Ebola's cold, hard facts
There’s no miracle drug and no fictional heroes – what we need is cash, doctors and resources, writes
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 traveller in the eyes and see infection, blocking that passenger’s entry? You believe novelist Dan Brown’s utterly absurd description of a World Health Organisation with a private C5 military transport jet and diseases Swat team that can swoop into outbreaks, saving the world from contagion?
Wake up! What’s going on in West Africa now isn’t Brown’s silly Inferno scenario – it’s Steven Soderberg’s movie Contagion, but without its high-tech capacity.
Last week, my Council on Foreign Relations colleague John Campbell, a former United States ambassador to Nigeria, warned that the spread of the virus inside Lagos – which has an estimated population of 22 million – would instantly transform this situation into a worldwide crisis, thanks to the chaos, size, density, and mobility of not only that city but dozens of others in the enormous, oil-rich nation.
Let’s be clear: Absolutely no drug or vaccine has been proven effective against the Ebola virus in human beings. To date, only one person – Kent Brantly – has apparently recovered after receiving one of the three prominent putative drugs, and there is no proof that that was key to his improvement.
None of the potential vaccines has even undergone Phase One safety trials in humans, though at least two are scheduled to enter that stage before December.
And Phase One is the swiftest, easiest part of new vaccine trials. If one of the vaccines is ready to be
Let’s be clear: Absolutely no drug or vaccine has been proven effective against the Ebola virus in human beings.
used in Africa in 2015, the measure will be executed without prior evidence, which will require massive public education to ensure people who receive the vaccination do not change their behaviours in ways that might put them in contract with Ebola because they mistakenly believe they are immune.
We are in for a very long haul with this extremely deadly disease. It has so far killed more than 50 per cent of those laboratoryconfirmed infections, and possibly more than 70 per cent of the infected populations of Liberia, Sierra Leone, and Guinea.
Nigeria is struggling to ensure that no secondary spread of Ebola comes from one of the people already infected by Liberian traveller Patrick Sawyer – two of whom have died so far.
That effort expanded on Wednesday, when Nigerian health authorities announced that a nurse who had treated Sawyer escaped her quarantine confinement in Lagos and travelled to Enugu, a city that, as of 2006, has a population of about three million. Though the nurse had not shown symptoms, the incubation time of up to 21 days hadn’t elapsed.
Since the Ebola outbreak in March there have been many reports of isolated cases of the disease in travellers to other countries. None have resulted, so far, in a secondary spread.
It’s only a matter of time before one of these isolated cases spreads to a chaotic urban centre far larger than the ones in which it is now claiming lives: Conakry, Guinea; Monrovia, Liberia; and Freetown, Sierra Leone.
First of all, we must appreciate the scale of need in the three Ebola- plagued nations. Before Ebola, these countries spent less than $118 (US$100) per capita on healthcare each year.
The World Health Organisation has repeatedly warned this epidemic could persist for perhaps a year. US experts concur. I myself have received emails from physicians in these countries, describing the complete collapse of all non-Ebola care, from unassisted births to untended auto accident injuries. People aren’t just dying of the virus, but from every imaginable medical issue a system of care usually faces.
Even if the world dodges a viral bullet and Ebola fails to take hold in a metropolis in a different country ( such as Lagos, Johannesburg, Delhi, or Sao Paulo), controlling the disease and saving lives in Liberia, Sierra Leone, and Guinea will require resources on a scale nobody has delineated.
Let’s start with simple manpower. All three countries desperately need doctors, nurses, medical technicians, ambulance drivers, Red Cross volunteers, epidemiologists, and health logistics experts.
Emmet Dennis, president of the University of Liberia, e-mailed that he needs gowns, gloves, face masks, body bags, infectious waste bags, sanitiser wipes, disinfectant and rehydration fluids for his medical school personnel now fighting cases in Monrovia.
As there are no miracle drugs for Ebola, the needs include few medicines, though local responders tell me they wish they had sterile syringes, saline drips, and fever modulators such as aspirin.
Over the next six to 12 months, these countries will needs millions of dollars’ worth of basic supplies, and hundreds of highly skilled healthcare workers. If the virus takes hold in another, more populous nation, the needs will grow exponentially, and swiftly.