The threat of the Ebola virus that has claimed close to 1000 lives in West Africa felt a little too close to home with reports this week that a person had returned from Nigeria with symptoms that referenced the highly fatal virus.
The question of what exactly had caused the illness of the person who had been quarantined at Brampton Civic Hospital hung for days before the province’s health minister, Eric Hoskins, stated that the infection was likely not Ebola since the person began to show signs of recovery, which is not what usually happens once the Ebola virus is contracted.
Proof positive that he tested negative for the disease, however, would have to come after Hoskins’ statement from the only laboratory in Canada qualified to carry out such testing, which is located in Winnipeg.
The terrible toll that SARS (severe acute respiratory syndrome) took on this region back in 2003 would mean that we can still be hyper-vigilant when diseases which, once contracted, quickly result in fatalities.
From one person who had returned to Toronto from Hong Kong at the time SARS was emerging there, 44 people including that person died here from the disease, some 400 became ill, and 25,000 were placed in quarantine.
We want to trust that those tasked with ensuring our safety against such viruses have learned from the SARS outbreak, and that the Ebola virus, a disease that has now been categorized by the World Health Organization (WHO) as an international health emergency, will not have a similar devastating effect here as people are now facing in Guinea, Liberia, Nigeria and Sierra Leone, the country that has been hardest hit.
However, the managing of this latest Ebola outbreak raises questions about how international health organizations are responding. We recognize that frontline medical workers are trying their best to contain the outbreak, despite the risk of also contracting the virus. Already, medical personnel have died from or contracted the virus. Many mourn the loss of Dr. Sheik Humarr Kahn in Sierra Leone. He had been credited with saving many lives before the virus took his.
With almost 2000 now infected in West Africa, why the delay in using experimental vaccines in this outbreak – the worst since the disease emerged in 1976 – which seem to work?
The question of whether the response or lack of response is because the disease emerged in Africa has been raised. It emerged after the WHO had backed away from the proposition of trying experimental vaccines despite the fact that once contracted, patients with the Ebola virus face a 55-60 per cent rate of death. Death rates in previous outbreaks have been as high as 90 per cent for this hemorrhagic fever.
Yet, the experimental vaccine Zmapp was administered to two American aid workers who had apparently contracted the virus in Liberia. There is of course the ethical question of how vaccines can best be tested, but this stark case of decision-making speaks for itself.
Why would it be ethically acceptable to administer experimental drugs that would save the lives of two Americans, yet not be considered for people suffering from the disease in West Africa who stand a much greater chance of dying if left untreated?
WHO ethicists posit that people in crises such as this one would feel they are being used as guinea pigs for experimental vaccines, suggesting that people most affected by the outbreak would have no say in whether they receive the drug or not. This is patently ridiculous. How difficult would it be to ask any individual whether he is willing to allow a health practitioner to administer a drug that could aid in his recovery? The thinking from WHO is that individuals are like children who have no ability to make personal decisions. This kind of condescending colonialist mentality is nothing new. Some would argue that it appears well-meaning, but it is the kind of thinking that is costing lives in this emergency. If presented the choice between taking the vaccine and upping the chances of surviving Ebola or refusing it and risking death what would any suffering person choose? Obviously the two American aid workers made the choice to take the vaccine and are recovering. Why wasn’t that an option for the leading African doctor fighting the disease in Sierra Leone?