With Common Sense: Dan Carlin on Ebola

So I’m a really big fan of Dan Carlin’s podcast “Common Sense.” He provides intellectual and critical assessments of current events, which I find very intriguing and informative. He discusses topics that I often know nothing about, but presents information in a real way in which I don’t feel lost or manipulated.

I was a bit late on listening to this one, episode 283. I am not sure how to provide a direct link, but for now, here’s the website, which you can scroll down to find the player for Summoning the Demon. I normally have the episodes downloaded to my phone using iTunes. I urge you to have a listen, as I absolutely love his proposal for Ebola relief worker recruitment.

In the meantime, I’ll summarize what he says. And as a note, Carlin speaks from the perspective of an American citizen, yet I still use “we” when I write, as I feel that I can generalize about the responsibilities and actions of both Canadians and Americans in the same way in the response to the epidemic.

As a lead up to his argument, he offers a similar sentiment recently expressed by New York Governor, Andrew Cuomo:

“Let’s put these people on the payroll and pay them like military reservists.”

Carlin suggests that it’s not just the time abroad that people are concerned about. It’s also the 21-day incubation period. And fair enough, there’s a lot of hype, and a lot of fear building around this idea. It just adds to the panic surrounding Ebola. So, he says, we need to treat it as an over-the-top safety precaution, and add a healthy financial incentive to convince people to sign up, including this period of incubation.

“We just have to pay them enough… Everybody’s got a price point.”

Carlin says there are two reasons for this: “One, you’re trying to get those people to put up with nicely and quietly with their quarantine period, and at the same time you’re trying to add a motivational tool.”

He compares the way we’re handing the Ebola crisis to the way that we would handle terrorism. He discusses how the US government is concerned over Ebola relief spending; that it might reach US $1 billion. But, he points out that “if this were terrorism, they would have 30 billion dollars there the next day, and we’re sweating a billion?” Thus, he suggests that we start treating these threats the same.

“If you’re trying to set a standard that encourages more people to go out and do this kind of thing, why won’t you just pay the people the way that we would be doling out cash if this were Haliburton* solving the problem for us.”

*Haliburton is the private company in the US “responsible for creating the entire infrastructure of a US military operations overseas” (Naomi Klein, Shock Doctrine, 2007). 

Carlin reminds us of different industries (financial, automotive, etc.) in the US that have received government bailouts in the past, and suggests that we approach the issue of Ebola in the same way. He calls is the “Ebola Middle-Class Stimulus Act of 2014.”

His proposal goes like this: take a middle-class healthcare worker, and offer them an incentive to work overseas with the Ebola epidemic. Give them a completion bonus and something like $10,000/day during the incubation period. This will “give them an inheritance… a new house.” And that’s surely a motivational prospect, especially when he reminds us that we’re not looking for specialized critical care nurses, just regular healthcare workers. Ones that can run IVs and feed patients.

Carlin then goes into some arguments that I suspect of being a little unfounded. He suggests that US taxdollars would be well spent, as sort of an “Anti-Ebola Insurance”. He offers that investments in infrastructure building in the regions currently affected by Ebola would serve the world, by containing the spread in the future. My problem with this, however, lies in the assumption that this region will be affected again, or will be the only region in the future, as this was the first instance of an Ebola outbreak in West Africa in history. He claims that it occurs “nearly every year”, which in itself is false (especially when we remove laboratory/chimpanzee-based cases from consideration), and completely neglects that it’s only ever been found previously more than 3000km away. So I contest the idea that any amount of funding for infrastructure building will be able to eradicate the disease, but I do however, completely agree with his ideas on incentivising the relief effort.

So have a listen, as his presentation is much more convincing than mine!

Status

On the web: MSF Ebola webinar

Happening now! Looks to be pretty interesting and might help to answer some questions you might have. Join in. 

http://www.msf.ca/en/live-webcast-stopping-ebola-msf%E2%80%99s-experience-front-lines-historic-epidemic

 

Update: Some great insights into the effort to control this outbreak, but still a distinct lack of calls to action, metrics, strategies, etc., as mentioned in my previous post. At least the World Bank has identified a need for 5000 new workers in the fight. Also learned that the MSF has been training the Red Cross, Save the Children, and the Centre for Disease Control out of their mock treatment facility in Brussels, on how to deal with the outbreak and build their own training and treatment centres.

Also had a heartwarming story of Patrick, who survived the Ebola virus. Read it here.

From the comfort of home: still thinking of Ebola

As someone who regularly picks up a cause and runs with it, not only do I relate to, but I also really admire those who have something they stand for, day in and day out. Regardless of their opposition. Who shout from the rooftops incessantly, shining light onto whatever it is that they are riled up about.

So shine on, my friends, because there are so many distractions in our world, and so many ways for us in the West to avoid these dark corners. So some of us need some flashlights. Shine on. Thus, regardless of the fact that I am no longer in the region, I will continue to keep my personal spotlight on the subject of Ebola. I guess, having been there, I have a good grasp of the scenario in my mind’s eye, which makes it easier for me to feel compelled by the images, and the descriptions; to bring myself to the ground, and comprehend the disaster. The social and cultural components which are perpetuating the disease; the merciless environment which takes a toll on even the most able-bodied of us. I can picture it, and yet, I’m still sure that my idea is still not even close to reaching the actual level of desperation in the affected areas.

So perhaps I have a bit better of an understanding of the problem that most of my friends, but it’s actually not that complex, so I cannot understand how with such a relatively simple problem, there is such little action.

This is not a civil war. This is not a complicated, religious/tribal/ethnic, heavily-skewed-in-the-media kind of problem. It does not stem back several decades. There is no unrest; no clashing forces. This is not an incomprehensible kind of problem; the kind we normally avoid with ease, due to too many factors obstructing our ability to understand.

This is the kind of problem that, in the West, gets immediate and exaggerated attention. There are protocols, education campaigns, and safety precautions (think: SARS, or the ongoing debate about vaccinations in Canada). On an international level.

But above all, this problem, if it were in the West, would receive funding. Funding and manpower.

No one is asking where the rest of the response is. They don’t question why, after five months of talk, and more than 1,500 known deaths, the epidemic is still raging. They don’t ask, “Where is the money donors are pledging? Where are the boots on the ground?” – Ebola: “Fighting a Forest Fire With Spray Bottles”, MSF 09/02/14

But instead, they are receiving the attention of a handful of actors, who are struggling under the weight of this epidemic; working tirelessly to get it under control, but repeating the fact that they cannot do enough. There needs to be more.

I took Tewa’s aunt home when she recovered—one of the rare happy days—and saw her mother. I looked for Tewa’s face among the sea of excited children even though I knew she wasn’t there. “How is she?” her mother asked me. “Yesterday she was able to shower,” I told her. But the next day when I asked about Tewa, the doctor in charge of her care shook his head. “It’s not good. She started bleeding,” he told me, “and she has that look.” I knew the look. I’ve seen it too many times over the past five months. “Ok,” I said, biting my lip and willing my eyes to not fill with tears. “I’m sorry,” he told me.

We’re all sorry.

We’re sorry that we don’t have a medicine proven safe and effective to kill the Ebola virus. We’re sorry that we don’t have a vaccine. We’re sorry that we’ve failed to stop the epidemic. We know we should be doing more but we don’t have the resources, we don’t have the capacity, we don’t have the staff. Some days it feels like it doesn’t matter how hard we work because there aren’t enough of us.

I mean, come on. We’re flying home 3 Canadians because someone in their hotel became infected, and we recently flew home two Americans who contracted the disease. Now that’s totally fine, and I wish them all the best of health and recoveries, but if we can do this, why can’t we do more to save the lives of those who cannot leave?

It’s as if the world wants to bury its head in the sand and hope that it all goes away. I made it in and out of three airports after leaving Morocco, and not a single person stopped to ask me anything about it! I had to spoon-feed the information to the one person that got even close, but as much of an annoyance it would have been, I was really hoping for a little quarantine. At least take my goddamn temperature!

“This is not an African disease. This is a virus that is a threat to all humanity,” Gayle Smith, special assistant to US President Barack Obama and senior director at the National Security Council, told reporters. – “Ebola death toll accelerates in West Africa“, Aljazeera 09/03/14

At least I have the luxury of returning to a place where I can receive adequate medical attention; at least pretend it’s on the radar. Because those who do not have western medical facilities to return to, and whose situation worsens by the day, as fear overtakes the population and dictates their behaviour, they are the ones that will truly suffer.

If it were in our backyard, the international community would not sit by and watch, so I shall continue to advocate until I see that they stand up and take action.

On the bus: thinking about Ebola, again.

So I crossed the border the other day from Mali info Burkina. It’s a very simple border, quick and easy, no hassle. Except that right now, I think I would like a bit more hassle. I’d like to see the west African countries and international health organizations doing a lot more to contain the spread of Ebola.

There is NO public education on this. And if there is, it’s not getting out there. And there are absolutely zero screening measures in place. Zero. Do they think that the majority of west African people travel by airplane? Because they certainly do not.

For example, on this bus, I was seated next to a lovely Nigerian man. He was coming from Sierra Leone. Which means he was coming from an extreme hotspot, a country in an official state of emergency, passing through the disease-ridden origin nation of Guinea, and onward through Mali, Burkina, Benin, and finally to rest in Nigeria.

And what if he was sick? I’m not too concerned because he was in obvious good health at the time, and thus not contagious, but what if he develops some symptoms; a little bit of a flu, you think. Malaria, or typhoid; just the regular maladies that are common in this area. But what if it’s Ebola? What if he brings back an unintended souvenir and starts wiping out his community (which happens to be Lagos, a gigantic hub of people)?

You know what he asked me?

Now tell me, is Ebola actually real?

Actually real? ACTUALLY REAL?!

Yes, it’s real! And yes, it’s actually killing hundreds of people, regardless of race or profession or any other divisive quality. And it’s out of control.

Side note: I’m writing this in the midst of a typical west African downpour, but there is some very ominous thunder, which keeps crashing down as I talk about the impending doom of Ebola. Just saying.

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So as usual, I did my best to equip him with all the information I could. Modes of transmission, cultural practices which perpetuate the infection, signs and symptoms, etc., while emphasizing heavily the importance of seeking medical attention at the first sign of illness. Because it’s really, really real.

Oh, now the power’s been cut. That’s not foreboding at all.

Just today, the executive director of MSF Canada has called for a mobilization of global resources to combat this disease. He illustrates the same difficulties in public awareness and a lack of support for their strained and exhausted staff.

Up until now, MSF has been among just a handful of organizations responding to the Ebola crisis on the ground. But our efforts are reaching a tipping point: We and our partners will soon be too overwhelmed to do any more, and we will no longer be able to respond to new cases.

A job on this scale requires a co-ordinated global response: It is the responsibility of the WHO to mobilize the necessary resources and to guarantee immediate impact on the ground.

Full article here.

The disease is spreading. Two Americans have just returned home after contracting the disease. My good friend Kyle has just told me that it’s in Saudi now too. As with most developing-world problems, it’s only once it comes home that we take notice, but let this be it’s homecoming. We need action, now.

Bloody Hell! Ebola.

Oh dear. Please, Ebola, don’t come to Mali! And please, friends in the region, be informed and help educate others about best practices, so we can help stop the spread of this monster!

six degrees north

Ebola Virus Disease (EVD). Formerly known as Ebola Hemorrhagic Fever (EHF). Currently enjoying its worst season ever (for people, not the virus) in West Africa, with over 800 infections and over 500 deaths in 100 days since March 23.

800 infections in 100 days doesn’t sound like much and I’m no epidemiologist. But surely the measure of control of an outbreak is the rates of new infections? Below is a graph based on the WHO Global Alert and Response (GAR) data. The simplest grasp of the graph shows that at this time, the virus is winning. And starting to win exponentially! Case in point – in the last 2 days, the total number of fatalities has risen by more than 10%. 31% of all deaths have occurred in the last two week. The outbreak was centered on Guinea, in a district immediately bordering Sierra Leone and Liberia. The…

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