Ebola’s Rivers of Blood

Blood dripping from reddened eyes. Nausea, flu, diarrhea. Uncontrollable vomiting of blood. Almost certain death in 10 days. And if the disease was not scary enough, the latest outbreak adds over 5,000 deaths. Reported. More than 8,000 confirmed, and 14000 total, cases. An estimated 70% chance of death for a person infected. Cases & deaths in all major cities of 3 big West African countries; along with in Lagos – one of the biggest cities Africa. A death in Texas; cases reaching as far as Spain. Seems like cause enough to panic? Maybe even cause enough to stop all flights to and from Africa; isolate the 3 countries; and quarantine anyone from Africa? The outbreak is a definite cause of worry: the biggest Ebola outbreak in history (by some leaps and bounds); the speed of it’s devastating spread; it’s transmission by airplane to one of the world’s major airplane hubs; and now to the West too. However, evidence from the response in the countries majorly affected suggests that panic, alienation and unwarranted quarantines are more harmful than helpful. Maybe what the monster that Ebola threatens to become needs is a cool calculated response, rather than a hasty, absolute one.

The hunter

Ebola Virus Disease (EVD) previously known as Ebola hemorrhagic fever, was first identified in 1976: when two simultaneous outbreaks of two separate strains of the disease in the African nations of Sudan and the Democratic Republic of Congo brought the disease to light. The latter outbreak took place in a village on the banks of Congo’s Ebola river; hence the disease’s name. Since then, 4 more major outbreaks have helped us identify 5 different strains of the disease: however, even the sum of deaths caused by all major outbreaks since 1976 is much, much less than the deaths from this one outbreak of 2014. That is the seriousness of the situation. Although it broke the news headlines only in late July-early August, the current outbreak traces back to March this year, when the government of the West African nation of Guinea declared the mysterious disease that had killed 59 of its citizens was Ebola. The disease is believed to have been caught by a Guinean baby from some still unidentified animal all the way back in December last year: it then spread from that Patient Zero to friends, family, and the rest of the village. The intial deaths can be tracked as they spread through funerals mainly; and direct body fluid contact. From March onwards, however, the path of the murderer is lost in the speed of its killing: the disease takes 180 lives in Guinea, and even causes suspected deaths in the neighbouring Liberia by early May. It was a frightfully fast killer; but this, along with its not-so-contagious nature, means that as a disease, it is hard to sustain. So it wasn’t surprising when the outbreak suddenly seemed to die out by May’s end, like every previous outbreak in history – the epidemic contained in under 200 deaths – the WHO declaring the outbreak would be completely neutralized by May 22nd. On May 23, however, 4 deaths caused by Ebola were reported in Sierra Leone, the small war torn nation enclosed by Guinea and Liberia on either side, and all hell broke lose. Within weeks the stability of the disease in Guinea was lost: deaths rising to nearly 300; while Sierra Leone suddenly became a hotbed of new cases. Even in Liberia, where the disease was assumed to have been vanquished after the lack of new cases for over a month, the disease made a come back. From then on, the disease continued to spiral further and further out of control – with a impossibly high fatality rate only adding to an unstoppable contagion. By mid-July, the disease began to abate in Guinea while growing exponentially in Liberia and SL; crossing 600 deaths. Ebola’s first case in Lagos, Nigeria (Africa’s biggest city) displayed how air travel could be a terrifying new outlet for the spread of the disease. The disease slowly began to break the news: how this grotesque disease rampaging across Africa, killing everyone it infected. Around the same time, Dr. Kent Brantly – an American doctor who had volunteered to go to Liberia to fight Ebola – was diagnosed with it himself. The story, full of human sacrifice, created a storm around the world – a selfless foreigner who had contracted the disease from his patients. When he was deported and cured: his story became a beacon of hope, bringing to light all the foreign doctors risking their lives to help. World attention was really drawn by these July stories: but it took a 1000 deaths for WHO to announce an international health emergency on August 8, and Ebola became a household name. The numbers continued to swell, as the WHO became a Cassandra on the subject: foretelling worse and worse situations as the growing numbers seemed to confirm their worst predictions. On October 31, the number of deaths crossed 4800. Reported. There cannot be an accurate fatality rate while the disease is still on; but the number of success stories is scarily low. In West Africa, the crisis gets more and more apocalyptic: Liberia shows signs of completely breaking down as a nation; beddings and doctors miles short of what is needed; and confused governments trying to figure out what areas to quarantine, and how to fund this war they are fighting. A case in Spain; and a runaway American from Liberia who reached Dallas have seen the disease spread overseas. And scariest of all; 15,000 cases of Ebola: it is the beginning of the end.

Apocalypse now?

Ebola’s association with apocalypse, and the disease that will wipe humanity out, began much before this outbreak. In entertainment media, movies like Outbreak and books like The Hot Zone used the disease because of the gruesome nature of its killing, the speed with which it spread and killed, and largely the fact that so little is known about it. These factors have also helped induce the panicked international reaction to the disease: the three source countries have been completely isolated by international airlines: in some places, flights from anywhere in Africa are treated with fear! A sense of panic pervades the very mention of Ebola online, as if the disease is going to kill us all tomorrow. There are a few facts about Ebola such fear overlooks. Firstly, unlike H1N1 swine flu or other extremely contagious diseases, Ebola can only be contracted by direct contact with body fluids of the infected person. It cannot spread through the air, and is much less contagious than influenza and so many other diseases. Another fact that stems from this is that Ebola victims are easy to quarantine: its proof is in Dr. Brantly’s story. He came to Maryland in the US, but no one was infected in the months he has now been there. As long as there is no direct contact, the disease cannot spread: even Malaria is harder to control than that. Finally, it may have killed 4000: but that number is miniscule compared to the millions HIV and Malaria kill every year in these very countries. Quite simply, there are reasons other than the disease’s sheer deadliness for its horrifying spread. The economic state and condition of institutions in the affected nations: they did not have the capabilities to respond. Liberia has approximately 1 hospital per 140,000 citizens; Sierra Leone is equally horrifying. Customs of the people, and a lack of awareness: 30-35 people have been known to contract the disease from one victim because of the West African tradition of hugging their dead. Response from the national governments too has been heavily misguided: experts critical of district quarantines and other measures.

In some ways, however, the national and international response has improved. Up till now volunteer doctors from Doctors without Borders (MSF), missionary organisations, and even some independents, have been the only ones fighting the virus; now, as the US, Cuba and much of Europe send workers, doctors & soldiers to the region: the fight is expected to improve. The national governments are now accepting all the help and advice they are getting, Ebola is their only agenda. It would help them if the world’s panic was not crippling their economies, and robbing them of the money needed to fight the disease. The WHO’s Emergency Committee has advised against general travel or trade bans, but no one seems to heed their advice. Locals who initially rejected/denied the disease and the volunteers now wait anxiously for the MSF teams, proclaiming how “Ebola is there, and it is worse than the war.” Nigeria’s powerful awareness campaign has been hailed as an illustration of the right way to handle Ebola – no one has died in Lagos after that first airplane case; and WHO even announced the disease was defeated in Nigeria. Still very little is known about the medical aspects of disease, still we are haplessly unaware of its salient features, and there remains no cure: these remain major problems. But if one American doctor was successfully treated, anyone can be.

The WHO’s latest prediction sits at 5-10,000 new cases every week in West and Central Africa by December, a number they believe will continue to rise exponentially. The possible worldwide epidemic will be prevented not by quarantining the nations, or better airport awareness: because one man through an airport cannot spread the disease. The apocalypse can be prevented, very simply, by understanding and hopefully developing a cure/vaccine for the disease: which remain possible; or just by crushing the disease in West Africa. It is imperative for the world to try and constructively help the affected countries in their fight and not isolate and wait for the disease to reach home shores for it to be stopped.