Ebola, Shmeebola?

During the Age of Limits conference, Orren Whiddon asked us for predictions about when the apex of world population might occur and what might affect it. I think I said something about widespread outbreaks of disease caused by failing antibiotics, breakdowns in water management and poor sanitation in large cities. I was thinking about familiar scourges like influenza, malaria and botulism. I couldn’t come up with the word (sheesh) but I think Dan or someone just after me agreed that a pandemic might be in the offing. A few others agreed, too, but John Michael Greer pronounced pandemics to be as unpredictable as asteroids.

To most Americans, except for a few infected doctors being flown back, Ebola is mostly happening waaay over there in hot, crowded Africa, and I suspect that many think that Ebola could never happen here, anyway. Many MSM articles have concentrated on calming fears of another Black Death – because Ebola is not an airborne disease. At ScienceBlogs, while Tara Smith reblogged her Slate article, Here’s Where We Stand With Ebola, Orac took the opportunity to attack Ebola quackery.

Greer is now very, very concerned about Ebola and deep in the comment section of his latest post warns us:

… you’ll want to read up on Ebola, … its early symptoms resemble flu, it can stay latent for up to three weeks, and it spreads from person to person quite well — right now, the number of cases in Africa is doubling every 20 days, which is not the profile of an easily contained virus. Current estimates are that if things continue as they’re going, 1.4 million people will be infected by January 1, 2015; at that rate, we get 2.8 million by January 20, 5.6 million by February 9, 11.2 million by March 1, 22.4 million by March 21, and so on. It doesn’t take all that many more doublings — I’ll leave the number for you as a math exercise — before the total number of infected people passes the total population of the planet.

Now of course it’s not going to infect everyone on the planet; there are geographical barriers to get past, and odds are that the currently very high rate of transmission is being driven by extreme poverty, overcrowding, and poor sanitation. That said, unless something happens fairly quickly, Ebola will spread to East Africa; once it’s there, stopping it from getting to the Middle East and the Indian subcontinent will be a very difficult thing; and if that happens, it’s probably a safe bet that over the next five years or so, it’s going to hit the Third World globally and make forays into the more developed countries as well. We are potentially looking at the Black Death of the 21st century, and the easy assurance with which people in the developed world insist, inaccurately, that it’s not something they have to worry about is among the major factors that are driving Ebola toward pandemic status.

I’m glad I didn’t predict an asteroid, but I did start to read up on Ebola.

The New England Journal of Medicine (NEJM) admits that Ebola is out of control, but notes that the primary reason for the spread:

“is more likely to be a result of the combination of dysfunctional health systems, international indifference, high population mobility, local customs, densely populated capitals, and lack of trust in authorities after years of armed conflict. Perhaps most important, Ebola has reached the point where it could establish itself as an endemic infection because of a highly inadequate and late global response.”

It is certainly good that the US doesn’t have a dysfunctional health system in which people have to wait for several hours in a crowded emergency room to get treatment, and equally good that the US doesn’t have high population mobility, densely populated areas and lack of trust in authorities. Otherwise I might be worried.

Laurie Garrett, who released her book The Coming Plague in 1995, writes for Foreign Policy (paywall):

Wake up, fools. What’s going on in West Africa now isn’t [Dan] Brown’s silly Inferno scenario — it’s Steven Soderbergh’s movie Contagion, though without a modicum of its high-tech capacity.

Last week, my brilliant Council on Foreign Relations colleague John Campbell, former U.S. ambassador to Nigeria, warned that spread of the virus inside Lagos — which has a population of 22 million — would instantly transform this situation into a worldwide crisis, thanks to the chaos, size, density, and mobility of not only that city but dozens of others in the enormous, oil-rich nation. Add to the Nigerian scenario civil war, national elections, Boko Haram terrorists, and a countrywide doctors’ strike — all of which are real and current — and you have a scenario so overwrought and frightening that I could not have concocted it even when I advised screenwriter Scott Burns on his Contagion script.

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3 responses to “Ebola, Shmeebola?”

  1. cmaukonen says :

    MCCOY: Have you ever seen a victim of Rigelian fever? They die in one day. The effects are like bubonic plague.
    FLINT: Constantinople, summer 1334. It marched through the streets, the sewers. It left the city by ox cart, by sea, to kill half of Europe. The rats, rustling and squealing in the night as they, too, died. The rats.
    SPOCK: Are you a student of history, sir?
    FLINT: I am. The Enterprise, a plague ship. You have two hours, at the end of which time you will leave.

    My mother had said a number of times that over population would not be a problem as a plague of some sort would take care of it. She had been an RN and worked public health for many years.

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    • cmaukonen says :

      Ironic that her predictions of a plague would ring so true and she herself would die of an un-killable bacterial infection she acquired while hospitalized.

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    • artappraise says :

      From “Painting in Florence and Siena After The Black Death” by Millard Meiss, 1964, p. 67:

      In the immediate wake of the Black Death, we hear of an unparalled abundance of food and goods, and of a wild, irresponsible life of pleasure. Agnola di Tura writes that in Siena “everyone tended to enjoy eating and drinking, hunting, hawking, and gaming” 31 and Matteo Villani laments similar behavior in Florence:

      “Those few sensible people who remained alive expected many things, all of which, by reason of the corruption of the sin, failed to occur among mankind and actually followed marvelously in the contrary direction. They believed that those whom God’s grace had reserved for life, having beheld the extermination of their neighbors, and having heard the same tidings from all the nations of the world, would become better men, more virtuous, and Catholic, that they would guard themselves from iniquity and sins; and wold be full of love and charity for one another. But no sooner had the plague ceased than we saw the contrary; for since men were few, and since by heredity succession they abounded in earthly goods, they forgot the past as though it had never been and gave themselves up to a more shameful and disordered life than they had led before….And the common people…, but men and women, by reason of abundance and superfluidity that they found, would no longer work at their accustomed trades; they wanted the dearest and most delicate foods for their sustenance; and they married at their will, while children and common women clad themselves in all the fair and costly garments of the illustrous ladies who had died.”32.

      This extraordinary condition of plenty did not, of course, last very long. For most people the frenzied search for immediate gratification, characteristic of the survivors of calamities, was likewise short-lived. Throughout the subsequent decades, however, we continued of hear of an exceptional indifference to accepted patterns of behavior and to institutional regulations, especially among the mendicant friars. It seems,as we shall see, that the plague tended to promote an unconventional, irresponsible, or self-indulgent life, on the one hand, and a more intense piety or religious excitement on the other. Villani tells us, in his very next sentences, of the more lasting consequences of the epidemic…

      This includes inflation because of labor scarcity, lots of lawsuits,quarrels and rioting about legacies and successions, wars and scandals everywhere, and the rise of “nouveaux riches”. The latter led to: the development of both capitalism and a renaissance, The Renaissance, of classical knowledge and culture, and a rejection of much of the accepted culture of recent centuries past.

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