Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, has been all over the media trying to damp down the excessive fear over the Ebola virus and reassuring people that it is not that easy to get the disease. In this photo, we see that he stands by his conviction, showing him embracing the nurse Nina Pham who got the disease after treating a person who died from the disease but has now been declared disease-free. I hope that photo calms some people down.
President Obama has also publicly embraced her.
I hope that this will help to calm people who may avoid the two nurses Pham and Amber Vinson who contracted the disease after treating an Ebola patient.
The fact that Pham is among several people in the US who have been treated successfully for a disease that has a staggering mortality rate as high as 70% raises the question of why so many have survived in the US while so many are dying in West Africa. NPR had an interview with an Ebola expert Daniel Bausch to try and uncover the reasons and he says:
“Well, that’s a big debate that’s going on right now that I think we would all agree that exceptional care or even really routine but aggressive medical care is something that will make a difference and I think we’re seeing that with the care that the repatriated cases, for example, in the United States and Europe have gotten. Of course, those people are getting IV fluids – others, sometimes experimental therapies. And it seems to make a difference when you compare it unfortunately to many people in West Africa for whom we can’t give those therapies right now.”
…“These patients with Ebola have seemed especially severe in this particular outbreak, where we’re getting people who lose eight to 10 liters of fluid a day from diarrhea, nausea and vomiting and sometimes bleeding. So if you just think about that, just getting an IV line into someone, giving them fluids, basic things, for example, what we call electrolytes that we would normally do in any patient who was admitted to a hospital in the United States very routinely – I think if we can do those things and do those things aggressively, we would see a big difference.”
While the efforts to cure and treat the disease are important, so are efforts to ease the fears and remove the stigma and Fauci and Obama are to be commended for their actions.
I know a lot of my impression of Ebola (I don’t say “knowledge”) is based on bad movies and reading The Hot Zone at an impressionable age. But it still seems amazing how casual, as a society, we have been with the stuff. When some of my friends were saying it was a bad idea to bring infected patients to the US, I disagreed because I thought 1st world medical procedures and common sense were good enough. But then you get this completely insane keystone kops comedy of people getting exposed and then going on cruises, subways, etc. It’s simultaneously heartening (that we’re dealing with it so well when someone gets sick) and mind bogglingly dumb.
When SARS happened, I thought it was a piss poor dry-run for how humanity would handle something like an Ebola outbreak where people got on airplanes, etc. So, it turns out that humans do exactly that kind of dumb thing, and Ebola’s bad ass (pretty much as bad as it comes) and -- not so bad -- they’re handling it OK. Yay, us!
It is remarkable how the US death rate from Ebola is way lower than Africa. In the US 9 people have or had Ebola, and only one died. In Africa the death rate was 50% and now is being reported as 70%.
Aggressive Hi Tech supportive care is clearly making a huge difference.
We are always fighting the last war on these Emerging Diseases. That is why this latest outbreak caught the entire world, asleep at the wheel, except for the docs on the ground.
1. There are at least 6 antiviral drugs against Ebola in late preclinical. The US has been funding emerging disease and bioterrorism antiviral research for over a decade. They’ve spent billions. It’s still not enough.
There isn’t a clear pathway to human clinical trial test a drug against a disease with 5 cases every few years like bubonic plague or sporadic outbreaks like Ebola. But we can come up with something workable.
The big hangup has been money. Preclinical is cheap and easy compared to clinical trials. So these drugs have just been creeping along almost as Zombies.
I’d estimate with a hundred or few hundreds of millions of USD, we could advance a few of these to something usable. It sounds like a lot of money. Until you look at what this Ebola outbreak is costing us and the world. In economic damage especially in West Africa, it’s in the tens of billions of USD. So far.
The other issue is that even with hi tech Personal Protection Equipment and training, medical personnel are still getting infected. In Africa, ca. 500 have gotten it and half have died. This is asking too much of the medical people!!! It’s highly irresponsible to not develop better medical and protection care.
2. The vaccines are the same story as the antivirals.
Ebola produces immunity and vaccines just mimic the disease. A vaccine is almost certainly possible.
3. In fact, there are two or three vaccine candidates in late preclinical and at least one has gone into phase I human. It might be usable in early 2015 against the epidemic. By then it will be too late unless what we do now fails. By then, the Ebola epidemic would be almost unimaginable.
We are always fighting the last war on emerging diseases. If we are lucky. Quite often, when the outbreak is over, everyone who controls the funding just forgets about them like it never happened. SARS was one that became human adapted and almost got away like SIV to HIV did. Seen any SARS vaccine or SARS antivirals lately? There might be a few stuck in preclinical limbo somewhere but that is about it.
Unfortunately not only the right-wingers but much of the center and a fair chunk of the left seem to have become crisis junkies -- they depend on the rush from preceived danger for the excitment in their lives.
The success rate also seems (based on a very limited sample) to depend on starting treatment early in the course of the disease. I have also heard that the mandatory cremation of the bodies of the victims runs against the religious and cultural traditions in some countries, which is making some people reluctant to seek treatment. They would apparently rather die at home and be buried, even though it spreads the contagion.
There’s the reason why developed nations are complacent -- the economic toll is not being felt by them.
There’s the reason why developed nations are complacent – the economic toll is not being felt by them.
I have a friend who completely didn’t give a shit about Ebola until she realized that the world’s chocolate supply comes from the region that’s been hit, and it might affect prices.