Uncontrolled Spread by Scott Gottlieb

Author:Scott Gottlieb
Language: eng
Format: epub, mobi
Publisher: Harper
Published: 2021-08-05T00:00:00+00:00

Chapter 15

Evidence Is Hard to Collect in a Crisis

He had a low-grade fever. Then some muscle aches. However, at first it wasn’t so bad. Not bad enough to keep him from traveling. He got on a commercial airplane from Saudi Arabia, where he was working as a healthcare provider, bound for Chicago, and then took a seventy-minute bus ride before arriving at his home in Indiana. Three days later, his nagging symptoms abruptly worsened: he grew short of breath and developed a high fever. He was evaluated at a local hospital, where a chest X-ray showed a right-lower-lobe pneumonia, and a CAT scan would show that the infection had progressed to both of his lungs. As his condition deteriorated, he was admitted to the Community Hospital in Munster, Indiana.

These events took place at the end of April 2014. The man admitted to the hospital was America’s first known case of a novel coronavirus known as Middle East Respiratory Syndrome, or MERS. During the course of his trip through the healthcare system, fifty-three healthcare workers were in contact with him before his diagnosis emerged. Probably hundreds of others were exposed to the virus during his journey from Saudi Arabia.1

A few days after the Indiana man was admitted to the hospital, a second case of MERS emerged in America, another healthcare provider who worked in Saudi Arabia and had similarly traveled by a commercial airline from the kingdom via London, Boston, and Atlanta, to his final destination in Orlando. He had first started to feel sick on the flight, but it wasn’t until a few days later, on May 9, that he visited a local emergency room and was admitted.2 The Florida Department of Health confirmed his diagnosis on May 12.3

Once again, hundreds of people had been exposed along his route.

The two episodes showed how easily a novel virus can journey across the world and infect people along the way. MERS had first emerged in Jeddah, Saudi Arabia, two years earlier, with a cluster of infections in June 2012. It would continue to spread across Asia, Africa, and Europe before reaching America.4 By December 2015, a report from the WHO identified 1,621 cases in twenty-six countries, with 584 deaths.5

The MERS virus never obtained the ability to spread easily between people; it was largely transmitted through close contact with its animal hosts, usually camels. When human transmission occurred, most of the cases were confined to healthcare settings, where providers would have sustained contact with patients, often without taking adequate precautions to protect themselves.6 But the virus proved to be dangerous, and it should have been a provocation to take the threat of novel coronaviruses more seriously. MERS arrived just a few years after SARS-1 had already sparked a dangerous epidemic, infecting more than eight thousand people and ultimately spreading to twenty-nine countries, killing at least 774 people worldwide. Most of the cases of SARS-1 would occur over an eight-month period in 2002 and 2003, but the virus would linger for another year.7 It was clear that coronaviruses were on the march.

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