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ByMikeStobbe TheAssociatedPress ATLANTA Last fall, when Martin Meltzer calcu- lated that 1.4 million peo- ple might contract Ebola in West Africa, the world paid attention. This was, he said, a worst-case scenario. But Meltzer is the most famous disease modeler for the na- tion's pre-eminent public health agency, the Centers for Disease Control and Pre- vention. His estimate was promoted at high-level in- ternational meetings. It ral- lied nations to step up their efforts to fight the disease. But the estimate proved to be off. Way, way off. Like, 65 times worse than what ended up happening. Some were not surprised. Meltzer has a lot of critics who say he and his CDC col- leagues have a habit of will- fully ignoring the complex- ities of disease outbreaks, resulting in estimates that over-dramatize how bad an outbreak could get — esti- mates that may be skewed by politics. They say Meltzer and company also overesti- mate how much vaccine is needed and how beneficial it has been. Overblown estimates can result in unnecessary gov- ernment spending, they say, and may further erode trust in an agency that recently has seen its sterling repu- tation decline. "Once we cry wolf, and our dire predictions turn out not to be the case, peo- ple lose confidence in pub- lic health," said Aaron King, a University of Michigan re- searcher who in a recent journal article took Meltzer and others to task for mak- ing what he called avoidable mistakes. Meltzer, 56, is unbowed. "I am not sorry," he said. He dismisses his peers' more complicated calcula- tions as out of touch with political necessities, telling a story about President Lyn- don Johnson in the 1960s. Johnson was listening to an economist talk about the uncertainty in his forecast and the reason a range of estimates made more sense than one specific figure. Johnson was unconvinced. "Ranges are for cattle," Johnson said, according to legend. "Give me a number." What Meltzer does is not particularly glamorous. He and others use mathemat- ical calculations to try to provide a more precise pic- ture of a certain situation, or to predict how the situa- tion will change. They write equations on chalkboards, have small meetings to de- bate which data to use, and sit at computers. Meltzer spends a lot of time with Excel spreadsheets. But modelers have be- come critical in the world of infectious diseases. Top CDC officials came to Meltzer last summer, when the epidemic was spiraling out of control and interna- tional health officials were quickly trying to build a re- sponse. Meltzer was asked to project how bad things could get if nothing was done, as well as to estimate how stepped-up aid could bend the curve of the epi- demic. Meltzer and his col- leagues created a spread- sheet tool that projected uninterrupted exponential growth in two countries, Li- beria and Sierra Leone. His prediction — pub- lished last September — warned that West Africa could be on track to see 500,000 to 1.4 million Ebola cases within a few months if the world sat on its hands and let the epidemic blaze. About 21,000 cases ma- terialized by mid-January — a terrible toll, to be sure, but also just a tiny fraction of the caseload Meltzer and his CDC colleagues warned about. Did Meltzer blow it? Many say no. He and his col- leagues clearly stated they were providing a worst-case scenario of how bad things could get. They also predicted a far lower number of cases if more help was sent — which already was hap- pening when the model es- timates were released. But the worst-case fig- ures got the most atten- tion. The media focused on them in headlines. Health officials highlighted them in their push to get more money and manpower de- voted to the epidemic. And interestingly, those are the numbers health officials de- scribe as the most success- ful part of Meltzer's predic- tion paper. "I think it galvanized countries — and people — to put in more effort" into fighting the epidemic, said Dr. Keiji Fukuda, formerly a colleague of Meltzer's at CDC who is now assis- tant director-general of the World Health Organization. CDC is supposed to pre- pare the America for the worst, so it makes sense for CDC modelers to explore extreme scenarios. If Melt- zer's estimates push poli- cymakers to bolster public health defenses, it's all to the greater good, some say. But there are others who feel that the result corrupts both science and politics. "Public health officials are well aware that their statistics get used — and misused — to justify an in- crease in their funding" or to bolster vaccination cam- paigns and other efforts, said Peter Doshi, assistant professor at the University of Maryland School of Phar- macy. Modeling — so poorly un- derstood by the public, the media, and even many peo- ple in public health — pro- vides an opportunity to bend numbers to support goals, he argued. Said David Ozonoff, a Boston University environ- mental health professor: "The way risk assessment is done in this country is the policy makers shoot the ar- row and the risk assessors paint a target around it. There's a flavor of this with modeling, too. If you say the purpose (of a modeling esti- mate) is motivational, that's another way of saying it's not scientific." DISEASE CDC'stopmodelermakesestimatesandcourtscontroversy By Stephen Wade The Associated Press RIO DE JANEIRO The World Health Organization has asked the IOC to analyze virus levels in Rio de Janei- ro's Olympic waters, and the governing body of world sailing says it will start do- ing its own independent vi- rus tests. The moves come after an Associated Press inves- tigation showed a serious health risk to Olympic ath- letes in venues around Rio rife with sewage. In a statement to the AP, the World Health Orga- nization said it suggested the International Olympic Committee start monitor- ing for viruses at the Rio venues. "WHO has also advised the IOC to widen the scien- tific base of indicators to include viruses," the state- ment said. "The risk assess- ment should be revised ac- cordingly, pending the re- sults of further analysis. The Rio Local Organizing Committee and the IOC are requested to follow WHO recommendations on treat- ment of household and hos- pital waste." A spokesman from the Rio organizing committee referred comment to the IOC, which is meeting in Kuala Lumpur, Malaysia. "We follow WHO advice," IOC spokesman Mark Ad- ams said in a statement to the AP. "The health and welfare of the athletes is a top priority for the IOC. The Rio authorities are follow- ing WHO testing standards and, according to the WHO, there is no significant risk to athletes." Olympic organizers and the Brazilian government have tested only for bacte- ria to decide if the water is safe. Many experts say vi- ruses are a far bigger prob- lem and need to be moni- tored. The International Sailing Federation said indepen- dently it would start test- ing for viruses. "We're going to find someone who can do the testing for us that can safely cover what we need to know from a virus perspective as well as the bacteria per- spective," Peter Sowrey, chief executive of the ISAF, said. "That's my plan." The sailing venue in Gua- nabara Bay is badly pol- luted, as is a separate venue for rowing and canoeing — Rodrigo de Freitas lake — in central Rio. The AP investi- gation also showed venues for triathlon and open-wa- ter swimming off Copaca- bana Beach had high virus levels that pose a threat to athletes and tourists. Sowrey, who spoke from Kuala Lumpur, has a local interest. His wife Alesan- dra is a native of Rio, and he has a 9-year-old daugh- ter Marie. "I'm a father myself," Sowrey said. "I want to make sure that everyone who goes out in the water is as safe as possible and is given the right guidance and right security." T he A P a n a ly si s showed dangerously high levels of viruses and bac- teria from sewage in ven- ues where about 1,400 athletes will compete in water sports, in the games which open in a year — Aug. 5, 2016. In Rio, much of the waste and sewage goes untreated and runs down hillside ditches and streams into Olympic water venues that are littered with floating rubbish, household waste, and even dead animals. At the world swimming championships in Kazan, Russia, swimmers said they were worried about the sit- uation in Rio. "The athletes and the athletes' commission have expressed their concern at the current problems with the quality of water, the cleanliness of the water," Vladimir Salnikov, a for- mer Olympic gold-medal winner, said. "That will be put into a recommendation, and people will pay atten- tion to that." Shin Otsuka, an execu- tive board member of the International Triathlon Union, said on Friday his body was considering test- ing for viruses. The ITU is holding an Olympic qualifying race on Sunday using the waters off Copacabana Beach. Costa Rican triathlete Leonardo Chacon said he knows the risks, but will take them. "We know we are ex- posed to viruses, maybe to a health problem later," he said on Friday in Rio. "But in my case, I have invested so much to prepare myself for this, and I want this to happen because I can't re- cuperate this investment any other way other than competing and winning the points that I need to win." When Rio was awarded the Olympics in 2009, it promised cleaning its wa- ters would be an Olympic legacy. But Rio Mayor Ed- uardo Paes has repeatedly acknowledged this will not be done, calling it a "lost op- portunity." Sowrey said the ISAF would start doing its own water testing in Rio this month, no longer relying solely on Brazil's govern- ment analysis. "We want to make sure we keep pressure on the organizing committee and the Brazilians to make sure they put some energy into cleaning up the bay," Sow- rey said. "My job is to make sure something actually happens and it's not just talk, and someone is actu- ally walking the walk." Sowery said he received a call from a woman who wanted reassurance that the ISAF was giving the right guidance to her child and others competing in an Olympic sailing test event this month in Rio. He said a "backup plan" included sailing all the events outside Guanabara Bay in the open Atlantic. The ISAF has three courses there, and three inside the bay. He said it would be "'heartbreaking" to sail outside the bay and lose the postcard backdrop of Sug- arloaf Mountain, which will be a focus of television cov- erage. In most Olympics, sail- ing is contested far from the main Olympic venues. In Rio, the sailors and row- ers and canoeists get cen- ter stage — a chance to win fans and valuable sponsors. "We're not going to sac- rifice health for the sake of good pictures and good TV," he said. "But the backdrop of Rio is an amazing back- drop, and will do something for the sport of sailing." AP reporters Jenny Barchfield and Tales Azzoni in Rio de Janeiro, and James Ellingworth in Kazan, Russia, contributed to this report. RIO DE JANEIRO WHO, sailing body seek virus tests in Olympic venues THEASSOCIATEDPRESS A discarded ball floats on the water in a canal at the Mare slum complex in Rio de Janeiro, Brazil. In Rio, much of the waste runs through open-air ditches to fetid streams and rivers that feed the Olympic water sites and blight the city's picture-postcard beaches. THE ASSOCIATED PRESS Martin Meltzer stands in his office at the Centers for Disease Control and Prevention in Atlanta. His early scientific interest was in the health of animals, not humans. He was working on animal diseases at the University of Florida when some work on rabies brought him to the attention of CDC, which was recruiting economists to develop numbers for policy discussions. 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