World Health Organization (WHO) and the US Centers for Disease
Control and Prevention (CDC). Their representatives have accompanied the
presentation of these estimates with powerful rhetoric, as have
representatives of other public health organizations. Headlines predictably focus on the upper bound of the CDC estimate, rather than providing the range.
Yet both the WHO and the CDC have arrived at their distressingly high
figures by ignoring epidemiological principles successfully applied
since the nineteenth century. These indicate that Ebola infections and
even cases may have already peaked.
“The Ebola crisis we face is unparalleled in modern times,” said WHO Assistant Director-General Bruce Aylward,
while WHO Director-General Margaret Chan declared Ebola to be “likely
the greatest peacetime challenge that the United Nations and its
agencies have ever faced.”
In fact, tuberculosis alone has killed an average of 3,561 people per
day in the past year, whereas the death toll from the recent epidemic of
Ebola stood at 3,439—total—on October 1, 2014. According to the WHO’s
data, recent death tolls from malaria, chronic diarrhea, and other
plagues of that region have also been orders of magnitude higher. These
diseases, too, for the most part confine their killing to same
continent.
Only if the estimates are correct or relatively close could Ebola
be considered in the same league with those diseases, much less
considerably worse. These assessments might generously be considered
“beat-ups,” as in “beating up the numbers.”
The term is owed to Elizabeth Pisani, a former epidemiologist for
UNAIDS (the Joint United Nations Program on HIV/AIDS), the WHO, and
other agencies. In her book, The Wisdom of Whores: Bureaucrats, Brothels, and the Business of AIDS,
she says of drastically inflated predictions, “We did it consciously. I
think all of us at that time thought that the beat-ups were more than
justified, they were necessary” to get donors and governments to care.
In the September 26, 2014, issue of its in-house journal, The Morbidity & Mortality Weekly Report (MMWR),
the CDC wrote, “[e]xtrapolating trends to January 20, 2015, without
additional interventions or changes in community behavior (e.g., notable
reductions in unsafe burial practices), the model ... estimates that
Liberia and Sierra Leone will have approximately 550,000 Ebola cases
(1.4 million when corrected for underreporting).
The choice of a seemingly odd date, as opposed to the end of the
calendar year, will be discussed shortly. The CDC also made a
shorter-term estimate of “approximately 8,000 Ebola cases” by September
30, 2014. A WHO analysis published in the September 23 New England Journal of Medicine (NEJM),
widely considered the United States’ most prestigious medical journal,
predicted more than 20,000 cases in Guinea, Liberia, and Sierra Leone by
November 2, 2014. Both estimates were entirely of morbidity, with no mortality component.
Even a cursory analysis should make one skeptical. Such an increase
in the number of cases would be quite dramatic, given the starting
point. On October 3, 2014, the WHO reported that only two days before,
there had been 7,178 “probable, confirmed and suspected cases,” with
3,338 deaths, in Guinea, Liberia, Nigeria, Senegal, and Sierra Leone.
(The Democratic Republic of the Congo has a small, separate epidemic of
a different strain that has received only passing remark from the WHO.)
They allow for a two-day lag in reporting, and more cases may come in
for that period, thereby expanding the figure; but many of those
probable and suspected cases will prove to be false positives, reducing
the figure. (The CDC notes that only 4,087 of these reported cases, or
slightly more than half of them, have been confirmed by a laboratory.)
That means the CDC short-term estimate through September has already
been proved false. The epidemic officially began in December 2013, so
the WHO is suggesting that morbidity from a nine-month outbreak will
approximately triple in one month. The CDC is claiming there will be an almost 75-fold increase (using the lower boundary) in little more than three months.
During all major recent epidemics, from HIV to the current Ebola
epidemic, individual observers and organizations have warned that a
mutation might make the pathogen more contagious.
But this has never been observed. Nor does either agency’s estimate
rest upon the assumption of increased contagiousness. It is also
somewhat remarkable that these estimates showing sudden, huge spurts in
growth were published after the WHO announced that Ebola had, in fact,
been eliminated from one of the countries suffering internal
transmission, Nigeria.
In an online response to the WHO analysis in the NEJM, the
French mathematician Marc Artzrouni explained why that agency’s model
and that of the CDC are at best meaningless, and at worse designed in
such a way as to overstate future cases. “Extrapolating an epidemic on
the basis of the early exponential period alone is pointless—simply
because there is no way of knowing how long this period will last. This
was done 30 years ago with HIV and produced very misleading results.”
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