Before I really get going with this post, I want to say I’m not panicked, and I suggest you stay the same. Meanwhile, it’s pretty clear the currently cavalier attitude toward Ebola needs to change. And of course, it all boils down to humans being the fallible creatures they are.
How Ebola Works
There’s good information on How Ebola Works, and how it kills you, but I’ll summarize. Ebola is a Biosafety Level 4 contagion, meaning proper attire when interacting with infected is a fully sealed safety suit with respirator, which should be decontaminated before and after exposure.
These kinds of precautions are necessary because Ebola is a hemorrhagic fever that causes multiple organ failure within days of exposure. How does that happen? Ebola is capable of replicating without the immune system taking immediate notice, because it attacks the dendritic cells of the immune system itself. Since these cells are how the immune system recognizes new invaders, there’s no defense while Ebola replicates. During the infection, it enters cells and makes them make more Ebola, which in turn causes them to explode. Eventually enough of this happens that the immune system actually does something once it notices the damage.
Unfortunately that something is a cytokine storm. In effect, the immune system freaks out and disgorges all of its killing might, severely damaging blood vessels in the process. This internal bleeding, in turn, causes blood pressure to drop. Combined with tissue damaged by Ebola, this leads to organ failure and eventually death. The mortality rate is quoted as anywhere between 25% to 95%, but it’s quite a bit more potent than the flu.
During all of this, you can’t have painkillers to ease the agony of your dying organs due to the likelihood your liver is among the casualties. It is a horrible, painful way to die that I wouldn’t wish on anyone.
How Does it Spread?
Some comparisons have been made that suggest Ebola is about as communicative as Hepatitis C. The CDC suggests that bodily fluids become a vector when the patient starts showing symptoms, which may take up to three weeks. With an incubation period that long, this allows travelers to reach quite diverse destinations before symptoms appear and spreading becomes likely.
Usually it’s easy to avoid bodily fluids like blood, mucus, semen, or diarrhea. But the problem with Ebola is that sweat is also a vector. Even during a cool day, the body produces sweat, and that sweat can get smeared on things like doorknobs.
Why it Bothers Me
The patient who recently died in Dallas has already infected his third health care worker. I’m pretty sure Hepatitis C doesn’t spread so easily, or every nurse in the country would have it. What’s worse, the nurse traveled on a plane a day before being diagnosed, potentially infecting anyone she encountered at both the departure and destination airports, as well as anyone in the plane. Yes, that includes the flight attendants.
And that is the real problem: people.
People generally don’t wash their hands before eating or itching their eyes. People don’t cough or sneeze into their elbows. People work sick for fear of loosing their jobs, or falling behind, thereby spreading diseases to the entire workplace. People reuse gloves. People travel when they’re not supposed to. People get scared and make mistakes. People cut budgets so there aren’t sufficient resources to handle outbreaks. People send patients home with incorrect diagnoses.
We can claim “it will never happen here,” or “you’d have to roll around in Ebola diarrhea to catch it,” or “our infrastructure will prevent spreading,” but that’s all wrong. All it takes is one weak link: one lazy person who didn’t fill in a checkbox on a medical form; one person who neglected to change gloves between patients; one person who thinks the rules don’t apply to them; one person in denial about how sick they are; one person who works in fast food and can’t afford a sick day. Or in the case of Dallas, a hilariously incompetent string of mishaps that led to at least three nurses being infected, people who presumably have better access to sterilization and proper handling of contaminated material than the rest of us.
And all of this is happening right as we start to enter flu season. The symptoms of Ebola are very similar to the flu, which means misdiagnoses will become problematic. Being sloppy with the flu is a nuisance, but with Ebola, it’s deadly. We need to stop fucking around and get serious, or we’ll end up like Liberia and Sierra Leone.
We can mock those countries all we want for shoddy infrastructure and lack of education, but are we really any better? People are fallible, and whether they’re in the US or Africa, we need to account for Murphy’s Law and Finagle’s Corollary. We can call Dallas a fluke, but it’s not. Shit happens, and the sooner we accept that, the sooner we can actually address Ebola before it becomes a real problem.
Hopefully, we still can.