Well, it’s not looking good on the ebola front. We still don’t know why the nurse in Dallas has ebola despite all of her precautions but I’m still not panicking. My relatives in Houston are probably safe, though what did they say during the Black Death? Run fast, go far, stay long? Ok, that’s not really funny and is only encouraging a kind of hysteria that isn’t helpful. Two ebola patients in Texas does not an epidemic make. Then again, it’s Texas.
Nevertheless, there is a some speculation that the virus has become more virulent. Peter Jahrling of the National Institute of Allergy and Infectious Diseases says this may be due to the increased viral load in infected individuals:
You’re seeing all these patients getting infected, so people think there must be aerosol spread. Certainly, it’s very clear that people who are in close contact with patients are getting a very high incidence of disease and not all of that can be explained by preparation of bodies for burial and all the standard stuff. But if you are to assume that the differences in virus load detected in the blood are reflected by differences in virus load spread by body secretions, then maybe it’s a simple quantitative difference. There’s just more virus.
Jahrling says that HIV was actually a hotter disease, primarily because carriers weren’t obvious and were able to spread the disease easily. It also helped that HIV attacks cells in the immune system, which prevents a vigorous response. But it’s a little hard to make this argument when comparing it to ebola. HIV is a long, slow death and we now have drug cocktails to treat it. Ebola is quick, excruciating, bloody and the lethality is alarming, especially because the treatment options are so few.
Which brings me to the next bit of bad news. Frances Collins of the NIH says we might have had a vaccine for ebola except our politicians, with anti-governmental fervor, cut funding to those very institutions that might have helped to develop one. I’d heard from researchers I met in Cambridge who had recently been to the CDC that morale was pretty low and disorganization was high. Then, I lived through the summer of sequester when university research groups lost a sizable chunk of their funding as grants became more and more unattainable. Layoffs quickly ensued.
One of the reasons I have been reluctant to pursue a job in research is because the money isn’t there anymore and I’m really sick of layoffs. And let me make it clear that while scientists like to get paid fairly for the work they do, they don’t work for the money, for the most part. They just like the work. It can be frustrating and maddening and discoveries take a long time. But it is also intensely rewarding in a way that money isn’t. That’s not to say that we don’t have our own caloric requirements and shelter needs. Also, no one likes to be exploited. But bankers and Jack Welch types don’t understand the nature of science or the vast majority of people who do it for what is turning out to be a vanishing living. But I digress.
The problem is that the patent cliff spooked pharma shareholders and they abandoned American research in search of get-rich-quick schemes and foreign research that isn’t ready for prime time. At the same time, rabidly anti-government Republicans, abetted by complacent Democrats, have been slashing research budgets.
This is not the same America that we had in the post World War II days. This is an infrastructure that is rapidly being gutted. If you have any doubt of how bad things are, consider that Mapp Pharmaceuticals is virtually the only company on the planet with a possible treatment for ebola (we won’t know how the GSK vaccine is doing for awhile yet) and it is a small company in San Diego facing a logistical nightmare. How does it grow the monoclonal antibodies and purify them on a scale to meet the urgent need of thousands of patients around the world? Where is the CDC/NIH/Private Industry SWAT team that can get this off the ground? We are asking this company to do the impossible on a massive scale in such a way that would attract every class action lawyer in the country if there wasn’t a health care emergency.
But it’s even worse than that. As Collins says, ebola is only the tip of the iceberg. The vast majority of us will not die of ebola. We’re going to suffer from other maladies that no one is studying right now. The funding is low on antibiotics, certain central nervous system disorders, heart disease, etc. Companies just stopped working on these diseases because the research was expensive and shareholders didn’t think the profits were high enough.
All of this is happening when there is a revolution in biology. The most ironic aspect of this problem is that thousands of trained researchers have been sidelined right at the same time that there is more than enough work to keep every one of them extremely busy for the rest of their lives. There’s a profound disconnect between the people who are experienced enough to do the work and the funding mechanisms, either private or public, that will allow it to get done.
I see a lot of fuming on the ebola twitter feed about how scientists should just step up and get it done. We’re all going to be saved by scientists. How this is going to happen without funding is anybody’s guess. It takes money to buy the equipment and reagents and research the papers and feed these scientists who everyone seems to think are going to be self-sacrificing for the betterment of mankind and to save their asses from some exotic African disease. But as soon as the crisis is over, will we go back to chain sawing through the NIH budget?
From what I can see, neither private industry or our political leaders are taking the threat seriously. So, I stand by my earlier prediction. It’s going to take a plague to focus the nation’s attention on our crumbling research infrastructure. It might as well be ebola.