About this time last year I first heard about a few cases of Ebola in the Guinea Highlands. It was, I thought , a bit strange. A long way from the Congo River basin, with which Ebola is usually associated.
But I was busy finishing a big project. Infectious disease is not my specialty. The occasional human contraction of Ebola has typically produced a rapid and effective professional response. As previously outlined, I also missed some other important connections that could have enhanced my attention.
I was not alone.
Fast-forward to today. According to the most recent WHO situation update, in mid-January, 148 new cases of Ebola have been confirmed in Guinea, Sierra Leone, and Liberia. Compared to August and September this is good news. At any other time and at any other place, this level of Ebola transmission would be the epidemiological equivalent of a three alarm fire.
This is not a disease we want to treat as a chronic condition. We ought not allow it to become endemic. It is too deadly. The current transmission cycle must be fully, wholly stopped. Then we must each and all do better with early identification and elimination of future animal-to-human and the first human-to-human transmissions.
This is the way with networks and we are — technically and socially — increasingly a networked world.
It would be easy to move to measles or seasonal influenza. But I want to try a more audacious analogy.
Last week Secretary Kerry spoke to the World Economic Forum. The whole speech was better than the sound-bites I had been fed. Following is the whiff of epidemiology I noticed in his remarks.
We have to do more to avoid an endless cycle of violent extremism, a resupplying on a constant basis. We have to transform the very environment from which these movements emerge. And that’s why we are committed to enlarging our strategy in ways that respond effectively to the underlying causes, as well as the visible symptoms of violent extremism. That’s why we’re developing an approach that extends far beyond the short term, and which cannot be limited to the Middle East or to any other region.
We need – all of us – to take these steps so that a decade or two in the future, when the economic forum meets and you hear from leaders, they’re not standing up here responding to a new list of acronyms to the same concept, but different players. We cannot have our successors come back here to face the same questions and the same challenge. The terror groups may have those different acronyms in the future and they may be targeting different countries, but if we don’t do what is required now, then I guarantee you the fundamental conflict will either stay the same or get worse.
We were very late, nearly too late, in the West African Ebola outbreak. Thousands have — potentially will — die needlessly. My too-simple — but not necessarily inaccurate — analysis: When the usual professional methods were distracted and delayed, the contagion multiplied reaching an extent beyond the capacity of professionals alone.
Sierra Leone applied significant command-and-control techniques. In retrospect, these were entirely ineffective. Liberia — more by accident than intention — came to depend on an extraordinary network of neighbors working with neighbors. Eventually this whole community approach was adopted in Sierra Leone as well. This mostly spontaneous bottom-up engagement became the essential foundation on which current containment was achieved.
Professionals have certainly been needed at every stage. Coordination, collaboration, communication, and clinical care have been built upon the foundation. Spontaneous beginnings have been systematically reinforced. But until the community — really multiple communities — mobilized the deadly disease was quickly spreading.
This is the way with networks.