(I know many of you are suffering from ebola fatigue, but here are some of my thoughts on the matter. They arent as wacky as those of the end-is-neigh types, but theyre quite a bit more circumspect than whats circulating in the mainstream right now.) Heres why you should be concerned about the spread of ebola both in Western Africa and the United States, and how the calm-mongering should be taken with a grain of salt. (Note that I wrote concerned about not scared of or in a state of panic because of.) 1. Many of those who are stating that it wont be widespread in the US have had several of their claims already proven wrong (i.e. we wont have an outbreak here.) Those claims seem to have gone down the memory hole, but they were made. So, why would you believe them this time? I know Im not convinced. There seems to be a lot of this calm-mongering going around because Im pretty sure that its believed (not without reason) that US citizens have two states: blissful ignorance or outright panic. 2. Ebola *is not* a significant threat in the US...right now. Many in the press are saying things like, oh, youre much more likely to die of a car accident, so why worry about ebola? Thats true...right now. But, the outbreak continues to spread in West Africa (which seems more likely than not) and the number of cases rises towards the number predicted by the CDC (1.4m by late January), the odds of more cases exported to the US will also increase exponentially. With those cases will come the risk for small outbreaks here in the US. 3. If the number of cases and deaths in West Africa continue to climb towards 1.4m, were going to start seeing failed states and mass migrations of people trying to outrun the epidemic (see the little girl who died in Mali a couple of days ago.) This migration will inevitably carry the disease with it, spreading it across the African continent and beyond. Furthermore, the failed states and mass migrations will bring war, famine, and genocide with them. This would be, at the very least, a humanitarian catastrophe. 4. Its true that diseases like malaria, HIV and other diseases kill more people in Africa on a daily basis than does ebola. Once again, this is a right now statement. If there are 1.4m cases in West Africa, there will be thousands of deaths per day. Furthermore, people die from HIV and malaria because of lack of access to treatment and prophylaxis. We know how to reliably treat and/or cure and prevent most of these killers. We only know in a vague way how to prevent ebola at scale (but were learning), and there is no reliable treatment that doesnt require substantial critical care resources. Also those resources arent really available in West Africa. 5. Our ability to treat and cure many ebola cases in our modern US hospitals is both our greatest strength and biggest weakness in fighting ebola here. Our politicans have been bragging that no American has ever died from ebola. Thats because of the massive amount of resources that can be poured into each case and the treatment of the patients in 3 elite care facilities that have 2 to 4 beds. What if there are 10 simultaneous cases? Or 100? Or 1000? Of course, you can try to get more facilities up to speed, but how long will that take (especially since were currently in whistling-by-the-graveyard mode) and how many of our hospitals can be equipped to do so? I believe that, particularly in a situation where we have 100s to 1000s of cases, it will be impossible to provide that same standard of care. What would happen if all of the ebola beds were full? What would the social/political ramifications be? 6. What happens if a true ebola panic does take hold here? Many people who would normally stay home in bed when they get a cold or the flu are going to run to the ER, a prompt care facility, or their PCP. (I predict this is going to happen on a smaller scale this fall even if the spread of ebola were to be stopped right now.) Theyre going to overwhelm the system. Furthermore, that load combined with a (potential) load of people truly sick with ebola could be catastrophic. This isnt fear-mongering based on the virus becoming airborne, or any of the other ridiculous, nearly impossible ma, get to th ebola bunker! The virus is comin! scenarios that have been proposed in certain corners. Its simply based on the CDC being correct about the 1.4m number, the basic history of the Western African region (i.e. the relatively recent civil wars fought in all three countries currently involved), the history of war and disease being joined at the hip, and human nature. TL;DR: Dont panic, for Gods sake, but prepared for a not insignificant number of ebola cases here. (Pray for peace, but prepare for war.) And, encourage everyone who has the power to do so to pour *everything* they can, resource-wise, into West Africa. The best way to prevent these second and third-order calamities Ive outlined here from coming to pass is to snuff this out before we have hundreds of thousands or millions of cases in West Africa and beyond.
Posted on: Sun, 26 Oct 2014 01:59:15 +0000
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