How Slate and Bioethicist Nicholas Evans Miss The Point
First, the virus isn’t a viable bioweapon candidate. It doesn’t spread quickly—its R0, a measure of how infectious a virus is, is about 2. That means that, in a population where everyone is at risk, each infected person will, on average, infect two more people. But because someone with Ebola is infectious only when she shows symptoms, we’ve got plenty of chances to clamp down on an outbreak in a country with a developed public health system.
This is assuming that each infected person behaves like a normal human being and isn’t utilizing the virus as a weapon. With flu season as a shroud, a spread could reasonably occur without anyone noticing initially. Sure, our health care system is far better equipped to deal with an outbreak than Liberia, Sierra Leone, and Guinea, but mistakes can… and as of this morning… have been made by medical professionals.
And unlike some bioweapons, such as anthrax, Ebola’s transmission mechanism makes it really hard to weaponize. Anthrax spores can be dried and milled so they form little particles that can float on the air and be inhaled. Ebola requires the transmission of bodily fluids, and those don’t make efficient or stealthy weapons….
This alone pretty much rules it out as a bioweapon. A terrorist organization would have to go door to door with bags of blood and vomit to infect even a handful of people—and you’d probably notice it.
What about “suicide sneezers,” you may ask? Someone who deliberately infects herself with Ebola and then proceeds to pass it on to others?
That’s a losing game for the terrorist. Someone with Ebola isn’t infectious until she has symptoms, and even then, there is often only a small window for action before the disease takes hold.
I agree with Dr. Evans that Ebola is not as dangerous as anthrax and can’t be readily weaponized because it isn’t airborne. I also agree with his later points that Ebola wasn’t created and that smallpox is more dangerous. I also agree that it would be cost prohibitive to make Ebola airborne. However, terrorists don’t have access to anthrax nor smallpox (without huge amounts of money in attempts to bribe generally readily traceable sources).
Dr. Evans clearly isn’t familiar with creativity of terrorists and people at war. It doesn’t require “suicidal sneezers”. It doesn’t require people going door to door with bags of vomit.
First, Ebola has been shown to survive in a dead body for several days. Is it that hard to believe that a terrorist group can’t get a body out of Sierra Leone, Guinea, and Liberia when hospitals there can’t even keep patients inside of the hospitals and entire medical emergency tents have been destroyed and sacked by local people?
Second, terrorists groups worldwide have shown a willingness to take captives. The US military does the same. If you don’t have willing suicidal terrorists, you can create a reservoir by exposing a kidnapped victim. What happens if they expose dozens of journalists and then release them back into their native countries after pretending to negotiate for something they “want”.
Third, the US borders are so porous that we can’t prevent boat loads and truck loads of illegal shipments, submarines and tunnels full of drugs, and millions of migrants. Further, it’s been shown that the United States is incapable of tracking all the world’s terrorists. They come from all walks of life. They come from throughout Asia, North America, South America, Europe, and Africa. They are armed with valid passports and no criminal records.
Where does that lead us? The fact of the matter is that you just need bodies to be brought into the United States as virus reservoirs if you will. Whether it is kidnapped victims smuggled in or suicidal terrorists exposing themselves, once they show symptoms, all you need is their fluids. They don’t need to be the ones spreading the virus. They don’t even need to be alive.
For Dr. Evans to downplay liquids as a weapon by using the example of bags of blood/vomit going door to door is irresponsible. Do you think a syringe of inflected blood into a Coke syrup bag at a soda fountain would be noticed or detected? You definitely won’t taste the difference. (I worked in food service we didn’t exactly guard those cardboard boxes that hold those bags or just go to your local Sam’s Club or Costco and check out their drink fountains and displays to sell soda syrup).
Yes, we can safely assume we can shut down a major outbreak from happening. Yes, it’s far more likely we will die from anything else.
But the point of terrorism is terror. Ebola already has the country (and its hypochondriacs) scared. If terrorists expose a handful of kids in an elementary school/pre school, how long before anyone notices? I’m not sure if Dr. Evans is a parent, but I’m sure he’s well aware how children are often vectors for diseases (plenty of current research on that especially in light of the stupidity of anti-vaccination movement). Parents are generally up to their noses in their own kids’ bodily fluids especially when they are sick.
What’s more scary to Americans than their kids being vulnerable at school? Or any other large gatherings of human beings? Mass transit, large sporting events, music concerts, conventions, churches, grocery stores, malls, etc. come to mind. What is a better weapon that scaring individuals from participating in societies?
Full disclosure: My sister is a medical doctor at The Hospital of the University of Pennsylvania in Philadephia which is now open to treating Ebola patients and is probably a colleague of post-doctoral fellow Dr. Evans. If my brilliant Ivy League medical school sister contracts the virus, I hope Dr. Evans is forced to sit with her and explain how the disease is hard to spread and doesn’t make sense as a bioweapon despite its availability, inexpensive costs, and ease of transport.
Maybe it’s my history with working for the department of health or having 3 doctor uncles, 2 doctor aunts, a nurse uncle, a half dozen pharmacists in the family, and countless friends who are in the medical profession that is making me concerned about the virus… at least more so than Dr. Evans.