There is currently an epidemic of Ebola Virus. Nearly all of the cases have been seen in West Africa, concentrated in the countries of Guinea, Sierra Leone, and Liberia.
This is a particularly deadly outbreak. As of July 30th, more than 670 deaths and more than 1,200 infections. This number is climbing daily. This Ebola outbreak kills 90% of those it infects. Comparatively, the plague outbreaks in the middle ages killed 25%-75% of those infected.
Ebola is a hemorrhagic disease, causing uncontrollable bleeding leading to death. It is not spread through the air, but rather through contact with a patient or infected animals or their bodily fluids, including blood, sweat, saliva, vomit, or excrement.
A few of these cases are of particular concern. For instance, a patient in Sierra Leone was forcibly taken from the quarrantine in a hospital by the family, treated with traditional medicine, was found, and died in the ambulance returning to the hospital. http://www.reuters.com/article/2014/07/27/us-health-ebola-africa-idUSKBN0FV0NL20140727. Another, possibly of greater concern, died in Lagos, Nigeria, after arriving on a flight. Lagos, Nigeria is a city of 21 million people, most of whom live in abject poverty with little hygiene. This disease could spread rapidly in such an environment.
It is no longer considered safe for healthcare workers, most of whom are caring for the sick out of altruism, mostly with groups such as the Peace Corps, Doctors Without Borders, Samaritan’s Purse, or other organizations.
Doctors Without Borders says this epidemic is out of control. The Peace Corps said it was evacuating 340 volunteers from Liberia as well as neighbouring Guinea and Sierra Leone.
A Canadian physician, working in with Samaritan’s Purse, was first said to have put himself in quarantine after returning from Liberia. He has not tested positive for the disease, and now says quarantine is not the correct term. Two US healthcare workers, also working with Samaritan’s Purse, are in quarantine after having the disease when they returned home. One has died. Both were in quarantined in US hospitals after they returned. Two more Peace Corps volunteers are quarantined after contact with Ebola cases.
Somehow, even with the isolation suits, specifically designed to keep the worker/wearer of the suit out of contact with patients with a communicable disease, some of these workers have gotten the disease! They had them, they were trained how to wear them, they wore them even though the temperature inside the suit would get dangerously hot, and it still did not protect them! Either they did not observe these precautions or universal precautions 100% of the time, which is unlikely since they understood what the likely results of catching ebola would be, or this is not adequate to protect against ebola. Again, several organizations have decided that west Africa is no longer a safe place for their workers, even with protective equipment and training.
The patient identified in Lagos is of particular concern, since he demonstrates that a person infected with Ebola, although possibly not yet symptomatic, can board an aircraft and fly almost anywhere in the world, unwittingly spreading the disease. The European Union is concerned with Ebola spreading there, as there was a suspected patient in Spain, who tested negative after the incubation period was over – but it is possible that someone with the disease could spread it in Europe. There is concern about Ebola spreading to Asia as well, as reported by Japanese media.
In the UK, a Lyberian asylum-seeker developed Ebola days after arriving in Britain. He was tested upon arrival, and tested negative for the disease. However, it broke out days later, and tested positive.
The UK, Canada, US, and Hong Kong are taking precautions and being on the alert for passengers who look sick, especially after being in West Africa. Canada’s concern is documented in a CBC (Canadian Broadcasting Company) video.
On a more somber note, it is known that terrorist groups, including Al Qaeda, Boco Haram, or ISIS using this epidemic to spread terror. ISIS especially has a history of desicrating graves of the dead. Graves cannot be guarded 100% 24×7. As was pointed out in The Economist, one terrorist cell taking one ebola victim and putting blood or tissue from the body into water upstream from a city could cause massive infections – and panic and terror – anywhere in the world. Sure, it would lead to the deaths of terrorists, but as many of them value their cause more than they value their own lives, that would probably not stop them.
Experts say that ebola is unlikely to become an epidemic in the US. VOX gives a number of reasons why it could not become an epidemic in the US. They list how such an epidemic would probably go down:
- The first 24 hours: identify the outbreak As I have pointed out in several other posts, the US medical system is poor at correct and early identification of disease.
- The next step: isolate the patient Isolation in US hospitals is pretty hit-or-miss, due to the variable effectiveness of isolation rooms, isolation equipment, use of Universal Precautions, and patients’ contact with others. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0015174/ For instance, if a patient is taken to another part of the hospital, and the patient bleeds, vomits, or drops other fluids in the hallway, others may be exposed. In some hospitals, isolation rooms share the same ventilation system as the rest of the hospital, so airborne pathogens can be transmitted. However, ebola is not transmitted through the air. I experienced an especially eggredious instance of utter carelessnesses, recounted in my post on antibiotic bacteria. I fear they would not do any better with ebola.
- Track down other potential patients Fortunately, the United States is superb at being able to locate other potential patients, and those who a patient has been in contact with.
- Keep patients in hospital until they’re not a threat This is likely to be a problem in the US, with its for-profit health system having insurance companies as the gatekeepers. Insurance companies will likely, especially if this is a widespread problem, limit the number of days for hospital stays, or not authorize such things as isolation when it’s recommended. While this would be illegal, court cases take months or years to get through. The epidemic spreads in days.
Personally, I am not so sure that it would not become a serious, deadly epidemic in the US for these very reasons.
The US is not especially eager to accept quarantines, as has been demonstrated with the resistance to quarantining AIDS patients. Commercial insurance is not eager to pay for this, nor are individual patients – who usually cannot pay for a long-term isolation room. Ability to properly test and diagnose even common diseases is hardly outstanding, but very hit-or-miss, as anyone with an uncommon illness can attest. Moreover, as most US doctors have never seen a case of Ebola, as many of them have never seen cases of other once-common diseases, such as chickenpox, rubeola, or polio, this could become more problematic unless great effort is made to educate ALL healthcare workers on such diagnoses immediately. Even then, if ebola is on the forefront of their minds, many people will be misdiagnosed with ebola when they have a different health problem.
This could likely cause a severe problem in the US. That could be one of the reasons that tens of thousands of Central American children are emassed on the southern border of the US. Since Representative. Phil Gingrey (R, GA), himself a physician, says that some of these Central American children are carrying a multitude of diseases, including ebola. That claim is ludicrous on its face. Ebola is not native to Central America, these minors have not travelled to Africa, it’s unlikely they contacted anyone who had been to Africa or on a plane. Dr. Gingrey would have to know better, as a physician! If he really didn’t pay attention in school, certainly some of his staff could have before he publicly said it or wrote it in a letter to the Center for Disease Control.
I’ve long wondered about these children or minors, whether they are refugees or economic migrants, nothing substantial has changed to make Central America worse than it’s been for decades. Most of them say they are “escaping violence”, but the violence has remained at the same very high level in Honduras, Guatemala, and El Salvador since the 1980s. Why are these “unaccompanied minors” coming to the US by the tens of thousands in 2014? They could be being set up as scapegoats. Certainly, if ebola becomes a major epidemic in the US, it will be much more convenient to blame the Central American minors on the border or the countries that sent them than to blame inadequacies in the US public health or healthcare system.
That would give the US military contractors something they could fight and win more easily than fighting against the spread of a deadly disease. Neither corporate nor government officials would not have to take the blame for their inadequacies. The liberals or progressives who have been urging the US to take all of these “children” in, without legally-required medical bills of health could also be blamed for an epidemic which neither they nor the Central American children had anything to do with, regardless of the real reasons they’ve come to the US border. All of the problems would get worse, not better.