It may have been a Friday, but Wesleyan World Wednesday on Oct. 23 drew a nearly full house in PAC 001. Students and faculty members listened as three experts shared their knowledge of the ongoing Ebola epidemic. Connecticut State epidemiologist and Professor at the University of Connecticut and Yale School of Medicine Matthew Cartter ’76, Visiting Assistant Professor of the Science in Society Program Anna Geltzer, and Assistant Professor of Mathematics David Constantine shared their knowledge about the past, present, and future presence of the virus.
The purpose of the lecture was to make sense of the media’s presentation of Ebola. The experts who were invited to speak presented the facts on Ebola from political, social, economic, and medical perspectives.
Cartter began his discussion, which made up the majority of the hour-long event, with some basic information about the expression of the virus within the body and the way it spreads among people. Ebola’s incubation period can last anywhere between 2 and 21 days, with symptoms generally appearing between 8 and 20 days. Ebola first appeared in the Democratic Republic of Congo in 1976 in the area surrounding the Ebola River. It spread among populations in two ways: person-to-person contact and contaminated needles. Over the past 38 years, there have been more than 20 Ebola outbreaks.
The current outbreak, first publicized in March 2014, is concentrated in the West African countries of Guinea, Sierra Leone, and Liberia. To date, there have been approximately 10,000 reported cases and 5,000 reported deaths.
Cartter stressed that one of the factors contributing to the scale of this outbreak is that the current strain of the virus has spread to urban areas.
“We have never encountered urban transmission before,” Cartter said. “Quarantine doesn’t work in an urban setting. You can’t even find all the contacts anymore. This is a totally new situation.”
The first reported case of Ebola in the United States was in October 2014, when a man who had recently traveled from Liberia developed symptoms and died in Texas. Since then, three other cases have been diagnosed in the United States, two associated with the first patient and one isolated case.
Cartter noted that although the four American diagnoses pale in comparison to those in the affected West African countries, widespread panic has ensued.
“Over the next 10 days [following the first diagnosis of Ebola], we saw an incredible series of headlines coming out of Dallas,” Cartter said.
Cartter presented headlines from across the country related to Ebola’s entry into the United States. He also mentioned that schools in Akron, Ohio were closed due to Ebola-related fears.
While Ebola is only transmittable through contact with bodily fluids when one is already showing symptoms, in its late stages, it can live on the skin of patients. This can present problems given traditional funeral rituals in some countries. Cartter stressed that understanding cultural practices is crucial when studying Ebola in the United States and West Africa.
“These epidemics or outbreaks are not just scientific events,” Cartter said. “They’re cultural events, they’re political events, and they require understanding of all those areas.”
The next speaker, Geltzer, explained how the culture of the pharmaceutical industry, in addition to the relatively weak West African economy, has hindered the development of an effective treatment for the virus.
Geltzer explained the “Drug Development Pipeline,” or the steps through which a drug must go in order to be available for purchase. Generally, it takes about 12 years and over 1 billion euros to produce a viable drug, which is why only about one in every 10,000 compounds developed actually makes it onto the market.
According to Geltzer, pharmaceutical companies are most interested in creating blockbuster drugs, generating maximum profits either through widespread purchase or high prices for specific ailments.
“[The West African] population is not in a position to be a viable market,” Geltzer said. “They don’t have the money and the market does not serve them. This is true of all patients everywhere who cannot afford to pay for treatments. One must put it into the perspective of the political economy.”
Currently, ZMapp, a drug derived from tobacco plants, is the most promising treatment for Ebola. The drug is produced by a small company based in San Diego, Calif., and is currently only available in limited quantities. Researchers in the United States are searching for a possible Ebola vaccine, but progress has been slow.
Geltzer believes that a large-scale change must occur in order for an effective treatment for Ebola to be developed.
“[We] have to create a public health system where drug development follows a different logic,” she said.
Lastly, Constantine shared a few mathematical models of the potential growth of Ebola in the affected West African countries. According to the World Health Organization, without changes in prevention efforts, the total reported cases could rise to 20,000 within one week. The Centers for Disease Control reports that approximately 500,000 cases could be reported by January, though they estimate that this could be an underrepresentation by as much as a factor of 2.5. He also presented models that showed the change in reported cases over time for each affected country.
“[That is why it is] important to get those control measures in place as soon as possible,” Constantine said.
All three presenters stressed that West Africa is the region most affected by the virus and toward which most efforts must be directed.
“Things like this should make you worried not about what’s happening here, but what’s happening in West Africa,” Constantine said.
1 Comment
Aaron
I appreciate this thorough, informative article. I think math is really critical here. The models should be ample reason for the whole world to tackle the problem with all available resources. But I fear it won’t, because look at the climate change mathematical models. The Keeling Curve for example, as compelling as it is to me, doesn’t concern most people. I think I read only 17 percent of voters are “very concerned” about climate change. I don’t know what that says about our math skills, but it’s an example of why I’m very worried about this epidemic. As with climate change, it’s not linear, there are positive feedback loops, and exponential changes, so if we wait until a time that it’s super serious and like an emergency situation, it’s way too late, it’s like “closing the barn door after the horses have gone”. EVERY expert I’ve heard who has been on the ground reporting the crisis, says that the numbers are very underestimated. So it’s clear that the actual numbers are terrifying and very serious. And as the article points out, it’s much more serious this time with urban outbreaks, we can’t assume that past containment protocols will work like they have in the past. I think the “different logic” phrase is exactly right. Heck, any logic at all would be nice right about now.