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DAILY COMMENT

TODAY 12:00 AM

After EbolaBY MICHAEL SPECTER

Red Cross workers carry the body of an Ebola victim inGuinea.PHOTOGRAPH BY SAMUEL ARANDA/THE NEW YORK TIMES/REDUX.

Since September 11, 2001, Americans have

had to adjust to an unsettling truth: as the

world becomes smaller and easier to

traverse, it also becomes more dangerous and difficult to control.

There are simply not enough fingers to put in all the dikes. So we

do our best: At airport security, we take off our shoes and dutifully

toss water bottles into the trash. On buses and in the subway, we are

often reminded, sensibly enough, that if we see something we

should say something.

But as the world’s worst Ebola epidemic yet spreads through

western Africa, it is important to remember that we won’t always

see something. “The single biggest threat to man’s continued

dominance on this planet is the virus,” the Nobel Prize-winning

biologist Joshua Lederberg once wrote. Few epidemiologists would

disagree. There is no bomb, no poison, no plan of attack with the

potential to do as much damage.

It doesn’t take much effort to see that. Smallpox killed up to half a

billion people in the twentieth century alone, before its eradication,

in the nineteen-seventies. (That’s why it was so terrifying to learn,

last month, that vials full of smallpox, alive and forgotten, had been

lying for decades in the refrigerators of a former N.I.H. laboratory.)The global public-health system needs to become far more vigilantin detecting new viruses before they spread. That will requirepatience, time, and money—an unlikely combination at best.

On Thursday morning, the President of Sierra Leone cancelled aplanned visit to the United States, declared a national healthemergency, and ordered the Army to quarantine people in theworst-affected areas. The Liberian government has shuttered thecountry’s schools and placed most public employees on a thirty-dayleave. The Peace Corps this week pulled three hundred and fortyvolunteers out of Liberia, Guinea, and Sierra Leone.

As many as ninety per cent of those infected with Ebola will die.There is no cure or treatment. There are several vaccines underdevelopment; in early animal tests, more than one has shownpromise. But it will be years before they are ready for humans. Untilthen, if you get Ebola, you are most likely done for. The virus caneat away at capillaries and blood vessels, causing you to drown inyour own blood. As David Quammen wrote in “Spillover,” thedefinitive book about the origin and evolution of human epidemics,“Advisory: If your husband catches an Ebola virus, give him foodand water and love and maybe prayers but keep your distance, waitpatiently, hope for the best—and, if he dies, don’t clean out hisbowels by hand. Better to step back, blow a kiss, and burn the hut.”

Still, Ebola’s more prosaic symptoms—abdominal and muscle pain,fever, headache, sore throat, nausea, and vomiting—also apply to atleast a dozen other conditions. Could an infected airline passengermake it to the United States? Absolutely. But in this country everydoctor and nurse in every clinic and hospital uses gowns, latexgloves, masks, and disinfectants. Those precautions are rarelyavailable in the parts of Africa where the epidemic has been mostsevere. Ebola is contagious only when it is symptomatic, and by thattime people are almost invariably too sick to travel. (Patrick Sawyer,

the only American to die so far in this outbreak, collapsed after a

flight from Liberia to Lagos. He was planning to fly next to

Minnesota. He never got on that plane.)

“I wouldn’t be worried to sit next to someone with the Ebola virus

on the Tube, as long as they don’t vomit on you or something,” Peter

Piot told Agence France-Presse this week. Piot, the director of the

London School of Hygiene and Tropical Medicine, was one of the

two people who, in 1976, discovered Ebola. He then ran the United

Nations’ AIDS program for more than a decade. “This is an

infection that requires very close contact,” he said.

Ebola is truly deadly, but the many lurid headlines predicting a

global pandemic miss a central point. In its epidemic reach, Ebola is

often compared with H.I.V. But they are nothing alike. H.I.V. has

killed at least thirty million people, mostly by spreading quietly,

burrowing into the cells it infects, and then, at times, lurking for

years before destroying the immune system of its host. Ebola’s

incubation period is between two and twenty-one days long. The

virus kills rapidly. There is nothing insidious about it.

Ebola won’t kill us all, but something else might. Like everything

living on Earth, viruses must evolve to survive. That is why avian

influenza (http://www.newyorker.com/magazine/2012/03/12/the-

deadliest-virus) has provoked so much anxiety; it has not yet

mutated into an infection that can spread easily. Maybe it never

will, but it could happen tomorrow. A pandemic is like an

earthquake that we expect but cannot quite predict. As Quammen

puts it, every emerging virus “is like a sweepstakes ticket, bought by

the pathogen, for the prize of a new and more grandiose existence.

It’s a long-shot chance to transcend the dead end. To go where it

hasn’t gone and be what it hasn’t been. Sometimes the bettor wins

big.”

He’s right, of course, and it is long past time to develop a system

that can easily monitor that process. If we don’t, the next pandemic

could make Ebola look weak.

Michael Specter has been a staff writer at The New Yorker since 1998, and haswritten frequently about AIDS, T.B., and malaria in the developing world, as well asabout agricultural biotechnology, avian influenza, the world’s diminishingfreshwater resources, and synthetic biology.

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