The Response to the Epidemic

In the middle of a New York Times article on the worldwide response to the Ebola epidemic in West Africa, I found this passage:

“We considered the only organizations in the world that might have the means to fill the gap immediately might be military units with some level of biological warfare expertise,” Christopher Stokes, general director of M.S.F., is quoted as saying in the report. Dr. Joanne Liu, the group’s international president, added, “U.S. helicopters would not even transport laboratory samples or healthy personnel returning from treating patients.”

Jeremy Konyndyk, director of the Office of Foreign Disaster Assistance at the United States Agency for International Development, said in an interview that those criticisms reflected a misunderstanding of the American military’s capabilities.

“There was a perception among M.S.F. and more broadly that surely somewhere in the Pentagon there must be some rapid biohazard response team that could go and do this,” Mr. Konyndyk said. “That just wasn’t the case.”

Let’s decompress that a bit.

  1. Foreign health authorities assumed that the U. S. had a biohazard rapid response team.
  2. We don’t have a biohazard rapid response team.
  3. There was a certain level of resentment at what we were able to do.

and this despite the fact that the value of the U. S. contribution to fighting the epidemic dwarfed that of any other country.

That brings up all sorts of interesting considerations. For example, we don’t have a biohazard rapid response team. Should we? Such things are very expensive. How much should we be willing to pay for something that may never be used or may only be used once every couple of decades? How much should the rest of the world expect us to pay for it and why? Whatever your answer how is that consistent with how much you’re willing to spend on defense?

Should other countries be more aware of what capabilities we do or do not have? Answer carefully. You’ll be telling your enemies as well as your friends.

Also, note that resentment was baked into the reactions quoted above. Rather than being grateful for the aid we provided I interpret Dr. Liu’s rejoinder as resentment at the level of capability we were able to provide.

Just as a reminder the epidemic is not over. Based on the World Health Organization’s most recent weekly reports there have been about 150 new Ebola cases in the three subject countries in each of the last two weeks. That’s down from the 300 new cases per week they had been reporting for months which provides at least some hope that the epidemic may actually end. But it isn’t over yet. Not nearly.

21 comments… add one
  • mike shupp Link

    Uh, we have a fleet of nuclear-armed submarines. They’re expensive, and we don’t use them all that often. So it follows ….

    I think we probably could afford the bill for a middling sizable biological hazard response unit, as a form of insurance. Whether it should be a military unit or a branch of the Public Health Service I’ll leave open (my gut preference is for the PHS, but I can see arguments for a military unit).

  • PD Shaw Link

    Is part of the riddle that the U.S. has _domestic_ biohazard response teams? I assumed they did. For example, I know that after 9/11, the feds increased funding for emergency response to things like chemical spills on railroads, hijacking trucks containing low-level (medical) nuclear waste , . . . IOW, the civilian emergency management teams at the state and local level, in some situations coordinated by FEMA.

  • steve Link

    The article notes that they were not disappointed in just the US, but they were surprised that no one has a good biodefense team. We have made great improvements in preparing for smallpox, and we do have the ability to handle these diseases in the US. We just don’t have anything deployable.

    Steve

  • Ben Wolf Link

    Dave, I’m sorry for going off-topic but need some advice and can’t think of a better person to ask.

    I’ve got a 4 1/2 year old mastador and a 10 week old puppy I just adopted from a local rescue (came from a hoarding situation and needed a home immediately.) The elder is really out of sorts since the puppy came home. Wants nothing to do with it (which I understand) but lets the puppy take his food, his toys and chase him off even though I can see he doesn’t like it. I’m wondering if Atka has for so long been at the “bottom” of our own little pack he thinks the puppy has a right to push him around. I have made a point of giving Atka the best/first/most of everything while correcting the puppy whenever it gets pushy with him, but so far Atka isn’t behaving confidently as he does everywhere else

  • I’ll talk it over with my wife whom I’m sure will hash it over with the folks she trains with. We’ll come up with something.

    It may be too early to worry about it. There’s something referred to as “puppy license”. Adult dogs sometimes let puppies get away with murder. For a while.

  • Ben Wolf Link

    On topic, I don’t understand why the U.S. no longer maintains a civilian capability for international disaster relief.. Relying on our military for everything sends the wrong signal, nor is its training and mindset suited toward problems like dealing with outbreaks.

  • PD Shaw Link

    @steve, “We just don’t have anything deployable.” The word I was thinking of was “conscription.”

    @Ben, we had a civilian international biohazard response team at one time?

  • That was the question I was going to ask, Ben. Did we ever have such a civilian capability?

    Historically, the U. S. has found it easier to justify all sorts of programs as necessary for defense. That pertains to things from building highways to student loans.

  • steve Link

    ” The word I was thinking of was “conscription.””

    ??? The military is all volunteer. Why would we need conscription? Anyway, I know, as well as it is possible to know, that we did not have deployable units for Biodefense during the Gulf War. I was deployed. I was part of that defense, but we certainly didn’t have organized units or special gear. We would have dropped like flies. I honestly don’t know if we don’t have such a thing now. Individuals within the military have been calling for these, but I think the prevailing thought has been that it is a low probability event, so it has not been prepared for. Just hired a new guy coming out who spent a year in Afghanistan. Will ask him.

    Steve

  • but I think the prevailing thought has been that it is a low probability event, so it has not been prepared for

    That’s what I would assume.

  • PD Shaw Link

    @steve, I’m just drawing the obvious conclusion from the domestic presence of emergency response/ public health resources that are not deployable. We would have to conscript them.

    I’m not arguing for it. I don’t think it would be politically tenable, maybe not Constitutional unless you accept the argument that epidemics are as much a threat to the U.S. as conventional or unconventional military threats.

    Another example of domestic capabilities are the cops that bust meth houses. These are toxic dumps and require HAZMAT training and equipment to secure the evidence and premises. This could be a relevant resource in certain situations.

  • Andy Link

    Traveling this week with only an iPhone, so comment will be brief.

    What is a “biohazard rapid response team” exactly? Domestically, we rely on local state and federal capabilities, but these are not dedicated to biohazard or biodefense and they aren’t deployable. We do have various detection programs as well as a large research effort which is, iirc, mostly federal and includes the military.

    Imo the military doesn’t need a “biohazard rapid response team” assuming that means the capability to respond to something like Ebola. That might be nice to have somewhere, but it’s not a military function. The DoD cares about this stuff in relation to the defense of military forces and most of that is focused on detection and prevention for troops.

  • CStanley Link

    I’m interested in the response to Ben’s question about dog behavior, because as a vet I have some rudimentary behavior training but often find it lacking- and the specialists in the veterinary behavior field generally focus on remediation of abnormal behaviors rather than normal pack behavior. I have some thoughts on it but would like to know if it jives with what is recommended by the real experts….basically I’m agreeing with Dave but further wondering if doing less is more in this situation. My thinking is that it will take time for the puppy’s temperament to show and in any case the older dog has to assert himself rather than having the human pack member do it for him. He might have to reach some level of frustration before he does that (so the well meaning attempts to help him might prolong the adjustment period and undermine the natural sorting of the social hierarchy.)

  • Ben Wolf Link

    Not biohazard specifically, but we used to put civilian agencies on the front lines of disaster relief; The Commision for Relief, Marshall Plan via the State Department, U S. AID. I understand the military has an established logistical network but there’s no reason civilians on the ground can’t draw from it, is there?

  • Ben Wolf Link

    CStanley,

    I’ve been working under the assumption I am responsible for teaching the puppy proper protocol toward Atka, as I am in teaching behavior toward myself, others, household furniture, etc. If I’m running the show I’m not sure Atka should have to work it out for himself or if I establish everyone’s rules.

    Atka is universally praised for his confidence and civilized behavior; I worry that perhaps I broke something with my training methods, some ability to push back against an irritating puppy in our own home.

  • My wife’s and my consensus opinion is that a) it’s too early to tell–could be puppy license; b) it may be that the puppy will be alpha–too early to tell; c) dogs usually work these things out and less from the humans in the pack is more; d) get local help. However, I also asked her to confer with her cohorts on this. I think she’s going to an obedience class on Thursday. I’ll report back.

    However, I’ll take this opportunity to recommend an excellent book: Suzanne Clothier’s Bones Would Rain from the Sky for insights into pack dynamics (and dog training more generally).

  • Cstanley Link

    @Ben: to add more nuance to my comments, I didn’t mean that I thought you should do the opposite, just perhaps back off a bit. I agree that you need to set rules and teach the puppy boundaries.

    Thanks for the book recommendation, Dave. I intend to check it out.

  • Ben Wolf Link

    Dave, Thanks for your efforts, I’ll order the book from my local store today.

    CStanley,

    I didn’t think you meant I should do the opposite, just laying out my thinking on the subject so far. I may be getting emotional about the problem as Atka and I are very close and I can see he isn’t happy which bothers me. Also I tend to blame myself for everything.

  • CStanley Link

    It sounds like your temperament may be similar to mine so I definitely understand, Ben. It’s clear that you have a strong emotional attachment to Atka and I’m sure you will do well by him.

  • Ben Wolf Link

    CStanley,

    In my experience people reflexively hard on themselves are very consciencious, so you’re probably a good vet. Plus dog people are psychologically superior to non-dog people, moving you into the vet elite.

    I got Atka to play with the puppy for a few minutes. Atka likes to grab a toy and be chased around our home by me. The puppy tried to join in and I gave Atka the “kill” command which resulted in a bit of chase and wrestling. It’s a joke command fyi.

  • CStanley Link

    That sounds like a good start. When I was a kid we had an old dog who was lame and then got a puppy. The elder dog was very unhappy about the situation and spent a few weeks curling himself up in a tight ball on the sofa, keeping tail and feet tucked up so that the puppy couldn’t nip at them. One day his guard was down and she did nip and he jumped down and growled and snapped at her- which she interpreted as play and then he started to tussle with her. From then on they got along well and he was somewhat rejuvenated by the physical and social interaction.

    As for being a good vet, I certainly try although my career has taken the back burner due to family needs. I feel privileged to be part of the field of veterinary medicine because most are really fine people- I guess it’s the nature of the profession coupled with a rigorous selection process.

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