Worth Reading: “How Ebola Roared Back” by the New York Times

I read the New York Times almost every day for 20 years. I started simply because it was required reading when I was in Journalism school back in the 1980s. (Seriously, there were weekly quizzes on current affairs based on what the NYT covered.) I continued reading it when I lived and worked in New York City, where it really was the official record of business.  I kept up even after I left the city for greener pastures. but over time, my fondness for The Grey Lady waned and my disgust increased as its politics and mine grew apart. Sometime after 9/11, I could no longer stomach their liberal view on topics like gun control, the War in Iraq, and politics, so I cancelled my subscription.

I should note that I continue to read the Wall Street Journal, which has grown in stature and in breadth of coverage during the same period in which the New York Times diminished. (Not unlike Fox News growing at the expense of CNN.)

Despite my disagreements with their editorial biases, I cannot ignore the fact that the NYT occasionally produce stories that are well worth reading. This lengthy piece on Ebola Viral Disease, how it grew undetected, and how it got to be the epidemic it is today, is one of those stories that rises to the top of that pile.  I encourage you to read it as one of your free 10 articles per month, per device.)

Ebola Warning SignThe results of a two-month investigation into why this outbreak was not contained after the initial outbreak =– like those before it — has heroes and villains, governments and NGOs, alarmists and those who downplayed the dangers, patient zeroes and patient 20,000. It’s an in-depth look mistakes, misunderstandings, and the inevitable dangers that are brought on by fear, denial, and a lack of knowledge.

It is also well produced in this online format, something they do not always get right.

A few basic takeaways from the article:

  • When it comes to disease, the government, NGOs, doctors and other learned men  may mean well but their mistakes can kill you.  As always, you need to look out for yourself and question everything.
  • Epidemics are best avoided. Even considering that this one is still quite mild, when viewed in a historical perspective, it may not remain mild, and it may not be the only epidemic we could face.  Be alert and be prepared.  Do not assume that a drop in media coverage equates to a reduction in danger.
  • There is no better answer to avoid contamination during and epidemic than social isolation and self-quarantine, with the possible exception of evacuation to an area where there is no disease.
  • Ignorance and assumptions (yours or someone else’s) can kill you.  Stay informed.



The Latest Ebola News: What it Means

In the 10 days since our last post on Ebola (which  I encourage you to read), there’s been both bad news and good. The bad news is that two nurses involved in treating Thomas Eric Duncan, patient zero, were stricken with Ebola, and one of them was allowed by the CDC to fly from Cleveland to Dallas despite showing mild symptoms. The good news is that there is no broad outbreak. School children in Dallas remain safe. None of Duncan’s family members and friends became sick, nor did the EMTs or the initial medical personnel who saw Duncan in the emergency room.


Click to enlarge Infographic on Ebola symptoms

This seems to confirm statements that the illness is difficult to catch through casual contact and that victims are not contagious until they are exhibiting symptoms. On second glance, I would modify that to say: The evidence seems to imply that Ebola is difficult to catch from a patient in the early stages of the disease, but as patients become sicker, they become more contagious and it becomes easier to catch the disease, even when gowned up and wearing gloves and masks.

It is also interesting to note that while the first patient was treated at Texas Health Presbyterian, the next two victims were flown to specialized hospitals for treatment. It appears that that despite initial claims from the CDC, not every hospital is capable of treating Ebola patients.

I liken this first U.S. exposure experience to a football game where your team fumbles and its players make dumb mistakes, but they regroup at halftime and come back to win. If these two nurses can recover and no one else gets sick, we will have limited the damage from fumbling the initial handling of Duncan. We will have learned some important lessons, and we will be better able to treat the next patient. And we can expect another patient, because as long as another carrier can fly in and start the cycle all over again, we face a future where Ebola patients will continue to walk into emergency rooms.

What new information can a prepper glean from this first cluster of cases in the U.S.?

  1. Gowns and gloves are not enough protection in late stages of the disease. You need to cover every spec of skin and use either a full gas mask or a positive pressure breathing system that provides filtered air.
  2. We used to worry about blood because of HIV. Now every bodily fluid is a potential disease carrier. Stay away – and teach your kids to stay away — from vomit, diarrhea and blood.
  3. If you or someone else from your household is diagnosed with Ebola, you lose all rights, including the right to privacy. Someone else will come in and decontaminate your house. (What will they say when they see your store of food, guns and ammo?) Anyone else who lives there will be quarantined for 21 days.

Here are a few interesting articles on Ebola I recommend:

  • From the New York Times, a good wrap up on how people reacted to Ebola, from panic to the political impact of the disease.
  • Six Reasons to Panic, from The Weekly Standard reminds us that the danger has not passed and things could take a turn for the worse.
  • In contrast, we have an article from Wall Street Journal, which reports that it is unlikely that Ebola could evolve to become airborne.  “No human virus is known to have changed its mode of transmission,” reports the author.
  • And another article from the WSJ reporting that the scientific journal Lancet that “suggests Ebola cases could be spread by unwitting travelers.” (Yeah, I know, that should be obvious, but now there is scientific “proof” to back up our common sense.) The study authors also concluded that “screenings can miss travelers who don’t yet show signs of Ebola.”  Ya think?

As you can tell, I think the CDC’s willingness to allow potential disease vectors easy access to the giant petri dish that is our population is misguided. They’ve made a number of missteps already, and I am afraid the decision to leave our border open to passengers from the stricken countries will prove to be another one.

I am reminded of the difference between experience and wisdom:  Experience is learning from your mistakes while wisdom is learning from the mistakes of others.  I wish those in charge of protecting this country from an outbreak would demonstrate a bit of wisdom instead of having to learn the hard way.  Again.


Should You Be Worried about Ebola? This Prepper’s Perspective

A number of people have asked me, “Aren’t you worried about Ebola?” So let me take a deep dive into this topic:

I look at this single case of Ebola in Dallas as the warning shot across our bow. I hope it is something our hospitals, county health departments, state health departments, and the CDC can learn from, because clearly mistakes were made.

EbolaGasMaskI look at this as I would look at the very early report of a tropical storm forming somewhere in the Atlantic. We do not know if the tropical storm will become a hurricane. We do not know how strong it will be. We do not know where it will land – will it Florida? Go up the East Coast? Roar into the Gulf and hit Mississippi or New Orleans? Heck, we don’t even know if it will make landfall. But a wise person will buy plywood, stock up on bottled water, have gas for their generator, and have a plan for bugging out.

This is what the current case of Ebola provides us: A reminder that we should plan, prepare, and be ready, because if Hurricane Ebola sets its sights on your town, it’s too late to wonder what to do.

I’ll cover in detail how to prepare, but let’s take an objective look at Ebola first.


The Bad News

Ebola Viral Disease, often called Ebola in the press or EVD by the medical community, is a hemorrhagic fever that kills anywhere from 50 to 90 percent of its victims.

EVD originated in Africa, where it is thought the epidemic was initially spread by eating bats or monkeys. Once it infected a human host, it spread person-to-person through close contact with sick people or dead bodies.

Earlier outbreaks have been controlled, but the outbreak in West Africa (specifically Liberia, Guinea, and Sierra Leone) spread from small, isolated villages to large, crowded cities where it has proven to be unstoppable, overwhelming the local medical system.

If you exposed to the bodily fluids of a living or dead EVD victim – vomit, blood, semen, tears, sweat, diarrhea, etc. – then you are at a high risk of getting the disease. It is not an easy death as it causes your internal organs shut down, your blood to lose its ability to clot, and your blood vessels leak, giving you a blood shot eyes and bleeding from any or all of your orifices. This also causes a rapid drop in blood pressure which contributes to death.

EVD is spreading in West Africa at the rate of two new people falling sick for every person infected with the disease. So the numbers of infected are rising and the scope of the disease doubles every three to four weeks. (The only thing keeping it from growing faster is the relatively long incubation period.) There have been 4,000 acknowledged deaths, with many more going unreported. Experts estimate that EVD could reach 1.4 million people if it is not controlled. And that’s just in Africa.

Doctor writes Ebola symptoms on whiteboard isolated on white backgroundEVD has reached the U.S. There is one victim in Dallas, Texas, who was infected in his native Liberia by taking a sick woman to the hospital. He traveled to the U.S. and became sick here. He exposed his relatives in the U.S., both adults and children, putting them at grave risk. (They are now quarantine.) More than 100 people are being monitored to see if they will present symptoms, but only the 10 closest to him after he fell ill are thought to be at grave risk of getting EVD.

One of the chief dangers our healthcare system faces is that the symptoms of the flu are similar to the onset of EVD (fever, chills, muscle pain, and weakness). So if you show up at the hospital complaining of fever and chills, the medical staff does not have any idea which virus you are fighting. That’s why they ask if you have been traveling or exposed to someone from West Africa. But if Ebola gets a strong foothold here in the U.S., then the traveling question won’t matter.

There are a limited number of medical facilities in the U.S. that can isolate and treat EVD patients, and there are nowhere near enough in West Africa. There are also limited supplies of personal protective gear designed to keep medical staff protected. This results in many health care professionals getting infected in West Africa and we could see the same thing here.

There is currently no cure or vaccine. If you get EVD, you either get better, or you die.


The Good News

EVD is not yet able to spread via air – at least outside the range of droplets in a cough or sneeze. Granted, you don’t want a victim to cough on you, but you don’t have to worry about walking around and catching EVD by simply breathing the air near a sick person’s house. This makes it much less transferrable than the flu or SARs. It is also not thought to be transferrable through insects.

You can catch it by getting the virus and/or aforementioned bodily fluids in your eyes, mucous membranes or through an open wound or scratch. This is why doctors wear face shields and why you should wash your hands with soap and water frequently. Be aware that a sick person could leave one or more of these bodily fluids on something that you could touch – a door handle, a bus seat, a dollar bill, a sidewalk – and no one really knows how long that virus will stay dangerous. Another reason to wash your hands, use hand sanitizer and wash any potentially exposed area with a Clorox solution. (Medical personnel recommend a 10-to 1 solution of water to bleach.)

While the disease has an incubation period of 2 to 21 days (most people get sick 4 to 10 days after exposure), people who are carrying the disease but not yet showing symptoms are reportedly not contagious.  The danger is that people with mild illnesses tend to show up at work or school, which means they could be spreading it even though they don’t feel very sick.

EbolaLabCompanies are working on developing drugs to treat EVD and vaccines to prevent or mitigate infection. At some point, there may be antibodies from patients who survived that can be given to new patients. While these are largely untried and developmental, it is expected that the government will provide expedited approvals rather than the years it normally takes to get a drug through the FDA approval process. So if you can survive the epidemic long enough, there may be a vaccine you can take in the future.

If things get bad, I expect the government to require or force companies work on and production of vaccines and other drugs for the treatment of EVD. All it takes is one executive order and the government could swoop in and take over a production facility. Thais assumes, of course, that there is a vaccine to produce.

As things stand today, your chances of getting Ebola are quite small. Keep in mind, Liberia is in the middle of the epidemic and only 1 in 1,000 people there have contacted the disease, and many of them were medical personnel who were directly treating the sick. If it hits the U.S., it will start slowly and you should have some warning and time to prepare.

Still, there are things you can do to minimize those chances even further. Here are some suggestions of things to do now, before the outbreak reaches the U.S. in any kind of severity:

  • Avoid travel outside the U.S., especially to Africa and other third-world and developing nations.
  • Avoid people who have traveled internationally in the past three weeks.
  • Stay off airplanes, which appear to be the primary vector of EVD into the U.S.
  • Avoid emergency rooms for routine medical care (unless you think you have Ebola). If possible, make an appointment with your doctor instead of going to the emergency room.
  • Avoid anyone who is sick, especially if they look sweaty and worn out. Call an ambulance if they need it, but do not provide any care personally that could potentially expose you to the Ebola virus.
  • Get a flu shot. I don’t usually get one, but I think I will this year. Probably not a good year to show up at the ER with the flu.

Once the virus reaches the U.S. and begins to spread, add these additional steps:

  • Start practicing social withdrawal or social avoidance to minimize potential exposure. In other words, don’t go out any more than you have to.
  • Minimize your exposure to other people. Do business by phone or video chat, not in person.
  • Avoid shaking hands. Adopt the “fist bump” instead, or just keep your distance.
  • Avoid crowded areas, including athletic events, state fairs, concerts, etc.
  • Stop eating out.
  • Wash your hands frequently and/or use hand sanitizer. Why? Because the average adult touches his or her face between 15 and 20 times per hour, and that’s how diseases can enter your body. (It’s reportedly 50 times per hour for kids.)
  • Stay off mass transit and avoid public places where a contagious person could have sweated.
  • Consider working out at home instead of going to the gym.
  • Avoid unnecessary shopping. When you have to go shopping, minimize the time spent in the store and shop at slow times when fewer people are present. Order online and have goods dropped on your porch instead of meeting the driver and signing for the order.
  • When you come home from work, shopping or another activity, consider heading right to the shower and showering with plenty of soap when you do get home.

Should the virus start to spread more rapidly, or when someone you know or know of is confirmed to have EVD, take these additional measures:

  • Move from social avoidance to self-quarantine. In other words, stay at home. Do not leave the house or yard unless it is an emergency and if you are in the yard, make sure you have no contact with neighbors or strangers/ (People with kids will have to enforce this with an iron fist.) This means
    • Pull the kids from school. If the teachers threaten you, tell them you are leaving town or are going to be home schooling them for the duration of the emergency.
    • Stop going to work. Get permission to work from home. Take a leave of absence if you can, use the FMLA if possible, or just quit if they give you no choice.
  • If you are an apartment dweller and live in an urban area, this would be a good time to consider leaving for the duration of the emergency. In other words, bug out before martial law or travel restrictions prevent you from leaving. Bug out to a place with much lower population density where you can easily go all day without coming face-to-face with another person.
  • If one family member insists on working or cannot participate in self-quarantine, that individual should stay at home and the others bug out, or he or she should move into a hotel or short-term rental for the duration. You can Skype, use Facetime or other electronic means to communicate, but do not meet in person for any reason.

The good news is that unlike a hurricane or an EMP strike, the power and other utilities are likely to stay on – at least for a while — during an Ebola epidemic. That means you can live on food in your freezer, heat or cool your house, have hot-and cold running water etc. While you may not be able to go to the bank, electronic systems may keep working, allowing you to pay bills and make purchases. The pandemic would have to reach catastrophic levels for a complete and total failure of our infrastructure. Far more likely would be a shortage fo food and other goods that must be transported and handled by people.

Stock Up Now

I have always said that by preparing for a specific event, you are at least 80% prepared for any event. So if you are prepared for the end of the world as we know it (whether that is an EMP, economic collapse, war or other cataclysm), then you are already 80 percent of the way to being prepared for EVD. That means you only need to add preps that are specific to Ebola or any other deadly, contagious disease. This would include:

  • CloroxBottleBottles of Clorox or another brand of bleach, which can be used to decontaminate areas and kill the virus. Consider adding some buckets, small spray bottles, and possibly a larger garden sprayer to use to spray down people or things that may be contaminated.
  • Cans of Lysol, Clorox wipes, and other cleaning products.
  • M95 face masks, face shields, gloves, and protective clothing. A full suit would include the mask and face shield, as well as a hooded suit with protective booties and two layers of gloves. These are useful should you need to leave your self-imposed quarantine for any length of time to deal with the outside world. Many of these items are already in short supply and manufacturers are reportedly working three shifts a day to produce as many as possible. If standard suppliers are out of stock, consider looking at Home Depot or Lowes. Often items designed to protect painters and people using hazardous materials will protect you from biological hazards as well. Even if they are not certified, it’s better than nothing.
  • Hand sanitizer and other personal cleansing products.
  • Think about what you and your family would need to occupy themselves if you were to be locked inside your house for six months. Yes, you can download movies and watch TV, but that if services are degraded? Have books and board or card games you can play by candle light.
  • Double check your traditional preps, especially related to food and water, to ensure you could survive for three to six months without outside support. Stock up on

Remember, this is early in the advanced warning phase, yet supplies are already getting harder to find. Our MRE supplier is back ordered on multiple MRE menus and cannot tell us when they can fill our back order. Our canned meat supplier is running three weeks behind on filling both beef and chicken orders. Suppliers of medical and personal protective equipment are working three shifts and these items are still back ordered. So if you need supplies, buy them – or at least order them – now, because it will be too once Ebola reaches your state.


Have A Plan, Build Some Skills

The important thing is to have a plan. Know what you will do before Ebola hits your town so that you can put your plan into action instead of wasting time. Planning to leave? Have a map with alternate routes, have a list of what to pack, know where you plan to stop along the way, have a means to communicate between vehicles if you take more than one, etc. Be ready to leave on short notice so you can beat the rush and beat the potential government roadblocks.

If you are sheltering in place and practicing self-quarantine, know when you will go into lock down. Know how you will communicate with others and enforce your plans. Know how you will protect yourself from contact or from aggressive predators looking to loot and steal.

If you don’t know how to insert an IV or how to make oral rehydration solution, this is the time to learn. If you haven’t unpacked your grain mill or checked to see if the brick of yeast in your pantry is still active, this would be a good time to do that. If you are a prepper, practice prepping.


The Danger Lies Beyond the Virus

You may never get Ebola, but that doesn’t mean this epidemic can’t kill you. If it spreads in the U.S., EVD is likely to incite panic, and possibly a deterioration of the rule of law. Either one could result in a dangerous situation. Let’s look at some scenarios for how the outbreak might happen in the U.S.

(Please keep in mind that these scenarios are made up. We’re not saying we expect one or the other. This is just a few potential scenarios that are useful to consider as you evaluate your preps and develop your plan.)

Scenario 1 – A Large Single-Point Outbreak

Ebola breaks out in a large, crowded city that has a large immigrant population and is served by an international airport, such as Miami or New York. By “breaks out” I don’t mean infects a few people; I mean a few hundred people over the course of a week or so, enough that the National Guard builds tents in the hospital parking lots to treat the influx of patients and where refrigerate tractor trailers are lined up to hold the dead bodies.

In this scenario, expect the following:

  • People will panic and try to flee, and the government will want to contain the outbreak, so it will try to stop them from doing so. This will result in civil unrest, someone will over-react, and people will be killed. It will probably be filmed and broadcast via YouTube, and things will escalate, getting much worse more quickly. Before you know it, there will be looting and arson, and mayhem.
  • Full out martial law could be declared with curfews and travel limitations. This will be protested as racist, as a violation of our rights, etc., but it won’t matter. Just as smugglers have always been able to run blockades, it will also be impossible to stop everyone from leaving and the disease will break out in surrounding areas as “escapees” who are contaminated but not sick bring it with them. This will result in more aggressive government action and probably vigilante action as both formal and spontaneously-formed militias step in to protect their town, county or nceck of the woods from “disease-ridden outsiders.”
  • Expect airlines to stop flying in and out of infected areas, not just due to government orders but because pilots and flight crews will refuse to do so. As the disease spreads, all commercial airliner passenger flights could be suspended.
  • Truck drivers may also refuse to drive into contaminated areas, meaning food deliveries will slow or even stop. Companies may stop sending trucks if the roadblocks will not let them back out. The government will be forced to set up transfer areas outside the infected zone where commercial trucks drop off supplies that are then carried into the danger areas by military or contractors.
  • During an outbreak of this magnitute, people will stop going to work because they fear getting sick, and the local population won’t get services. Restaurants will close. Stores will run out of food and supplies or will close simply because they do not have staff to work the registers. It won’t be long before people like ambulance drivers will quickly see that risking exposure is not worth their $12 to $15-an-hour paycheck. Then things will slowly shudder to a halt. Some healthcare workers will stop showing up for their shifts. Police and firemen will stop responding to sickness calls and change the way they respond to keep themselves safe. The rule of law will have fault lines, and chaos and mayhem will enter in through those cracks.
  • Ideally, the damage will be contained to one geographic area and other parts of the country will function relatively normally. Crops will be harvested, oil will be pumped and refined, food will reach store shelves, and help will be provided to the infected area. Sure, people will die, but the country as a whole will survive.


Scenario 2 – Multiple, Small Outbreaks

In this scenario, there are pockets of small scale outbreaks that pop up seemingly at random. At first, it will be in big cities and people in small towns will feel safe. Then some small ton in Indiana or Oregon will have an outbreak and people will recognize that it could happen anywhere.

The outbreaks will be contained – just like in Dallas – but they will happen over and over again until it becomes the New Normal. Today, one patient with EVD in the U.S. makes national headlines and dominates cable news. When an outbreak doesn’t get mentioned on the national news, you will know it Ebola is here to stay.

The results of this scenario will be far different and involve significant social change, just as the emergence of HIV and AIDS did three decades ago:

  • There will be significantly less in-person social interaction. The bubble of personal space most of us are used to will increase to three or four feet.
  • Sick people will be shunned and treated with fear and suspicion. People who catch the common cold will be sent home from work and not allowed to come to school.
  • Laws will be passed stripping civil rights from anyone with symptoms. There will be plans in place to snatch up potentially sick people and whisk them off to isolation units where they will be tested and monitored. Should they be sick, everything from the contents of their phones to the contents of their homes will be subject to official search and seizure.
  • Homeless people will be shunned and swept up as a potential “disease vector.”
  • Containment camps will be created to hold the families of those in isolation units or with the disease.
  • Our ability to cure infected people will improve, but the treatments will be expensive, and there will be complaints that the poor or certain minority groups are not receiving treatments. Health insurance costs will go up for everyone.
  • Eventually, a vaccine to prevent it will be developed. The government will go to great lengths to force everyone to get vaccinated and there will be protests and strife, but the vaccine will reduce Ebola to a nuisance instead of a death sentence.
  • In five years, no one will really worry about Ebola.


Scenario 3 – Massive, Multiple Outbreaks

This is the worst-case scenario, and would be likely only if Ebola mutates to become transmissible by air. While this is possible, it is considered highly unlikely.

In this scenario, the Ebola spreads to dozens and then hundreds of locations, overwhelming the medical system. It becomes so pervasive that the government cannot control outbreaks and cannot provide enough emergency response. Commerce could grind to a halt. Utilities could slowly shut down. Law and order will evaporate. It will be a WROL (without rule of law) situation in which it is every man for himself.

In urban areas, half the population could be sickened and at least half of them could die. Others will get sick due to lack of food, lack of running water, lack of sanitation facilities, etc. Then cold weather will set in when there is no gasoline, no natural gas, and no oil and people who managed to avoid the disease will be killed by exposure.

Survivors will be those who are lucky, or self-sufficient. They will have avoided exposure and have enough resources to live. They will have had effective plans in place to minimize or eliminate disease vectors and avoid infection. This is where your preparations will benefit you the most.

Should You Worry about Ebola?

If you unprepared, then you should probably worry. And that worry should motivate you to prepare as best you can given your resources. If you are already well-prepared, then you should plan, practice and update your preps.


Recent Resources

Read this excellent article from the Washington Post that provides a great deal of useful information:



Ebola isn’t the only communicable disease of concern, as we see in this article from Forbes.



An Interesting Discussion of What Happens to Your Rights Under Ebola



How’s the government doing so far?



The Latest Ebola Danger: India

I know we’ve been writing about Ebola quite a bit lately, but it’s an issue that those concerned about their survival and long term well-being should not ignore. This is the calm before the storm – possibly your final chance to prepare. It’s analogous to the time between when the hurricane has been spotted out at sea and when it hits your town. But instead of buying batteries, bottled water and plywood for your windows, this is the time to stock up on masks, filters, gloves, Lysol, bleach, and enough supplies for a long period of self quarantine.

How long should you prepare for? As long as you can. The disease has been spreading for six months in Africa. Who knows how long it will take to run its course if it reaches the U.S.? Of course, if the disease strikes here, you really only need to live in self quarantine until they come out with a vaccine and have had enough trial cases to prove that it works.

In any case, this article from the Times of India was posted earlier today on the Drudge Report, and from what I can see, the potential disaster it represents is being ignored. India is tracking 773 passengers who have flown into India from Ebola hot spots, and several of them have been quarantined at the airport.

If you didn’t bother clicking on the link, just look at this quote:

On Tuesday, IGI airport witnessed hectic activity with passengers being rushed out of the airport and an APHO (Airport Health Organization) ambulance making several rounds from their office at the airport and T-3’s arrival terminal. The first flight from Liberia, routed via Doha, QR564, landed at IGI at 7.40 am. The next flight — Ethiopian Airlines — came almost an hour later. Three passengers from it were rushed to APHO in an ambulance.

The Ebola suspects were wearing a suit and face mask. Officials at the airport said the aircraft carrying the passengers was being sequestered and fumigated. “The luggage of the Ebola suspects is also being isolated,” an official said.

The scare this disease has caused was palpable inside and outside the airport.

To give the Indian authorities credit, they seem to be on top of this and doing a pretty good job monitoring the incoming travelers, but I have to ask: When will it be time to stop allowing inbound flights from these countries where the Ebola pandemic rages?

I am by no means an expert on conditions in India, but I do know that they have slums with millions of people packed together, living in tight confines with little access to medical care or running water.  (Watch this short  video from National Geographic for a glimpse of life in the slums.)   How fast would Ebola spread if a few people in one of these slums got sick?

Slums of Hyderabad India

If hundreds of sick people in villages spread across four countries in Africa is considered a crisis, what would you call tens of thousands of Ebola victims in Delhi, the worlds’ sixth largest city?

“The end of the world as we know it” comes to mind.

Ebola Drops from News, But Epidemic Worsens

Now that the two U.S. missionaries have been returned to the U.S. for treatment, Ebola has become less of a news story.  Like the evolving situation in the Ukraine and the progress of ISIS in Iraq, Ebola has been removed from the top of news casts by news closer to home: civil unrest in Ferguson, Mo., where protests against the shooting of an unarmed black man by a white police officer have evolved into looting.

Do not for as second think that Ebola is less of a threat than it was two weeks ago.  If anything, things have grown worse as the disease has spread further and become more difficult to contain in Africa.  While cases have yet to be found in the developed world, it will not be Here are just a few stories to keep you up to date:


New York Hospital May Have Ebola Patient

Earlier today, the Wall Street Journal published an opinion piece by W. Ian Lipkin, who is professor of epidemiology and director of the Center for Infection and Immunity at the Mailman School of Public Health and College of Physicians and Surgeons, Columbia University.

Among his salient points are these that should be of interest to those concerned about a pandemic in the U.S.:

  • Ebola requires “Intimate contact with bodily secretions such as vomit, blood or feces,” while viruses like the flu and SARS are “primarily transmitted through droplets in the air and on surfaces, droplets released when an infected person coughs or sneezes.” So Ebola is harder to transmit.
  • There won’t be animal vectors like pigs, rats, or mosquitoes, which will mitigate transmission.

Of course, it was only a few hours later when they reported that the Mount Sinai Hospital in New York was testing a patient for Ebola. He had just returned from West Africa and had a high fever and “symptoms consistent with the Ebola virus.” Results are expected in 24 to 48 hours.

My guess is that they are doing everything they can to expedite the test. If it turns out to be Ebola, we’ll get to see the accuracy of Dr. Lipkin’s hypothesis with a real-world experiment on how well the virus spreads.  Could be the beginning of a significant health crisis or tit could be a false alarm.

What To Do if an Ebola Outbreak Reaches the U.S.

I think it is quite possible that we will see cases of Ebola in the United States within the next 90 days. I expect it will be like SARS, only a small outbreak that will be contained but there could be hot spots where there are a concentrated number of cases, especially in urban areas where. Health care workers may be the most likely to get it, followed by family members of those who are already ill.

This disease reportedly has an incubation period of two to 20 days, with most cases developing in 8 to 10, but it is not believed to be contagious during this incubation period. This means that people who might be exposed would have to be quarantined for three weeks to be sure they are not carrying the disease. And if you are quarantined with someone who does have it, the odds of you walking out not something a betting man would wager on.

Ebola Warning SignFrom what we know if of it, the Ebola virus is spread by blood, fecal matter , saliva and semen, but is much harder to catch than the flu or the common cold. Symptoms present like the flu with fever, weakness, headaches, diarrhea and vomiting, Then the hemorrhaging starts and you bleed from every orifice. This Is when it is highly contagious because you are leaking, vomiting, coughing and pooping a spray of highly contagious, bodily fluid.

How to protect yourself: Unless you strongly believe you are a victim, try to stay out of hospitals and other medical facilities where sick people will go to seek treatment. Stay far away from people who are sick and their caregivers. Don’t travel by air. Do not go to crowded locations like the state fair, concerts, malls, etc. Buy lots of rubber gloves, surgical masks, and goggles. Stock up on food before an epidemic strikes.

Self-quarantine yourself and your family at the first sign of an outbreak in the U.S. This means that you withdraw from society and stay away from those who may have it or have been exposed to it. Ideally, you will have stored food, but if not, make on last trip to the grocery store or club store and buy enough food for six or eight weeks. Then lock your doors and talk to people via phone or skype rather than in person. Don’t have contact with anyone for at least 28 days after the outbreak is over.

In Liberia, where the outbreak has killed hundreds, schools have been closed and public events cancelled. This is a good idea, but it is too late. Self quarantine means taking yourself out of school, work and public activities well before the government takes action. Preferably, you would withdraw before the disease reaches your area of the country.

Keep your spirits up! Remember that SARS was an ugly disease with a high rate of death and today we barely remember it. Chances are, an Ebola outbreak in the U.S. will be small and contained. In any case, we’ll know pretty quickly if it starts to spread.