What We’re Afraid to Say About Ebola

The Opinion Pages | Op-Ed Contributor

What We’re Afraid to Say About Ebola

By MICHAEL T. OSTERHOLMSEPT. 11, 2014

Photo

Credit Jonathon Rosen

MINNEAPOLIS — THE Ebola epidemic in West Africa has the potential to alter history as much as any plague has ever done.

There have been more than 4,300 cases and 2,300 deaths over the past six months. Last week, the World Health Organization warned that, by early October, there may be thousands of new cases per week in Liberia, Sierra Leone, Guinea and Nigeria. What is not getting said publicly, despite briefings and discussions in the inner circles of the world’s public health agencies, is that we are in totally uncharted waters and that Mother Nature is the only force in charge of the crisis at this time.

There are two possible future chapters to this story that should keep us up at night.

The first possibility is that the Ebola virus spreads from West Africa to megacities in other regions of the developing world. This outbreak is very different from the 19 that have occurred in Africa over the past 40 years. It is much easier to control Ebola infections in isolated villages. But there has been a 300 percent increase in Africa’s population over the last four decades, much of it in large city slums. What happens when an infected person yet to become ill travels by plane to Lagos, Nairobi, Kinshasa or Mogadishu — or even Karachi, Jakarta, Mexico City or Dhaka?

The second possibility is one that virologists are loath to discuss openly but are definitely considering in private: that an Ebola virus could mutate to become transmissible through the air. You can now get Ebola only through direct contact with bodily fluids. But viruses like Ebola are notoriously sloppy in replicating, meaning the virus entering one person may be genetically different from the virus entering the next. The current Ebola virus’s hyper-evolution is unprecedented; there has been more human-to-human transmission in the past four months than most likely occurred in the last 500 to 1,000 years. Each new infection represents trillions of throws of the genetic dice.

If certain mutations occurred, it would mean that just breathing would put one at risk of contracting Ebola. Infections could spread quickly to every part of the globe, as the H1N1 influenza virus did in 2009, after its birth in Mexico.

Why are public officials afraid to discuss this? They don’t want to be accused of screaming “Fire!” in a crowded theater — as I’m sure some will accuse me of doing. But the risk is real, and until we consider it, the world will not be prepared to do what is necessary to end the epidemic.

In 2012, a team of Canadian researchers proved that Ebola Zaire, the same virus that is causing the West Africa outbreak, could be transmitted by the respiratory route from pigs to monkeys, both of whose lungs are very similar to those of humans. Richard Preston’s 1994 best seller “The Hot Zone” chronicled a 1989 outbreak of a different strain, Ebola Reston virus, among monkeys at a quarantine station near Washington. The virus was transmitted through breathing, and the outbreak ended only when all the monkeys were euthanized. We must consider that such transmissions could happen between humans, if the virus mutates.

So what must we do that we are not doing?

First, we need someone to take over the position of “command and control.” The United Nations is the only international organization that can direct the immense amount of medical, public health and humanitarian aid that must come from many different countries and nongovernmental groups to smother this epidemic. Thus far it has played at best a collaborating role, and with everyone in charge, no one is in charge.

A Security Council resolution could give the United Nations total responsibility for controlling the outbreak, while respecting West African nations’ sovereignty as much as possible. The United Nations could, for instance, secure aircraft and landing rights. Many private airlines are refusing to fly into the affected countries, making it very difficult to deploy critical supplies and personnel. The Group of 7 countries’ military air and ground support must be brought in to ensure supply chains for medical and infection-control products, as well as food and water for quarantined areas.

The United Nations should provide whatever number of beds are needed; the World Health Organization has recommended 1,500, but we may need thousands more. It should also coordinate the recruitment and training around the world of medical and nursing staff, in particular by bringing in local residents who have survived Ebola, and are no longer at risk of infection. Many countries are pledging medical resources, but donations will not result in an effective treatment system if no single group is responsible for coordinating them.

Finally, we have to remember that Ebola isn’t West Africa’s only problem. Tens of thousands die there each year from diseases like AIDS, malaria and tuberculosis. Liberia, Sierra Leone and Guinea have among the highest maternal mortality rates in the world. Because people are now too afraid of contracting Ebola to go to the hospital, very few are getting basic medical care. In addition, many health care workers have been infected with Ebola, and more than 120 have died. Liberia has only 250 doctors left, for a population of four million.

This is about humanitarianism and self-interest. If we wait for vaccines and new drugs to arrive to end the Ebola epidemic, instead of taking major action now, we risk the disease’s reaching from West Africa to our own backyards.

Michael T. Osterholm is the director of the Center for Infectious Disease Research and Policy at the University of Minnesota.

A version of this op-ed appears in print on September 12, 2014, on page A31 of the New York edition with the headline: What We’re Afraid To Say About Ebola. Order Reprints|Today's Paper|Subscribe

Why Is Pope Francis Throwing Nuns Who Share His Beliefs Under the Bus?

  BELIEF  

The Guardian

by Sadhbh Walshe

Why Is Pope Francis Throwing Nuns Who Share His Beliefs Under the Bus?

Not a peep from the Pope as nuns are censured for not focusing on abortion and gay marriage.

May 8, 2014

In the earliest days of his tenure, Pope Francis became one of the world's most admired religious figures – due in large part to his vocal support and actions on behalf of social justice. So, to many Catholics, there is more than a little disappointment that he is turning a blind eye to the Vatican's ongoing crackdown on America's nuns.

The really disheartening thing about the pope's unwillingness to end the nuns' censure – indeed, about his unwillingness to openly support them – is that his stated values are no different than the ones the Leadership Conference of Women Religious (LCWR) is being punished for carrying out. 

Instead, the church has scolded a group of highly-educated, highly-accomplished and forward-thinking women like a bunch of errant school girls.

The first time was in 2012, when the nuns got accused of undermining the church's hierarchy by "promoting radical feminist ideology". Yes, the Vatican officially censured the LCWR – with no apparent irony – for spending too much time on poverty and social justice concerns, and not enough time condemning abortion and gay marriage.

A year later, when the more liberal Pope Francis took over, the nuns and their many supporters were hopeful that the censure would be lifted. But last week's rebuke by Cardinal Gerhard Mueller, the head of the the Vatican's doctrinal watchdog, dampened those hopes.

In this latest knuckle-rapping, Mueller took issue with the LCRW's plans to honor a feminist theologian, Elizabeth Johnson, whose writings on conscious evolution and other matters have been criticized by US bishops. He went on to remind the "misbehaving" nuns in the strongest possible terms that their organization held its status within the church only through Vatican approval – and that if they wished to retain that status, they would have to toe the church line and focus more of their work on issues like abortion and less on social justice.

I spoke this week with Sister Simone Campbell, the executive director of Network (a Catholic social justice lobby) and the driving force behind the Nuns on the Bus tour. Sister Campbell's group was singled out as one of the trouble-makers in the Vatican's 2012 assessment, mostly because it came out in support of the Affordable Care Act, which the US Catholic bishops opposed. "The Catholic sisters in the United States keep getting caught in the middle of the Vatican's infighting over political resistance to reforms," she told me. "Calming the concerns of conservatives is still a priority for the church."

Still, Campbell says she believes the pope does support the sisters' goals, even if he can't (or won't) come out and say it directly. She pointed out that Cardinal Kasper, who is generally known as the pope's theologian,came out in support of the LCRW's work during a speech at Fordham University in New York this week. Kasper told the crowd that he highly esteemed the work of Elizabeth Johnson, and joked that he, too, is considered "suspect" by the Vatican. Given Kasper's close relationship with the pope, it's not unreasonable to assume that he spoke with the Pontiff's knowledge – if not approval. But is this indirect endorsement really the most that women in the church can hope for from a pope who's supposed to speak their language?

At the very least, women in the church – and women everywhere – should not have to question whether a pope who can speak so eloquently about the scourge of inequality is incapable of recognizing the very unequal treatment of women and men by his own church. Last year, 60 Minutescompiled a comprehensive report on the Vatican's standoff with the nuns. Among the many issues raised in the segment, the program noted the incongruity of the women's alleged doctrinal misdemeanors being treated as a "crisis" that required swift action, while it took decades for the church to seriously address the infinitely more serious crimes of pedophile priests – about which the Vatican only this week began issuing comprehensive data. For example, in 2007, when the church finally faced up to the sex-abuse scandal and began making reparation payments to victims, some archdiocese tried to evict nuns from their convents to fund the out of court settlements.

When women sin, they are made to pay the price. When men sin ... not so much.

Pope Francis has repeatedly stressed the importance of mercy over morals, while insisting upon the need to focus more attention on social justice. Last September, when the pope was asked by a fellow Jesuit what kind of church he dreamed of, he replied:

We cannot insist only on issues related to abortion, gay marriage and the use of contraceptive methods.

Whatever this week's censure of nuns – who are in trouble precisely for stressing social justice issues over abortion, gay marriage and birth control – says about the pope's dedication to his stated mission, one thing is more clear than ever: if the church continues to pressure an already-dwindling population of nuns to abandon its social justice work, Pope Francis may undermine his own agenda, just as much as some power players at the Vatican hope to undermine the nuns on and off the bus.

Sadhbh Walshe is a film-maker and former staff writer for the CBS drama series The District. Her opinion pieces have also been published in the Chicago Tribune and Irish Times.