Story 1: Obama Claims Ebola Virus Not Airborne — Why are The Two Confirmed Cases of Ebola in Dallas Being Sent To a Bio-Safety Level 4 Hospital Bed in A Biocontainment Center — Dr. Nicole Lurie, “The Ebola Czar” Missing In Action — CDC Director Opposes Travel Ban On West African — Videos
BioContainment Unit at The Nebraska Medical Center
The United States Centers for Disease Control commissioned The Nebraska Medical Center biocontainment unit in 2005. It was designed to provide the first line of treatment for people affected by bio terrorism or extremely infectious naturally occurring diseases. It’s the only non-governmental facility of its kind in the U.S.
Ebola Update – The Nebraska Medical Center
Dr. Phil Smith and Dr. Mark Rupp discuss the improving condition of the patient being treated for the Ebola virus at The Nebraska Medical Center. They also answer questions about what may have happened to the health care worker in Dallas who now appears to have Ebola. This video is from a live Ustream broadcast October 12, 2014.
Activation- A Nebraska Medical Center Biocontainment Unit Story
Dr. Sacra’s Tunnel Walk – The Nebraska Medical Center
Dr. Rick Sacra gets an official Nebraska sendoff from staff members who cared for him at The Nebraska Medical Center. Dr. Sacra spent three weeks in the hospital’s Biocontainment Unit being treated for the Ebola virus. He was the third American health care worker to be treated for the virus after contracting it treating patients in West Africa.
NEIDL: Biosafety Level 4
MWV Episode 68 – Threading the NEIDL: TWiV Goes Inside a BSL-4
In the Hot Zone with Virus X – Richard Preston
Elbows-Deep in Ebola Virus – Richard Preston
The Hot Zone” author Richard Preston tells the story of a U.S. Army Lt. Colonel’s life-threatening experience while researching a strain of deadly Ebola virus.
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Richard Preston talks about Panic in Level 4: Canibals, Killer Viruses, and Other Journeys to the Edge of Science. These dramatic accounts, all updated since appearing in The New Yorker, are true tales, taking readers on a journey to military labs, hospitals, and jungles around the world, revealing frightening forces and constructive discoveries that are reordering our world – Book Passage
Richard Preston is the author of seven books, including The Hot Zone, The Cobra Event and The Demon in the Freezer, which are his “Dark Biology” series.
Preston is a regular contributor to The New Yorker. His books have been translated into more than 30 languages, and he has won numerous awards, including the American Institute of Physics Award and the National Magazine Award.
Preston is the only non-medical professional ever to receive the Centers for Disease Control’s Champion of Prevention Award for public health.
The Ebola virus The Search for a Cure BBC Full Documentary 2014
Beating the world’s deadliest viral villains
Ebola : Inside the Deadly Outbreak (Documentary 2014)
Ebola: The world’s most dangerous Virus (full documentary)
Ebola – The Truth About the Outbreak (Documentary)
WATCH: CDC Director Dr. Frieden Grilled over Travel Ban at House Ebola Hearing
WATCH: Megyn Kelly Goes Head to Head with CDC Director over Ebola in America
Dr. Nicole Lurie – HHS Assistant Secretary for Preparedness & Response
“I have responsibility for getting the nation prepared for public health emergencies—whether naturally occurring disasters or man-made, as well as for helping it respond and recover. It’s a pretty significant undertaking.”
Dr. Lurie is Assistant Secretary for Preparedness and Response at the US Department of Health and Human Services at HHS. Prior to that, she was Senior Natural Scientist and the Paul O Neill Alcoa Professor of Health Policy at the RAND Corporation. There she directed RANDs public health and preparedness work as well as RANDs Center for Population Health and Health Disparities.
Ebola Czar hides away in bunker — Dr. Nicole Lurie
John McCain: U.S. Needs an Ebola Czar
Ebola Czar pissed away a billion dollars on kick-backs — Dr. Nicole Lurie
Dr. Nicole Lurie’s Ebola death squads — urr — temporary morgues
Experts: Ebola Could Go Airborne, Kill Millions
Expert Doctor says CDC is lying about Ebola virus
Ebola strain appears to be different
The Structural Basis of Ebola Viral Pathogenesis
Obama administration failed to implement all of the CDC’s advice to prevent an Ebola outbreak
The Centers for Disease Control told the incoming Obama administration in 2008 that it should establish 18 regional disease detection centers around the world to adequately safeguard the U.S. from emerging health threats like Ebola, according to an agency memo.
But six years later, as the government struggles to contain the fallout from a deadly Ebola outbreak at home and abroad, the CDC still has only 10 centers — and none of them operates in the western Africa region hardest hit by the deadly virus.
“The existing centers have already proven their effectiveness and impact on detecting and responding to outbreaks including avian influenza, aflatoxin poisoning, Rift Valley fever, Ebola and Marburg virus outbreaks,” the CDC said in its memo to the Obama transition team, which The Washington Times obtained through a Freedom of Information Act request.
At the time, the CDC had five centers set up, and has only added five more of the 13 the agency had proposed “to complete the network and properly protect the nation.”
The memo sheds new light on the problems dealing with the current Ebola crisis, which intensified with the revelations Wednesday that a second Texas nurse had tested positive for the disease and President Obama used a White House Cabinet meeting to promise a “more aggressive” federal response to the threat.
The CDC’s plan outlined in the transition memo was based on the notion that the U.S. shouldn’t wait for a disease to enter the country but rather monitor threats in hot spots overseas to try to help local public health authorities control outbreaks before then.
The CDC didn’t respond to messages seeking comment on its plans Wednesday.
On its Web page, the agency said it has eight regional centers running, with another two in development.
Aside from detecting and monitoring diseases, the centers also provide education to local public health authorities. Though the CDC operates three response centers in Africa — in Kenya, Egypt and South Africa — none of those are based in the western parts of the continent that have seen major Ebola outbreaks this year.
News on Wednesday that another patient in the U.S. — a second health care worker who treated an Ebola patient in Texas — may be infected prompted calls for tightened travel restrictions and at least a temporary travel ban for Liberia, Guinea and Sierra Leone, including one from House Speaker John A. Boehner, Ohio Republican.
The administration has so far rejected those calls, with health officials saying they fear the bans could prevent them from getting aid workers and medical assistance to and from Africa.
Meanwhile, the fight over funding for anti-Ebola efforts has turned political.
Fights over funding
Five Democratic House members on Wednesday called for hearings into budget cuts at the National Institutes of Health and CDC.
The lawmakers said NIH has lost $1.2 billion in funding over the last four years and that a CDC program that supports public workers was slashed 16 percent during the past four years, while a hospital preparedness program lost 44 percent of its funding.
“The CDC and the NIH are already working to combat the spread of Ebola,” said Rep. Michael M. Honda, California Democrat. “In light of recent tragic developments in Texas, and in the interests of ensuring public safety and transparency, we need an update from these agencies so we can ensure they have the proper funding to protect patients, health care workers and the public at large.”
As the deadly virus continues to spread, the CDC has sent dozens of disease control experts into western Africa. In a recent budget document, the agency also has said it’s seeking an extra $45 million for global health security “to accelerate progress toward a world safe and secure from infectious disease threats.”
But the agency’s own memo to the president’s transition team highlighted the need for beefed-up infectious disease detection and other public health efforts overseas. It also reflects funding concerns during the George W. Bush administration.
“Our investment is modest,” the CDC memo stated, “but our capacity in most critical areas has been eroded by budget attrition and increases in the cost of science, travel and infrastructure support in recent years.”
The comments were included in the appendix to the agency’s 128-page briefing memo to the transition team. That same portion of the report had been sent in 2007 to a House appropriations subcommittee overseeing CDC funding, according to the transition memo.
The memo also stated that “core funding” for noninfluenza infectious diseases was lacking, “leaving us many millions behind where we were five years ago when adjusted for inflation.”
“Programs for rabies, rotavirus, food safety, special pathogens like Ebola virus and many others need immediate support if they are to sustain their baseline capabilities.”
The White House and CDC have both cited the regional response centers in recent weeks as an example of the administration’s Ebola response.
Neither the White House nor the Department of Health and Human Services, which oversees the CDC, responded to messages about the recommendation for 18 regional centers.
Senate Health, Education, Labor and Pensions Committee Chairman Tom Harkin, Iowa Democrat, said in a recent floor speech that he’s worked for years to secure more funding for CDC disease detection centers overseas.
“We must stop chasing diseases after the fact and start building public health systems capable of detecting and stopping diseases before they cross borders,” Mr. Harkin said.
The transition memo sounded a similar warning to Mr. Obama’s team as the president prepared to take power in late 2008: “Our nation’s preparedness has greatly benefited from government investments in terrorism and pandemic influenza preparedness, but recent events illustrated that vulnerabilities remain.”
(Via The Federalist) […] See, in 2004, Congress passed The Project Bioshield Act. The text of that legislation authorized up to $5,593,000,000 in new spending by NIH for the purpose of purchasing vaccines that would be used in the event of a bioterrorist attack. A major part of the plan was to allow stockpiling and distribution of vaccines.
Just two years later, Congress passed the Pandemic and All-Hazards Preparedness Act, which created a new assistant secretary for preparedness and response to oversee medical efforts and called for a National Health Security Strategy. The Act established Biomedical Advanced Research and Development Authority as the focal point within HHS for medical efforts to protect the American civilian population against naturally occurring threats to public health. It specifically says this authority was established to give “an integrated, systematic approach to the development and purchase of the necessary vaccines, drugs, therapies, and diagnostic tools for public health medical emergencies.”
If you look at any of the information about these pieces of legislation or the office and authorities that were created, this brand new expansion of the federal government was sold to us specifically as a means to fight public health threats like Ebola. That was the entire point of why the office and authorities were created.
In fact, when Sen. Bob Casey was asked if he agreed the U.S. needed an Ebola czar, which some legislators are demanding, he responded: “I don’t, because under the bill we have such a person in HHS already.”
[…] So, we have an office for public health threat preparedness and response. And one of HHS’ eight assistant secretaries is the assistant secretary for preparedness and response, whose job it is to “lead the nation in preventing, responding to and recovering from the adverse health effects of public health emergencies and disasters, ranging from hurricanes to bioterrorism.”
In the video below, the woman who heads that office, Dr. Nicole Lurie, explains that the responsibilities of her office are “to help our country prepare for, respond to and recover from public health threats.” She says her major priority is to help the country prepare for emergencies and to “have the countermeasures—the medicines or vaccines that people might need to use in a public health emergency. So a large part of my office also is responsible for developing those countermeasures.” (read more)
Or, as National Journal rather glowingly puts it, “Lurie’s job is to plan for the unthinkable. A global flu pandemic? She has a plan. A bioterror attack? She’s on it. Massive earthquake? Yep. Her responsibilities as assistant secretary span public health, global health, and homeland security.” A profile of Lurie quoted her as saying, “I have responsibility for getting the nation prepared for public health emergencies—whether naturally occurring disasters or man-made, as well as for helping it respond and recover. It’s a pretty significant undertaking.” Still another refers to her as “the highest-ranking federal official in charge of preparing the nation to face such health crises as earthquakes, hurricanes, terrorist attacks, and pandemic influenza.”
Now, you might be wondering why the person in charge of all this is a name you’re not familiar with. Apart from a discussion of Casey’s comments on how we don’t need an Ebola czar because we already have one, a Google News search for Lurie’s name at the time of writing brings up nothing in the last hour, the last 24 hours, not even the last week! You have to get back to mid-September for a few brief mentions of her name in minor publications. Not a single one of those links is confidence building.
So why has the top official for public health threats been sidelined in the midst of the Ebola crisis? Only the not-known-for-transparency Obama administration knows for sure. But maybe taxpayers and voters should force Congress to do a better job with its oversight rather than get away with the far easier passing of legislation that grants additional funds before finding out what we got for all that money we allocated to this task over the last decade. And then maybe taxpayers should begin to puzzle out whether their really bad return on tax investment dollars is related to some sort of inherent problem with the administrative state.
The Ron Perelman Scandal
There are a few interesting things about the scandal Lurie was embroiled in years ago. You can—and should—read all about it in the Los Angeles Times‘ excellent front-page expose from November 2011, headlined: “Cost, need questioned in $433-million smallpox drug deal: A company controlled by a longtime political donor gets a no-bid contract to supply an experimental remedy for a threat that may not exist.” This Forbespiece is also interesting.
The donor is billionaire Ron Perelman, who was controlling shareholder of Siga. He’s a huge Democratic donor but he also gets Republicans to play for his team, of course. Siga was under scrutiny even back in October 2010 when The Huffington Post reported that it had named labor leader Andy Stern to its board and “compensated him with stock options that would become dramatically more valuable if the company managed to win the contract it sought with HHS—an agency where Stern has deep connections, having helped lead the year-plus fight for health care reform as then head of the Service Employees International Union.”
The award was controversial from almost every angle—including disputes about need, efficacy, and extremely high costs. There were also complaints about awarding a company of its size and structure a small business award as well as the negotiations involved in granting the award. It was so controversial that even Democrats in tight election races were calling for investigations.
Last month, Siga filed for bankruptcy after it was found liable for breaching a licensing contract. The drug it’s been trying to develop, which was projected to have limited utility, has not really panned out—yet the feds have continued to give valuable funds to the company even though the law would permit them to recoup some of their costs or to simply stop any further funding.
The Los Angeles Times revealed that, during the fight over the grant, Lurie wrote to Siga’s chief executive, Dr. Eric A. Rose, to tell him that someone new would be taking over the negotiations with the company. She wrote, “I trust this will be satisfactory to you.” Later she denied that she’d had any contact with Rose regarding the contract, saying such contact would have been inappropriate.
The company that most fought the peculiar sole-source contract award to Siga was Chimerix, which argued that its drug had far more promise than Siga’s. And, in fact, Chimerix’s Brincidofovir is an antiviral medication being developed for treatment of smallpox but also Ebola and adenovirus. In animal trials, it’s shown some success against adenoviruses, smallpox, and herpes—and preliminary tests show some promise against Ebola. On Oct. 6, the FDA authorized its use for some Ebola patients.
It was given to Ebola patient Thomas Eric Duncan, who died, and Ashoka Mukpo, who doctors said had improved. Mukpo even tweeted that he was on the road to recovery.
Money, or rather the lack of it, is a big part of the problem. NIH’s purchasing power is down 23 percent from what it was a decade ago, and its budget has remained almost static. In fiscal year 2004, the agency’s budget was $28.03 billion. In FY 2013, it was $29.31 billion—barely a change, even before adjusting for inflation.
Indeed. The Progressive belief that a powerful government can stop all calamity is misguided. In the last 10 years we passed multiple pieces of legislation to create funding streams, offices, and management authorities precisely for this moment. That we have nothing to show for it is not good reason to put even more faith in government without learning anything from our repeated mistakes. Responding to the missing Ebola Czar and her office’s corruption by throwing still more money, more management changes, and more bureaucratic complexity in her general direction is madness.
Tracking a Serial Killer: Could Ebola Mutate to Become More Deadly?
Why we need to terminate Ebola 2014 before the virus learns too much about us.
bY David Quammen
Forty years ago, Ebola was just the name of a river. It was a small waterway of no particularly sinister character that flowed through northern Zaire, not far from the village hospital where the first known outbreak of a new viral disease had been centered. That river gave its name to the new virus, and now “Ebola” is a global byword for ugly death, misery, and fear of contagion.
The 2014 epidemic of Ebola virus disease in West Africa is unprecedented in scope, and much attention has been focused, rightly, on how it has gotten so badly out of control.
Behind that question are three others, less obvious, more complicated, and crucial to seeing Ebola in a broader context: Where did the virus come from? Where is it going? What’s next? We do well to consider these questions even as we react to the daily headlines, urge our leaders to take more deeply committed action, and support the organizations (such as Doctors Without Borders) that are fighting the epidemic so courageously in West Africa.
Where Did It Come From?
The outbreak began in early December, in a village called Meliandou, southeastern Guinea, not far from the borders with both Liberia and Sierra Leone. The first known case was a two-year-old child who died, after fever and vomiting and passing black stool, on December 6. The child’s mother died a week later, then a sister and a grandmother, all with symptoms that included fever, vomiting, and diarrhea. Then, by way of caregiving visits or attendance at funerals, the outbreak spread to other villages.
It wasn’t until March, three months later, that local officials alerted the Guinean Ministry of Health about these clusters of a strange, lethal disease in the countryside. By then, human-to-human transmission had started to multiply the case count. But tracing linked cases raises the question of ultimate origin. How did that first child get sick?
Ebola virus is a zoonosis, meaning an animal infection transmissible to humans. The animal in which a zoonosis lives its customary existence, discreetly, over the long term, and without causing symptoms, is called a reservoir host. The reservoir host of Ebola virus is still unknown—even after 38 years of efforts to identify it, since the original 1976 outbreak—although one or more kinds of fruit bat, including the hammer-headed bat, are suspects. There are hammer-headed bats in southeastern Guinea. It’s possible that somebody killed one for food and brought it to Meliandou, where the child became infected either by direct contact with the bat or by virus passed on the hands of an adult.
Why are these facts and suppositions significant? Because they remind us that Ebola virus abides endemically in the forests of equatorial Africa. It will never be eradicated as long as those forests exist, unless the reservoir host itself is eradicated (not recommended) or cured of the viral infection (not likely possible). The virus may retire into its hiding place for years at a time, but eventually it will return, as a result of some disruptive contact by humans with the reservoir host. Then it will spill over into us again. All thinking and planning about how to defend against Ebola virus disease in the future needs to take account of that reality.
Another puzzling fact about origins is that the West Africa epidemic involves a species of ebolavirus (that’s the label for the group, which includes five species) previously known only from outbreaks in the Democratic Republic of the Congo and its close neighbors.
A different species has emerged in Ivory Coast, another West African country, just east of Guinea and Liberia. According to a study published in Science in late August by Stephen K. Gire of Harvard and a long list of co-authors, the virus in West Africa seems to have diverged from its lineage in Central Africa just within the past decade. It somehow leapfrogged over or around the Ivory Coast ebolavirus in order to situate itself in southeastern Guinea. That suggests the unnerving prospect that the Central African ebolavirus (the only one strictly known as Ebola virus) is expanding its range, either by infecting new populations of reservoir hosts or by migrations of those host animals.
One way or another, it has been on the move.
Fruit bats are sold at an outdoor market in Brazzaville, capital of the Republic of the Congo. The reservoir host of Ebola virus is still unknown, but one or more kinds of fruit bat are suspects.
Where Is It Going?
The virus has also traveled within living human bodies. We know that it went from Liberia to Dallas within the late Thomas Eric Duncan, from Liberia to Nigeria by way of the late Patrick Sawyer, and from Sierra Leone to Spain by way of two Spanish missionary priests, both also now deceased, who were evacuated for treatment.
And it has been carried to Omaha, Atlanta, London, Paris, Hamburg, Frankfurt, and Oslo within infected people, mostly health and aid workers brought home to be treated.
But just as worrisome as the virus’s geographic spread is its journey across the evolutionary landscape. Is it mutating in ways that could make it more dangerous to humans? Is there any chance that it might become transmissible through the air, like the flu, the SARS virus, or a common cold?
Although Ebola becoming airborne is the ultimate disease nightmare, that seems to be almost vanishingly improbable, for reasons well put in a recent article in the Washington Post by Laurie Garrett, a senior fellow for global health at the Council on Foreign Relations. What is now a fluid-borne virus attaching itself to cells lining the circulatory system can’t easily change into one that targets the tiny air sacs in the lungs.
“That’s a genetic leap in the realm of science fiction,” Garrett wrote.
The virus probably will not go airborne, but it could conceivably increase its Darwinian fitness in other ways, becoming more subtle and elusive.
The genetic study by Gire and his colleagues (five of whom were dead of Ebola by the time their study appeared) found 341 mutations as of late August, some of which are significant enough to change the bug’s functional identity. The higher the case count in West Africa goes, the more chances for further mutations, and therefore the greater possibility that the virus might adapt somehow to become more transmissible-perhaps by becoming less pathogenic, sickening or killing its victims more slowly and thereby leaving them more time to infect others.
That’s why, the Gire group wrote, we need to stop this thing everywhere as soon as possible. Future spillovers of Ebola are bound to occur, but those freshly emerged strains of the virus, direct from the reservoir host, won’t contain any adaptive mutations that the West Africa strain is acquiring now.
We need to terminate Ebola 2014 before the virus learns too much about us.
Kumba Conde cries after her sister Marie, 14, died from Ebola in Koundony, Guinea, in July 2014. The current outbreak began in December 2013 in southeastern Guinea, not far from the borders with both Liberia and Sierra Leone.
What’s Next?
No one knows, of course, how much worse the epidemic in West Africa will get. The U.S. Centers for Disease Control and Prevention issued a report, in late September, projecting that under the worst-case scenario there could be 1.4 million cases by early next year. The World Health Organization said Tuesday that new cases could rise to 10,000 per week by December, ten times the rate of the previous month. And the World Bank has warned that costs of the epidemic could reach $32.6 billion, which would be an economic catastrophe for the three West African countries that would compound their health catastrophes.
Will the epidemic spread more widely, igniting outbreaks in other parts of the world? We hope not. Will it turn up as additional cases, here and there, among people who have traveled from West Africa unaware, as Thomas Eric Duncan was reportedly unaware, that they were infected before boarding the airplane? Probably.
What’s the best way to limit such occurrences? Rigorous screening at airports, quarantine for travelers who test positive, travel restrictions, or perhaps total bans on commercial flights arriving from Liberia, Guinea, and Sierra Leone-these measures should help. The most important and effective thing we can do, though, is to provide all possible assistance toward ending the outbreak where it began, in West Africa.
The world won’t be free of Ebola 2014 until West Africa is free of it. Even severe restrictions, barring entry to anyone traveling from West Africa, would not make it impossible for the virus to get into America, or Europe, or wherever. To understand why, consider what I call the Nairobi Tabletop Scenario.
Imagine a doctor who departs from Monrovia, the capital of Liberia, feeling fine, on a flight to Nairobi, Kenya’s capital, in East Africa. In transit he begins suffering a headache-nothing terrible yet, just discomfort, but it’s the first hint of Ebola. At the Nairobi airport, in a café, the Liberian doctor coughs onto a table. Five minutes later, an American businessman touches that table. He rubs his eye. He departs to Singapore and spends three days there, in good health, discussing finance for his project in Kenya. Then he flies home to Los Angeles. To the screeners at LAX, he is an American businessman arriving from Singapore, with no history of recent travel in West Africa. But he’s now infected with Ebola, carrying it into the United States.
How do you defend against the Nairobi Tabletop Scenario? By doing everything possible to end the epidemic in West Africa, and thereby to ensure that the Liberian doctor is healthy when he visits Nairobi.
Our safety against the menace of killer viruses can never be an absolute safety. There are too many of them, lurking within reservoir hosts amid distant forests or closer to home-viruses such as Nipah in Bangladesh, Marburg in Uganda, Lassa in West Africa, Sin Nombre virus in the American West, all the new influenzas coming out of southeastern Asia, plus many others that haven’t yet been identified and named.
And there are too many of us humans, sharing the landscape with the reservoir hosts and with one another. We are too interconnected by air travel and transport. Viruses are simple organisms but well-adapted to the modern world. This year it’s Ebola, devastating and scary. Next year it will be something else.
The Pronk Pops blog is the broadcasting and mass communication of ideas about life, liberty, and the pursuit of happiness, prosperity, truth, virtue and wisdom.
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The Pronk Pops Show 350, October 16, 2014, Story 1: Obama Claims Ebola Virus Not Airborne — Why are The Two Confirmed Cases of Ebola in Dallas Being Sent To a Bio-Safety Level 4 Hospital Bed in A Biocontainment Center — Dr. Nicole Lurie, “The Ebola Czar” Missing In Action — CDC Director Opposes Travel Ban On West African — Videos
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Pronk Pops Show 350: October 16, 2014
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Pronk Pops Show 290: July 3, 2014
Pronk Pops Show 289: July 2, 2014
Story 1: Obama Claims Ebola Virus Not Airborne — Why are The Two Confirmed Cases of Ebola in Dallas Being Sent To a Bio-Safety Level 4 Hospital Bed in A Biocontainment Center — Dr. Nicole Lurie, “The Ebola Czar” Missing In Action — CDC Director Opposes Travel Ban On West African — Videos
BioContainment Unit at The Nebraska Medical Center
The United States Centers for Disease Control commissioned The Nebraska Medical Center biocontainment unit in 2005. It was designed to provide the first line of treatment for people affected by bio terrorism or extremely infectious naturally occurring diseases. It’s the only non-governmental facility of its kind in the U.S.
Ebola Update – The Nebraska Medical Center
Dr. Phil Smith and Dr. Mark Rupp discuss the improving condition of the patient being treated for the Ebola virus at The Nebraska Medical Center. They also answer questions about what may have happened to the health care worker in Dallas who now appears to have Ebola. This video is from a live Ustream broadcast October 12, 2014.
Activation- A Nebraska Medical Center Biocontainment Unit Story
Dr. Sacra’s Tunnel Walk – The Nebraska Medical Center
Dr. Rick Sacra gets an official Nebraska sendoff from staff members who cared for him at The Nebraska Medical Center. Dr. Sacra spent three weeks in the hospital’s Biocontainment Unit being treated for the Ebola virus. He was the third American health care worker to be treated for the virus after contracting it treating patients in West Africa.
NEIDL: Biosafety Level 4
MWV Episode 68 – Threading the NEIDL: TWiV Goes Inside a BSL-4
In the Hot Zone with Virus X – Richard Preston
Elbows-Deep in Ebola Virus – Richard Preston
The Hot Zone” author Richard Preston tells the story of a U.S. Army Lt. Colonel’s life-threatening experience while researching a strain of deadly Ebola virus.
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Richard Preston talks about Panic in Level 4: Canibals, Killer Viruses, and Other Journeys to the Edge of Science. These dramatic accounts, all updated since appearing in The New Yorker, are true tales, taking readers on a journey to military labs, hospitals, and jungles around the world, revealing frightening forces and constructive discoveries that are reordering our world – Book Passage
Richard Preston is the author of seven books, including The Hot Zone, The Cobra Event and The Demon in the Freezer, which are his “Dark Biology” series.
Preston is a regular contributor to The New Yorker. His books have been translated into more than 30 languages, and he has won numerous awards, including the American Institute of Physics Award and the National Magazine Award.
Preston is the only non-medical professional ever to receive the Centers for Disease Control’s Champion of Prevention Award for public health.
The Ebola virus The Search for a Cure BBC Full Documentary 2014
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Ebola – The Truth About the Outbreak (Documentary)
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Dr. Nicole Lurie – HHS Assistant Secretary for Preparedness & Response
“I have responsibility for getting the nation prepared for public health emergencies—whether naturally occurring disasters or man-made, as well as for helping it respond and recover. It’s a pretty significant undertaking.”
Dr. Lurie is Assistant Secretary for Preparedness and Response at the US Department of Health and Human Services at HHS. Prior to that, she was Senior Natural Scientist and the Paul O Neill Alcoa Professor of Health Policy at the RAND Corporation. There she directed RANDs public health and preparedness work as well as RANDs Center for Population Health and Health Disparities.
Ebola Czar hides away in bunker — Dr. Nicole Lurie
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The Structural Basis of Ebola Viral Pathogenesis
Obama administration failed to implement all of the CDC’s advice to prevent an Ebola outbreak
The Centers for Disease Control told the incoming Obama administration in 2008 that it should establish 18 regional disease detection centers around the world to adequately safeguard the U.S. from emerging health threats like Ebola, according to an agency memo.
But six years later, as the government struggles to contain the fallout from a deadly Ebola outbreak at home and abroad, the CDC still has only 10 centers — and none of them operates in the western Africa region hardest hit by the deadly virus.
“The existing centers have already proven their effectiveness and impact on detecting and responding to outbreaks including avian influenza, aflatoxin poisoning, Rift Valley fever, Ebola and Marburg virus outbreaks,” the CDC said in its memo to the Obama transition team, which The Washington Times obtained through a Freedom of Information Act request.
At the time, the CDC had five centers set up, and has only added five more of the 13 the agency had proposed “to complete the network and properly protect the nation.”
The memo sheds new light on the problems dealing with the current Ebola crisis, which intensified with the revelations Wednesday that a second Texas nurse had tested positive for the disease and President Obama used a White House Cabinet meeting to promise a “more aggressive” federal response to the threat.
The CDC’s plan outlined in the transition memo was based on the notion that the U.S. shouldn’t wait for a disease to enter the country but rather monitor threats in hot spots overseas to try to help local public health authorities control outbreaks before then.
The CDC didn’t respond to messages seeking comment on its plans Wednesday.
On its Web page, the agency said it has eight regional centers running, with another two in development.
Aside from detecting and monitoring diseases, the centers also provide education to local public health authorities. Though the CDC operates three response centers in Africa — in Kenya, Egypt and South Africa — none of those are based in the western parts of the continent that have seen major Ebola outbreaks this year.
News on Wednesday that another patient in the U.S. — a second health care worker who treated an Ebola patient in Texas — may be infected prompted calls for tightened travel restrictions and at least a temporary travel ban for Liberia, Guinea and Sierra Leone, including one from House Speaker John A. Boehner, Ohio Republican.
The administration has so far rejected those calls, with health officials saying they fear the bans could prevent them from getting aid workers and medical assistance to and from Africa.
Meanwhile, the fight over funding for anti-Ebola efforts has turned political.
Fights over funding
Five Democratic House members on Wednesday called for hearings into budget cuts at the National Institutes of Health and CDC.
The lawmakers said NIH has lost $1.2 billion in funding over the last four years and that a CDC program that supports public workers was slashed 16 percent during the past four years, while a hospital preparedness program lost 44 percent of its funding.
“The CDC and the NIH are already working to combat the spread of Ebola,” said Rep. Michael M. Honda, California Democrat. “In light of recent tragic developments in Texas, and in the interests of ensuring public safety and transparency, we need an update from these agencies so we can ensure they have the proper funding to protect patients, health care workers and the public at large.”
As the deadly virus continues to spread, the CDC has sent dozens of disease control experts into western Africa. In a recent budget document, the agency also has said it’s seeking an extra $45 million for global health security “to accelerate progress toward a world safe and secure from infectious disease threats.”
But the agency’s own memo to the president’s transition team highlighted the need for beefed-up infectious disease detection and other public health efforts overseas. It also reflects funding concerns during the George W. Bush administration.
“Our investment is modest,” the CDC memo stated, “but our capacity in most critical areas has been eroded by budget attrition and increases in the cost of science, travel and infrastructure support in recent years.”
The comments were included in the appendix to the agency’s 128-page briefing memo to the transition team. That same portion of the report had been sent in 2007 to a House appropriations subcommittee overseeing CDC funding, according to the transition memo.
The memo also stated that “core funding” for noninfluenza infectious diseases was lacking, “leaving us many millions behind where we were five years ago when adjusted for inflation.”
“Programs for rabies, rotavirus, food safety, special pathogens like Ebola virus and many others need immediate support if they are to sustain their baseline capabilities.”
The White House and CDC have both cited the regional response centers in recent weeks as an example of the administration’s Ebola response.
Neither the White House nor the Department of Health and Human Services, which oversees the CDC, responded to messages about the recommendation for 18 regional centers.
Senate Health, Education, Labor and Pensions Committee Chairman Tom Harkin, Iowa Democrat, said in a recent floor speech that he’s worked for years to secure more funding for CDC disease detection centers overseas.
“We must stop chasing diseases after the fact and start building public health systems capable of detecting and stopping diseases before they cross borders,” Mr. Harkin said.
The transition memo sounded a similar warning to Mr. Obama’s team as the president prepared to take power in late 2008: “Our nation’s preparedness has greatly benefited from government investments in terrorism and pandemic influenza preparedness, but recent events illustrated that vulnerabilities remain.”
http://www.washingtontimes.com/news/2014/oct/15/cdc-outbreak-prevention-advice-dismissed-by-obama-/?page=2
We Already Have An Ebola Czar – Dr. Nicole Lurie – The Obama Administration Just Wants To Hide Her….
(Via The Federalist) […] See, in 2004, Congress passed The Project Bioshield Act. The text of that legislation authorized up to $5,593,000,000 in new spending by NIH for the purpose of purchasing vaccines that would be used in the event of a bioterrorist attack. A major part of the plan was to allow stockpiling and distribution of vaccines.
Just two years later, Congress passed the Pandemic and All-Hazards Preparedness Act, which created a new assistant secretary for preparedness and response to oversee medical efforts and called for a National Health Security Strategy. The Act established Biomedical Advanced Research and Development Authority as the focal point within HHS for medical efforts to protect the American civilian population against naturally occurring threats to public health. It specifically says this authority was established to give “an integrated, systematic approach to the development and purchase of the necessary vaccines, drugs, therapies, and diagnostic tools for public health medical emergencies.”
Last year, Congress passed the Pandemic and All-Hazards Preparedness Reauthorization Act of 2013 which keep the programs in effect for another five years.
If you look at any of the information about these pieces of legislation or the office and authorities that were created, this brand new expansion of the federal government was sold to us specifically as a means to fight public health threats like Ebola. That was the entire point of why the office and authorities were created.
In fact, when Sen. Bob Casey was asked if he agreed the U.S. needed an Ebola czar, which some legislators are demanding, he responded: “I don’t, because under the bill we have such a person in HHS already.”
[…] So, we have an office for public health threat preparedness and response. And one of HHS’ eight assistant secretaries is the assistant secretary for preparedness and response, whose job it is to “lead the nation in preventing, responding to and recovering from the adverse health effects of public health emergencies and disasters, ranging from hurricanes to bioterrorism.”
In the video below, the woman who heads that office, Dr. Nicole Lurie, explains that the responsibilities of her office are “to help our country prepare for, respond to and recover from public health threats.” She says her major priority is to help the country prepare for emergencies and to “have the countermeasures—the medicines or vaccines that people might need to use in a public health emergency. So a large part of my office also is responsible for developing those countermeasures.” (read more)
Or, as National Journal rather glowingly puts it, “Lurie’s job is to plan for the unthinkable. A global flu pandemic? She has a plan. A bioterror attack? She’s on it. Massive earthquake? Yep. Her responsibilities as assistant secretary span public health, global health, and homeland security.” A profile of Lurie quoted her as saying, “I have responsibility for getting the nation prepared for public health emergencies—whether naturally occurring disasters or man-made, as well as for helping it respond and recover. It’s a pretty significant undertaking.” Still another refers to her as “the highest-ranking federal official in charge of preparing the nation to face such health crises as earthquakes, hurricanes, terrorist attacks, and pandemic influenza.”
Now, you might be wondering why the person in charge of all this is a name you’re not familiar with. Apart from a discussion of Casey’s comments on how we don’t need an Ebola czar because we already have one, a Google News search for Lurie’s name at the time of writing brings up nothing in the last hour, the last 24 hours, not even the last week! You have to get back to mid-September for a few brief mentions of her name in minor publications. Not a single one of those links is confidence building.
So why has the top official for public health threats been sidelined in the midst of the Ebola crisis? Only the not-known-for-transparency Obama administration knows for sure. But maybe taxpayers and voters should force Congress to do a better job with its oversight rather than get away with the far easier passing of legislation that grants additional funds before finding out what we got for all that money we allocated to this task over the last decade. And then maybe taxpayers should begin to puzzle out whether their really bad return on tax investment dollars is related to some sort of inherent problem with the administrative state.
The Ron Perelman Scandal
There are a few interesting things about the scandal Lurie was embroiled in years ago. You can—and should—read all about it in the Los Angeles Times‘ excellent front-page expose from November 2011, headlined: “Cost, need questioned in $433-million smallpox drug deal: A company controlled by a longtime political donor gets a no-bid contract to supply an experimental remedy for a threat that may not exist.” This Forbespiece is also interesting.
The donor is billionaire Ron Perelman, who was controlling shareholder of Siga. He’s a huge Democratic donor but he also gets Republicans to play for his team, of course. Siga was under scrutiny even back in October 2010 when The Huffington Post reported that it had named labor leader Andy Stern to its board and “compensated him with stock options that would become dramatically more valuable if the company managed to win the contract it sought with HHS—an agency where Stern has deep connections, having helped lead the year-plus fight for health care reform as then head of the Service Employees International Union.”
The award was controversial from almost every angle—including disputes about need, efficacy, and extremely high costs. There were also complaints about awarding a company of its size and structure a small business award as well as the negotiations involved in granting the award. It was so controversial that even Democrats in tight election races were calling for investigations.
Last month, Siga filed for bankruptcy after it was found liable for breaching a licensing contract. The drug it’s been trying to develop, which was projected to have limited utility, has not really panned out—yet the feds have continued to give valuable funds to the company even though the law would permit them to recoup some of their costs or to simply stop any further funding.
The Los Angeles Times revealed that, during the fight over the grant, Lurie wrote to Siga’s chief executive, Dr. Eric A. Rose, to tell him that someone new would be taking over the negotiations with the company. She wrote, “I trust this will be satisfactory to you.” Later she denied that she’d had any contact with Rose regarding the contract, saying such contact would have been inappropriate.
The company that most fought the peculiar sole-source contract award to Siga was Chimerix, which argued that its drug had far more promise than Siga’s. And, in fact, Chimerix’s Brincidofovir is an antiviral medication being developed for treatment of smallpox but also Ebola and adenovirus. In animal trials, it’s shown some success against adenoviruses, smallpox, and herpes—and preliminary tests show some promise against Ebola. On Oct. 6, the FDA authorized its use for some Ebola patients.
It was given to Ebola patient Thomas Eric Duncan, who died, and Ashoka Mukpo, who doctors said had improved. Mukpo even tweeted that he was on the road to recovery.
Back to that Budget
Consider again how The Huffington Post parroted Collins’ claims:
Of course, between the fiscal years 2000 and 2004, NIH’s budget jumped a whopping 58 percent. HHS’s 70,000 workers will spend a total of $958 billion this year, or about $7,789 for every U.S. household. A 2012 report on federal spending including the following nuggets about how NIH spends its supposedly tight funds:
Last year there were news reports about a $509,840 grant from NIH to pay for a study that will send text messages in “gay lingo” to meth-heads. There are many other shake-your-head examples of misguided spending that are easy to find.
And we’re not even getting into the problems at the CDC or the confusing mixed messages on Ebola from the administration. CDC director Tom Frieden noted:
Indeed. The Progressive belief that a powerful government can stop all calamity is misguided. In the last 10 years we passed multiple pieces of legislation to create funding streams, offices, and management authorities precisely for this moment. That we have nothing to show for it is not good reason to put even more faith in government without learning anything from our repeated mistakes. Responding to the missing Ebola Czar and her office’s corruption by throwing still more money, more management changes, and more bureaucratic complexity in her general direction is madness.
http://theconservativetreehouse.com/2014/10/14/we-already-have-an-ebola-czar-dr-nicole-lurie-the-obama-administration-just-wants-to-hide-her/
Tracking a Serial Killer: Could Ebola Mutate to Become More Deadly?
Why we need to terminate Ebola 2014 before the virus learns too much about us.
bY David Quammen
Forty years ago, Ebola was just the name of a river. It was a small waterway of no particularly sinister character that flowed through northern Zaire, not far from the village hospital where the first known outbreak of a new viral disease had been centered. That river gave its name to the new virus, and now “Ebola” is a global byword for ugly death, misery, and fear of contagion.
The 2014 epidemic of Ebola virus disease in West Africa is unprecedented in scope, and much attention has been focused, rightly, on how it has gotten so badly out of control.
Behind that question are three others, less obvious, more complicated, and crucial to seeing Ebola in a broader context: Where did the virus come from? Where is it going? What’s next? We do well to consider these questions even as we react to the daily headlines, urge our leaders to take more deeply committed action, and support the organizations (such as Doctors Without Borders) that are fighting the epidemic so courageously in West Africa.
Where Did It Come From?
The outbreak began in early December, in a village called Meliandou, southeastern Guinea, not far from the borders with both Liberia and Sierra Leone. The first known case was a two-year-old child who died, after fever and vomiting and passing black stool, on December 6. The child’s mother died a week later, then a sister and a grandmother, all with symptoms that included fever, vomiting, and diarrhea. Then, by way of caregiving visits or attendance at funerals, the outbreak spread to other villages.
It wasn’t until March, three months later, that local officials alerted the Guinean Ministry of Health about these clusters of a strange, lethal disease in the countryside. By then, human-to-human transmission had started to multiply the case count. But tracing linked cases raises the question of ultimate origin. How did that first child get sick?
Ebola virus is a zoonosis, meaning an animal infection transmissible to humans. The animal in which a zoonosis lives its customary existence, discreetly, over the long term, and without causing symptoms, is called a reservoir host. The reservoir host of Ebola virus is still unknown—even after 38 years of efforts to identify it, since the original 1976 outbreak—although one or more kinds of fruit bat, including the hammer-headed bat, are suspects. There are hammer-headed bats in southeastern Guinea. It’s possible that somebody killed one for food and brought it to Meliandou, where the child became infected either by direct contact with the bat or by virus passed on the hands of an adult.
Why are these facts and suppositions significant? Because they remind us that Ebola virus abides endemically in the forests of equatorial Africa. It will never be eradicated as long as those forests exist, unless the reservoir host itself is eradicated (not recommended) or cured of the viral infection (not likely possible). The virus may retire into its hiding place for years at a time, but eventually it will return, as a result of some disruptive contact by humans with the reservoir host. Then it will spill over into us again. All thinking and planning about how to defend against Ebola virus disease in the future needs to take account of that reality.
Another puzzling fact about origins is that the West Africa epidemic involves a species of ebolavirus (that’s the label for the group, which includes five species) previously known only from outbreaks in the Democratic Republic of the Congo and its close neighbors.
A different species has emerged in Ivory Coast, another West African country, just east of Guinea and Liberia. According to a study published in Science in late August by Stephen K. Gire of Harvard and a long list of co-authors, the virus in West Africa seems to have diverged from its lineage in Central Africa just within the past decade. It somehow leapfrogged over or around the Ivory Coast ebolavirus in order to situate itself in southeastern Guinea. That suggests the unnerving prospect that the Central African ebolavirus (the only one strictly known as Ebola virus) is expanding its range, either by infecting new populations of reservoir hosts or by migrations of those host animals.
One way or another, it has been on the move.
Fruit bats are sold at an outdoor market in Brazzaville, capital of the Republic of the Congo. The reservoir host of Ebola virus is still unknown, but one or more kinds of fruit bat are suspects.
Where Is It Going?
The virus has also traveled within living human bodies. We know that it went from Liberia to Dallas within the late Thomas Eric Duncan, from Liberia to Nigeria by way of the late Patrick Sawyer, and from Sierra Leone to Spain by way of two Spanish missionary priests, both also now deceased, who were evacuated for treatment.
And it has been carried to Omaha, Atlanta, London, Paris, Hamburg, Frankfurt, and Oslo within infected people, mostly health and aid workers brought home to be treated.
But just as worrisome as the virus’s geographic spread is its journey across the evolutionary landscape. Is it mutating in ways that could make it more dangerous to humans? Is there any chance that it might become transmissible through the air, like the flu, the SARS virus, or a common cold?
Although Ebola becoming airborne is the ultimate disease nightmare, that seems to be almost vanishingly improbable, for reasons well put in a recent article in the Washington Post by Laurie Garrett, a senior fellow for global health at the Council on Foreign Relations. What is now a fluid-borne virus attaching itself to cells lining the circulatory system can’t easily change into one that targets the tiny air sacs in the lungs.
“That’s a genetic leap in the realm of science fiction,” Garrett wrote.
The virus probably will not go airborne, but it could conceivably increase its Darwinian fitness in other ways, becoming more subtle and elusive.
The genetic study by Gire and his colleagues (five of whom were dead of Ebola by the time their study appeared) found 341 mutations as of late August, some of which are significant enough to change the bug’s functional identity. The higher the case count in West Africa goes, the more chances for further mutations, and therefore the greater possibility that the virus might adapt somehow to become more transmissible-perhaps by becoming less pathogenic, sickening or killing its victims more slowly and thereby leaving them more time to infect others.
That’s why, the Gire group wrote, we need to stop this thing everywhere as soon as possible. Future spillovers of Ebola are bound to occur, but those freshly emerged strains of the virus, direct from the reservoir host, won’t contain any adaptive mutations that the West Africa strain is acquiring now.
We need to terminate Ebola 2014 before the virus learns too much about us.
Kumba Conde cries after her sister Marie, 14, died from Ebola in Koundony, Guinea, in July 2014. The current outbreak began in December 2013 in southeastern Guinea, not far from the borders with both Liberia and Sierra Leone.
What’s Next?
No one knows, of course, how much worse the epidemic in West Africa will get. The U.S. Centers for Disease Control and Prevention issued a report, in late September, projecting that under the worst-case scenario there could be 1.4 million cases by early next year. The World Health Organization said Tuesday that new cases could rise to 10,000 per week by December, ten times the rate of the previous month. And the World Bank has warned that costs of the epidemic could reach $32.6 billion, which would be an economic catastrophe for the three West African countries that would compound their health catastrophes.
Will the epidemic spread more widely, igniting outbreaks in other parts of the world? We hope not. Will it turn up as additional cases, here and there, among people who have traveled from West Africa unaware, as Thomas Eric Duncan was reportedly unaware, that they were infected before boarding the airplane? Probably.
What’s the best way to limit such occurrences? Rigorous screening at airports, quarantine for travelers who test positive, travel restrictions, or perhaps total bans on commercial flights arriving from Liberia, Guinea, and Sierra Leone-these measures should help. The most important and effective thing we can do, though, is to provide all possible assistance toward ending the outbreak where it began, in West Africa.
The world won’t be free of Ebola 2014 until West Africa is free of it. Even severe restrictions, barring entry to anyone traveling from West Africa, would not make it impossible for the virus to get into America, or Europe, or wherever. To understand why, consider what I call the Nairobi Tabletop Scenario.
Imagine a doctor who departs from Monrovia, the capital of Liberia, feeling fine, on a flight to Nairobi, Kenya’s capital, in East Africa. In transit he begins suffering a headache-nothing terrible yet, just discomfort, but it’s the first hint of Ebola. At the Nairobi airport, in a café, the Liberian doctor coughs onto a table. Five minutes later, an American businessman touches that table. He rubs his eye. He departs to Singapore and spends three days there, in good health, discussing finance for his project in Kenya. Then he flies home to Los Angeles. To the screeners at LAX, he is an American businessman arriving from Singapore, with no history of recent travel in West Africa. But he’s now infected with Ebola, carrying it into the United States.
How do you defend against the Nairobi Tabletop Scenario? By doing everything possible to end the epidemic in West Africa, and thereby to ensure that the Liberian doctor is healthy when he visits Nairobi.
Our safety against the menace of killer viruses can never be an absolute safety. There are too many of them, lurking within reservoir hosts amid distant forests or closer to home-viruses such as Nipah in Bangladesh, Marburg in Uganda, Lassa in West Africa, Sin Nombre virus in the American West, all the new influenzas coming out of southeastern Asia, plus many others that haven’t yet been identified and named.
And there are too many of us humans, sharing the landscape with the reservoir hosts and with one another. We are too interconnected by air travel and transport. Viruses are simple organisms but well-adapted to the modern world. This year it’s Ebola, devastating and scary. Next year it will be something else.
http://news.nationalgeographic.com/news/2014/10/141015-ebola-virus-outbreak-pandemic-zoonotic-contagion/
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