Deadly diseases do not respect political correctness. Polio was once a disease of the rich, but after the vaccination program – before it was eliminated in the wild – it became a disease of the poor. Ebola is a deadly contagious disease that never got much attention in the past because it was confined to small villages in Subsaharan Africa. Ebola would break out, kill off a remote village and then disappear into some latent host, often for years or decades, only to break out again in another remote spot. Because Ebola is so deadly, it rarely was spread from village to village since no one survived long enough to make the journey.
Transportation has changed all that. Paving the Kinshasa Highway and other roads into the interior of Africa has allowed people infected with this disease to travel rapidly to coastal cities. In the current outbreak, Ebola has, for the first time in history, become worldwide due to air transportation of people who contracted the disease in areas of the outbreak, and then flew.
Several weeks ago, when asked to comment for a WND article on Ebola, I stated that the disease would not be a problem for America if we controlled transportation into the country. In other words, I suggested that we stop anyone from entering the United States whose travel originated in areas of Africa affected by the outbreak of Ebola. This seemed a simple and obvious measure given the nature of this deadly disease.
Sadly, our government failed to do this. Ironically, we are cautious about bringing potentially infected plants or animals into our country, but don’t seem to think deadly human diseases deserve the same scrutiny. And although we were quick to recommend avoiding travel to SARS-infected areas, and prohibited passengers with fever from boarding planes in China, we seem to be applying a totally different standard to Africans. Up to this point the CDC and State Department have only issued travel “advisories,” and the information at the State Department website is tragically comic. They advise travelers about insurance aspects of traveling to Ebola areas, sounding more like your local travel agent rather than representatives of a government agency presumably tasked with protecting its citizens. “The cost for a medical evacuation is very expensive. We encourage U.S. citizens travelling to Ebola-affected countries to purchase travel insurance that includes medical evacuation for Ebola Virus Disease (EVD).” Sadly, I am not making this up.
Simple transportation limitations would have prevented case zero in Dallas. But now the Ebola genie is out of the bottle and probably loose in America. And it almost could not have been a worse scenario – the patient was not just from an endemic area, but had actually carried a sick Ebola patient to a hospital in Liberia for treatment. That patient and her whole family died of the disease before or during the time case zero boarded an airplane. He changed planes several times through several major worldwide hubs before arriving in Dallas.
In Dallas he became deathly ill, exposing children and adults in his family – and who knows how many else in the area of his domicile. He vomited in the parking lot en route to the hospital, and an aerial photo of the family’s apartment complex shows a man without protective gear cleaning the patient’s vomit from the street using a broom and hose. At the hospital he probably sat in a waiting room, signed in with a clerk – did he nervously chew on the pen while filling out forms? – and after examination was sent home. He did tell the screener of his recent trip from Liberia, but that information did not make it to the medical care providers. (I cannot help but wonder if that was an effect of the Electronic Medical Record nightmare.) After his nephew contacted the CDC, the patient was isolated and treated, and now we are holding our collective breath to see how many others pop up with the disease. Because people become sick variably after exposure (by reports 2-10 days), who knows when or if he became infectious along his travel route?
As bad as this all sounds, it is probably going to get even worse. Now ISIS has declared it will wage “Ebola Jihad” against America by purposely infecting people, then flying them into our country. They certainly have the capacity to do this and to do it without being detected. And these “Ebola Jihadists” could be from Amsterdam or London or Madrid, thus eliminating our ability to do screening by point of origin. Multiple sick Ebola patients on multiple airlines will expose thousands and thousands of fellow airline travelers, most of whom will not get the disease, but the sheer numbers of contacts will exceed the ability of our medical system to identify and track them.
As we have more real Ebola cases of very sick people, keep in mind that there are only four true bio-containment specialized facilities for Ebola patients in the United States. Once that capacity is reached other patients will be treated in less rigorous hospital environments by less experienced people not familiar with handling of highly infectious material.
What should we do? First and foremost, the American people are not fooled by reassuring pronouncements by the CDC. Sadly, most doctors – even epidemiologists – don’t consider bioweapons a reality and don’t think like military strategists. It is time to discuss this outbreak frankly as a real medical emergency – not to cause panic, nor to curtail basic civil liberties, but to admit the devastating potential of Ebola and our lack of perfect knowledge as to the degree of danger to the nation and its citizens. At some point we need to quit worrying about harming the travel and cruise economy and tell people to stop flying to and from Africa. We should halt all flights from areas of outbreak. We should screen all foreign incoming passengers for temperature at the very least, and do better intake screening from all overseas travel. If this begins to get away from us, i.e. there are unexplained cases in multiple areas consistent with the jihadist scenario, then all air travelers should be screened, and air flight may need to be curtailed for the time it takes to track sources and let the disease burn itself out.
I’m not sanguine about flying in the near future until the true nature of this problem has become manifest. Ultimately, as I have said in lectures on bioterrorism, biologic agents are a cheap alternative to nuclear destruction. Ebola – if used as a weapon – should be treated with the same respect as a nuclear attack on our nation, and it may become necessary to actually take appropriate military action to neutralize the threat.