MAXIMUM ALERT: DALLAS EBOLA VICTIM MOST LIKELY ACQUIRED HIS INFECTION ON HIS FLIGHT

CDC's time line of the Dallas Ebola victim's flight date and symptom onset date indicates a greater than 50% probability that the Dallas Ebola victim ACQUIRED HIS INFECTION DURING HIS FLIGHT.

Per the Center For Disease Control's very own Ebola simulation model, 50% of all Ebola infections develop symptoms five and a half days after infection. Given that the Dallas victim's symptom onset occurred within 6 days of his Liberian departure flight; it is most likely that he/she was infected on that flight by someone else on that flight who was actively shedding Ebola virus.

Since the Dallas victim is most likely a secondary infection, patient zero from that flight is still on the loose and more victims are to follow in the near term. The situation is potentially catastrophic because of the massive number of potential secondary victims who have no African travel history and are likely to not attract attention in any Emergency room until massive hemorrhaging has started.

CDC Ebola Symptom Onset Distribution Days After Infection

DALLAS EBOLA Victim Time Line- HAT/TIP to the NYTIMES

Sources:

http://www.cdc.gov/mmwr/preview/mmwrhtml/su6303a1.htm?s_cid=su6303a1_x

http://www.nytimes.com/2014/10/01/health/airline-passenger-with-ebola-is-under-treatment-in-dallas.html?smid=tw-share

http://www.cdc.gov/media/releases/2014/s930-ebola-confirmed-case.html

Aerosolizing ONE DROP of Ebola Infected Blood Can Kill 500,000 People

US ARMY Says EBOLA = FLU in Airborne Stability, Needs Winter Weather To Go Airborne

http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0041918

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1997182/

http://vet.sagepub.com/content/50/3/514.full

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4113787/

Ebola Bodily Fluids Readily Weaponizable Using An Ultrasonic Humidifier

Ebola Emergency ZMAPP Production Rates & Costs

CDC's "Lesser Of Evils" Double Standard On Health Care Worker Protection Indicates They Expect a Large Ebola Outbreak In USA

CDC Warns Hospitals On EBOLA "CONTAMINATED AIR" and Directs use of "Airborne Infection Isolation Room"s

Inhalation Ebola: Governments Ready For World War Ebola

CDC Sees AIRBORNE EBOLA Transmission, Issues Guidance For Aircraft Flight Crews, Cleaning & Cargo Crews

 CDC is already evacuating DOUBLE the number of expected Ebola infected personnel at a rate of 7 doctors per month

MAX ALERT Joplin Missouri: Nursing Student From Congo Dies Showing Respiratory Symptoms

Big hat tip to  @StudioInCabot  for alerting us to this news out of Joplin Missouri.

 Over the weekend in Joplin, Missouri, a nursing student from the Congo died after he was spotted having respiratory symptoms while out on a walk. The local coroner attributes the death to cardiac arrest. The coroner is quoted as saying he "understood the victim had been in the U.S. long enough to have passed the incubation period for the disease"

Unfortunately the Coroner's statement has an aire of uncertainty about it. Moreover we also find Coroner's public Linkedin profile to be concerning as the is seems to indicate zero medical training, and that his prior employment was as county Sheriff.

We believe it would be wise for Public Health officials to start contact tracing on the victim to determine what the true exposure risk.

Did he have contact with other International students from Ebola infected areas? 

As a nursing student was he in any way involved in medical care in Ebola infected areas?


Hopefully the Coroner is correct in his diagnosis, but given the alignment of risk factors and the dangerous impact of a positive Ebola case,  further DETAILED investigation is needed to rule out Ebola and potentially even Enterovirus 68.

Sources:

http://www.joplinglobe.com/news/article_6e3a8d0c-484e-11e4-bebb-fb3f783dbd69.html


Mark Bridges coroner at newton county,mo

Inside Missouri's Enterovirus Outbreak: 6 Year Old Girl Wakes Up To Find Her Legs Didn't Want To Work

There's a lot more going on with the current Enterovirus Outbreak than the public knows; we'll pull back the curtains a little bit on what the local Pediatricians here in the Saint Louis area are dealing with.

Likely the most important thing to know is that the local Pediatricians believe that multiple different strains of Enterovirus are surging locally. This belief seems to be based on the wide variety of symptoms being displayed by pediatric patients, it may or may not be the case.

And that brings us to the 6 year old girl who woke up one morning to find that her legs did not want to work. Her first symptoms started a week prior and they came in the following approximate order.

Day 1:  Burping, acid reflux
Day 2:  Stomach discomfort, minor nausea, burping acid reflux
Day 3:  Lethargy after moderate physical activity
Day 4:  Lethargy, Fever ~102F, Headache, slight back ache, & previous symptoms
Day 5:  Improvement after OTC medicine given, Fever remains ~100F
Day 6:  Continued improvement, minor scratchy Throat, leg complaints, Fever@ 99F, & previous symptoms
Day 7:  Profound calf pain in both legs upon awakening, significant difficulty walking, other symptoms improved

Diagnosis: Enterovirus, But D68 not suspected; throat is red but Strep test is negative; deemed not contagious while fever is under 100F

Treatment: Symptomatic using OTC medicine,

Day 8: All symptoms greatly improved
Day 9: Some stomach discomfort remains


Conclusion:

Strange things are afoot in Missouri, the enterovirus outbreak seems to be very wide spread and victims may not necessarily show coughing, sneezing or other respiratory aspects.

Aerosolizing ONE DROP of Ebola Infected Blood Can Kill 500,000 People

One milliLiter of aerosolized Ebola infected blood is capable of infecting 10,000,000 people.
One DROP of  aerosolized Ebola infected blood is capable of infecting 500,000 people.

Those are the maximum boundary conditions for Airborne Ebola infection based on USAMRIID's report that an airborne dose of less than 10 Plaque Forming Units [PFU] is capable of creating an infection. Research indicates that one mL of Ebola infected blood often contains on the order of 100,000,000 PFU's.

Of course this begs the question, how much could one sneeze in a room infect?

The Answers:

One milliLiter of  Ebola infected blood, at maximum, is capable of infecting a 22,072 Square Foot room to the extent that taking one breath of air from that room would infect a person

One DROP of Ebola infected blood, at maximum, is capable of infecting a 1,104 Square Foot room to the extent that taking one breath of air from that room would infect a person

The key take away from this analysis is that an INSANELY small amount of Airborne Ebola has a MASSIVE infectious potential. In fact Ebola's infectious potential is so great that its not the amount of Ebola that is the infectious constraint, rather the constraint is how long Ebola can survive in the Air.

Unfortunately, According to the US Army's  Center for Aerobiological Sciences, Medical Research Institute of Infectious Diseases at Fort Detrick, Maryland:

(1) Ebola has an aerosol stability that is comparable to Influenza-A

(2) Much like Flu, Airborne Ebola transmissions need Winter type conditions to maximize Aerosol infection

"Filoviruses, which are classified as Category A Bioterrorism Agents by the Centers for Disease Control and Prevention (Atlanta, GA), have stability in aerosol form comparable to other lipid containing viruses such as influenza A virus, a low infectious dose by the aerosol route (less than 10 PFU) in NHPs, and case fatality rates as high as ~90% ."

"The mode of acquisition of viral infection in index cases is usually unknown. Secondary transmission of filovirus infection is typically thought to occur by direct contact with infected persons or infected blood or tissues. There is no strong evidence of secondary transmission by the aerosol route in African filovirus outbreaks. However, aerosol transmission is thought to be possible and may occur in conditions of lower temperature and humidity which may not have been factors in outbreaks in warmer climates [13]. At the very least, the potential exists for aerosol transmission, given that virus is detected in bodily secretions, the pulmonary alveolar interstitial cells, and within lung spaces"

In summary:

Quite possibly the only thing standing between us and a massive EBOLA outbreak is, Winter Weather and ONE Ebola infected sneeze.

Sources:

Preparedness for Prevention of Ebola Virus Disease

http://www.mdpi.com/1999-4915/4/10/2115/pdf

US ARMY Says EBOLA = FLU in Airborne Stability, Needs Winter Weather To Go Airborne

http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0041918

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1997182/

http://vet.sagepub.com/content/50/3/514.full

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4113787/

Ebola Bodily Fluids Readily Weaponizable Using An Ultrasonic Humidifier

Ebola Emergency ZMAPP Production Rates & Costs

CDC's "Lesser Of Evils" Double Standard On Health Care Worker Protection Indicates They Expect a Large Ebola Outbreak In USA

CDC Warns Hospitals On EBOLA "CONTAMINATED AIR" and Directs use of "Airborne Infection Isolation Room"s

Inhalation Ebola: Governments Ready For World War Ebola

CDC Sees AIRBORNE EBOLA Transmission, Issues Guidance For Aircraft Flight Crews, Cleaning & Cargo Crews

 CDC is already evacuating DOUBLE the number of expected Ebola infected personnel at a rate of 7 doctors per month

US Government on H7N9 MERS EBOLA Pandemic Purchasing Spree: Millions for Adjuvanted Vaccine; Ventilators; Doxycycline Injections; Mobile Killing Chambers; Air MEDEVAC

Fall 2014 is starting to look much like Fall 2013 in terms of the Federal Government Pandemic Spending

In the last week:

(1) HHS gave Sanofi Pasteur $105 million to produce an adjuvanted H7N9 influenza vaccine; Last year they purchased the syringes needed to give EVERY American two of these vaccinations. Even more troubling the CDC had ALWAYS previously banned the use of adjuvanted flu vaccines in the USA because they were considered dangerous.


(2) HHS also gave PHILIPS RESPIRONICS  a $46 million dollar sweet heart deal funding the entire R&D development to production cycle of 10,000 Advanced All Hazard Stockpile Ventilators (AAHSV)


(3) The US Army ordered a stockpile of test reagents for H7N9 and MERS-CoV specifically

"in preparation for potential pandemic outbreak of H7N9 and/or novel Middle East Coronavirus".

(4) The Department of Defense has also placed a large order for Doxycycline Hyclate Injections to fill their Pandemic Influenza Stockpile. Interestingly, there is also a US Patent on the use of Doxycycline to spur blood serum treatments for Ebola, as has been recommended by WHO to treat Ebola infections. The supply has been directed to USNORTHCOM, meaning the outbreak is expected to occur in North America. It also just happens that this drug is currently in critically short supply in the US.


(5) The USDA has awarded a contract to build multiple Mobile Modified Atmosphere Killing Trailers

"for the depopulation of poultry in response to an animal health emergency such as a catastrophic infectious poultry disease" aka H7N9 Bird Flu

(6) And not to feel left out, The US State Department expects its going to have to do A LOT of Ultra high infectious containment Aeromedical Evacuations after February 2015. As such, they have put out an RFI seeking additional EBOLA type air ambulance medical flight airlift capability.



Of course all of these expenditures just scratch the surface of the pandemic preparations the US Government undertook in 2013. If the population had just an inkling of what was actively being prepared for, they'd be in Church as if it were Christmas and Easter combined.

Our Analysis:

H7N9 is low risk with medium impact. Its had every chance to go Global and has not. If it appears NATURALLY in the USA, hot points for infection are river deltas like San Francisco, Houston, and New Orleans

MERS is a low to medium risk with medium impact. MERS has had several chances to breakout at HAJJ and has not. But since MERS outbreaks have previously occurred 6 months out of phase with HAJJ, mostly in Spring camel birthing season, a human infection carry over into October might allow HAJJ to be fuel to the fire. That said, the spread of MERS seems to be tied to behaviors related to Eastern toilet habits and Islamic palliative care,

EBOLA is High Risk with High Impact. The experts at the ARMY's Aerobiological Science center report that Ebola has an airborne stability like Flu, and that Winter type weather may allow for airborne spread to occur. One must also consider the Airborne implications of Ebola victims have co-infections with Cold, Flu, Tuberculosis, or even seasonal allergies. All these factors make for the potential of an EXPLOSIVE number of Ebola cases in cold weather climates.

Source and background info:

Award is for the development of an adjuvanted pandemic influenza vaccine.

Advanced All-Hazards Stockpile Ventilator

preparation for potential pandemic outbreak of H7N9 and/or novel Middle East Coronavirus.

Doxycycline Injection

Doxycycline Hyclate Injection Shortage

Compositions and methods for treating hemorrhagic virus infections and other disorders

Mobile Modified Atmosphere Killing Trailers

Emergency Aero-Medical Services

US ARMY Says EBOLA = FLU in Airborne Stability, Needs Winter Weather To Go Airborne

[H7N9 Vaccine] New Information, Its MORE Dangerous Than Previously Thought

[ALERT!] ALL 300 Million American Citizens WILL Be Given TWO Experimental Adjuvant Laced H7N9 Vaccinations!

BIRD FLU: US Government quietly orders 600 Million syringes stockpiled in 10 Cities

CDC Contracting With Poison Control Centers and 2-1-1 to Create Public 'Phone-In' Bird Flu Triage Centers

Systems & Intrinsic Disorder: MERS-CoV's "Hard Shell" Is Key To Understanding Its Epidemiology

All Public Ebola Growth Models Are Wrong, And NONE Are Useful To The Public

UPDATE: 11/14/14
CDC now admits

"The numbers of cases projected, based on an exponential growth model that used early epidemic trends and assumed no effective interventions, did not materialize"

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm63e1114a2.htm?s_cid=mm63e1114a2_x

UPDATE: 10/20/14 
Its interesting to note that the Johns Hopkins Center of Advanced Modeling agrees with our analysis and Ebola modeling curve
http://www.c-span.org/video/?c4511957/johnhopkins-agrees-potrblogcom-ebola-model

Original post below
-------------------------------------------------------------------------------------------------------------
"All models are wrong, but some are useful" is a well known quote by statistician George Edward Pelham Box. Unfortunately we have not seen a single useful Ebola model published anywhere.

All published Ebola models basically follow an uncontrolled cockroach reproduction premise (as shown below). In short if all goes well, it doesn't take too long before the whole world becomes literally knee deep in cockroaches. Of course in the real world, even though cockroaches are prolific, we don't use snow plows to clear them off the streets. The only thing these models are useful for are separating taxpayers from their money

The reality of these Ebola growth models is that the driving assumptions are valid only for modeling an Airborne spread in which countermeasures only slow that spread. And even then, these models are less than useful.

The reality is that if Ebola is contact spread via cultural behaviors, it's growth will follow a roller coaster type pattern as seen below.

Unlike the Ebola models presented in the media, a useful model would give insight into the "Behavioral Inflection Point" shown in the graph above.
Insights such as:

1. Are people fleeing to new geographic regions PRIOR to infection risk being high
2. What percentage of those fleeing are infected?
3. In what time frame must behavior changing information be supplied to avoid geographic spread
4. What is the influence of this Geographic node on the spread of Ebola to the Global network
5. What is the most effective use of countermeasures across the Global network

From what we know of West Africa

1. Rapid global transportation was shut down prior to large scale infection
2. Populated areas are altering interpersonal behavior to avoid spread
3. Deeply held cultural death cult behaviors are still ongoing
4. Population flight is still a major concern

What we expect:

1. The outbreak may rapidly self contain and rebound later as a sexually transmitted disease

2. An outbreak spread into Winter Climate regions has the potential to allow any equatorially suppressed airborne transmission routes to become the primary EXPLOSIVE infectious route.

Sources:

US ARMY Says EBOLA = FLU in Airborne Stability, Needs Winter Weather To Go Airborne

US ARMY Says EBOLA = FLU in Airborne Stability, Needs Winter Weather To Go Airborne

According to the Center for Aerobiological Sciences, U.S. Army Medical Research Institute of Infectious Diseases at Fort Detrick, Maryland:

(1) Ebola has an aerosol stability that is comparable to Influenza-A

(2) Much like Flu, Airborne Ebola transmissions need Winter type conditions to maximize Aerosol infection

"Filoviruses, which are classified as Category A Bioterrorism Agents by the Centers for Disease Control and Prevention (Atlanta, GA), have stability in aerosol form comparable to other lipid containing viruses such as influenza A virus, a low infectious dose by the aerosol route (less than 10 PFU) in NHPs, and case fatality rates as high as ~90% ."

"The mode of acquisition of viral infection in index cases is usually unknown. Secondary transmission of filovirus infection is typically thought to occur by direct contact with infected persons or infected blood or tissues. There is no strong evidence of secondary transmission by the aerosol route in African filovirus outbreaks. However, aerosol transmission is thought to be possible and may occur in conditions of lower temperature and humidity which may not have been factors in outbreaks in warmer climates [13]. At the very least, the potential exists for aerosol transmission, given that virus is detected in bodily secretions, the pulmonary alveolar interstitial cells, and within lung spaces"

Analysis: 

Its clear that when Ebola is in the air it is at least as hardy as Influenza. Its also clear that coughing and sneezing is what makes Influenza airborne; the same should be expected of Ebola.

Moreover, just as sun, heat, and humidity along the Earths' Equatorial regions serve to 'burn' Influenza out of the air, the same should be expected of Ebola. The difference with Ebola is that physical contact with even the tiniest amounts of infected bodily fluid can cause infection, hence unlike flu it also readily spreads in equatorial regions. When Ebola spreads to the regions of the Earth which experience Fall and Winter Flu seasons, airborne Ebola infectious routes are to be expected in conjunction with direct contact infection.

Ebola has the capability to infect pretty much every cell in the entire human respiratory tract. Similarly, our skin offers little resistance to even the smallest amounts of Ebola. How much airborne transmission will occur will be a function of how well Ebola induces coughing and sneezing in its victims in cold weather climates. Coughing and nasal bleeding are both reported symptoms in Africa, so the worst should be expected. In that regard, co-infections with Flu, Cold, or even seasonal Allergies will readily transform Ebola victims into  biowarefare factories.

Unlike Flu, a person need not inhale airborne Ebola to be infected via airborne transmission. Merely walking through an airspace (or touching the objects therein) where an Ebola victim has coughed or sneezed is potentially enough for a cold weather infection to occur. As such, all indicators are that Ebola's potential rate of infectious spread in cold weather climates is EXPLOSIVELY  greater than what is occurring in Equatorial Africa


In that regard, the government's Filovirus Animal Nonclinical Group [FANG] is standardizing on a Airborne Ebola Infectious "challenge" of 1000 PFU that all proposed medical countermeasures must defeat in order to gain acceptance.

Mutation:

Given that the experts are keenly aware that most mutations lead to viral dead ends and given the ARMY's public research documents make such a clear case that the Ebola airborne risk is here and now, the question remains: why are the experts pushing a "future mutation"fear on the public?


The primary benefits of the media mutation gambit are:

1) When the public becomes aware Ebola is airborne, the public will default to blaming a mutation rather blaming the experts for having prior knowledge of Ebola's transmissability

2) A scary future fear makes for great immediate fund raising from a public seeking to avoid it.

3) The expert clique comes down hard on experts that do anything which is perceived to immediately raise public fear, an accurate warning to the public can immediately negatively affect a forthright expert's budget and prestige

4) Public knowledge of imminent Public Health threats negatively affects supply chains and the logistics planned responses


The next time some expert pushes the Ebola mutation risk ask them to specify exactly what mutations would be required to do as they claim. When they refuse, ask why experts spelled out the mutation steps of Avian Influenza and why they won't for Ebola. The answer is: Ebola can already infect pretty much every cell in the human respiratory system. 

Sources:

http://www.mdpi.com/1999-4915/4/10/2115/pdf

http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0041918

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1997182/

http://vet.sagepub.com/content/50/3/514.full

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4113787/

Ebola Bodily Fluids Readily Weaponizable Using An Ultrasonic Humidifier

Ebola Emergency ZMAPP Production Rates & Costs

CDC's "Lesser Of Evils" Double Standard On Health Care Worker Protection Indicates They Expect a Large Ebola Outbreak In USA

CDC Warns Hospitals On EBOLA "CONTAMINATED AIR" and Directs use of "Airborne Infection Isolation Room"s

Inhalation Ebola: Governments Ready For World War Ebola

CDC Sees AIRBORNE EBOLA Transmission, Issues Guidance For Aircraft Flight Crews, Cleaning & Cargo Crews

 CDC is already evacuating DOUBLE the number of expected Ebola infected personnel at a rate of 7 doctors per month

Sierra Leone Set to Spread Ebola To Everyone, Door to Door Nationwide Next Weekend

The road to Ebola Hell is paved with good intentions:

"The Government of Sierra Leone has announced plans to conduct a three-day door-to-door
nationwide public awareness campaign from Friday September 19 to Sunday September 21. The
goal of this “House to House Ebola Talk” is to educate people about EVD and identify cases. As
such, all individuals in Sierra Leone are being asked to remain in their residence during this three
day period so they may be reached by the volunteer teams."

Unless these door to door "volunteers" are wearing Space Suits and then burning them after each household visit, this door to door visit plan by Sierra Leone sounds more like a way to ensure that their entire population is exposed to Ebola. 

The only way Sierra Leone's plan makes any real sense is if they believe the majority of the country has already been exposed to Ebola and will become ill soon. As such, they would need to keep the population off the streets as a logistical precursor to stage some sort of large scale mobilization / quarantine. Or, maybe its just that the road to Ebola hell is paved with good intentions. 

Edited to add:
And since it looks like it is going to be aided by 165 Cuban health care workers, there's a reasonable chance that this will be a route for Ebola into the Caribbean & South America.

Sources:

Security Message for U.S. Citizens: Freedown (Sierra Leone), Nationwide Ebola Virus Disease Information Campaign

Statement by Dr. Roberto Morales Ojeda, Minister of Public Health of the Republic of Cuba, at a press conference in the World Health Organization. Geneva, September 12, 2014

.

USAID DART: Alaska SmokeJumpers Deploying to Liberia Ebola Crisis

Based on today's SmokeJumper status report a Bureau of Land Management SmokeJumper unit is taking part in a DART USAID Ebola response in Liberia (see image below)

The CONOPS of the response is not explained, but one might assume that aircraft J-17 fits a flight need in remote Liberia, or even that SmokeJumper medics may vertically insert into remote parts of Liberia. One thing seems sure though, the deployment increases the return risk of Ebola to Alaska.

Aircraft J-17

Sources:

http://webcache.googleusercontent.com/search?q=cache:x2ftyCjQ1YsJ:www.nifc.gov/smokejumper/reports/smjrpt.php+&cd=1&hl=en&ct=clnk&gl=us

Disaster Assistance Response Team (DART)

CDC: Three Scientists Per Month Expected To Catch Ebola As A result of US Surge Into Africa

Update: As of early September the CDC is already evacuating DOUBLE the number of expected Ebola infected personnel at a rate of 7 doctors per month.

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The US State Department has issued a 6 month $4.9 million dollar contract to  Phoenix Air Group for use of the only two Aeromedical Biological Containment System [ABCS] aircraft available in the World. The aircraft are needed to support a surge of US government personnel into Ebola torn regions of Africa. The contract justification states that CDC is expecting to internationally evacuate up to three EVD cases per month

The following rationale was given supporting the rush sole source contract.

1. Professional medical personnel were refusing to deploy to AFRICA without an evacuation plan
2. Mexico, Japan, Canada, UK, UAE, WHO, and the UN were attempting to contract for these aircraft. The Obama Administration had previously dropped funding for these aircraft
3. CDC regulations for transport of ASYMPTOMATIC Ebola exposed personnel are so onerous that only the ABCS aircraft can support evacuation of exposed personnel

Other illuminating information from the contact include:

• Europe has denied overflight for Ebola MEDEVAC flights 
• The Azores denied civilian airport access for Ebola MEDEVAC Aircraft refueling
• All Ebola flights must land a military airfields "for security reasons"
• The US Military has a "transport pod" but it does not allow access to patients and Government regulations prevent its use on commercial aircraft

ANALYSIS:

The purpose of the State Department's contract is to give a false sense of security to CDC personnel who wouldn't otherwise deploy to Africa. Nothing in the contract addresses Aircraft support services such as manufacturer response to Aircraft stuck On the Ground [AOG] in Africa. Aircraft don't fly long without support, and Bio-level 4 aircraft maintenance is non existent.

Moreover, the contract stated repatriation rate of 3 Ebola infected or exposed US personnel per month assumes an insanely small amount of interaction between the pool of people at risk. Alternatively, it means only the creme-de-la-creme of USA response personnel will be evacuated and the rest will have to remain in Africa.

Sources:

Emergency Aeromedical Evacuation Services Solicitation Number: SAQMMA14C0155

Sole Source Justification