Advisor: Professor Sabounchi Fear as Contagion the Ebola Crisis and Public Fear Networks A System Dynamics Approach Nasser Sharareh Advisor: Professor Sabounchi Systems Science and Industrial Engineering Department Event: System Dynamics Colloquium Albany University - State University of New York 03/17/2015

Agenda What is Ebola? Introduction Causal Loop Diagram Simulation Models Outputs vs Real Data Interested Parameters Next Steps and Future Research Conclusion nsharar1@binghamton.edu

What is Ebola? Patient Zero: a 2-year old boy Endemic Transmission occur, but the number of cases remains constant Epidemic The number of cases increases Pandemic When epidemics occur at several continents – global epidemic Patient Zero: a 2-year old boy Case Fatality Rate of 50 to 90 percent Why are we interested in simulating this problem? His mother, sister, grandmother died. But his father survived. So if consider this family as our samle, we can say the CFR is 80%. But this Virus has spreaded before in countries such as Zaire. And CFR is changing between 50 to 90% nsharar1@binghamton.edu

WHO Situation Report Total Deaths: 10689 Total Cases: 25791 nsharar1@binghamton.edu

Introduction Ebola Virus Disease (EVD) as a Behavioral Disease Using fear as a leverage or try to remove fear Just As Well Strategy Consequences of a Ebola High death rate Economical loss Spread of fear Uncertainty in news Absence of control over getting infected The speed of disease spreading and the mortality rate Infectivity or Case Fatality Rate (CFR) CFR is the proportion of deaths within a designated population of "cases" (people with a medical condition), over the course of the disease. Economical loss is much higher, because there would be no tourists anymore. Their currency would loose its worth. Also by closing the borders, sutuations will get worth. nsharar1@binghamton.edu

Death Incidence vs Number of Tweets #Ebola facts #Ebola outbreak #Ebola virus #Fighting Ebola #Stop Ebola Reference: www.Symplur.com, Accessed March 2015 http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/cumulative-cases-graphs.html nsharar1@binghamton.edu

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Negative Social Response nsharar1@binghamton.edu

Dealing With Situations Reference: www.Symplur.com, Accessed March 2015 nsharar1@binghamton.edu

Decline In The Attention nsharar1@binghamton.edu

Doctor’s Activity nsharar1@binghamton.edu

Twitter Data of Healthcare Worker tweets Reference: www.Symplur.com, Accessed March 2015 nsharar1@binghamton.edu

WHO - CDC Deaths of HIW is 1.5 Million, and deaths of Influenza was 22 million People in Africa are not educated enough, so numbers are making complications for them, and also it may create fear among them nsharar1@binghamton.edu

Simulation nsharar1@binghamton.edu

Simple SIR Model nsharar1@binghamton.edu

Phase 1 nsharar1@binghamton.edu

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Phase 2 nsharar1@binghamton.edu

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Phase 3 nsharar1@binghamton.edu

Parameters Parameter Description Literature Review Value Total Population Guinea + Liberia + Sirrea Leone 22,136,000 Initial infected Patient Zero 1 Contact Rate In a day 25 Infectivity Probability of becoming infected 0.03 Average DiceaseTime (4,5) 10 Average DiceaseTime For Quarantined Persons 15 Average Recovery time (7,12) 7 Average Recovery time From Quarantined Average Disinfection Time Bed Turnaround Time [0.5,1.5] 2 nsharar1@binghamton.edu

Next Steps Dividing Susceptible, Infected, and Recovered population into two groups, and adding the corresponding fear of Ebola to the simulation Susceptible Aware Unaware (Higher irrational behavior, higher contact rate, and infectivity) Infected Symptomatic Asymptomatic (Incubation time (2,21) with the average of 8-10 days) Recovered Completely (People who recover from Ebola infection develop antibodies that last for at least 10 years) Partially (a few weeks to a few months) nsharar1@binghamton.edu

Potential Future Research Reservoir Human Cases Carrier Animal Gorillas chimpanzees Bat Non-Living It’s very difficult to study on these things, it needs research on the field. But I have started working with a anthropologist thay may help me to do that nsharar1@binghamton.edu

Conclusion The reason of invalidity of previous models (Arreola, McDuffy, Mejia, & Oliver, 1999), (Kiskowski, 2014) is the absence of Sociocultural and psychological effects Behavioral effect Intervention Most important key points in controlling the pandemic Public Perception Risk Management nsharar1@binghamton.edu

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