Too Little Leading to Too Late? Inevitably, the previous week’s focus on the potential spread of the Ebola virus by commercial airplane has landed people at my electronic doorstep with questions about my 1995 best seller, Pandora’s Clock (also an NBC mini-series). Yes, that storyline involved the potential spread of a Level 4 virus (90% kill rate untreated) via airplane, but one of the key postulates of the plot was that governments would overreact to the threat, not the apparent under-reaction which has characterized the real world’s response to Ebola breaking out of Africa. In Pandora’s Clock, a sick passenger in Frankfurt wobbles aboard a pre-Christmas flight to New York and when, after takeoff, he goes into cardiac arrest, the mere suspicion that he might have been exposed to a “doomsday” virus causes all of Europe and the UK to slam their doors shut, refusing the distressed captain landing permission anywhere. In real life, we have major airline hubs in Amsterdam, London, Brussels, Paris, and Frankfurt all continuing operations as normal, with inbound flights from western Africa spilling thousands of passengers per day into the hub and spoke system through which any one of them could be the carrier that brings Ebola to practically any other place on the planet. Dallas, for instance. Yes, authorities in many of those African airports are taking very seriously their duty to try to identify and deny boarding to anyone who shows early signs of an Ebola type infection, but travelers themselves have to tell the unvarnished truth to make that stopgap approach work, and in the case of the critically ill gentleman now fighting for his life in Dallas’s Presbyterian Hospital, there is a high possibility that the entire truth was not told. Here is thing we’re missing: A 10 or 15 hour international flight sequence can easily span the timeline from “no symptoms” to “overt symptoms,” as was feared in Newark on Saturday. In that case, a passenger who became violently ill in flight - with his itinerary origin being Western Africa - was handled as a potential Ebola case and all his fellow passengers quarantined for a few hours until the CDC could confirm that Ebola was not involved. But there is an open-ended possibility that others who may be wholly unaware of their exposure potential in West Africa could board in all innocence with no fever, and arrive at a foreign destination contagious and dangerous. There are two key questions: First, can we, as a world airline system interlaced with airport and aviation and public health authorities, be absolutely certain that if symptoms emerge during an international flight, the sick individual, fellow passengers, and the virus itself can all be safely contained at destination? And secondly, can we absolutely assure that the individual who became obviously ill in flight on a two-leg international trip was not contagious before boarding that last flight? Yes, I know the strongly stated epidemiological reality attaching to Ebola of “No symptoms, no danger,” but deciding precisely when symptoms began to emerge leaves us with a problem, and every European hub needs to be reconsidering their approach to flights - and passengers - flooding out of the hot zone. If we’re not going to shut down air traffic from West African nations, and obviously we aren’t, then how can we assure the virus won’t escape? Sadly, I think our current efforts are dangerously short of the mark. In the final analysis, the world leaders in Pandora’s Clock were too conservative beyond a fault. I worry, however, that the laisse faire, business-as-usual confidence now governing the world’s response to this deadly virus breaking out of Africa is too liberal. And, the nightmare scenario is just this: What if it mutates to an airborne contagion potential in which a mere sneeze can infect? Will we know in time? Will we react in time?
Posted on: Mon, 06 Oct 2014 00:22:24 +0000