Ebola

Fruit Bat 512

As a result of the Thalidomide disaster new drugs have to go through incredibly thorough testing before they are licensed for general use. This includes three phases of human trials and the criteria are so very strict that very few drugs make it through the entire process. It is also incredibly expansive, some use a ballpark figure of a billion pounds to get one molecule from the laboratory for the market. So it is little wonder that there is no treatment for an obscure African virus that was only identified in 1976 in Africa. The small number of previous outbreaks had only killed hundreds of people which is a drop in the ocean in Africa compared to diseases like Malaria, HIV, Pneumonia and Tuberculosis.

Ebola exists in nature in a reservoir in other species, probably fruit bats, and is transmitted to humans when we come into contact with them. Many diseases do this, the 1918 influenza pandemic came from hens, as did SARS and we had a recent flu epidemic that came from domestic pigs. In the African bush there are probably many such potential diseases and we have experienced some of them, including HIV, Lassa Fever, Lujo Virus and Marburg Virus. Because our bodies have no developed immune response to these alien pathogens they can be particularly dangerous, as history has shown us.

All transmittable pathogens have a route from victim to victim. Some viruses survive in the air and can be transmitted just by breathing. These are very contagious indeed and human influenza is our best example, rapidly spreading and infecting millions of people. Other viruses, like HIV, can’t survive outside the body so can only be caught by a penetrative exchange of body fluids. This is why HIV remained with a very low profile after it first transferred to humans in the 1920s. It was only modern travel and social behaviour that allowed it to blossom into an epidemic. Ebola sits somewhere between these two contagion extremes. It is not airborne (yet) but can persist on a surface exposed to the air for about a week. Certainly it has infected a lot of health workers who were taking all reasonable precautions.

Ebola is probably killing about 70% of those infected (previous outbreaks have varied between 25% and 90% fatality). The current epidemic has officially killed about 4,000 people. But lack of communications in the bush, weak state institutions and deliberate obsfucation mean that many think this figure can be doubled. And, because Ebola has an incubation period of up to three weeks, the real position is far worse than what the current news is telling us. Epidemiology is the science of studying and predicting diseases in society and there are many people in the world who have huge expertise and computer models to tell us what is going to happen. They have been tracking and predicting the current epidemic and they have consistently been very, very wrong. It has got out of control in a way that none of them predicted. On 19 September CDC were predicting half a million cases, by 23 September they were predicting 1.4 million.

Africa has far worse education than we have in the West, so many people have false beliefs. So they often ignore what health workers and their government tell them. If their culture says they must wash down a dead body (an incredibly dangerous practice with Ebola victims) then bury them in the ground then they will strongly resist being told that bodies must be cremated unwashed. So communities will hide cases of the disease whilst acting in ways that maximise its spread. When these people are in the bush, away from easy communication with the authorities, it makes matters even more problematic.

Next we come to the virus itself. It is a relatively simple, incredibly small life form and must reproduce by dividing millions of time in order to infect just one person. These divisions are very prone to mutation, so viruses tend to change their nature very quickly, as we see with Influenza. Most mutations just die out, but occasionally one comes along which works more efficiently, and with Darwin’s work with evolution we know that this natural selection leads to survival of the fittest. So the Ebola virus is becoming progressively more virulent. It is developing into an ever more efficient killing machine. If it mutates to airborne transmission then we will be in incredible pandemic trouble.

So here is a scenario for you. Someone from Africa arrives in London with absolutely no symptoms whatsoever. Two weeks later he is contagious and uses the Tube, holding the escalator handrail. Six days later you use the same escalator and the virus transfers to you. Now you have a 70% chance of death. With no available medicine.

Throughout this entire epidemic the West has acted vastly too slowly and with nowhere near enough commitment. We could have quarantines entire countries and imposed incredible strict travel restrictions. But now there are people all over the world, walking round, carrying the virus. It is spreading exponentially and utterly out of control. It is going to get many times worse before it starts to get better.

 

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