← The Watch Floor with Sarah Adams
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for I'm Sarah Adams. Ebola is in the headlines. And anytime it pops up, Americans reaction is immediate. It goes to fear, confusion, questions about travel, questions about the safety of airports, questions about whether it will reach the United States. And when. This episode is not about panic. It's about facts. It's about what's happening right now in Africa, what the numbers are actually showing us, how this compares to the last time Ebola touched US soil. And what has changed since our response in 2014. Because the right question isn't, will Ebola come here? The question needs to be, are we better prepared this time to handle it? When we talk about this current outbreak of Ebola, it's centered around the Democratic Republic of Congo, where the largest number of cases are and then these overflow cases that are occurring in Uganda. This outbreak involves the Bundi Bug Joe strain of Ebola. Now, when we talk about these different strains, they matter because Ebola is not like one simple operational term. So there are different species, there are different strains, and as you can imagine, each of those then have different fatality rates. There's different countermeasures, and there's different response challenges to each. So this strain was first identified in 2007, and according to CDC, about 30% of people who get this strain die from it. The interesting thing, though we're seeing seeing out of Africa is health officials. They're saying, ooh, it's looking a little higher. It's looking like a range from 30 to 50%. So already we're learning something new about this strain. So at the time of this recording, let's pull the exact numbers. So health officials are tracking over 250 confirmed cases of Ebola, with 40 confirmed deaths again in the Congo and Uganda. At the same time, though, there are more than 1,000 suspected cases that remain under investigation, highlighting the uncertainty around the scale of this outbreak. Because you have to confirm a case of Ebola in a laboratory. Now, there are a number of people who have symptoms, links to people with symptoms, and they have yet to be through any sort of testing. That distinction matters because it tells us two things at once. First is the outbreak is, of course, serious. And second, the data is still evolving. We don't actually have a pulse yet on the true number. Think about it this way. First off, there's testing backlogs we're talking about conflict zones, we're talking about a region where there is mass population displacement. We have another issue where there is, is lack of access even into these areas to properly test people. So all the numbers and facts around this can change very, very quickly. When we talk about Ebola, it's not a respiratory virus that spreads easily through airborne exposure, right? That's a good thing. It spreads through direct bodily fluids from someone who is sick or has died from the disease. So that, as you can imagine, should make containment much easier. But in practice, when we talk about Ebola, it's never just a medical problem. And that's what we have to talk about today. First off, it's a trust problem, then it's a logistics problem, then it's a security problem, then it's a communications problem. And so with an outbreak like this, all those challenges are happening at once. You have to deal with all of them at once. One thing I've learned over the years is that maintenance beats repair every single time. And that's one of the reasons I've stuck with One Skin because it focuses on the skin science of aging. I've recently been using the OS1 hair serum. 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And after your purchase they'll ask who sent you, Let me know. The Watch floor did. So when we talk about like the Congo. This outbreak is affecting the eastern region of the Congo where we have violence, massive displacement and a massive distrust of authorities. You already don't trust your government, you don't trust the medical facilities. And now they're coming and telling you there is this deadly disease outbreak, do you trust that? Right. It's very, very hard in an environment like this with so much violence, so much misinformation. So the World Health Organization has leaned in and their officials have at least called the communities to, to cooperate. And they've even said, hey, we even need to see ceasefires happening, because medical teams need to be able to get into these areas first to isolate the patients, then to, of course, trace contacts and then to run the treatment centers to help. And you can't really do any of that effectively when violence is ongoing. So this is the part many people miss. You can have the right medical guidance, you can have the correct protective equipment, you. You can have the best trained responders. But if the patients are afraid to report symptoms, if families reject any sort of safe burial procedures, if armed groups prevent access to this population, or if misinformation spreads faster than public health guidance, the outbreak can overrun the system. That's where Ebola becomes so incredibly dangerous. It's not that it's impossible to contain, it's the fact that containment works only if there's a trust of a system. And the system isn't even in place yet. And you're expecting these people to trust it in an environment where there is no trust. Super, super complicated. Now, let's go back in time for a minute. So let's go to the last outbreak. So it was about 2014-2016, and this was the West Africa Ebola outbreak, and it remains one of the largest outbreaks in history. So at the time, CDC reported more than 28,600 cases and 11,308 deaths. It began in guinea, it moved to Liberia, it went to Sierra Leone, and then it touched multiple countries. Because people traveled, there are medical evacuations and of course, different secondary transmissions. So in the United states, we had 11 people treated for Ebola at the time. Two, unfortunately, died. So most were infected, as everyone remembers, outside of the United States, and then were medically evacuated here for their care. Now, the case most Americans remember is, of course, out of Dallas. So on September 25, 2014, a man who traveled from Liberia went into an emergency room in Dallas, said, I have a fever, abdominal pain and a headache. He was discharged and he returned three days later by ambulance with a persistent fever, again, abdominal pain and diarrhea. So it was on September 30 that they did confirm he had Ebola. So he became the first imported case of Ebola at the time diagnosed in the US and then a first, unfortunately, he died October 8th. So there was two nurses that cared for him that later contracted Ebola. And it marked the first known transmission of Ebola in the United States. So both of those nurses fortunately recovered. But the episode exposed a real weakness in our system. Right? Hospital screening for sure. Failed travel history was not handled properly. This frontline infection occurred that really shouldn't have. You know, the protective equipment procedures were not consistent. And then the public watched in real time as officials were trying to catch up to the crisis. And they didn't seem at all ready to handle it. 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Around the initial start of this incident in 2014, I was actually in Dallas. And the crazy part is, you know, I went into this office building and there was a television studio in there. And I met this gentleman, and he was a doctor. And we shook hands. And then later in the day I was told, oh, that was the Ebola doctor. So he was the doctor that worked on the Ebola patients. And I was like, why didn't no one tell me this ahead of time? I probably shouldn't have shaken hands with the Ebola doctor. But again, of course, I wasn't going to get it from shaking hands. But at the time, we all didn't really know what was going on. There was a little bit of panic that ensued because the government was not clearly handling it. Public facing. But of course, things were done right. We have to talk about those as well. Best thing that happened during this case is contact tracing worked in Dallas. The CDC and local officials identified 48 close people to these three cases we talked about. They decided to monitor them for 21 days. They made sure they stayed in the upper limits of the incubation period for Ebola. Now, that monitoring obviously stopped any sort of wider spread. The isolation of these patients really did work. And once the diagnosis was recognized, the patients were further isolated, and then they were under strict protocols. So there was specialized medical care that worked. There was several medically evacuated patients that were treated in the United States and survived. And then after the fact, people took the lessons learned, right? They made training modules out of it, and it was standardized. So that's a really good thing. After those early mistakes of the Ebola outbreak, we luckily had hospitals improve their screening questions. We had changes in the protective equipment procedures, and then we improved our patient isolation protocols. So public health monitoring did work. Right. People got on top of this and they stop some sort of uncontrolled spread of Ebola in the United States. Huge win. That's very important. So when we think of 2014, there are a lot of mistakes to talk about, but the system did quickly correct itself and it prevented a larger domestic crisis. So what's it like today? Well, the US Response is actually quite different today than it was in 2014. First off, screening procedures happen more earlier and they're much more aggressive. So if we just look at enhanced screen at the airports, it started at Washington Dulles on May 20th. It then became effective in Atlanta just two days later. And then it moved to Houston and JFK. So, you know, these major US airports where passengers come from, those regions have this enhanced screening network in place, and it's working. So how the airport screening actually works is, of course, there's designated countries they're traveling from, and those people all get screened. And when they come in, they get checked for symptoms. They have to confirm their contact information. And then of course, they have to agree to support any follow on monitoring if they were to get it. And then also, of course, if we have to do contact tracing, you know, after the fact. And then second, the travel policy is so much more restrictive today than it was in 2014. So right now, with our current measures, there is this strong focus of this 21 day period coming from the regions in Africa where people are affected by this. So we're leaning in really heavily on travelers who've been in those regions within the last 21 days. So it's not like we're waiting till they get here to think through, oh, there's a 21 day problem. Third, and this is very important, the US posture towards repatriation has changed significantly. So during the 2014 outbreak, of course, the thought is we need to bring all the Americans here for treatment in these high contamination facilities. So now the administration has explored plans to keep exposed Americans kind of in quarantine or treatment facility or off US Soil to prevent the virus from spreading here. It's very smart. So first off, the plan was to actually bring Americans to Kenya. It was to a military base there. It had about 50 hospital beds. And it sounded like a really great challenge. Unfortunately, some activists in Kenya had a little bit of uproar. First, right, do we want you to bring Ebola here? And second, is this affecting our sovereignty? Right. If another country, in this case us, can bring their citizens here and likely maybe trump even our own citizens and get better health care, be first in line, et cetera. So they did have valid concerns. They brought it to the court, and the court upheld to halt kind of this plan to bring Americans to Kenya. So this is something we have to keep in mind because we can't just say, oh, we're gonna do this in another country. We actually have to get the policy in place to make it happen. And that can be complicated, as we're seeing now in Kenya. So the Kenya issue does reveal this larger tension. First off, if you get a deadly disease overseas, what does your own country have to do for you? Do they owe it to you to come help save you? The second thing is, if a host country offers to help citizens from another country, what do they owe to their own citizens by bringing this virus in and potentially exposing others, medical staff in country, et cetera. They are important arguments that have come up and they are things we have to think through when these crises occur. This controversy also happened in 2014. The so there are a lot of people saying, whoa, whoa, whoa, why are we bringing people with Ebola cases back to the United States? And there was some pushback, but we did bring them back. But it was something to where there was a concern. We saw this recently in the hantavirus case. A lot of countries were saying, hey, hey, hey, can't we just keep people quarantined on this cruise ship? Why should we bring them back and bring this virus onto our soil? So it's a very complicated thing. So we saw countries push back and not let the ship berth there. We've obviously seen Kenya push back. And it is just something we have to keep in mind when this happens. Right? Any kind of outbreak, we might have to bring the Americans back here with the disease. We might need to find alternate facilities, maybe in a nearby country or maybe even on like a US Military base somewhere. So, you know, it is a complicated situation, but it's important we're at least not making the same mistakes as we have in the past. And I do think we are doing a much better job of dealing with at least Ebola than we did in 2014. So the question is then about risk. The risk to Americans remains extremely low to contract Ebola. So it's not spreading like the measles or how Covid spread. It's nothing like that. So, so low risk doesn't mean no risk. But we have to understand that it's not going to move quickly or in a way that really should cause some sort of panic. As long as our government keeps these effective practices in place to screen persons coming from this region. And most importantly, sticking to the 21 day window so they don't accidentally expose anybody. So the next several weeks are important. There's five things we should watch for. First, if there's any kind of massive confirmed case growth. Second is if there's a geographic spread. Right. We're focused right now on passengers traveling in, let's say from two countries. Well, that might expand. What if it's four or five countries? Third, contact tracing works. Right. Officials need to keep on top of that. Fourth, just this idea of having some sort of community resilience. If something occurs in an area, of course, in Africa, that means we want people to have access to these health centers. We want them to have safe burials, and we want kind of this Misinformation not to go out as to how this transmits, among others. Fifth, it's really important to watch how our travel and evacuation policy shifts and changes. And that's really what our government needs to stay tight on and not get lax, because again, we don't actually yet know the scale of this problem in Africa. And until we do, we need to stay on top of screening and just be proactive to not make those same mistakes as last time. So no one should be panicking in this situation. We did learn a lot. Now, I'm not saying dismiss this threat, but we do have a system in place to deal with it. And the good thing is we can identify cases faster. We seem to be communicating the problem better now. The public doesn't feel enough has been said about Ebola, but at least we saw the government enhance screening at the four major airports. So they are responding to it quickly, even if not enough maybe has been shared with the public. Ebola is one of those diseases that really points out every weak piece of a system. So it exposes weak hospitals, weak public messaging, weak border coordination. You know, this trust between citizens and government, you know, it kind of questions whether some of our international partnerships are really a partnership or was it just for convenience? So this outbreak is not the same as 2014. It's even a different strain, but the politics of it are exactly the same. Ebola can be contained, right? You just have to move faster than the virus. You have to communicate clearly. You have to protect health workers. You have to earn community trust, especially in these villages where it's spreading. And you have to avoid pretending that screening alone is. Is the only successful strategy, right? So you got to layer everything on, take the right lessons from the past and do a better job this time, which does seem to be happening. And it's why we haven't had an outbreak, thankfully, yet in the United States. Thanks for being here today on the watch floor.