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Global Health Expert In San Diego To Discuss Lessons From Ebola Outbreak

Pulitzer Prize-winning journalist Laurie Garrett is pictured. She wrote about the threat of Ebola and the need for strong public health systems in her best-selling book "The Coming Plague."
Council on Foreign Relations
Pulitzer Prize-winning journalist Laurie Garrett is pictured. She wrote about the threat of Ebola and the need for strong public health systems in her best-selling book "The Coming Plague."
Global Health Expert In San Diego To Discuss Lessons From Ebola Outbreak
Global Health Expert In San Diego To Discuss Lessons From Ebola Outbreak GUEST:Laurie Garrett, senior fellow for global health, Council on Foreign Relations

THIS IS KPBS MIDDAY EDITION I MAUREEN CAVANAUGH. YOU MAY NOT HAVE HEARD BUT LATE LAST WEEK, AN AMERICAN HEALTHCARE WORKER EMERGED FROM A SPECIAL TREATMENT UNIT AT THE NATIONAL INSTITUTES OF HEALTH. FULLY RECOVERED FROM THE EBOLA VIRUS. HE WAS THE 11th PERSON TO BE TREATED IN THE US FOR EBOLA SINCE THE OUTBREAK BEGAN LAST YEAR AND WEST AFRICA. BUT HIS CASE RECEIVED LESS ATTENTION THAN THE OTHERS. THE PANIC APPEARS TO BE OVER AND THE NEW CASES OF THE VIRUS IN WEST AFRICA CONTINUES TO WIND DOWN. BUT, HAVE THE US AND OTHER RESPONDING NATIONS LEARNED THE RIGHT LESSONS FROM THIS EPIDEMIC? MY GUEST LORI GEER WROTE ABOUT THE THREAT OF THE DISEASE AND A NEED FOR LONG -- STRONG PUBLIC HEALTH SYSTEMS IN HER BOOK "THE COMING PLAGUE" A PULITZER PRIZE-WINNING JOURNALIST AND SEARCH FOR SENIOR FELLOW FOR THE COUNCIL FORMULATIONS AND RUNS THE COUNCIL'S GLOBAL HEALTH PROGRAM. WHAT INTO THE PROGRAM. HIGH. YOU WILL BE IN SAN DIEGO TO MARK -- TOMORROW TO JOIN THE SYMPOSIUM ON THE TOPIC OF EBOLA PICK YOU HAVE BEEN WRITING ABOUT EBOLA AND THE POTENTIAL AS A GLOBAL HEALTH THREAT FOR ABOUT 20 YEARS NOW. HOW HAVE REAL-WORLD EVENTS MIRRORED THE PREDICTIONS THAT HAVE MADE ABOUT THIS VIRUS ? WELL, EBOLA HAS ALWAYS BEEN A SPECIAL VIRUS IN THE MINDS OF PEOPLE THAT FOLLOW SUCH THINGS BECAUSE IT IS SO LETHAL, KILLS MORE THAN 60% OF THE PEOPLE IT INFECTS AND THE ACTUAL AILMENT, EVEN IF YOU SURVIVE IT IS QUITE A GRUESOME DISEASE. IT'S ALWAYS HAVE THIS VERY SPECIAL PLACE IN THE LITANY OF DISEASES THAT HAVE EMERGED OVER THE LAST 30 YEARS. BUT IT IS HARDLY THE ONLY ONE THAT HAS EMERGED. LET'S NOT FORGET SWINE FLU AND SARS AND NIPA, IT'S A LONG LIST. THE KEY THING THAT WE HAVE SEEN HAPPEN IN THE LAST SEVERAL EPIDEMICS I'VE NOW BEEN IN THREE EBOLA EPIDEMICS MYSELF, IS THAT THERE IS A KIND OF SMUG NOTION THAT THIS VIRUS AND MOST OTHER TERRIFYING NEWLY EMERGING OR PREVIOUSLY LITTLE UNDERSTOOD VIRUSES TAKE ADVANTAGE OF VERY POOR SETTINGS AND EMERGE IN A SORT OF PREDICTABLE, ALBEIT, REMOTE, RURAL WAY. AND THAT HAD, INDEED, BEEN A PRIOR HISTORY OF THE ROUGHLY 20-21 EYED BREAKS OF EBOLA SINCE IT WAS FIRST DISCOVERED IN 1976. BUT WHAT WAY HAVE SAW WITH THIS EPIDEMIC IS NOT YET OVER, BUT IT CERTAINLY HAS WOUND DOWN CONSIDERABLY, IS THAT THERE IS NO WRITTEN RULE THAT SAYS EBOLA IS ALWAYS GOING TO STAY OUT IN SOME VERY REMOTE, RURAL AREA. IT MADE HIS WAY INTO THE CAPITALS OF THREE NATIONS, ALL OF WHICH HAD INTERNATIONAL AIRPORTS. THEY WERE SPILLOVERS INTO SENEGAL, INTO MOLLY, AND INTO NIGERIA. THAT ONE WAS POTENTIALLY THE GREATEST RISK TO SOCIETY AROUND MUCH OF THE REST OF THE WORLD. AND WAS BROUGHT QUICKLY UNDER CONTROL BY THE NIGERIANS. LAURA, HOW DO YOU RATE THE WORLD'S RESPONSE TO THE WEST AFRICAN EBOLA EPIDEMIC? I'VE -- OBVIOUSLY, IF YOU WERE SAYING, THIS IS NOT THE KIND OF OPERATES -- OUTBREAK THAT HAPPENED IN AFRICA, THE EBOLA OUTBREAK THAT WE WERE USED DO SO TO SPEAK IN A LIMITED RURAL SETTING. SO DID THIS TAKE THE WORLD BY SURPRISE ? EVERY OUTBREAK TAKES THE WORLD BY SURPRISE. IF WE ALWAYS DO WHEN AN OUTBREAK WAS GOING TO OCCUR, WE WOULD HAVE NO TROUBLE STOPPING THEM. RIGHT. BUT FOR QUITE SOME TIME, I GUESS, I MEAN, FOR LONGER THEN PERHAPS THE WORLD SHOULD HAVE BEEN SURPRISED. LOOK, I THINK THE REAL POINT IS THAT THE WORLD RESPONSE WAS LARGELY TOO LITTLE TOO LATE. THE MAJORITY OF COMMITMENTS TO ASSIST IN THE EPIDEMIC NEVER WERE ACTUALLY REALIZED. IN TRUTH, LIBERIA STOPPED LIGHT BEERS EPIDEMIC. SIERRA LIT -- LIGHT BEERS EPIDEMIC. SIERRA LEONE HAS LARGELY STOPPED ITS OWN EPIDEMIC WITH SOME HELP FROM THE OUTSIDE WORLD. AND GINNY HAS STRUGGLED ALONG SOME FRENCH ASSISTANCE FROM -- ALSO WORLD HEALTH ORGANIZATION, DRS. WITHOUT BORDERS, AND A COUPLE OTHER GROUPS. THIS HUGE BROUHAHA ABOUT AN INTERNATIONAL RESPONSE CAME WHEN LIGHT BEERS EPIDEMIC WAS ALREADY HEADING DOWNWARDS BY THE TIME ANY OF IT REALLY SHOWED UP AND SIERRA LEONE WAS ON THE ASCENT BUT MOST OF THE INTERNATIONAL SUPPORT FOR SIERRA LEONE DID NOT ARRIVE UNTIL CHRISTMAS BY WHICH TIME SIERRA LEONE'S EPIDEMIC WAS ALREADY STARTING TO WIND DOWN. SO I THINK THERE IS A LOT OF LESSONS HERE THAT HAVE TO DO WITH HOW INTERNATIONAL COMMUNITIES RESPOND, HOW THEY EXECUTE THEIR EFFORTS, AND WHETHER OR NOT THEY TAKE SERIOUSLY ANYTHING THEY SAY. SOMEBODY IS POUNDING ON MY HOTEL ROOM DOOR. [ LAUGHTER ]. WHAT WERE SOME OF THE REASONS THE GLOBAL RESPONSE SAYS -- WAS SO INADEQUATE? YOU WERE WRITING IN YOUR BLOG ABOUT THIS, THE WORLD HEALTH ORGANIZATION DOES IT HAVE A GIANT SWAT THE -- TEAM OF DISEASE FIGHTING SOLDIERS AT THE READY WAITING TO GO INTO AREAS OF THE WORLD WERE EPIDEMICS BREAK OUT, BUT WHAT ARE THE RESOURCES THAT THE WORLD HAS BEEN ABLE TO GARNER SINCE THEY KNOW THERE IS A POTENTIAL FOR A TERRIBLE EPIDEMIC DISEASE ? WELL, LET'S GO BACK A STEP. WE KNOW AND WE HAVE KNOWN FOR A LONG TIME THAT OUTBREAKS WERE GOING TO OCCUR, THAT WE WERE GOING TO EVENTUALLY HAVE ONE THAT WOULD GLOBALIZE AND CAUSE THREATS TO ALL NATIONS, RICH AND POOR ALIKE, WHICH HAPPENED IN 2009 WITH THE H1N1 INFLUENZA. FORTUNATELY, NOT A TERRIBLY LETHAL FORM OF FLU. SO WE DIDN'T WRECK THE KIND OF HABIT THAT WE HAVE BEEN WORRIED ABOUT. BUT IT IS JUST ONE SHOT ACROSS. WHEN YOU LOOK CAREFULLY AT WHAT HAS ACTUALLY TRANSPIRED, YOU SEE THAT THE WORLD RESPONSE IS A RESPONSE TO PANIC. AND IT'S A RESPONSE TO THAT MOMENT WHEN IN THE UNITED STATES, YOU HAVE RIGHT WING REPUBLICAN SCREAMING KEEP ALL THE FOREIGNERS OUT BECAUSE THEY ARE GOING TO BRING VIRUS TO US AND YOU HAVE DONALD TRUMP SAYING, YOU CAN'T LET THE MISSIONARY THROUGH INFECTED RETURN TO AMERICA FOR TREATMENT BECAUSE I WILL PERSONALLY BE AT RISK, HE SAID, OF COMING DOWN WITH EBOLA. WHEN YOU HAVE THAT KIND OF PANIC ENSUE, TWO THINGS HAPPEN: THE BAD THING IS THAT YOU START SHUTTING BORDERS DOWN, YOU START SHUTTING DOWN SERVICES, TO THE COUNTRIES, AIRLINES ALL STOP FLYING THERE, CARGO SHIPS STOP MAKING DELIVERIES, AND THE POVERTY AND DIFFICULTY OF THE COMMUNITIES JUST GETS WORSE AND WORSE AND WORSE. BUT THE POSITIVE SIDE IS IT DOES GARNER RESOURCES. YOU DO START TO SEE PEOPLE ASKING THE QUESTION, G, CAN WE HELP THESE PEOPLE? AND A DRAW -- DRAWS ATTENTION JUST AS FAMINE DOES WHEN CAMERAS GET IN THERE AND YOU SEE ALL THE DYING CHILDREN. BUT, THIS DOES NOT FUNDAMENTALLY PROTECT THE WORLD. FUNDAMENTAL PROTECTION DOES NOT WAIT UNTIL THINGS ARE ALREADY OUT OF CONTROL PICK FUNDAMENTAL PROTECTION DOES NOT WAIT UNTIL THERE ARE THOUSANDS OF DEAD BODIES. FUNDAMENTAL PROTECTION IS AN INTERNATIONAL INFRASTRUCTURE OF DISEASE SURVEILLANCE MONITORING AND RESPONSE. I THINK PEOPLE HAVE THIS CRAZY NOTION, CERTAINLY DAN BROWN DOESN'T HELP ANY WITH HIS BOOKS WHEN HE WRITES HE GROSSLY EXAGGERATES THINGS. HE HAS -- WE HAVE THIS NOTION THAT THE WHO IS WORTH BILLIONS OF DOLLARS AND IS JUST THIS HUGE FACILITY IN GENEVA STOPPED WITH ITS OWN PRIVATE HELICOPTERS AND JETS AND ARMIES OF DISEASE FIGHTERS, AND NOTHING CAN BE FURTHER FROM THE TRUTH. THE ENTIRE STAFF FOR WHO FOR DISEASE RECOGNITION AND FIGHTING FOR NEWLY EMERGING DISEASES WOULD BILL FOR EBOLA HAPPENED WITH 32 PEOPLE INCLUDING SECRETARIES. SO I THINK THE WORLD NEEDS TO WAKE UP AND REALIZE, YOU CANNOT GET DISEASE PROTECTION WITH BARGAIN-BASEMENT SPENDING. BASICALLY, THAT'S WHAT WHO IS ABOUT. CORE BUDGET BROUGHT IT HAS BEEN GOING BACKWARD STEADILY FOR THE 1990S BECAUSE -- SINCE THE 1990S BECAUSE OF MEMBER COUNTRIES REFUSE TO VOTE ANY INCREASE IN THEIR OWN COMMITMENT TO SUPPORT WHO'S BUDGET. WELL, GIVEN INFLATION, THEY ARE GIVING LESS EVERY YEAR. THE UNITED STATES GOVERNMENT, THE TAXPAYERS OF AMERICA, AND A PRIVATE INDIVIDUAL BILL GATES ARE THE TWO BIGGEST SUPPORTERS OF THE WORLD HEALTH ORGANIZATION. AND NOTHING ELSE, NO THE COUNTRY, NO OTHER ENTITY EVEN COMES CLOSE. YES SPEAKING WITH HEALTH WRITER LAURIE GARRETT WHO ALSO RUNS THE COUNCIL ON FOREIGN RELATIONS GLOBAL HEALTH ROW GRAHAM. YOU KNOW WE HEARD A LOT ABOUT LIVES BEING SAVED IN THIS EPIDEMIC. BY EXPENDABLE -- EXPERIMENTAL DRUGS LIKE THE MAP, THERE ARE DRUGS AND VACCINES BEING TESTED IN WEST AFRICA. DO YOU THINK THAT IS THE ANSWER PERHAPS THE TWO FUTURE EBOLA THREATS ? OBVIOUSLY, FOR ANY FUTURE VIRUS THREAT, IF YOU HAVE TO HAVE VACCINE HANDY, THAT'S NICE. BUT WE NEVER DO. NOT WHEN A DISEASES NEWLY EMERGING, WE NEVER HAVE VACCINE. THE VACCINE ALWAYS COMES MUCH, MUCH LATER. WE NEVER HAVE AN INFLUENZA VACCINE IN A TIMELY FASHION. FOR WHEN AN OUTBREAK IS ACTUALLY OCCURRING AND AS YOUR LISTENERS KNOW, THIS YEAR'S VACCINE TURNED OUT TO BE DIRECTED TO THE WRONG VIRUS AND WE WERE OVERWHELMED ACROSS AMERICA WITH A DIFFERENT STRAIN IN H3 AND TWO VIRUS. IF HER FROM THE ONE WE PREPARED FOR. VACCINES ARE SWELL, BUT THEY ARE VERY RARELY AVAILABLE AND NOR CAN THEY BE GIVEN WHAT IT TAKES TO DEVELOP AND TEST ONE. IN A TIMELY FASHION DURING AN OUTBREAK. AND TREATMENTS VERY MUCH THE SAME THING. WE STILL HAVE NO VIABLE COMMISSARS EMERGED IN 2003. WE HAVE NO SARS VACCINE AND NO SOURCE TREATMENT AND NOW IT IS CLOSE COUSIN VIRUS GENETICALLY VERY SIMILAR THE MERS VIRUS OR MIDDLE EAST RESPIRATORY SYNDROME HAS BEEN SPREADING STEADILY IN SAUDI ARABIA AND NEIGHBORING COUNTRIES FOR -- SINCE LATE 2012 AND WE STILL HAVE NO VACCINE OR DIAGNOSTIC TOOL OR RAPID TREATMENT AND SO ON. SO, YES, WE IN AMERICA GET HOPPED UP, LET'S GET THE MAC TO THE WORLD. THERE WERE ONLY ABOUT 30 DOSES OF IT SO THERE WAS NOTHING TO GET TO THE WHOLE WORLD. THIS QUESTION OF EQUITY OF ACCESS. EQUITY OF ACCESS TO WHAT? DOES IT WORK IT HAD NEVER BEEN TRIED IN HUMAN BEINGS FOR KEN BRADLEY, THE FIRST MISSIONARY TO COME DOWN WITH EBOLA FLU TO EMORY UNIVERSITY IN ATLANTA AND UNDERWENT TREATMENT WITH A. I THINK THERE IS JUST THIS CRAZY NOTION IN TYPICAL EBOLA THINK THAT THERE'S GOING TO BE AN INSTANT TECHNOLOGICAL SOLUTION TO THE REAL TECHNOLOGY THAT WE NEED IN EVERY SINGLE EPIDEMIC AND EVERY SINGLE EPIDEMIC IS MISSING, WE DON'T HAVE IT. IT IS A RAPID POINT OF CARE DIAGNOSTIC. LET ME EXPLAIN WHAT THAT MEANS. MANY OF YOUR LISTENERS ARE PROBABLY -- HAVE HEARD OF DNA TESTING AND THEY KNOW AND WATCH CSI AND SO ON AND KNOW YOU CAN RUN A PCR DNA TEST AND KNOW WHETHER OR NOT THIS CRIMINAL IS IN THE ROOM. THAT SORT OF THING. WELL, OF COURSE YOU CAN DO THAT WITH VIRUSES. YOU CAN RUN PCR TESTS UNTIL OF A SAMPLE OF BLOOD OR TISSUE OR WHATEVER YOUR TESTING HAS THAT VIRUS ON IT. HOWEVER, THIS REQUIRES THAT YOU HAVE LABORATORY, AND A PRETTY DARNED SOPHISTICATED LABORATORY. AND YET PEOPLE WHO KNOW HOW TO DO PCR TESTING AND WORK IN SUCH LABORATORY CONDITIONS AND AVOID CONTAMINATION OR ELSE ALL OF YOUR RESULTS ARE MEANINGLESS. AND THAT YOU HAVE TRANSPORT THAT CAN GET SAMPLES FROM A VERY REMOTE AREA ON ROADS OR SOME FORM OF TRANSPORT, IN A TIMELY FASHION TO THE LABORATORY AND BE TESTED. WE HAD NONE OF THOSE THINGS OF THIS EPIDEMIC. THE PCR TEST THAT WERE AVAILABLE WERE ALL REQUIRED A DAY OF WORK. AND THE SAMPLES HAD TO BE COLLECTED FROM PATIENTS OR THEIR FAMILY MEMBERS IN ORDER TO FIGURE OUT WHO WAS THE CARRIER OF THE DISEASE. IN SOME REMOTE PLACE, BY PEOPLE THAT HAD TO CLIMB MOUNTAINS, FORGE STREAMS, DRIVE THROUGH KNEE-DEEP MUD IN THE RAINY SEASON AND SO ON, AND THEN GET ALL THE WAY OUT THERE, GET THE SAMPLES, AND THEN DRIVE ALL THE WAY TO THE LABORATORY, AND RUN THOSE TESTS AND DRIVE ALL THE WAY BACK. THE PROCESS COULD BE 5-6-9 DAYS, BY THE TIME YOU GET BACK THE PATIENT WAS DEAD, SPREAD VIRUS TO MANY OTHER PEOPLE, AND YOU HAD NO IDEA WHO WAS INFECTED AND WHO WASN'T. THE RESULT WAS A LOT OF VERY DIFFICULT POLITICAL PROBLEMS ASSOCIATED WITH WORKING PEOPLE UP WITH MASS QUARANTINES, -- LOCKING PEOPLE UP, MASS CORE TWO, AND THE INSANITY OF THE INTERNATIONAL RESPONSE BECAUSE WE DIDN'T HAVE A WAY OF ATTITUDES LATE -- OF WAY OF GUARANTEEING THAT THIS PERSON WHO FLEW FROM LIBERIA TO LONDON WAS NOT A CARRIER OF THE VIRUS. LAURIE GARRETT, YOU HAVE GIVEN EVERYBODY A REALLY GOOD IDEA OF WHAT YOU ARE TALKING GOING TO BE LIKE TOMORROW. THE SYMPOSIUM ON EBOLA, LESSONS FROM THE FIELD WILL BE HELD ON THE SDSU CAMPUS TOMORROW FROM 4-6. I'VE BEEN SPEAKING WITH SENIOR FELLOW FOR GLOBAL HEALTH FOR THE COUNCIL ON FOREIGN RELATIONS, HELLFIRE LAURIE GARRETT. BECKY SO MUCH. THANK YOU.

A Pulitzer Prize-winning journalist who has studied Ebola for 20 years will be in San Diego on Tuesday to discuss the outbreak.

Laurie Garrett’s visit to San Diego State University comes as the World Health Organization continues to treat Ebola patients in West Africa. The virus has so far killed more than 10,500 people in Sierra Leone, Liberia and Guinea.

Garrett, who wrote about the threat of epidemic disease and the need for strong public health systems in her best-selling book "The Coming Plague,” will speak at the SDSU symposium, "Ebola: Lessons from the Field.”

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She said the most recent epidemic of Ebola proved that viruses aren’t limited to certain types of communities. In the U.S., an American health care worker who was infected with the disease was released last week after recovering. He was the 11th person to be treated in the U.S.

“There’s a kind of smug notion that this virus takes advantage of very poor settings,” Garrett told KPBS Midday Edition on Monday. “That had indeed been the prior history of the 20 to 21 outbreaks of Ebola since it’s been discovered but what we’ve seen with this epidemic there’s not a written rule.”

Garrett said the world responded with panic during the most recent epidemic.

“Ebola has always been a special virus in the minds of people who follow such things because it is so lethal,” said Garrett who also serves as a senior fellow for Global Health for the Council on Foreign Relations. “It’s quite a gruesome disease.”

Garrett will speak at 4 p.m. Tuesday at Arts and Letters Room 101. For more information about the symposium, go to sdsu.edu.