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Forecasting Threats Like Ebola

Eleven months into the world’s worst Ebola outbreak, there have been more than 9,200 suspected cases and 4,500 deaths. The World Health Organization (WHO) estimates that 2.5 times that many have gone unreported and warns that there could be up to 10,000 new cases each week by December. At the current rate of spread, there could be 6 million infections by early April 2015 and over 6 billion by the following Halloween.

In Vietnam, Myanmar, and several major Chinese cities, health workers are screening international visitors for fever before they are allowed to leave the airport, though there has not been a single case of Ebola in Asia.

In the US, Congressional leaders are calling for a ban on travel to West Africa. President Obama found it necessary to warn that Americans “can’t give in to hysteria or fear” over Ebola and appointed a “czar” to deal with the crisis.

A few infectious-disease specialists have speculated that Ebola could mutate into a form that spreads through the air. “It’s the single greatest concern I’ve ever had in my 40-year public health career,” says Dr. Michael Osterholm, director of the Center for Infectious Disease Research at the University of Minnesota. If Ebola can be caught from a cough or sneeze, that would be a nightmare, and a catastrophic global pandemic would be all but guaranteed.

Is the global pandemic envisioned by TechCast’s Wild Card already at hand? Our forecasts offer some perspective on the odds for Ebola and other pandemics. The TechCast panel of experts estimates a 22-percent probability that “A new pandemic devastates a major region, destabilizing global society.” They also think the impact would be serious, measuring -4 on a scale of -10 to + 10.

Although an Ebola pandemic is possible, these estimates suggest that it is unlikely there will be 6 million infections. The Ebola outbreak spread because of basic mistakes. WHO experts in Africa downplayed the risks in reports to headquarters. Many countries were slow to react. Budget cuts at WHO and the US Centers for Disease Control impaired their preparations and hampered their response. In general, the world was unequipped for a major outbreak of a disease formerly limited to isolated villages in Africa.

This has changed dramatically. WHO estimated it would cost $600 million to end the epidemic. Governments and philanthropists have pledged nearly $2.1 billion. Funding for CDC’s work on Ebola has been restored. Experimental drugs from the U.S. and China are on their way to Africa, and development work has been ramped up.

As a result, there has been major progress against the epidemic. WHO has declared both Senegal and Nigeria free of Ebola. Success in Nigeria is especially good news. The slums of Lagos, variously estimated at between 15 and 25 million people, were considered the worst danger zone for a pandemic.

No matter how many new patients appear in December, the balance clearly is tipping. Ebola will be controlled long before infections soar into the millions.

The real danger comes from superbugs that develop resistance to antibiotics. It is widely believed that the excessive use of penicillin and other drugs for minor medical problems, and especially in livestock, is promoting the development of far more ferocious bacteria that could devastate modern societies. TechCast experts estimate a 38-percent probability that “Antibiotic-resistant superbugs become common threats to health.”

These TechCast estimates are just that—expert estimates—but they help give us a better basis for our judgments and actions. In the case of today’s Ebola outbreak, they suggest the dangers are manageable and there is no cause for panic. They also remind us there are far more likely and enduring health concerns, like superbugs, that deserve our attention.

For more forecasts, See

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