Thursday, October 09, 2014

Civilization Is A Disease Vector

     I'd been snickering at the "ebola has gone airborne!!!" alarmists -- the trope is a rehash of one applied to AIDS/HIV and, conversely, is a sneeze not airborne enough?* -- when I realized it in fact has gone airborne, and used our passenger jets to do so.

     Civilization is a disease vector.  The plagues of antiquity didn't hit when culture's candle was guttering low and isolated populations of huddled villagers hardly heard from the rest of the world.  Nope, you need some basic level of trade and travel, a certain population density, and a link that reaches a pool of the infected.  While your circle of friends is likely to be made up of a hundred or so people, most of them in close geographical proximity, it takes only a stunningly small number of world travelers to link your circle with everyone else's -- yes, Kevin Bacon is only six hops away and I sure hope that's just hay fever his friend's friend's second cousin's babysitter has got.

     Once upon a time, the Black Death came shambling down the Silk Road.  These days, ebola flies coach.  Don't like it?  Of course not!  But it comes with the territory.  Once it was silk; now, it's the exotic materials in your smartphone's battery.  You can't get 'em without travel. 

     Civilization is and has always been a race between problems and solutions -- and each solution carries with it another set of problems.  Stop running and they'll overwhelm it.
* If it isn't, there's always anthrax -- but listen up: anthrax is a bacteria; forming tough, wretched little endospores that linger for decades is what it does.  Ebola is a virus and like the common cold, it wants to travel from one warm wet environment to another.  Roughly, ebola sticks to doorknobs while anthrax drifts on the breeze, and that right there is the useful difference between "airborne" and "not."  Also?  Wash your hands.


LCB said...

Well said.

The Spanish flu managed to hit the "civilized" world during 1918, and it didn't even need planes to travel. Just ships.

I don't worry so much about a sickness that is on the radar. The one that could cause TEOTWAWKI would spring up all over the world with in days and kill quickly.

Hmmm...another thought, even if we get to where antibiotics no longer work on dah germs, it only means we're back to the 1930's in medicine. Humanity survived just fine before penicillin.

Kristophr said...

I'll prep anyway.

At worst, I have a bunch of freeze-dried food I'll need to cycle through backpacking trip within the next 25 years.

My wife is retired and I can work from home. No contact works during a pandemic.

Matthew said...

There was a recent article tracing HIV that pointed out the British african railway addiction helped it spread out of its little pocket of origin. Maybe "the Ghost and the Darkness" were antibodies?

Railways spread a lot of infectious diseases from their origins to places where they can really explode... Marxism, for example.

Ken said...

Matthew, please arrange to collect your one complete set of Internets for October 9, 2014.

Anonymous said...

The good news is that the Dallas Deputy tested negative for Ebola. Hopefully no one else will have gotten sick from Mr. Duncan. We will know by Halloween.

Quarantining Liberia, Guinea and Sierra Leone makes sense. Anyone that needs to travel from there can spend 21 days in quarantine. With modern communications and virtual conferencing, most interactions do not need to be in person. Products leaving the country? Put them on a slow boat for 21 days. The virus will die if there is no host.

Roberta X said...

I do wonder what the outcome would have been if Mr. Duncan's first visit to the ER had resulted in a correct diagnosis.

It is also of some interest to me that the very outlets that had condemned "drug companies using experimental treatments in the Third World" are now complaining that the cutting-edge (and barely-if-at-all tested) treatments given to the U. S. survivors aren't being applied in Africa. Dammned if they do and damned if they don't and, as ever, it's the people without good access to the ears of the world who are paying the deadliest price. Oh, to swap self-appointed "spokespersons" from outside for a liberal dollop of literacy and Internet access....

Roberta X said...

Matthew: Nicely put!

Jake (formerly Riposte3) said...

"The good news is that the Dallas Deputy tested negative for Ebola. Hopefully no one else will have gotten sick from Mr. Duncan.

Well, so much for that hope. One of the hospital workers who treated him has tested positive. They're saying he was wearing the recommended protective gear, too, and "among the things CDC will investigate is how the workers took off that gear — because removing it incorrectly can lead to a contamination."

Roberta X said...

The quote is accurate -- removing PPE is the riskiest part of the process and easy to get wrong. It only takes one careless move and you've touched where you shouldn't.

I had to be trained in it (the 24-hour quickie-cert) nearly twenty years ago after a fire at work that might have involved PCBs. I worked in a taped-up "moon suit" with an air-purifying respirator for about a month, guiding the abatement crew. --It turned out okay in the end but we had to go by the book.

Jake (formerly Riposte3) said...

"removing PPE is the riskiest part of the process and easy to get wrong. It only takes one careless move and you've touched where you shouldn't."

Yup. It's also worth noting that the folks in Texas probably got an even shorter crash course than you did. The level of PPE needed for Ebola, especially in its final stages, is well beyond what most health-care providers receive any real training in (outside of possibly a few days while in school). I can't imagine them getting anyone up to speed and properly habituated to the procedures in the time they had.

IOW, she may have slipped up at that point not through carelessness or inattention, but because she was unfamiliar with and unpractised at the proper procedures.

That being said, it looks like the CDC is actually backing off of that particular claim. They're still saying it was possible, but now they're also looking at some of the more aggressive procedures he underwent (dialysis or intubation) as possible exposure points.

Realistically, I think if they're not going to move these patients to one of the four hospitals that are properly equipped and trained to handle diseases like Ebola, then they need to be moving properly equipped and trained teams to those patients. NOT throwing the local staff through a quickie crash course in the proper procedures and then expecting them to execute them flawlessly every single time.