Connecting the dots . . . national security and ebola

   After a long silence, but for the one moment when the National Security Council representative said the equivalent of "gee, this Ebola thing is bad in West Africa," President Obama has taken action. Connecting the collapse of these nations and their economies affected with Ebola to a threat to global security, President Obama took action.  The WashingtonTimes reported Tuesday that the U.S. would deploy 3,000 American troops to build treatment centers.

“It’s spiraling out of control, it’s getting worse, it’s spreading faster and exponentially,” Mr. Obama said of the epidemic while touring the Centers for Disease Control & Prevention in Atlanta. “The world is looking to us, the United States. It’s a responsibility that we embrace.”

Mr. Obama said the crisis is a national-security threat to the U.S. because “we could be looking at hundreds of thousands” of dead if the epidemic gets worse, which could lead to governments and societies collapsing.

“It’s a potential threat to global security if these countries break down, if their economies break down, if people panic . . .” 

PBS Frontline in Sierra Leone with the Ebola epidemic

PBS Frontline went to Sierra Leone to produce the best documentary yet on the Ebola epidemic.  http://www.pbs.org/wgbh/pages/frontline/ebola-outbreak/ .
  The method of eliminating Ebola is much like what was done to eliminate smallpox.  Workers go village to village and house to house to identify anyone who is sick.  Just like the WHO elimination of smallpox operation in the 60s and 70s, people with Ebola symptoms are hiding from discovery because of the high mortality rate for those who leave to go to the Ebola hospital. Privacy in the traditional human rights sense is diminished, balanced against the need to protect the public from infection. In a country with strong civil rights traditions, the door to door operation in the event of a pandemic would be a major transformation in expectations of privacy in a social sense, but also in a legal sense.  

ISIS laptop with bioweapons 19-page document

     The news broke this week that an ISIS laptop had been captured and a document outlining bioweapons was found on the computer harddrive. The owner of the laptop was purportedly a Tunisian member of ISIS who had attended a university in Tunisia in physics and chemistry.  Foreign Policy was the first to break the story and it has been reported by so many news outlets and blogs that I never reached the end of my Google string query.  That said, I will add only what I think has not been said about the information that was found.
     The "19-page document" on the laptop harddrive that serves as the article's only source contains such quotes as:

"Use small grenades with the virus, and throw them in closed areas like metros, soccer stadiums, or entertainment centers. . .Best to do it next to the air-conditioning. It also can be used during suicide operations."

     The Foreign Policy authors write, "The ISIS laptop contains a 19-page document in Arabic on how to develop biological weapons and how to weaponize the bubonic plague from infected animals."

Then the authors quote from the 19-page document:

"The advantage of biological weapons is that they do not cost a lot of money, while the human casualties can be huge," . . . 

    Then some instructions on testing a plague weapon, according to the authors:

"When the microbe is injected in small mice, the symptoms of the disease should start to appear within 24 hours. . . ."

    These few phrases tell us a world of information about the stage of development and level of understanding of ISIS's members ---and this is not to be ignored.

 

Ebola Clinics are Overwhelmed and Help is NOT on the Way

   The shocking video in today's The New York Times shows the reaction in Liberia to a man walking out of an Ebola clinic.  If a picture is worth a thousand words, these two videos are worth a million words. The situation is dire and the lack of funding and human resources from and through the World Health Organization is now clearly failing to turn back this disaster. 
   Phone calls from victims go unanswered because the government system is too overwhelmed to pick them up or care for them.  Even food and water is apparently scarce in the Ebola clinic and the pressure is mounting on those who are brave enough to be on the ground helping staff the Ebola clinics. 
   The World Health Organization is an international intergovernmental organization --nothing more than the sum of its parts --- and depends completely on its member nations to respond to calls for funding and help.  Doctors Without Borders may be the riskiest profession in the world and to them we owe a tremendous amount of respect and gratitude, along with other organizations funding medical missionaries to these areas like Samaritan's Purse and others.
   There is no governmental solution except in retrospect, it would have helped to have funded better infrastructure for public health surveillance and perhaps an epidemic could have been averted.  Lawrence Gostin, law professor and friend, at Georgetown University School of Law, authored an article in today's Lancet that makes that argument and offers suggestions of setting up a fund for funding better infrastructure for prevention of biodisasters. Here's the article: Ebola: towards an International Health Systems Fund.
  Meanwhile, the peak of the epidemic is still rising and I expect a rally at the World Health Organization in another call for assistance to its member states.  But with multiple global disasters unfolding at the same time, it is going to be a challenge.

CDC finally issues Ebola guidance for travelers and students

   CDC finally posted guidelines for travelers regarding the Ebola epidemic in West Africa, August 29, well after students have returned to campuses and schools all over the U.S. from summer travels.  In The Chronicle of Higher Education today, one epidemiologist had this to say,

"These guidelines reinforce what a lot of colleges are doing already, but it would have been nice if they’d come out two weeks ago," when students were arriving and health centers were unsure what to do, said Craig M. Roberts, an epidemiologist with the University of Wisconsin at Madison’s student health service."

   Students are advised to monitor their health for 3 weeks if they have been in "countries where the Ebola outbreaks are occurring?"  But CDC does not give anyone a clue what those countries are and never mentions Senegal where the first case was brought into the country with subsequent in country infections.
   CDC also advises colleges and universities to postpone all non-essential travel to these three countries until further notice, but no such warning for Nigeria -- all education travel is still open to Nigeria with precautions to protect yourself. Yes, that's right.  This includes tips to
   But the most important legal aspect of the announcement is typical of most Department of State warnings about travel to other countries, and here, they have crafted the warning to cover the risk of travelers being detained due to a government-issued quarantine:

The US Department of State takes action to protect US citizens who travel outside the US through a number of diplomatic channels. However, in the event of an outbreak, any country has the right to enact measures (such as quarantine of exposed people, isolation of sick people, and screening of people entering or exiting the country for sickness or disease exposure) to protect its citizens and to prevent the spread of an outbreak to other countries. These measures may infringe on the individual rights of those who appear to be infected with or exposed to a disease of public health concern—including visiting US citizens. The ability of the U.S. Department of State to intervene in such situations is limited. See the US Department of State’s Emergency Resources page for more information.

   U.S. citizens traveling abroad are often taken by surprise that the civil rights they enjoy in the U.S. are not practiced in many other countries.  Although human rights in international law is expected to be observed in every country, the concept of human rights may vary from one culture to the next, and many countries do not feel bound by international law despite their signatures and ratifications of treaties.  No doubt one of the reasons that the television series, Locked Up Abroad, has enjoyed so much success.

Department of Homeland Security has "Nothing to Report"

   Normally, I would not think it important to write a post on three words, but these words were rather jolting as I looked under the heading of the Public Healthcare sector, in the DHS Daily Infrastructure Report, an area of jurisdiction for the Department of Homeland Security.  The global news media is ablaze with following the rapid spread of Ebola, not to mention the Sunday edition focus by the Atlanta-Journal Constitution with the arriving Ebola patients a couple of weeks ago.  Wouldn't the Department of Homeland Security have something to say about it this week?
   The strange omission by the Department of Homeland Security seems odd especially given their office of the Chief Medical Officer who should certainly be involved, even if DHS does not have the federal government lead on the issue.  The Department of Health and Human Services in the early turf battles over biodefense, won the "lead" on public health matters, but why would DHS be left completely out of the looming threat of Ebola to the global community, including the U.S.?
   Having spent a substantial amount of time in the White House and other Executive Branch offices, I understand the turf wars, but to leave DHS completely out of this issue seems counterproductive to any organized domestic response to a potential biothreat.  If there is a plan out there for the U.S. to address the potential arrival or spread of Ebola in the U.S. could someone please comment and post it here?