Fighting Ebola When Mourners Fight the Responders

May 19, 2019 · 28 comments
smarty's mom (NC)
I keep wondering when ebola is going to become world wide
Cyclist (NYC)
This is our future if anti-Vaxxers have their way.
Mike Holloway (NJ)
"accusing them of stealing the organs of corpses" Make you feel superior? There are far more people in the US who, without evidence, believe that organ theft occurs here than the number believing it in Africa, with as tragic an outcome. The ghoulish character it gives organ donation prompts rejection of the kind of organ donation system that works, altruistic by permission of next of kin. As a result children, women, and men, of all races and income levels, die on the waiting list.
foodalchemist (The city of angels (and devils))
It's easy for many in our society to be appalled at their ignorance which only harms them in the not quite so long run as the refusal to allow proper burial, containment, testing, vaccination, and immediate treatment for those infected allows the virus to spread even further. We shouldn't be so quick to judge, this is the end result when scientific expertise is dismissed, politicians and lobbyists question consensus (looking at you, GOP), disinformation and misinformation proliferate on social media, and more of the population adopts Isaac Asimov's warning of "my ignorance is just as good as your knowledge." We're seeing it with the anti-vaxxers and the current measles outbreak, which I predict is far from over. That's what happens with infectious diseases with a long latency between the onset of symptoms and when the affected individual is first contagious. Need I mention climate change, or why we want regulations to check air, water, and soil pollution in lieu of corporate profits and convenience? If current trends aren't reversed, and none of the news give any hope that's on the horizon, it's not too much of a stretch to imagine a similar scenario here. Too many folks are deeply suspicious of government and science. This is a canary in the coal mine of sorts.
natan (California)
Ebola is not the fastest spreading virus, in part because it is so lethal. The immunizations also seem promising. Overall we are handling it greatly. But nothing is immune to irrationality, ignorance and plain stupidity.
RLiss (Fleming Island, Florida)
Horrible, tragic article. Read Gina Kolata's book "Flu" about how the 1918 flu epidemic, newly crossed over to humans from pigs, devastated the planet, with no cure available..... In fact, the above book should be required reading for all anti vaxxers, since it occurred in the days before there was a flu vaccine (though by now we should all understand the flu, which is a virus, morphs regularly and so the flu vaccine is always a "best effort"). No idea what can be done in the Congo....if the people hate/ fear the health workers so much.....just tragic and will get worse.
Samantha Kelly (Long Island)
Mistrust is key. Americans mistrust vaccinations largely because health care is for profit. Everyone beats the autism drum as the reason, because that makes anti-vaxers look like idiots. I think the deeper cause is mistrust of a for-profit system. Scare tactics are used to push vaccines on TV, Shingles, Hepatitis C .. Ca Ching! It’s not for our health or well-being. $$ Lets have a national health system, and then we’ll trust vaccine recommendations. I am not an anti-vaxer, but I do think too many are required of young children. Chose the most important. I feel we know very little about the effect of bombarding an immature immune system with so many threats, so soon. I an tired of pro-vaccination hysteria.
scsmits (Orangeburg, SC)
@Samantha Kelly "...I do think too many are required of young children." and "I feel we know very little..." are indications that you are an anti-vaxer. Any time someone like you thinks that they know more than the thousands of people who have taken all the chemistry and immunology courses that make someone an expert, you are an anti-vaxer. What makes you believe that you have your thinking is superior to that of all the experts?
Alexander Harrison (Wilton Manors, Fla.)
@Samantha Kelly: Yours is a thoughtful response, but I would not trust the government to administer such a program.Let private enterprise handle it. Were it not for the pharmaceutical companies and their dedication to research, finding cures for various "fleaux,"we would be in even worse shape. When a vaccine to prevent malaria, or attenuate the effects was developed, lariam ,and then malarone, an even more effective anti dote were perfected, it was not accomplished by government bureaucrats, but by well paid epidemiologists in the private sector.Likewise, consider advances in treatment of Sida, Aids patients, all done by the private sector. When MICK JAGGER was told he needed a heart operatgion, he chose to have it done, not in Old Blighty, but in the US.When a cure for Ebola is finally found, it will be a well paid researcher working for Big Pharma who will have accomplished what now seems impossible.
Peter (CT)
@Alexander Harrison Malarone was developed by GlaxoSmithKline - a British company. Lariam, developed by the U.S. Army, is no longer sold in the U.S., as a common side-effect (come to find out, after very little testing and thousands of lawsuits...) is psychosis. They still sell it, but now they call it mefloquine, and put a disclaimer on the label. Big Pharma will develop a cure for Ebola as soon as it looks profitable, and not before. Maybe if MICK JAGGER, or someone else with bucketloads of money gets Ebola, things will start happening. In the meantime, I know some very good British researchers who are working as hard as anyone at Eli Lilly, and fortunately their research is not (entirely) directed by the bean counters. The people who are "well-paid" at Lilly aren't the researchers.
W (Minneapolis, MN)
You would think that modern communication methods would help the medical community confront this epidemic. Instead, it only seems to hinder their efforts because of disinformation and conspiracy theories.
Emily Corwith (East Hampton, NY)
Irrationality is so prevalent in the human species that one would think it conferred an evolutionary advantage.
Doug Karo (Durham, NH)
@Emily Corwith Perhaps this is another test of that proposition, but it seems to me that the evidence so far does not seem to support the hypothesis.
Thoughtppnder (California)
On a purely evolutionary level the “irrationality” in this case would work its way it if the gene pool as all those with irrational genes would die of Ebola and take that gene to the grave with them. I know here is collateral damage of non-irrational along the way and this is not a humanist approach, but biologically disease will take care of those who don’t use rational thought to treat them and prevent them.
Richard (Mertens)
The signs and symptoms of Ebola are similar to those of malaria. In West Africa in 2014-15 protocol demanded we quarantine any person who displayed one or more of several signs and symptoms: temperature over 101.5, blood shot eyes, patient report of nausea/vomiting. recent contact with a known Ebola victim. Malaria patients were mixed with Ebola patients in wards called Suspect units until test results could confirm the disease. Malaria patients were treated for several days and released. Weeks later some these patients would return to us as Ebola patients. We simply did not have the resources to isolate each patient. The open ward of Suspect Units was an unnecessary risk to patients, rationalized away by the fact health workers could not tell the difference if a fever was caused by Ebola or something else, an excess of caution to protect the larger community over the rights of the individual. As best I can tell, the current response is rather anemic compared to the West Africa outbreak. With warlords causing problems, there needs to be a more robust military element to this response to guard Ebola treatment efforts and facilities.
mr isaac (berkeley)
DRC is a failed state. Everything starts and ends with that fact, including Ebola outbreaks.
Doug Karo (Durham, NH)
@mr isaac It seems to me that Ebola outbreaks do not respect political boundaries although responses to Ebola might well.
Karl (Englewood, Florida)
This situation, and the anti-vaxxers in supposedly first-world countries, shows us how fragile our trust is, in modern medicine, in science, in government, and in our social infrastructures. The hostility towards refugees, the clinging to religious teachings of centuries ago, the mindless partisanship of politics . . . Nevertheless, trust has been shown to be genetically part of us, and I'm hoping for more sanity to prevail.
Richard (Mertens)
There's a ton we have left to learn about the vaccine to know exactly how much protection if offers. There certainly seems to be a short term protection but from what I'm hearing is that there has been difficulty in tracking those who received the vaccine, leaving holes in follow up.@Karl
scsmits (Orangeburg, SC)
@Richard "...from what I'm hearing..." is the best that you can do?
Jacquie (Iowa)
Why is the World not stepping up to irradiate Ebola before a widespread outbreak outside of Africa? We now have the vaccine which is effective.
Lyn (Canada)
@Jacquie the World is really trying. And doing it under the most trying of conditions, as described in detail in this article. Eradicating this disease may not be possible at this time. Ebola is classified as an Emerging Disease, meaning that it has only recently jumped across from its natural host to "emerge" as a disease infecting humans. I seem to remember that it has done so on several previous occasions over the last 50 years roughly. I am not sure if we even know the natural host for sure for this disease. Until we know for sure the natural host where this virus hangs out, that is, what the reservoir is, how can we possibly eradicate the disease?
Chuck (CA)
@Jacquie You mean like how they eradicated measles about 20 years ago? My point being... you cannot actually irradicate any disease in the world. You can squelch it to the point where it appears irradicated.. but it will still linger in the wild in a subset of natural vectors. And see. where ebola is concerned.... there are a number of animal vectors in Africa that act as an immune but persistent reservoir just waiting for a non-immune human host to infect. Wide spread vaccinations with the new vaccine is the best program currently to wall off Ebola from ongoing infection of humans in Africa.... but what happens when it suddenly mutates, as virus are prone to do? And then there is the issue of reaching 95%+ of the local populations with the vaccine which is what is needed to effectively wall it off from humans. That said.. the vaccine is great progress even in limited distribution because it now means health care and local enforcement workers can move freely among the infected and not receive a death sentence for their efforts.
Lyn (Canada)
@Chuck By vaccination we eradicated Smallpox. We did eradicate it "in the wild". BTW, it has been kept in 3 laboratories. Otherwise, it would have completely disappeared from the planet. Smallpox was easy because it had no host other than humans. There certainly was no subset of "natural vectors". We don't know if there is just one, or more than one, animal vector for Ebola in Africa. Currently, a species of bat seems the most likely natural host. The health workers, although vaccinated against Ebola, may indeed receive a death sentence, from some of the local people who are opposed to their work, due to suspicion of "what they are up to".
Lawrence Siegel (Palm Springs, CA)
Even though I admire the health workers who put themselves at risk, I wonder why they try so hard. There are countless areas of the globe that both need and want assistance. It seems there's easier paths to helping more people. Ebola isn't the only scourge on the planet; malaria, polio, measles and countless other illnesses afflict populations which offer far less resistance. Noble motivations, but dangerous situations and modest outcomes.
Lyn (Canada)
@Lawrence Siegel To my mind it is largely that Ebola poses a greater threat to the survival of the human species than any of the other diseases you list. The mortality rate from Ebola is at least as high, if not higher, than the other diseases you mention. I am not sure about measles in under developed countries; that has a very high death rate for unvaccinated children. Terrifyingly, Ebola is highly infectious, extremely lethal and has the potential of transmission globally by air travel. Have you noticed the pictures how the health care workers are dressed?? What these pictures tell us is the extreme danger posed by this disease. Once this genie escapes from the Congo, it may be very, very difficult to stop it spreading globally. One good thing is that we have a very effective vaccine now. However, it would not be possible to produce that vaccine in the quantities required to protect most of the planet. So, if Ebola escapes its current limited areas, it could be the equivalent of the 21st century plague. And we know how that story went in the Middle Ages. We should try and help and educate these people all we can or can manage under the conditions - for humanitarian reasons, and to prevent the nightmare of global spread.
Casual Observer (Los Angeles)
An infected person can ride an airplane to anywhere on the planet within a day.
JC (Dog Watch, CT)
@Lawrence Siegel: Yeah, people should focus on other things; we don't need people trying so hard on this outbreak. . . If it's hard work, it pretty much isn't worth doing. . . Maybe, as well, those having expertise and experience re specific viruses should be assigned to other areas that they may have less knowledge of. Seems to be working for us in the US, in other venues. We should also eliminate any efforts to stop the spread via travel from Congo to places like Palm Springs.