Ebola: Get Ahead Of The Curve And Worry Now

It turns out that the Dallas patient had at least 18 contacts once he became symptomatic, four of them schoolchildren.  That’s more than worrisome enough, given that there could always be a nineteenth person who was overlooked, and knowing further that each of the eighteen known contacts might have had ten or twenty or thirty contacts of their own, and so on.  Beyond that, we have no way of knowing if some other traveler from West Africa has arrived somewhere besides Dallas, or will tomorrow or the day after, and then might start showing symptoms in a day or a week or three weeks, since the incubation period for Ebola is anywhere from 2 days to 21 days.  It’s not just in the US.  The same possible scenario applies to every country on the planet.  It’s not a matter of if Ebola will spread beyond Africa, it’s a matter of when.

All the reassuring infectious disease specialists employed by CNN and the major networks will be telling you just how difficult it is to contract Ebola…while you’re watching the health care workers in Africa and in our own ICU’s prancing around in biohazard suits that rival anything NASA puts on astronauts before they venture outside the International Space Station.  Nothing to see here…move along.  Here’s the facts as we know them now: Ebola is spread by contact with bodily fluids from a symptomatic patient, with bodily fluids being basically anything wet or moist that comes out of a human being.  Ebola is not transmissible before a patient is feverish, but once he is, those bodily fluids are as deadly as a bath in the retention pond at Chernobyl.  The fluids need to enter your bloodstream before you can be infected, and that’s why every inch of health care worker’s bodies are covered with waterproof materials…skin is not itself always intact, and Ebola can enter the body through tiny micro-lacerations and micro-abrasions.  As we’ve already seen in at least half a dozen cases, even the most stringent precautions aren’t 100% effective if one is exposed to Ebola patients enough times.  So yeah, Ebola isn’t easy to contract, but it’s not as tough as winning the lottery either.

But here’s a little sidebar you won’t see trumpeted by the national media: There are some scientists who worry out loud that Ebola could mutate and become transmissible by air…just a cough or a sneeze.  Every time this little RNA virus replicates within a new host, there are a few tiny mutations.  There is nothing to say that one of those won’t be THE mutation, and then we’re in Stephen King/The Stand/The Last Ship territory.

That’s all I’ve got.  Have a pleasant evening.

BW

Monday Morality Play

We’ve made it through another weekend, if only barely, without another jumbo jet being shot out of the sky, and without anyone else starting a new war in the Middle East, but we didn’t make it out unscathed by any means.

We feel pretty safe and insulated here in the US even in the worst of times.  No matter what, even when bullets and rockets and IED’s flew like flocks of sparrows in Iraq and Afghanistan, and now when the same ordinance crosses over the skies of Gaza and Tel Aviv, we can’t help but grin and grab another Coke and handful of Doritos as Jeff Gordon kisses the bricks and makes it a historical five-peat at the Brickyard 400, because, after all, that other stuff is happening over there.  It makes it to our TV and our consciousness if we switch from FOX to CNN and from Entertainment Weekly to CNN, but it’s just as easy to head back to the refrigerator for another snack or the backyard for a couple of rays and the view of the cardinals and squirrels, or over to the county fair for fried Oreos, shaky amusement rides, and pre-teens showing off today’s  4-H pigs that will be tomorrow’s Kroger ribs…because those are things we can taste and see and smell and touch and those other things are just passing lights and noises on a screen.

But the world gets smaller by the day.  I’m not a big fan of reading books over and over, but one book I have read at least three times is Stephen King’s “The Stand”.  Something draws me to it every two or three years.  So when I hear that the Ebola outbreak in Western Africa has now spread to Lagos, Nigeria, Africa’s most populous city, I sit up and take notice.  When it is announced that two American doctors, including one from nearby Indianapolis, who are in Africa to help stem the outbreak, have themselves contracted the virus, despite latex gloves and surgical masks and goggles and scrupulous attention to sterile technique, I feel an electrical shock in my spine from the tip of vestigial tailbone all the way to the clump of cells in my hippocampal gyrus that hold the memories of “Captain Trips” from The Stand.  Ebola is one nasty little son-of-a-bitch of a bug.  It’s easily transmitted in blood and secretions, and it’s just one or two mutations away from being airborne, and if you get it, you’ll almost certainly die, and not neatly or painlessly or quickly. Right now, it doesn’t matter much to you and me, ensconced safely in our midwest bungalows watching NASCAR and awaiting the return of the NFL, but all it would take is one guy getting on one plane, one guy who feels like he might be coming down with something, but figures it’s just a cold, and all of a sudden, you’re not so sure about handshakes anymore and you run screaming in terror from anyone with a nosebleed.

We’re also only worried in a mostly academic way about other people’s wars, which is hardly surprising, since most of us barely gave a thought to our own wars for the last dozen or so years.  It’s sad that we’ve all become so inured to war as a way of life.  George Orwell accurately predicted our complacency with conflict in “1984”, and our various governments have done more than their part to convince us that we need to be killing someone somewhere for some reason on a daily basis, and hardly any of us ever stop to give serious consideration as to whether it must actually be so.  I gave it some thought this morning, at, of all places, the YMCA.  I was blithely pedalling along on my recumbent bicycle, listening to Pet Shop Boys singing about West End Girls on my headphones, and watching out of the corner of my eye as one of those wars or plane crashes played out in a loop on the CBS Morning News, when a lady motioned me to take off my headphones and informed me that she had my bike reserved in a few minutes (while the other six bikes were currently unoccupied, by the way).  I told her that I was virtually certain that I’d signed the reservation white board for slots up to 9:20, but she said I’d mistakenly checked up to 8:20.  So I smiled, said “fine”, and dismounted my exercycle.  I went over to get some paper towels to wipe off the bike and glanced at the board as I passed.  As I’d recalled, quite correctly, I did in fact have the machine reserved for another ten minutes.  I thought about going back and correcting the woman who was now on the device, but that thought only lingered for a moment before it was replaced with “ah…fuck it”…because not every wrong needs to be righted and not ever mistake needs to be corrected and not every inequity needs to be balanced.  Sometimes you just smile and walk away.  Which is what I did…right before I signed up for a different recumbent bike and got back on, doing ten minutes more than I’d originally planned for…so it all worked out fine for everyone.

What I’m working up to here is a discussion of Israel, Gaza, and the ongoing bloodbath that is “the Palestinian problem”.  I saw two things in the media this weekend that gave me a bit of perspective.  One was the John Oliver piece on his weekly HBO show “Last Week Tonight”.  Like Jon Stewart, Oliver has a brilliant way of employing humor to shed some real light on very serious topics.  While ostensibly making fun of Anderson Cooper’s seeming agelessness, Oliver actually provided a visual history of the Israel/Gaza conflict.  What was both shocking and at the same time completely unsurprising was the footage of Anderson Cooper giving virtually the same report with the same circumstances for the same reasons in 2012, 2009, and even 2006.  Same Hamas rockets, same Israeli bombs, same civilian deaths, like some kind of nightmarish “Groundhog Day”.  Then, Sunday morning, I awakened and perused my daily H-T, including an op-ed piece from Eugene Robinson on the same subject.  Here’s what Robinson says, in part: 

The civilian death toll in Gaza from Israel’s latest incursion is appalling. The right to self-defense is inalienable, but it is not free from moral constraints.

I support Israel. I abhor Hamas. But unleashing such devastating firepower on a tiny, densely crowded enclave in which civilians are trapped — and thus destined to become casualties — is wrong by any reasonable moral standard.

The Israeli government’s motivations in Gaza deserve to be taken seriously. But they do not justify the onslaught that is now in its third week. For Israeli military action to be justifiable, it must be proportionate. What we’re witnessing is not.

What I’ve witnessed personally and in that great arbiter of modern ethics and commentary, Facebook, is a knee jerk reaction from many of my Jewish friends, including one Israeli, to support Israeli actions completely and without question, up to and including suggesting that anyone who questions their current campaign is hypocritical or worse…anti-Semitic.  Here’s my point, and it’s in agreement with the views of Eugene Robinson: Israel does have the right to defend itself, and moreover, by any standard historical or ethical, Israel IS the good guy in this particular morality play.  But just like the US, when you are the good guy, when you are the example, the role model, the freedom loving democracy, you are held to a HIGHER standard.  Just as it made no difference how many peasants Sadam Hussein had murdered or tortured or raped when we employed torture in order to prosecute our war on terror, it makes no difference how many Palestinians have been murdered or displaced or abused by Syria or Jordan or Egypt when Israel is targeting hospitals or schools in the Gaza Strip.  Good guys just don’t do certain things.  They find another way.  I hope Benjamin Netanyahu eventually comes to this same conclusion…because clearly the current campaign’s strategy didn’t work in 2006 or 2009 or 2012, and when you look at it with that historical perspective, you have to ask the same question Eugene Robinson asks:

Let me frame the question in practical terms: How many civilian casualties are needed to guarantee another generation of hatred and war?

Good guys sometimes just walk away…or at least find another way.

BW

Enter Randall Flag Stage Left. Cue “Don’t Dream It’s Over”

In Stephen King’s “The Stand”, which is just about the only book I’ve read more than twice, the end of the world starts slowly.  Someone catches a cold in Maine and someone else comes down with pneumonia in California.  There’s a death in the Midwest and then a few more on the coasts.  The government isn’t overly alarmed, but recommends caution, maybe staying home from work if you’re feeling sick.  Then one city is quarantined and then another.  Soon, no flights are allowed into the US, but by then it’s too late.  Viruses obey no laws and recognize no national boundaries.

We’ve had epidemic frights before.  There’s been SARS and swine flu and bird flu, and none of them ever came to much.  Before that, and before we really understood it’s origin and transmission, AIDS looked like a possible world-ender.  But we’re actually long overdue for a global pandemic.

In 1918 and 1919 Spanish Flu swept the globe, killing more people than the black plague and more than died in WWI.  The estimates at the low end were 21 million dead and ranged up as high as 50 million, with the actual toll probably somewhere in between.

So MERS (Middle East Respiratory Syndrome) will probably be just another flash in the pan, pandemic-wise, but you never know.  There have been two cases in the US, both health care workers who’d been in Saudi Arabia, and so far no one they’d been in contact with has tested positive.  On the other hand, cases keep popping up here and there, now including 18 different countries, the latest being Denmark.  

In those individuals who contract MERS, the mortality is 30%.  There is no cure, and truth be told, modern medicine’s ability to treat viruses is only slightly improved when compared to our abilities back in 1918, when treatments included aspirin, quinine, and oil of cinnamon, all of which amounted to a recommendation to put your head in your lap and kiss your ass goodbye.  Today, while there are antivirals, they aren’t particularly effective, and their efficacy is unknown in the case of MERS.  Our main advantage in 2014 is the advance in intensive care medicine, where individuals can be kept alive on fluids and pressors and ventilators until the body’s own immune system can finally fight off the invader.  Which works just fine…until there are more people sick than there are beds in ICU’s.

I’m sure it’s not the end of the world.  But just in case, I think I’ll cancel that vacation in Dubai.

BW