BLOG: The Ebola Genie Is Out Of The Bottle.
The gross mismanagement and incompetence demonstrated in the handling of the country’s first Ebola case is mind-blowing. From the Emergency room sending Thomas Duncan home after noting on the chart that he was recently in Ebola-infected Africa to the pressure spraying of his vomit on the sidewalk outside his apartment by an unprotected worker while a woman wearing sandals stood nearby, to the long delay in properly cleaning the Ebola-infested apartment where he was living practically insures that additional cases of Ebola will be diagnosed in the next several weeks.
Before going any further, let me give my qualifications for being greatly concerned. I graduated from the University of Michigan Medical School (M.D.) and School of Public Health ((MPH) and in 1971 passed the board exam in Occupational and Environmental Medicine. In 1964, I was the sole physician in Barrow, Alaska, when there was an epidemic of meningococcal septicemia. I worked closely with the CDC team sent to Barrow to manage the disease and published a paper along with co-author Jacob Brody, leader of that group, in the Journal of the American Medical Association. I wrote a fictionalized account of that epidemic in my book BARROW (Huttmann Co, Ann Arbor, 1985). In the mid-1970s, I was intimately involved in Michigan’s PBB contamination disaster, having studied reproductive effects of PBB in rodents, finding it produced birth defects, and trying to convince regulatory agencies of the need to stop exposing Michigan residents from eating contaminated animal products. Nothing was done until several years later, when I finally arranged for Dr. Irving Selikoff and his team from Mt. Sinai in New York to come to Michigan and investigate the problem. The incompetence of the politicians and state regulatory agency officials was staggering. I published an account of the disaster in my book, Cancer and Chemicals (Nelson-Hall, Chicago, 1977).
My observations of the handling of the country’s first Ebola case compel me to write this blog. The incompetence and mismanagement of politicians and public regulatory officials convince me that the Ebola Genie is now out of the bottle, and it is likely that an epidemic will sweep through the country, and will probably become a world-wide pandemic. The mortality rate for Ebola is even higher than for smallpox. There is no vaccine, and antibiotics do not kill the virus. The potential for a disaster of epic proportions is significant. (Read “Epidemics” in the A Dangerous World” section of this website.)
The performance of our government officials to date does not inspire confidence that they will contain the disease. It appears that we must look out for ourselves. The best way to protect ourselves from Ebola is to severely limit contact with others once the disease has spread. Epidemics spread in geometric fashion. For example, if the first person infects ten others, then about two weeks later, those ten people will develop the disease. If they each infect ten more people, the those people will come down with the disease two weeks later. Then there will be one hundred cases. Two weeks later, one thousand cases. Every two weeks the case rate will multiply by tenfold.
Since there is no cure for Ebola, the only way to insure you will not get the disease is to not become infected. When there are many cases, you will not know who is contagious, so the best protection is self-quarantine. You will need to be able to survive with a minimum of contact with others for an extended period of time. Preparedness and self-reliance will be the key to survival.
The arrival of Ebola is a compelling reason to have a well-designed preparedness program.
-Mark Raven, MD, MPH
October 4, 2014
