Last Thursday, the Program in Public Health sponsored a panel of speakers in Paresky Auditorium to discuss the recent Ebola outbreak. The event, titled “Ebola: What Have We Learned?” approached the virus from a variety of angles, including biological and political perspectives.
Lois Banta, associate professor of biology, spoke first, focusing on the biology of the Ebola virus.
Banta explained the origin of the virus and how it can spread.
“We still don’t know for sure where this disease hangs out in between these outbreaks, but there are a few possible candidates,” Banta said. “There is some thought that Ebola may also in some cases be transmitted to people from eating contaminated bush meat or butchering contaminated monkeys … But there is also, as you may have heard, a fair amount of evidence that fruit bats may be infected.”
She also described symptoms and mutations, related this outbreak to past outbreaks and presented current possible treatments.
“We think it’s a little unlikely to become airborne, in part because there’s really no selective pressure on Ebola to find a new route of infection,” Banta said. “It’s doing really well as it is, it doesn’t need to go through a bottleneck where only Ebola viruses that have mutated to pass through the air could move on.”
Banta believes that the high number of cases in the most recent outbreak is a result of factors other than its biology.
“So, is there any hope? Can you become immune? It seems pretty clear that some people can become immune … Among the treatments, then, are antibodies, but for the vast majority of people, the only treatment – if they have access to treatment – is palliative, that is to say providing IV fluids and balancing electrolytes to try to negate the severe diarrhea and vomiting and trying to maintain their oxygen status, replacing lost blood and treating other infections if they occur. In terms of experimental treatments, the one that has gotten a lot of press is Zmapp. That’s a mix of three antibodies that are actually being infused in plants. These tobacco plants have been genetically engineered to produce these antibodies, the thought being that you can grow a lot of tobacco,” Banta explained.
Next, Kim Yi Dionne, assistant professor of government at Smith College, spoke about the political response to the Ebola outbreak.
She explained that because there has never been a recorded outbreak in the past, “People just didn’t have experience responding to the disease.”
In addition, she said, “These are three poor countries which are heavily aid-dependent and don’t get to make decisions themselves because they have all these pesky Americans and Europeans coming in and telling them what’s best for them. Now, you add to these challenges that there’s a really poor health care infrastructure, especially in the three most heavily affected countries … Another major challenge has been the slow response from the international community.”
Dionne also noted that the current epidemic is not confined to one country, which “requires coordination across governments and health systems.”
Dionne then focused on the slow response of the international community and discussed a timeline of the Ebola virus and the responses of other countries, including the United States.
After Dionne, World Bank senior economist David Evans discussed the economic impacts of Ebola in Africa.
“The tragedy is really that the deaths are just the first scar that Ebola leaves behind and the economic impact really has a human face,” Evans said. “And when we think about the economic impact, what we’re thinking about are children who are missing meals, mothers and fathers and men and women who don’t have employment and fall deeper in poverty than they have before. These aren’t just numbers of output and capital but really some of the long-term impacts of the virus.”
Evans clarified the difference between the direct impact, indirect impact and aversion behavior caused by the disease. Ebola, unlike some other diseases, causes much of its economic damage through aversion behavior because of the irrational fear it can inspire.
Evans then presented findings on economic leading indicators and shared predictions based on these models. Estimates predicted significant economic loss in the greater area of West Africa by the end of 2015. However, he also presented evidence that domestic economic recovery from Ebola can occur, citing a study of economic activity in Dallas before, during and after Ebola patients were in the city.
Finally, MCJ/Amelior Foundation senior advisor Wendy McWeeny spoke about the impact of Ebola on Africa’s health systems.
McWeeny focused on Africa’s health systems by demonstrating their current status through statistics on other diseases. She began her talk by posing the question, “What does the Ebola outbreak tell us about health systems? What is the impact of Ebola on health systems? Is there a way to respond to the Ebola crisis in a way that it strengthens health systems?”
She showed that civil unrest and other diseases, such as malaria, have weakened the health systems already. McWeeny said there are 50 doctors in Liberia for a population of five million. Post-outbreak, all funding now is going to Ebola and there are fewer resources for patients of other diseases, according to McWeeny.
At onset, many of these other diseases show symptoms very similar to those of Ebola and victims fear going to clinics with knowledge that they may be quarantined with Ebola victims and then become infected.
McWeeny predicted widespread problems unless a group of tens of thousands of doctors intervenes and works in West Africa to improve the current health systems.