Ebola expert says CDC lied to the people and gives large indepth look at ebola
Brilliant piece by James Hamblin in The Atlantic. Worth reading the whole thing. Here are some highlights
"I want to be pleasant through this whole thing," California Representative Darrell Issa said on Friday, unpleasantly, to a panel of medical experts at a congressional oversight-committee hearing. "But," he continued, scolding from his perch, "we have the head of CDC--supposed to be the expert--and he's made statements that simply aren't true."
During the tense four-hour session, the subcommittee challenged almost every element of the United States' response to its domestic Ebola cases so far. Most pointedly, chairman Issa criticized the Centers for Disease Control and Prevention's messages to the public.
"Doctor," Issa said, turning slightly to address Assistant Secretary of the Department of Health and Human Services Nicole Lurie, "You can get Ebola sitting next to someone on a bus if they, in fact, throw up on you, can't you? That's reasonable?"
Lurie responded deliberately, after a brief pause, "The way you get Ebola is by exposure to bodily fluids, yes."
This week I received a "monograph" for review from an unlikely, politically removed scientist. It was plainly titled "Summary of Ebola Virus Disease," and written in exhaustive scientific detail. The author was Steven Hatfill.
If the name rings a bell--I don't want to dwell on this, but it's germane to the context of his perspective I'm sharing here--it's because he was very publicly, very falsely accused of killing several people with anthrax in 2001.
One of the oddest things about the whole ordeal was that Hatfill knows relatively little about anthrax. Even though he was touted as an international expert with unique access and knowledge to the bacterium, he has always been primarily a student of deadly viruses. What he does know, at a depth that can rival any scientist's knowledge, is Ebola.
For one objection, Hatfill wants it known that, while it must be emphasized that airborne droplet and particle transmission between humans has not been evident in this outbreak, aerosol droplet transmission of Ebola virus has been shown in animal studies. "It is therefore irresponsible for government health officials to emphatically state that aerosol transmission does not occur," he writes. He also believes the argument against a national quarantine is "inexcusable in light of the size of the current West African epidemic."
There was one other Ebola outbreak in the United States, for which the country was well prepared. It happened in 1990, when a shipment of macaque monkeys from the Philippines fell ill in the laboratories of Hazelton Research Products in Reston, Virginia. The company sent tissue samples from the animals to nearby Fort Detrick, where tests showed antibodies to Ebola virus. The macaques were evacuated to Fort Detrick by its highly trained Aeromedical Isolation Team. There they were euthanized and studied. No humans there contracted the virus, despite handling the extremely contagious tissue.
Now infected materials have to be transported by a medical-waste company. That facility at Fort Detrick was the quintessential Biosafety Level 4 (BSL-4) containment lab. But it was shuttered in 2010, a casualty of what Hatfill understands to be imprudent budgetary cuts. The World Health Organization classifies the Ebola virus in the highest-risk category of infectious pathogens, Risk Group 4, denoting that infected people should be handled with BSL-4 precautions. But since its outbreak in the United States, Ebola guidelines from the CDC have treated the virus under the much less stringent BSL-3.
Many of the deadly emerging RNA viruses arise, as Hatfill makes clear in his work, from biodiversity hotspots--regions that house at least 1,500 species of vascular plants and have lost at least 70 percent of their vegetation. These biodiversity hotspots are home to more than half of the world's plant and non-fish animal species, as well as more than a billion of the world's poorest people. The regions also involve more than 90 percent of recent armed conflict. Refugees hunt for meat and build remote encampments, increasing pressure on local resources and interfering with wildlife, drawing people into the line of fire between the viruses and their animal reservoirs. And so it is there that Hatfill believes efforts to manage inevitable future outbreaks must focus.
Hamblin: So you're saying there is at least some evidence that a person could brush up against someone and contract Ebola virus?
Hatfill: People have touched the bed of a patient and caught this, after the patient died and was removed. They brushed up against the bed and caught it. [Ed: Such a bed would need to be grossly contaminated, according to the vast majority of evidence.]
Hamblin: You write that as few as 10 Ebola virus particles could cause human infection, though that number needs more research. Everyone is sticking very hard to the message that unless you've come in contact with the bodily fluid—
Hatfill: Here's the problem. You don't want to panic everyone. And [the CDC leaders] were at a loss that their [preventive] procedures didn't work and this happened and the leadership were shocked. You don't want to panic people, but people aren't stupid. You see people wearing semi-space suits taking these patients into hospitals, and everyone's telling you there's no aerosol transmission.
So we're talking about viral shedding, and the question is, how much virus is being secreted from what sites, what fluids? There are a lot of unknowns. Most particularly, when does viral shedding start?
Hamblin: And what we're hearing most commonly is that it's around when a person develops a fever.
Hatfill: Well, 12.5 percent of patients don't run a fever. In that New England Journal of Medicine study, where they just looked at several thousand of these cases in West Africa, the lead author of the paper is adamant. He says, I sat there, I monitored this patient's temperature myself until they died and they never ran a fever.
Hamblin: Travel-ban opposition is largely based on the claim that it would impede our ability to help stem the epidemic in West Africa.
Hatfill: You know, I went for a Department of Defense interview years ago. They wanted a scientist down at the Pentagon that could invent stuff that would support presidential policy. They just wanted a spokesperson that could kind of come up with a plausible explanation to explain a higher-up directive. And I think this is the same thing.
Hamblin: I'm wondering what is driving—
Hatfill: There are no cases in Kenya.
Hamblin: And they have a travel ban?
Posted by: anon1 2014-10-29