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Modeling the Ebola Outbreak in West Africa, 2014

Modeling the Ebola Outbreak in West Africa, 2014. August 19 th Update Bryan Lewis PhD, MPH ( blewis@vbi.vt.edu ) Caitlin Rivers MPH, Eric Lofgren PhD, James Schlitt , Katie Dunphy , Stephen Eubank PhD, Madhav Marathe PhD, and Chris Barrett PhD. Currently Used WHO Data.

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Modeling the Ebola Outbreak in West Africa, 2014

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  1. Modeling the Ebola Outbreak in West Africa, 2014 August 19th Update Bryan Lewis PhD, MPH (blewis@vbi.vt.edu) Caitlin Rivers MPH, Eric Lofgren PhD, James Schlitt, Katie Dunphy, Stephen Eubank PhD, MadhavMarathe PhD, and Chris Barrett PhD

  2. Currently Used WHO Data • Data reported by WHO on Aug 22 for cases as of Aug 20 • Sierra Leone case counts censored up to 4/30/14. • Time series was filled in with missing dates, and case counts were interpolated.

  3. Epi Notes – WHO reports • Unsettling Underestimation assessment http://www.who.int/mediacentre/news/ebola/22-august-2014/en/ • Significant undercounting of cases suspected • Lots of fresh graves in villages with no reported cases • ETCs overwhelmed in hours, non-ETC triage centers getting flooded with patients • Large swaths of areas blockaded off with rumors of infections • Healthcare worker impact http://www.who.int/mediacentre/news/ebola/25-august-2014/en/ • 240 HCW infected, 120 dead • Depleting the workforce, estimate 1-2 docs /100K pop • Liberian doctor Borbor dies after Zmapp Rx • First WHO HCW infected (Brit already back in UK)

  4. Epi Notes • Travel restrictions (flight bans) increasing • Limiting WHO’s ability to bring in staff • Addressing a very small risk and counter productive • WHO tweet (8-25 @4pm) • 100 more confirmed cases than previously reported as of 8-20 (16 additional deaths) • Maybe a reporting artifact from more tests

  5. Epi Notes • Outbreak in DRC • Dozen or so suspected cases a couple confirmed positive • Confirmed evidence that it is NOT related to West African outbreak, different strain • Supplies are arriving! • 16 tons of USAID supplies https://twitter.com/theOFDA/status/503625464049856513) • 68 tons of UNICEF supplies (http://www.unicef.org/media/media_74868.html) • Many other smaller ones like: 30k lbs from Fort Worth http://www.star-telegram.com/2014/08/25/6066313/planeload-of-ebola-supplies-leaving.html

  6. Tweet volume

  7. Liberia Forecasts

  8. Liberia Forecasts rI: 0.95 rH: 0.65 rF: 0.61 R0 total: 2.22

  9. Liberia Forecasts

  10. Liberia Vaccinations

  11. Liberia – Better Isolation

  12. Liberia – Better Contact Tracing

  13. Sierra Leone Forecasts

  14. Sierra Leone Forecasts rI:0.85 rH:0.74 rF:0.31 R0 total: 1.90

  15. Sierra Leone Forecasts

  16. Sierra Leone Vaccinations

  17. Sierra Leone – Better Isolation

  18. Sierra Leone – Better Contact Tracing

  19. All Countries Forecasts rI:0.85 rH:0.74 rF:0.31 Overal:1.90

  20. Guinea, Sierra Leone, and Liberia

  21. Why now? What is different • Role of chance not to be discount • Running expt to look at expected outcome in this pop

  22. Next Steps • Data pouring in: • Landscan • Tribal Distributions • Road networks • Procedural info for delivery of care and diag etc. • Initial version of Sierra Leone constructed • Tests to verify and validate • Begin simulations • Build similar versions for other affected countries

  23. Next Steps • Mobility data from Flowminder • Under Analysis to compare with our estimates

  24. Next steps • Publications • One planned for submission • 2 quick communications in prep • Problems appropriate for agent-based approach • Logistical questions surrounding delivery and use of medical supplies • Effects of limited HCW both direct and indirect • Synthetic outbreaks to compare to what we’ve observed of this one, to estimate true size

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