The Most Terrifying Thing About Ebola

Health and medicine explained.
Sept. 19 2014 12:13 PM

The Most Terrifying Thing About Ebola 

The disease threatens humanity by preying on humanity.

Photo by John Moore/Getty Images
Suspected Ebola patient Finda “Zanabo” prays over her sick family members before being admitted to the Doctors Without Borders Ebola treatment center on Aug. 21, 2014, near Monrovia, Liberia.

Photo by John Moore/Getty Images

As the Ebola epidemic in West Africa has spiraled out of control, affecting thousands of Liberians, Sierra Leonians, and Guineans, and threatening thousands more, the world’s reaction has been glacially, lethally slow. Only in the past few weeks have heads of state begun to take serious notice. To date, the virus has killed more than 2,600 people. This is a comparatively small number when measured against much more established diseases such as malaria, HIV/AIDS, influenza, and so on, but several factors about this outbreak have some of the world’s top health professionals gravely concerned:

  • Its kill rate: In this particular outbreak, a running tabulation suggests that 54 percent of the infected die, though adjusted numbers suggest that the rate is much higher.
  • Its exponential growth: At this point, the number of people infected is doubling approximately every three weeks, leading some epidemiologists to project between 77,000 and 277,000 cases by the end of 2014.
  • The gruesomeness with which it kills: by hijacking cells and migrating throughout the body to affect all organs, causing victims to bleed profusely.
  • The ease with which it is transmitted: through contact with bodily fluids, including sweat, tears, saliva, blood, urine, semen, etc., including objects that have come in contact with bodily fluids (such as bed sheets, clothing, and needles) and corpses.
  • The threat of mutation: Prominent figures have expressed serious concerns that this disease will go airborne, and there are many other mechanisms through which mutation might make it much more transmissible.

Terrifying as these factors are, it is not clear to me that any of them capture what is truly, horribly tragic about this disease.

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The most striking thing about the virus is the way in which it propagates. True, through bodily fluids, but to suggest as much is to ignore the conditions under which bodily contact occurs. Instead, the mechanism Ebola exploits is far more insidious. This virus preys on care and love, piggybacking on the deepest, most distinctively human virtues. Affected parties are almost all medical professionals and family members, snared by Ebola while in the business of caring for their fellow humans. More strikingly, 75 percent of Ebola victims are women, people who do much of the care work throughout Africa and the rest of the world. In short, Ebola parasitizes our humanity.

More than most other pandemic diseases (malaria, cholera, plague, etc.) and more than airborne diseases (influenza, swine flu, H5N1, etc.) that are transmitted indiscriminately through the air, this disease is passed through very minute amounts of bodily fluid. Just a slip of contact with the infected party and the caregiver herself can be stricken.

The images coming from Africa are chilling. Little boys, left alone in the street without parents, shivering and sick, untouchable by the throngs of people around them. Grown men, writhing at the door to a hospital, hoping for care as their parents stand helplessly, wondering how to help. Mothers and fathers, fighting weakness and exhaustion to move to the edge of a tent in order to catch a distant, final glimpse of a get-well video that their children have made for them.

If Ebola is not stopped, this disease can destroy whole families within a month, relatives of those families shortly thereafter, friends of those relatives after that, and on and on. As it takes hold (and it is taking hold fast), it cuts out the heart of family and civilization. More than the profuse bleeding and high kill rate, this is why the disease is terrifying. Ebola sunders the bonds that make us human.

Aid providers are now working fastidiously to sever these ties themselves, fighting hopelessly against the natural inclinations that people have to love and care for the ill. They have launched aggressive public information campaigns, distributed updates widely, called for more equipment and gear, summoned the military, tried to rein in the hysteria, and so on. Yet no sheet of plastic or latex can disrupt these human inclinations.

Such heroic efforts are the appropriate medical response to a virulent public health catastrophe. The public health community is doing an incredible job, facing unbelievable risks, relying on extremely limited resources. Yet these efforts can only do half of the work. Infected parties—not all, to be sure, but some (enough)—cannot abide by the rules of disease isolation. Some will act without donning protective clothing. Some will assist without taking proper measures. And still others will refuse to enter isolation units because doing so means leaving their families and their loved ones behind, abandoning their humanity, and subjecting themselves to the terror of dying a sterile, lonely death.

It is tempting, at these times, to focus on the absurd and senseless actions of a few. One of the primary vectors in Sierra Leone is believed to have been a traditional healer who had been telling people that she could cure Ebola. In Monrovia a few weeks back, angry citizens stormed a clinic and removed patients from their care. “There is no Ebola!” they are reported to have been shouting. More recently, the largest newspaper in Liberia published an article suggesting that Ebola is a conspiracy of the United States, aimed to undermine Africa. And, perhaps even more sadly, a team of health workers and journalists was just brutally murdered in Guinea. It is easy, in other words, to blame the spread on stupidity, or illiteracy, or ritualism, or conspiracy theories, or any number of other irrational factors.

Photo by John Moore/Getty Images
A man checks on a very sick Saah Exco, 10, in a back alley of the West Point slum on Aug. 19, 2014, in Monrovia, Liberia.

Photo by John Moore/Getty Images

But imagine: You are a parent whose child has suddenly come ill with a fever. Do you cast your child away and refuse to touch him? Do you cover your face and your arms? Stay back! Unclean! Or do you comfort your child when he asks for you, arms outstretched, to make the pain go away?

Imagine: You live in a home with five other family members. Your sister falls ill, ostensibly from Ebola, but possibly from malaria, typhoid, yellow fever, or the flu. You are aware of the danger to yourself and your other family members, but you have no simple means to move her, and she is too weak to move herself. What do you do?

Imagine: You are a child of 5 years old. Your mother is sick. She implores you to back away. But you are scared. What you need, more than anything, is a hug and a cry.

Who can blame a person for this? It is a terrible, awful predicament. A moral predicament. To stay, comfort, and give love and care to those who are in desperate need, or to shuttle them off into an isolation ward, perhaps never to see them again? What an inhumane decision this is.