By Alice G. Walton
(Photo credit: Wikipedia)
The Ebola situation in West Africa is clearly not good. The death toll is rising, and people continue to become infected. Global efforts to contain the outbreak and care for patients are ramping up somewhat, as help from other nations, finally, steps in.
In the last couple of days, however, Ebola-related fears, at least in the U.S. and Europe, seem also to have risen significantly. Planes have been delayed; healthcare workers in Spain have walked out; airplane cleaners at New York’s La Guardia Airport have gone on strike; and the among many fear-inducing headlines, some have advertised CDC director Thomas Frieden’s likening Ebola to the next AIDS. What’s more, many Americans apparently believe that grounding flights from West Africa is prudent.
But the reality is that for people in America and other places outside of West Africa, the risk is still quite low. Caution is important, obviously, and airports and hospitals are taking measures to screen people and protect the public. The real issue is a different one: Our fear of Ebola has become many times worse than the problem.
“The ultimate risk to America is very, very, very small,” says Ashish K. Jha, MD, MPH, K. T. Li Professor of International Health and Health Policy Harvard School of Public Health and Director of the Harvard Global Health Institute.
“I understand the fear. It’s a deadly disease. That Mr. Duncan died in a Dallas hospital made it that much more dramatic. Even though it doesn’t spread easily, not remotely as easily as the flu, it’s scary. But to me the real issue is that the growth of the disease continues in West Africa—it’s worse today than it was last week. To the extent that it doesn’t get stamped out, it will continue to pose risk to the rest of the world. But aside from the horrendous tragedy in West Africa, we’ll continue to see Ebola patients just once in a while here in the U.S.”
He adds that our energies are largely misdirected: “In an ideal world, you’d see—instead of fear—a resolve to stamp it out of West Africa.”
But we’re mainly just in the fear stage. The reality is that the U.S. won’t see any big outbreaks. “We’ll see ongoing cases like one in Dallas from time to time. ERs are on high alert. Worst-case scenario, we’ll get a dozen or two Ebola cases—not thousands. We have the infrastructure to deal with it.”
The obvious question is whether hospitals in the U.S. are prepared. “They’re all on high alert,” says Jha. “If you walk in tonight, and say, ‘I was in Liberia last week and have symptoms,’ they would immediately isolate and assess. If you’re positive, you go into the isolation ward. You would probably get an experimental treatment. I don’t quite understand what happened in Dallas. My sense is if you got sick tonight, that within 24-48 hours, you’d be given experimental drugs, or get transfusions from someone who’s had the virus.”
As far as reducing the likelihood of more cases coming into the U.S., restricting flights from West Africa will likely only worsen the situation. Frieden himself released a statement yesterday laying out exactly why banning flights would be misguided and, in the end, counterproductive. “Importantly,” he writes, “isolating countries won’t keep Ebola contained and away from American shores.
Paradoxically, it will increase the risk that Ebola will spread in those countries and to other countries, and that we will have more patients who develop Ebola in the U.S.”
Jha agrees. “Banning flights is a really good idea if you don’t actually think about it! It would mean you’d also have to ban all flights coming through Europe. It’s completely ridiculous, and there’s zero advantage. The bottom line is you can’t isolate a country, a continent. Anything that makes it harder to fight infection in West Africa makes Americans worse off. For sake of the U.S. public, there’s absolutely no value.”
To this end, Brussels Airlines has said it will not limit service to Sierra Leone, Guinea, or Liberia. As the airline’s vice president Geert Sciot told TIME: “It is our humanitarian duty to operate there. Without our flights it would become almost impossible for medical staff to reach the country.” New York’s JFK Airport has just begun a separate screening process for people coming in to the U.S. from the countries with highest Ebola incidence, and other airports will follow suit.
The outbreak in West Africa is obviously critical and will take time to manage. But here in the U.S., panicking at every headline is not the answer. Since that’s easier said than done, though, perhaps the media should use a little discretion when covering Ebola.
“The problem is that every timesomeone has fever and has been in Africa, the media are reporting it,” says Jha. “People are getting excellent assessment care here; that’s actually good. I’d rather have a thousand false positives than to miss one real case. The problem is the media: Every fever patient becomes a message of, “Oh my God, suspected Ebola case!’ The narrative in the media then becomes, ‘This Is Everywhere!’” And that’s, unfortunately, what the majority of the headlines reflect.
Jha points out that even when possible Ebola cases are mentioned in the press, putting them in context is critical—that is, underlining that real risk is still quite low, and that much of the hoopla about each suspected case is for the sake of erring on the side of caution.
Another reason to keep our wits about us: “We’re coming into flu season,” says Jha. “Is every flu patient going to be a possible Ebola case? If so, it’s going to be a nightmare. At some point we’ll reach saturation. But right now, we just need to take a deep breath.”
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