I'm used to being hijacked by one outbreak or another: H7N9, cholera, chikungunya. So it's no surprise that Ebola has dominated the posts here for the last few weeks. No doubt that just as Ebola starts fading, some other upstart virus will appear—or MERS will declare itself a seasonal virus and come back for a triumphant autumn tour of Saudi Arabian hospitals.
I can wait. In the meantime, a couple of thoughts about Ebola:
First, the attack on healthcare workers. Very worrying. I'm most concerned about Dr. Sheikh Umar Khan, who at last report was in stable condition. He's the local warrior, and if Sierra Leone loses him as Liberia lost Dr. Samuel Brisbane yesterday, West Africa will feel itself that much weaker and that much more dependent on western help...which is more promised than delivered.
I certainly worry as well about the two Americans in Liberia, who as missionaries have acted on their beliefs and, so to speak, put their bodies where their souls are—in the service of others. I wish them a quick and complete recovery.
Inevitably, people are starting to worry about Ebola getting out of Africa. I'm not. An occasional case arriving in Jeddah or Paris or New York would be swooped down upon with blinding speed, triggering massive adrenaline rushes in the local public health folks and many hyperventilating news reports. But it wouldn't get anywhere beyond the nearest isolation ward.
Lagos might be another story. When you're dealing with a city of 21 million, even an attack rate of one per thousand gives you more cases than any healthcare system could cope with. Far worse than the actual cases would be the social, economic, and political disruption, harming a big country already under more stress than it needs.
And that's what always worries me about any outbreak: the harm it does to those who don't catch whatever disease it might be. They lose income, like all those Chinese chicken merchants last year, and they often lose what little faith they have in the ability of their government to deal with the problem. (And lord help those suffering from more mundane illnesses like diabetes or measles.) The local politicians, like those in West Africa, exult in insulting one another and create still more distrust in government.
International humanitarian agencies have to get out their begging bowls for yet another Good Lost Cause; they know relief efforts will be underfunded and the problem left to fester: violence, the loss of social capital, sick and malnourished kids, demoralized communities, and still more outbreaks of opportunistic infection exploiting the problem.
Even if Ebola ceased at 8:00 a.m. Monday morning and all present cases miraculously recovered, the repercussions would shake West Africa for years if not decades. Maybe those countries will somehow find the resources to build an effective healthcare system. More likely not.
Even if they do, they'll then have to solve another problem: What to do with all the big, healthy kids who grow to maturity instead of dying by age five or ten. It will be a better class of problem than West Africa now has, but it will still be a problem.
And of course, Ebola won't go away on Monday morning.