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October 20, 2014

On December 6, 2013, a little old boy named Emile died of Ebola in the Guinean village of Meliandou. The two-year old’s death was the first in what has become the world’s biggest Ebola outbreak in the 40-year history of the disease. By March 31, 70 Guineans had died, including Emile’s mother, sister and grandmother. That day, the United States Centers for Disease Control dispatched a five-person team to assist Guinean containment efforts.

Through the spring and into the summer, the outbreak spread, without much public attention in the West. By mid-July, there were 1,048 known and suspected Ebola cases in Guinea, Liberia and Sierra Leone, including 632 deaths. In late July, a Liberian-American flew to Nigeria, bringing the outbreak to a fourth country. On July 31, the U.S. evacuated Peace Corps personnel from Guinea, Liberia and Sierra Leone, citing the risk of Ebola. During August, patients who contracted Ebola in West Africa brought the disease to Senegal, the United States, Spain, Germany and Britain. Two later cases brought Ebola to France and Norway.

Four American medical workers infected in West Africa were flown to the U.S. during August and September and treated at the Emory University Hospital and the Nebraska Medical Center. Three have been cured, and one remains in treatment. But on September 20, a Liberian man named Thomas Eric Duncan arrived by plane in Dallas. He developed symptoms on September 24. He went to the Texas Health Presbyterian Hospital Dallas, was found to have a temperature of 100.1 degrees, but was sent home with antibiotics – which are, of course, ineffective against viruses. Three days later he was taken back and admitted to Texas Health Presbyterian, where he died on October 8.

Two of the nurses who cared for Mr. Duncan contracted Ebola from him. One of them flew to Cleveland and back to Dallas shortly before becoming symptomatic. Planes have been scrubbed, schools have been closed, hearings have been held, and blame has been laid. The cry has arisen, from the usual suspects, that we need to secure our borders.

Meanwhile, Mr. Duncan’s girlfriend, who lived with him for four days after he became symptomatic, and who was initially quarantined in their home, has completed the 21-day waiting period and is Ebola-free. Same with her five kids.

I obviously have no idea how close Mr. Duncan and his girlfriend were. I’m just saying, if a woman and her five kids can live with a symptomatic Ebola patient and come out of it OK, maybe the medical experts who say Ebola is not easily transmitted are right.

Outside of West Africa, the best information is that there have been 17 Ebola infections during the current outbreak. Fourteen of those were contracted in Africa, and the other three were health care workers caring for the other 14 – a nurse in Spain, who was declared cured yesterday, and the two nurses in the United States, who have been transferred from Dallas to two of the leading contagious disease treatment facilities in the world.

Outside of West Africa, at least, there has not yet been a single Ebola transmission on a train, plane, subway or cruise ship; no one has caught the bug in school or in church, or in any building other than a hospital. Sitting in crowded sports arenas, swimming in pools, walking on the streets and generally living our lives, have all so far proved to be Ebola-free experiences. The only profession that has proved at all risky is the health care profession, and only then when treating highly symptomatic Ebola patients; we can only guess whether Mr. Duncan and the two Dallas nurses might have been spared had Mr. Duncan been admitted and isolated on his first visit.

On October 17, the World Health Organization officially declared Senegal to be Ebola-free, followed today by Nigeria. Nigeria had 20 cases, including eight fatalities; Senegal had one, fatal, infection.

Mr. Duncan was isolated 22 days ago, so it is all but certain that he transmitted the Ebola virus to no one outside the hospital, including the homeless man who shared Mr. Duncan’s ambulance ride on September 28. Mr. Duncan died 12 days ago, so it is becoming increasingly unlikely that he transmitted the disease to anyone in the hospital other than the two nurses – both of whom were isolated upon showing early symptoms. The nurse who took the Cleveland trip was asymptomatic when she flew back to Dallas, developing a fever the next day; she was then isolated within 90 minutes.

Worldwide, nearly 10,000 people have been infected with Ebola, and almost 5,000 have died. The U.S. has had eight of those cases, and one death that may well be attributable to a single admitting mistake at a Dallas hospital.

The CDC should by all means review and improve its biohazard protocols. The Food and Drug Administration should fast-track testing and approval of potential vaccines and drug therapies. Deployment of military and medical personnel to West Africa should be maintained, or even stepped up. All that should happen.

At least as important, we need to revisit the 40 percent budget cuts that Congress has taken from federal programs for bio-disaster hospital readiness since 2010 – 50 percent since 2003. While we’re at it, Congress might want to look into restoring recent cuts to foreign medical aid programs, including the sequester cuts to the United States Agency for International Development.

What we don’t need is elected officials calling for Dr. Thomas Frieden’s job as head of director of the CDC. We don’t need to ban air travel from whole countries. We don’t need to close schools in a city that was visited by someone who developed Ebola symptoms after she left. In all likelihood, in a few weeks our Ebola patients will have gotten well and no one else will have contracted the disease in this country. We’ll move on to the next crisis. In the meantime, we need to keep just calm enough to maintain a sense of proportion.


From → All Posts, Obama 2.0

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