Ebola: An Evolving Story (World Scientific)

Today, Liberia announced that it has released what appears to be their last EVD patient, a 58-year old teacher named Beatrice Yardolo.  This is a good sign, no, a great sign if it’s true… but that’s the catch.  The question now of Ebola is whether it will become endemic in the human population in West Africa.  I personally don’t think it will become part of the normal daily existence, but it is a virus.  It does evolve.  Right now the task is to track down all of the contacts via contact tracing.  That, along with the ending the practice of bring suspected cases to hospitals, seems to have helped turn the tide. For now.  Upticks in the number of new cases per week in Sierra Leone are troubliing.

Today I also received an updated look at the cover of the book from World.  It’s been less two months since I contacted World Scientific, and they have been doing all they can do to get the copy editing done as fast as possible.   The number of new cases per week peaked in September 2014 (at least we hope that’s the is highest we’ll see with this outbreak).  Let’s hope that they trend down again and stay down for 4-5 weeks more.

Naturally, I have mixed feelings about the book.  I wrote it because of the confusing mess of information in the press, in the testimony on the hill, mixed messages from experts.  The need for a clear, logical analysis was clear to me (and to many of my colleagues), and, thankfully to World Scientific.  They were the second publisher I approached with the book concept.  My editor replied with a simple “Yes, we will publish your book”.  World Scientific has been excellent to work with.

The mixed feelings come from my seemingly eternal position in life of dealing with the pain of loss due to death.  Every page of the book was written with the lost in mind, and their surviving loved ones, especially the orphaned children.  No one should have to try to make it in life without their own mom and dad.  Hopefully my colleagues will see the deep compassion and respect for everyone involved I felt for all involved, including the public, the scientists, the policy makers, and the politicians, whom I hope will digest and take to heart one of the messages of Ebola: that fear is not always a bad thing, sometimes it is necessary, and, odds are, it exists because it helped our ancestors survive in the face of danger.  It is important to keep in mind the difference between decisions made from fear expressed in an overly reactionary, emotional manner out of fear “which some call terror”, and decisions made from fear based on rational knowledge of the high risks of injury and death, which some call “respect”.

I’m fairly happy with the book as a window for the general public to see into the world of science and public health policy.  As confusing as the initial reaction to the outbreak and epidemic was, It seems to have provided a springboard of sorts into a new area of analysis of how we do research, how medicine is practiced, and how policy is (or, frequently) is not based on the most solid and best results of science.   Even before I finished Ebola, I found a new book forming on the side on the relationships between research, medical practice and public policy.  World is mulling over the second book.  I’ve completed a few chapters, but they will have to wait.  I have some galley proofs to review, and I have to get back to them on the cover.

Thinking of Liberia today, a boost in morale.

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