Ebola.

[JR11]

The Ebola virus is now killing people by the hundred in the small, impoverished states of Sierra Leon, Liberia and Guinea. The way things are going, it could soon be by the thousand, and by the tens of thousand. Local health systems are being overwhelmed, in spite of the incredibly courageous work of NGO medical volunteers and local health workers. Being a viral disease, it is not particularly surprising that there is no actual cure for Ebola (there is no actual cure for the common cold, either). More surprising, perhaps, is that there are no means of immunization. This disease did not emerge from the jungle just yesterday; the first recorded case dates from what is now South Sudan in 1976. Depending on the strain, mortality among those infected with Ebola can range, untreated, from 70 per cent up to about 90 per cent. The only known treatment is isolation, rehydration, and hoping that the patient’s immune system will fight back successfully. Otherwise, the victim will suffer huge superficial blisters (similar to plague sores), severe bleeding from just about every orifice of the body along with crippling headaches and fever, and eventual death through the breakdown of vital internal organs. This may take only days.

Some accuse western states of over-reaction to the possibility (or reality) of Ebola arising on their territory. This criticism may to some extent be justified. The conditions favouring the spread of Ebola in West Africa - unclean water supplies, people being forced to live cheek-by-jowl in primitive conditions, basic medical infrastructure, poor education and so on - are generally not present in the West. While the export of Ebola to the West is inevitable to a limited extent, fingers crossed, we should be able to handle it. The real question is why, given that we knew that this was a virus (and have known since 19760; that we know that most viral diseases are virtually or actually impossible to cure; that there was no known means of inoculation against this virus; and that we have long known that the thing was a very effective killer; why was more effort made since 1976 at least to develop antivirals effective against this plague, and why. at least, more effective isolation and palliative measures were not developed ? Of course we know the answer. This was a little plague, plying its trade among the fruit bats and monkeys of far-off Congolese jungles, killing small numbers of fruit bats, monkeys and of course native humans in that far-off place. There was no priority, and no money, in addressing this disease. Even as it is, it is likely that our advanced Western medical technology and well-developed sanitary systems will enable us to contain or even prevent any significant outbreaks of the disease in the West. Little consolation to our brothers and sisters in West Africa, who are confronted not only by the threat of the disease, but by the economic disaster that is likely to result from its sudden and extensive expansion in their space. Makes one a bit ashamed to be a member of what one notable atheistic scientist describes as “a species of intelligent monkeys”.

In the longer term, our own relative safety in relation to Ebola as now known may not be such good news. Already, there are four known strains of Ebola virus. We evolve through generations averaging 30 years in duration; bacilli and viruses have a generational turnover of days or even hours. This is why we are faced with the problem of antibiotic resistance to new strains of bacilli, and the need to concoct new influenza “jabs” every year; bacilli and viruses have vastly greater opportunity to adapt and evolve than do we. It is all too possible that the end for Humanity (or, at least, for our present civilization) will come, not through nuclear war or global warming, but through the development of “superplagues” to which we can find no answer in good time. How, one might ask, would we deal with an Ebola mutation capable of transmission in the same manner as its cousin-virus, influenza ? The 'flu is bad enough, but …

It is not just a matter of “human” viruses. Coincidentally (and no attempt was being made to suggest a link with Ebola) I just recently heard a report of a family of viruses spreading among frogs, toads and other amphibians in rainy northern Spain, the symptoms of which are strikingly similar to Ebola in humans. There is some evidence that this “family of viruses” may have developed a mutation that attacks snakes and lizards. Allowing for the wonders of capitalism and the pharmaceutical industry, we really cannot afford to ignore obscure little plagues in places far, far away. Even animal ones. Otherwise, it seems only a matter of time before they mutate into a form that can come and get us. Will this be noted by the cigar-puffers at the head of our pharma giants ? I doubt it. Yours from the Plague Hospital, expiring, JR.:mad:

[tankgeezer]

A weekend viewing of Steven King’s “The Stand” might be in order. I am surprised a bit that some dubious cable channel isn’t running a marathon of such movies. Outbreak, Contagion, The Stand, etc. Could even include a few zombie type films to boot. Glad I live in the Mountains. All of this has given rise to a series of topical posters.

[Ardee]

JR, I’m sure you know as well as anyone that we’re overdue for a pandemic. It’s been almost 100 years since the last one (the Spanish Flu of 1918). It’s not a question of IF, but WHEN and HOW BAD. We are overpopulated, and it is all but inevitable the nature will partially redress the balance. But ending civilization seems a bit much. Setting it back, yes; ending it no. The possible warfare triggered by panic refugees and other fallout from a plague, perhaps combined with other things (I could give you a list) might do the job, but in and of itself – I’m dubious.

Meanwhile, it is disconcerting to see how people in some quarters are blowing things out of proportion, while both fear-mongers and profiteers step up. The news tonight reported on places selling Ebola cures, Ebola preventitives, Ebola protection suits, and even an Ebola domain name on the Internet. I fear by far the most likely cause our civilization’s demise is a combination of our own base emotions, stupidity, and cupidity.

But then, that last is hardly a new idea.

[JR11]

Remains to be seen, Ardee. Of course, Ebola as such is not going to end civilization as we know it - but some real plague that could is a possibility, sooner later. When it comes, it is likely to as easily communicable as influenza (which is itself a proven killer) but more deadly in its effects. Fair chance that it will evolve in some out-of-the-way place where it will kill a few fruit bats, monkeys, local humans, not drawing much attention from Western governments and pharma companies, waiting until it is good and ready, and then … " … the worst is Death, and Death shall have his day !".

In any event, what really angers me about Ebola is, that we have known about it for nearly forty years; it was known to be a horrible disease with an ultra-high mortality rate among those unlucky to catch it; and few thought about developing an effective countermeasure until it threatened to move beyond the status of a little plague, far, far away, that was only killing less cute varieties of wildlife and Africans. No profit in it, of course, but now …

As regards the possibility of a new great plague, well, all I will say is that the little buggers do evolve much faster than do we. Ebola itself probably evolved in the African wildlife population before communicating itself to humans - otherwise we would have noticed it sooner. Something that, from our point of view, would be a lot worse could do the same. On balance, I think I would prefer to be hit by a comet … Yours from Somewhere Up the Jungle, JR.

[Ardee]

Be careful what you wish for JR! A large enough comet would do far worse than any disease. Of course, we could also talk about a gamma burst from any nearby super nova, but what the heck…

I was recently discussing Ebola on facebook: the amount of ignorance and raw fear displayed was amazing. Even more amazing was how the only facts and half-facts most individuals would pay any attention to were the ones that fed their fears.

As I’m sure you know, Ebola hasn’t been ignored. It has been studied. Some trial/experimental drugs were available, and were used. Other killers and potential killers are likewise being studied. The problem is they outnumber us by several powers of 10. The scale of such study is typically small, mostly because no one knows in advance which one is going to be a real menace. Ebola, historically, killed so effectively and quickly that outbreaks burned themselves out before reaching major populations centers. In other words, it killed faster than it spread. Modern civilization’s wealth and modes of transport have finally penetrated sufficiently into rural areas that Ebola could slip its traditional bounds. That of course is one of the concerns epidemiologists have been warning about for years. The problem is, Ebola’s only one of many such diseases, and no one has a functioning crystal ball. So far as the evolution of the buggers – evolution is as likely to make the disease more benign as more virulent, and the virus is more likely to succeed the more benign it is. Admittedly, that doesn’t help us much if things go the other way.

The thing to try and take away here is the need to improve our preparations for when the “thing nasty” finally does come. Before Dallas, US officials in their pride were yapping about how Ebola could never be a problem here, because our health care and sanitation, etc., are so advanced. Maybe so, but Dallas also exposed how poorly prepared the “human” part of the equation is. And, I fear, even in terms of equipment resources, we are not as prepared as we think.

[leccy]

Countries like India refuse to recognise drug patents so making some companys question R&D, national policy is to make the drugs available to all for a fraction of the developers costs (good) unless the developer is Indian then it will give them exclusive for 5 years (hmmmm)

They originally did this when an epidemic hit part of India threatening millions, one company (France based) made a drug to counter it - but refused to reduce price or to ramp up production to more than 15k treatment doses a year (grrrrrrr money grabbing) - so the Indian government decided to manufacture it themselves (start of slippery slope)

With things like that happening it is little wonder that there is little known about what R&D is being done on Ebola (at least 2 different drugs suddenly appeared and are being used in live trials, several lives have been saved by them as far as I know).

Ebola has been hidden away from the world affecting a limited geographic area, parallel with Aids also affecting Africa and little was done till it hit the public notice - then years went by before any treatment was found - it affects and kills more people in Africa as does Malaria but neither are stopped - and they are easier to control.

[JR11]

At the risk of seeming picky - India, along with some other countries, did not exactly refuse to recognize drug patents. Patent law operates on the basis of national territories; it is not internationally harmonized, although a somewhat bewildering range of treaties do harmonise aspects of patent law structures, up to a point. In the case of India, its patent law recognized (perhaps still recognizes) what are sometimes somewhat misleadingly called “process patents” for pharmaceuticals. This differs from patents as understood, say, in the UK, insofar as a process patent will give a good measure of patent protection to the end-product, but will not at the same time protect the process. Simply put, this enabled (?enables) Indian pharma companies to produce lawful “copies” of an end-product identical to one under patent protection, say, in the UK, so long as the process used to produce it is significantly different from that used by the original patent holder. In this system, it is not impossible for two firms to produce identical chemical products so long as different chemical/technical processes are used to produce it. This has, not surprisingly, been a source of major contention in the patents world for a long time. I am a bit out of touch with this stuff, so I am not sure what the state of play is at the moment. No doubt my former collaborators at the World Intellectual Property Organisation in Geneva are plugging away at the problem. Don’t hold your breath … Yours from Backstreets of Bangalore, JR.