Airborne Ebola? More Settled Science?

As the number of Ebola cases continues to grow, many of us are asking whether we are safe.  How easily is it transmitted?  The answer will determine whether this is a small outbreak in a few isolated areas or a pandemic worthy of a science fiction movie.

Virologists are experts in viruses; their words carry weight.  So it’s comforting to read, “Virologists rejected suggestions on Tuesday that Ebola might mutate to become an airborne virus.”  Going farther, “Peter Piot, director of the London School of Hygiene & Tropical Medicine, and co-discoverer of the virus, called the suggestions that the virus could be transmitted through the air completely irresponsible.”

Yet CDC Director Tom Frieden, another expert, believes that “[t]he Ebola virus becoming airborne is possible but unlikely.”  Well, that’s comforting: two experts can’t agree on something profoundly consequential.  Once upon a time, a President Obama was also unlikely, but here we are.  And as for the so-called experts, much of what they originally said about the transmission of HIV/AIDS turned out to be false.

Climatologists, experts in climate, should also know what they speak of regarding climate change.  Yet they were wrong; “[t]op climate scientists have admitted that their global warming forecasts are wrong.”  What if the virologists are also wrong?

Just as there are inconvenient truths within the science of climate change, the recent case of a nurse in Spain contracting Ebola raises more questions than answers.  She entered the room of the infected patient only twice; “[b]oth times, the nurse wore personal protective equipment.”  But her protective gear did not include “autonomous breathing,” meaning that she might have inhaled Ebola.  Not conclusive, but it certainly raises the inconvenient possibility that Ebola in this case was airborne.

Interestingly, there was a photo in the NY Daily News of an ambulance transporting an Ebola patient this week from the Omaha airport to the Nebraska Medical Center.  The ambulance driver was wearing protective gear, including a facemask.  Why was that necessary if the patient was in the back of the ambulance and if the virus cannot be transmitted through the air?  The CDC is confident that Ebola can be transmitted only via “blood or body fluids.”  So facemasks shouldn’t be necessary unless one is close enough to the patient to be splashed with blood or fluids.  Yet photos of health care workers in Sierra Leone show most of them wearing masks or air filters over their noses and mouths.

I wonder how many virologists that are quite certain that airborne transmission of Ebola is impossible would be comfortable with an Ebola patient breathing on them.  Not coughing or sneezing, just breathing.  Would they be agreeable having an Ebola patient as their seatmate on a trans-Atlantic flight?  I suspect they wouldn’t want to be in the same airport, much less in the adjacent seat.

Unlikely isn’t impossible.  Given the consequences of “choosing poorly,” it would be more prudent for government agencies and virology experts to err on the side of caution in managing this outbreak.  This includes not only in handling infected patients, but also in commonsense measures such as travel restrictions in and out of hot zones, securing the U.S. borders, and quarantining any suspicious immigrants or travelers.  Otherwise, the “settled science” of Ebola transmission may turn out to be anything but.

Dr. Joondeph is a retina surgeon at Colorado Retina Associates and serves on the faculty of Rocky Vista University School of Medicine.  Twitter @retinaldoctor.

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