[thinkcontext]

I read elsewhere that this strain is less deadly than previous strains. I'm no epidemiologist but being less deadly could allow it to spread further, which is obviously concerning.

Also, the article says surveillance picked up the spread late. I wonder if the US's pulling back from the WHO and other international functions had anything to do with this, it used to make up a big chunk of its resources and staff.

[JumpCrisscross]

> read elsewhere that this strain is less deadly than previous strains

"Case fatality rates in the past two [Bundibugyo virus disease] outbreaks, reported in Uganda and in DRC in 2007 and 2012, have ranged from approximately 30% to 50%" [1]. Given "as of 15 May, a total of 246 suspected cases and 80 deaths" were reported, the current disease's 33% fatality rate is in the historic range.

[1] https://www.who.int/emergencies/disease-outbreak-news/item/2...

[ChrisMarshallNY]

Lower fatality rate (and longer gestation times) are things that make a disease spread farther (not necessarily faster -but we take care of that, with international travel).

The OG Ebola had almost 100% fatality rate, and a short gestation time (I think only a few days). It didn't spread too far. The one that killed a few thousand people, though, had about a 50% fatality rate, and I think its gestation period was a bit over a week (these are the products of a faulty memory, but quoting LLM output isn't considered polite, hereabouts, and, for all we know, they could hallucinate the stats, anyway). Also, a hemorrhagic fever pretty much chews up your organs, so it's likely to drive bad health outcomes, for the rest of our lives, even if we survive.

HIV/AIDS has (the meds just keep it at bay) a 100% fatality rate, but a very long gestation period.

COVID, I believe, had about a 1% rate, in the OG variant, and that brought the world to a standstill. I think Spanish Flu (another world standstill), had about 2.5%, and a relatively short gestation period, but it was also quite communicable.

[Izkata]

> COVID, I believe, had about a 1% rate, in the OG variant, and that brought the world to a standstill.

The claims that caused lockdowns were 3-10% death rate.

The world was brought to a standstill primarily due to massive fearmongering. The earliest high rates came from three things: Conflation of "infection" and "case", rationing of tests to people doctors were already pretty sure had been exposed (suppressing the denominator and inflating the rate), and biased samples (for example the Diamond Princess cruise ship was weighted towards the most susceptible population and maxed out 1.2% a month after the lockdowns had begun).

[michaelmrose]

Lockdowns were not after very very early numbers ever based on lies or fearmongering. The fatality rate we observed in the developed world was based on bad cases being able to receive prompt treatment.

Had it expanded faster it risked not only infecting a larger portion of the population pre-vaccination but also seeing more people who would have been salvageable with treatment dying innecessarily.

Pretending we could have experienced the death rate we did in our experience whilst also adopting a different strategy is farcical reasoning.

[pnt12]

Also, in my country, more hospitalizations would be quite severe, as the hospitals are already short staffed. There were also not enough masks for everyone to mitigate it.

I think a lot of anti-lock down claims are too simplistic. There were too many unknowns, and there's little consensus about the ideal outcomes.

(I'm a bit biased: I was able to do remote work and move to my parents house, which is quite spacious and near the woods, so I could go outside a bit - so it didn't affect my finances or mental health too much)

[pinkmuffinere]

I try to keep an open mind, and this is something that you might legitimately convince me of. However:

1. A comment on this forum is not really the place to convince people of such a bold claim. It deserves at least an article/blog post, and maybe even a short book.

2. There is a large jump between the claims [the initial fatality estimate was high] and [the world was brought to a standstill due to fearmongering]. This gap is perhaps something you could address in a longer blog post

This is exactly the kind of topic that I’d love to see gwern or slatestarcodex tackle. There might be some truth to your story, but it’s a complex topic and needs a _ton_ of discussion

[leereeves]

I used to have an open mind about this myself, until I saw the other side of healthcare.

Even with the lockdowns, Covid nearly overwhelmed the healthcare system in America. It led to a massive nursing shortage as nurses quit. The system could not have handled more cases appearing faster.

[whynotmaybe]

It's been picked up late because it's from Goma, a region in Congo currently operated by the March 23 Movement a "rebel" group against the current Congo's government.

[delichon]

GDP per capita, $1,884. I don't think poverty is a coincidence. Helping them become wealthy is a global health priority.

[cluckindan]

That would set a terrible precedent for all other areas suffering from poverty.

[javascriptfan69]

is this satire

[sofixa]

To expand on this, it's universally accepted that they're a group backed by Rwanda, and are there for the resources that the DRC has, which are being trafficked to Rwanda for export.

[throwaway27448]

> and are there for the resources that the DRC has

Oh dear. This has found its way on to HN. Since finding resources that clearly explain the situation is difficult from the west and difficult in english, the situation is many times more complicated. It's true that some of the resources that flow out of the eastern DRC flow out through Rwanda. It's true that M23 is clearly backed by Rwandan people and money. And for the record, I do not support any of the involved groups or states, but I do speak a couple of the many involved languages, and I did marry into the region, and I have spent years in north kivu in both the congo and in rwanda, southern Uganda, and a little in Burundi, and a little in Tanzania, and I have a large social network across the region.

Let us start with the surface level. M23 is just a puppet of Rwanda for regional imperialism, right? But the profits of the mines in the east Congo have never gone to the east Congo: the DRC has been essentially refusing to build infrastructure, or even govern, the east Congo since Zaire, since the first DRC, since the Belgian Congo, since the Congo Free State. And it's not easy, either: trying to govern Goma from Kinshasa is like trying to govern Berlin from Lisbon, but without developed roads or trains, through dense forest and up a river with many cliffs and rapids that make using it... actually governing the eastern Congo from Kinshasa is absurd. It's purely through the insistence of the west that this actually be the case.

Second, the DRC has one of the worst militaries (the FARDC) in the world. Probably easily the worst compared to the insane wealth it sits on top of. It's not a mistake: there has, essentially, never been a peaceful transfer of power in the country's history since colonization. This has been exacerbated by the literally hundreds of local militias that pepper the north and east of the country, actively armed by the government. This creates a situation of lawlessness and violence seen in few other places on earth: for instance, it has the highest rate of sexual violence of any place on earth, one of the highest rates of malnutrition, one of the lowest literacy rates, one of the lowest life expectancies. So: the country invests in collecting money from the mines as policed by its own military, invests in local militias to counter the military, and refuses to actually govern the area to enforce its own laws, build schools or hospitals, educate its populace, develop some of the most fertile ground on earth, let alone actually build supply chains around the mines it produces. By all reason it should be one of the wealthiest countries on earth, and yet it is not.

Third, the ethnic conflict of abanyarwanda never vanished. Not only does the FDLR (the remnants of the interahamwe) survive and thrive in the Congo after having fled their blatant attempt to exterminate the Tutsi in Rwanda in 1994, it is actively armed and works with the FARDC. Today you can go onto TikTok and find members of the FDLR who were born in the Congo talk about how much they hate the Tutsi and want to exterminate them once and for all. For the last six decades, the radios of northern and eastern Congo are filled with rhetoric about the Hema/Tutsi/Nilotic conspiracy to dominate the Bantu (Hutu/Lendu). Think the anti-semitic rhetoric we're all familiar with, but amplified by a conflation with hatred of the bourgeois, all driven from a city 1500 kilometers away. For a region that has one of the lowest literacy rates on earth, this means that violence has simply not stopped during this time. And yes, even today, abanyamulenge are subjected to concerted, state-driven, mass violence—because the locals think that Rwanda, the hand of Hema imperialism, has been on a centuries-long campaign to drive the Congolese from the region and take it out on the highland herders. The Hutu have, of course, also been subjected to mass violence for decades—including multiple obvious and internationally recognized genocides—but anti-hutu rhetoric is certainly not spread by Rwanda, or (by all indications available in the languages I can read) M23, or any of the AFC.

Why does the DRC actively perpetuate this ethnic conflict? Because it is a barely functional state, and the rulers are all deeply corrupt, and much of this money flows from the mines in the east, and it is easier to blame ethnic conspiracies than it is to build roads, bridges, schools, hospitals, electrical infrastructure, and in short develop anything. To admit the reality in naked terms—a necessary step to heal—would immediately start a civil war across the entire country, which is again barely tied together with twine to begin with. Both Kabila Sr (...an enormously interesting man) and his son clearly attempted to govern in an idealistic sense... but both eventually turned back to relying on ethnic tensions to explain the poor governance, particularly outside of but also in Kinshasa itself (...confusingly, but racism has rarely been very rational)

And of course, the mines are of deep international interest. Specifically, Canada, the US, China, and the UAE (I'm sure others too) all have their grubby mitts in the region developing only the infrastructure solely necessary to extract minerals, raping and enslaving the local populace, and paying off all the local governments to keep this ruse going. The governments of Burundi, Uganda, Tanzania, Kenya, Rwanda, and the DRC are each complicit in this obvious crime against humanity, each interested in their cut of the dollars that flow outward.

Now, of course, Trump managed to meddle in the region, and Erik Prince with his blackwater thugs are there ensuring that the terror of drone striking civilians and villages is well understood by the people of the eastern Congo. The DRC is now using US and UAE funds to build a new paramilitary to police its mines. The result will almost 100% certainly be a larger civil war in the east in the best case scenario, and in the worst case scenario complete regional total war with millions dead. Tshisekedi has obliquely telegraphed a desire to seize territory and/or topple the states of Rwanda, Uganda, and Burundi—in part because he realizes his life depends on the region not successfully ousting him. (Though—Burundi is now acting as a sort of mercenary force for the Congo, which is again unwilling to bankroll its own military, but I would not expect this relationship to last for very long.)

And do I support M23, the AFC? No. Absolutely not. But there is no solution for the region short of peace, and there is so many arms and so little infrastructure and so little centralized authority this is simply not possible. At the very least, it needs 100x the international attention and capital inflow that it is getting, and I see about as much chance of that as a wounded calf being saved from a pack of ravening wolves in the middle of nowhere. So is it surprising that Rwanda (or Uganda, or Burundi) has their troops in the DRC? No, not at all—it is an enormous, enormous existential risk to not do that. The east Congo makes the balkan powder keg look wet.

I'm sorry to have typed so much, but it is infuriating to watch the violence tearing apart my beloved north kivu being written off by one interest or the other as a simple conflict. No, there is nothing simple about the conflict, it is an enormous tragedy, and it was international intervention that created this problem with the Congo crisis—all to preserve precious mineral extraction supply chains. By all rational understanding I have, the east Congo should have some degree of self determination rather than being exploited and enslaved by Kinshasa, Uganda, Rwanda, the US, Canada, the UAE, and China—and there is simply zero path to that. Paradoxically, the attention M23 is bringing the region may have resulted in more efforts to govern.

And in the case of Ebola, nobody gives a fuck. Hah. LMAO, even. There is simply zero chance that something as delicate as disease management will visit the region before the governance question is answered. If this concerns you, become a praying person.

The resource is deeply outdated, and it has its biases and blind spots and points of frustration where the journalist who wrote it sees things from a very western perspective and/or was manipulated by the person he was interviewing or he is too skeptical to see what is in front of his face, but from the west if you only know English, I recommend the book Dancing in the Glory of Monsters: The Collapse of the Congo and the Great War of Africa by Jason Stearns.

I'm afraid I have mildly butchered the topic, but there is no easy way to approach the utter shallowness of which this will be seen from the west. The Congo suffers from a "resource curse", and I'm afraid it will be exploited until long after I die.

EDIT: there are other resources, some better than others.

EDIT2: cleaned up my language a little bit to reflect the seriousness of the topic.

The War That Doesn't Say Its Name, also by Jason Stearns.

Crisis in the Congo: The Rise and Fall of Laurent Kabila by François Ngolet is pretty self-explanatory and illustrates well why the issue with Zaire wasn't just Mobutu, though he was particularly incompetent.

Les guerres à l'est de la RD Congo, entre génocide et statocide by Claude Nsal'onanongo Omelenge. This is the best work and most academic, but my French is rusty, so I may be overpraising it. I've had a hard time getting my hands on this one but there are PDFs if you look carefully. If you're in Europe it might be easier.

The Trouble with the Congo by Séverine Autesserre explores why peace efforts have failed.

In the Footsteps of Mr. Kurtz: Living on the Brink of Disaster in Mobutu's Congo by Michela Wrong and The Rise and Decline of the Zairian State by Crawford Young and Thomas Edwin Turner explore the damage Mobutu did to the post-colonial Congo (Zaire).

Congo, A Sublime Struggle by Finbarr O'Reilly is more of a personal account, but it has excellent color pictures and you can feel the emotional investment in the topic.

Death in the Congo: Murdering Patrice Lumumba by Madeline Kalb, The Congo Cables by Emmanuel Gerard, and Chief of Station, Congo by Lawerence Devlin explain the Congo Crisis and the role that specifically the US, Belgium, and less directly the UN played in ensuring that the original DRC survived its postcolonial civil war. Carnages: Les guerres secrètes des grandes puissances en Afrique by Pierre Péan covers the francophone vs anglophone meddling in the region.

La guerre civile du Congo-Brazzaville specifically covers the rise of militias, the incentives, the funding, etc. It is a tad outdated in the current conflict—I don't know of a good resource to cover funding of militias today, but I will figure something out.

La première crise congolaise racontée aux Camerounais by Jean Koufan Menkéné is a historiographically good overview of the Congo Crisis (1960-1965) in general.

King Leopold's Ghost: A Story of Greed, Terror, and Heroism in Colonial Africa covers The Congo Free State, perhaps the most ironically named country of all time as it covers how the state was the personal property of Leopold II

In the Forest of No Joy: The Congo-Océan Railroad and the Tragedy of French Colonialism by J. P. Daughton is quite good and, well, self-explanatory.

Finally, if you're a fan of Adam Curtis (a documentarian, but a propagandist of the greatest order, albeit one I tend to agree with), he has an excellent series called "All Watched Over by Machines of Loving Grace". The final episode covers postcolonial Congo. You can find that here: https://archive.org/details/BBC.All.Watched.Over.by.Machines...

[tor0ugh]

Thank you very much for this well structured comment despite your clearly visible emotional turmoil speaking if the region. It matches what a friend of ours tells about her relatives that still live there in parts. The diaspora of people from the DRC is surprising huge in Europe - a fact I was not aware of really.

[thelastgallon]

Thank you for the insightful summary!

Found this interesting tidbit on https://en.wikipedia.org/wiki/Ethnic_groups_in_Rwanda: > Although these groups were distinct and stratified in relation to one another, the boundary between Tutsi and Hutu was somewhat open to social mobility. The Tutsi elite were defined by their exclusive ownership of land and cattle. Hutus, however, though disenfranchised socially and politically, could shed Hutuness, or kwihutura, by accumulating wealth, and thereby rising through the social hierarchy to the status of Tutsi.

[sofixa]

Thank you for the detailed comment, but I'm a bit confused.

You start like you're disagreeing with me, but in the end it seems to me you're just providing some (very much needed) context around the whole quagmire.

The Eastern DRC has been a mess since forever, and nobody's actions seem to be towards improving the situation. But ultimately, M23 control parts of it, probably couldn't care less about public health, and they're why Rwanda is suddenly a major resource exporter for things it doesn't have. Nobody is saying it's simple, but that's the headline.

[mos_basik]

Thank you for the pointers to all those resources!

I spent my childhood in the Kasaï-Oriental - my parents were aid workers - and though I lived through some of the key periods of the country (Kabila Sr's rise and assassination) I was young and had no idea of the more general goings-on beyond our town. I've been trying to learn more about the period and I imagine these will be very helpful.

I wonder if my French is still good enough for Les guerres à l'est de la RD Congo...

[VHRanger]

Do you have a better source if I speak fluent French by any chance?

Thanks for the recap

[dgellow]

I would also be interested, native French speaker

[BLKNSLVR]

I was wondering about that with the hantavirus, whereby if it's got a higher fatality rate then it's less likely to be easily transmitted.

Is that like a general rule, or pure bunk? (I'd probably assume the answer 'depends').

[fpaf]

From COVID-era discussions (when virologists were briefly the stars of every talk show) I remember one explaining that it was less about fatality rates per se and more about the length of time you could carry the virus around and be nearly asymptomatic while still able to infect others.

I understand the jury is still out on whether a virus can be considered "alive" but, like us, it is capable of replicating itself and mutating. In that sense, it benefits from the same evolution strategies as more complex beings: a strain that gets its host very sick very quickly gets a lower chance to spread to a new host and multiply.

This creates an evolutionary advantage for strains of that virus that are less aggressive or at least develop the worst symptoms more slowly and more covertly.

[cogman10]

Yeah. HIV is a good example of this. Without treatment, it is deadly pretty much 100% of the time. However, it takes a long time after the shut down of the immune system before a systematic infection takes over and kills you.

That allowed for a deadly disease that's somewhat hard to spread (mostly just through sex) to ultimately go on a rampage.

[AbstractH24]

I never thought about this.

So without concern for the humans with HIV* there an argument to be made that treating symptoms without curing made it spread more?

*obviously, this is just hypothetical. It’s important to care about the life of those with HIV. No banish them all to something like a leper-colony. Although it explains the logic for those at the time they existed better than a religious one did.

[cogman10]

HIV specifically targets the immune system. There's no way to just treat the symptoms.

The treatments we have now also decrease the risk of spread significantly.

It's a bit like the chickenpox. Once infected, you always have chickenpox ready to burst out in the future as shingles. But for the most part, it's dormant and you aren't infectious.

HIV treatment does the same. It doesn't clear your body of HIV, but it does decrease the HIV load to such low levels that it can be undetectable. That, in turn, decreases the likelihood you'll spread it.

[AbstractH24]

These are relatively recent advances. But for the longest time wasn’t that case.

[hyrix]

There's a significant difference in the risk and mechanisms of transmission between these two viruses. The modern effective reproductive number for HIV is less than 1, about 30-50% lower than ebola in similar subsaharan countries [1][2]. You can get ebola from contact with an infected person's sweat during the active phase [3]. You can get it from their semen years after they have apparently recovered [4]. We don't have treatments that work in this longer term. The drugs that we do have are used during the active infection period to reduce the probability of death during the crisis. Folks are working on reducing the longer term infectiousness but it's a ways off yet [5]. We also don't have pre- or post-exposure prophylactic treatments for the medical workers who are at the highest risk of infection or the family members--the most common transmission mechanisms for ebola are home caregiving and contact with traditional burial practices. In this context of containing an active outbreak, quarantine is mostly helpful in reducing pressure on the medical system for a short term.

Compare this with HIV, which can be rendered untransmittable with modern treatments, which is primarily a sexually transmitted disease, which has pre- and post-exposure treatments. It's simply not very efficient/effective to exile millions of people with a lifelong latent infection and little risk of transmission.

The instinct towards ostracism of those who are perceived as unclean is some pretty primordial lizard brain shit which was a great rule of thumb two thousand years ago, along with wearing garments made of only one kind of material. It's actually actively harmful to the process of stopping infection. It leads to fear, distrust, and reduced reporting, hindering the medical system's ability to reach the people who most need to be reached, and encouraging the spread of superstition and suspicion of pre- and post-exposure treatments. In both diseases, the actual infection risk is modest compared to an airborne virus like COVID.

[1] https://journals.lww.com/jphmp/Abstract/2022/03000/Estimatin...

[2] https://pubmed.ncbi.nlm.nih.gov/34189844/

[3] https://pmc.ncbi.nlm.nih.gov/articles/PMC4252165/

[4] https://pmc.ncbi.nlm.nih.gov/articles/PMC7875361/

[5] https://academic.oup.com/cid/article/73/10/1849/6168541?logi...

[marcosdumay]

> So without concern for the humans with HIV* there an argument to be made that treating symptoms without curing made it spread more?

No, because HIV treatment is about killing the virus, and we don't have any that only treats the symptoms.

But there is an argument like that for the flu and colds.

[bookofjoe]

>I understand the jury is still out on whether a virus can be considered "alive"

I remember way back in med school in the mid-70s our infectious disease professor asking this same question, in a philosophical as much as a mechanistic sense.

[jijijijij]

Here is the fun thing to think about: If viruses aren't alive, neither are men. Men, too, lack the biological means of reproduction. On the other hand, parthenogenesis may even rarely happen in female humans.

https://en.wikipedia.org/wiki/Parthenogenesis

[RobotToaster]

I don't think it's just fatality rate, but also how long it takes to kill you. HIV is a great example of a disease that (untreated) has near 100% mortality rate, but can spread because it takes years to kill you.

[mlinhares]

The real issue with HIV is that you can easily spread it before being symptomatic, so far we haven’t seen hantavirus spreading before folks become symptomatic. The strain that spreads through humans has been active in south America for a while as well and hasn’t really gone anywhere yet.

[jimberlage]

Plague, Inc (an iOS game where you control the parameters of a pandemic and try to get a 100% infection rate) will give you a really good feel for the math behind this.

The most successful strategy is to make a virus that spreads fast, with few visible symptoms until the late stages of the disease. A deadly virus, early will just cause borders to be locked and the international research community to swarm on a cure.

[leptons]

If AIDS were airborne, I think we'de have a fraction of the billions currently living today. It takes a while for symptoms to show up, there is still no real cure, and drugs to keep it supressed took many years to develop.

[Jach]

"It depends" is usually a safe (if not always helpful) answer. The older idea was that viruses always evolve to be less virulent/deadly, but that didn't match observations. The newer idea is simply that of a virulence-transmission trade-off. But there are various assumptions behind both ideas, and not all viruses follow those assumptions, so.. it depends. A decent review: https://pmc.ncbi.nlm.nih.gov/articles/PMC10066022/

[alamortsubite]

Definitely, but the hantavirus incubation period ranges from 1-8 weeks after exposure.

[rolph]

this is a case specific example of a dynamic that may exist dependent on the properties of the pathogen.

https://en.wikipedia.org/wiki/Myxomatosis#Australia

there are ways to escape the dynamic, such as latency of deleterious symptoms

[microtonal]

Also worrying that the existing approved vaccine does not protect against this variant.

That said I'm quite hopeful, since there is a vaccine for other strains.

[mentalgear]

It figures: Right before the COVID-19 outbreak, Trump dismantled the White House pandemic response team and pushed to downsize the CDC—later pulling out of the WHO entirely. A new Trump term, a new pandemic?

[mschuster91]

In this case I'd guess the DOGE cuts to foreign aid are a massive, massive contributor to the problem. A lot of third-world countries heavily relied on USAID et al to keep basic sanitation and healthcare going.

[zzzeek]

They are. This is why the billionaire tech class is complacent in this disaster. Musk is already a mass murderer due his illegal sabotage of USAID (estimates of 600000 deaths already [1]) this new outbreak adds to his death toll.

[1] https://www.newyorker.com/culture/the-new-yorker-documentary...

[picsao]

The WHO is just another politically subverted organization. It declared covid for half an eternity as not airborne. If its connected with a loos of face or economic short term losses- many actors will put the pressur on to prevent the declaration of an pandemic or other travell restrictions.

The us is not involved in this mess.

[JumpCrisscross]

> us is not involved in this mess

If by not involved you mean still massively subject to the public health and econonomic consequences of a containment failure, then sure.