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A
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B
This is the political scene, a weekly conversation with New Yorker writers and editors about Politics. It's Thursday, October 30th. I'm Dorothy Wickenden, executive editor of the New Yorker.
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C
Only two people so far have contracted Ebola on American soil. The two Dallas nurses who treated a patient who contracted it in West Africa today. Both of them are disease free.
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B
That was President Obama at the White House this Tuesday trying to quell the Ebola panic that surfaced with quarantine measures being implemented in a number of states.
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C
America, in the end, is not defined by fear. That's not who we are.
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B
Dr. Jerome Grootman is here to talk with me about Ebola and about contagion in general. What we should and shouldn't worry about. So, Jerry, welcome.
- [02:03]
D
Pleasure to be here.
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B
This Ebola outbreak is the largest in history. The World Health Organization warns that we could start seeing thousands of new cases anytime. The CDC says that we could have 1.4 million cases by January. But Obama was right, was he not? That a pandemic in the United States is extremely unlikely, Right?
- [02:24]
D
I think he is correct, although the administration should be faulted for giving mixed signals and not being consistent with regard to its recommendations. But the most important thing is that this is a highly virulent virus, extremely dangerous, induces shock, but it requires direct contact with infected body fluids. And. And then that infected material needs to be inoculated by a person touching his eyes or having an open cut. It's not airborne. It's not like tuberculosis where someone coughs and then it's spewed all through the atmosphere. So we have a very, very clear idea of transmission. But the fear that's gripping the country has to do with the severity of the disease and the fact that it's new on our shores.
- [03:11]
B
You know, you talked earlier about the president sending mixed signals about all of this, and we will get back to that. But the press also is complicit, spreading misinformation. And so we're getting. Every day we're getting different kinds of signals. And the latest news from west Africa seems somewhat less dire, at least according to the New York Times. The number of new cases in Liberia each week seems to be falling. What's happening there, as far as you know?
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D
Well, it is true that the numbers of cases that are being recorded by public health officials in Liberia fortunately appears to be declining. What's not known is whether there are cases in the rural areas that are continuing to increase. And so there's still uncertainty about whether the epidemic is beginning to taper.
- [03:59]
B
And as for here, you know, even healthcare workers who understand how Ebola is and isn't spread are panicking. So last Friday, an extraordinary number of staffers at Bellevue Hospital here in New York called in sick rather than treat Dr. Craig Spencer, who is the city's first Ebola patient, or they refused to treat him. I think one woman faked a stroke. 39% of Americans think there's going to be a huge Ebola outbreak in the United States. Talk a little bit about that.
- [04:26]
D
Well, I think part of the fear and panic among health care workers has to do with the fact that the care that was delivered in Texas resulted in the infection of two nurses who fortunately have survived in a place like Bellevue, which is highly specialized and has an superb infectious disease team. The right protocols are in place, and the risk to the staff and certainly to other patients is nil. But I think what we're seeing is the result of poor handling from the initiation of the outbreak in the United States, which has sown a great deal of panic and also lack of trust and authority.
- [05:09]
B
Right. And so we See Governor Cuomo or we have seen of New York and Christie of New Jersey coming under attack for their quarantine policies by the administration, by the way, which, you know, sort of put a lid on some of that. And yet, as you were saying earlier, Obama has been sending mixed signals. The administration has. So the military has imposed a 21 day quarantine even though they haven't been exposed to patients.
- [05:33]
D
So this is really a disaster from the point of view of public perception. The administration is criticizing New York, New Jersey for imposing a quarantine, and yet the military is imposing a quarantine. And the president said, well, you know, volunteers are the ones who are going to West Africa and they have to be encouraged to volunteer people in the military. Soldiers don't have that freedom. Well, that has nothing to do with the science or the biology of stemming an epidemic or the rationale for isolation. This mixed message is very detrimental to the public health interventions that CDC and others are trying to foster.
- [06:17]
B
What is the proper health policy here? What do the CDC guidelines stipulate?
- [06:22]
D
A few days ago, October 28, the CDC came out with new guidelines. So they revised the original guidelines that initially they assured the public were completely airtight. And I think that the new guidelines are much smarter. And they basically classify individuals who have been in West Africa into different risk categories. And the highest risk category are people who are healthcare workers who have had direct contact with Ebola patients. And what this involves now is what's called direct active monitoring. That means public health officials with expertise in epidemics will directly visit these individuals coming back from West Africa who are in the high risk category and check on them physically, actually be present there once a day, and then check on them periodically through the day by telephone to make sure that they are not developing any of the symptoms of Ebola. And the CDC recommends very strongly that the high risk individuals restrict public activities, going to parties, seeing other people, going to work, and so on, and also restrict public travel. But the recommendations that came out two days ago should have come out two months ago.
- [07:39]
B
I also want to ask you, since you've had such a long history of treating AIDS as well as other infectious diseases, fear mongering about contagion has had a long history in the west, has had a long history everywhere. But here in the 1830s, poor Irish were said to bring cholera. At the turn of the century, tuberculosis was called the Taylor's disease and associated with Jews, Italians. Italians were seen as bearers of polio. You treated AIDS patients in the 80s when the taboos against Homosexuality became even more painfully clear with Ebola. There are racial overtones. Talk a little bit about that and how it plays into this.
- [08:16]
D
Well, there's definitely stigma that's associated with epidemics. I mean, it even traces back to black plague, to the Middle Ages, where Jews were poisoning the wells or carriers of disease and so on. And it typically involves xenophobia, typically involves a vulnerable minority group. And of course, there's absolutely no genetic or racial difference that's known to date in terms of most of these infections, so that it's not as though one group is particularly predisposed to be a carrier and so on. And I think this clearly plays into the social fear, and the way to deal with it is to be absolutely upfront about it. I think that it's vital that this kind of negative, stigmatizing overtone be brought out from the shadows, confronted, and the humanistic imperative of caring for anyone and everyone who's afflicted with a serious illness be highlighted.
- [09:18]
B
And do you think that's Obama's job? Could he use the bully pulpit here and give a short speech laying all this out even more clearly than he has been trying to do in recent days?
- [09:28]
D
Yes, I think that it involves two dimensions. The first is to have scientifically meaningful and targeted public health recommendations, which again, just came out 48 hours ago. And also I think the President should state quite clearly that Americans are a compassionate and caring people and that we take care of our own, and when we have the opportunity, we take care of. And, you know, he's got a lot on his plate and so on. But this is certainly something that the public is fixated on right now.
- [10:06]
B
Experimental vaccines aren't being produced in high enough quantities, quickly enough. What can be done there?
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D
It's interesting because there was some initial work around an Ebola vaccine, but there isn't enough of a market in the developing world. And so I think that one of the imperatives, just like, and interestingly, it was George W. Bush who did this, largely through the prodding of Anthony Fauci at nih. There was a special fund set up to subsidize AIDS medications for Africa and other developing countries, which made enormous impact in saving lives and reducing transmission on that continent. And the same should be done in terms of the developed countries, the west, putting real money into the development of vaccines for these kinds of epidemics, because we live in a global world and we have a responsibility to everyone.
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B
What are the challenges in containing Ebola as compared to, say, HIV or swine flu? Are they different?
- [11:12]
D
They are different. I was thinking about this in the early days of the AIDS epidemic, before we knew it was a virus. I was on the front lines at University of California, Los Angeles, where the first patient was reported to the Centers for Disease Control and then came back to Boston. And we didn't have gloves. I remember doing bone marrow examinations on these patients. Without precautions. It's actually quite difficult to contract HIV in comparison to Ebola. The virus is extremely efficient in entering a whole spectrum of different cells in our body. While HIV is highly specific and restricted in terms of the cells that it can enter, Ebola is much more nefarious and able to enter epithelial cells and other cells which HIV can't infect.
- [12:08]
B
What are we learning?
- [12:09]
D
Well, we seem to be playing catch up with this. I think that hopefully we're going to take lessons from the current outbreak and have a more far sighted view and begin to plan because this is not the last of these. There will certainly be other outbreaks. We have a profound knowledge of HIV in terms of how the virus operates biologically and we really have relatively scant understanding on a biological basis of how Ebola works.
- [12:42]
B
But as you pointed out, we've been living with HIV for decades now.
- [12:46]
D
We have, we've lived. And it's also, of course, affected the west in a dramatic and widespread way. And you know, as Tip o' Neill used to say, all politics are local. So when Rock Hudson and others got it, all of a sudden Ronald Reagan paid attention. Speaking historically from the AIDS epidemic, I think we need to have a wider vision than we have had in the past. We live in a global world. We live with lots of travel and interaction and the importance of developing a strong scientific basis with which we can contain epidemics, combat epidemics and save lives really should be the lesson drawn from the current panic and tragedy.
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B
Okay, thanks so much, Jerry. That was very clarifying.
- [13:38]
D
Thank you.
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B
Jerry Grootman is a staff writer and the author with Pamela Hart's Band of youf Medical Mind. This has been the political scene from the New Yorker. I'm Dorothy Wickenden.
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E
You can subscribe to this podcast and other free New Yorker podcasts in the itunes store. The weekly audio edition of the magazine is available@Audible.com New Yorker subscribers can access the digital edition for tablets and phones at no extra charge from the App Store Store or from Google Play.
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F
I'm Katie Drummond. I'm Wired's Global Editorial Director. I'm Michael Colory, Wired's Director of Consumer Tech and Culture.
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B
And I'm Lauren Good. I'm a senior correspondent at Wired, and our show, Uncanny Valley is about the people, power, and influence of Silicon Valley.
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F
And right now, Silicon Valley and Washington have never been more intertwined. So each week we get together to talk about a big story, often at the intersection of tech and politics. Right. So whether we're talking about Trump, Coin Doge, or Elon Musk, we will always explain how these Silicon Valley forces are affecting Washington and how they affect you. Make sure you're following Uncanny Valley in your podcast app of choice so you don't miss an episode.
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D
From prx.