First and foremost, a travel ban to the United States from West Africa will be counterproductive and will help to spread, not contain, the outbreak. Science knows that, medicine knows that, but politically, it’s close to inevitable, even though there are no direct flights from that part of Africa to North America.
The saddest part about our fractured politics and polarized electorate is that reason takes a back seat to the political whims of idiots. (For those of you who like to write me about the difference between idiots and morons, yes, I’m using the right choice here with “idiots”.)
When doctors do what they’re supposed to do they treat the cause of the disease, not the symptoms. When there is no cure, they provide palliative care. In this case the cause is in Africa, and we should be undertaking treatment there. We should be making it easier for doctors and nurses to go to West Africa by insuring that the few planes available to transport Ebola victims are not denied access to America. We should make military transports available for the healers who agree to travel to the region, we should help prop up the private companies equipped to transport sick people.
Further, we should honour our pledge to WHO, and encourage other countries to do so. We can argue later about the disaster that WHO’s African branch has been, as now Dr. Chan and her cohorts are coordinating out of Geneva. Of the $20 billion (with a b) that has been pledged, only $100,000 has been received. That was from Colombia. Shame on the rest of us.
And the medical personnel? Only one country has sent its doctors and nurses (the rest are all through aid groups). Want to guess? Cuba. The same only country who sent doctors and nurses to fight cholera after the Haiti earthquake. If we won’t support Cuba with matching humans, at least we should help transport their medical personnel here to the US’s nine Ebola beds when some of them contract the disease. And they will. Because doctors and nurses are the most likely to contract Ebola – not strangers on a train, not the person across the airport lobby and certainly not someone who just happened to be in the city of Dallas. That’s right kids, an idiot city in Maine put a teacher on leave because she was 10 miles from Texas Presbyterian for a conference.
In addition to sending medical personnel, we should continue to utilize the troops we’ve sent, and we should send more, to build medical facilities in Africa. Including related infrastructure like roads, sanitation, food distribution. The things our military is actually really good at. I concur with the idea that we should stop bombing for a few days and take those dollars and do something good with them: like save West Africa. This is, for sure, a contrarian view, as polls show most Americans want to kill in Syria, Iraq and the rest of that region rather than save lives in Africa. Most people are idiots.
We should also stop blaming the nurses and doctors in Dallas for not following protocol and admit that Texas Presbyterian HAD no actual protocol. CDC lacked clear guidance, which will likely be issued today and will follow MSF guidelines, modified for places with running water and autoclaves. It will include full body coverage, a buddy system, and rigorous, on-going training. Until then, medical personnel and first responders should err to the side of caution, and stay 3 – 6 feet away from potential Ebola victims until someone dressed properly arrives.
We should also realize that our health care system is stratified, much like our population. Texas Presbyterian has been nicknamed the Neiman-Marcus of hospitals. It is dedicated to rich people and their first world problems. I haven’t seen their stats, but I’d bet they see a lot more heart disease, cancer, births and plastic surgery than they do MRSA, CDiff, AIDS or Tuberculosis. They weren’t ready. Most private hospitals that spend money attracting rich patients with suites and private chefs are not. Put the money into training and supplies. Increase your nursing staffs and pay them correctly. And, oh yeah, Single Payer….but I digress.
The politics of Ebola are the politics of panic and pandering to the uniformed. The chances of contracting Ebola through the air are nil, and the chance that the virus will mutate to an airborne form are minuscule. Yet, the right wing, the science-averse, and even some people in tight races who should know better prey on the fears of people facing something they don’t understand. Something new.
The way we eradicate Ebola is not any different from how we went after other scourge diseases like smallpox, polio, typhoid or plague. We treat what we can, we contact trace, we quarantine, we endeavor to develop drugs and vaccines. We stamp it out as close to the root cause as is possible. We understand that with diseases in new places, there will be deaths, and those are sad and unavoidable. Most likely, those deaths will come more from medical personnel than anyone else.
Thus, we seek to eradicate this outbreak in West Africa by moving people and money there. We protect the medical personnel, aid workers, and soldiers as best we can. We care for those who get sick. While we’re there, we endeavor to make the continent better in terms of sanitation and infrastructure, because that will help going forwards.
In this country, we leave the panic behind, and protect our first responders and health care personnel with full body garb, training, and proper procedures for removing, disinfecting and destroying Personal Protective Equipment. We make sure that facilities utilized by Ebola patients are equally disinfected and that the staff who does that work are also protected.
We should focus on what WILL kill Americans in vastly higher numbers in the next months: flu, enterovirus 68, heart disease and cancer.
Finally we should remember that we live in a wholly interconnected world. The reason we didn’t look for Ebola cures back in the 70’s was because it was Africa’s problem. Ditto for AIDS, which first reared its ugly head in Africa in the 1800’s. (Yes, 1800’s.) And let’s not forget Marberg, another African hemorrhagic fever. Not to mention the Middle Eastern MERS, nor bird flu and SARS which hail from China. We need to funnel dollars to researching these diseases before they, too, spread.
So my advice for you? Are you a health care provider or first responder? Full body suits, proper protocols. The rest of you? Live your lives, wash you hands (as always, fingers, nails, fingers, fingers, fingers.) Vaccinate your kids. If you’re sick, stay home. If you think you, or your child, is sick with something communicable, stay home and call your doctor. Can’t afford a doctor? VOTE, you know the drill.
Above all else, avoid panic and idiocy. This too shall pass, and hopefully we’ll learn from our mistakes.