Happy, happy ----- follow link to original
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http://mobile.nytimes.com/2014/09/12/opinion/what-were-afraid-to-say-about-ebola.html
MINNEAPOLIS — THE Ebola epidemic in West Africa has the potential to alter history as much as any plague has ever done.
There have been more than 4,300 cases and 2,300 deaths over the past six months. Last week, the World Health Organization
warned that, by early October, there may be thousands of new cases per
week in Liberia, Sierra Leone, Guinea and Nigeria. What is not getting
said publicly, despite briefings and discussions in the inner circles of
the world’s public health agencies, is that we are in totally uncharted
waters and that Mother Nature is the only force in charge of the crisis
at this time.
There are two possible future chapters to this story that should keep us up at night.
The
first possibility is that the Ebola virus spreads from West Africa to
megacities in other regions of the developing world. This outbreak is
very different from the 19 that have occurred in Africa over the past 40
years. It is much easier to control Ebola infections in isolated
villages. But there has been a 300 percent increase in Africa’s
population over the last four decades, much of it in large city slums.
What happens when an infected person yet to become ill travels by plane
to Lagos, Nairobi, Kinshasa or Mogadishu — or even Karachi, Jakarta,
Mexico City or Dhaka?
The
second possibility is one that virologists are loath to discuss openly
but are definitely considering in private: that an Ebola virus could
mutate to become transmissible through the air. You can now get Ebola
only through direct contact with bodily fluids. But viruses like Ebola
are notoriously sloppy in replicating, meaning the virus entering one
person may be genetically different from the virus entering the next.
The current Ebola virus’s hyper-evolution is unprecedented; there has
been more human-to-human transmission in the past four months than most
likely occurred in the last 500 to 1,000 years. Each new infection
represents trillions of throws of the genetic dice.
If
certain mutations occurred, it would mean that just breathing would put
one at risk of contracting Ebola. Infections could spread quickly to
every part of the globe, as the H1N1 influenza virus did in 2009, after
its birth in Mexico.
Why are public officials afraid to
discuss this? They don’t want to be accused of screaming “Fire!” in a
crowded theater — as I’m sure some will accuse me of doing. But the risk
is real, and until we consider it, the world will not be prepared to do
what is necessary to end the epidemic.
In 2012, a team
of Canadian researchers proved that Ebola Zaire, the same virus that is
causing the West Africa outbreak, could be transmitted by the
respiratory route from pigs to monkeys, both of whose lungs are very
similar to those of humans. Richard Preston’s 1994 best seller “The Hot
Zone” chronicled a 1989 outbreak of a different strain, Ebola Reston
virus, among monkeys at a quarantine station near Washington. The virus
was transmitted through breathing, and the outbreak ended only when all
the monkeys were euthanized. We must consider that such transmissions
could happen between humans, if the virus mutates.
So what must we do that we are not doing?
First, we need someone to take over the position of “command and control.” The United Nations
is the only international organization that can direct the immense
amount of medical, public health and humanitarian aid that must come
from many different countries and nongovernmental groups to smother this
epidemic. Thus far it has played at best a collaborating role, and with
everyone in charge, no one is in charge.
A Security
Council resolution could give the United Nations total responsibility
for controlling the outbreak, while respecting West African nations’
sovereignty as much as possible. The United Nations could, for instance,
secure aircraft and landing rights. Many private airlines are refusing
to fly into the affected countries, making it very difficult to deploy
critical supplies and personnel. The Group of 7 countries’ military air
and ground support must be brought in to ensure supply chains for
medical and infection-control products, as well as food and water for
quarantined areas.
The United Nations should provide
whatever number of beds are needed; the World Health Organization has
recommended 1,500, but we may need thousands more. It should also
coordinate the recruitment and training around the world of medical and
nursing staff, in particular by bringing in local residents who have
survived Ebola, and are no longer at risk of infection. Many countries
are pledging medical resources, but donations will not result in an
effective treatment system if no single group is responsible for
coordinating them.
Finally, we have to remember that
Ebola isn’t West Africa’s only problem. Tens of thousands die there each
year from diseases like AIDS, malaria and tuberculosis. Liberia, Sierra
Leone and Guinea have among the highest maternal mortality rates in the
world. Because people are now too afraid of contracting Ebola to go to
the hospital, very few are getting basic medical care. In addition, many
health care workers have been infected with Ebola, and more than 120
have died. Liberia has only 250 doctors left, for a population of four
million.
This is about humanitarianism and
self-interest. If we wait for vaccines and new drugs to arrive to end
the Ebola epidemic, instead of taking major action now, we risk the
disease’s reaching from West Africa to our own backyards.
This is the End and a New Beginning
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I've been thinking about this for some time.
After 21 years of writing this blog almost daily, I've decided to stop
writing the daily updates on the blog.
...
6 months ago
