Ebola: did we learn nothing from AIDS?

Very early in the AIDS catastrophe, I read an article about how new infections spread. This was likely in Nature or Scientific American, and I’m not sure which. The article was not deeply technical, but explained how a new sickness can suddenly be everywhere.

What disgusted me then was, the AIDS epidemic was still tiny and the article was, obviously, ignored by those prophylactic institutions that supposedly guard our health. In simple terms, it was explained how the disease was about to spread. The prediction turned out to be dead on for AIDS. It went something like this:

A new disease arises in some remote locality. Generally it has jumped to humans from local animals. The number of cases is small, and remoteness may keep them unnoticed by the world at large.

Communication (travel) allows some carriers to spread the disease to new centres. Often the sick will be perceived as being in a minority group (gays and needle users, in the AIDS case.) This will allow the general public to be complacent. Meanwhile more carriers bring the disease to more locations, to larger and larger cities with more interpersonal contact.

(( One story has it that the North American ‘patient zero’ was a gay male flight attendant landing in various Canadian and US cities. (I personally believe this, having seen ‘patient zero’ trackback reports. “And who are your friends?” led back to a very small number of individuals.) ))

Suddenly the disease is capturing ‘normal’ people, i.e. not the original minority group(s). With AIDS, when sufficiently present, the normal ‘fooling around’ of heterosexuals was enough to greatly increase the spread of the disease. In some places, prostitution was a major factor.

The point here is that ‘regular society’ abruptly finds itself in an exposed position, as the disease is no longer limited to minorities of one kind or another.

The eventual size of the AIDS epidemic was in fact warned of, but ignored.

Back to Ebola.

Ebola was originally confined to poor African countries. Travel being limited, nobody much noticed. Health workers seemed to be at risk, but that was ‘over there.’ So we did little, with the WHO being harangued by the head of Medecins Sans Frontiers (Doctors Without Borders) for their inaction.

Now Ebola is present in a few North American hospitals. BBC News reported Spain as having “the first Ebola case outside of Africa” – the first Spanish resident, I assume they mean.

I predict we will continue to sit on our duffs until many hospitals are housing Ebola cases. Then it will not be safe to have any serious health problem, because one will be unwilling to go to Emergency.

I predict the disease becoming more communicable as time goes on. We are ‘selecting’ for communicability, eh?

Back to the comparison with AIDS.

While an Indian pharmaceutical company can produce a month’s worth of AIDS cocktails for about $6.00, it sells for about $1300.00 in North America. AIDS is an ideal pharma company disease: you pay, and are glad to be alive to pay, for the rest of your life.

Ebola has had a different twist: pharma companies are rushing relatively untested vaccines and compounds to be tried ‘live’ on Ebola victims. This is an amazing reduction in cost: Phase III trials of drugs are Really Expensive and can take years. The WHO decided, probably with the moral right on their side, to allow experimental drugs to be tried on human subjects. Given the high Ebola death rate, it seems to be by far the lesser of two evils.

So, to repeat the dumb question: did we learn nothing from AIDS? Will Ebola spread more rapidly than our response can contain it? Will there be expensive cocktails to control it? Will those with funds gladly pay?

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