I got my flu shot yesterday. I wasn’t thinking, “Phew, I’ve really cut down my chances of being one of the approximately 32,000 people that die of influenza in these United States every year”. I just want to cut down my chances of getting sick, and hey, if I don’t get the shot, my employer, Robert Wood Johnson University Hospital, would mandate that I wear a mask all of flu season. A flu shot is to influenza, what a seat belt is to an automobile passenger. It won’t guarantee that one will escape illness (injury) or death, but it definitely cuts down on the chances. By the way, about as many people die in cars in the US each year (about 31,000 in 2012) as die from the flu.
Which brings me to Ebola. There have been 4500 deaths worldwide since the outbreak started about 7 months back. You’d figure that would give most of us perspective. Yet, by some estimates there could be 10,000 cases per week by December. Given the revised mortality rate of 70%, the numbers could add up quickly. The fact that health care workers taking significant precautions in caring for these patients still get sick, also gives us pause. We just don’t see that kind of infectivity with other infections we treat.
We’re told that a person is not infectious until he is symptomatic. I heard an official during the congressional hearings yesterday state that the virus just isn’t detected in someone who is not symptomatic. I just wonder where that data comes from. Was there a study in which serial blood samples were drawn from a cohort of folks in close proximity to victims and which followed them over time? Such a study may have been done in the 40 year history of the disease, but after a cursory search I’m not sure upon what data this truism is based. I will continue to search, however. And what of patients with very minimal symptoms who might not yet be aware that they are sick, and are just chalking up feeling blah to a bad night’s sleep? How much virus are they shedding? It’s really the unknown that has officials overreacting and closing schools in Dallas and Ohio. That and the feeling that perhaps those we entrust to keep a lid on this thing aren’t really firing on all cylinders yet. The CDC advising a nurse who treated an Ebola patient that it is okay to fly on a commercial jet with a low grade fever? And what about restricting travel from endemic areas? I’ve heard the arguments for and against. I listened to Dr. Frieden of the CDC testify before Congress yesterday. It just seems to be good science and medicine to attempt to quarantine cases (which travel restrictions would go a long way in doing) and to throw all possible resources at the populations in West Africa that are being most devastated by this. The world needs to come together on this and quickly. And believe me, if the citizens of Liberia, Sierra Leone and Guinea see resources pouring in to their countries, they will not be clamoring to leave to get better care.
It’s just refreshing that 24 hours have passed without news of a new case in the US. Meanwhile, perhaps as a country we can further educate ourselves, get some perspective and respond in a more decisive, rational and generous manner than we’ve seen over much of the last week.