I’m not an microbiologist or epidemiologist, but as some of my readers are aware, I did work for many years under a few of the most renowned infectious disease experts (microbiologists, immunologists, and epidemiologists) on the planet. As such, I picked up a lot – and what I picked up makes me more alarmed than most Americans at what I am seeing with regard to the procedures and precautions being used to protect Americans from the Ebola virus here and abroad – as well as how it came to be a threat to America in the first place.
As widely reported, the first patient to break with Ebola in the U.S., Thomas Eric Duncan, a Liberian visiting family in Dallas, Texas, died this week. Half a dozen more Westerners are being observed for possible symptoms of Ebola; this does not count the hundred or more in Texas being observed whom Duncan may have infected directly or indirectly.
Perhaps even more disturbing is the Spanish nurse who recently contracted Ebola while treating aid workers who had been flown from Africa to Spain for treatment.
No one seems to have any idea how she contracted the disease, particularly given the fact that she was working in a developed Western nation, presumably with all of the technology and precautions available. Prior to this week, we’d all been told that one had to come in direct contact with bodily fluids in order to contract the disease.
Now, as reported by WND, we hear that the World Health Organization has admitted that Ebola could be transmitted through coughing or sneezing.
This does not surprise me, because we know that Ebola is a disease that propagates very prodigiously in so many mucous membranes in the human body, it would be astounding if it was not transmissible via this route.
Given this revelation, I am also inclined to disagree with the contention of the Centers for Disease Control and Prevention and the National Institute of Infectious Diseases that one cannot transmit Ebola if they are asymptomatic (not yet displaying symptoms). All of our lives, we are told that not only can many of the infectious diseases against which we are warned be transmitted when the carrier is asymptomatic, but that they are often more contagious during periods immediately prior to an infection presenting itself.
Yet inexplicably, like so much of the government bafflegab that is being ascribed to Ebola, conventional wisdom seems to have gone out the window.
But on to the major reason I believe Ebola is going to spread in the West…
All strains of Ebola are Biosafety Level 4 (BSL-4) pathogens, Level 4 being the highest virulence designation for infectious agents. To convey an idea of just how dangerous BSL-4 pathogens are: When a laboratory facility is built with the intention of housing BSL-4 pathogens, the entire structure must be designed to unbelievably exacting specifications. Generally, this winds up costing thousands of dollars more per square foot than for BSL-2 or BSL-3 agents, or for a laboratory that is not designed for infectious disease research.
I have personally worked with architects and regulators in such designs and the drafting of protocols for said facilities, in case anyone is curious about my credibility in this area.
Type “BSL-4” into a search engine and search the images, and one will find the personnel handling these agents wearing equipment that resembles the space suits an astronaut might wear. In fact, they are nicknamed “space suits” in the field of those who handle infectious diseases and those who supply the equipment. BSL-4 pathogens are so virulent that even when laboratory personnel are working with cultures in a biocontainment hood (an enclosed work bench which draws air inside and filters it prior to being vented elsewhere), they are still wearing the “space suit” in the event of a splash back into the lab area.
The key to the effectiveness of BSL-4 personal protective equipment (PPE) comes down to two things: One is the impenetrability of the material of which the suit is constructed. They’re very tough, heavy flexible polymers that one would have to work very hard to puncture or cut. Two is the High-efficiency Particulate Air (HEPA) filter; forced-air, powered units which provide filtered air to the individual in the suit. There is no chance for the intrusion of ambient air. A decent HEPA filter in good repair will filter out viruses. Many BSL-4 suits used in laboratory applications actually have hoses that provide dedicated airflow from outside the work area, forcing the worker to remain tethered to their air supply.
Yet, most of the photographs available (and there are plenty) of doctors, aid workers, and now American military personnel working with Ebola and Ebola patients in West Africa do not show them wearing BSL-4 PPEs.
Occasionally, one finds a worker with some BSL-4 equipment, usually a filtered air unit worn on the back, and a sealed hood – but this appears to be the exception, not the rule.
The vast majority of these workers are demonstrably ill-protected; one can see this for themselves – if one knows what to look for. Obviously, most people don’t.
Most of the personnel in these photos are wearing Biosafety Level 3 (BSL-3) personal protective equipment. This is a markedly less effective barrier than BSL-4 protection – which makes sense, since the industry employs such designations in the first place.
These photos depict aid workers wearing Tyvek suits, Tyvek hoods, paper face masks, and occasionally goggles or a face shield that is open at the bottom. Sometimes, they utilize heavy rubber gloves and boots, but quite often, they are wearing Tyvek shoe covers (booties) and surgical gloves.
Tyvek is essentially coated paper. It isn’t as easy to tear as a grocery bag, but it can be torn by nearly any adult, and it can be fairly easily pierced without the wearer’s knowledge during the course of work – particularly outdoors.
Goggles are probably useful in keeping infected material out of the wearer’s eyes, but if one is wearing goggles and a mask, there are still facial areas exposed. If the contaminant splashes around the goggles and mask, the wearer will be contaminated. Further, if a BSL-4 contaminant splashes onto a paper mask, the wearer is now potentially breathing in that contaminant, because paper masks are not designed to filter out viruses.
Years ago when I was working with BSL-3 infectious agents, we wore equipment identical to what I’m seeing in the photographs coming out of West Africa (not including the native workers and funerary personnel, who wear even less protective gear). Biosafety Level 3 infectious agents (such as tuberculosis) however, are not generally diseases one can catch if their PPE is momentarily breached. The protocol in such an instance is to leave the area (usually into an airlock with dedicated ventilation), dispose of the garments, and take a shower.
But if one is working with Ebola, a BSL-4 infectious agent, but only employing BSL-3 protective gear and protocols, then all bets are off in the event of an equipment failure – even if we’re working under the now dubious assumption that it is only spread via direct contact.
As perverse as it may sound, it is likely that cost is a factor with regard to the ill-advised employment of BSL-3 protocols. A change of clothing (most of which is disposable) for an individual working in a BSL-3 environment runs anywhere from $10 to $20, whereas a BSL-4 “space suit” can run into several thousand dollars. Even the bare minimum BSL-4 field outfit would probably cost the government between $500 to $1,000 per person.
In the case of responders who live in impoverished nations areas affected by Ebola, obviously we understand that they have to make do with what they have, unfortunate though it may be. However, sending American doctors, aid workers, and military personnel into seething cesspools of virulence and skimping on precautionary measures given what we know – and don’t know – is nothing short of criminal.