It’s amazing how much Ebola news we get each week. On the September 12, for example, the Cubans said they would provide substantial, although at the time unspecified, assistance for fighting Ebola in West Africa.[1]President Obama trumped that on the  16th, vowing to send 3000 troops, plus lots of supplies, to build Ebola Treatment Units and to train health workers in the infected areas.[2] The World Health Organization [WHO] was suitably grateful, and urged other members of the U.N. to follow suit. On the 18th WHO told the U.N. Security Council, of which the U.S. is a member, that the current Ebola outbreak is “the greatest peacetime challenge that the United Nations and its agencies have ever faced.”[3] Shortly thereafter the U.N. voted to set up a separate UN Mission for Ebola Emergency Response [UNMEER} to manage the international effort.[4]

Case reports continued to trickle in over the same period. It now appears that, as of September 14, total cases of actual and suspected Ebola sickness came to 5500, and deaths attributed to Ebola equaled 2500.[5] These casualties, while tragic, aren’t high compared to total world population, or for that matter the total population of Africa. Each year thousands more people die in automobile accidents in the U.S, for example[6]. But the disturbing thing about the Ebola numbers is not their absolute size at this point in time. Instead it’s their rate of increase. As more people become infected, there are more of them to go out and infect others. Unlike automobile accidents, total Ebola cases seem to double over very short intervals.

A while back we offered a spread sheet that displayed how quickly an Ebola outbreak might grow if it doubled the number made sick every 35 days. Our model, if you want to call it that, was based on scientific observations published on August 28, and did not take into account the effect of any prevention measures that local authorities or the world community might implement. Instead, it set out a simple mathematical progression. [7] As of mid-September the official case counts from West Africa exceed the kind of growth we projected. Our spreadsheet showed 4,480 cases by September 21; the 5500 cases WHO reported on September 19 exceeded that by quite a bit.

Our projections were bad enough. They forecasted total world infection in slightly more than two years if nothing was done to contain the epidemic. But lately it seems other folks think we were unduly optimistic. There seems to be a general consensus that official statistics grossly undercount actual cases; and some analysts say that currently Ebola cases might double in as little as three weeks. Stories have begun to appear that total Ebola cases may number in the 100’s of thousands by the end of January.[8] Our spreadsheet shows “only” about 70,000 cases for that time.[9]

So, is there any good news on the horizon? Well, there could be if our efforts to reduce, and possibly contain the spread of the disease by isolating and treating victims actually work.

  • People who are isolated can’t spread the disease, except to each other and possibly their care givers.
  • Right now we don’t know how to cure the disease but perhaps if we provide nutrition, hydration, etc. and help the victims live long enough, their own immune systems might kick in and effect a cure. Or perhaps not. Actually, we don’t seem to know much about how Ebola interacts with the immune system.[10]

In the short term, what we’re doing now seems to be about the best we can do.

In the intermediate term, we might develop a vaccine. It seems that, in the bad old days of the later Cold War, both we and the old Soviet Union studied Ebola as a possible Weapon of Mass Destruction. Both sides, of course, foreswore the use of biological warfare back in 1972.[11] But that didn’t prevent them [or us] from studying how to defend against such weapons. Research for “prophylactic, protective or other peaceful purposes” was permitted.[12]

We know that the old Soviet Union took an interest in Ebola back in the 1980’s[13], and no doubt we did [and do] as well.[14] Given that, it might be that we, and probably the Russians have some knowledge not generally available to others about how the disease works, and may have candidate vaccines under development. [Actually, we have one in trials right now[15], and the Russians say they’re working on one as well.[16]]  So perhaps effective vaccines will be fielded in the not-too-distant future, and that would be a good thing.

Let’s be clear about this. We’re not saying that the Cold War was a good thing – although it was better than a hot one with nuclear weapons. We’re saying that if any knowledge we have from that unhappy period is useful in fighting Ebola, we should deploy it. We’d be even happier if an effective vaccine came out of brand spanking new research, conducted in the last nine months, and unindebted to prior work on biological warfare. Nevertheless the main thing is to get an Ebola vaccine, not to worry about its antecedents.

Of course, that’s just our opinion, and we’re not in charge of anything.

 

 

 

 

[1] See WHO, Media centre, Remarks at a press conference: Cuban government announces substantial support to WHO Ebola response (September 12, 2014), available at http://www.who.int/mediacentre/news/statements/2014/cuban-government-support/en/

[2] See WHO, Media centre, WHO welcomes the extensive Ebola support from the United States of America (September 16, 2014), available at http://www.who.int/mediacentre/news/statements/2014/usa-ebola-support/en/ : “The backbone of the US response is military leadership and the establishment of a regional command and control in Monrovia. The approach includes a military staging base to facilitate the coordination of the American and international response and to expedite the transportation of equipment, supplies and personnel including up to 3000 from the military. … In addition, engineers will construct additional Ebola Treatment Units in affected areas and establish a site to train up to 500 health workers per week to care for patients.” See also The White House, FACT SHEET: U.S. Response to the Ebola Epidemic in West Africa (September 16, 2014), available at  http://www.whitehouse.gov/the-press-office/2014/09/16/fact-sheet-us-response-ebola-epidemic-west-africa

[3] See WHO, Director Chan, WHO Director-General addresses UN Security Council on Ebola (September 18, 2014), available at http://www.who.int/dg/speeches/2014/security-council-ebola/en/

[4] See WHO, News Release, WHO welcomes decision to establish United Nations Mission for Ebola Emergency Response (September 19, 2014), available at   http://www.who.int/mediacentre/news/releases/2014/ebola-emergency-response/en/ : “Nearly six months after the first case of Ebola in West Africa was reported to the World Health Organization … the United Nations (UN) General Assembly and the Security Council have approved resolutions creating the United Nations Mission for Ebola Emergency Response (UNMEER) to contain the ongoing outbreak which has sickened more than 5,500 people and killed over 2,500.”

[5] See note 4.

[6] Wikipedia shows over 30,000 automobile deaths a year in the U.S. in 2012.  See Wikipedia, List of motor vehicle deaths in U.S. by year at http://en.wikipedia.org/wiki/List_of_motor_vehicle_deaths_in_U.S._by_year

[7] The August 28 scientific report we relied on for our modest estimate appears in Sciencexpress Reports, Gire et al., Genomic surveillance elucidates Ebola virus origin and transmission during the 2014 outbreak (28 August 2014) (hereafter cited as Genomic Surveillance at __), available at http://www.sciencemag.org/content/early/2014/08/27/science.1259657.full.pdf

[8] See Bloomberg News, Chen et al., Ebola Worst-Case Scenario Has More Than 500,000 Cases (September 20, 2014), available at http://www.bloomberg.com/news/2014-09-19/ebola-worst-case-scenario-has-more-than-500-000-cases.html

[9] Actually, 71,680 by February 8, which is bad enough.

[10] But scientists are working on it. See Science Daily, Search for Ebola immune response targets (September 9, 2014) at http://www.sciencedaily.com/releases/2014/09/140909123603.htm

[11] See Convention on the Prohibition of the Development, Production and Stockpiling of Bacteriological (Biological) and Toxin Weapons and on Their Destruction (signed, 1972, effective 1975), available at   http://www.opbw.org/convention/conv.html

[12] See note 11 at Article I.

[13] See, e.g.,  Alibek, Biohazard (Random House, 2001) at p. 261-262. Dr. Alibek was a KGB Colonel, in charge of a good part of the Soviet Union’s biological warfare program, who defected to the U.S. in 1992.  You can find him in Wikipedia at http://en.wikipedia.org/wiki/Ken_Alibek .

[14] Currently Ft. Detrick, MD appears to be at the heart of U.S. biological defense. It’s the home of the joint command that develops “[FDA]-approved medical systems for protection, treatment, and diagnostic capabilities against chemical, biological, radiological, and nuclear (CBRN) threat agents.” See Joint Program Executive Office for Chemical and Biological Defense at http://www.jpeocbd.osd.mil/packs/Default.aspx?pg=180

[15] See CNN Health, Hellerman, Human trial of experimental Ebola vaccine begins this week (September 2, 2014) at http://www.cnn.com/2014/09/02/health/ebola-vaccine-trial/index.html

[16] See This Day Live, Russia working on Ebola vaccine (14 August, 2014) at http://www.thisdaylive.com/articles/russia-working-on-ebola-vaccine/186309/

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