Friday, December 4, 2020

Five Things I Learned About Ebola from "Ebola" by Laurie Garrett

five things to learn from ebola story of an outbreak


Why read a book about the Ebola virus in this our most awful year that is 2020? *deep shoulder shrug* honestly, I really don't know what I was thinking, *but* this book caught my interest and I'm glad I read it! I learned a lot and gained some perspective and insight into viruses and outbreaks. Perhaps reading a book about a far deadlier and more contagious virus than COVID was sort of refreshing and perspective-shifting? And also, reading about the cleanliness and supply issues faced in Africa during their Ebola epidemics was a much needed dose of gratitude for me, as well. Keep reading this post to learn five things you might not know about Ebola!

Ebola 

by Laurie Garrett

Where does Ebola originate? How does it spread? And what should governments do to stop it? Few people understand the answers to these questions better than Pulitzer Prize-winning journalist Laurie Garrett.

In this masterful account of the 1995 Ebola outbreak in Zaire, Garrett, now the Senior Fellow for Global Health at the Council on Foreign Relations, shows how superstition and fear, compounded by a lack of resources, education, and clearheaded government planning have plagued our response to Ebola. In an extensive new introduction, Garrett forcefully argues that learning from past outbreaks is the key to solving the Ebola crisis of 2014. ( from Amazon.com)

 

Modern medicine, or attempts at it, initially hurt Ebola prevention and containment...

 "In the villages, where the only medical care available were the ministrations of friends and relatives, Ebola failed to pass beyond its initial chain of infections. But in Kikwit, where public health was in shambles, but medical clinics abounded, the virus would find grand opportunity."

I was surprised by this idea explored in the book! Typically in America, the best cutting edge healthcare is available in larger cities and is seen as the best option when facing a serious illness. We look to these large established hospitals for guidance in the medical community. However, in Africa, researchers found that the smaller communities without access to public health had a much easier time containing the virus. Despite the fact that part of the grieving process is washing the bodies, which led to a large amount of contagion spread, the families in small villages were separated enough that it did not spread quickly. However, in the larger cities, such as in Kikwit, with a population of 400,000 in 1995, hospitals were the primary location for catching the Ebola virus. These chapters of the book were so difficult to read as incredibly brave, and often unpaid, health care workers did the very best with what they had available, and yet, in the end, were actually only helping to spread the virus further.


You just can't make this stuff up...

"Things began to go wrong as soon as Nkuku made his incision, for Kimfumu's distension was full of blood, which spewed all over the unprotected surgical team. As they tried frantically to comprehend what was happening and save their colleague, the team members became drenched by Kimfumu's blood."

When coronavirus first hit, my husband and I watched the movies "Outbreak" and "Contagion". They felt silly and light compared to the news we were watching, but they also depicted far more contagious and deadly - and also imaginary - viruses. But even with boundless imagination, *nothing* in those movies conveyed the horror of the initial Ebola outbreak depicted in Garrett's book. The reality of true helplessness, and confusion, was unlike anything I've seen in a "virus apocalypse" type of film. Before reading this book I didn't realize that the Ebola outbreak in 1995 was initially a mystery to those affected. And their unfolding realization that they were dealing with a deadly and highly contagious virus, that also caused a horrific death, was truly unsettling.


Things weren't perfect here either...

"So serious was the decay that air ducts meant to draw biological hazards away from lab benches and into safety filters actually did the reverse: they blew microbes right into scientist's faces. On at least three occasions in the last eighteen months, scientists had, as a result, caught the very diseases they were studying."

Reading about the failing public health systems in Africa certainly puts many things in perspective. I feel incredibly lucky to live in a country with a world renowned healthcare system. In fact, the head of WHO at the time was quoted as saying, "The CDC is the only ball game in town", acknowledging that the CDC was the only one with the resources to assist in testing. Despite this, I was surprised to learn just how poorly funded this vital department was, and in fact, on three occasions scientists had been infected by the diseases that they were studying because of faulty ventilation systems! If that doesn't sound like the plot outline for beginning of a viral apocalypse...


Ebola is highly contagious and lives for extraordinarily long periods of time on surfaces

"More than a month after he'd collected them, and left them sitting on a desktop at 90 degrees Fahrenheit, Swanepoel harvested living Ebola viruses off the needles."

While this wasn't shocking information, I knew Ebola was contagious - I had no frame of reference for just how contagious. Less of "Ebola" than I expected was about the virus itself. Mostly it is the story of how the Ebola outbreak of 1995 occurred and how the government, citizens, and healthcare system struggled to deal with the outbreak. But there are anecdotal glimpses in the book at just how contagious the virus is and they are startling. Such as when a patient caught the Ebola virus after being put on a gurney that another patient died of Ebola upon 15 days prior. Or in the quote above, when the virus survived an entire month on a surface! The book was refreshing in that it was a quick read that didn't delve too deeply into the science behind the epidemic and spent more time on the human efforts to combat it.


Creating long lasting change is an incredibly complex problem 

"All of these beliefs, coupled with the poverty of the healthcare system, conspired to create a profound level of post epidemic denial. The people returned to practices that spread Ebola in 1995, including cleansing bodies of dead family members and thus exposing themselves to infected fluids. At the hospitals all the infection control practices followed during the epidemic were swiftly abandoned."

One *huge* takeaway for me from this book was just how complexly layered the problems that lead to the Ebola outbreak were to solve and how quickly they were unsolved once the outbreak ended. At the start of the book, I just kept wanting a team of people to jump in and solve the problem. Like a movie scene where a top team of researchers gets "the call". First, the CDC stepped in, which was great, but with that came a whole other host of issues. So then Doctors Without Borders stepped in, also a huge boon, but it was like a gopher game where at each turn a new problem popped up that requires an additional agencies worth of assistance. Unfortunately it became clearer as I read that none of the problems could be solved with just some additional manpower or funding. There were cultural and religious beliefs that created a perfect environment for spread, and also disappointingly led to the abandonment of infection control after the epidemic ended.


"Ebola" by Laurie Garrett was a quick and informative read! Click the link below to learn more about the book. And as always, thanks for reading, readers!


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