We have been following the Ebola outbreak in Africa, the worst on record. With today’s article Runaway Ebola-Infected Woman Dies As US Doctor Tests Positive For Virus, we have decided to alert our readers and explain the danger that we see. Two days ago it was reported that Man Carrying Ebola Virus In World’s Fourth Most Populous City, Dies In Quarantine. We shall give a bit of information about Ebola and then argue the international danger it presents.
Wikipedia has a description of symptoms of the disease and incubation period:
Symptoms start two days to three weeks after contracting the virus with a fever, throat and muscle pains, and headaches. There is then nausea, vomiting and diarrhea along with decreased functioning of the liver and kidneys. At this point some people begin to have problems with bleeding.
The World Health Organization discusses transmission of the virus as:
Ebola then spreads in the community through human-to-human transmission, with infection resulting from direct contact (through broken skin or mucous membranes) with the blood, secretions, organs or other bodily fluids of infected people, and indirect contact with environments contaminated with such fluids. Burial ceremonies in which mourners have direct contact with the body of the deceased person can also play a role in the transmission of Ebola. Men who have recovered from the disease can still transmit the virus through their semen for up to 7 weeks after recovery from illness.
Airborne transmission is not mentioned but it is reasonable to assume there may be risk of inhaling droplets expelled by an infected person coughing since mucus membranes are one path of entry into the body.
There is no vaccine for Ebola and no treatment other than to try and keep the patient hydrated. Wikipedia notes that The disease has a high death rate: often between 50% and 90%. Treatment is done in special isolation facilities administered by staff wearing full body protection including re-breathing equipment.
High Cost of Treatment and Containment
This is the main deterrent to control of an outbreak in places like Africa. Few hospitals would have the necessary isolation facilities or staff trained in their use. Certainly no hospital will be able to properly handle a large influx of patients for this reason. Then there is the issue of safe disposal of any equipment and materials used to treat patients, especially since such may be highly contaminated by bodily fluids. Disposal of bodies presents a similar problem compounded by cultural practices. The local dump and the local funeral home don’t qualify.
The SARS outbreak in Canada in 2003 revealed how ill-prepared a modem country’s health system was to respond to a major health threat. Canada at least had a system of government and politics that was capable of recognizing the seriousness of the problem and of providing resources and mobilizing a response, even though there were gaps, overlaps and delays. Africa is certainly far from this state of preparedness.
The articles at the beginning cite cultural issues such as the trust of the local medicine man over nurses and doctors. Such beliefs impede any effort to act. Corruption at all levels of government is another problem. But it will remain the high cost per patient in terms of facilities and trained staff that will make any containment difficult, and in large numbers, impossible.
Come Fly with Me …
… unless you have Ebola. Is the world community prepared to quarantine a country? How about a continent? Assuming such could be done, how long would it take to implement? Would all countries participate? What would a country like Canada do with citizens who hold dual citizenship in Canada and say, Liberia (one of the countries currently participating in the outbreak)?
What are the legal issues? What does international law say? Whatever is done, there would likely be massive dissent in terms of personal rights, human rights, sovereign rights, etc. Would the UN support a quarantine? How many months would the issue have to be debated, hearings held, and for all the processes that accretes around anything in our society that is at all controversial, to be exercised?
We hope this outbreak is quickly contained. If it’s not, then there is a good chance that any global response will be too little too late. The results would not be good.