Why is this Ebola outbreak so bad?

CNN unwittingly hit the nail on the head in this article.

“I think that the government and the ministry of health here in Sierra Leone is not able to deal with this outbreak. We need much more help from international organizations — as WHO, as CDC, as other organizations — to come to support the government,” Wolz said.

“Still we have unsafe burials; people who are doing the burial without disinfection of the body; still we have patients who are hiding themselves; still we have patients or contacts of patients who are running away because they are afraid.”

The duration and impact of the 2014 West African Ebola outbreak — or rather, the attention it has been receiving from our mainstream media outlets — has prompted the less-inquisitive elements of our society to completely ignore what science has taught us about how Ebola is transmitted in favor of their own imaginative speculations. The stupids wonder aloud: “How could the disease have spread so far and infected so many, of whom a fair portion are medical professionals, if it were not airborne?” But in the fashion typical of cranks, the question is posed only as a lead-in to their predetermined conclusion… that scientists are wrong, that Ebola is indeed airborne.

The article, however, answers the question rather succinctly: West Africa is the very definition of “third world”. Public sanitation is unheard-of; aseptic technique, even in professional medical environs, is not enthusiastically maintained; border security is laughable; and the people, largely uneducated and reeling from past experiences with western medical researchers, are outright distrustful of doctors. To put it simply, Ebola has thrived there because is it is biologically suited to the environment. There are few barriers, natural or man-made, preventing the disease’s spread.

What differentiates this outbreak from those past is a simple matter of locale. Previous outbreaks were relegated to the hinterlands, where relative isolation kept the fast-acting virus far and away from densely populated urban centers. That isn’t the case this time around. Ebola has made it into the cities, and now has access to an immeasurably larger pool of hosts and rapid transport to other urban centers.

Even if you ignore what scientists have to say about this strain of Ebola (EBOV), there nevertheless remains no reason whatsoever to suspect the virus has mutated to facilitate airborne transmission. The lethality, scope, and duration of the “burn” (badass USAMRIID slang for “outbreak”) are well within the capabilities of a non-airborne virus.

Furthermore, there are events that simply do not support claims of airborne transmission. Take, as a case study, the events that preceded the virus’ spread to Nigeria.

On July 20th, Liberian-American Patrick Sawyer flew from Liberia to Lagos, Nigeria, whereupon he became severely ill with what was undoubtedly Ebola. This wasn’t a short flight, nor was it direct. Sawyer and his fellow passengers made stops in Togo and Ghana before reaching their final destination. Yet, only Sawyer and the doctor who treated him in Lagos have presented symptoms of Ebola. If EBOV were airborne, we would expect to see many more infected from Sawyer’s presence on the flight, possibly all of them. To date, none of the other passengers or airline staff, who spent hours with him breathing the same recycled air in the same confined space, have broken with the disease.

What about the American aid workers who fell ill? What of the “top researchers” who broke with Ebola despite their “space suits”?

These questions, though apparently pressing to the uninitiated, aren’t particularly relevant. The suits aren’t fool-proof. They won’t protect against abrasions or accidental sticks with an infected needle. And it isn’t as if the aid workers wear the suits at all hours of the day. They live in the same country as the people they treat, and in their off-hours interact with people who may have exposed themselves to Ebola.

It’s a risky job. They know that. Unlike the people at home, they aren’t panicking.

Which means there’s no reason to panic.

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