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Losing Sleep Over the Ebola?

For 10 years, I studied to become an Ebola researcher, getting a degree in cellular molecular biology then going into family medicine. After interviewing at the CDC, I realized that the job was not for someone like me, unaccustomed to following rules and always a skeptic. However, I think that despite the Texas debacle, the CDC is right in this case. Most people have nothing to fear in the USA. The Ebola will never take a firm foothold or have more than 2-3 layers of transmission. I think that the current debate in how to handle the Ebola is healthy, as it forces the people in charge to voice their opinions and outline concrete steps on handling a potential public health emergency. By the people in charge, I mean not just the Executive branch of the US government, but all levels of government and the entire medical profession. There are a lot of hospitals and doctor's offices with poorly-developed execution plans in case of emergencies. I hope that this will be a final wake-up call. We will continue to see sporadic cases in the US for a while, so the medical profession needs to be prepared.

Africa, though, is going to be a long war. The epidemic started in December of 2013 in Guinea when a toddler likely contracted the virus from a fruit bat being prepared as food. It spread and killed until March of 2014 when a doctor finally realized that the illness was not cholera, nor Lassa Fever, but Ebola. Apparently more than 50% of patients with Ebola develop hiccups, and that's what tipped off the doctor. Then governments took action, quarantines were initiated, pilgrimages to Mecca blocked, political elections inserted into the dialogue about Ebola, the conspiracy theorists blossomed, and patients stopped reporting to hospitals. In May, after 248 cases, there were 21 days (the longest incubation period) without a new case, which meant that the outbreak was over. The medical staff began to leave Guinea. What actually happened was just that the sick people stopped coming for treatment. The epidemic was still smoldering, and at end of May, it could no longer be hidden. Since then, over 10,000 people have been infected, with a death rate of nearly 50% in Africa.

Basic infrastructure has broken down in West Africa. People can't get enough to eat because the farmers are afraid to work in the fields or go to market. People are resorting to looting, violence, and simply doing the wrong things out of desperation and fear. The number of cases are still rising rapidly. If the usual rules hold for what an epidemic looks like, it could go much higher before plateauing. That means completely destabilized governments and civil war.

Why should we care about problems in Africa? Two possibilities:

  • The disease can become endemic, becoming a permanent problem in West Africa with travelers in and out of the endemic region carrying the illness back. So we'll never be "safe" from Ebola in the Western world and will have to be on constant guard. (Can you imagine the lines at the airports?)
  • When people are fed up, scared, and desperate, they are easy recruits for terrorists. Because the Western world didn't respond, we were to blame, and we are to pay. We have to care, even if in a selfish way, about what's going on in Africa.
  • If you are losing sleep over the Ebola, I hope it's about the thousands of sick people in Africa. Doctors Without Borders will accept your donation to combat the epidemic on your behalf. Now, go get your flu shot.

More people will die from the flu this year in the US than the Ebola. Don't lose any more sleep. Use your SleepPhones!

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