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Ebola and What the Hey Can Be Done

.......and SHOULD before it gets to ME, damn it.......you, I'm less concerned about.

This is Dark Cloud on Wednesday, August 06, 2014.

I'm hesitant to address the Ebola outbreak in Africa, now spreading with some rapidity. I fell for concern about bird flu a decade back, because as laid out by the media there was very little to prevent a global pandemic. With the world warming up, formerly tropical diseases may well spread deep into the temperate zones in the northern and southern hemispheres, so concern about this brutal hemorrhagic disease born by mosquitoes is hardly bizarre. It could happen, and there is no known antidote or preventive inoculation.

Or is there? Two Americans who had dedicated and risked their lives in Nigeria fighting this horror, rather predictably came down with it themselves and were playing hearts with the Reaper when a drug company in San Diego that "had three doses of an experimental Ebola medicine that showed promise in monkeys but had never been tested in humans," says the LA Times, offered it up. They drug was sent to the two ill Americans in Liberia but not to the indigenous people dying there.

There is some fear this premature offering would undermine ability to determine whether the drug was actually either safe or effective and, hopefully, both. Already, drug companies bypass the doctors and advertise right on television to potential customers. Imagine during an epidemic of a deadly disease. The public pressure would be intense, and yokel politicos would champion idiocies. Riots and bedlam.

The ill doctor and hygienist are now in Atlanta at Emory University in isolation. In they survive, there would be no way to know if the doses helped or not. They will know that the dose didn't make it worse, and thus could be considered safe for human use. And human experiment. But they won't actually know, given all the variables, its exact effect, if any.

The outbreak has infected about 1600 people and it is fatal in 45 to 90 % of its victims. 887 have already died. The experimental drug at issue is called ZMapp, is one of several under development. The head of New York University's Langone Medical Center said "There's a fairly good chance that it could do more harm than good....The drug could kill you faster, or make you die more miserably."

Eleven years back, a patients' rights group called " The Abigail Alliance argued that patients with "desperate diagnoses" had a constitutional right to potentially lifesaving treatments that had passed an initial round of safety testing." But the story in the LA Times says "...that would have removed a powerful incentive for patients to participate in clinical trials" as the FDA claimed. A federal appeals court backed the FDA, and the Supreme Court declined to hear the case. So, it seems the two Americans would therefore not have received the last ditch drug if they were in the United States. But shipping it to Africa, where the two were ill, was legal.

It has seemed to me that there could easily be three groups of medicine. First, the long time tested and known, like aspirin and penicillin. Then, the newer drugs that have not been used long enough for complete understanding of long term or even intermediate term effects, bad and good, but currently in use. And then the blue sky options like the drug in question. If a person is going to die shouldn't they have the right to risk survival? Can't that be part of insurance coverage and hospital intake paper work? It would, if done properly, increase knowledge faster and might save lives. But because hospitals and doctors fear lawsuits, justifiably, and lawyers in general, they won't go for it absent clear protection.

And the shocking history of medicine shows that human experimentation - especially on those unknowing and most probably unwilling - is not entirely a beneficial course of action. Experiments on people based on race has a less than charming narrative, and not just those in Nazi Germany. Walter Reed's experiments with Yellow Fever protections have racial aspects that make one blanch. The near sure thing was given to the whites, who became heroes, and placebos and less likely successes given to those of darker hue. Which is to say, to those thereby condemned to die or wish they had.

But surely such last minute heroics might be clearly beneficial with the structure and regulations built into medical procedure and law. There are numerous supposed cancer cures, a great number by charlatans of the first water, and it would be great to see them exposed and ousted. Would be nice to see people saved, as well. This is doable, and should be done.