America Failed Mr. Duncan!

Medical treatment for Ebola should not be subject to any health insurance qualification or citizenship test. It cannot be over-emphasized that Ebola is a threat to humanity as we know it. If you don’t understand this fact, wake up! I compare Ebola to a much fictionalized specter of a deadly alien invasion of our planet. This time, we are not dealing with a movie. It’s a reality! The World Health Organization (WHO) says that “the average EVD case fatality rate is around 50% [,] and that case fatality rates have varied from 25% to 90% in past outbreaks” (http://www.who.int/mediacentre/factsheets/fs103/en/).

The fact that, so far, this deadly alien invasion is largely confined to a segment of our world but with sporadic and minor leakages onto other parts of our planet, should not lull us into thinking that we are inexorably shielded from it. Our fellow human beings who have been stricken by this alien invasion are innocent and hapless victims and should be treated with sympathy and given all the support and help that we can muster as humanity acting together for our collective good.

All of this brings to mind the recent case of Mr. Thomas Eric Duncan, a fellow human being, who we lost to Ebola a few days ago. So far, humanity has lost close to four thousand hapless men, women and children to this new but biggest outbreak of Ebola (http://apps.who.int/iris/bitstream/10665/136020/1/roadmapsitrep_8Oct2014_eng.pdf?ua=1). You will recall that in September, 2014, the late Mr. Duncan visited family members in the city of Dallas in Texas State of the United States from Liberia. All available news reports indicate that he did not show any symptom of the disease before he left Liberia although he might have been exposed to someone who was suffering from it (http://fox40.com/2014/10/02/us-ebola-patient-thomas-duncan-lied-about-exposure-to-disease/).

It would appear that Mr. Duncan's case was mishandled from the very get going. He should not have been turned away or allowed to go home during his first emergency room hospital visit in Dallas, Texas on September 26. It would appear that what sometimes comes across as a general grassroots lack of knowledge of world geography in our society, might have played a role here. If the staff on duty at the Dallas Presbyterian Hospital where he initially went for emergency medical help upon taking ill, had a prior knowledge of a country called Liberia and a patient walked in identifying himself/herself as having recently arrived from Liberia and was actually ill and feverish, pertinently-knowledgeable staff should have swung into action by immediately putting him in a quarantine for urgent and serious treatment. If the staff on duty had pertinent knowledge of geography (unfortunately, a lot of students tend to refer to Africa as a "country"), the word "Liberia" would have signaled danger to them once a patient reported himself as having recently arrived from there, feverish and feeling seriously ill.

Another aspect of our socioeconomic system that probably proved problematic in the case of Mr. Duncan is the system of health insurance. I don't know if people who go to hospital emergency rooms (ERs), as Duncan did, without medical insurance, do receive attentive attention and good care.

Furthermore, extreme individualism, which tends to be a prevalent social ethic within this Western world, seemed to have also manifested its downside in the sub-conscious in terms of the fact that the hospital staff, who initially attended to Mr. Duncan, demonstrably did not feel compelled and apparently did not experience an innermost sense of urgency to immediately quarantine Mr. Duncan for the sake of the public good.

How about our unresolved problem of reflexive negativism towards people who do not look like us? Did race play a role here as well? Would anyone contend that if Mr. Duncan was white and was also visiting from Liberia, that he would have been treated in the same manner by the various points-of-contact in our overall system of health care? Are we not aware that all of the Ebola-stricken persons (white Americans of course) who, prior to Mr. Duncan’s case, had been specially flown back here and hospitalized here, did receive a successful cure? Are we proud to establish a new record in differential treatment of patients who are sick of the same disease—a record that, this time, received world-wide attention? Did Mr. Duncan’s noncitizen ship affect the quality of care that he received? Should it have been so, given that Ebola threatens all of humanity as we know it?

I don't think that Mr. Duncan had Ebola before he left Liberia. If he did, he would not have passed the preboarding temperature test that was reportedly administered upon him at Monrovia, capital of Liberia.  Even if he had harbored an innermost worry that his alleged contact with an Ebola patient, while in Liberia, might have compromised his health without him being aware of it and without him showing any symptoms of the disease, the fact that he was not only successful in securing a visa to visit the USA (a herculean task in and of itself in today's Ebola-induced international panic), but he was also able to purchase a flight ticket whose cost cannot be afforded by an average member of the poor and downtrodden population of Liberia, to me, represented transient life opportunities that perhaps anyone in Mr. Duncan’s shoes would have taken advantage of in order to seek refuge and succor in our country which possesses an abundance of viable health facilities where his life could be saved in the eventuality that he came down with the disease.

Though I give credit to the United States government for all of the efforts and resources that it has deployed (http://www.whitehouse.gov/the-press-office/2014/09/16/fact-sheet-us-response-ebola-epidemic-west-africa) in helping the geographically far-away West African countries (Liberia, Guinea and Sierra Leone) that are currently the most Ebola-victimized population centers of our planet (below is a WHO latest table of Ebola cases and deaths in those three most-victimized countries), it is my humble conclusion that America failed Mr. Duncan who was within our shores and whose proximity to us should have thus made him an easier target of our generous hearts!

Table

Country	Case Definition	Cases	Cases in past 21 days	Cases in past 21 days/total cases	Deaths
Guinea	Confirmed	1044	253	24%	587
	Probable	180	13	7%	179
	Suspected	74	65	88%	2
	All	1298	331	26%	768
Liberia	Confirmed	941	136	14%	1018
	Probable	1795	567	32%	701
	Suspected	1188	651	55%	491
	All	3924	1354	34%	2210
Sierra Leone	Confirmed	2455	924	38%	725
	Probable	37+	0	0%	123
	Suspected	297	190	64%	31
	All	2789	1114	40%	879
Total		8011	2799	35%	3857

Table: Courtesy of the World Health Organization (WHO) (http://apps.who.int/iris/bitstream/10665/136020/1/roadmapsitrep_8Oct2014_eng.pdf?ua=1)

Given our country’s prior record of success in curing Ebola patients (though those patients were US citizens and, of course, white) who were brought back to the United States for medical treatment after contracting the disease abroad, there exists a track record of therapy that serves as a reasonable basis for one to suggest that Mr. Duncan did not have to die (http://abcnews.go.com/Health/texas-ebola-patient-thomas-eric-duncan-died/story?id=26045360). Our society should have extended to him, the same quantity and quality of care that were given to prior cases by our system of medical therapy.

In any case, there is hope that we may not be too far away from completing the development of instruments by which humanity can halt the occurrence and spread of Ebola. According to the World Health Organization (WHO), there have emerged “two candidate vaccines” with “clinical-grade vials available for phase 1 pre-licensure clinical trials.” In the words of WHO, the potential vaccines are as follows:

One (cAd3-ZEBOV) has been developed by GlaxoSmithKline in collaboration with the US National Institute of Allergy and Infectious Diseases. It uses a chimpanzee-derived adenovirus vector with an Ebola virus gene inserted.

The second (rVSV-ZEBOV) was developed by the Public Health Agency of Canada in Winnipeg. The license for commercialization of the Canadian vaccine is held by an American company, the NewLink Genetics company, located in Ames, Iowa. The vaccine uses an attenuated or weakened vesicular stomatitis virus, a pathogen found in livestock; one of its genes has been replaced by an Ebola virus gene (http://www.who.int/mediacentre/news/ebola/01-october-2014/en/).

As we make progress on these and other ongoing projects designed to checkmate Ebola, let us do and continue to do all we can to help out its victims, no matter what may be their citizenship and regardless of the color of their skin pigmentation.