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DAILY COMMENT
TODAY 12:00 AM
After Ebola
BY MICHAEL SPECTER
Red Cross workers carry the body of an Ebola victim in
Guinea.
PHOTOGRAPH BY SAMUEL ARANDA/THE NEW YORK TIMES/REDUX.
Since September 11, 2001, Americans have
had to adjust to an unsettling truth: as the
world becomes smaller and easier to
traverse, it also becomes more dangerous and difficult to control.
There are simply not enough fingers to put in all the dikes. So we
do our best: At airport security, we take off our shoes and dutifully
toss water bottles into the trash. On buses and in the subway, we are
often reminded, sensibly enough, that if we see something we
should say something.
But as the worlds worst Ebola epidemic yet spreads through
western Africa, it is important to remember that we wont always
see something. The single biggest threat to mans continued
dominance on this planet is the virus, the Nobel Prize-winning
biologist Joshua Lederberg once wrote. Few epidemiologists would
disagree. There is no bomb, no poison, no plan of attack with the
potential to do as much damage.
It doesnt take much effort to see that. Smallpox killed up to half a
billion people in the twentieth century alone, before its eradication,
in the nineteen-seventies. (Thats why it was so terrifying to learn,
last month, that vials full of smallpox, alive and forgotten, had been
lying for decades in the refrigerators of a former N.I.H. laboratory.)
The global public-health system needs to become far more vigilant
in detecting new viruses before they spread. That will require
patience, time, and moneyan unlikely combination at best.
On Thursday morning, the President of Sierra Leone cancelled a
planned visit to the United States, declared a national health
emergency, and ordered the Army to quarantine people in the
worst-affected areas. The Liberian government has shuttered the
countrys schools and placed most public employees on a thirty-day
leave. The Peace Corps this week pulled three hundred and forty
volunteers out of Liberia, Guinea, and Sierra Leone.
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 bestand, if he dies, dont clean out his
bowels by hand. Better to step back, blow a kiss, and burn the hut.
Still, Ebolas more prosaic symptomsabdominal and muscle pain,
fever, headache, sore throat, nausea, and vomitingalso 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 wouldnt be worried to sit next to someone with the Ebola virus
on the Tube, as long as they dont 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. Ebolas
incubation period is between two and twenty-one days long. The
virus kills rapidly. There is nothing insidious about it.
Ebola wont kill us all, but something else might. Like everything
living on Earth, viruses must evolve to survive. That is why avian
influenza (http://www.newyorker.com/magazine/2012/03/12/the-
deadliest-virus) 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.
Its a long-shot chance to transcend the dead end. To go where it
hasnt gone and be what it hasnt been. Sometimes the bettor wins
big.
Hes right, of course, and it is long past time to develop a system
that can easily monitor that process. If we dont, the next pandemic
could make Ebola look weak.
Michael Specter has been a staff writer at The New Yorker since 1998, and has
written frequently about AIDS, T.B., and malaria in the developing world, as well as
about agricultural biotechnology, avian influenza, the worlds diminishing
freshwater resources, and synthetic biology.
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