Michael Gerson: On Ebola, hard choices - Opinion - MailTribune.com - Medford, OR

Mail Tribune (Medford, OR — Wayback)

2014-11-29

Document text

0 of 3 Premium Clicks used this month SUBSCRIBE Print + Online Subscriber Activation  |  Register x Forgot Password | Need an Account? e-edition | subscribe | newsletter | deals Home News Latest Stories Emergency services Since You Asked: You got pups? We got paper Mail Tribune 100 Get Up & Go: Nov. 29 Wrap Up, Nov. 28 Crime, Courts and Emergency Services Emergency services Wrap Up, Nov. 28 Former Central Point residents accused of abusing their adopted children Homemade bomb found inside stolen car after arrest of fleeing transient Police gain a clue in pumpkin smashing spree Politics and Elections Buckley again named Ways and Means Committee co-chairman Latest count shows Measure 92 supporters narrowing deficit Granlund cartoon: GOP wrecking balls Ballot measures played little role in mobilizing voters in state Senate race 'Euphoria' over pot initiative Education Homelessness is growing problem for Medford students Les AuCoin recommended for SOU board Good news for SOU: Enrollment's up Mom gives school lobby a makeover Crater students present play about Thoreau's night in jail Environment Hawks use I-5 as hunting ground Curbing urban runoff in Gold Hill Mt. View Estates' fill, riprap work lacked county permit Birders sought for bird counts Grow 'em before you plant 'em State News Bill would tighten limits on license plate readers UO teaching assistants prepared to strike Growers cheer higher Christmas tree prices Police dog fired for poor performance Turkey's great escape foils Thanksgiving plans Nation - World Grand jury won't indict Ferguson cop in shooting Obituaries Earle Morgan Swift Jr. Death Notices Lue K. Woolstenhulme Mary "Janet" Kimmons In Appreciation Weather Photo Galleries Since You Asked Videos Web Cams Mail Tribune 100 Sports Latest Stories Grizzlies snap Blazers’ streak Spurs win second straight without Popovich Kaminsky, Badgers kings of Atlantis Green light Chalmers leads Australian Open; McIlroy shares second Varsity 541 College Sports Kaminsky, Badgers kings of Atlantis Green light No. 12 Arizona takes Pac-12 South Western Kentucky edges No. 19 Marshall — 67-66 — in OT Texas A&M fires defensive coordinator Pro Sports Grizzlies snap Blazers’ streak Spurs win second straight without Popovich Chalmers leads Australian Open; McIlroy shares second Ray Rice wins appeal; suspension vacated Sherman’s big night leads Seattle past 49ers again Community Sports RESULTS/STANDINGS LOCAL EVENTS Business Latest Stories Blog: 'Twas the 12 Days of Deals... Asante expands cardiac center Jackson County sees workforce and job growth Regional hotels and motels outperformed statewide marks in October Incorrect labeling prompts Kroger ice cream recall Real Estate News Dear Monty: Violation of HOA rules creates conflict Farmers file suit over GMO crop ban Financial webinars offered for veterans and their families Home prices rise across Jackson County People In Business People in Business, Nov. 18 People in Business, Nov. 8 Transportation Allegiant Air will resume Medford-Phoenix service May 22 Medford airport passenger counts sky high in October Erickson reports third quarter profit Agriculture Farmers file suit over GMO crop ban Lawsuit seeks to overturn Jackson County's GMO ban or net $4.2 million for farms Latest count shows Measure 92 supporters narrowing deficit Opinion Latest Other Views: Klamath Basin agreement deserves approval Granlund cartoon: Holiday boxes Kent Bush: Ferguson case shows racism belief system still reinforced Maddocks: Republicans claim president overstepped his constitutional powers in pardoning turkeys Amy Gehrt: Justice is not color-blind Editorials Other Views: Klamath Basin agreement deserves approval Our View: Cheers (too thankful for a jeer this week) Our View: Day of abundance, season of sharing Another View: Logging still has a place in Oregon Our View: Lawsuit reopens the GMO debate Letters to the Editor Letters to the Editor, Nov. 28 Letters to the Editor, Nov. 27 Letters to the Editor, Nov. 26 Letters to the Editor, Nov. 24 Letters to the Editor, Nov. 23 Guest Opinions Guest Opinion: Are we the preferred path to global devastation? Guest Opinion: Fight for the rights of independent voters will continue Guest Opinion: 'Natural' not necessarily better for forest management Guest Opinion: County voters rebuffed judicial appointment process Fix health care reform, don't scrap it Lifestyle Latest stories Barry Lewis: When in America, do as the Romans do Frank Talk: It was all just a dream Facing Extinction Looking Up: Orion, a starry friend, returns Fishing through readers' stream of consciousness Food Community blog: In soup or salad, savor pumpkin with leeks Be a gravy-making star on Thanksgiving Food for Thought: Add new twists on Thanksgiving favorites Community blog: Feast on this blog's Thanksgiving recipes, tips Kitchen Call: Both sides of the kiddie table Home and Garden 9 ways to green your gift wrap Dear Monty: How to find a good real estate attorney Home Help: Quick tips for getting your home ready for the holidays Mortgage insurance: Your questions answered Home Help: Spruce up your home with quick DIY painting projects Health Health Watch: Fuel up on carbs before workouts Health insurance enrollment help available Community blog: Appreciating Clouds: Year-Round Gratitude Community blog: A Little Toilet Talk 'Tis the season to be jolly Hiking Biking Faith Religion news: Pope aims to expedite sex abuse rulings Religion news: Seattle-based mega-church dissolves Religion Briefs 'Walk the talk' Religion briefs Milestones and Achievements ACCESS receives $50,000 donation from Wells Fargo Wedding: Rogers-Horn Century Club Wedding: Tomlinson-Nowak Local farmers need more products in grocery stores Columnist for a Day Rogue Healthy Aging Tempo Latest stories Brunch at Loft Brasserie 2014 Providence Festival of Trees A grand illumination at the Commons Lighting up memories Jacksonville's Victorian Christmas Theater OCT's holiday show is a wonderful play New 'Alice' has some for kids ... and adults 'It's a Wonderful Life: A Live Radio Play' opens at Oregon Cabaret Theatre 'Red Noses' a romp through slapstick and pathos SOU presents 'The Drunken City' Music Shae Johnson releases 'Can You Feel the Music' Jeff Kloetzel releases 'Long Time Coming' A new guitar slinger in town Peter Chianca: Top 40 songs even a dad could love The Farr Side: Different artists, common songs Community Events 2014 Providence Festival of Trees A grand illumination at the Commons Lighting up memories Jacksonville's Victorian Christmas New exhibits highlight Third Fridays Dining Brunch at Loft Brasserie The Bohemian Club Thanksgiving comes early at Taprock Word of Mouth: Brunch at Brothers' Restaurant Blue Toba is a cultural experience Tempo Videos Classifieds Jobs Autos Real Estate FEATURED   » Obituaries Blogs TV Listings Movie Listings Oregon Outdoors Oregon Healthy Living Magazines & Special Sections NEWS NOW   Homemade bomb found inside stolen car after arrest of fleeing transient       ...       Police gain a clue in pumpkin smashing spree       ...       Neglect leads list of adult care facility failings       ...       Homemade bomb found inside stolen car after arrest of fleeing transient       ...       Police gain a clue in pumpkin smashing spree       ...       Neglect leads list of adult care facility failings       ...           ANOTHER VIEW Michael Gerson: On Ebola, hard choices MailTribune.com Writer Posted Oct. 7, 2014 @ 12:01 am Posted Oct. 7, 2014 @ 12:01 am »  Social News Here is what officials at the Centers for Disease Control and Prevention and the National Institutes of Health have been telling us: America has some Ebola infections (and is likely to see more) but America does not have an Ebola outbreak, which is extremely unlikely in a health system capable of basic public health measures (such as isolation and contact tracing). So: Infections but no outbreak. Some in the media — splicing their own agendas into the Ebola virus — have used this response (variously) to criticize governmental doublespeak, diagnose institutional rot, or slam immigration laxity. This is political and ideological scavenging. It also pits people with limited credibility on this issue against national experts who actually know their business (as opposed to locals who sometimes don't). There is a time to question authority. And then there is a time to shut up and listen carefully to medical experts, who sometimes say complex and difficult things. Such attentiveness is about to become even more important. The Ebola outbreak in Liberia, Guinea and Sierra Leone (countries lacking effective health systems) is not contained; it is catastrophic. Photographers send back pictures like tourists in hell. Desperate attention will soon turn to an Ebola vaccine, for a specific reason. The first participant in a Phase 1 trial was injected at the NIH clinical center on Sept. 2. Twenty people are now in the study. This possible vaccine, as usual, is the result of money, brilliance and luck. Following the 9/11 attacks, the U.S. government began funding research on an Ebola vaccine in earnest (to counter the possibility of bioterrorism). The effort went slowly until about two years ago, when scientists chanced upon a new vector, or method of vaccine delivery: a chimpanzee virus. Injecting even a dead Ebola virus into a human being (one of the ways to produce an immune response) is too dangerous. So scientists have spliced just one gene of the Ebola virus — the one that codes for its outer coating, called a glycoprotein — into the DNA of a chimp adenovirus. After injection, this harmless virus infects a human cell, which, in turn, pumps out a lot of Ebola glycoprotein. The immune system responds as though the whole Ebola virus — not just the protein for Ebola's coating — were in the body, producing resistance to future infection. At least theoretically. By the end of November, we will know two limited things about this proposed vaccine: Is it immediately harmful? (So far, it is not.) And does it produce an immune response? If the vaccine looks promising after Phase 1, an ethical debate will commence. Some will suggest, as some at the World Health Organization have already suggested, that further testing be bypassed and the vaccine be given immediately to health workers in West Africa. Others may demand that the partially tested vaccine be produced and given out broadly. This reaction is emotionally understandable. I would probably share it if I lived in a hot zone. But the main response is: the STEP trial. This was the study of a promising HIV vaccine, which went successfully through Phase 1. But two years into the Phase 2 trial — in which participants were given either the vaccine or a placebo, with no one (researcher or subject) knowing who got what — it became evident that the vaccine resulted in a 41 percent increase  in the risk of HIV infection. This "paradoxical effect" (scientists love understatement) has also been seen in other vaccine development efforts. There is another, apparently pitiless reason that health workers should be involved in a controlled, double-blind Phase 2 study of the Ebola vaccine — because their higher risk of infection would increase the likelihood of the study giving meaningful results (since those results depend on comparing rates of infection within high-risk groups, after some receive the vaccine and others do not). Why, in times of medical emergency, do we need to trust reliable scientific authorities? Because they are required to do unspeakably difficult things that would not survive the majority vote of a frightened public. In a Phase 2 trial, researchers give some people a vaccine that may hurt them, and some people a placebo that may result in their infection and death. This turns out to be the only ethical way we currently have to determine if a vaccine actually works. On an Ebola vaccine, this process should be expedited in any way possible. But it can't be avoided without the potential for great harm. Michael Gerson's email address is [email protected]. MailTribune.com Writer Posted Oct. 7, 2014 @ 12:01 am » Comment or view comments   Reader Reaction »  STAY INFORMED   Email NewsLetter   Sign Up Today   Sign up for our newsletter and have the top headlines from your community delivered right to your inbox. calendar Connect with MailTribune.com Facebook Twitter RSS Back to top Reader Services Reader Services Home Subscriptions Subscriber controls Contact us Submissions Photos Events Letters to the editor Corrections Announcements Obituaries Story ideas Since you asked Alerts Email Alerts RSS Feeds Text Alerts Advertise Media Kit Home Products and services Ad rates Advertising contacts Mail Tribune Daily Tidings The Nickel Shop Our Valley Blogs Stay Informed   Email newsletter   Sign Up Today   Sign up for our newsletter and have the top headlines from your community delivered right to your inbox. Your privacy is important, read our privacy policy. © Copyright 2014 Local Media Group, Inc. All Rights Reserved.    Privacy Policy  |  Terms of Service  |  Local Media Group Publications Original content available for non-commercial use under a Creative Commons license, except where noted. MailTribune.com | P.O. Box 1108, Medford, OR 97501