Overall, the Black Death of the 14th century killed 45–50% of the Europeans in a four-year period. In the Middle East, roughly a third died. While bubonic plague probably had a mortality rate of between 30% to 75%, scientists now believe the epidemic was combined with two other forms other forms of plague—pneumonic plague with a mortality rate of 90% to 95% and septicemic plague with nearly 100 % mortality. Worldwide some 75 million people perished. Do the potentialities of Ebola compare to the Black Death?
In 2013, several estimates of the world population in 1340 put the numbers between 378 million and 443 million. West Africa in 2014 had a population of approximately 245 million. By September of 2014, the number of Ebola patients in West Africa was 5,000 and that number doubled in just one month. According to Ken Isaacs, vice president of programs and government relations at Samaritan’s Purse, a missionary group that ran an Ebola treatment center in Monrovia, the capital of Liberia, “If cases continue to double every three weeks, as some predict, the outbreak could affect 100,000 people, or even 250,000, by some estimates.”
Although Ebola and its varieties of hemorrhagic fevers have been endemic in some areas of Africa for decades, the 2014 outbreak appears to be a more easily spread form of the virus. The current mortality rate appears to be between 60 and 90 percent depending on the strain. Although the current assumption is that airborne transmission is not possible, virologists do report the virus is present not just in mucus and other bodily fluids but in the lungs of infected individuals. Therefore, it seems quite possible the virus could be expelled by coughs. At this point, a saving grace, at least in the U.S. and northern Europe seems to be that, as some medical scientists believe, the virus is too fragile survive for long in tropical climates What happens if infected individuals reach the northern, cooler climates as it seems they are beginning to do since we will not ban flights from epidemic countries even though legally we could.
We know the influenza virus is spread more easily in the winter months—what about Ebola if the virus lives longer in the winter time in the air and on surfaces touched by others? What happens then to the blithe reassurances of “experts” and politicians that an epidemic in the United States is so extremely unlikely? Interestingly enough, in 1989 a medical report published in Reviewsof Infectious Diseases, 1989 May-Jun;11 Suppl 4:S730-5 reported that “Aerosol and nosocomial [emphasis mine] transmission are especially important with Lassa, Junin, Machupo, Crimean-Congo hemorrhagic fever, Marburg and Ebola [emphasis mine] viruses. Seasonality of hemorrhagic fever among humans is influenced for the most part by the dynamics of infected arthropod or vertebrate hosts.”
Given the central purpose of this blog is hospital dangers, how prepared are U.S. hospitals to handle more than a few cases of Ebola in very specific locations? In 2009, a survey by SEIU (Service Employees International Union) of readiness in 104 facilities in 14 states for a flu pandemic found these results:
- Very ready – 4%
- Ready for most things = 33%
- Ready for some things – 29%
- Ready for just a few things – 17%
- Not ready at all – 17%
- Yes – 43%
- No – 57%