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Monday, November 3, 2014

Where Did The Money Go?

The Atlantic has published an article called "21 Days" which discusses the difficulties with containing and treating Ebola, as well as an interview with Dr. Steven Hatfill, a former biowarfare expert for the United States (at one time falsely accused of spreading anthrax, even though he was an Ebola expert), and currently an adjunct assistant professor at George Washington University School of Medicine, chair of the Asymmetrical Biodiversity Studies and Observation Group in Malaysia, and medical director of EFP Tacmed. According to the article, "[h]is training was in military special operations and tropical pathology, and after serving as an overwinter physician in Antarctica, he obtained master’s degrees in microbial genetics, medical biochemistry, and hematological pathology, including postdoctoral fellowships at Oxford University, the National Institutes of Health, and the National Research Council, in addition to over 15 years of clinical work in Africa."

Hatfill maintains:
 “The initial response to the outbreak of Ebola in the United States has been badly designed, and poorly and incompetently implemented. In their effort to minimize public concern or even panic, the leading health authorities of the United States have made far over-reaching statements and assumptions that are not fully supported by the existing scientific literature.” 
For one objection, Hatfill wants it known that, while it must be emphasized that airborne droplet and particle transmission between humans has not been evident in this outbreak, aerosol droplet transmission of Ebola virus has been shown in animal studies. “It is therefore irresponsible for government health officials to emphatically state that aerosol transmission does not occur,” he writes. He also believes the argument against a national quarantine is “inexcusable in light of the size of the current West African epidemic.”
He notes other problems, such as that 12.5% of persons with Ebola never develop a fever, so using fever as a sole screening tool is not practical. Hatfil also notes that infected patients will shed virsuses with skin cells, and so there is a possibility of infection from brushing up against a bed rail or infected person's skin.

Nevertheless, he believes that notwithstanding the poorly executed response, this current outbreak will burn out, but there will be a larger, more dangerous outbreak in the future.

What caught my attention were his comments regarding wasted money. For instance, in discussing the lack of facilities able to handle infected persons, he stated:
Now, USAMRIID could change it back over quickly, but the most they could handle would be one or two patients. But instead of [investing in] that, we went out and built all new research centers. We've wasted $120 billion over the last 20 years. Nothing to show for it. We can't even handle one patient with Ebola.
Later, in discussing why national quarantines are needed:
Hamblin: Is this a a wake-up call for the U.S.? 
Hatfill: If it isn't, then we're doomed. Dr. Hamblin, there are worse things out there. Again, we're finding viral sequences, and we don't know what these are from. There are other things out there. 
Hamblin: How do we get the government to invest in emerging infectious disease preparedness? 
Hatfill: We spent 120 billion on this, on emerging disease and bioterrorism, what have we got to show for it? Machines that the FDA hasn't licensed for rapid diagnosis. 
Hamblin: I don't understand where the money you mention is going. 
Hatfill: It disappeared. It just disappeared. 
Hamblin: I don't know what that means. 
Hatfill: We have nothing to show for it. … Mother Nature is not happy with us at the moment.

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