Laurie Garrett: Opinion. You Are Not Nearly Scared Enough about Ebola

[Vibrant62]

http://www.foreignpolicy.com/articl...red_enough_ebola_vaccine_west_africa_outbreak

By Laurie Garrett: Laurie Garrett is senior fellow for global health at the Council on Foreign Relations and a Pulitzer Prize winning science writer.


You Are Not Nearly Scared Enough About Ebola
Experimental drugs and airport screenings will do nothing to stop this plague. If Ebola hits Lagos, we're in real trouble.

Attention, World: You just don't get it.

You think there are magic bullets in some rich country's freezers that will instantly stop the relentless spread of the Ebola virus in West Africa? You think airport security guards in Los Angeles can look a traveler in the eyes and see infection, blocking that jet passenger's entry into La-la-land? You believe novelist Dan Brown's utterly absurd description of a World Health Organization that has a private C5-A military transport jet and disease SWAT team that can swoop into outbreaks, saving the world from contagion?

Wake up, fools. What's going on in West Africa now isn't Brown's silly Inferno scenario -- it's Steven Soderbergh's movie Contagion, though without a modicum of its high-tech capacity.

snip

Let's be clear: Absolutely no drug or vaccine has been proven effective against the Ebola virus in human beings.

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Since the Ebola outbreak began in March there have been many reports of isolated cases of the disease in travelers to other countries. None have resulted, so far, in secondary spread, establishing new epidemic focuses of the disease. As I write this, one such case is thought to have occurred in Johannesburg, South Africa's largest city, and another suspected case reportedly died in isolation in Jeddah, Saudi Arabia, prompting the kingdom to issue special Ebola warnings for the upcoming hajj. It's only a matter of time before one of these isolated cases spreads, possibly in a chaotic urban center far larger than the ones in which it is now claiming lives: Conakry, Guinea; Monrovia, Liberia; and Freetown, Sierra Leone.

So what does "getting it" mean for understanding what we, as a global community, must now do?

First of all, we must appreciate the scale of need on the ground in the three Ebola-plagued nations.

snip

Read full article at: http://www.foreignpolicy.com/articl...red_enough_ebola_vaccine_west_africa_outbreak

 

[Lizw]

Re: Laurie Garrett: Opinion. You Are Not Nearly Scared Enough about Ebola

From the snippets, I thought the article was going to be another gloom 'n' doom harangue. But it's absolutely right on target. This isn't going to be contained if the most that the world is doing is closing borders and monitoring suspect cases outside the region. It's like fighting a wild fire by just putting out the embers that the wind throws out from the fire, and doing nothing about the fire itself.

 

[Donners]

Re: Laurie Garrett: Opinion. You Are Not Nearly Scared Enough about Ebola

Since the Ebola outbreak began in March there have been many reports of isolated cases of the disease in travelers to other countries. None have resulted, so far, in secondary spread, establishing new epidemic focuses of the disease. As I write this, one such case is thought to have occurred in Johannesburg, South Africa's largest city, and another suspected case reportedly died in isolation in Jeddah, Saudi Arabia, prompting the kingdom to issue special Ebola warnings for the upcoming hajj. It's only a matter of time before one of these isolated cases spreads, possibly in a chaotic urban center far larger than the ones in which it is now claiming lives: Conakry, Guinea; Monrovia, Liberia; and Freetown, Sierra Leone.

That's blatantly deceptive.

Those "isolated cases" haven't resulted in "secondary spread" because they weren't Ebola.

The reader is left with the distinct impression, even excluding the two specific examples referred to (both of which turned out to not be Ebola) that there have been multiple isolated cases in other countries.

 

[Lizw]

Re: Laurie Garrett: Opinion. You Are Not Nearly Scared Enough about Ebola

Well...firstly, she said "reports" of isolated cases, not that there actually were known cases. She obviously didn't know that all these cases have been ruled out. The article is dated 14 August, but may well have been written a day or two before the publication date. The overall conclusion of that paragraph is that they are Ebola, but even though that has turned out not to be the case, I think her ultimate conclusion is correct--that if this gets into the slums of Lagos or any other densely populated urban center in that part of the world, we're in for a lot more trouble than just the relatively few cases we've seen so far.

If her next sentence had been "We're all doomed!" I'd dismiss the article as just another fear-mongering harangue, but in spite of the perhaps overly emotional tone of the beginning, what she's asking for is exactly what's needed, in my opinion. Basic skilled medical care, of the kind that Americans take for granted, to keep this from spreading. If we can't even send gloves and gowns and masks to fight this in Africa, then we very well may end up fighting it in Europe and the Americas. Or, God help us, in India, which does have a high population density and apparently not much better of a public health system than some of the African countries.

 

[Nox]

Re: Laurie Garrett: Opinion. You Are Not Nearly Scared Enough about Ebola

I've read most of what Laurie Garret has written. She is a Pulitzer prize winning journalist for covering the Zaire Ebola outbreak in 1995.
http://en.wikipedia.org/wiki/Laurie_Garrett

 

[Nika]

Re: Laurie Garrett: Opinion. You Are Not Nearly Scared Enough about Ebola

There are so many possible hot zones across the world. Its something we know but i think most of us comfort ourselves w the thought that it wont spread in the first world. What sort of world will it be should this decimate India or south east asia, favelas of Brazil, huge swathes of Mexico City? Gaza? Its not just the death its the destabilizing nature of a plague. If it doesnt happen this go round how about as the numbers of climate refugees grow forming poor slums on the edges of already swollen cities in the future. If you let this play out as a thought experiment public health investment is always one with a huge ROI.

 

[sharon sanders]

Re: Laurie Garrett: Opinion. You Are Not Nearly Scared Enough about Ebola

I think all of you are correct.

Laurie is both a Pulitzer winning journalist and an author with books/career to promote. Just like most journalists she is not always correct. Other times she makes great points.

The viewers can read along and form their own opinions.

Thanks for the discussion. :tiphat:

 

[Donners]

Re: Laurie Garrett: Opinion. You Are Not Nearly Scared Enough about Ebola

Well...firstly, she said "reports" of isolated cases, not that there actually were known cases. She obviously didn't know that all these cases have been ruled out. The article is dated 14 August, but may well have been written a day or two before the publication date.

The word "suspected" would have been very appropriate to insert into there at the very least. Even by the time of that article, numerous suspected cases had been ruled out. It leaves a distinct misunderstanding without further reading. Given the tone of the article, such a misleading impression serves the purpose of the author.

It's the same issue as the article last week about "hundreds" of bodies in the streets. The established situation is horrific enough. Gilding it is not necessary, and even runs the risk of detracting from an otherwise valid point.

I love The Coming Plague - overblown though it may be, it was thoroughly well-researched and detailed - but that paragraph really bugged me (almost as much as when she referred in a recent interview to measures which "we" took in Kikwit).

 

[GardenSpider]

Re: Laurie Garrett: Opinion. You Are Not Nearly Scared Enough about Ebola

Laurie Garrett has worked tirelessly to bring public awareness to public health issues including, but not limited to Ebola. She has fought to reform public health and tried to awaken the world to the rise of emerging infectious diseases. Despite her heroic efforts, so much of what she has advocated for has fallen on deaf ears. I read her opinion in part from someone who is also fed up with the lack of activism from western powers to take this threat seriously. How loud does a person have to scream to be heard?

Regardless of whether or not the details are spot on- her worries are well founded. It's what we are all concerned about here: secondary spread creating new focal points of the epidemic, lack of supplies and support to contain the spread and manage the sick. The article today about what happened to the clinic in Monrovia is a case in point.

"Angry Mob Destroys West Point Ebola Clinic, Smash and Grab- Steal Everything"
http://www.flutrackers.com/forum/showthread.php?t=226639 and relates directly to Laurie's point in the opinion.

 

[Nordica]

Re: Laurie Garrett: Opinion. You Are Not Nearly Scared Enough about Ebola

There is a lot of bad things happening in the world now. The Israel-Palestinian conflict. IS attack on civilians and the crises in Ukraine. And more?

WHO writes that Air travel is low-risk for Ebola transmission. This is good news but in the same time I am afraid that if people in the rich world don?t see Ebola as a threat, Ebola news will soon be forgotten and Ebola will become just a disease in the poor world like Malaria and others..

If people are just little afraid there will be more focus and money to stop Ebola both from spreading and at the source.

http://www.who.int/en/

 

[Donners]

Re: Laurie Garrett: Opinion. You Are Not Nearly Scared Enough about Ebola

If it is able to be contained in Nigeria and the Americans recover, I think quite a bit of the attention will drop off.

The attention is already off Guinea, which still has a worrying trickle of cases which could turn into a deluge again, and the reports out of Sierra Leone and Liberia suggest that there is much more going on there than is generally recognised.

Certainly plenty more needs to be done at an international level, even if it is out of a degree of self-preservation.

 

[Lizw]

Re: Laurie Garrett: Opinion. You Are Not Nearly Scared Enough about Ebola

I see attention dropping off already. It doesn't seem possible to have a moderated reasonable response to threats--either it's a long way off and who cares, or OMG we're all going to die!!! I used to think this was peculiar to the US, but the international groups that I'm in are behaving much the same way. Of the two, at least the panicky one does result in some kind of response, even if it's only to strip the local pharmacy shelves of gloves and masks, sigh.

 

[Gemineye]

Re: Laurie Garrett: Opinion. You Are Not Nearly Scared Enough about Ebola

Should HCWs from outside Africa risk their lives treating cases when the resident doctors and nurses are running away or on strike as in Nigeria? Where local residents are burning and looting clinics and threatening workers with bodily harm. If you want to become a martyr, west Africa is your place.

 

[GardenSpider]

Re: Laurie Garrett: Opinion. You Are Not Nearly Scared Enough about Ebola

Should HCWs from outside Africa risk their lives treating cases when the resident doctors and nurses are running away or on strike as in Nigeria? Where local residents are burning and looting clinics and threatening workers with bodily harm. If you want to become a martyr, west Africa is your place.

I think the point is: This is a global issue, not a local one relegated to the limited resources of the world's most impoverished- so YES; this is all our problem and the world does have to respond immediately, efficiently and affectively as Laurie stressed in her opinion. The responsibly will fall on those international organizations (not individuals) with the skill set to manage this, provided the funding is adequate for the scale of this blooming epidemic. Hopefully that will happen.

It's important to keep in mind that while transmission by air appears low- it only is until it isn't. Not much is known about this virus or how it can/will mutate. It is humbling to remember the great epidemics in our history were NOT airborne. Small pox, the Black Death and Sweating Sickness to name a few.

 

[Emily]

Re: Laurie Garrett: Opinion. You Are Not Nearly Scared Enough about Ebola

I think the point is: This is a global issue, not a local one relegated to the limited resources of the world's most impoverished- so YES; this is all our problem and the world does have to respond immediately, efficiently and affectively as Laurie stressed in her opinion. The responsibly will fall on those international organizations (not individuals) with the skill set to manage this, provided the funding is adequate for the scale of this blooming epidemic. Hopefully that will happen.

It's important to keep in mind that while transmission by air appears low- it only is until it isn't. Not much is known about this virus or how it can/will mutate. It is humbling to remember the great epidemics in our history were NOT airborne. Small pox, the Black Death and Sweating Sickness to name a few.

This is a full text article that indicates much is known about the virus. I think the science still stands 3 years later.

http://onlinelibrary.wiley.com/doi/10.1111/j.1469-0691.2011.03535.x/full

Ebola and Marburg haemorrhagic fever viruses: major scientific advances, but a relatively minor public health threat for Africa
E. M. Leroy1,2,
J-P Gonzalez1 and
S. Baize3
Article first published online: 4 JUL 2011
DOI: 10.1111/j.1469-0691.2011.03535.x
Clinical Microbiology and Infection
Volume 17, Issue 7, pages 964?976, July 2011

 

[JimO]

Re: Laurie Garrett: Opinion. You Are Not Nearly Scared Enough about Ebola

Should HCWs from outside Africa risk their lives treating cases when the resident doctors and nurses are running away or on strike as in Nigeria? Where local residents are burning and looting clinics and threatening workers with bodily harm. If you want to become a martyr, west Africa is your place.

I can certainly understand this perspective, and I also feel strongly that we have a moral obligation to help the needy. To me, stopping the disease in Africa to prevent it from spreading to my backyard is definitely a motivation, but for me, it is secondary to having compassion for those in the midst of this crisis. It's a serious problem when there is local opposition to outside help, especially when it becomes violent. The top priority should be to secure treatment centers so that people from the outside can help without fearing for their lives. Let's face it, if someone punches you every time you try to pull a splinter from their hand, after a while you just say "ok, just deal with it yourself". But, those opposing help were probably in the minority until things got out of control and admission to a treatment center was essentially a death sentence.

I hope things can be brought under control to allow for aid to be deployed where it is needed. If not, it will stop making the news when the next crisis hits and West Africa will be left to suffer.

 

[Vibrant62]

Re: Laurie Garrett: Opinion. You Are Not Nearly Scared Enough about Ebola

In my opinion the world has two choices.

Go and fight this outbreak and eradicate it in West Africa NOW or fight it after it has spread further internationally on even arrived on our own shores.

If the disease is widespread enough, there will be multiple introductions, and any one of them could light a bushfire. Imagine an illegal immigrant - they wont seek help and could set up an extensive transmission chain. Sooner or later this would happen, if not in the US, then imagine Italy or Greece or the UK, and other infected people would very likely export the disease to the US.

Ebola will continue circulation indefinitely until it is eradicated; it will remain a threat to the world until it is eradicated. It is highly contagious.

But if we dont tackle this now, the scale of the battle we will face (one way or the other) will increase exponentially the longer this problem is left.

 

[Donners]

Re: Laurie Garrett: Opinion. You Are Not Nearly Scared Enough about Ebola

With incidents like the recent one at the Liberian isolation centre, there is an increasingly prevalent public sentiment that the area should just be quarantined and locals should essentially be left to their devices. Essentially, if "they" won't accept "our" help, then "we" shouldn't bother.

Of course, it ignores the fact that the international response has been completely inadequate, and that the centre was desperately low on basic equipment and staff.

It also ignores the limited ability to impose a quarantine when the situation is so out of control that numerous regions and an untold number of people are affected.

Such an attitude will only result in far more cases, and a greater threat to the wider world.

 

[Lizw]

Re: Laurie Garrett: Opinion. You Are Not Nearly Scared Enough about Ebola

I can't envision Ebola ever being eradicated--it's a virus, after all. But with wholesale changes in living conditions, education, clean water, medical care and culture, it can certainly be reduced to a minor occasional threat. It's that last element--culture--that's going to be the kicker. Changing all the parameters that make Ebola easy to spread, such as funeral practices, eating bush meat, distrusting outsiders and modern medical care, etc, etc, is such a huge job that I can't see it happening quickly enough to make any difference in this go-round. I hate to be so pessimistic, but there isn't enough compassion in the international community to make it happen. There probably is enough money, but it takes people--feet on the ground--to make a real difference, and I don't see that happening.

 

[Thornton]

Re: Laurie Garrett: Opinion. You Are Not Nearly Scared Enough about Ebola

from Donners above

...increasingly prevalent public sentiment that the area should just be quarantined and locals should essentially be left to their devices.

This realm of pessimistic perception and denial is where Flutrackers can be most influential in a humanitarian way. I have been talking with medical students on my psychiatry consultation service the past couple of weeks about the Ebola outbreak. As they learn about the human aspects of the outbreak and actually think through all the ramifications of "cordon," they are disturbed. There is the appearance that our authorities can sit here in the US and have a policy that quarantine (cordon) is the most effective containment for the next few months. In the process we exacerbate the suffering and deaths among a million or more people in order to make us feel more secure. We lose severely if we are satisfied with this strategy. If it fails, we harmed people in vain, if it works, we harmed many in order to remain comfortable.

Given that the world sent armies across the globe to fight terrorists in their homeland instead of ours, then we need something equivalent in resources deployed to fight Ebloa in Africa rather than Europe, Asia or the Americas. An effective quarantine requires some support from the people quarantined. To earn that cooperation the authorities imposing the quarantine have the moral and practical responsibility to provide for the basic survival and psychosocial needs of the people who are set apart.

We (flutrackers) need to find reliable contacts with knowledge or who are experiencing the quarantine and help spread the word on their experiences and their needs. The authorities hopefully have plans in place on how to keep communications open and free flowing. Misplaced efforts to control people rather than support people will worsen the humanitarian crises. If we support "cordon" without supporting people, we could be looking back at this as the public health equivalent of war crimes.