WITH SUSPECTED AND/OR actual Ebola cases appearing in the US, the UK, Spain, and now in Australia, a belated zero-tolerance approach to this disease must be urgently adopted in the interests of public safety; despite assurances of the difficulty in catching the Ebola virus, new infections continue to occur — and current practices guarantee they will occur in Australia. A failure of governance could cause a catastrophe that kills millions.
About five years ago I recall reading an article in a magazine in London that told the story of an Ebola outbreak, somewhere in Africa, from the biographical perspective of a Portuguese doctor who had travelled to the affected country as a volunteer medic.
At the end of a sixteen hour shift in a makeshift hospital, this doctor’s last act for the day was to help carry a sick patient between wards; ready to go home for the night he had removed his protective mask, and the Ebola-infected patient sneezed on him. A fortnight later, the doctor was dead. He had contracted the virus from his patient, and it killed him.
Try as I might, I can’t find a copy of that article online, nor remember the magazine it was published in, but it doesn’t really matter in the big scheme of things. Remember this anecdote. Its importance will become clear soon enough.
Likeable as I find him, it’s not often I agree with the pronouncements of Independent MP Bob Katter Jr that are roundly condemned and dismissed as “outrageous” or “hysterical;” even so, I can’t disagree with his assertion — if not, perhaps, some of the florid rhetoric used in making it — that Western medical volunteers returning from treating Ebola patients in Africa are placing whole populations at risk from the disease.
And as a conservative, I must remind readers that advocacy of limited government should not be confused with the advocacy of no government; there are clear circumstances in which the role of the state ought to be unquestioned, and the obligation of government to protect its people from a very real and potentially cataclysmic biosecurity risk is one instance in which libertarians and do-gooders need to be shut down in the interests of the greater good.
With 11 Australians having been tested for suspicious symptoms in recent weeks, Cairns nurse Sue Ellen Kovack — the latest suspected case that “everyone is watching” — is awaiting test results to learn whether or not she contracted the virus whilst working in West Africa, and whilst that outcome will show whether or not Australia has dodged yet another bullet in the growing international Ebola crisis, her unfortunate case highlights the shocking inadequacy of existing measures to insulate Australia — and Australians — from the threat of the disease.
(UPDATE: Happily, Kovack has tested negative to Ebola. Nevertheless, her case should still sound as a clarion call for government to clamp down on people movements from Africa).
I have resisted the impulse, until now, to post on the growing threat Ebola poses to Western populations; my intention is not to be alarmist, or fuel panic, or sound heartless, or propagate a view that this evil scourge should be confined to and left in the wilds of Africa where it can’t hurt anyone in the comfortable first world society I live in — out of sight and out of mind — although no doubt I will be accused of some or all of these things by those who disagree.
But whilst reassurances about the low risk of an epidemic (or even infection) to the general population are welcome, they lack the kind of rigid, inflexible protocols that go as close as humanly possible to ensuring these things are not merely unlikely, but become virtually impossible.
There are five strains of Ebola viruses; the one responsible for the present (and historically, most widespread) outbreak is the most potent, killing between 50% and 90% of its victims, with an average of 83% of those infected with it dying since it first appeared in 1976. As such, it is arguably more lethal than smallpox was at the peak of its terrible power. Even though Ebola is far less transmissible than smallpox, it is obvious that it represents a threat that could, if allowed to spread, kill hundreds of millions of people. This is not a disease that any chances or levity ought to be taken with.
I was absolutely mortified when US doctor Kent Brantly and his colleague, Nancy Writebol — both volunteers who had travelled to Africa to help treat Ebola cases, only to become infected themselves — were repatriated to the US whilst infectious to receive treatment in American hospitals, and whilst it’s fantastic that both recovered from the virus after receiving an experimental drug, the risks of importing live cases from Africa into Western populations outweigh, in my mind, the assurances provided to the public around infection control protocols, the effective disinfection of vehicles and equipment used in transportation and treatment, and so forth.
In Spain, nurse Teresa Romero Ramos contracted Ebola and has since died after treating two missionaries who returned from treating patients in Africa; not only did the pair spread the virus from Africa to Spain, but the nurse is on the record as attributing her own infection with the virus to a mistake, probably by touching the exterior surface of her biohazard clothing.
The recently documented case in America of Thomas Duncan — who had travelled to the US from Liberia — told the story of a man who had lied on a declaration form, stating he had not been exposed to populations within Africa in which Ebola was present, when in fact he had helped care for friends and family members stricken with the virus before taking his flight to America.
And as I write, a law enforcement officer who had face-to-face contact with Duncan after his arrival in the US has been hospitalised with suspected Ebola symptoms and is awaiting the results of tests for the disease.
The point is that despite the public assurances by healthcare bureaucrats about how unlikely it is anyone would be at risk if cases are confirmed in Australia, new cases are occurring already in other countries the Ebola virus has already travelled from Africa to reach — and despite the very protocols these bureaucrats are brandishing.
I fully support anything that mitigates or eliminates the risk of public panic, but not when the realities of Ebola and its spread appear completely at odds with the semantics of the assurances being given.
I know I’m talking about America when I say this, but the desire of American doctors to receive treatment in American hospitals should have been immediately vetoed when weighed against the risks of transporting them into an Ebola-free country; it seems an act of utter idiocy to knowingly import such a scourge in the knowledge of the potential consequences, no matter how much was done to mitigate those consequences.
The US got lucky the first time; the case of Duncan (and possibly the Police officer he potentially infected) came after a terrifyingly short interval that should rightly alarm anyone inclined to listen to the “highly unlikely consequences of confirmed cases in our country” spiel that is being disseminated.
The spiralling Ebola outbreak in Africa is being worsened, in part, by traditional customs that involve people touching, caressing and even kissing the bodies of their dead relatives and friends, and with Ebola spread by contact with any bodily secretions from infected persons — blood, urine, faeces, vomit, semen, saliva, sweat — it’s clear that this is a primary infection route.
Apparently, education efforts to alert local populations to the threat have proven fruitless, as the adherence to custom transcends any sense of fear, so much so that reports of folk hiding sick people suspected of having Ebola and refusing to allow them to be treated — even to the extent of hiding dead bodies from authorities so traditional practices can be carried out — are widespread.
But what traditional African custom exacerbates on the one hand is ameliorated to a degree on the other by the comparatively low population densities in many of the areas of West Africa this Ebola outbreak has originated in.
Here in the West, we’ve been told that you can’t catch Ebola from an infected person on an aeroplane, and that carriers don’t become infectious until symptoms appear. But this is no guarantee; and the onset of symptoms at all — whilst said by doctors to be rapid — could very well begin near the end of a flight, or as the carrier walks out of the airport, past hundreds of people.
It only takes a sneeze or a cough at the right stage of the incubation of the virus — perhaps before a full onset of symptoms is suspected or even apparent — and this is why I mentioned the case of the Portuguese doctor I’d read about at the beginning of this morning’s article.
Now, many Western countries are announcing inbound Ebola screening at airports, at the same time the incubation period (which ranges from 2 to 21 days) means Ebola-infected travellers could simply walk out of airports and into population centres exposing hundreds, or thousands, to the virus as a consequence.
The point is that much of the public information being relayed to the general public is based on probability, but is not total, cannot anticipate human error, and cannot hope to account for exceptional cases.
Repatriating Western citizens to provide them treatment in their own countries is an exceptionally desirable course that should simply not be taken when the potential death toll of any consequent proliferation of the Ebola virus is considered.
The service of doctors in volunteering to travel to Africa to help the sick is an almost inexpressible example of compassion and human decency by those who choose to undertake it. It is literally embarked upon at considerable mortal risk to those who do so. But just as those risks are known upfront, they should not be transferred — however remote the prospect of doing so — to their own countries at the end of their service.
Infection control protocols, as any doctor will admit off the record, can break down, and in any case are no a guarantee: nothing, where human intervention and human imperfection are involved, ever is.
And no safeguard can be taken against the utter selfishness or the contempt for human life that the case of Thomas Duncan represents, who held his personal agenda in higher regard than the welfare of potentially millions of Americans, despite the probability that he was a carrier of the virus when he boarded a plane to the States.
Regrettably — and at the risk of being accused of a very cynical world view — there are plenty of “Thomas Duncans” in this world who don’t give a rat’s arse about anyone except themselves. When it comes to something like Ebola, that cavalier disregard for others is a potentially deadly sleight.
The nurse Kovack did the right thing, handing herself over to authorities the instant she suspected she was ill. But had she been infectious, her return journey from Africa to Cairns was via Perth and Melbourne. Kovack is to be commended for doing everything she could to ensure she posed no risk, but the fact she was allowed to travel through two Australian ports to reach a third whilst potentially carrying such a lethal virus is unforgivable where the country’s border control agencies are concerned.
Exception, exception, exception, exception…for all the harmlessness and absence of risk governments in Australia and elsewhere in the West are selling their people, cases of Ebola are now materialising across the world with increasing frequency.
And it is the responsibility of those governments to protect their people.
What would happen if an Ebola-infected individual, thinking they were off to see their doctor with a case of ‘flu, hopped on a suburban train carriage during peak hour one morning — coughing and sneezing and sweating in a packed carriage with standing room only — with up to 200 people in a confined space?
There is nothing “hysterical” — for once — about Katter’s warning about the risk posed by those who have travelled to Ebola-ravaged locales returning to Australia.
The libertarians really won’t like this, but in the face of an exploding global health threat with the potential to rival the smallpox epidemics that are thankfully a relic of history, no tolerance can be shown, nor exceptions made, in seeking to eliminate the threat of Ebola infection in our midst.
There can be no repatriation of virulently ill people; the risks are too great. Medicines and expertise, where volunteers are willing and resources can be provided by our governments, should instead be taken to the people where they are.
Scanning at airports is well and good, but anyone from Ebola-certified countries should be prevented from travelling to Australia at all until they have undergone a period of quarantine, in facilities that meet Australian specifications, for 21 days prior to commencing their journey here.
That must include volunteer medics and others who have been in Africa to help with the Ebola menace. Unfair it might sound, but these people should be the top priority for quarantine before they come back to Australia.
Passports should be scrutinised to weed out any country jumpers — for example, someone who had been in an Ebola-affected country and fled to, say, South Africa to evade pre-flight quarantine — and to isolate them before they are permitted to enter this country.
Quarantine facilities should be readied at major points of international entry to isolate persons who somehow slip through preventative measures at the other end.
And some kind of protocol must be quickly established to proactively, efficiently and regularly follow up anyone who, for whatever reason and on whatever level, may have been exposed to the Ebola virus for three weeks after they enter Australia: even if it’s a drastic overreaction (which we hope it would be), it would create telemarketing and other support jobs that didn’t exist before the current Ebola outbreak began.
In the end, and in contrast to accusations Bob Katter is a frenzied panic merchant fomenting fear and hysteria, the Editorial in this morning’s edition of Sydney’s Daily Telegraph has it about right: the threat of Ebola in Australia is real. It should not be dumbed down or downplayed. And the fact conversations like this one are being had at all highlights the failure of the rhetoric of government to date to match the reality. Much tougher measures are required to deal with it.
Ebola is not harmless. Its spread is not some latent phenomenon that poses so little risk that we should dismiss it without a care. Far from being complacent, people should be vigilant. And government — whilst justified in preventing panic — has a responsibility to do far, far more in preventing the threat of this insidious virus gaining traction in Australia, or entering the country at all.
This is one door that will be impossible to nail closed if the horse, God forbid, should ever bolt through it.