Interview with Ebola Discoverer Peter Piot 'It Is What People Call a Perfect Storm'

Interview Conducted by Rafaela von Bredow and

AFP

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.

  • Horst Friedrichs/ DER SPIEGEL
    Peter Piot, 65, a virologist from Belgium, began his career as a Ph.D. candidate in a university laboratory in Antwerp. After traveling to Africa to help track down the Ebola virus he became a hospital doctor and, later, director of the United Nations AIDS program. In 2012, he wrote the book "No Time to Lose: A Life in Pursuit of Deadly Viruses." Currently, he is head of the London School of Hygiene and Tropical Medicine. One of his professors once warned him against a career in virology, saying that viruses and bacteria had basically been conquered.

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ro.p 09/28/2014
1. Right one.
P.Piot perhaps is not a Nobel scientist, but is a right one to listen to, because every first hand fact is maybe the virologic truth to come, that, unlikely what is said, we don't know.
kraichgau12 09/28/2014
2. 1 british billion every month to keep the beheaders quiet,but for a pandemy no money...
its funny,how a system of short-thinking politicians results in strange decissions. ok,you need to curb the islamic freaks which tend to read the book by the word but more serious is the threat for the whole humanity by a sickness,which is going totally out of control,because nobody really cares..its the system,democracy has failures built in,especially the us-western form of this political system..nobody wants to take responsibility,everybody only covers the short term media show in order to keep his face in the picture
nsmith 09/29/2014
3.
It will be difficult to make any significant progress against fighting the Ebola virus as long as the governments of those countries most afflicted continue to deny and subvert the aid that is being offered, regardless of how many doctors and medical personnel are sent.
mishoj 09/29/2014
4. Interview With Professor Piot
Very well done....this interview has answered many questions - My own thoughts about the outbreak was to educate the African population, by understanding Ebola - how it spreads, then caring for their own infected patients, etc... Hundreds of thousands of Africans will most likely die in the next few months....Educating the African people will be the best weapon against this killer virus...
hayate 10/31/2014
5.
The conversation was good and I also got a lot of informations about that issue.
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