By Robin Williams
It is quickly becoming apparent that current policy and practice is inadequate to prevent an Ebola pandemic. A bipartisan letter signed by 26 members of Congress urges the president to take stronger action to protect the nation from the spread of Ebola.
The incubation period for Ebola is anywhere from 2 to 21 days. One is infected during the incubation period without being symptomatic. Taking the temperature of an infected person only catches individuals who are past the incubation period. It does not protect the public from those who are infected but still asymptomatic and are in effect walking time bombs travelling to the four corners of the globe. We should not convey a false sense of security with such gestures. While the history of quarantine is long and sordid, every infectious disease has its own specificity and what measures are necessary for one infectious disease are far different from those of another.
In the case of Ebola we are dealing with a virus that at times has been transmitted despite apparent precautionary measures. Ebola is an RNA filovirus and RNA viruses have a much higher mutation rate than DNA viruses. The more cases of Ebola, the more mutations are likely to occur. This also increases the risk of it becoming easier to transmit.
Considering unexplained transmissions of Ebola, current knowledge and practice may be inadequate. Many health workers caring for Ebola patients died in previous outbreaks and not all are likely attributable to poor working conditions and practice. Medical workers in Dallas and Spain were infected even though they wore full protective gear. We are ill equipped to handle many cases in many places when we have so bungled even one case in one place.
Ebola has a 50 to 90 percent mortality rate with no effective treatment or prevention readily available at this time. We are living in the age of jet planes which did not exist when last we faced a deadly 1918 influenza pandemic. To put this in perspective, while the flu was more easily transmissible, it still killed between 40 – 50 million people in less than two years with only a 2.5 percent mortality rate. This should send off alarm signals. It is absolutely critical to stop Ebola from being distributed across the globe by our failure to do what is required.
Since we do not have pre- nor post-exposure vaccines, nor effective antiviral medications available to prevent a pandemic, stopping commercial aviation in and out of those countries affected is immediately necessary.
Banning commercial flights should not be equated with isolating Liberia, Sierra Leone and Guinea. Flights into the affected countries must occur for purposes of medical aid with strict oversight and with all precautions taken. Those leaving the affected areas on medical aid missions should be quarantined for the longest incubation period of 21 days before boarding flights back to assure they are not spreading the virus to other nations.
Pre and post exposure vaccine development and anti-viral medications must be viewed as not just the prerogative of the private sector and a few pharmaceutical and biotech companies. Ebola is a major global security threat and needs to be dealt with as such. Therefore, elected world leaders need to use their executive power to allocate necessary resources for vaccine development and the ramping up of production and distribution to face a possible pandemic. All facilities needed for research, development and production of vaccines, monoclonal antibodies, and other effective medications need to be utilized, private sector or not. This should be viewed as a military operation. It is the greatest threat to world heath since the 1918 flu pandemic or perhaps the bubonic plague of the 14th century. Unlike the deadly flu strain it will not go away in a couple of years unless we rise to the challenge, mobilize resources and act decisively.
Had we not turned a blind eye to the suffering of people in afflicted areas since 1976 when this disease first occurred in a more rural location and developed the necessary vaccines and antiviral medications to prevent and treat Ebola, we would not be facing the current global threat.
Were even several thousand cases to occur in Europe or the U.S., the fear could lead to an economic meltdown.
This is an extraordinary and dire situation. It requires resolute action now.
Contact the White House, your senators, and representatives and call for full funding for vaccine and antiviral medication development, and distribution with increased medical support to the affected areas of Africa and an immediate halt to commercial aviation to those countries until the current outbreak has been quashed.
Robin Williams is a biology teacher and resident of Lawrenceville.
