Interview with Ebola Discoverer Peter Piot 'It Is What People Call a Perfect Storm'
Part 2: 'An Outbreak in Europe Would Quickly Be Brought Under Control'
SPIEGEL: For the first time in its history, the virus also reached metropolises like Monrovia and Freetown. Is that the worst thing that can happen?
Piot: In large cities -- particularly in chaotic slums -- it is virtually impossible to find those who had contact with patients, no matter how great the effort. That is why I am so worried about Nigeria as well. The country is home to mega-cities like Lagos and Port Harcourt and if the Ebola virus lodges there and begins to spread, it would be an unimaginable catastrophe.
SPIEGEL: Have we completely lost control of the epidemic?
Piot: I have always been an optimist and I think that we now have no other choice than to try everything, really everything. It's good that the United States and some other countries are finally beginning to help. But Germany or even Belgium, for example, must do a lot more. And it should be clear to all of us: This isn't just an epidemic anymore. This is a humanitarian catastrophe. We don't just need care personnel, but also logistics experts, trucks, jeeps and foodstuffs. Such an epidemic can destabilize entire regions. I can only hope that we will be able to get it under control. I really never thought that it could get this bad.
SPIEGEL: What can really be done in a situation when anyone can become infected on the streets and, like in Monrovia, even the taxis are contaminated?
Piot: We urgently need to come up with new strategies. Currently, helpers are no longer able to care for all the patients in treatment centers. So caregivers need to teach family members who are providing care to patients how to protect themselves from infection to the extent possible. This on-site educational work is currently the greatest challenge. Sierra Leone experimented with a three-day curfew in an attempt to at least flatten out the infection curve a bit. At first I thought: "That is totally crazy." But now I wonder, "why not?" At least, as long as these measures aren't imposed with military power.
SPIEGEL: A three-day curfew sounds a bit desperate.
Piot: Yes, it is rather medieval. But what can you do? Even in 2014, we hardly have any way to combat this virus.
SPIEGEL: Do you think we might be facing the beginnings of a pandemic?
Piot: There will certainly be Ebola patients from Africa who come to us in the hopes of receiving treatment. And they might even infect a few people here who may then die. But an outbreak in Europe or North America would quickly be brought under control. I am more worried about the many people from India who work in trade or industry in West Africa. It would only take one of them to become infected, travel to India to visit relatives during the virus' incubation period and then, once he becomes sick, go to a public hospital there. Doctors and nurses in India, too, often don't wear protective gloves. They would immediately become infected and spread the virus.
SPIEGEL: The virus is continually changing its genetic makeup. The more people who become infected, the greater the chance becomes that it will mutate ...
Piot: ... which might speed its spread. Yes, that really is the apocalyptic scenario. Humans are actually just an accidental host for the virus, and not a good one. From the perspective of a virus, it isn't desirable for its host, within which the pathogen hopes to multiply, to die so quickly. It would be much better for the virus to allow us to stay alive longer.
SPIEGEL: Could the virus suddenly change itself such that it could be spread through the air?
Piot: Like measles you mean? Luckily, that is extremely unlikely. But a mutation that would allow Ebola patients to live a couple of weeks longer is certainly possible and would be advantageous for the virus. But that would allow Ebola patients to infect many, many more people than is currently the case.
SPIEGEL: But that is just pure speculation, isn't it?
Piot: Certainly. But it is just one of many possible ways the virus could change to spread itself more easily. And it is clear that the virus is mutating.
SPIEGEL: You and two colleagues wrote a piece for the Wall Street Journal supporting the testing of experimental drugs. Do you think that could be the solution?
Piot: Patients could probably be treated most quickly with blood serum from Ebola survivors, even if that would likely be extremely difficult given the chaotic local conditions. We need to find out now if these methods, or if experimental drugs like ZMapp, really help. But we should definitely not rely entirely on new treatments. For most people, they will come too late in this epidemic. But if they help, they should be made available for the next outbreak.
SPIEGEL: Testing of two vaccines is also beginning. It will take a while, of course, but could it be that only a vaccine can stop the epidemic?
Piot: (Long pause) I hope that's not the case. But who knows? Maybe.
SPIEGEL: In Zaire during that first outbreak, a hospital with poor hygiene was responsible for spreading the illness. Today, almost 40 years later, almost the same thing is happening again, just much worse. Was Louis Pasteur right when he said: "It is the microbes who will have the last word"?
Piot: Of course we are a long way away from declaring victory over bacteria and viruses. HIV is still here; in London alone, five gay men become infected daily. An increasing number of bacteria are becoming resistant to antibiotics. And I can still see the Ebola patients in Yambuku how they died in their shacks and we couldn't do anything except let them die. In principle, it's still the same today. That is very depressing. But it also provides me with a strong motivation to do something. I love life. And that is why I am doing everything I can to convince the powerful in this world to finally send sufficient help to West Africa. Now!
SPIEGEL: Professor Piot, we thank you for this interview.
- Part 1: 'It Is What People Call a Perfect Storm'
- Part 2: 'An Outbreak in Europe Would Quickly Be Brought Under Control'