Ebola: Stop it Now, Before it Reaches Facebook


Ebola: Stop it Now, Before it Reaches Facebook

I’ve been following the unfolding ebola catastrophe in Africa via two very excellent, well-regarded, and level-headed infectious disease blogs: Avian Flu Diary and H5N1. As a parent of three small children, I’ve been following these blogs on and off for a few years now, and if you don’t have these two in your regular rotation, I highly recommend both of them. Between them these blogs cover 90% of the non-alarmist, fact-based news in the realm of infectious diseases. And both of these blogs are run by amateurs, so they have no financial incentive to drum up pageviews with alarmist headlines and ledes.

All of that having been said, I’ve recently found myself reading these two blogs’ coverage of ebola and wondering, “Okay really, should I freak out or not? Because I’m pretty sure I’ve seen this movie a few times, and I don’t love the ending.”

Ultimately, I’ve decided not to freak out, but I’ve also come to believe that ebola could have serious consequences for the US without actually infecting anyone on US soil. It has to do with the many ways in which we’re all so interconnected and with the fact that the foundation for domestic panic has been laid by Hollywood.

Good News, Bad News

Both blogs mentioned above have consistently taken the “don’t freak out” position, which can be roughly summarized as follows:

  1. The industrialized west is just not in direct danger from an ebola outbreak. Ebola is a disease of poverty, superstition, and spotty medical infrastructure. We have good hospitals here, and the capability to implement all of the protocols that can prevent something like ebola from spreading.
  2. Ebola is not nearly as contagious as something like the seasonal flu. You can avoid catching it by avoiding direct physical contact with the infected (and/or their fluids), which seems simple enough.
  3. Other diseases, like malaria, kill orders of magnitude more people every year than ebola has since it was discovered, and nobody flips out about those. So chill out.

So that’s case for calmness, which I generally subscribe to.

On the other hand, the WHO’s pronouncements have become increasingly apocalyptic as the disease continues its ever expanding rampage. On the nightly news we’re treated to scenes from the first act of every pandemic apocalypse movie ever: doctors in full hazmat gear who nonetheless succumb to the disease, infrastructure collapse and bodies in the streets, riots and quarantines enforced at gunpoint, the US and UK sending in the troops, and so on.

And then there are the articles like this one, admittedly from one of the aforementioned pageview mills, entitled: “This Mathematical Model from 2006 Shows How Ebola Could Wipe Us Out”.

Yaneer Bar-Yam, the complex systems analyst whose model accurately predicted the global unrest that led to the Arab Spring, is also worried about the patterns he sees in the disease’s advance. Models he designed for the New England Complex Systems Institute back in 2006 show that Ebola could rapidly spread, and, in a worse case scenario, even cause an extinction event, if enough infected people make it through an international airport.

“What happened was that we were modelling the dynamics of the evolution of diseases—of pathogens—and we showed that if you just add a very small amount of long-range transportation, the diseases escape their local context and eventually drive everything to extinction,” Bar-Yam told Motherboard. “They drive their hosts to extinction.”…

The argument has been made that an Ebola outbreak would not be as severe in the West as it is in Africa, because the poor healthcare infrastructure where the disease has struck is the chief vector of its spread. Bar-Yam sees this assumption as a vast overestimation of our handle on the dynamics of disease containment.

So, corpses in the street, hazmat suits, riots, the world’s militaries, and now a crazy statistician with complex computer models is desperately trying to hit the panic button, but the medical establishment just won’t listen until it’s TOO LATE! Like I said, I’ve seen that movie before. (Paging Jeff Goldblum or, more recently, Corey Stoll.)

But real life isn’t a disaster movie. So let’s assume that the cooler heads in the medical world are correct, and that even if ebola does hop a plane to JFK and infect a few people in Manhattan, we’ll be able to contain the outbreak in short order. In this scenario, it’s only those poor Africans and third-worlders who are screwed, and hey, they were pretty screwed anyway, amirite? I mean, if ebola doesn’t get ’em, malaria, or civil war, or malnutrition, or God only knows what else will–or so goes one line of reasoning for not doing too much.

Unfortunately, thanks to the myriad ways in which we moderns are intimately wired together, it’s not that simple.

The Problem with the “It Stays in the Third World” Scenario

A recent post on reddit has helpfully pointed out something that has been bothering me about the “it stays in the third world” scenario, and that is this: the ebola outbreak could very well spread to where the oil is. Plus, some of the non-western countries with shaky medical infrastructure (where ebola could potentially sow chaos) have nukes and aren’t in the best shape right now.

People shouldn’t be worried about Ebola crossing an ocean. They should worry about it crossing a desert.

If an epidemic breaks out in North Africa, if Ebola makes it North of the Sahara, the world could be in for a horrific pandemic. There would be no stopping an epidemic in a region torn apart by war and revolution. Algeria, Tunisia, Libya and Egypt could all be breeding grounds.

In the wake of Israel’s massive assault, Gaza would be ravaged by an Ebola epidemic. The IDF would enforce a shoot-to-kill quarantine. They might even hold it for a while.
In truth there is not a single regime from the ruins of Carthage to the slopes of the Himalayas that could properly deal with such an outbreak. Militias of every stripe carry the disease in every direction. Oil production rapidly declines as illness and war ravage the region.

Back in North Africa, a mass exodus is underway. People pile on to boats of every kind and pour into Italy and Spain by the thousand. Battleships attempt to enforce a quarantine by deadly force, but the sinking of the first ship along with some 300 civilians sparks mass rioting in immigrant neighbourhoods throughout Europe.

By the time the pandemic reaches the Indian subcontinent the world is already facing an economic crisis. World trade falls by 90% as governments scramble to defend their own borders from an enemy that is just 80 nanometers in diameter…

The India/Pakistan situation is already heart-stoppingly terrifying enough without adding even a small ebola outbreak to the mix. The same is true for any number of regional hotspots where just the right mix of a handful ebola cases plus widespread panic could theoretically bring long-simmering ethnic and political tensions past the boiling point.

In all, there’s no telling what kind of catastrophic ripple effects even small outbreaks in the wrong regions could have on the price of oil, the world economy, or in a worst-case-scenario of a nuclear-armed state, the environment. All that has to happen is for the local population to freak out and destabilize one of these critically important but already fragile regions.

What if it Actually Hits Home?

What would the town of Austin, TX, where I live, look like if North Africa and parts of the Middle East were in the throes of ebola-driven, Michael Bay-directed turmoil, and I were seeing camera phone shots on Facebook of a makeshift ebola ward in a hospital downtown?

Whatever you think about that reddit post’s plausibility, the thing I appreciate about it is that it puts its finger on the very thing that makes ebola so dangerous, and that thing is not something that you can vaccinate against or that we will ever develop an immunity to. I’m talking about ebola’s unique ability to generate stark freaking terror in human social networks.

What ebola does to the bodies of those it infects is awful, but the disease is potentially the most devastating in its potential for large, fear-driven secondary impacts. Collective panics, crazy rumors, migrations, protests, riots, first-responders and medical personnel leaving their posts–all of this stuff is happening right now in the less-wired parts of the world in response to a few thousand cases, and it’s not a stretch to imagine that with a very few domestic cases, contained though they may be, some sub-communities on Facebook might whip themselves into a panic.

Social media could act as vectors for ebola’s fear-induced secondary effects, transmitting and amplifying them “virally,” if you will. It’s sort of like the Arab Spring’s evil twin. Throw in a Ferguson-style police crackdown against protestors demanding that the borders be closed or victims be deported, with the Internet rumors that such crackdown would engender (“They’re covering something up! Secret FEMA camps!”), and all of the sudden things could get nastier than we’ve seen since the 70’s, especially if there were an oil or economic shock of some sort to go along with it.

Yeah, I realize that it’s a stretch, but Americans of all stripes have seen this disaster movie before. Hollywood has primed us, and if ebola shows us a graphic enough opening act, we may well play out the rest of the script on our own, regardless of what the disease itself actually does. So ebola may not really have to be that big of a threat in actual disease terms to cause some fairly large disruptions in our economy and way of life.

As I write this, I’m thinking, what would the town of Austin, TX, where I live, look like if North Africa and parts of the Middle East were in the throes of ebola-driven, Michael Bay-directed turmoil, and I were seeing camera phone shots on Facebook of a temporary ebola ward in a hospital downtown? Would people still be out on South Congress or biking in the local green belt? Would the kids still be in school? Would the Whole Foods downtown still be packed to the gills with grossly overpriced produce? I’d like to answer “yes” to all those questions, but given the freakout about the few cases that were flown to the midwest for treatment, all I can say is that I don’t know what impact one or two local cases would have on the city.

What is to be Done?

It’s important that we realize that getting ebola under control immediately is in all of our best interests. It’s not a third-world charity thing. It’s an economic and national security thing. Even if you don’t care about the people that live in afflicted countries, you should care about what can happen if those countries collapse. Some countries that have creaky medical infrastructure, populations with a deep mistrust of authorities foreign and domestic, they also have oil that we need, some of them have nukes, and all of them have throngs of people and international airports. We need to pressure our politicians to act before ebola gets to those places.

My Twitter and Facebook feeds are full of outrage and activism around all kinds of issues–whether the police are too militarized, whether the Oscars were feminist enough, whether the iWatch will be awesome or lame. Here’s hoping that those feeds don’t jump directly from that stuff to “I heard Costco still has canned food… better get over there ASAP,” without at least passing through a “send aid to Africa now!” phase. It’s not too late for us to make a difference.

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