This Is No Time to Remain Calm

According to the Mayo Clinic’s helpful website the symptoms of a panic attack are:

  • Sense of impending doom or danger
  • Fear of loss of control or death
  • Rapid heart rate
  • Sweating
  • Trembling
  • Shortness of breath
  • Hyperventilation
  • Chills
  • Hot flashes
  • Nausea
  • Abdominal cramping
  • Chest pain
  • Headache
  • Dizziness
  • Faintness
  • Tightness in your throat
  • Trouble swallowing

I don’t feel any of those symptoms other than, possibly, nausea but that’s clearly because I listen to the political discourse in the United States too closely. Indeed, when I look around the clearest signs of panic are among Democratic politicians rather than the public at large. It’s just like in the movies. The most panic-stricken guy on the boat is the one who’s rushing around frantically telling everyone else to remain calm.

In this post I’d like to suggest that we not remain calm.

In every crisis over the period of the last century or more the only things that have motivated Americans to action have been strong emotions: pity, fear, most commonly anger. Those are what motivated us to enter World War I, to act during the Great Depression of the 1930s (whether you think we acted prudently is another question entirely), to respond to the Japanese attack on Pearl Harbor, to become the primary healthcare provider in Pakistan for a year following a massive earthquake there, or even to send a man to the moon. Calm motivates us to watch the World Series or check out the antics on The Big Bang Theory.

The reality is that the Ebola epidemic that has struck Guinea, Liberia, and Sierra Leone is beyond those countries’ ability to manage. Not only are they among the poorest countries in the world but they have among the least competent and most corrupt governments, not unrelated things. Since healthcare workers are highly at risk from Ebola the epidemic has depleted their already weak healthcare systems.

The number of deaths from Ebola in those countries is already approaching 5,000. There are projections that within a month or so it will rise into the tens of thousands and if unchecked it could rise into the millions by early next year.

Each new case is accompanied by the possibility that the virus could go airborne, a prospect that would be a disaster of global proportions, or that it could become endemic in that region of Africa or even beyond. Those are things we don’t want to happen.

The time-honored approach to dealing with the disease and the approach that has been successful in Nigeria and Senegal already has been to isolate the active cases and track down and quarantine those most at risk from the disease due to their contacts with people with active cases. That still is not impossible, as Nigeria and Senegal have demonstrated, but it soon may become so and Guinea, Liberia, and Sierra Leone are incapable of managing the problem on their own. I also think that our own greatest safety lies in treating the epidemic successfully in West Africa.

We need to intervene with all due speed and I don’t see calm as motivating us to do that. It’s the last thing we need. A few hundred soldiers erecting tent hospitals, our present commitment, isn’t enough to do the job.

11 comments… add one
  • Piercello

    Dave, have you listened to/seen this video clip yet?

    Michael Osterholm, from the University of Minnesota’s CIDRAP, speaking on Ebola at Johns Hopkins (C-SPAN) on October 14th.

    There is also a text summary at the blog link.

  • Too be fair, mutations to Ebola could also help. Such mutations could make it less deadly, for example.

  • Points (4) and (9) at Piercello’s link have been the points I’ve been trying to make.

    I’ll try to watch the whole presentation later, but the biggest take-away for me was seeing the numbers involved in our current understanding versus the numbers infected now, and that this has traveled through many more generations than any previous outbreak, with no end in sight:

    3) Everything we know about Ebola so far is based on a total of 2400 patients from the past 24 outbreaks over 40 years. the longest set of generations has been 5.
    (For reference, we are at 9000-20000+ patients, and we’re on generation 20-25, this time around).

    That all seems pretty straightforward, but I confess I just hadn’t considered it.

  • That point 3 is a good, succinct way of saying what I’ve been trying to get at for several posts now.

  • steve

    While we could be looking at a different virus, we also know that we are looking at a much different culture. The people routinely handle the dead. They treat disease with shame, reminiscent of AIDS in S. Africa. They distrust government and first world governments. Even if we know how to contain the disease, and the experience in Nigeria and Senegal points that way, it is not clear that we know how to change culture. We have certainly demonstrated that in the ME over and over. Which means that you need to add another possibility to your earlier list. It is possible, that, absent finding a vaccine quickly, that the population of West Africa is depleted at levels not seen since the Black Plague.

    As to your other point, I agree that our response is much too slow. Since this is still seen as, mostly, a problem for Africans I expect that efforts to isolate us will outweigh those aimed at working in Africa. The one exception I expect is more of a push on the vaccine.


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