We begin with root causes, starting with this from the Guardian:
Ebola is a product of a destructive and exploitative global economic system
Deforestation and increasing demands on habitats to produce food don’t just wreck the environment, they are increasing the risk of global pandemics like Ebola
Like a sleepwalker roused from his dream, the world is slowly waking up to the full nightmare of the Ebola outbreak decimating west Africa. With small numbers of cases turning up in western countries, governments here are belatedly pledging action to fight the disease, which has already claimed almost 5,000 lives.
Liberia, Sierra Leone and Guinea – all countries struggling to recover from wars still fresh in the memory – have buckled under the onslaught of this horrific virus. Inadequate, creaking health services have been no match for a ruthless killer. But while the shocking poverty of these countries provides the fertile ground for the disease to spread, there are bigger issues at play that ought to cause us to think about the macroeconomic conditions that brought us to this point.
Ebola – like HIV, anthrax, Sars, avian flu and other pandemics of recent years – is a zoonotic virus, one that has crossed from animals to humans. It was first identified in 1976 during near-simultaneous outbreaks in Sudan and what is now the Democratic Republic of the Congo (DRC).
The strain of Ebola implicated in the current outbreak is thought to have originated from a mutant pathogen found in fruit bats. This is where we see a direct connection with economic development. The conflicts which have done so much damage to the affected countries have also attracted a range of activities – both legal and illicit – including logging and extractive industries like bauxite mining, which have deforested large swathes of the region.
More from The Ecologist:
Oil palm explosion driving West Africa’s Ebola outbreak
The medical response to the Ebola outbreak in West Africa has been monstrously inadequate, writes Richard Kock. But so has been recognition of the underlying causes – in particular the explosive spread of industrial oil palm, which disrupts the ecology of forests and farms, and undermines local economy and traditional governance, leading to a ‘perfect storm’ of disease.
It is poverty that drives villagers to encroach further into the forest, where they become infected with the virus when hunting and butchering wildlife, or through contact with body fluids from bats – this has been seen with Nipah, another dangerous virus associated with bats.
The likelihood of infection in this manner is compounded by inadequate rural health facilities and poor village infrastructure, compounded by the disorganised urban sprawl at the fringes of cities.
The virus then spreads in a wave of fear and panic, ill-conceived intervention and logistical failures – including even insufficient food or beds for the severely ill.
Take for example the global palm oil industry, where a similar trend of deep-cutting into forests for agricultural development has breached natural barriers to the evolution and spread of specific pathogens.
The effects of land grabs and the focus on certain fruit crop species leads to an Allee effect, where sudden changes in one ecological element causes the mechanisms for keeping populations – bats in this case – and viruses in equilibrium to shift, increasing the probability of spill over to alternative hosts.
Next, some possibly good news from the Guardian:
Ebola may have reached turning point, says Wellcome Trust director
- Dr Jeremy Farrar says international community is belatedly taking the actions necessary to stem the tide of the disease
Writing in the Guardian, Dr Jeremy Farrar says that although there are several bleak months ahead, “it is finally becoming possible to see some light. In the past 10 days, the international community has belatedly begun to take the actions necessary to start turning Ebola’s tide.
“The progress made is preliminary and uncertain; even if ultimately successful it will not reduce mortality or stop transmission for some time. We are not close to seeing the beginning of the end of the epidemic but [several] developments offer hope that we may have reached the end of the beginning.”
Farrar’s comments come as the World Health Organisation confirmed that the number of Ebola cases in Liberia has started to decline, with fewer burials and some empty hospital beds. But the WHO warned against any assumption that the outbreak there was ending.
“I’m terrified that the information will be misinterpreted,” said Dr Bruce Aylward, assistant director-general in charge of the Ebola operational response. “This is like saying your pet tiger is under control. This is a very, very dangerous disease. Any transmission change could result in many, many more deaths.”
Science qualifies the optimism:
Liberia’s Ebola progress real, but epidemic far from under control
The apparent decline in cases could mean that families are hiding patients and secretly burying the dead, but it is more likely that a combination of factors has reduced the spread of the disease, said Aylward. “There was a rapid scale up in safe burial practices in the month of September,” he said, adding that many people were isolated in Ebola treatment units, further curbing spread. There also has been intensive education of communities about the disease, including how it is spread, the value of seeking care, and self-protection strategies.
The situations in Guinea and Sierra Leone, the other two hard-hit countries, have not changed as dramatically.
In a disconnect with the drop of cases in Liberia, Aylward noted that WHO has tallied 13,703 cases—a jump of more than 3000 from the figures released 25 October. He said the steep increase reflects reporting on a backlog of cases “With the huge surge in cases in certain countries, particularly in September and October, people got behind on their data,” he said. “They ended up with huge piles of paper and we knew we were going to see jumps in cases at certain times that are going to be associated with more new data coming in that are actually old cases.” He said about 2000 of the latest cases came from old data collected in Liberia, where reporting of cases continues to be a problem. “Data for Liberia are missing for 19, 20, 21, 26 and 27 October,” the latest update from WHO notes.
And from Liberia itself, another caution via The NewDawn:
Ellen warns against early excitement – Chinese military team arrives
President Ellen Johnson-Sirleaf has warned against early jubilation over news of reduction in the infection across the country with news of less than 400 cases nationwide.
The Liberian leader is cautioned citizens and residents against a repeat of a scenario in March this year when people got “too happy too soon” over decline in Ebola infection, thereby giving room for the virus to resurface by June when preventive measures were largely downplayed.
“Yes we feel good, but we want to be cautious. We don’t want people to get happy too soon; we got to continue this fight, and we got to continue it with everything that we got,” President Sirleaf said Tuesday in Monrovia when she received an advance Chinese military delegation of 15 personnel to build ETUs here.
Judging from previous scenario, she warned, “This time we want to be careful, we’ll not be satisfied until we are declared that the last Ebola victim has been cured and is freed of this disease.” President Sirleaf’s warning comes as government prepares to conduct a mid-term election for 15 senators in December.
A video report from euronews:
Ebola: WHO announces ‘slowing rate of new cases’
Liberia may be experiencing a slowdown in the rate of new cases of the deadly Ebola virus according to the World Health Organization.
“We are seeing a slowing rate of new cases, very definitely,” WHO Assistant Director General Bruce Aylward announced.
The African country has reportedly seen a drop in burials and new hospital admissions, while the number of laboratory-confirmed cases has levelled out.
While the Associated Press adds more nuance:
Top UN Ebola official: new cases poorly tracked
Authorities are having trouble figuring out how many more people are getting Ebola in Liberia and Sierra Leone and where the hot spots are in those countries, harming efforts to get control of the raging, deadly outbreak, the U.N.’s top Ebola official in West Africa said Tuesday.
“The challenge is good information, because information helps tell us where the disease is, how it’s spreading and where we need to target our resources,” Anthony Banbury told The Associated Press by phone from the Ghanaian capital of Accra, where the U.N. Mission for Ebola Emergency Response, or UNMEER, is based.
Health experts say the key to stopping Ebola is breaking the chain of transmission by tracing and isolating those who have had contact with Ebola patients or victims. Health care workers can’t do that if they don’t know where new cases are emerging.
“And unfortunately, we don’t have good data from a lot of areas. We don’t know exactly what is happening,” said Banbury, the chief of UNMEER.
Meanwhile, the crisis remains both critical and costly. From Sky News:
Ebola: DEC Launches ‘Unprecedented’ Appeal
The charity group asks the public for money to halt the “explosive” virus – the first time it has done so for a disease outbreak.
The Disasters Emergency Committee is to launch a major television appeal over the Ebola crisis, the first time it has called for donations in response to a disease.
The committee, which is made up of 13 of the UK’s major aid charities, said it took the decision because the killer virus threatens to become a “catastrophe”.
The DEC described the spread of the virus as “explosive”, and said it was devastating communities, health services and people’s ability to support themselves.
Next, California joins the list of states with Ebola quarantine policies, via the San Jose Mercury News:
Ebola: California is latest state to impose 21-day quarantine for those exposed to Ebola
California on Wednesday became the latest state to order a 21-day quarantine for travelers who have been in close contact with Ebola patients.
In an attempt to avoid the criticism lodged against New York, New Jersey and Maine that had blanket quarantine orders, however, California will allow county health agencies to impose the quarantine on a case-by-case basis.
By working with county health departments to assess the individual risks, the California Department of Public Health said it “respects the individual circumstances of each traveler while protecting and preserving the public health.”
And a case at hand, via KCBS in San Francisco:
Stanford Surgeon Under ‘Modified Quarantine’ In San Mateo County After Returning From Liberia
A Stanford surgeon has been put on modified quarantine in San Mateo County after treating Ebola patients in Liberia for the past month.
Dr. Colin Bucks returned to the Bay Area on Friday, but no state or federal quarantine orders were in place at the time. Dr. Bucks is not experiencing any symptoms of Ebola, but he is the first Californian to be quarantined under the new guidelines. Bucks is considered by health officials to be at “some risk.”
The doctor contacted San Mateo County health officials. After consultation with the U.S. Centers for Disease Control and the California Dept. of Public Health, Dr. Bucks was told to stay away from work and to stay away from others for 21 days. However, he can leave his house to go jogging by himself. He is taking his temperature every day and has not developed any symptoms.
Politics of pain, via the Los Angeles Times:
Obama urges Americans to honor aid workers fighting Ebola in Africa
President Obama on Tuesday urged Americans to set aside their fears of the Ebola virus and make sure U.S. healthcare workers who go to West Africa are “applauded, thanked and supported” when they return home.
If those workers are successful in fighting the virus at the source of the outbreak, he said, “we don’t have to worry about it here.”
“They are doing God’s work over there,” Obama said, “and they are doing that to keep us safe.”
And a fundamental lack from the Associated Press:
Funding to tame an Ebola outbreak has fallen short
“We don’t really have a pharmaceutical response for Ebola,” said retired Air Force Col. Randall Larsen, the former executive director of the Congressional Commission on the Prevention of Weapons of Mass Destruction. “But could you imagine if there were 20,000 sick people in 10 cities and we did not have a pharmaceutical response? We would be completely overwhelmed.”
Emergency preparedness programs ramped up significantly in the U.S. after the Sept. 11 attacks and the 2001 anthrax scare, said Dr. Gerald Parker, a former principal deputy assistant secretary in the U.S. Health and Human Services preparedness office. Those efforts included research and development of vaccines and anti-viral drugs.
“It was recognized that there would be a dual benefit from research on vaccines, therapeutics and diagnostics to counter bioterror threats and emerging infectious diseases,” said Parker, now a vice president at Texas A&M Health Science Center.
But a combination of budgetary constraints and politics has delayed many of those plans.
Other quarantine news from the New York Times:
New York State Ebola Policy Allows for In-Home Quarantine
Offering the first detailed account of how New York State’s quarantine order for health care workers returning from West Africa will be put into effect, the Cuomo administration has issued guidelines that go beyond federal recommendations but seek to allow individuals to spend their enforced isolation in a location of their choosing.
The state documents, copies of which were obtained by The New York Times, show an effort by Gov. Andrew M. Cuomo’s administration to portray the quarantine in a humane manner.
The protocols are meant to ensure “a respectful and supportive approach” to arriving travelers, who are supposed to be “treated with the utmost respect and concern,” according to a document prepared by the State Health Department that outlines the screening procedures.
While the Guardian covers a controversy:
Ebola: Maine deploys state police to quarantined nurse’s home
- Kaci Hickox, who was held for days in an isolation tent in New Jersey, says she doesn’t plan on obeying home quarantine in her home state
A nurse freed from an Ebola isolation tent in a New Jersey hospital declared on Wednesday the she will not comply with a quarantine request imposed by state officials, saying the policy is not based on science and infringes on her civil liberties.
“I don’t plan on sticking to the guidelines,” nurse Kaci Hickox told the Today show from her home in Maine. “I remain appalled by these home quarantine policies that have been forced upon me, even though I am in perfectly good health and feeling strong and have been this entire time completely symptom-free.”
The governor’s office said in a statement that Maine state police would monitor Kickox’s home “for both her protection and the health of the community”. A TV reporter with the local WLBZ news channel said as of 1pm ET on Wednesday at least two police cars were parked out front of the home.
More from the Washington Post:
Maine Gov. Paul LePage is seeking legal authority to enforce Ebola quarantine on nurse
Maine Gov. Paul LePage (R) is looking for ways to force a nurse released from mandatory Ebola isolation in New Jersey to abide by a similar 21-day quarantine in Maine.
“The Office of the Governor has been working collaboratively with the State health officials within the Department of Health and Human Services to seek legal authority to enforce the quarantine,” LePage’s office said in a statement Wednesday. “We hoped that the health-care worker would voluntarily comply with these protocols, but this individual has stated publicly she will not abide by the protocols.”
Still more from the Guardian:
Maine prepared to go to court to enforce nurse’s Ebola quarantine order
- Officials plead with Kaci Hickox to abide by 21-day order
- ‘I have been this entire time completely symptom-free’
Maine’s top public health official has said the state will if necessary seek a court order to ensure a nurse stays quarantined in her home after returning from treating Ebola patients in Sierra Leone.
Mary Mayhew, the commissioner of the state department of health and human services, pleaded with Hickox to abide by the state’s 21-day at-home quarantine order.
“We do not want to legally enforce an in-home quarantine unless absolutely necessary,” Mayhew said on Wednesday afternoon.
More quarantine politics from Reuters:
Obama sees different Ebola rules for U.S. military than for civilians
President Barack Obama on Tuesday appeared to back more rigorous procedures for dealing with soldiers returning from missions to Ebola-hit West African countries, even as he criticized moves by some U.S. states to quarantine returning civilian health workers.
Obama said that American military personnel were in a “different situation” compared with healthcare workers. While civilians may be discouraged from volunteering to help fight the Ebola if they are facing quarantine on their return, troops were sent as part of their mission and could expect such inconveniences.
“They are already by definition if they are in the military under more circumscribed conditions,” Obama told reporters at the White House. “We don’t expect to have similar rules for our military as we do for civilians.”
More from USA Today:
Quarantine ordered for troops returning from W. Africa
U.S. troops returning from Ebola-stricken nations will be isolated for 21 days, Defense Secretary Chuck Hagel announced Wednesday, a day after the White House raised concerns about states imposing strict quarantines of health care workers returning from West Africa.
Top commanders for the Navy, Air Force and Marine Corps made the recommendation to Hagel on Tuesday. The Army instituted an isolation requirement for 21 days — the incubation period for the deadly virus — on Monday.
Hagel directed the isolation policy be reviewed in 45 days to see whether it was necessary to continue with it, said Rear Adm. John Kirby, Pentagon press secretary.
Still more from the Guardian:
Conflicting Ebola guidelines put US defense secretary in a tough spot
- Hagel’s choice on quarantining troops returning from west Africa involves rebuking either government scientists or military leaders
The Ebola outbreak has placed the US secretary of defense on the horns of a dilemma: whether to back the military service chiefs about a quarantine for troops or to support the Centers for Disease Control and Prevention (CDC), which recommends no such thing.
Defense chief Chuck Hagel has received a recommendation for a “quarantine-like program” for all US servicemembers returning from Liberia and Senegal, where they are supporting civilian efforts to contain the disease, Rear Admiral John Kirby, the Pentagon spokesman, said on Tuesday.
The recommendation, made by the heads of the military services, would expand across the military a directive made on Monday from the army chief, General Raymond Odierno, to keep soldiers returning from Operation United Assistance in Liberia and Senegal under a 21-day period of “controlled monitoring”.
Kirby said Hagel has yet to make a decision, having received the quarantine recommendation earlier on Tuesday. But imposing a broader military quarantine for returning servicemembers goes beyond new guidance set on Monday by the CDC, which urged a home quarantine only for high-risk individuals, such as those whose body fluids have been directly exposed to Ebola. US troops have not been involved in treating Ebola patients.
And yet more from Reuters:
US isolates troops
The U.S. military has started isolating soldiers returning from an Ebola response mission in West Africa and Australia became the first rich nation to impose a visa ban on the affected countries amid global anxiety about the spread of the virus.
The latest measures, along with decisions by some U.S. states to impose mandatory quarantines on health workers returning home from treating Ebola victims in West Africa, have been condemned by health authorities and the United Nations as extreme.
The top health official in charge of dealing with Washington’s response to Ebola warned against turning doctors and nurses who travel to West Africa to tackle Ebola into “pariahs”.
From Reuters, intranational man of mystery:
In Ebola response, Obama’s ‘czar’ stays behind the curtain
It’s not often that a White House official gets mocked on both Saturday Night Live and a major daily newspaper before he makes his first public appearance.
But Ron Klain’s low-profile first week as President Barack Obama’s behind-the-scenes Ebola “czar” has become another attack point for a White House struggling to show it’s on top of the crisis.
Since starting last Wednesday, Klain has been seen only once, in a photo op on his first day, leaving health officials from the Centers for Disease Control and Prevention and National Institutes of Health – and Obama himself – to be the public “face” of the response.
The White House has declined to give details about his activities, especially what role he played as governors Andrew Cuomo of New York and Chris Christie of New Jersey undermined the White House’s attempt to keep the nation calm about the risk posed by healthcare workers returning from Ebola-stricken West Africa.
More predictable politics from the Associated Press:
Jeb Bush: Obama handling of Ebola ‘incompetent’
Former Florida Gov. Jeb Bush on Tuesday criticized President Barack Obama’s initial handling of the Ebola crisis as “incompetent,” saying it gave rise to unneeded fears among the American public about the virus.
Bush, who is the latest potential Republican presidential candidate to attack the president over Ebola, also said in a wide-ranging discussion at Vanderbilt University that he supports travel restrictions for people who have been to the most severely affected countries in Africa.
Bush said Obama should have been more “clear and concise” about his plans, and lent more credibility to health officials leading the response.
“It looked very incompetent to begin with, and that fueled fears that may not be justified,” Bush said. “And now you have states that are legitimately acting on their concerns, creating a lot more confusion than is necessary.”
Meanwhile, the Obama administration made a notable symbolic move sure to piss off some of Bush’s former Florida constituents, via the Associated Press:
US sends health official to Cuban Ebola meeting
The United States has sent a health official to a Cuban meeting on coordinating Latin America’s response to Ebola. The participation of the Centers for Disease Control’s Central America director is the most concrete sign to date of the two nations’ expressed desire to cooperate against the disease.
The two-day meeting that began Tuesday in Havana is sponsored by ALBA, a forum of left-leaning Latin countries founded by Cuba and Venezuela as a counterweight to U.S. influence in the region.
Cuba is sending at least 256 medical workers to West Africa to treat and prevent Ebola. The World Health Organization says it’s the largest contribution by a single government, although there may be more doctors of other nationalities who are sent by non-governmental organizations.
The U.S. has welcomed Cuba’s response.
Ebolaphobia from the New York Times:
Connecticut Child Barred From School After Trip to Africa; Father Sues
The father of a Connecticut third grader filed a federal lawsuit on Tuesday, saying his daughter has been unfairly barred from school amid fears she may have been exposed to the Ebola virus while in Africa.
The daughter, Ikeoluwa Opayemi, and her family, who live in Milford, visited Nigeria for a wedding from Oct. 2 to 13, according to the lawsuit, which was filed in Federal District Court in New Haven.
When the girl tried to return to the Meadowside Elementary School, she was told by the school district’s health director that she would have to stay home until Nov. 3 “due to concern from certain parents and teachers that she could transmit Ebola to other children,” according to the lawsuit.
More from Ebolaphobics from Science:
Been to an Ebola-affected country? Stay away from tropical medicine meeting, Louisiana says
Ebola fears are interfering with the world’s premier scientific meeting on tropical diseases. Today, Louisiana state health officials asked anyone who has traveled to Liberia, Sierra Leone, or Guinea in the past 21 days, or has treated Ebola patients elsewhere, to stay away from the annual meeting of the American Society for Tropical Medicine and Hygiene (ASTMH), which begins on Sunday in New Orleans.
ASTMH doesn’t know exactly how many scientists will be affected, but there are several, says incoming president Christopher Plowe, including representatives from the World Health Organization (WHO) and the U.S. Centers for Disease Control and Prevention (CDC). “They are quite disappointed,” says Plowe, a malaria researcher at the University of Maryland. ASTMH sent all meeting registrants an email today containing a letter from Kathy Kliebert, secretary of Louisiana’s Department of Health & Hospitals, and Kevin Davis, director of the Governor’s Office of Homeland Security & Emergency Preparedness, that outlines the state’s position. ASTMH referred registrants to the state’s health department for further information.
“Given that conference participants with a travel and exposure history for [Ebola] are recommended not to participate in large group settings (such as this conference) or to utilize public transport, we see no utility in you traveling to New Orleans to simply be confined to your room,” the letter says.
After the jump, an infectious lie, a sole supplier, North Korean Ebolaphobia, Hong Kong preparedness, fast-tracking a vaccine, anger at Aussie exclusion, Japanese angst leads to a task force, then on to Africa and vigilance in the newest addition to the ranks of the stricken while a border remains open, a study of who survive in Sierra Leone, Tokyo lends mobile assistance, Brits train “Ebola warriors,” missing funds, and survivors are shunned, then on to Liberia and the crisis personified, the healthcare worker’s painful conundrum, another blow to overstretched police resources, long overdue pay for healthcare workers, a cultural belief hampering prevention efforts with specific voices heard, Christian leaders call a three-day fast, a Christian tradition invoked, a change in command of American boots on the ground, and a presidential birthday is deferred, thence to Nigeria and an unanticipated arrival, followed by a precipitous tourism decline in Kenya. . . Continue reading