Time to Crawl under a Rock?

October 7th, 2014

I’m quite familiar with Texas Health Presbyterian Hospital where Ebola patient, Thomas Eric Duncan, is currently being treated. I know more than I care to about the Emergency Room he initially visited and was released from before being readmitted. Back when I lived in Dallas, I would occasionally find myself in that ER as a patient for various reasons.  Also, my grandfather sadly passed away in that ER twenty-eight years ago as he was waiting to be moved to a room after suffering a heart attack.

Since then, I’ve been in other ERs in other hospitals in other cities.  For the most part, I’ve found them to be the same. Particularly in the bigger cities, the general rule is that they’re always crowded and appear frenzied and that unless you arrive by ambulance you’re likely to suffer awhile before you find any relief from whatever ails you.

I’m not blaming doctors or nurses for this problem because I imagine the job of these professionals in an ER setting is especially difficult, but I can certainly appreciate how easy it is for mistakes to be made and why everyone going forward will need to demonstrate an extra dose of vigilance in advocating for their own medical care.

We’re also going to need to start paying more attention to our health care from a policy perspective outside of the ongoing contentious issue of who should pay for our treatment.

A few years ago, another attorney in the law firm where I worked told me that his brother-in-law worked for the National Institute of Health in Maryland and that specifically he was part of a team looking at the next generation of antibiotics. According to my friend, this wasn’t a subject he liked to think about much because his brother-in-law indicated that science was having a hard time keeping up with increasing bacterial resistance to existing drugs.

It’s hard to imagine now, but antibiotics are relatively new.  Just one hundred years ago, individuals died at alarming rates from things that today would amount to minor irritations.  For example, in 1924, during his father’s presidency, sixteen-year-old, Calvin Coolidge, Jr., developed a blister on his toe after playing tennis without wearing socks.  The blister became infected and young Calvin died from blood poisoning a few days later.  Today, this sort of death would be unheard of but back then it was more common than we’d like to think.

Before antibiotics, people frequently died from infection.  We’ve gotten so used to having these drugs now that we can’t imagine a world where this could ever happen.  Unless we stay ahead of the ever changing threat posed by mutating germs, however, we may very well see that world again.

The history of infectious disease is similar.  For generations, no one had a clue how disease transmitted and people often did things that unwittingly spread deadly illnesses. In some parts of the world, this is still true.  Much of the spread of Ebola in West Africa, for example, can be attributed to cultural practices (such as burial customs) that cause widespread infection.

With all the advancements in science, we are clearly light years ahead of our ancestors where medicine is concerned.  Unfortunately, for all our improvements over the past we have one huge Achilles Heel which is both a blessing and a curse.

Over a twenty-four hour period you can travel almost anywhere in the world. And your diseases can travel with you and you can bring new diseases home.

Given this, we’re going to need to quickly make very important and perhaps controversial policy decisions.

For example, historically quarantine has proven an effective way to combat infectious disease.

Taking this step becomes particularly difficult when the person quarantined is asymptomatic.  The most famous such case is that of Mary Mallon, better known as Typhoid Mary, who carried Typhoid Fever but refused to quit working as a cook in the early 1900s.  Many people contracted the disease and a few died.  Authorities quarantined Mary over her strong objections against this violation of her civil liberties. At one point, she was released under the promise that she’d quit cooking but she soon abandoned that promise and was quarantined again but not before infecting (and sadly killing) more people with the disease. By the end of her life, Mary had spent about a quarter of a century living in quarantine.

With the current Ebola crisis, several countries are currently banning flights to and from West Africa.  Currently, the United States is not one of these countries but the reason we’re not following suit isn’t entirely clear.  Presumably, it’s because isolation of these countries could actually exacerbate the problem.

Hopefully, the situation in Dallas will prove to be a needed wake-up call to address this issue and not something much more dire.

Either way, time to address how we intend to handle these problems as a nation is clearly running out if it hasn’t already.

 

 



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One Comment

  1. Posted Oct 09 2014 at 8:56 am | Permalink

    I am retired now but for 26 years I ran a company that I started. We did Clinical trials for major Pharmaceutical companies in many other countries including 3rd world and we employed over 300 Clinical personal. I’m very happy to read from someone that understands the severity of the conditions we face today. Now for my main reason for writing is I’m good friends with someone deep within our country’s security sec. I “may” have been informed 6 days ago that the gentleman in the Texas hospital with Eboli had died when he was first admitted. I wondered, “why there” because there are many other hospitals much better equipped to handle his condition. Well after possibly speaking with my friend I knew why. Many events happen in our country that we aren’t privy to know. Under President Bush we would have been told, only if the “Donkey” press would have reported it. But mainstream media back then knew to report the facts to the people. Not a country we live in now. Thank you