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It’s been one year since the Ebola epidemic outbreak in the Democratic Republic of Congo. So far, more than 2,400 cases have been detected and over 1,700 people have died from Ebola. Richard Preston’s new book “Crisis in the Red Zone” chronicles the epidemic and the challenges in containing it. He joins Hari Sreenivasan to discuss.
This week marked the one-year anniversary of the ongoing Ebola outbreak in the Congo. So far, more than 2,600 cases have been reported and 1,700 deaths. I recently sat down with Richard Preston. His latest book "Crisis in the Red Zone" reports on the Ebola epidemic and how our interconnected world is making it difficult to contain.
Well it's really because of Mother Nature. Ebola is a kind of warning shot across our bow. It's an example of what are known as emerging viruses, which are viruses that are essentially leaking out of the troubled ecosystems of the planet and getting into humans. We don't have any immunity to these emerging viruses, so they can be extremely deadly, highly infectious. And we really don't have good medical defenses against them.
Where do they start from?
Well they start from animals, wild animals typically. Now a virus is a tiny parasite that needs to have a host. It can only make copies of itself inside the cells of some host. And one of the biggest potential hosts on the planet right now is the human species. There are seven and a half billion of us. And increasingly in history, humans are gathering into these gigantic urban megalopolises, super cities. To give you an example, New York Super City where we are is about 20 million people. Now that's about the population of Florida. So if you take everybody in Florida and you cram them into one city and everybody is breathing one another's air and touching one another. And if an emerging virus from a rainforest organism gets into a human population like that and there is no immunity to the thing and it's extremely infectious and has a high mortality rate, then what you're going to see is an immense challenge to the medical system and to everything.
The good news about Ebola is that there seems to be a vaccine that is working and is pretty effective. Why can't we get that vaccine to all of these places that are having these outbreaks?
Well you know it's crazy. So there is this big outbreak of Ebola going on in eastern Congo right now. And 160,000 or more vaccinations have been made. People are getting the vaccine, but the virus continues to spread. And the doctors and medical workers can't trace the cases. A lot of the cases that are coming up are brand new. Ebola has been in the human population of eastern Congo now for more than a year. And I think there is a question. So the vaccination strategy just isn't working even though it's a great vaccine. But Ebola is seemingly more and more rooted in the human population. And I think there is a question as to whether Ebola could change and eventually become established as a permanent human disease.
Well that's startling. What what are the sort of cultural impediments now to trying to treat Ebola? I mean whether it's civil wars or whether it's social media, what are the challenges that we're facing in trying to get a population armed with the information to be able to say, here's what you should do, here's what you should look for, here's where you should go?
Let's talk about the American population. Let's talk about New York City. Because the problem of education is just as deep here in New York as it is anywhere else on the planet. So I did a little survey and I found out that in the New York City hospitals there are a total of eight so-called red zone beds for patients who are infected with a highly infectious lethal virus for which there is no cure and no vaccine. Only eight beds. And there are not enough trained hospital personnel to handle more than about eight patients.
When there was one patient with Ebola at Bellevue Hospital in New York City, there was a huge team that treated the individual. They spent millions of dollars saving that patient's life. Now what if an emerging virus — I'm not necessarily talking about Ebola but something Ebola-like, and there are many other kinds of viruses that are out there lurking in nature that are making these so-called cross-species jumps. They're coming out of ecosystems and getting into humanity. So what if we had a thousand patients in New York City with a really hot virus? What if we had 10,000 patients? What you would see in a city like New York in the developed world is exactly what happened in cities in West Africa when Ebola got into them. You would see medical personnel risking their lives and sacrificing their lives. A thin line of defense. The medical people, the doctors, the nurses would really be dying. They would be going into horrific conditions to try to save patients just as was done in Africa. And then you can just imagine the possibilities that they're — in a way they're sort of hard to imagine, but you would have people trying to leave the city in large numbers. You would have people fleeing from hospitals as happened in Africa. Nobody would want to go to the hospitals because they would be hot. And so people would be dying in apartments and the way it works in New York City is that the Fire Department has special HASTAC teams that are trained to go in and bring out a bio-hazardous patient or a bio-hazardous corpse and deliver it properly.
What about the miseducation, the rumors, the conspiracies that kind of impede that education for the rest of us, the consumer class? And we're seeing these challenges on much more basic vaccinations towards children's. But when you add that layer of fear that, oh my gosh, this is a deadly virus, it's affecting adults of all types and shapes and sizes. It could be worse.
Yes it is. And unfortunately social media has played I think a very damaging role in these situations. Just to give you an example, in the Congo outbreak of Ebola, which is going on now, people there are very well-educated people, they have access to the Internet, they read Le Monde the media from Paris, and they use a lot of social media and a lot of rumors go around on social media that are not correct about how you can protect yourself against Ebola or you know paranoid rumors about the doctors that are treating Ebola. And I fear or suspect that the same thing would be going on in the United States if a Biosafety Level 4 hot virus got going in the population.
The frontline physicians and aid workers that are in the field, oftentimes especially in areas like Africa, the narrative is that the Americans or the Europeans come in and they're saving all the Africans. But really in your books what you're showing also is that it's African doctors that are doing the hard horrible work, right?
Absolutely. You know there's this cliche that you know the people from the developed world, the white people, come into Africa and they save hapless Africans. But "Crisis in the Red Zone" is about something different. I take a magnifying glass and I put it on a small forgotten hospital in Africa that was devastated by Ebola. And in that hospital you had American doctors and medical people scientists and African scientists doctors and medical people fighting this dreadful virus in the hospital, which killed a lot of the staff. They were putting their lives on the line, often sacrificing their lives going into situations where they knew they were probably going to die in an effort to save a patient's life.
Is there a lesson we can learn from what happens, I mean, some of the ethical dilemmas and challenges if you've got a vaccine? Do you save a doctor? Do you save a patient?
In the face of a crisis, the medical people at this little hospital faced terrible ethical choices, choices that no doctor should ever have to make. Choices in which you know the Hippocratic Oath says, "First do no harm." But these were choices where the doctors no matter what they did there were going to cause harm. And it was a life or death crisis.
Richard Preston is the author of the book is called "Crisis in the Red Zone." Thanks so much for joining us.
Great to be with you.
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