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Warning: Flu Season Peak Hits Late This Year — Like Maybe Now

See those rising red triangles? That's this season. The CDC shows a rise in flu cases later than in previous years. (CDC FluView)

See those rising red triangles? That’s this season. The CDC shows a rise in flu cases later than in previous years. (CDC FluView)

It knocked me flat. Then it hit me with chills so violent only piles of blankets could calm them. It left me too weak to do anything but watch brainless TV all weekend, wondering how I’d become such a wimp that some garden-variety virus could lay me so low.

Then, Monday morning, my weekend misery suddenly all made sense.

“Believe it or not, flu season still hasn’t peaked,” said the email from Flu Near You, which crowdsources flu surveillance. “In most years, cases of the flu virus peak in February or early March, but as of this week, flu is still spreading and the height of it is not in sight yet, according to epidemiologists at the CDC.”

Aha. Nice to know that I wasn’t hit by sudden sloth. Though I got no lab diagnosis, chances are I was felled by the common virus that scares me most, far more than Ebola or Zika: the flu. Here on the Eastern Seaboard, we’d been largely spared our annual flu woes this year — until now. And nationwide, as of last week, flu reports were spiking in more than half of states, amounting to what’s looking like an unusually — though not uniquely — late peak to the flu season.

“This has been a really late influenza season,” Dr. Lynnette Brammer, an epidemiologist in the influenza division of the CDC, said in an interview. “If you go back and look at the last 33 seasons, only five of those have peaked during March, and none of them have peaked in April. We don’t yet know when influenza activity is going to peak this year. Data that we posted last week for the week ending March 12 showed influenza activity still increasing.”

Here in Massachusetts, case numbers are shooting up, as you can see on the graph below:

(Source: The Massachusetts' Department of Public Health's weekly influenza update, for March 18)

(Source: The Massachusetts’ Department of Public Health’s weekly influenza update, for March 18)

“We are definitely seeing an increase in flu activity, in the last week or two in particular,” says Dr. Larry Madoff, director of epidemiology and immunization at the state Department of Public Health. “We’re characterizing it as ‘moderate’ and ‘widespread’ in Massachusetts right now.”

And it does not yet seem to be abating.

“It still seems to be on the way up,” Dr. Madoff says. “Anecdotally, we’re hearing this from providers, from people in the community, and we’re certainly getting this from our sentinel networks and laboratory testing that flu is on the way up, so we don’t know when it will peak.”

On the positive side, he notes, it has been a milder flu season than usual until now. That may be in part because the predominant strain of the virus this year is H1N1 — remember the pandemic of 2009? — and the population has had time to build up some immunity to it, Dr. Madoff says.

Also, this year’s vaccine is a good match for the flu strains that are circulating, and is estimated as 60 percent effective.

So that’s the good news. The bad news is that if you were rejoicing that you made it through winter flu-free, not so fast: You still have to weather spring.

A questionnaire from Flu Near You asks about symptoms. (Carey Goldberg/WBUR)

A questionnaire from Flu Near You asks about symptoms.

What might be causing this late flu peak? After an oddly warm winter here in Massachusetts, followed by an oddly warm then suddenly cold March, might climate be at work?

The short answer is that flu dynamics are highly complex and nobody really knows, but Dr. Madoff says the year’s weather is a possible factor.

“The weather has an impact and climate has an impact,” he says. “We know that flu is transmitted better during periods of cold weather and we certainly see that with the seasonality of flu every year. And it’s been shown that flu is better transmitted with dry cold air, and that certainly could have an impact, and it has been a mild unusual winter here.” Continue reading

A $1 Pill That Could Save Thousands Of Lives: Research Suggests Cheap Way To Avoid U.N.-Caused Cholera

(United Nations Photo/Flickr)

(United Nations Photo/Flickr)

By Richard Knox

Here’s a way to get a big bang for a buck:

If a few hundred United Nations peacekeeping troops had taken a $1 antibiotic pill five years ago before they were deployed to Haiti, it may well have prevented a cholera outbreak that has so far sickened 753,000 Haitians and killed more than 9,000.

That’s the takeaway of a new study by Yale University researchers in the journal PLoS.

The authors believe their evidence should prompt the U.N. to adopt a simple and incredibly cost-effective strategy: Make sure all the 150,000 peacekeepers it sends out into the world each year from cholera-afflicted countries get preventive doses of antibiotics before deployment.

It’s not the first time the U.N. has gotten that advice. It was first suggested by a panel of outside experts the agency appointed back in 2011 to investigate the Haitian epidemic. But so far the U.N. has rejected the panel’s recommendation on preventive antibiotics.

It’s not clear whether that will change. The U.N.’s chief medical officer, Dr. Jillian Farmer, said in an interview Friday that she welcomes the new study. But she noted it does not address “the biggest barrier to implementing the antibiotic recommendation” — a concern that what she calls “mass administration” of antibiotics would give rise to antibiotic-resistant strains of cholera.

“It may be we will be able to do this [administer pre-deployment antibiotics to U.N. peacekeepers],” Farmer said. “I don’t have a closed mind.”

The Yale researchers and others argue that the concern about generating resistant cholera strains is overblown because the antibiotics would be targeted — not administered massively. They further argue that the U.N. should sponsor research to answer that question, given the urgency of the question.

“When we have a case as extreme as Haiti showing the status quo doesn’t work, we should be working to build evidence for a solution that does, not using a lack of proven solutions as an excuse not to act,” said Adam Houston, who works with the Boston-based Institute for Justice and Democracy in Haiti.

The new study is the latest chapter in a tragic story that’s been unfolding since mid-October of 2010, when, researchers say, a single U.N. peacekeeper from Nepal most likely introduced cholera to Haiti, touching off the most explosive cholera epidemic in modern times. Before the outbreak. Haiti had been cholera-free for at least a century; thus, its citizens had no immunity to the disease.

“Based on DNA evidence, this outbreak was probably started by one or very few infected, asymptomatic individuals — I would guess one,” said Daniele Lantagne, a Tufts University environmental engineer who was one of four independent experts appointed by the U.N. in 2011 to investigate the outbreak.

Since none of the 454 Nepalese peacekeeping troops deployed to Haiti in late 2010 showed any symptoms of cholera, all of them would have had to take a prophylactic dose of antibiotic to prevent any one of them from starting the outbreak. That would have cost around $500 — a tiny price to pay to avoid a devastating epidemic that — absent the investment of billions of dollars in clean water and sanitation — will continue into Haiti’s indefinite future.

The new analysis finds that prophylactic antibiotics would have reduced the chances of the Haitian epidemic by 91 percent. When antibiotics are combined with cholera vaccination, the risk of an outbreak goes down by 98 percent.

The U.N. began requiring cholera vaccination of all its field personnel late last year. But the new study says vaccination by itself isn’t very effective; it reduces the risk of an outbreak by only 60 percent at best.

That’s because vaccination can prevent someone from falling ill from cholera, but it doesn’t prevent infection — so a vaccinated person can still carry the cholera bacterium and pass it on to others.

“Vaccination alone is not enough,” said Virginia Pitzer, who led the Yale research team. “Vaccination plus antibiotic prophylaxis would be best.”

“Antibiotics are far and away the most effective and the least expensive,” added epidemiologist Joseph Lewnard, the study’s first author. “It hits the problem from two angles. It not only prevents those exposed to cholera from experiencing an infection, but if they do get infected it shortens the duration of shedding the bacteria. So once they arrive [at their deployment destination] they would no longer have bacteria in their stools.” Continue reading

Why You Should Get Plenty Of Sleep Tonight: Avoid That Cold

Lack of sleep can lead to bad outcomes, from crankiness to extreme mental distress.

Now researchers report an association between insufficient sleep and getting sick. Specifically, they conclude that shorter sleep duration was associated with increased susceptibility to the common cold. Adults who slept fewer than 5 hours or between 5 and 6 hours were at greater risk of developing a cold compared to those sleeping more than 7 hours per night, according to the study, published in the journal Sleep.

(Seniju/Flickr)

(Seniju/Flickr)

The authors conclude:

Given that infectious illness (i.e., influenza and pneumonia) remains one of the top 10 leading causes of death in the United States, the current data suggest that a greater focus on sleep duration, as well as sleep health more broadly, is indicated.

NPR reports further on the study:

Aric Prather, a psychologist at the University of California, San Francisco, who studies how our behaviors can influence our health…wanted to document the extent to which a good night’s sleep is protective. So, he and a group of colleagues recruited 164 healthy men and women — their average age was 30 years old — to take part in a study. Using sleep diaries and a device similar to a Fitbit, the researchers assessed each participant’s sleep for a week.

Then the scientists sprayed a live common cold virus into each person’s nose.

“We infected them with the cold virus,” Prather says, then quarantined everybody and watched to see who got sick…

“What we found was that individuals who were sleeping the least were substantially more likely to develop a cold,” Prather says. Continue reading

Mass. Prisoners Sue For Better Hepatitis Care

Prisoners in Massachusetts are not being given expensive new medications to treat hepatitis C, according to a prisoner rights group that is suing the state, WBUR’s Martha Bebinger reports:

The lawsuit says new drugs that can cure Hep C are now standard care, especially for patients at risk of death from the disease. It’s not clear how many of the 1,500 state prisoners with Hep C are in an advanced stage that would warrant use of the $80,000-90,000 treatment.

But Joel Thompson at Prisoners’ Legal Services says all prisoners are entitled to adequate medical care under the Constitution.

“And the treatment of Hepatitis C, given all the changes that have come, in the treatment of the disease, is no longer adequate. It violates their constitutional rights,” Thompson says.

There is no comment yet from the state or the private group that handles prison medical care.

Here’s the full news release from Prisoners’ Legal Services and the National Lawyers Guild:

Hundreds of prison inmates are in danger of losing their lives because the Department of Correction refuses to provide the medicine that will cure their potentially fatal disease. A class action lawsuit filed in federal court today by lawyers for the National Lawyers Guild and Prisoners Legal Services says it is Massachusetts’ legal responsibility to provide adequate medical care to state prisoners. Urszula Masny-Latos, Executive Director of the Massachusetts chapter of the National Lawyers Guild, said: “It is the responsibility of the state, which spends millions to incarcerate thousands of people, to provide adequate medical care for them. Without such care, many of them will develop serious complications of this disease, and some will die. These people were sentenced to incarceration, not to death.” The lawsuit seeks to compel the Department of Correction (DOC) and its health care contractor, the Massachusetts Partnership for Correctional HealthCare, LLC (MPCH) to provide inmates in their custody with new, lifesaving medications for Hepatitis CHepatitis C, an infectious disease which causes progressive damage to the liver and ultimately liver failure, is widely prevalent in prisons and jails. New medications approved by the FDA in 2014 represent a dramatic improvement over their predecessors, curing nearly one hundred percent of patients, with far fewer side effects. The DOC and MPCH have stopped using the now-outdated medications, but have failed and refused to provide prisoners with the new treatment. Continue reading

What’s The Vaccination Rate At Our School? Mass. Parents Can Now Look It Up

CLICK TO ENLARGE: A sample from the Massachusetts Department of Public Health's compilation of school immunization rates, recently made public

CLICK TO ENLARGE: A sample from the Massachusetts Department of Public Health’s compilation of school immunization rates, recently made public

Amid the current Disneyland-vector measles outbreak and the new spotlight it’s putting on vaccine gaps, many a parent is wondering: What’s the vaccination rate at my own child’s school? What are the chances that my kid will come into contact with an unvaccinated kid? And does our school make the cut-off for “herd immunity,” that desirable state when so many people are vaccinated that even if a bug gets in, it’s unlikely to spread?

USA Today has published a beautifully granular look-up tool of vaccination rates broken down by school, with data for 13 states, including Massachusetts. Its interface lets you look up a specific school by typing in its name.

But we in Massachusetts are particularly data-rich, in that the state Department of Public Health has just recently posted a spreadsheet of all our schools, grouped together by town; that means we can not only check a particular school’s rate but also compare it with its neighbors’.

The full state list of schools and their kindergarten vaccination rates is here, in an easy format that looks like the spreadsheet shown above.

So what are we to make of these numbers, particularly if our own school’s rate looks low?

I spoke with Pejman Talebian, chief of the immunization service at the state’s Department of Public Health. My biggest takeaway: If your school’s numbers look low, don’t freak out. It could be an artifact of under-reporting, particularly if the numbers of vaccine exemptions are low. But there are, he said, pockets of concern, particularly on Cape Cod and in western Massachusetts, where the numbers of exemptions tend to be high and vaccination rates lower than desired.

Our conversation, lightly edited:

What would you hope that parents and school communities do with this data?

We hope that it starts conversations around immunization. And we hope that in areas of the state where there are lower rates, and higher rates of exemptions, it prompts more conversations between health care providers in those communities, local health officials in those communities, and the community as a whole — that they talk about the benefits of immunization, prompting folks to potentially reconsider their stance around immunization. Hopefully, it will lead to more individuals seeking to be fully vaccinated.

“These pockets are not in lower-income city areas, they generally tend to be in middle and upper middle class communities.”

– Pejman Talebian,
state Department of Public Health

Is there anything that communities should be sure not to do?

I wouldn’t take one data point around one specific school and assume there’s definitely a concern or definitely a problem. This is all self-reported information and some of it may not be a true reflection of what is the actual immunization coverage in the school. So if you do see a school with what appears to be very low immunization rates, that doesn’t mean that that school is definitely ripe for an outbreak tomorrow and that’s a major concern. It should just prompt questions and conversations with school health staff and with the community, ensuring the population is being properly vaccinated.

How long have we had this data? When did it go public? Continue reading

Why The Current, Post-Eradication Measles Outbreak Is So Infuriating

Back of female with measles/ Wellcome Library, London. Wellcome Images/flickr

Back of female with measles/ Wellcome Library, London. Wellcome Images/flickr

That certain parents refuse to get their kids vaccinated isn’t new. But suddenly, it’s news. And it’s troubling. I’m a big supporter of “crunchy” parenting, but not when it puts other people’s children (and mine) at risk. The current measles outbreak has infuriated many parents and medical professionals who, fuming, wonder why we are arguing about a virus that was already eliminated here in the U.S. 15 years ago.

So, here’s one such parental rant on the topic by Alicair Peltonen, an administrative assistant at the Harvard School of Public Health and a journalism student at the Harvard Extension School.

By Alicair Peltonen
Guest Contributor

When I was in elementary school, one of my favorite books was called “The Value of Believing In Yourself,” by Spencer Johnson, MD. It was part of a children’s book series meant to teach lessons through the life stories of historical figures. The Value of Believing In Yourself was about Louis Pasteur and his quest to develop the rabies vaccine.

That book still stands as my most cherished source for the science of immunity. Even with a bachelor’s degree in biology, a career spent working in scientific and medical research and a current job in the immunology department of a prestigious graduate school, I still picture all viruses as scruffy black blobs with scary pink faces and foaming fangs. And vaccines are the steadfast soldiers in uniform with huge mustaches and bayonets that are sent in to get the bad guys. How on earth could anyone be more scared of the soldiers than the black blobs?

I have kids. I know all about fear. Those first days with my oldest daughter were magic, but it was a dark magic. It came with visions of this tiny creature I was now in charge of falling off my lap as I breast-fed or rolling face-first into a crib bumper. I imagined a hundred ways she could be injured or worse — and I imagined all the ways it would be my fault.

I went straight to my local Isis Maternity (a wonderful organization that no longer exists) and signed up for new mommy classes. Those classes were an education for me, not in what to do as a new parent, but what not to do. All the women I sat criss-cross applesauce with were lovely, caring, engaged moms who were genuinely searching for the best way to rear happy, healthy child. And every single one of them was irrationally afraid of one thing. And those “things” were all different. Continue reading

How To Talk To Parents Who Oppose Measles Vaccines? We Don’t Know

In this Jan. 29 photo, pediatrician Charles Goodman vaccinates 1-year-old Cameron Fierro with the measles-mumps-rubella vaccine, or MMR vaccine, at his practice in Northridge, Calif. The measles outbreak that originated at Disneyland in December has prompted politicians to weigh in and parents to voice their vaccinations views on Internet message boards. (Damian Dovarganes/AP)

In this Jan. 29 photo, pediatrician Charles Goodman vaccinates 1-year-old Cameron Fierro with the measles-mumps-rubella vaccine, or MMR vaccine, at his practice in Northridge, Calif. The measles outbreak that originated at Disneyland in December has prompted politicians to weigh in and parents to voice their vaccinations views on Internet message boards. (Damian Dovarganes/AP)

Suddenly, measles is political. The Disneyland outbreak has turned the long-simmering issue of parents who decline vaccinations for their kids into a political hot potato, to the point that the New York Times just did a round-up of where potential presidential candidates stand on vaccination. (Classic Hillary Rodham Clinton tweet: “The science is clear: The earth is round, the sky is blue, and #vaccineswork. Let’s protect all our kids.”)

My thought: Great. The topic is already rife with fear and anger and parental conflict, and now we’re adding politics? And I wondered: Is there, in fact, a known way to discuss vaccine resistance constructively? When a pediatrician faces a hesitant parent, or when I encounter a parent in my community who fails to get a child vaccinated?

I asked Dr. Barry Bloom, an infectious diseases expert at the Harvard School of Public Health, who co-authored an editorial in the journal Science — “Addressing Vaccine Hesitancy” — and was also recently featured here: “Talking The Talk On Vaccines.” His reply:

One of the amazing things is that we don’t know the answer to your question. I chaired a meeting at the American Academy of Arts and Sciences on the subject of trust in vaccines. We brought in lots of people — from state governments, doctors — to find the answer to your question: What do we know about how to persuade people that it is in kids’ best interest to protect them against diseases they’ve never seen?

My take is that the answer is two-fold:

One, not everyone is the same. There are a myriad of reasons that people give when questioned about why they don’t vaccinate kids, or delay vaccinations. So there’s no one-size answer that will fit all.

The vast majority of people listen to their doctors — they’re very important — and they do what is recommended because they believe doctors wouldn’t want to harm their kid.

Then there’s a very small group of people who, for a variety of ideological, certainly not scientific, reasons, are opposed in any manner, shape or form to being told what to do, to having government make requirements for school entry, and so on.

The third part of that is people who are responding to discredited publications claiming that vaccines cause bad things to happen. I have to say when I saw one of the physicians in Congress, Rand Paul, say that he had heard vaccines cause neurological or psychological damage, I was absolutely stunned, because there’s no data to support that whatsoever. Continue reading

Rare Good News On Antibiotic Resistance: Promise Of Tougher New Drug

Northeastern researchers use an "iChip," a miniature device that can isolate and help grow single cells in their natural environment, and was instrumental in the discovery of teixobactin. (Slava Epstein/Northeastern U.)

Northeastern researchers use an “iChip,” a miniature device that can isolate and help grow single cells in their natural environment, and was instrumental in the discovery of teixobactin. (Slava Epstein/Northeastern U.)

Here’s a rare treat: potential good news about antibiotic resistance.

For years, the drumbeat of warnings has grown increasingly dire: The bugs are evolving more and more resistance to our biggest antibiotic guns. Some bacteria — strains of tuberculosis and gonorrhea among them — have even become resistant to all antibiotics. Remember the bad old days before these wonder drugs, when bacterial infections were so often death sentences? No one wants to go back there.

So today’s report in the journal Nature offers a nicely contrasting ray of antimicrobial hope: It reports the discovery in soil of a potentially powerful new antibiotic, dubbed teixobactin (pronounced takes-o-bactin), that appears to be less vulnerable to evolving resistance than other antibiotics.

“Early on, we saw that there was no resistance developed to teixobactin, and this is of course an unusual and intriguing feature of the compound,” says Northeastern professor Kim Lewis, senior author on the Nature paper. The methods used to discover and develop the compound have “a good chance of helping revive the field of antibiotic discovery,” he says.

Northeastern Prof. Kim Lewis, director of the Antimicrobial Discovery Center in the College of Science, researches novel antibiotic treatments. (Brooks Canaday/Northeastern Univ.)

Northeastern Prof. Kim Lewis, director of the Antimicrobial Discovery Center in the College of Science, researches novel antibiotic treatments. (Brooks Canaday/Northeastern Univ.)

Teixobactin worked “exceptionally well” to kill resistant bacteria in mice, Lewis says, but it will take several years and probably over $100 million to develop it into a drug that could be prescribed to human patients. It’s among two dozen other compounds that he and colleagues have turned up using a novel method to develop substances found in soil that could be useful as antibiotics.

Teixobactin works by attacking the biological building blocks of the bacteria’s cell walls, says co-author Tanja Schneider of the University of Bonn. That basic target, which is hard for the cell to modify, may help explain why the bacteria seem unable to develop resistance, she says. Continue reading

Ebola Tipping Point? Dispelling Myths And, Possibly, Less Hysteria Over Virus

A World Health Organization worker trains nurses on how to use Ebola protective gear in Freetown, Sierra Leone. (AP)

A World Health Organization worker trains nurses on how to use Ebola protective gear in Freetown, Sierra Leone. (AP)

Has the national hysteria over Ebola peaked? Who knows. Maybe. There seem to be fewer front page headlines screaming about it; a new national poll finds most Americans are “positive” about the response by public health authorities; and today’s news is that more than 40 Dallas residents (all who had been in contact with the Liberian man who died of Ebola) were declared virus-free.

Still, education is the antidote to hysteria, so it’s worth reiterating some of the facts. Many of them can be found in this must-read commentary in the London Review of Books by Paul Farmer, the rock star Harvard infectious disease doctor and leading advocate for global health equity in the world’s most impoverished regions. Farmer, who is also a co-founder of the Boston non-profit Partners in Health, writes that despite some of the truly scary aspects of the virus, an Ebola diagnosis is not necessarily a death sentence:

The Ebola virus is terrifying because it infects most of those who care for the afflicted and kills most of those who fall ill: at least, that’s the received wisdom. But it isn’t clear that the received wisdom is right….

…the fact is that weak health systems, not unprecedented virulence or a previously unknown mode of transmission, are to blame for Ebola’s rapid spread. Weak health systems are also to blame for the high case-fatality rates in the current pandemic, which is caused by the Zaire strain of the virus. The obverse of this fact – and it is a fact – is the welcome news that the spread of the disease can be stopped by linking better infection control (to protect the uninfected) to improved clinical care (to save the afflicted). An Ebola diagnosis need not be a death sentence. Here’s my assertion as an infectious disease specialist: if patients are promptly diagnosed and receive aggressive supportive care – including fluid resuscitation, electrolyte replacement and blood products – the great majority, as many as 90 per cent, should survive.

And he adds this:

I’ve been asked more than once what the formula for effective action against Ebola might be. It’s often those reluctant to invest in a comprehensive model of prevention and care for the poor who ask for ready-made solutions. What’s the ‘model’ or the ‘minimum basic package’? What are the ‘metrics’ to evaluate ‘cost-effectiveness’? The desire for simple solutions and for proof of a high ‘return on investment’ will be encountered by anyone aiming to deliver comprehensive services (which will necessarily include both prevention and care, all too often pitted against each other) to the poor. Anyone whose metrics or proof are judged wanting is likely to receive a cool reception, even though the Ebola crisis should serve as an object lesson and rebuke to those who tolerate anaemic state funding of, or even cutbacks in, public health and healthcare delivery. Without staff, stuff, space and systems, nothing can be done.

If you want to become more educated on Ebola and find out what you can do to support the global effort, Partners In Health/Engage and Harvard are sponsoring an Ebola teach-in Wednesday night in Cambridge with a panel of practitioners and public health experts. Continue reading

Opinion: Why America’s Ebola Fears Are Dangerously Misplaced

Cpl. Zachary Wicker demonstrated the use of a germ-protective gear in Fort Bliss, Texas on Tuesday. (Juan Carlos Llorca/AP)

Cpl. Zachary Wicker demonstrated the use of a germ-protective gear in Fort Bliss, Texas on Tuesday. (Juan Carlos Llorca/AP)

By Richard Knox

At the memorial service last weekend for the only person to have died of Ebola on American soil, the Liberian clergyman who eulogized his countryman Thomas Eric Duncan posed a question we all should be thinking hard about right now.

“Where did Ebola come from to destroy people — to set behind people who were already behind?” Methodist Bishop Arthur F. Kulah wondered.

Here’s the reality: Until the world (and especially the United States of America) refocus on the “people who were already behind” in this battle of virus-versus-humanity, no one can rest easy.

Ebola is an animal virus that has sporadically caused local human outbreaks in Africa for at least 38 years. But now it has crossed into people who live in densely populated African nations with barely functioning health systems and daily jet connections to the rest of the planet.

“It’s like you’re in your room and the house is on fire, and your approach is to put wet towels under the door.”

– World Bank chief Jim Yong Kim

This is entirely predictable, as scientists who watch emerging diseases have long known. They just didn’t know which virus would be the next to terrorize the world. (SARS and HIV showed how it can happen, remember?)

Those of us who, like me, report on global public health have a sense of inevitability as we watch the Ebola crisis unfold. We always knew it would mostly affect, as Bishop Kulah so aptly puts it, “people who were already behind.”

And we knew the people least affected by this scourge — privileged denizens of wealthier countries — would overreact out of misplaced fear for themselves, rather than a reasoned and compassionate understanding about what needs to be done.

So we see the freaked-out, wall-to-wall, feedback-loop media coverage we’re experiencing now. Schools closing down in Ohio for completely unnecessary disinfection. Recriminations against hapless health workers who suddenly find themselves dealing with an exotic new threat. Continue reading