Fever

24 10 2014

As is not-unexpected, New York has its first case of Ebola.

Am I worried? Nope, not even a little—at least, not for myself. For the doc who got it, on the other hand. . . .

My students have asked me, a not-MD, about Ebola, and I have been vigilant in cutting down any fears about the disease. I even went after a colleague who said she was hesitant to fly due to Ebola.

It’s not airborne! I barked at her. You’re not going to get it.

And that is the crucial piece for those of us who a) do not live in Guinea, Liberia, or Sierra Leone, and b) are neither health care nor mortuary workers—i.e., those of us who are unlikely to come into contact with the bodily fluids of infected persons.

Those who are likely to so come into contact are at great risk: the virus is highly infectious, so tremendous caution must be taken to avoid contact with any fluid. But, again, for the rest of us—something else will get us before Ebola does.

Laurie Garrett introduced me (personally!) to Ebola in her terrific book, The Coming Plague. The cases she discussed had a very high kill rate—over 90 percent—which was both terrifying and, oddly, a kind of insurance against its spread: it killed people so quickly it could sweep through an isolated population before anyone had a chance to travel and transmit it elsewhere.

That kind of virulence-insurance would crumble once it reached more densely populated areas, which of course, it has. The death rate in some cases has fallen to “only” 50-60 percent, which is still appallingly high, and this microbe will kill thousands more people before health officials get ahead of it. That these outbreaks have occurred, and that the world health community (WHO, CDC, pharma, health ministries & depts, etc.)—with the exception of MSF—have, shall we say, underperformed in response to initial reports of its spread, is appalling in its own way, but there does seem to be a fair amount of confidence that the spread can be halted.

Or, to put it another way, Ebola may terrify us for its fast-moving virulence, but those old standbys HIV and malariaand flu—will likely kill far more people this year and next than Ebola.

This could change, of course: as Ebola spreads, it’s changing (as infectious microbes are wont to do), and epidemiologist Michael Osterholm has written of his fears that, via combination with other microbes, it could—could—become airborne.

Now, it’s possible that any mutations which lead to Ebola becoming a respiratory illness might also mean it becomes less virulent, but it’s also possible that it could join its mighty virulence to easy transmissibility to become a super-bug, much like the (misnamed) Spanish Flu pandemic of 1918.

If that happens, then, yep, I’ll be afraid.

But until then, I’ll be more worried that the kid sitting next to me or the guy standing in front of me on train will give me the regular old flu (due to my egg allergy, my doc advises against a flu shot) than a deadly hemorrhagic fever.





Everybody knows that the Plague is coming, 4

6 08 2014

File under: why would anyone be surprised?

First up: Professor John Ashton, the president of the UK Faculty of Public Health, who writes:

“In both cases [Aids and Ebola], it seems that the involvement of powerless minority groups has contributed to a tardiness of response and a failure to mobilise an adequately resourced international medical response.”

and World Health Organization director general Dr Margaret Chan:

“We must respond to this emergency as if it was in Kensington, Chelsea and Westminster. We must also tackle the scandal of the unwillingness of the pharmaceutical industry to invest in research [on] treatments and vaccines, something they refuse to do because the numbers involved are, in their terms, so small and don’t justify the investment. This is the moral bankruptcy of capitalism acting in the absence of a moral and social framework.”

Second, Allan Sloan, who is surprised enough to be outraged that American companies would park their “incorporation” overseas so as to avoid taxes:

Inverters don’t hesitate to take advantage of the great things that make America America: our deep financial markets, our democracy and rule of law, our military might, our intellectual and physical infrastructure, our national research programs, all the terrific places our country offers for employees and their families to live. But inverters do hesitate — totally — when it’s time to ante up their fair share of financial support of our system.

Profit-seeking companies seeking to maximize their profits?! Who ever heard of such a thing?

And those who don’t invert?

Wall Street is delivering a thumbs down to Walgreens’ announcement of a $15.3 billion plan to complete its acquisition of Europe-based Alliance Boots and decision not to pursue potential major tax savings by shifting its headquarters overseas.

Bad capitalists!

Since all is not gloomy, allow for a bit of intellectual-property absurdity:

Wikimedia, the US-based organisation behind Wikipedia, has refused a photographer’s repeated requests to remove one of his images which is used online without his permission, claiming that because a monkey pressed the shutter button it should own the copyright.

Cheeky monkey*!

David Slater/Caters—and monkey!

*Actually, a crested black macaque

~~~

h/t to a coupla’ folks at The Stranger: Charles Mudede, and Ansel Herz  (twice!)