Opting Against Ebola Drug for Ill African Doctor
nytimes.com
nytimes.com
It is really difficult to challenge this line of reasoning from the sidelines. Doctors especially those directly involved in public health are forced to make utilitarian decisions like this all the time - weighing the greater good against the good of an individual. People on the ground in West Africa are much better equipped than any of us in the West in assessing the risk of such a rumor damaging outbreak control efforts.
That said, it doesn't say whether they considered giving Dr. Khan the drug secretly. It seems like such a thing would be possible, and they could disclose that he had received the drug after the outbreak had started to slow down (which hopefully will happen soon).
Sounds like an easy way to worsen the worst-case scenario by quite a bit.
But this means the decision is political and rightly so. I don't know how I feel about foreign aid workers being the first to try the drug. On one hand they are politically safe. On the other hand, it looks like Western Privilege.
These things have no good answers. Sometimes we are left choosing between bad possibilities.
And if you give someone a drug and they consequently show a reversal of their symptoms instead of a slow die off as immune response kicks in, doesn't that pretty heavily imply that the drug worked?
I'm not against full clinical trials and the like, but I doubt that's a possibility with an epedemic like disease like ebola.
Strange thinking.
By the way, 200k people die each year from measles, that's 199k more than ebola.
Success would generate, at best, faint praise. Failure would generate a shitstorm and a half.
Given our rep over there, it could well generate one anyway.
One or two people die of a horrific disease, western doctors in spacesuits show up and spray the village and tell the locals to ignore their traditional burial rituals. Then loads more people get sick.
To a populace who don't understand what is happening and whose education is not that advanced it's easy to see how they could assume the westerners caused the disease to spread.
Wasn't it made in the US?
That's how the use of these drugs is perceived over there. Liberia is historically close to the US and as such more willing to work with unproven western technology in critical times. Others are suspicious even if the things they get is tried and proven for a century.
I really wouldn't put it past big pharma to have discussed that they could use these people as test subjects and get minimal bad press if it fails.
On the other hand, we don't have a reliable treatment for Ebola yet. The combination of having a longish incubation period and being highly contagious give it the potential to be very bad indeed. Hence the proverb 'better the devil you know.'
[1] http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6322a4.htm?mobile...
What is needed in the US is a more nuanced view on vaccination, and a realization that one can be against endlessly pushing ever-expanding vaccine regimens, but still in favor of widespread and routine vaccines for those few serious diseases for which vaccination is really ideally suited.
But once everything is black and white, usually both sides are wrong.
(a) people don't see the disease and thus are less scared of it, their imagined consequences of vaccination
and
(b) it appears the government will always choose to vaccinate if a vaccine isn't specifically required to stop disease transmission, the disease itself is not life threatening, and against parental opposition
BTW, I am against the sort of vaccine proliferation which leads the CDC to push for everyone to get an annual flu shot every year, for every kid to be vaccinated against chicken pox, etc. I think there is a real sense of "oh we have a vaccine to prevent that" and that gets pushed regardless of the severity of the illness.
But dividing everything into pro-vax vs anti-vax means we can't have a discussion about when we should be pushing vaccines (measles) and when we really should be leaving it to families to make the decisions (HPV, influenza, chicken pox, etc).
I also think the patient should have had a say in this -- they never even asked him what he wanted to do or mentioned that this was a possibility. He was a doctor and could have given informed consent.
Which makes sense, they already struggle with many Africans who are afraid of western medicine and prefer witch doctors to the strange outsider western doctors. Just a week or two ago I was reading of how western doctors were being turned away from infected villages by road blockades and armed men.
In ebola's entire 40 year history, it has killed less people than measles kills in a single month of any given year.
To date, no viral infection has been demonstrated to be resistant to the proper dosing of vitamin C as classically demonstrated by Klenner. However, not all viruses have been treated with Klenner-sized vitamin C doses, or at least the results have not been published. Ebola viral infection and the other acute viral hemorrhagic fevers appear to be diseases that fall into this category. Because of the seemingly exceptional ability of these viruses to rapidly deplete vitamin C stores, even larger doses of vitamin C would likely be required in order to effectively reverse and eventually cure infections caused by these viruses.
You also manage to embed the "no true Scotsman" fallacy into your very short argument; "no viral infection has been demonstrated to be resistant to the proper dosing of vitamin C" is trivially true if you just say that any failed treatment simply wasn't using a "proper dosing of vitamin C".