August 2, 2014
Obamacare for Ebola?
By Allan J. Favish
On August 1, 2014, President Barack Obama held a combination press conference and filibuster. Among other things, he stated:
Keep in mind that Ebola is not something that is easily transmitted. That’s why, generally, outbreaks dissipate.
Contrary to Obama’s statement, Ebola is easily transmitted. Moreover, past outbreaks have dissipated because the infected people died so quickly that the opportunity to infect other people was reduced.
According to an opinion piece in the New York Times by David Quammen, author of the book “Spillover: Animal Infections and the Next Human Pandemic,” Ebola:
... is transmissible from human to human through direct contact with bodily fluids, but can be stopped by preventing such contact. Furthermore, Ebola burns so hotly in its victims, incapacitating and killing so quickly, that it is poorly adapted to achieve global dispersal.
An article from July of this year in Great Britain’s The Independent entitled “Ebola Outbreak: Why Has a Disease That's Only Ever Killed 2,000 People Captivated the Darkest Side of Our Imagination?” makes the same point:
People who are infected with Ebola, after all, aren't out running around spreading the disease for long before they're too sick to leave the bed.
The virus is too hot – choke the supply of new hosts and it smothers itself.
The World Health Organization (WHO) states the following about the transmissibility of Ebola:
Once a person comes into contact with an animal that has Ebola, it can spread within the community from human to human. Infection occurs from direct contact (through broken skin or mucous membranes) with the blood, or other bodily fluids or secretions (stool, urine, saliva, semen) of infected people. Infection can also occur if broken skin or mucous membranes of a healthy person come into contact with environments that have become contaminated with an Ebola patient’s infectious fluids such as soiled clothing, bed linen, or used needles.
Health workers have frequently been exposed to the virus when caring for Ebola patients. This happens because they are not wearing personal protection equipment, such as gloves, when caring for the patients. Health care providers at all levels of the health system – hospitals, clinics and health posts – should be briefed on the nature of the disease and how it is transmitted, and strictly follow recommended infection control precautions.
Burial ceremonies in which mourners have direct contact with the body of the deceased person can also play a role in the transmission of Ebola. Persons who have died of Ebola must be handled using strong protective clothing and gloves, and be buried immediately.
People are infectious as long as their blood and secretions contain the virus. For this reason, infected patients receive close monitoring from medical professionals and receive laboratory tests to ensure the virus is no longer circulating in their systems before they return home. When the medical professionals determine it is okay for the patient to return home, they are no longer infectious and cannot infect anyone else in their communities.
Men who have recovered from the illness can still spread the virus to their partner through their semen for up to 7 weeks after recovery. For this reason, it is important for men to avoid sexual intercourse for at least 7 weeks after recovery or to wear condoms if having sexual intercourse during 7 weeks after recovery.
Does this sound like something that is not easily transmitted? WHO also states:
In addition to standard health care precautions, health workers should strictly apply recommended infection control measures to avoid exposure to infected blood, fluids, or contaminated environments or objects – such as a patient’s soiled linen or used needles.
They should use personal protection equipment such as individual gowns, gloves, masks and goggles or face shields.
They should not reuse protective equipment or clothing unless they have been properly disinfected.
They should change gloves between caring for each patient suspected of having Ebola.
Invasive procedures that can expose medical doctors, nurses and others to infection should be carried out under strict, safe conditions.
Infected patients should be kept separate from other patients and healthy people, as much as possible.
In an article entitled “Growing Concerns Over 'In the Air' Transmission of Ebola,” the British Broadcasting Corporation reported the following in November of 2012 about airborne transmissibility of Ebola:
Canadian scientists have shown that the deadliest form of the ebola virus could be transmitted by air between species.
In experiments, they demonstrated that the virus was transmitted from pigs to monkeys without any direct contact between them.
The researchers say they believe that limited airborne transmission might be contributing to the spread of the disease in some parts of Africa.
One possibility is that the monkeys became infected by inhaling large aerosol droplets produced from the respiratory tracts of the pigs.
One of the scientists involved is Dr Gary Kobinger from the National Microbiology Laboratory at the Public Health Agency of Canada. He told BBC News this was the most likely route of the infection.
"What we suspect is happening is large droplets - they can stay in the air, but not long, they don't go far," he explained.
"But they can be absorbed in the airway and this is how the infection starts, and this is what we think, because we saw a lot of evidence in the lungs of the non-human primates that the virus got in that way."
It looks like Obama’s medical advice is the first attempt to address the Ebola virus under Obamacare.