Ebola The Seventh Seal:
I don’t have much to offer about the Ebola epidemic in West Africa.  Today they are saying almost 5,000 have died and the disease incidence is doubling every three weeks or so.  Of course statistics in that part of the world were unreliable before, and although resources have been brought to bear, they’re probably worse now.  A nurse who was helping care for an Ebola patient in Spain, a priest who had gone to Africa on a mercy mission, has caught the disease and a nurse and a nurse assistant in Texas have caught it as well. 

It seems that the disease has outflanked every effort to stop it.  Health care workers wear protective clothing, but I had hardly seen a picture of a gowned and masked worker who had no skin showing until October 21.  Protective gear lay on the docks in Sierra Leon for weeks before the red tape could be cleared and it could be taken in and put to use.  They are screening arrivals in the US in five airports and cheerfully report that will include 94 % of travelers coming in from West Africa.  Really?  Somebody seems a lot less worried than I.  Would it cost that much to screen everybody?

It is very troubling that health care workers get the disease.  (Jon Cohen When Ebola Protection Fails SCIENCE vol. 346 no. 6205 October 3, 2014 page 17)  If they get the disease from caring for patients even in modern rich countries, the safeguards just aren’t in place.  For further troubles, those health care workers who have caught the disease from a patient by and large do not remember any breach of protocol when they might have become infected. 

It has often been said, “A person who is asymptomatic is not infectious.”  On that one there seems to be some good news.  One is symptomatic for about three days before one tests positive.  So it makes sense that you don’t get it from an infected individual before symptoms appear. 

I suppose eventually we will throw enough resources at this thing to stop it.  It is, after all, just another disease.  Many, not most, recover.  The UN has said that the world needs do mobilize twenty times the response made so far; that sounds about right to me

The burning question is: What happened?  Why did we get hit with this now?  I suppose mobility is at the root.  Somebody has reported antibodies in over thirty percent of the local population.  That means they had it, recovered and are now immune.  So maybe it has been smoldering a long time.  Maybe in the old days if it hit a village the village would just disappear. 

For some time I have thought idly about volunteering for Doctors Without Borders, the charity that has been providing essentially all the care for the victims.  That was before this outbreak.  I still can’t go.  I have ongoing research.  There’s this web site, but I imagine I could continue to pursue it.  A year from now?  The research really should be on the shelf.  But who knows what the world will look like?  It may be gone.  It may be here.  They’ll be able to use help under any circumstances.

The authorities keep telling us not to panic.  Right.  Don’t panic.  My impression is that people generally do not panic.  It’s the authorities who panic.  I’d not mind if they’d panic a little more on this one.  Maybe a century ago it would all have burned itself out without our ever knowing.  But the whole tragedy still strikes me as most mysterious.  It has long been reported that a wandering African who goes to a village not his own is put to death.  I have accounted for this in my mind by thinking, “Of course.  People have lived there a long time.  Bitter experience has taught them that bringing strangers in will make the babies go away.”  But if Ebola has long been endemic, and there are other diseases like it, maybe that was the cause of the xenophobia.  I don’t know. 

The American military is going to build some new clinics in places where the epidemic is worst.  I think I’d take a different approach.  I would mass produce isolation units for maybe two or three patients.  Each would be a negative pressure environment so that in any leak would be inward before going out through filters.  Access would be by way of suits like we used to see used for handling radioactivity.  The suit and a small access tunnel is attached permanently to an outside wall.  I’d build clothes washer-dryers into the wall with doors opening outside as well as in so clothes solid material could be washed and dried sort of like through an airlock.  I’d have an x-ray tube and imaging panel inside so x-ray studies could be done.  I’d have stethoscopes consisting of a microphone and transmitter that stayed inside and a receiver and headphone worn inside the suit.  I’d have ultrasound available inside including a handheld unit for finding veins when needed.  And I’d have people a lot smarter and more experienced than I figure out what else was needed.  And I’d not stint on the cost.  The units could be stored like a mothballed fleet for the next time, whenever and wherever. 

The is a move “The Seventh Seal,” that dramatizes a plague in the Middle Ages.  It’s pretty Grim. Real life just now is seeming grimmer. 

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