Can Ebola be Stopped?

ISIS is trying to expand its conquest of territory in the Middle East and everyone I talk to seems to agree that they need to be crushed. But how? At the same time, the Ebola virus is continuing its deadly spread in West Africa, and everyone agrees that this must be stopped. But how? In some ways, the situations are not dissimilar. The first reaction is panic, and then the next is quarantine. In the case of ISIS, try to keep them from grabbing any more territory. In the case of Ebola, keep people with the virus from getting out into public. In both cases, of course, you have mostly innocent people who are trapped inside the quarantine, and that is causing lots of problems. In West Africa, the government of Liberia lifted a quarantine it had placed on a large slum in the capital city of Monrovia. Throughout the region, the shutting down of airline travel to and from the infected nations appears to be hurting economies at the same time that a case has nonetheless appeared in Senegal and the WHO thinks the number of cases could rise to 20,000. 

So, quarantine serves mainly to get people's attention, and then the real work begins. In the case of Ebola it means trying to live in a more sanitary environment that minimizes the chance of contact with the bodily fluids of sick people. The Belgian research who first identified Ebola back in the 1970s was recently quoted as saying that:

"This is absolutely unexpected and unprecedented," he says. "We have here a situation where Ebola finds an enormously fertile ground in very poor countries with very dysfunctional health systems," he says. "A country like Liberia in 2010 had only 51 doctors for the whole country." He hopes there will never be another outbreak like this one. "I hope that this is the last epidemic where all we have [as treatment] is isolation of patients and quarantines and some supportive care, and we don't have stockpiles of vaccines and therapies."

There is potential for Ebola to spread to neighboring African countries, he says, but he is not worried about "high-income countries." "Our basic hospital hygiene is such that it is highly unlikely it would give rise to epidemics," he says.

So, the next step in the strategy is to guard against spread (without placing stifling quarantines that victimize the innocent) and build up protective and therapeutic measures. Since the best medicine for the long term is to prevent the disease, it is encouraging to read that progress is being made at a lab here in San Diego on the development of a vaccine against the Ebola virus. Next, of course, we need to vaccinate ourselves in some way or another against groups like ISIS.

Even More Bad News About Populations at Risk in Syria

The news out of Syria is only bad. Today the Middle East Daily (an email service of Foreign Policy) summed up information from several different sources as follows:

The U.N. refugee agency, UNHCR, stated over 3 million people who have fled the conflict in Syria will have registered as refugees in neighboring countries as of Friday. Another 6.5 million people have become internally displaced, so that about half of the Syrian population has been forced to leave their homes since fighting broke out in March 2011. The United Nations estimates that hundreds of thousands of people have additionally fled the conflict without registering as refugees. The UNHCR said this is "the biggest humanitarian emergency of our era" and noted the situation is worsening.

The idea that the worst demographic situation of our era is worsening is hard to wrap one's mind around. It is so easy to destroy a society, but so hard to build one. Considering that these people in crisis come from an environment of higher than average birth rates (albeit declining) and relatively low status for women (albeit improving) we can reasonably foresee, as I mentioned recently, that we are going to be dealing with the aftermath of the Syrian implosion and other consequences of the Arab Spring for a long time to come. It seems to me, however, that the world needs to help put the geographic pieces together differently than they are right now. George Friedman of Stratfor.com made this point a couple of days ago:

Lebanon was created out of the Sykes-Picot Agreement. This agreement between Britain and France reshaped the collapsed Ottoman Empire south of Turkey into the states we know today -- Lebanon, Syria and Iraq, and to some extent the Arabian Peninsula as well. For nearly 100 years, Sykes-Picot defined the region. A strong case can be made that the nation-states Sykes-Picot created are now defunct, and that what is occurring in Syria and Iraq represents the emergence of those post-British/French maps that the United States has been trying to maintain since the collapse of Franco-British power.

Sykes-Picot, named for French diplomat Francois Georges-Picot and his British counterpart Sir Mark Sykes, did two things. First, it created a British-dominated Iraq. Second, it divided the Ottoman province of Syria on a line from the Mediterranean Sea east through Mount Hermon. Everything north of this line was French. Everything south of this line was British. The French, who had been involved in the Levant since the 19th century, had allies among the region's Christians. They carved out part of Syria and created a country for them. Lacking a better name, they called it Lebanon, after the mountain by that name.

In other words, these countries that are falling apart are modern creations of European policy-making and should not be treated as somehow historically sacrosanct. It is the people, not the boundaries, that matter.

Putting People Into Climate Models

There is no question that global climate change is occurring--just ask anyone hanging around the melting glaciers at the poles. We humans are stereotypically charged with being the perpetrators (indeed, if we didn't use all that fossil fuel to increase our standard of living, where would we be?), and at the same time the victims (global warming will eventually kill us). While these stereotypes are based in reality, they are not sufficiently nuanced to tell us, in particular, how humans who are the worst victims (those who have not contributed much to the carbon dioxide poisoning of the atmosphere) are actually apt to respond to climate change. This is the sensible argument of Paul Palmer and Matthew Smith, writing in this week's Nature.

Current models of Earth's climate capture physical and biophysical processes. But the planet has entered a new state: humans are adapting to, as well as causing, environmental changes. This major feedback must be modelled. Projections of the future climate based on simple economic narratives1— from cuts in greenhouse-gas emissions to unmitigated growth — are unrealistic.

Faced with droughts and rising sea levels, people alter their behaviour. Even if global climate policy is effective, and nations deliver on ambitious green-energy-production and sustainability targets, societies will be different in a warmer world. People will move to places that are richer in resources, or stay where they are and be pushed further into poverty. Population growth, urbanization, migration2 and conflict3 will compound reactions to global temperature rises.

To understand the underlying patterns, we need to collect behavioural statistics on grand scales. How do people of different backgrounds respond to extreme weather, for example? Under severe drought, do people in sub-Saharan Africa behave differently from those in southern Australia? How do the decisions made by lower- and middle-income families differ?

Ultimately, we must establish an international data-collection effort involving the public, private and voluntary sectors. Much as we take global stock of forests or biodiversity, we should regularly assess how people are being changed by the climate that they are changing.

This is a call to action, not a definitive road map, but it's a start. I'm chairing a session on the "Spatial Demography of Population and Envirnment" at the Population Association of America meetings that will be held here in San Diego next Spring. The deadline for submission is 1 October and here's the link if you want to submit a paper. Let's get to work.

Deaths Continue to Mount in Syria

Media attention in the Middle East has recently focused especially on ISIS and its brutal murder of an American journalist, attempted genocide of the Yazidis in northern Iraq, among many other atrocities. All this time, however, people also continue to die in Syria. The United Nations estimated this week that nearly 200,000 people have died in the Syrian conflict. Of course, millions more are now refugees. Richard Engel of NBC News, who was himself kidnapped for a few days in Syria, was talking this evening about the fact that life in Syria is simply awful. Furthermore, even if the conflict ended today, it is not clear what kind of society would emerge in these places. The very rapid population growth in this part of the world--despite death and hardship--assures that a lot of people are going to be in a huge need of assistance for a long time to come. Engel's point was that no one seems to have yet given much thought to that future. At the moment, the demographic picture suggests a young population, with relatively limited educational attainment and few resources upon which to build. 

Seals May be Carriers of TB

In the modern world, tuberculosis in North and South America looks pretty much like TB in Europe and so the assumption has been that Europeans brought TB (along with many other diseases) to the New World. Not so fast, say biologists who have been examining skeletons at Peruvian burial sites. In a paper just published in Nature and reported by the Economist as well as by Nature.com, scientists say they have uncovered evidence of a different strain of TB among people that predates European contact. How did this happen? They believe that seals were the carriers of TB. It's not clear how they become TB carriers, but the data suggest that they are, and eating them then infected humans. 

This is a reminder, of course, of the many virulent diseases that humans have acquired from eating animals just in past few decades--HIV from chimpanzees, Ebola from bats and monkeys, Avian flu from birds, mad cow disease from you know who. The list is really a pretty long one. And the lesson seems pretty simple: love your animals, don't eat them.