Sawbones: A Marital Tour of Misguided Medicine - Sawbones: Ebola

Episode Date: November 4, 2014

Welcome to Sawbones, where Dr. Sydnee McElroy and her husband Justin McElroy take you on a whimsical tour of the dumb ways in which we've tried to fix people. This week: We talk ebola. Music: "Medicines" by The Taxpayers (http://thetaxpayers.net)

Saabones is a show about medical history, and nothing the hosts say should be taken as medical advice or opinion. It's for fun. Can't you just have fun for an hour and not try to diagnose your mystery boil? We think you've earned it. Just sit back, relax, and enjoy a moment of distraction from that weird growth. You're worth it. that weird growth. You're worth it. Alright, time is about to books! One, two, one, two, three, four! We came across a pharmacy with a toy and that's lost it out. We pushed on through the broken glass and had ourselves a look around.

Some medicines, some medicines, the escalant macaque for the mouth. Hello everybody and welcome to Saw Bones, a meerdal tour of Miscite of Medicine. For the mouth! Wow! Hello everybody and welcome to Saw Bones, a meerdal tour of Miss Guy to Medicine. I'm your co-host Justin McElroy. And I'm Sydney McElroy. Kind of an unusual one today for us, Sid, Stir. That's right. Justin, Stir. Kind of a weird topic today.

We're going to talk about something that a lot of people have been asking us to delve into and we have fought tooth and nail to keep for doing, I would say, but... Yeah, we try to stick with our theme for the most part as far as our show. We talk about medical history, about diseases or treatments or people who got it wrong in an effort to heal humanity and kind of make jokes about it. Yeah. So it's harder when a topic is one, not really historical, but current. Yeah, happening.

And two, not at all funny. Not really a chuckle fest with, oh, of course, we're talking about Ebola. Yes. So a lot of our listeners have emailed us and tweeted at us that we should talk about Ebola. Yes. So a lot of our listeners have emailed us and tweeted at us that we should talk about Ebola. Personally, I've had a lot of people ask me when we were going to talk about Ebola. And the problem with it, and I think we may have said this actually in our vaccine episode, which I would say is kind of a similar idea, is that one, it's not really a history of something that we got wrong. But one, it's not really a history of something that we got wrong. There is no long history of Ebola and all the ways we tried to treat it in the past that

were dumb and the crazy things people came up with, that doesn't really exist. It's a fairly current illness. I mean, if you consider the 70s current, it's been around since then. So not as many goops as this is your first episode of Sabons, it's normally lighter than this, we assure you. But we're also not going to be too dire. I don't think that this will be particularly, hopefully not a straining episode to listen to.

No. I don't want to bomb everybody out. In fact, I think one of my goals would be that we can calm you down if you're worried. Here's Hope and Sydney, you have a bit of a back history with Ebola. Can you talk about that? That's true. You make it sound like I have a personal interaction

with Ebola, which I think we do not. No, nothing like that. No, I've never had Ebola. I never knew it. To your knowledge. Well, you would know. You would know. I'll get into that, Well you would know. You would know. I'll get into that, but you would know.

You would know. You would know. That's fair. Yeah. But I've always kind of liked Ebola. That's a weird thing to say. I know that's a weird thing to say. And I used to see, this is a problem.

I used to a year ago, I would say that a lot. I tell my medical students that, I love Ebola, I love hemorrhagic fevers, and that used to be funny. It's not funny now. It's not funny. I know I can't tell people. Probably wasn't even that funny then. But like, they laughed.

Okay. If they didn't think it was funny, they were good at pretending. So now your old boyfriend Ebola is back and is not at all amusing anyway. No, no, no. This is why, let me just say this is why I used to love, I used to love Ebola. Yeah. Before it broke your heart. So I decided to be a doctor when I was 12.

And that was a direct result of reading the book, the hot zone. You may be familiar, the hot zone is Richard Preston's nonfiction but dramatized account of the history of the Bolivirus. It covers real people and their responses to various Ebola outbreaks throughout history and kind of covers where the Bolivirus may have come from, but he definitely does it in a way that it reaches beyond just informational. It's to get you freaked out and fascinated by a really scary virus.

Now, is he rereading that actually around the house? Well, I have, because I haven't read it again for a very long time, especially not since I've become a doctor. And I will tell you this. It's, I mean, it's a great book. It's thrilling. If it was, you would think it was nonfiction in the way that it was, or I think it was fiction,

sorry, in the way that it was written. So it's definitely, I would say, an enjoyable read if you like that kind of thing. But as a physician now, when I read some of the descriptions of kind of the medical end of it, it's a little, it's a little out there. It's got me rolling my eyes, so I'm like,'m like, well, I guess you could call it that. So Sid, give us your non flowery straight up. What's this, give me the straight dope on this Ebola thing. Okay, so Ebola is a virus.

It's in the phylovirate family. They, because they look like filaments, phylo is filament, they look like strings, these viruses, the genus's Ebola virus. There's one other virus related to it, you may have heard of, called Marburg, named for Marburg, Germany, where it was isolated.

And Ebola itself, there are five different strains of. So the... Flavours, if you will. Yeah, five flavors of Ebola. The worst flavor, I'd say, well, the worst for us, the best if you will yeah five flavors of Ebola the the worst flavor I'd say well the worst for us the best If you're Ebola would be the current strain that and if you are Ebola by the way just stop listening your jerk What are you doing buzz off? Disappear back into the jungle please. Yeah, yeah here

So the the current outbreak in West Africa is due to the Zaire strain of Ebola, named for formerly the country of Zaire now, the Democratic Republic of Congo. Right. There's also the Sudan strain and the Zaire and the Sudan strain make up the majority of outbreaks that we have seen in the past. There are a couple less common ones, the Thai forest and the Boundi Boudi Boudi Boudi Boudi Boudi Boudi strings that have had some isolated outbreaks. And then interestingly, there's a Reston strain, which is actually named for Reston, Virginia. Oh, a reason being is that it was isolated there in monkeys that had been imported to the US for various laboratory research, and they found the virus there.

It only infected monkeys, though, which is thankful because it was airborne, unlike what I'll talk about with these other viruses. Now, Sydney, we have talked a lot about how Ebola doesn't necessarily have a long history. Is that true? That's absolutely true. So when we go back to the first outbreak of Ebola, the first cases that we're aware of, we're going back to 1976. If there were isolated cases and humans before that, we don't know about them.

So in 1976, it's kind of interesting at the same time, well not the exact same time, but in that same year, I should say, we have two outbreaks of two different strains of Ebola. The first one occurred in the Sudan. And it spread so quickly that we barely had time to even kind of research it or trace it or try to figure out what was going on before it burned itself out. This was followed by one a few months later in Zaire and this one at then Zaire and this one we were actually able to send researchers several different countries and kind of try to figure out what this virus might be, what might be causing it and what we could

do about it. The Sudan strain killed about half of the people who got it and the Zaire strain during that outbreak killed almost 90 percent of the people who got it. So as far as what we know, a lot of the epidemiological work, it gets sketchy because we're dealing with some very rural areas in Africa where people don't necessarily have addresses where you can trace them to, you don't always know where they work or what they've been doing or who people are. It was difficult to track people down, but as far as we can tell, the initial outbreak

started in Sudan after a cotton factory worker became ill and went to a hospital. And this is a common theme you'll see in these outbreaks. So how he got ill, we don't know. There was a theory that there were a lot of bats who had kind of nested in this factory where he worked. Could have come from a bat. We don't really know. The point is he got to a hospital and it probably spread from the hospital.

Right. Through healthcare workers and through the use of probably not clean needles or other contaminated hospital equipment. That's our theory. We have a little more grounding for the following outbreak that happened in Zaire. So a teacher who worked in Zaire was touring the northern part of the country, which is actually along the border of Sudan. So did this start in Sudan and then mutate and spread to Zaire, that's very possible. We don't know. They returned back to a village called Yanbuku,

and it was at this time that the teacher started becoming ill. Again, where did it come from? We're not completely sure. There was a report that the teacher had bought some analogue meat off from a roadside stand. It's always the most delicious meats to have been ruled out from a biobola. You know what a fan Justin is of analogue.

Oh, can't get enough of that stuff. Fry it, bake it, which way isn't good? I actually don't know. Which, to be fair, it probably didn't come from of analogue. Oh, can't get enough that stuff. Fry it, bake it, which way is it good? I actually don't know. Which to be fair, it probably didn't come from the analogue meat, but one of the teacher's friends did buy some monkey meat from that same stand. Again. And that's a common theme, bush meat, or the meat of wild animals that is, first of all, the animals are killed so you come in contact with their flesh and their blood, and then secondly, eating that meat may be a source

of the virus, possibly. So this teacher went to the local hospital thinking that he had malaria, which was a fair bet. That's usually you got a fever, you got a headache, you start to feel lousy, and many parts of Africa, you probably do have malaria. That's a fair guess.

So he went to the local hospital, symptoms of malaria, they gave him an injection thinking that he did, in fact, have malaria. And unfortunately, that was not what was wrong. Later, he did die from the virus that at that point was still unknown. And unfortunately, at this hospital, as well, they had the practice of when they would give injections, they would rents the needle off in water, but then they would reuse it. No, well, that doesn't help. So at this point, an epidemic exploded from this hospital.

Unfortunately, one of the most common things that was being done there were, like like multivitamin injections given to young pregnant women. So those needles were reused and reused. Many people came in seeking treatment from malaria. Those needles were reused. And once you know, one needle was dirty, I mean, it started spreading from person to person and you can kind of see how this happened. And what I imagine is going to be a recurring theme. It feels like the lack of proper medical resources is really at the heart of it becoming a giant

issue. Absolutely. Absolutely. This hospital was almost certainly understaffed to begin with. And they didn't have enough equipment. They didn't have enough doctors. It was mainly being run, it was a mission hospital, mainly being run by Belgian nuns who were nurses, but they never had enough of the, you know, other medical personnel at this kind of facility.

And they didn't know that this was a danger. They didn't know that, you know, this was, we're talking about a pre-HIV era, just pre, but people didn't know the possibility of disease, you know, how severe that could be from needle to needle. You know, you wouldn't know that just rinsing it off might not be enough. So everybody at the hospital began to become sick and the epidemic spread from there. It actually only slows down during this particular outbreak when the hospital staff pretty much either all was either sick with Ebola or had already died from Ebola or had just took taking off out of fear. And once the hospital shut down, this actually kind of helps to diffuse the outbreak, which

is a sad statement. And again, just re-emphasizes what the problems are. They isolated it, though. So at this point, we don't know what this virus is. We're trying to figure it out. They start sending samples, doctors and researchers at the site start sending samples back to the CDC, Belgium, the UK, several different countries, and samples of blood from one of the

Belgian nuns who died in saying, can you figure out what's here? What is causing this? What the heck is going on? It's interesting because when you read accounts of this, and this is both from the hot zone and then from an interview I read with one of the researchers in Belgium, when they sent it back, samples of the blood, they were just two test tubes in a thermosful of ice that were shipped, you know, to other countries. So by the time that this thermos reached each of these labs,

it was reported that, first of all, the ice obviously had melted. Right, right, because it's a bad way of doing that. And secondly, in both accounts, one of the vials had broken. You know, I get not having like the proper resources to transport it, but you think it the very least so it could just, you know what, I'll drive it myself. I'm not going to go FedEx this time. I'll just go ahead and put that in the cup holder and get that bad boy to you right away.

Well, that'd be an awful long way to drive from Africa to the US. I'm also impossible. And also impossible, I guess. Get your own plane, maybe? I don't know. You're right, though. There definitely was not much caution being taken because, you know, what must have occurred in both cases that a laboratory worker reached into a thermos filled with broken

glass and a bowl of blood to fish out the other vial. And since we had no idea, he probably just like dumped it out and washed it out. I was like cool cool coffee right here. But free egg check me out for thermos. Look at some camels later. So they started trying to isolate what what virus may exist in Belgium., they took a picture of it. They found what would be known as the shepherd's crook, because it's like a long curly string that kind of looks like a shepherd's crook.

I mean, it doesn't always take that shape, but it does often. But it was actually our CDC, the Centers for Disease Control in Atlanta, who figured out that it was not Marburg, which is initially what everybody thought. So they look at this virus, it looks like the then known virus Marburg, which is initially what everybody thought. So they look at this virus, it looks like the then known virus

Marburg. And it's funny, because you read accounts of the researchers running to libraries and looking at Marburg in books. Can you imagine going to a library and looking at a book now? I can't. I mean, like the computers right there. I would rather get a vola, honestly. I would not.

That was a joke, I'm sorry. The CDC figured out that it was a brand new virus. They still hadn't named it. The naming of Ebola is actually interesting. So at this point, we've deployed researchers and doctors from all these different countries to go to Yambuku and try to figure out what's going on and how can we help.

While they're there, they're up late. This is the account told by one of the scientists from Antwerp, Peter Pio, who was up late with a group of researchers in a tent drinking and trying to come up with a name for the new virus. Everybody thought, maybe we should name it Jan Buku because that's where we are, but then they thought, well, that's a pretty terrible way

to stigmatize an area, right? I imagine this is one of the very few times in which researchers weren't like falling all over each other to get a name back for them. Yes. No one's like, hey, maybe we call it Dave. No. Maybe Dave the virus. Maybe.

I think I'm okay with this one. No, I'm good. Dave, do you want it? No, I'm good. Your name is Emile's, I guess. That's fine. They looked at a map, so they're also in their debating. They look at a map on a nearby wall and see a map of the area. And they see that there's a river, not too far from that site that's

called the Ebola River. There is in fact any Ebola River. It's actually mislabeled on this particular map. So it wasn't the closest river. So it was just kind of random that they picked that boy Howdy though. I bet uh that tourism that old ball of river certainly die down. No, no more no more fishing I'm sure on the Ebola river and come come experience the thrill of whitewater rafting down the Ebola river. This is this is actually really interesting if you, if you like this kind of thing, um, if you read the history of another virus, the antivirus, which existed out in the western part of the U.S. There was a similar problem trying to name this one, um, because they almost named it the four corners virus for the four corners area of the country, where

the four states come together. But then that would have killed tourism to the four corners. Right. So so there you go. If you like that kind of history, if you like this, that's true. There's a whole story there. Yeah, at least half of this podcast love stuff like that. At least half of our listeners must. Here's open. So all told from this outbreak, you know, we figured out the Ebola virus, we figured out this eye year strain. They eventually were able to, you know, we figured out the Ebola virus, we figured out this IEA strain. They eventually were able to, you know, kind of differentiate between that and the Sudan strain.

About 600 people between the Sudan and the then Zaire got Ebola all told. And then it kind of vanished. There were a few more cases, some sporadic cases in 79. Throughout the 80s, pretty much nothing. There's no Ebola. So where did it first pop up? Was it from a bat in a cotton factory?

Was it from eating monkey meat? Who knows? Where did it come from? It was living in the jungle. It burst out, unfortunately, killed many people very quickly and then vanished. Until 1989, and this is where the Ebola virus makes a really strange appearance in Rest in Virginia.

Okay. So, as I mentioned, there were some monkeys that were brought to the United States to do some laboratory research, and they were dying of an illness that researchers eventually figured out looked very similar to Ebola, you know, with the hemorrhagine and the very dramatic symptoms, which we will go into. The problem with this strain of Ebola was that there were monkeys caged in the same room,

but who had no physical contact with each other? Who are all getting Ebola? That's bad. Which was very scary as you can imagine to the scientists involved. Right. Because although they didn't prove it, they theorized that this indicated there was airborne spread of this particular strain of Ebola. But thankfully, the humans who were in direct contact with the monkeys, all of them never developed any symptoms. Although some did develop antibodies to Ebola, so they took blood from the people and checked it later

and it looked like they had survived Ebola. They had developed little antibodies, which are bad. So what happened there, is it just harder for that particular strain to, in fact, to make the jump from monkeys to humans? Exactly. For some reason, this particular strain is just not very adapted in fact in humans.

It's good at infecting monkeys. And certainly it could, it got into the human bloodstream, but as far as actually causing disease, making people sick, it didn't do that. Which, again, is a great relief since it may well have been airborne. Right. Throughout the 90s and then going into the 2000s, again, we saw little outbreaks here and there in different parts of Africa, again in the Sudan and the DRC and then in Uganda and Gabon.

And then we discovered the two, the other strains. and Gabon, and then we discovered the two, the other strains, but up until currently, the single largest outbreak of Ebola virus anywhere had been about 400 cases. So how did it, how did Ebola get its start with us, Sydney? Well, Justin, I need to keep talking about this very important topic, but before I do that, I'm, I'm going to have to insist you go visit our billing department. Well, all right, fair enough. Let's go. So, Sidney, I ask again, how did Ebola make the jump to us?

Again, it's really interesting. And if you like this kind of thing, although the hot zone is a dramatized version of events, Richard Preston paints a really interesting picture of being able to trace the Bolivirus back to a cave, a theoretical, you know, well, an actual cave that he theorizes maybe the origin and that there are bats that live there and did the first person who get it go hiking on this mountain and stay in this cave and maybe got bat guano in a cut and that's where it came from. It probably though is more than anything the result of our incursion into untouched rural spaces.

The more the same kind of idea with HIV is we begin to invade parts of the planet where humans have never been. We're going to keep getting these kinds of scary, awful diseases that had been unknown to us previously. So what are the symptoms? I know this. Go for it. I think the media has prepared me well for this. Probably. I know that you're going to get symptoms that are sort of like the flu. Yeah. Fever, chills, body aches, some pangs, quick side bar by the way. Get your flu shot, kills a lot more people in the US than a bowl has for sure.

Absolutely. Get your flu shot. Anyway, flu-like symptoms and there are, there's fevers and then when it gets really bad though, there's weird bleeding. Like you bleed from your eyes and your bottom and even maybe your pores, right? That's a really good, yeah. That's a good description of the symptoms. And I think it's because of the bleeding that comes, that it gets so publicized. I know when I was 12 and I read the hot zone, I was horrified and fascinated by the descriptions

and the descriptions in the book, I'd say, are overly dramatic of what can happen to the human body from this virus. And I think that's also why it's so highly publicized in the media, because they say things like your organs liquefied, which is not, medically, I probably would never use that terminology, but people hear that and it's kind of like a car crash, you can't look away, you hear that and you want to hear more even though it's horrifying to you. And I think that's why Ebola gets so publicized even though, like Justin said, we're coming

on flu season now, and the flu is certainly going to kill many more Americans this season than Ebola is. But ultimately, this can lead to multiple organ systems shutting down. You can start hemorrhaging in your internal organs. You can actually clot off some of your internal organs, and you can lead to kidney failure, liver failure. You need respiratory support, maybe with a ventilator to by being intubated. And you need constant lab monitoring, lots of fluid replacement, you'll dehydrate.

So as you can see, not only is this a very severe deadly virus, but in order to care for a person who has it, it requires a lot of equipment and a lot of intensive monitoring. What about people catching it? Like once you get it, how easy is it to spread to people? I know the media certainly made it seem like, you know, it's waiting on every flat service. It's not. It's not very contagious, thank goodness. It is spread by direct contact with a symptomatic person or their bodily fluids. So you actually have to have contact with someone who not only has the Ebola virus but is already displaying symptoms of Ebola, which is critical. That's why they talk about people coming back from

West Africa, don't necessarily need to be placed in a room, you know, and quarantined and not allowed to contact anybody if they're healthy. Because even if they end up having the bolivirus, they are not infectious until they start showing symptoms. It's not yet been demonstrated that you could pass it by what we what we call a foe might, which is just any non-living object. So, you know, a table surface, a door handle. There's no evidence at this point that if I have Ebola and I touch a table and then you come touch the table later that you're going to get Ebola. And as I said, this strain is not airborne. One infected person, you know, when we do when they do like analysis of how infectious an illnesses

they come up with a number of an R0 which is how many people are you likely to spread the virus to? And for something like measles that number can be quite high. I think it's like 16 or so but for Ebola it's about 1.5 So one and a half people yes, and I feel bad for the person that gets half a bowl. That's terrible because you can't get any of the sympathy because everybody's like, oh, you feel like I have a bowl that's not even a thing. And other people think you're making it up

because they've never heard of half a bowl. Hitty that person. The other person is gonna get a lot of media play, maybe a book deal. I'm just kidding. That 1.5 is like a statistic. I know. No, I'm not. I can maybe get it again. On the positive end, half of Ebola is probably not as bad.

Probably. Maybe not. Maybe that's true. And that number, that number 1.5 can drop to zero very easily. If you just use monitoring and when necessary quarantine effectively. So if I, if I do suspect I have it, how do I figure out if I do? Obviously, probably not at all. No, if you think you have a no-hunt test, you go to a hospital immediately.

And tell them that you think they have a, that you think you might have a boa. There's a lab test. There's several different ways that we can test for Ebola. Your local lab probably can't That's okay. We don't need you know for instance here in Huntington We don't need our local laboratory. I'm all about keeping jobs here in the town to stay I'm with you on that. Oh, that's when we could probably outsource

Exactly. It's fine your local health department can take care of things they will become involved There will be lots of people involved. There's no need for every laboratory in the U.S. to be able to test free bowl of immediately. Okay, let's say I have a bowl of what can you do for me? The main treatment for free bowl is supportive care. And that's probably why when we think about the doctors and health care workers who've been brought back to the U.S. to be treated, why they've done so well, is that they were given immediate supportive care as soon as they were

manifesting symptoms. With fluid replacement, if their potassium got too low, they could, first of all, we knew because we could draw lives and find out, and then secondly, we could replace it effectively. These are little things that, if your potassium is too low, your heart can go into an abnormal rhythm. They can't check potassium in, you know, a hospital way out in the brush in West Africa. They can't give you blood products

as soon as you might need them. Need them. They can't give you medications that will keep your blood pressure up if you're going into shock. They can't necessarily put you on a ventilator or do kidney dialysis if you need those kinds of things. So those are the main treatments for Ebola

is to keep you alive while your body's fighting off the virus on its own. And certainly here in the US, we have the resources to do that easier. There is, you've probably heard of the experimental Ebola drug that they gave to one of the doctors. To see her to Ebola drugs, that only Americans are allowed to have. Yeah, I've heard of thing or two. Menotti. That is, I think how it's being billed in the media. It's called Z-Map. It's made of antibodies that basically bind to the virus. It has not been tested in humans.

So it is not available for purchase. Although it was bought privately, not by the United States government, that everybody stresses that the CDC is very, they will tell, that's all over their website. They didn't buy it for anybody, but Samaritan's Purse, the private organization through which the doctors were working, did buy it for them. A minute hitch, I mean, I don't know if you can say it shows promise because it's helped a couple people, I don't think that's a big enough number.

It's not statistically significant as they say. No, but they're going to start doing human testing in it soon. And then there are also experimental vaccines. Again, no human trials have been started, but they're going to start trying those soon. So Sid, I want to know how frightened of this I should be. I've been watching a lot of the news coverage of it and I feel like I already know that the answer is super duper freaked out about it. But I wanted to get a second opinion if you will.

So I think if you're asking me how scared you should be, my answer would be not not scared. Unless unless you are listening to this podcast from one of the countries where the outbreaks are ongoing, Sierra Leone, Liberia, Guinea, if unless you're there, I would not be concerned. You can't get it unless you have direct contact with a sick person who is sick from Ebola. This is why we hear about cases among healthcare workers because who has contact with sick people?

Healthcare workers. Yes, exactly. It is not, you are not going to be, you know, on a flight with somebody who has Ebola and Gidey-Bola. You're not going to be in the same city as somebody, you have visited the same restaurant. These things just, they're just not going to happen. I would be concerned if I've been to West Africa to an area where an outbreak is occurring and had contact with people who

were sick. Otherwise not. Right. Well, so why is it so bad there? Sort of what we've talked about. Their healthcare facilities don't always have the same kind of hygienic standards that we routinely practice in the US. So needle reuse may happen. I don't and I don't have evidence that these things are happening. Let me say that in these hospitals in particular, but these are the kind of issues that exist. If we reuse equipment, reuse linens, people patients are close together. A lot of it has to do with cultural issues, burial practices, family members bury their own. burial practices, you know, family members bury their own. And so they may clean their own family members' bodies after they've died, kiss them, you know, wash them down before

they bury them. That kind of thing, not using appropriate equipment, you know, not wearing the space suit to you, what we see on television. There's a poor understanding of the virus, how it's spread in a lot of these areas. The education isn't there and it's hard to, in the middle of an outbreak, stop and get everybody to calm down and sit down and teach them about the virus because everybody's terrified. So it's a very chaotic environment. And then there's also the lack of doctors and public health workers. In the, one of the statistics I read, I think in 2010 there were like 51 doctors in all of Liberia.

I mean, when I read that, I made the comment to Justin that I have been in rooms here. You know, I work in an academic facility. I've probably been in rooms with 51 doctors and Huntington, West Virginia. So, you know, Sid, I What I wonder is why don't I don't actually wonder this I know the answer dig me But why don't we just shut down the airports to not let people from West Africa come here? That seems pretty smart Because first of all the best way that we can stop it from becoming a problem in this country because it's not, is to stop the outbreak in Africa. So if we start limiting travel back to the US, if you are a doctor or a public health worker and epidemiologist, what a nurse, why would you ever go help people who need your help if you

don't think you can get back home afterwards, aid from the US would almost certainly dry up in other countries if they just started quarantining the whole area. It would be a health disaster if it's not already in those countries. If we just basically locked everybody in and said, good luck, we're not going to help you anymore. We're not going to let you get out of there. We're definitely not going to send anybody else

because we're not going to let them back. It would just intensify the outbreak there. And the more severe it gets, it eventually will spill over if we don't do anything to stop it. It's going to spill over to other countries in Africa, which makes it more likely that we will have sporadic cases here at home, not outbreaks, but sporadic cases. So stop Ebola in its tracks. Right. If you want to find a way to help keep you or someone from getting Ebola, the best

thing we could do is worry about the people who live in West Africa who are actually getting Ebola and do something to stop the outbreak there. I mean, would you go help if you thought you weren't allowed to come home afterwards? I wouldn't go help in a bajillion years. I am a coward. But I get your point. By the way, those people who are coming back and maybe are infected with Ebola, I've seen them get a lot of crummy treatment in the media. Hey, maybe they're like heroes, so like buzz off. Yeah, they're heroes. They're like heroes and so like actual real heroes,

so maybe like don't rush to be a creep when you're complaining about a guy going bowling because also side note, he's like a hero, so maybe cut him a little slack. Yeah, here's the thing, they're doing what I wanted to do when I read the hot zone when I was 12 and decided I would be a doctor someday. This was the kind of thing that I had wanted to do.

And I'm a wimp because now I have a three month old and I don't want to leave. There it is. So there it is. They're braver than me and they're heroes. Just so you know, travel, there are new restrictions on travel. But again, you can still come back. If you decide to go help, you can still come back to the US at this point. When you do come back, you're put into a risk category and it depends on how much exposure you had. And these are the brand new things they just came out within the last three or four days.

And then you're monitored, depending on your risk level, whether you're high, some low or no risk. If you are higher risk, you may actually have to be, like, have someone from the local health department lay eyes on you once a day. So like you have to stop by or they come to your house and check on you, but you're not like held in a room. And they check your temperature twice a day.

Or if you're lower risk, they may just direct, they may just indirectly monitor you by phone. And then if you have any symptoms whatsoever, you have to immediately report to a local hospital. If you are high risk, you may not be able to travel from here to other places for a while. If you're within that 21-day window, and then of course, if you do have symptoms at that point, you would be quarantined, but not until you're actually manifesting some kind of symptom. If you're freaked out about Ebola, and I myself have done my fair share of fretting about

it, I instituted a policy for myself that I would encourage anybody else to do. Every time you get freaked out about it, donate some money to the people who are fighting it. I've donated a map international, they have had a bowl of fun set up, but there are lots of charities that are doing great work there that deserve your support.

Like it is so hard to dismiss panic, dismiss fear, but you can't turn it towards productive things by actually doing something to help stop this virus and this outbreak. So put that energy towards good use. Absolutely. The best way to prevent people here from getting a bullet, if that's your concern, if your concern is yourself or your family or your loved ones or your friends, the best way to prevent that eventuality is to help stop the epidemic in West Africa. Because again, up until now,

the largest case number had been about 400. And this is, I believe, over 5,000. The last I checked and those numbers may be wrong. It's really hard, like I said, it's a chaotic environment. It's really hard to count people. So. So thank you so much for listening to this episode. Hopefully you understand Ebola a little bit better. I know I do. We have a lot of other episodes about medical history, everything from gosh insomnia toaneous combustion to hiccups to bloodletting and they're all there for you on iTunes

You can go download and there maybe leave us a rating or review or subscribe if you haven't done that already and Thank you to folks tweeting about the show. Thank you to the maximum. We're at solbona's on Twitter By the way, thanks to the maximum fun network for having a song. They've got a great ton of great podcasts like join Jesse goes top podcasting yourself lady to lady baby geniuses the flop house my brother my brother and me thank you dear so many others to go check those totally out thank you to the taxpayers for letting us use their music for our intro and outro it's something called medicines go go buy it and thanks to you for listening we'll be with you next Tuesday until then.

My name is Justin McRoy. My name is Sydney McRoy. And as always, don't drill a hole in your head. Alright! Maximumfund.org Comedy and Culture, Artistone, Listener Supported.