You might think that you want to talk about the Greatest Debate Ever, but we're going to set that aside and let it breath for a week. It was glorious, but there are more things in heaven and earth Donald Trump. For instance: Remember Ebola?
For several weeks last fall, America was on high-alert as the largest outbreak in the history of Ebola hit West Africa, leading to four cases of infection here in the States. A quick refresher: While the Ebola outbreak in West Africa raged out of control in September and October of 2014, the American medical establishment engaged in a series of blunders and mis-statements that suggested they were either the Keystone cops of infectious diseases or more interested in ideological commitments than science. For instance: The head of the CDC, Thomas Frieden, insisted that Ebola couldn't come to America. And it did. Frieden then insisted that Ebola could not possibly spread in America. And it did. Frieden then dissembled, in a serial manner, about quarantines, travel bans, and the disease's modes of transmission. For example, at one press conference, Frieden was asked if someone could contract Ebola by sitting next to an infected individual on a bus —a question prompted by a statement from President Obama the week before, when he declared that you can't get Ebola "through casual contact, like sitting next to someone on a bus." Frieden answered: "I think there are two different parts of that equation. The first is, if you're a member of the traveling public and are healthy, should you be worried that you might have gotten it by sitting next to someone? And the answer is no. Second, if you are sick and you may have Ebola, should you get on a bus? And the answer to that is also no. You might become ill, you might have a problem that exposes someone around you." As I said at the time, this is not the sort of behavior that inspires confidence in our elites. But things turned out okay Or at least "okay" by the standard of pandemics. Which is to say that, to date, "only" 11,295 people in West Africa have died from the outbreak. It's still ongoing, with new cases having been reported in Liberia in late June and early July. And the spread of the disease outside of West Africa was halted after only a few cases in the United States and Europe. So that's the "good" news. The worse news is that in the aftermath we're beginning to get a clearer picture of how the medical establishment—especially the CDC and the WHO—conducted themselves. And the after-action reports are horrifying. Last week I linked to Ari Schulman's amazing New Atlantis essay about all of this, but I'm betting that most of you didn't read it because it's very long, and at times quite technical. And I understand that while a discussion about aerosolization and fluid dynamics blows my skirt up, this sort of thing isn't for everyone. So let me give you a very abbreviated version of Schulman's report. (Though by skipping this, or anything else in the New Atlantis, you're only cheating yourself.) At the heart of understanding the CDC and WHO response to Ebola was their view of the disease's transmission. Throughout the crisis, the establishment—and the CDC's Frieden, in particular— went to pains to deny that transmission could come from anything other than "direct contact" with bodily fluids. But it's now clear that this is false: Ebola can be transmitted when the virus is aerosolized via what Schulman calls "aerial transmission." Which means essentially this: A third of Ebola patients exhibit marked coughing. When they cough violently, the air rushing out of their mouths carries off very tiny droplets of saliva, sputum, or blood. And these droplets are so tiny that they can fly through, and even float in, the air currents of the immediate vicinity. How far? We don't really know. Three feet definitely. Eight feet probably. Possibly more. Here's Schulman summarizing one of the more unsettling research papers on the subject: Bourouiba's team concluded that droplets, particularly small droplets, can travel much farther than was previously believed—some up to eight feet away horizontally and twenty feet vertically under the energy of their initial expulsion. This is more than far enough, the authors note, to reach most hospital ventilation systems. The paper, which argued that "the transmission mechanisms of even the most common respiratory diseases remain poorly understood," prompted another researcher to comment that the study meant scientists "might have to rethink how we define the airborne respiratory aerosol size range." Let me emphasize: The CDC and WHO went to great lengths to obscure, misrepresent, and deny the research on how Ebola can be transmitted via aerosol. To go back to Obama and Friedman's example, if someone with Ebola was sitting next to you on a bus and sneezed or coughed, you would definitely have had cause for concern. This wasn't just a rhetorical exercise, because in the face of their insistence, the CDC and WHO both issued unsafe protocols for the healthcare workers dealing with Ebola, telling them that surgical masks were adequate to protect them from the disease and that respirators were unnecessary. This is much worse than it sounds, because it wasn't an honest mistake. As Schulman reports, several researchers and epidemiologists approached the CDC and WHO begging them to revise their guidelines and instruct healthcare personnel to use respirators. These people were either ignored, rebuffed, or publicly attacked for stoking "panic." In other words, the medical establishment decided that it was more important to convince the public of a lie (that Ebola couldn't be transmitted through the air) than it was to adequately protect the doctors, nurses, and technicians who were risking their lives to fight the disease. This is a shame and a scandal. But if you can believe it, it gets worse. More down below. |
Here's Schulman again from the New Atlantis: In March 2015, the Associated Press uncovered e-mails showing that WHO officials delayed declaring a global emergency over the Ebola epidemic because of "worries that declaring such an emergency—akin to an international SOS—could anger the African countries involved, hurt their economies, or interfere with the Muslim pilgrimage to Mecca." This is not the only instance in which the WHO has expended some of its apparently critically limited attentional resources on avoiding hurt feelings. In May 2015, as the outbreak was still gripping West Africa, the WHO called for changing practices in naming future diseases, so as not to include names of places, people, or industries, a practice that has "had unintended negative impacts by stigmatizing certain communities or economic sectors." The reason I hope you'll read the entire New Atlantis piece is that it makes clear that this is all about much more than Ebola. It's about how even our scientific establishment has become so ideologically corrupted that they cannot be trusted to automatically and transparently follow objective truth. Schulman again: It might seem that the belief that health care workers and the public are too psychologically fragile to handle open discussion of the evidence of infectious diseases is a kind of paternalism. But that isn't quite right. For paternalism—laws compelling seatbelt use, taxing tobacco, restricting the size of soda cups—is an attitude willing to sacrifice liberty for the sake of health and safety. No, in the attitude at play here, safety is just the thing being sacrificed. And not some lofty perfection of safety, but specific protective measures, minimally burdensome and already widely employed, against a highly lethal and poorly studied disease. This is a paternalism concerned with hygiene not of body but of speech and thought. It is not in fact paternalism but authoritarianism, whose interest is in calmness and order first, health and safety second, rational dissent last. It is the reverse ordering of an open, scientific society. It's bracing to realize that America simply got lucky with Ebola this time. Not just because all luck eventually runs out, but because our good fortune will probably make it even harder to fix the very real problems in within our elite medical institutions. Best,
JVL
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