(Update: My mention of the minimal response of the U.S. to the Ebola crisis seems to have gotten some traction with the administration.  President Obama is now sending 3000 troops and establishing 17 100-bed hospitals in Liberia!  Seriously, it had nothing to do with this article but a collective expression of dismay at our lack of action by hundreds of blogs and other sources.  Let’s hope it does some good without doing our people any harm.)

A number of my recent articles have concentrated on the epidemic of Ebola hemorrhagic fever in West Africa. Ebola is a highly contagious viral illness first identified in Central Africa in 1976. It’s known for a high death rate and no cure or vaccine. A curiosity until now, all previous outbreaks have been limited to a few hundred cases. At present, 4,800 cases have been documented in five countries: Guinea, Liberia, Sierra Leone, Nigeria, and Senegal. Over 2,400 deaths have occurred. For general information on Ebola, see this article:   https://www.doomandbloom.net/ebola-the-next-great-pandemic/

Even though the region has large numbers of cases of Malaria and Diarrheal disease (all of which kill more people in a given year than Ebola), this epidemic has caused major economic and personal misery in the areas it has invaded . In a desperate effort to identify and isolate new cases, the government of Sierra Leone has undertaken the drastic measure of forbidding people to leave their homes for three days starting September 18th. In other areas, entire communities are under quarantine.

Ebola cruelly affects a disproportionately large number of health workers, the very people most needed in this type of emergency. Over 300 medical personnel have contracted the disease and 150 have died. Dr. Olivet Buck, a German physician, is the latest; she died in Sierra Leone before she could be medically evacuated to her home country.

All this in a country that has 2 doctors for every 100,000 people. Compare that to the U.S., where there are 2.5 physicians for every 1,000 people. The group Doctors Without Borders says Liberia’s capital city needs 1,000 beds for Ebola patients; that’s bad, because there are only 240 beds available. That means three quarters of the people who have this contagious disease are on the streets.

Despite the best efforts of the World Health Organization and Doctors Without Borders, Ebola is expected to rage on in West Africa for another 12-18 months, with 20,000 cases predicted. Without coordination of relief efforts, the ability to contain the disease is limited and has been labeled a “failure” to date. Countries are sending supplies and equipment in piecemeal fashion. The U.S., for example, is setting up a 25 bed hospital for its part. Unfortunately, it’s far too little to make a dent in the epidemic.

It’s difficult for a person in a developed country to believe that medical systems, economies, even governments, might fail as a result of a virus. The average U.S. citizen suffers from what we call “Normalcy Bias”. This is the tendency to be believe that, since things have been just fine, everything will always remain so. This is foolhardy thinking at best, and dangerous thinking at worst. One wonders what the effect of normalcy bias was in 1918 when the Spanish Flu hit America.

These people become the casualties when a disaster actually does happen, such as a tornado, flood, or wildfire. They believed (and the odds were with them) that something like that just doesn’t happen in their town. Therefore, they made no provisions for the storage of extra food, water, and medical supplies. the likelihood that an individual will be hit by some catastrophe in the coming year is pretty small, but what’s the chance over a lifetime, or the lifetimes of their children? Not so small.

Despite this, few homes have gloves and medical masks in their medicine cabinet, even though they would be useful for any outbreak of infectious disease. This is in comparison to Asian countries, which carry these items oftentimes on their person and have no qualms about wearing them in public. Indeed, it is considered a sign of social responsibility to do so, especially when one has a cold or flu.

High heat, humidity and other requirements for Ebola’s survival make it unlikely to survive for long in temperate climates as seen in the U.S. Ebola will likely remain the scourge of the Third World. Having said that, complacency due to normalcy bias is why epidemics and natural disasters catch most people by surprise. Never panic, but make sure that your medicine cabinet can handle more than just a headache and a runny nose. Being medically prepared is not just a sign of social responsibility; it’s a sign of common sense in good times OR bad.

Joe Alton, M.D., aka Dr. Bones

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