Let's put the Ebola outbreak in perspective

Health scares presented in the news media often lack sufficient nuance and perspective, and Ebola is no exception. Right now reporters and the American public are struggling to understand how a deadly virus could be spreading in West Africa and not be a direct threat to us here.

Over and over we hear rational  scientific explanations for why we shouldn’t be afraid.
For example, as opposed to HIV, you have to be very sick with Ebola to spread it. That fact alone makes it much easier to contain the virus.

You also have to be in direct contact with the bodily fluids of someone who is sick with Ebola to get it. Unlike some other viruses, it doesn’t spread through the air.


Previous Ebola outbreaks have been squashed by isolating sick patients and their contacts. Yes, the current outbreak is the worst in history but only because it is taking place in a populous region with porous borders and local cultural practices (including washing dead bodies and lavishing attention on sick patients) which helps facilitate the spread of the virus.

If a new case of Ebola appears here, the patient will be isolated and the virus almost certainly will not spread.  This is what happened in Colorado in 2009 with the Marburg virus which is very similar to Ebola.

Still, no matter how many times we hear these reassuring narratives, when people are afraid it takes them a long time to see things in perspective and accept the scientific realities over the worst case scenarios. Fear spreads even when viruses don't.

Just as the American public was finally beginning to accept the complex truth about Ebola last week – that it is a risk to people in Africa right now but not to us -- three dangerous narratives supervened that once again spread irrational fear.

The first fiction was that Ebola patients Dr. Kent Brantly and nurse Nancy Writebol somehow presented a health threat to America despite the fact that they were isolated in facilities that were intended for much more contagious and airborne viruses.

Photographs of these containment facilities at Emory Hospital in Atlanta looked just like something out of the scary film “Outbreak” and helped to spread the myth that just this kind of quarantine is needed to contain Ebola. In reality, an Ebola patient may be isolated in almost any hospital, as long as caretakers obey protocols with gowns, gloves, eye and mouth protection.

The second fiction arose from the handling of the case of a sick traveler from West Africa who was isolated at Mt. Sinai Hospital in New York and tested for Ebola. There had been six previous patients isolated in the U.S. who had escaped the media’s attention.

But news of the Mt. Sinai patient leaked and instantly captured the public’s imagination. Misleading headlines screamed about Ebola spreading to the U.S.

The public received the wrong message that simply travelling to West Africa was a risk factor for getting Ebola. But with many millions of people living in the four affected countries and still less than 2,000 cases of Ebola, the chances of acquiring it by travelling there remains infinitesimally small. CDC officials told me that sick people coming from West Africa are not detained unless they have been found to have been directly in contact with an Ebola patient.

The third fiction centers around the simple word “mutation.” There are physicians of all specialties and backgrounds with no experience with emerging pathogens appearing on TV and radio right now, wildly speculating about the possibility of a mutation leading to Ebola becoming airborne and killing millions.

We are all part of a global health community but the scientific facts are, according to Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, that it is highly unlikely that Ebola will mutate in a major way. It is a stable virus, he told me in an interview last week. Unlike the flu, which is very prone to changes and presents us with a different major strain to contend with each year, the current strain of Ebola is almost identical to the original strain that first infected humans in what was then known as Zaire in 1976.

The World Health Organization (WHO) has already called the Ebola outbreak an international health emergency. That’s both a good thing and a bad thing. Though the WHO’s action will likely lead to more boots on the ground and more money pouring in, a good thing, at the same time it contributes to the narrative of fear. Americans are already petrified about disease coming from the underdeveloped world, they are already afraid of an invisible killer microbe like Ebola from “over there” coming “over here.”

Amidst all the madness and worry and fearful speculation, Dr. Tom Frieden, the director of the Center for Disease Control and Prevention has been a calm sober voice helping the public to keep the risks and realities in perspective. His focus has been is on intervention with disease detectives to help contain the epidemic “over there” in West Africa, while reassuring the public with scientific facts and perspective over here. The CDC has 20 quarantine stations at major airports around the country and has trained infectious disease specialists on-call 24/7 to field questions and help screen travelers. Customs and Border Protection Officers are trained to contact the CDC when needed.

Knowing the CDC has our backs when it comes to public health risks should comfort people, regardless of any recent lapses at high security labs. Those lapses are unrelated to the current coordinated effort.

I have been reporting on health scares since the anthrax mailings in 2001. I remember a time when outbreaks of deadly viruses or bacteria were handled even less responsibly by the media then they are now. In those days a hyperventilating media teamed up with hysterical officials to scare the public silly.

In 2005, one public health official announced, in a debate with me, that he was so afraid of bird flu mutating to kill humans on a mass scale that he couldn’t sleep at night.

I am refraining from Googling him to see what he is saying about Ebola or whether he’s sleeping now.