Ebola Expertise Veers Epidemic

The outbreak of Ebola in West Africa is both terrible and horrifying. But it should not be, for those of us lucky enough not to live in the region, terrifying. That is, it should evoke the empathetic emotion horror; it should not invoke the irrational response terror.
Let me be clear up front that I’m not an epidemiologist or biologist. I’m a reporter of wide interests. But by education I’m an evolutionist.
Let me also be clear that evolutionary biology is not a seer. But it it is sound science. And its lessons suggest informed citizens should give the side-eye to the freakout over Ebola by two prominent people who should know better, and, more important, throw shade at the media outlets who keep giving them column-inches to freak out upon.
I’m talking about Laurie Garrett and Michael Osterholm. Garrett is the author of The Coming Plague and the senior fellow for global health at the Council on Foreign Relations. The Coming Plague won a Pulitzer. Osterholm is an epidemiologist and professor at the University of Minnesota. Last week he wrote an op-ed for the New York Times purporting to reveal “what we’re afraid to say about Ebola"—namely, that it will evolve from a bodily-fluid-borne disease to an airborne one.
The Coming Plague came out twenty years ago. The plague hasn’t come. Osterholm has been predicting the breakout of high-mortality, tropical, Third World disease into the industrial, sub-tropical West for years. It hasn’t happened.
Yet the auguestest of august media institutions—the voices of record in the U.S.—continue to reward them for their alarmist prognostications. No doubt this is good for page-views. It’s also bad science, bad for science, and bad for institutions like the CDC, which can only do their work—protecting the U.S. from disease threats—well when they can do it independently. Public panic in a democracy makes that difficult.
Reporters who value analysis over hype and evidence over projection should consider speaking with Paul W. Ewald, who, like Garrett, published a widely lauded book in 1994. Unfortunately it had the unsexy title Evolution of Infectious Disease. A plague of scientists descended upon it wielding praise; The Coming Plague, unfortunately, infected the Pulitzer committee before it could book its tickets.
In his book, Ewald confronted a deathless axiomatic assumption of pathogens—that they “want” to kill—with a foundational tenet of evolutionary theory: that organisms’ sole measure of success is their own propagation. Logical progression from this tenet suggests that, since pathogens rely on hosts to propagate, evolution will encourage pathogens not to kill, but simply to incapacitate their hosts. When the hosts are human, dead hosts get buried or burned. Living hosts draw potential new hosts—moms, friends, nurses, doctors—to their side. Thus do pathogens find outlets.
And lo, evidence backed Ewald up. His research strongly suggested that the mode of transmission—and definitively disproved that some innate “desire”—is the primary influence on pathogenic virulence. For instance, water-borne diseases like dysentery, easily spread to large host populations by a common resource, evolve toward relatively high, though not rapidly fatal, virulence. But pathogens that transmit only after considerable effort by their hosts—the common cold, HIV—evolve toward benignity. Colds are mostly spread by mucosal contact—your coworker sneezes, then opens the office door; you open it later, then pick your nose. HIV spreads via sexual contact—a fraught and complex social vector. (HIV, speaking of benignity, doesn’t kill; in fact, it multiplies slowly in its hosts, in Ewald’s view because evolution favors this: slow growth leaves more time for each host to spread the infection. But HIV’s devastating effect on the immune system invites other, deadlier infections.) Ewald explains his theory and evidence in detail in this PBS interview.
As for Ebola, Ewald’s evolutionary theory of disease argues against panic.
In the Times, Osterholm raises the specter of an airborne version of the virus, despite the fact that no known disease has ever switched from one mode of transmission to another. Ebola is transmitted via bodily fluids, not air. Suggesting that this might change is akin to suggesting that cobras might develop wings: a frightening image; a preposterous idea.
For her part, Garrett writes in Foreign Policy that
Nothing short of heroic, record-breaking mobilization is necessary at this late stage in the epidemic. Without it, I am prepared to predict that by Christmas, there could be up to 250,000 people cumulatively infected in West Africa. At least 30 nations around the world, I dare predict, will have had an isolated case gain entry inside their borders, and some will be struggling as Nigeria now is, tracking down all possibly exposed individuals and hoping to stave off secondary spread. World supplies of PPEs (personal protective equipment, or “space suits”), latex gloves, goggles, booties — all the elements of protection — will be tapped out, demand exceeding manufacturing capacity, and an ugly competition over basic equipment will be underway. The great African economic miracle will be reversing, not just in the hard-hit countries but regionally, as the entire continent gets painted with the Ebola fear brush.
That’s a lot of being prepared and daring to predict. And Garrett’s doomsday scenario goes on from there, propagating like an airborne hemorrhagic Ingmar Bergman film. But little of it is anchored in firm evidence. And appearing as it does in FP, America’s most steadfast mouthpiece of Something Must Be Done punditry, that lack of evidence glows like neon.
Here’s the thing: Pathogens are stupid. Literally brainless. And humans are smart. Indeed, we are so smart that we often outsmart ourselves—we smoke, we skip the condom, because we invent reasons to believe that “It won’t happen to me.” But Ebola is not lung cancer or HIV. It presents itself plainly, quickly, and ruthlessly. And so people respond plainly, quickly, and directly. Liberian journalist Makanfi Kamara describes the way Liberians have already—wisely and sadly—altered their familiar, convivial social relations to thwart the disease.
That pragmatism alone will do more—far more—to stop the outbreak than any of the vague “responses” Western pundits are demanding. And the UN, the U.S. military, and other highly experienced and capable institutions are preparing direct interventions that promise to do even more.
People, in short, evolve faster than disease. Or can evolve faster than disease. That potential is increased by evidence and expertise. It is reduced by irresponsible projection and clickbait.
Image: Ebola virion, public domain via the CDC and Wikipedia.








