Response to Dr. Rahe: We Need Cool Heads on Ebola

 

shutterstock_209207017I have just finished reading Paul Rahe’s post “The Centers for Disease Control Loses Its Grip.” His post — and others like it on Ricochet — and the World War III style headlines I have been seeing elsewhere, prompted me to reply.

For the last several years, we’ve been in the midst of an epidemic of zombie-related literature, films, and television. Much of it is terrible. Some of it is good.  Some of it is excellent.  Zombie outbreaks take the form of a disease epidemic. It’s slow burning at first, but then hits everyone like a tsunami and wipes out all of civilization.

This epidemic of zombie media taps into a fear that lingers in the back of our minds: that this level of material prosperity — never before seen in human history — must be a passing phenomenon. That the other shoe must drop at some point. It could be a war with the Russians. It might be global warming. It might be the Second Coming. It might be the zombie apocalypse. But at some point, this decadent, comfortable world of ours with its hot showers, selfies, and decadent boutique pet foods must come crashing down when everything hits the fan.

That may well happen at some point, but Ebola won’t be the cause. Ebola isn’t the super plague that is going to wipe us out. It will rage in west Africa, in the Third World, but it will not wipe out America. Ebola isn’t the Black Death. It’s not Polio. It’s not Spanish Flu.

It’s also something we understand pretty well. Contrary Dr. Rahe’s piece, Ebola isn’t some giant question mark. We know a lot about it. We know how it spreads. Insinuations to the contrary are deeply counterproductive and unnecessarily induce fear.

Ebola is a hemorrhagic fever. In its final stages, your body melts down and you begin bleeding because your organs begin hemorrhaging. It’s so horrific because you begin bleeding from your eyes, nose, mouth, and ears. Everywhere. It’s highly contagious at that point — and if you’re attending to someone in that stage — there’s a good chance you’re going to get covered in blood. That’s why you wear protective gear.

Ah, but this health care worker was wearing that gear and still caught it!  They sure did.  It’s easy to do.

If you’re covered in infected blood, and then take off your gear, and get a little bit on you, and unthinkingly wipe your eye, that’s contact. That’s all it takes. That’s what they call protocol breach. That’s how it happens. It’s horrible and scary, but it’s not mysterious.

A travel ban is also a terrible idea. First of all, most US air carriers stopped going to places with Ebola months ago. Second of all, in order to accomplish the goal of a quarantine effectively, you’d also have to stop flights from any place that flies to an infected country — and to be safe — from any place that flies to any place that flies to an infected country. At that point, you might as well just shut down all air travel. That is a hysterical overreaction to what we are told is a gigantic epidemic that has caused exactly two cases in the US in the ten months it’s been raging.

A ban like that has the potential to make things worse. It would make it harder for aid workers, health care workers, and anyone else who wants to help to travel to and from infected areas, ensuring that the crisis continues to burn on. It’s an irrational, unnecessary, and heavy-handed response it’s not hard to find out why.

Let’s just say this: Barack Obama is a bad president. He’s terrible at his job. Most government agencies are terrible at their jobs. But some government agencies — given and abundance of cash and talented people — can accomplish great things. God help me, but even I’ll admit that government agencies can sometimes do good work.

So, remember: unless you touch the blood or vomit of someone with Ebola, you’re not going to get it.  You don’t need to be afraid. Panic is unwarranted.

Image Credit: Shutterstock.

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  1. ctlaw Coolidge
    ctlaw
    @ctlaw

    Fred Cole: It would make it harder for aid workers and health care workers and anyone else who wants to help to travel to and from infected areas. Period. It’s an irrational and heavy handed response and unnecessary.

    One irrationality, would be an “anyone else” wanting to go to an infected area. The prior portion of your post emphasized how only highly skilled, highly supported people should be going there. How many tons of equipment would be needed to support one worker? A few hundred hazmat suits per month per worker? Hundreds of gallons of decontamination chemicals per month per worker?…

    This all means special charter flights with cargo. Those can be arranged and the return flights routed through stages of quarantine. None of this needs commercial flights.

    • #1
  2. user_1938 Member
    user_1938
    @AaronMiller

    My understanding is that ebola can be transmitted via sweat. That seems a low bar. The trouble isn’t avoiding contact when you know who is infected. The trouble is all the contact that can occur before the afflicted become symptomatic.

    Did that medical worker kiss her kids goodnight while infected? Did her kids then get excited and spit all over their classmates while making play noises, as young kids are known to do? Or were they teenagers who play sports and make plenty of contact with other sweaty kids? Did someone with a scratched hand touch a doorknob that another’s sweaty hand had just infected? How near a table or desk must a person be for others to realize that his sneeze has infected the surface?

    I agree that it would be easy to be paranoid. I didn’t understand the fretting about ebola initially. But its exceptionally long period without symptoms and deadly mortality rate do seem ideal for the potential of plague.

    The higher the stakes, the harsher the acceptable measures. If ebola is a genuine plague threat, then quarantine and travel bans seem to be reasonable precautions.

    • #2
  3. hawk@haakondahl.com Inactive
    hawk@haakondahl.com
    @BallDiamondBall

    Well, that was a patronizing lecture from as progressive a shut-up-and-think-right libertarian as you’ll find.

    I agree, Ebola isn’t the superbug that confounds logic and defies method.  But this administration will turn it into just that, given half a chance.  What’s worrying is the condescending sneer with which our questions are batted down by an administration which has shown somewhat the opposite of a protective stance regarding borders and protocols.

    Outbreaks are also periods of maximum mutation.  This is an horrific disease, and whether its reproduction value is 2 or 30, the less of it we have here, the better.

    The administration is lying to us again, claiming certainty where there is none, and that’s reason enough to react pretty strongly.  I would rather not rely upon the how many kids will die compared to how many kids I have ratio to seek comfort.

    No, Fred, you have not discovered the Satanic Rock & Roll connection between Ebola and Zombies.  I will refrain from repeating everything I say several times as though lecturing a none-too-bright child, or making lurid excursions into tedious definitional prose that would shame to sleep the love child of Samuel Johnson and Miss Othmar.

    Zombie rhetoric is a lantern hung on preps.

    • #3
  4. Basil Fawlty Member
    Basil Fawlty
    @BasilFawlty

    First, we need to quarantine the Liberians. Then the Libertarians.

    • #4
  5. captainpower Member
    captainpower
    @captainpower

    Aaron Miller: My understanding is that ebola can be transmitted via sweat.

    Michael Fumento, an anti-hysteric with a track record, says that scientists are stoking fears by broadening the list of likely transmission methods. In reality, blood or vomit in your mouth is the way it is transmitted. I imagine other mucus membranes may also work, such as eyes and nose.

    http://nypost.com/2014/08/05/why-ebolas-nothing-to-worry-about/

    Compare the way that AIDS is talked about in the media (i.e. you can get it by walking down the street innocently minding your own business even if you are a heterosexual female) as a guideline for how people with agendas spin these outbreaks.

    • #5
  6. user_280840 Inactive
    user_280840
    @FredCole

    Aaron Miller: My understanding is that ebola can be transmitted via sweat. That seems a low bar. The trouble isn’t avoiding contact when you know who is infected. The trouble is all the contact that can occur before the afflicted become symptomatic.

    You are not contagious when you are asymptomatic.

    • #6
  7. user_280840 Inactive
    user_280840
    @FredCole

    ctlaw: One irrationality, would be an “anyone else” wanting to go to an infected area.

    Different people will come to different conclusions based on their own values sets.

    ctlaw: This all means special charter flights with cargo. Those can be arranged and the return flights routed through stages of quarantine. None of this needs commercial flights.

    Then do that.  I wouldn’t dare stop you.  A travel ban would make travel more difficult.

    • #7
  8. user_280840 Inactive
    user_280840
    @FredCole

    Basil Fawlty:First, we need to quarantine the Liberians.Then the Libertarians.

    Here’s the thing: This isn’t even a libertarian thing.  This is a use-your-brain thing.

    • #8
  9. Basil Fawlty Member
    Basil Fawlty
    @BasilFawlty

    “You are not contagious when you are asymptomatic.”

    Like when you get your temperature taken at the airport?

    • #9
  10. user_1938 Member
    user_1938
    @AaronMiller

    This is why I don’t even bother with mainstream news anymore. I usually get more detailed information from Ricochet conversations. Thanks.

    captainpower: Compare the way that AIDS is talked about in the media (i.e. you can get it by walking down the street innocently minding your own business even if you are a heterosexual female) as a guideline for how people with agendas spin these outbreaks.

    That says it all, doesn’t it? I did wonder before ebola penetrated our borders (the TSA and HSA at their finest!) if this disease was getting so much attention because it originates from the only continent with automatic victim status.

    • #10
  11. Basil Fawlty Member
    Basil Fawlty
    @BasilFawlty

    “Here’s the thing: This isn’t even a libertarian thing. This is a use-your-brain thing.”

    Are the two mutually exclusive?

    • #11
  12. EJHill Podcaster
    EJHill
    @EJHill

    Unhelpful to whom?

    • #12
  13. ctlaw Coolidge
    ctlaw
    @ctlaw

    Fred Cole:

    ctlaw: One irrationality, would be an “anyone else” wanting to go to an infected area.

    Different people will come to different conclusions based on their own values sets.

    Translation: There are objective rationality/irrationality standards only when Fred Cole accuses someone of being irrational.

    ctlaw: This all means special charter flights with cargo. Those can be arranged and the return flights routed through stages of quarantine. None of this needs commercial flights.

    Then do that. I wouldn’t dare stop you. A travel ban would make travel more difficult.

    How would it make it more difficult, let alone by a magnitude that outweighed the benefit?

    • #13
  14. user_280840 Inactive
    user_280840
    @FredCole

    EJHill:Unhelpful to whom?

    Everyone.  It makes people stress out when they don’t need to.

    A couple of weeks ago somebody commented on the massive economic disruption caused by this one Ebola patient.  Well no.  It’s wasn’t the Ebola patient, it was the freak out about the Ebola patient.

    Freaking out about this is going to do far more damage here in the US than the actual bug ever will.

    • #14
  15. user_280840 Inactive
    user_280840
    @FredCole

    ctlaw: How would it make it more difficult, let alone by a magnitude that outweighed the benefit?

    It depends on how the travel ban were structured.  This is a rapidly moving disease.  If you had to get some kind of special permit from the government to travel back and forth, the paperwork delay could cause problems.

    • #15
  16. user_138562 Moderator
    user_138562
    @RandyWeivoda

    Sure Fred, just keep up the happy talk. If it weren’t the apocalypse would the network news shows be talking about it constantly?  Don’t you remember how just a few years ago one-quarter of the American population died from the bird flu?  Or was it SARS?  Hoof-and-mouth disease?  No, mad cow disease, that was it!

    • #16
  17. hawk@haakondahl.com Inactive
    hawk@haakondahl.com
    @BallDiamondBall

    I denounce your sexist use of the term “hysterical”.  That’s the real fight we face today.

    • #17
  18. Doctor Bean Thatcher
    Doctor Bean
    @DoctorBean

    [Standing on my desk and clapping]

    Bravo! Bravo! Main feed, please.

    I hate it when our side devolves to running around screaming with our skirt over our head. The science here is pretty solid. Fear multidrug resistant TB. Fear multidrug resistant gonorrhea. Fear the common annual flu. Ebola isn’t a serious threat in the US.

    Thank you Mr. Cole.

    • #18
  19. Doctor Bean Thatcher
    Doctor Bean
    @DoctorBean

    In case anyone cares, here’s the post I wrote about Ebola a week ago:

    Why Ebola is not a Major Threat in the US

    Trust me. I’m a doctor.

    • #19
  20. user_280840 Inactive
    user_280840
    @FredCole

    Doctor Bean:In case anyone cares, here’s the post I wrote about Ebola a week ago:

    Why Ebola is not a Major Threat in the US

    Trust me. I’m a doctor.

    You should totally cross post that here.

    • #20
  21. Doctor Bean Thatcher
    Doctor Bean
    @DoctorBean

    Why? It has zero political / philosophical content (other than that it’s true).

    • #21
  22. 1967mustangman Inactive
    1967mustangman
    @1967mustangman

    Fred I actually agree with you here.  Shocking but true.  Look the idea of a mutation is extremely remote.  See the following from a CNN article:

    The World Health Organization says its scientists are unaware of any virus that has dramatically changed its mode of transmission.

    “For example, the H5N1 avian influenza virus… has probably circulated through many billions of birds for at least two decades. Its mode of transmission remains basically unchanged. Speculation that Ebola virus disease might mutate into a form that could easily spread among humans through the air is just that: speculation, unsubstantiated by any evidence.”

    Osterholm and other experts couldn’t think of another virus that has made the transition from non-airborne to airborne in humans. They say the chances are relatively small that Ebola will make that jump. But as the virus spreads, they warned, the likelihood increases.

    Yes the likelihood of mutation increases, but not by much.  Think of it as buying 1,000 lottery tickets instead of buying 1.  Except that instead of your chance winning (or losing as the case may be) being 1 in 400 million they are more like 1 in 500 quintillion (no expertise behind that number just trying to make a point please don’t stone me).

    Ebola spreads mainly due to poverty, unsanitary conditions, and burial rituals that involve actions such as washing the dead.  This isn’t going to be a big thing in the US.  It isn’t going to be a pandemic, it isn’t going to kill millions.  It will be horrible for everyone who gets it, but this will eventually burn itself out.  If for no other reason then that we will find a way to cure it.

    • #22
  23. ctlaw Coolidge
    ctlaw
    @ctlaw

    Doctor Bean:In case anyone cares, here’s the post I wrote about Ebola a week ago:

    Why Ebola is not a Major Threat in the US

    Trust me. I’m a doctor.

    Let me quote from that post.

    First: “What’s the worst that could (likely) happen? A few of the [four] people [from the apartment] under quarantine might get sick.” Oops!

    Second: “The first is that a very large number of the victims in Africa are healthcare workers. That’s because of the lack of even the most basic equipment for personnel protection, like latex gloves and disposable gowns.” Oops again! Apparently, even more than the most basic is not enough.

    • #23
  24. Larry3435 Member
    Larry3435
    @Larry3435

    I am getting really tired of people throwing around words like “hysteria” and “panic.”  I haven’t seen or heard about anyone who is hysterical or panicked.  But I think people are getting rightly disgusted with public officials lying to them and infantilizing them.

    The purveyors of soothing talk about Ebola are no different than the self-styled elites who rush to assure us that ISIS has nothing to do with Islam because they are afraid that we are going to run out into the streets and start bludgeoning the first person we see with a beard.

    Every time I hear one of these people talk, I think of the scene in Airplane! where Leslie Nielsen assures the passengers that nothing is wrong, while his nose grows longer and longer.

    • #24
  25. Doctor Bean Thatcher
    Doctor Bean
    @DoctorBean

    Are you saying the gist of my post is wrong because I didn’t include that you have to use the protective equipment correctly? I hate to blame the victim here, but she must have touched herself with the outside of her isolation equipment. That’s a no-no. You touch the inside of the isolation equipment and the outside of the isolation equipment touches the world. That’s how you stay isolated.

    If you finish caring for the patient, walk into the decontamination room, take off your mask, get an itch on your nose, and scratch it with the outside of your glove, you’re toast. That doesn’t make Ebola a larger threat.

    Look, I’ve argued this on other threads on the web and I’ll make here the same prediction I’ve made there. Fewer than 12 people will contract Ebola in the US this year. That’s a nice prediction because on January 1 you can tell me if I was wrong. So if you disagree, you can predict the opposite and we’ll see what happens. If you don’t disagree can you name a disease that will cause so few fatalities that is generating so much anxiety? Good grief, flu will kill more people than that in Los Angeles next month.

    • #25
  26. user_82762 Thatcher
    user_82762
    @JamesGawron

    Fred,

    This is one time the pooh pooh of a so called moderate is completely wrong.  First, it’s a killer disease.  Half the people diagnosed with it are dead.  Second, there are studies which confirm that in close contact even aerosol close contact this killer disease can be transmitted.

    Fred the surest way to get this up to a crisis is not to take it seriously.

    Regards,

    JIm

    • #26
  27. Basil Fawlty Member
    Basil Fawlty
    @BasilFawlty

    If ten asymptomatic but infected folks arrive on a plane and disperse around the country before they show signs of the disease, are we quite confident they will be identified and treated before each infects multiple other folks?

    • #27
  28. user_82762 Thatcher
    user_82762
    @JamesGawron

    Basil Fawlty:If ten asymptomatic but infected folks arrive on a plane and disperse around the country before they show signs of the disease, are we quite confident they will be identified and treated before each infects multiple other folks?

    Basil,

    Sort of like an infectious chain letter or nuclear reaction.  Fred isn’t concerned.  Wouldn’t it be nice if he discovered that his house guest of 2 weeks was on the list.

    Regards,

    Jim

    • #28
  29. Doctor Bean Thatcher
    Doctor Bean
    @DoctorBean

    It’s only a chain reaction if each patient, on average infects more than one other patient. (It doesn’t actually matter how many infected asymptomatic people are on the plane, only on how many people each infected person infects.) If each patient infects on average exactly one other patient than the illness smolders on forever, if fewer then the outbreak fizzles out. So far Mr. Duncan (RIP) has infected exactly one other person. Do you believe she’ll infect anyone? I’ll guess she won’t, though I can’t be sure.

    If ten Mr. Duncan’s get off a plane tomorrow, what happens is just what happened to him, times 10. They each infect a few unfortunate people who are immediately isolated and it ends with them. Fill a whole plane with asymptomatic Ebola patients and you still won’t kill as many Americans as the flu will kill this year.

    • #29
  30. 1967mustangman Inactive
    1967mustangman
    @1967mustangman

    James Gawron:

    Basil Fawlty:If ten asymptomatic but infected folks arrive on a plane and disperse around the country before they show signs of the disease, are we quite confident they will be identified and treated before each infects multiple other folks?

    Basil,

    Sort of like an infectious chain letter or nuclear reaction. Fred isn’t concerned. Wouldn’t it be nice if he discovered that his house guest of 2 weeks was on the list.

    Regards,

    Jim

    Your analogizing this to a nuclear reaction is actually quite perfect.  It is very hard to get a nuclear chain reaction and going most of them fissile …..in fact the only known natural nuclear reactor is in Africa

    • #30

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