It Ain’t Swine Flu

Back in 2009, according to the October 14^th Washington Post, 52 percent of Americans were concerned about the spread of the swine flu; in 2006 41 percent of us worried about bird flu, and in 2003 38 percent of us showed fear over the SARS outbreak. “Concern about Ebola, at this point, is real but not pervasive. About two-thirds (65 percent) say they are concerned about an Ebola outbreak in the United States. But while people are broadly concerned about an outbreak, they are not necessarily worried about that potential outbreak directly affecting them. Just 43 percent of people are worried about themselves or someone in their family becoming infected – including 20 percent who are ‘very worried.’

“That finding echoes a Pew poll from last week which showed just 11 percent were ‘very worried’ about themselves or their families becoming infected. Since that survey, Dallas Ebola patient Thomas Eric Duncan died, and news that a nurse who provided care for him became infected broke on the final day of the Post-ABC poll… [which] shows 67 percent of people say they would support restricting entry to the United States from countries struggling with Ebola. Another 91 percent would like to see stricter screening procedures at U.S. airports in response to the disease’s spread.” The Post.

That terrible disease has recently taken the lives of over 4,400 victims in several West African nations (with almost 9,000 currently-diagnosed cases). With communicable transmissions here as well as in Spain, major airports in the United States and Western Europe are adding extra screening (questionnaires, body temperature readings) for flights arriving from or connected with the major infected areas in Africa.

Time.com (October 14^th) reports some nasty warnings from the World Health Organization: “A World Health Organization official said [October 14^th] that up to 10,000 new cases of Ebola could be seen each week in two months, marking a steep rise from the nearly 1,000 new cases — suspected, probable and confirmed — that have appeared each of the past four weeks.

“Without an increased commitment to fighting the virus within 60 days, ‘a lot more people will die,’ said Bruce Aylward, the organization’s assistant director-general, according to the Associated Press. Speaking at a news conference in Geneva, Aylward also said the death rate in the current outbreak was now at 70%, well above the earlier estimate of 50%.”

Once a nation that the world could count on to deal with horrific global issues, the United States appears to be more of the source of global problems in recent years (e.g., our failure to reduce greenhouse emissions or even embrace treaty commitments to do so or destabilizing the Shiite-Sunni balance in the Middle East through failed sustained military missteps). Having accelerated its massive budget deficits in these lost causes, wasting trillions of dollars in the process, the U.S. is also no longer supporting the educational and research programs that once addressed such virulent outbreaks before such disasters could plant their feet. We could have had this one in the bag suggests one highly-placed government official who should know.

“Francis Collins, the head of the National Institutes of Health, said the agency has been working on Ebola vaccines since 2001. ‘It’s not like we suddenly woke up and thought, ‘Oh my gosh, we should have something ready here,'’ Collins told the Huffington Post. ‘Frankly, if we had not gone through our 10-year slide in research support, we probably would have had a vaccine in time for this that would’ve gone through clinical trials and would have been ready.’… Collins said researchers and doctors would likely have been ‘a year or two ahead of where we are’ had research funding stayed on track.” Time.com, October 13^th. By early next year, experts say, that Ebola outbreak could infect 1.4 million people. Our priorities seem to be completely off-kilter.

Clearly, with a nurse wearing protective garb in a Texas hospital getting Ebola, the Centers for Disease Control are rethinking the procedures used to protect healthcare professionals dealing with infected patients. “Officials are considering imposing a requirement that workers at Presbyterian [the Texas facility] be sprayed with a disinfectant, like chlorine, after they leave an infected patient, often in a side room that is connected to the patient’s room. The procedure, which is used in Africa, is rarely used in American hospitals… ‘Every option is on the table at this moment,’ said Abbigail Tumpey, a C.D.C. spokeswoman.

“Additionally, someone will be assigned to monitor health workers as they put on their protective gear and take it off, to reduce the risk that they infect themselves, for example, from fluid on gowns or gloves. And the authorities are weighing whether procedures like intubation and dialysis are worth the grave risks they pose to the medical workers who perform them. Such modern medical procedures can extend life, but are complex, and are not part of regular care in the African countries hardest hit by Ebola.” New York Times, October 13^th. Sadly, we still don’t know for sure how the disease was transmitted to that nurse. The clear and confident tones that our national medical experts exhibited earlier seem to have moderated of late.

Exactly how big are the holes in the system here in the United States? “Though the precise number of workers remains unknown, questions were also being raised about why they had not been monitored previously… Dr. Joseph McCormick, regional dean of the University of Texas School of Public Health in Brownsville, said he was shocked that none of those monitored by officials in recent days were the hospital workers caring for Mr. Duncan after he was put in isolation. Dr. McCormick worked for the C.D.C. in 1976, when he helped investigate the first epidemic of Ebola in Central Africa.

“‘You know that once this guy is really ill and he’s hospitalized, there’s going to be a lot of contact, manipulation of blood specimens, cleaning up if he’s vomiting or if he’s got diarrhea,’ Dr. McCormick said. ‘You certainly can’t assume that because he’s hospitalized and in this unit that everything is fine and everything that goes on will be without any risk. I mean, that’s just ludicrous to think that.’” NY Times. That’s the issue at the individual treatment level, but there are bigger questions being asked.

While there is a groundswell across the nation and even in Congress to cut off or at least severely restrict flights from infected regions, at least here in the United States, that effort has yet to resonate with the administration: “Thus far, some countries in Europe have restricted flights from these countries in West Africa, and an increasing number of U.S. lawmakers are calling for similar bans. The White House has yet to increase restrictions, with federal officials saying such a move could actually increase the spread of the disease by hampering the movement of aid workers and supplies.” The Post.

Knowingly getting onto a plane with a serious and dangerous infectious disease could run afoul of many state laws, originally focused on the transmission of AIDS. Word was that had Eric Duncan survived, Texas was considering prosecuting him under their local statutes. Duncan didn’t make it. What’s worse, dealing with sanitation on commercial aircraft – from tray-tables, volume and TV controls, headrests to air filtration – has never been particularly stringent, and sitting next to someone with even a minor cold has long been cause for concern.

Leadership requires responsibility and investment in what needs to be done. Aside from the hard job creation that follows a committed pattern of research, we also can expect to live longer, healthier or better. On the other hand, we could just keep cutting our budgets and wonder why our children cannot compete globally, why our infrastructure is failing on a massive scale and why disease outbreaks and environmental disasters keep piling up.

I’m Peter Dekom, and I keep thinking ‘bout that other definition of insanity that seems to define Congress and most of our state legislatures: repeating the same stupid behavior and expecting a different result.