The Fear and Science of Ebola By Marc Siegel
http://www.nationalreview.com/article/388261/fear-and-science-ebola-marc-siegel
Yes, it must be contained; but no, it’s not likely to mutate harmfully.
We should not be deathly afraid of Ebola.
Dr. Michael Osterholm, director of the Center for Infectious Disease Research and Policy and author of the bestselling book Living Terrors: What America Needs to Know to Survive the Coming Bioterrorist Catastrophe, strongly disagrees. He has been telling us for a long time that we shouldn’t be sleeping at night for fear of one contagion or other, even though loss of sleep is one of the greatest threats to our health of all.
Back in 2006 it was bird flu. I debated Dr. Osterholm on national TV, and he contested my caution by stating that he couldn’t sleep at night from worry over bird flu. I pointed out at the time that just because H5N1 was killing millions of birds didn’t automatically mean that it would mutate to kill millions of humans. Osterholm acted as if my doubting his end-of-the-world scenario was heresy. We took the debate to NPR, where I pointed out that two amoebas, one of them enteromoeba histolytica, the other enteromoeba coli, look almost identical under the microscope, yet the first is a pathogen that gets you very sick, and the other one is completely benign. And one amoeba doesn’t mutate to become the other or take on its characteristics. In other words, imagining what might happen if the most dreaded mutation occurs is not the best kind of science.
Dr. Jeffery Taubenberger, director of the Viral Pathogenesis and Evolution Section at the National Institutes of Health (NIH), told me back in 2006 that he found it extremely difficult to even induce in the laboratory the kind of mutation to the bird-flu virus that would make it pass easily from one human to another. He pointed out at a joint lecture we were giving at the then–Armed Forces Institute of Pathology museum that while we were worrying over the H5N1 bird-flu virus, another flu virus would likely “come in the back door” and cause the next pandemic. This statement proved prophetic in 2009, when H1N1 swine flu began to emerge, though it too ended up causing far more fear than death.
Dr. Osterholm must be counting on the fact that the news media have a very short memory when he discusses Ebola in the New York Times in the same way that he once discussed bird flu. He must know that we have all seen enough catastrophe movies such as Contagion and Outbreak to get our collective heart rate and blood pressure up any time we so much as hear the word “mutation.” But science fiction is not science, and Ebola Zaire, which was first identified in 1976, has been essentially stable since then, with no sign that it is about to become airborne. Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, who is considered by many to be the top expert in the country on emerging infections, told me during two interviews last month that he thought it was extremely unlikely that the Ebola virus would mutate into an airborne pathogen.
The 2012 Canadian Ebola study that Dr. Osterholm points to as evidence of an airborne mutation did not in fact show that the virus could be made to pass from one primate to another. And even if such a mutation could be induced, manipulations that occur in the laboratory are very rarely the same as those that take place in the real world.
Don’t get me wrong. With over 4,000 cases of Ebola now in West Africa and no end to the current outbreak in sight, we certainly need all the public-health resources and money we can get to squash the current outbreak. But fear and hype are not the best way to contain contagions. In fact, fear of the plague in the Middle Ages helped to hasten its spread, as people in panic tried to escape confinement and took fewer precautions in the process. The U.S.’s new military initiative, sending 3,000 troops to West Africa to help control Ebola while adding U.S. Public Health Service personnel and building 17 new facilities to handle 100 patients, is a positive step, provided that it introduces a calm order to things rather than more fear to a chaotic region.
A promising vaccine for Ebola is just starting clinical trials in humans at the NIH. While we wait patiently and calmly for these results, we must help those at risk in West Africa with proven public-health measures, not by injecting more panic.
— Marc Siegel, M.D., is a professor of medicine and medical director of Doctor Radio at NYU Langone Medical Center. He is a member of the Fox News Medical A Team.
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