Sunday, August 3, 2014

Biological Problems: What You're Looking At, vs. What You Should Be

This is most particularly in light of the current Ebola epidemic, but applies more or less generally.

First, let's get the stupid shit out of the way, specifically:

"ZOMG, they're importing infected Ebola victims to the US! Run for the hills!"

If that's your take, to any degree whatsoever, this is addressed to you:

Shut the fuck up, you ignorant hysterical jackasses.

At this point, the two known infected American healthcare workers are being returned to the US to Emory University Hospital's Infectious Disease unit.

Why?

I suspect it's:

1) Because I have more leftover health care and medical supplies laying around in just my storage unit than all that there probably is in all of Sierra Leone.
2) Because the local community hospital in Hootin Holler, Appalachia is more advanced than any ten hospitals within two tanks of gas in a Prius from the locus of this outbreak, let alone what's available at a Tier One first-world teaching and research hospital a short trip up the road from the CDC - like Emory.
3) Because one of the Americans was injected with the sole existing dose of way-pre-pre-pre-experimental Ebola vaccine, while the other one was transfused with blood from a previous Ebola survivor, and thus either or both may generate successful antibodies.
4) Because they're going to be in isolation that makes The Andromeda Strain precautions look quaint, as opposed to them being dropped onto the salad bar at the local TGIFridays, or seated on the mid-level at Yankee Stadium to drool blood and cough their internal organs onto passersby during a double-header.

This is as close to zero risk as is humanly possible, with an upside that something worthwhile may come from the research. Not to mention decreasing the load on medical resources over there, where they don't need it, and bringing them here, where if you hadn't read about it in the papers, you wouldn't even know it was going on in the first place.

It's also a non-shitty thing to do, considering the family may at least get to see them, through 4 layers of glass and vacuum seals, and talk to them, before they lapse into a coma, die in agony, and then get flash incinerated at 1500 degrees for a funeral.
And for the same reason we don't just shrug and say, "Oh, tough $#!^, they're dead..." when somebody gets killed any other way, and why we've sent recovery teams to scrape a few bones and some rags out of mildewing rusted debris that went down in Laos 50 years ago, and any other ends of the earth. Because we're not callous selfish bastards, and neither is the aid agency that these two worked for.

Nobody's asking any of us to take them home and care for them in the spare bedroom, or even chip in for their plane ticket. This is not a problem.

And bringing them home is the right thing to do.



The real problem is the non-symptomatic guy who was exposed, skipped out early, transferred in some European hub to an American air carrier, got off in Atlanta or Miami or Philly or Chicago, with no screening or quarantine, and is shivering and crapping his guts out in some flophouse right now, where in a week or two, he'll be found, after infecting god-knows-who-or-how-many family, friends, and random contacts going to the WalMart and gas station to get aspirin and tissues.

You wanna freak, freak about that.
And hey, how likely is THAT scenario, really?!?

Contagion was a so-so movie, but when it plays as a documentary, it should scare the $#!^ out of people.

Philadelphia, for one example, has a population of 10,000 Liberian-origin persons, including US citizens, legal residents, and illegals. Any one of whom could be the real Patient Zero for a US Ebola outbreak, rather than hissy fits over the two relief workers being treated at Emory Hospital.

That there aren't currently screening measures for all international travelers, quarantine for any recent visitors to the affected region, and a total embargo on all flights from Sierra Leone, Guinea, Liberia, and any contiguous countries (except for returning mercy flights each undergoing specific decon measures), right this effing minute, is a scandal presaging a tragedy leading to a catastrophe. It's playing Russian roulette with the entire country.

And for the people wearing both tinfoil hats on too tight, there's no secret reserve of Ebola vaccine, except in mediocre sci-fi movies. No matter what you read on WhackjobConspiracyTheorist.com. They don't keep the mythical vaccine just down the hall from where GM is sitting on a 400MPG carburetor, and where GE has secret perpetual motion Tesla coils sitting for when oil runs out. Or next to the room with the secret AIDS vaccine, all stored with loving care in the Secret Mountain Cave Of The Underpants Gnome. (Probably the same place they're hiding our flying cars, laser guns, and jetpacks too. Fuckers!) It simply doesn't exist.

If there were an actual vaccine for Ebola, the developed countries of the world would pay for it to be given away free to every swinging Richard from Casablanca to Capetown, just to be free of having to deal with it ever again. Airlines and hoteliers would simply slap a $20 or $50 or whatever surcharge for everyone coming and going to Africa, and countries would add it to their visa fees, and that would be that. Maybe someone will recall what we as a species did about smallpox?

But getting a vaccine of any type through Stages II, III, and IV testing takes
years. So far, they have one vaccine that's a candidate to begin Stage II, and the Stage I testing only confirms that it doesn't kill people outright, not whether it actually works. So we may never get an effective vaccine. The cost at that point is minimal, since the US .gov could spring for the $1B out of petty cash, given that they blow through that amount every 2.5 hours, 24/7/forever.

Oh, and the total number of viruses that we can cure after an infection manifests fulsomely, to date, since the dawn of time: 0.


I'm here to tell you, if and when the epidemic gets here in force, I won't be going to work. Not because the protective measures don't work - they do - except when they're not followed scrupulously, like anywhere in West Africa, which is why the healthcare workers there are regularly infected and die. And like they won't be followed here when things go to hell because of an influx of hundreds to thousands of people, which no hospital in Creation has stocked enough basic everyday supplies to handle, nor practiced to any degree to cope with properly and sensibly. (Ask me how I know that.)

Two people in a Level Four biohazard isolation unit is an easy day's work for a few people.

Two hundred people with fever and diarrhea in any ER I've ever worked in, where the price of any lapse, however minor, in standard precautions and infection control is a slow, agonizing death, is a recipe for killing the only people who can help.

Homie don't play that.

And it's far too late to clock out when people start staggering in bleeding from the eyeballs, shitting blood, and quite literally puking up their internal organs, or dropping in the streets. Like is happening now in West Africa.

An outbreak here that becomes a pandemic isn't going to be solved by everyone wearing Tyvek suits, N100 masks and enclosed goggles. (Those are all good to have anyways, but stupid to use unless absolute necessity forces your hand, and even then as a strictly one-time deal - like on a bug-out - not a daily gear-up.)

It's going to be solved by keeping your ass home, living on your canned goods and cash reserves for anywhere from a few weeks to a few months, and waiting it out until the stupid people either die off or learn that basic lesson. If you can do it away from crowds in a relatively rural environment, so much the better.

Ebola isn't going to blow in your chimney and ass-rape you, or drift up the driveway on the evening breeze to kill you in your sleep; there's no need to seal your house in plastic sheeting or get into MOPP IV to water the lawn.

But the mail is going into a trash bin (until they stop delivering it at all), the front gate is getting locked, the "No Trespassing" and "UNWelcome mat" are going out, and anyone coming over the fence is going to die where they lay when I drop them, and if I'm feeling moderately charitable, they'll get a Viking funeral with a couple gallons of regular unleaded, and a few words of benediction ending with "Flame on!".

If you're not geared up for that, you're not ready, and you're worrying about the wrong things.


 


1 comment:

Pakkinpoppa said...

Wish I had a fence. I was thinking a line of red paint, like in "Support Your Local Sheriff". The Unwelcome Mat is another acquisition I need to make.

I like your Viking Funeral idea, though.