Thursday, October 30, 2014

Cold Comfort

Ebola is far from the first disease to be politicized. Venereal diseases in particular are tailor-made for political grandstanding, which at least since the middle of the 19th century has been one of the infections’ nastier side effects. My degree is in history and classical humanities, not medicine, so I have no expertise and therefore no opinion in the current debate about what quarantine standards should or should not exist for those in contact with Ebola patients – other than the opinion that many of those who do have opposing opinions on the subject are, as in other politicized matters, ungenerous in describing each other.  While I’m aware that those who have expertise can and do make mistakes, at least their mistakes will be better informed than mine. One hopes they’ll be fewer, too.

However, the mentions of quarantine touched something in a dusty corner of my memory, so I rummaged around there until I found it. Some readers might be familiar with former NASA scientist Randall Munroe. On his website What If Munroe gives serious scientific answers to even the most absurd questions. Examples: How long could I swim in a pool of spent uranium fuel rods without it being fatal? (Answer: As long as you can swim without tiring and drowning. Water is great at absorbing radiation which is why spent fuel rods are stored in deep pools of water. So, unless you dive down right next to the rods you’ll be fine; near the surface you’ll actually be partially protected from normal background radiation and so will receive a lower dose than if standing in open air. Munroe notes that a bigger risk is getting shot by a security guard.) What if everyone in the world aimed a hand-held laser pointer at the moon? (Answer: nothing visible.) He backs up the answers with appropriate stats. One question, dating back before the present controversy, involved quarantines.

One reader asked, “If everybody on the planet stayed away from each other for a couple of weeks, wouldn’t the common cold be wiped out?” Maybe. And maybe a lot of other diseases too. Then again, Munroe tells us, maybe not. Diseases rely on the chain of infection. If, on average, each person with a cold does not infect at least one other person, that particular rhinovirus will fade away and vanish from the earth. Unlike some disease germs (notoriously chickenpox) which linger in a recovered person, rhinoviruses are completely eliminated by healthy immune systems within two weeks. Ah, you caught that qualifier. That’s where the “maybe not” comes in. We don’t all have healthy immune systems. It is almost certain that cold viruses would survive two weeks (or much longer) in some people; from that small pool there is every likelihood that colds would spread out again. Then there are the practical problems of a universal quarantine. Some people absolutely must go to work – and interact with others while there – in order to keep modern civilization from collapse. How long would the electric power grid, for example, last without intervention? I suppose essential workers in principle could isolate themselves by wearing hazmat suits, but I wouldn’t count on compliance. The lines at the grocery store checkout counters at the end of the two weeks are not pretty to contemplate either.

On the other hand, for reasons having nothing to do with disease control, the proposal to avoid other people for two weeks has a decidedly pleasant sound to it. Maybe we’d all be a little less cranky with each other after such a two week vacation.


2 comments:

  1. I'm going to have to remember that when swimming in a pool of fuel rods. :) Actually a pretty fun fact of trivia and I'd wondered why more Japanese haven't gotten ill from that meltdown in Japan some time back.

    The hospital, Presbyterian Hospital in Plano, was the main one my brother was in when he was in ill health. I've heard some pundits ask that if ebola is not so dangerous, how could a nurse get it wearing protective clothing, gloves, and mask and so forth. Well... because she was attending to the needs of an ebola patient more than likely ie. she came within close proximity of his bodily fluids, whereas the public does not, generally speaking.

    Another point I'd make, is the public thinks that health professionals,hospitals, and doctors are infallible, but they are. I'm glad they're around for sure, but they make mistakes like the rest of us, and probably don't train their subordinates and nurses as well as what they'd prefer you to believe.

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    1. All too true. According to a study in "Journal of Patient Safety" as reported in Forbes (http://www.forbes.com/sites/leahbinder/2013/09/23/stunning-news-on-preventable-deaths-in-hospitals/) and the New York Times, 440,000 Americans die every year from preventable medical errors, making them the third leading cause of death. That's an order of magnitude higher than automobile deaths. That is one reason I stay away from hospitals except in the direst of emergencies. But in an emergency...well, I rather chance the ER than than bleed to death.

      Munroe's site is fun. He also has a book titled "What If?" with several dozen questions and answers from the site.

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