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Sunday, Nov. 23, 2014

Michael Gerson: Nature's out to kill us

By Michael Gerson, Washington Post

Published: Fri, Sept. 5 6:10 a.m. MDT

 The Ebola outbreak in West Africa demands directness: We are about to witness a human catastrophe that could destroy large portions of a continent and pose a global threat. And the response of the world, including the United States, is feeble.

The Ebola outbreak in West Africa demands directness: We are about to witness a human catastrophe that could destroy large portions of a continent and pose a global threat. And the response of the world, including the United States, is feeble.

(Kjell Gunnar Beraas, MSF, File, Associated Press)

WASHINGTON — Sometimes the artifice of writing — metaphors, historical comparisons, the just-so quote — fails. The Ebola outbreak in West Africa demands directness: We are about to witness a human catastrophe that could destroy large portions of a continent and pose a global threat. And the response of the world, including the United States, is feeble, irresponsible and disrespectful of nature's lethal perils.

American health officials and nonprofit groups are bringing back the same report from the region. In Liberia, the rate of new infections has probably already moved from a linear to an exponential curve. The same may be true within the next week or so for Sierra Leone and Guinea. The normal countermeasures for an infectious disease — isolation, case investigation, contact tracing — are increasingly irrelevant given the rate of increase. Local health care infrastructure, which barely existed in the first place, is overwhelmed. People have lost faith in the large clinics, where 50 percent to 60 percent of patients who enter do not leave alive. And those in need of emergency care for other conditions — such as heart attacks or complicated births — are often frightened of clinics and hospitals, and are dying without treatment.

The international response is inadequate and disorganized. The World Health Organization (WHO) and the United Nations provide "road maps." But, according to one infectious disease expert, "there is no one to implement command, control and communications. No one." Multiple, uncoordinated organizations are attempting to confront a disease that is out of control. "They are quibbling over 25 to 30 bed units," the expert vents. Meanwhile, WHO has revised its prediction of new Ebola infections upward to 20,000 by year-end. Other models indicate more like 100,000.

Once the growth of an outbreak becomes exponential, the tools normally at the disposal of health officials have limited value. It may require military airlifts just to deliver sufficient rubber gloves, aprons, soap and buckets to highly affected areas. Doctors Without Borders is calling for the deployment of civilian and military medical teams to provide triage centers, field hospitals with isolation wards, mobile diagnostic labs and systems for the management of corpses.

But who will direct and implement such an effort? WHO is not an emergency response organization; it is known mainly for bureaucracy and infighting. The United Nations has no epidemic response force comparable to its peacekeeping operations (though perhaps it should). It is hard to imagine a coordinated effort on a sufficient scale that is not organized by America.

This is what should be happening: The White House should be instructing officials at the U.S. Agency for International Development, the Centers for Disease Control and Prevention, and the National Institutes of Health to come up with an ambitious plan on a blank chalkboard. The Office of Management and Budget (OMB) should be approaching House Republican leaders with a proposal to fund that plan, and the White House should be cultivating congressional champions for the measure. A continuing resolution to fund the government will be put together this month. If the Obama administration does not act quickly, it will lose its best chance at securing resources until December.

But, so far, there is no ambitious plan. OMB has not indicated it will make a request for additional resources.

The decision-making process at the White House is, no doubt, clogged with crises. But this is not one foreign policy challenge among many; it is nature out to kill us. Is there really no one on the White House staff willing to confront President Obama with the consequences of inertia?

At the current rate of new infections, affected countries are likely to see civil disorder, economic paralysis and corpses in the streets. The most immediate threat is the rapid spread of the disease in Nigeria. A major outbreak in a sprawling city such as Lagos would be unprecedented, unpredictable and horrific. And as a virus multiplies it also mutates. So far, scientists have not seen any changes in the Ebola virus that are relevant to its biological function. But with more replications, over more months, the risk increases. Scientists quietly fear genetic mutations that would make the virus harder to detect, more resistant to treatment, or (God forbid) easier to transmit. This is not likely, but it is possible.

Health officials are near wits' end. "I don't see any pathway that is easy to implement," one told me. Easy or hard, it is time for America to blaze a path out of this valley of death.

Michael Gerson's email address is michaelgerson@washpost.com.

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1. 2 bits
Cottonwood Heights, UT,
Sept. 4, 2014

Nature is not out to kill US..... WE are out to kill Nature (ask Al Gore or ANY Democrat)...

I'm sure this is man's fault somehow... it ALWAYS is...

2. Howard Beal
Provo, UT,
Sept. 4, 2014

To a certain extent it's a flat world. But even way back when, when there wasn't air travel, the Black Plague nearly killed 25-35% of the human population. The Columbian exchanged wiped out over 90% of the Native populations including killing completely many tribal nations. We can scoff and play politics or step up and help and have some sort of plan. To me, helping solve this crisis is as important or as big as doing something in Iraq or Syria...

3. marxist
Salt Lake City, UT,
Sept. 4, 2014

2 bits "I'm sure this is man's fault somehow... it ALWAYS is..."

What a fatuous comment. The lack of coordinated response however IS the fault of the congressional Republican establishment which has gutted the Federal health agencies. Can you believe it? Even in the face of this they want CDC's budget slashed!

4. Karen R.
Houston, TX,
Sept. 5, 2014

I heard the urgency in this piece and I wondered, "Is this just another case of ginning up hysteria to move a product?" "Would he be criticizing the Obama Administration if it was taking the very actions he suggests here?"

What bothers me about my reaction is that I don't place Mr. Gerson in the same category as some others that have sold out and now pen predictably partisan pieces. But it's clear that their transgressions are now eroding the ground from beneath his feet too, at least with me.

This is not just a swipe at the Right. "Journalists" on the Left are also guilty of infidelity to objective truth. When a population is consistently fed propaganda from every direction, when its emotions are constantly manipulated for the sake of profit, how is it supposed to know when someone is telling the truth?

I will go to the CDC web site for information. Or perhaps the DN could assign Dennis Romboy to report on this issue? His integrity as a journalist remains intact.

5. 2 bits
Cottonwood Heights, UT,
Sept. 5, 2014

@marxist,
That was actually sort of a joke...

BTW... what's YOUR plan? Same question for Howard Beal... what's your plan?

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Last time I checked on it... the CDC was working on it. Yes even despite all the Republican's efforts to stop them...

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BTW.... Something to think about... Who invented the new vaccine (ZMapp) they used on the 2 American doctors who got Ebola? Was it the CDC?

Nope... it was developed by Mapp Biopharmaceutical Inc. Yes... an EVIL "Corporation".
Wonder what Ultra Bob has to say about THAT...

It's going into human trials now... and it was invented by a Corporation (not the CDC).

Just something to think about while we're mulling over our political rhetoric and how it relates to this topic.