Doctors Without Borders: Don’t wait for Ebola magic bullets

Earlier this week I argued that hand-wringing over the lack of Ebola vaccines and drugs is misguided. We have effective tools to fight Ebola right now.

This week in the New England Journal of Medicine, physicians from WHO and Médecins sans Frontières make a similar argument much more eloquently:

There has recently been immense media, public, and medical attention to specific treatments for Ebola virus infection. Although these experimental interventions represent important potential treatments, they also reflect our seemingly innate focus on developing magic bullets. It seems that focusing on reducing mortality in the existing “control group” by applying the current standard of care is less interesting, even if much more likely to be effective. Though we recognize the potential incremental value of new antiviral options, we believe that EVD requires a greater focus on available basic care…

Public health interventions including characterizing the outbreak epidemiology, contact tracing, social mobilization, and public education are essential steps in stopping Ebola and will ultimately save many more lives than can be saved by individual patient care…

Excellent clinical care and improved outcomes will result in improved community compliance, will help to break transmission chains, and will lead to a greater willingness of health care workers to engage in care delivery. To quote William Osler, “The best preparation for tomorrow is to do today’s work superbly well.”

We don’t need to wait for vaccines to defeat Ebola

It’s unfortunate that Ebola drugs and vaccines are still experimental during the worst-ever outbreak of the virus. Ebola is causing massive disruption and economic damage in West Africa. The projection that, if things keep going as they are, tens of thousands could be infected by October is frightening.

But as I argue in my latest column over at Pacific Standard, we’ve already got the tools we need to fight the outbreak. While drugs and vaccines would without question be helpful, the main challenges are social, not scientific. Ebola infections have a high fatality rate, but like HIV (which infects almost 25 million Africans), the virus is not that inherently contagious. Outbreaks in the past have been quickly brought to an end with standard infectious disease control measures.

But there is the problem – those measures have failed in West Africa, and local institutions have been overwhelmed. Wealthier nations have been slow to give the help that’s needed. Contagion is not only a function of the virus itself, but also on social conditions. The current conditions in West Africa — poverty, poor communication, and a justified mistrust of local governments — have allowed this outbreak to get so bad. We don’t need to wring our hands over missing vaccines or drugs; we need to provide the equipment and personnel to tamp down the outbreak using the effective tools we already have on hand.

A 2006 report from a major conference on Ebola said as much: Continue reading “We don’t need to wait for vaccines to defeat Ebola”

Race for the Prize

There aren’t many mainstream songs about scientists. I only know of two. One is quite well-known but I don’t like it and it doesn’t really seem to be about science anyway. The other one is The Flaming Lips’ “Race for the Prize”. It was released in 1999 on The Soft Bulletin, and describes a competition between two scientists who are in a race to find “the cure” (not the band, all lower case).

Continue reading “Race for the Prize”