* * *
. . . As many as ninety per cent of those
infected with Ebola will die. There is no cure or treatment. There are several
vaccines under development; in early animal tests, more than one has shown
promise. But it will be years before they are ready for humans. Until then, if
you get Ebola, you are most likely done for. The virus can eat away at
capillaries and blood vessels, causing you to drown in your own blood. As David
Quammen wrote in “Spillover,” the definitive book about the origin and
evolution of human epidemics, “Advisory: If your husband catches an Ebola
virus, give him food and water and love and maybe prayers but keep your
distance, wait patiently, hope for the best—and, if he dies, don’t clean out
his bowels by hand. Better to step back, blow a kiss, and burn the hut.”
Still, Ebola’s more prosaic
symptoms—abdominal and muscle pain, fever, headache, sore throat, nausea, and
vomiting—also apply to at least a dozen other conditions. Could an infected
airline passenger make it to the United States? Absolutely. But in this country
every doctor and nurse in every clinic and hospital uses gowns, latex gloves,
masks, and disinfectants. Those precautions are rarely available in the parts
of Africa where the epidemic has been most severe. Ebola is contagious only
when it is symptomatic, and by that time people are almost invariably too sick
to travel. (Patrick Sawyer, the only American to die so far in this outbreak,
collapsed after a flight from Liberia to Lagos. He was planning to fly next to
Minnesota. He never got on that plane.)
“I wouldn’t be worried to sit next
to someone with the Ebola virus on the Tube, as long as they don’t vomit on you
or something,” Peter Piot told Agence France-Presse this week. Piot, the
director of the London School of Hygiene and Tropical Medicine, was one of the
two people who, in 1976, discovered Ebola. He then ran the United Nations’ AIDS
program for more than a decade. “This is an infection that requires very close
contact,” he said.
Ebola is truly deadly, but the many
lurid headlines predicting a global pandemic miss a central point. In its
epidemic reach, Ebola is often compared with H.I.V. But they are nothing alike.
H.I.V. has killed at least thirty million people, mostly by spreading quietly,
burrowing into the cells it infects, and then, at times, lurking for years
before destroying the immune system of its host. Ebola’s incubation period is
between two and twenty-one days long. The virus kills rapidly. There is nothing
insidious about it.
Ebola won’t kill us all, but
something else might. Like everything living on Earth, viruses must evolve to
survive. That is why avian influenza has provoked so much anxiety; it has not
yet mutated into an infection that can spread easily. Maybe it never will, but
it could happen tomorrow. A pandemic is like an earthquake that we expect but
cannot quite predict. As Quammen puts it, every emerging virus “is like a
sweepstakes ticket, bought by the pathogen, for the prize of a new and more
grandiose existence. It’s a long-shot chance to transcend the dead end. To go
where it hasn’t gone and be what it hasn’t been. Sometimes the bettor wins
big.”
He’s right, of course, and it is
long past time to develop a system that can easily monitor that process. If we
don’t, the next pandemic could make Ebola look weak.
* * *
Michael Specter, “After
Ebola,” The New Yorker, August 1, 2014
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