We Americans sometimes seem to have only two settings when it comes to public health issues: "unconcern" and "panic." (I think the media deserve a great deal of blame for this.) The last few weeks have seen the switch flipped to near-panic about Ebola after the recent infection of two Texas Health Presbyterian nurses who were treating infected patient Thomas Eric Duncan and possible exposure of additional people after one of the nurses took a commercial flight. The fact that 43 individuals who had direct contact with Mr. Duncan have now passed the 21-day incubation period for the disease without signs of infection, that Senegal has been declared free from Ebola (no new infections have occurred there for 42 days), that Nigeria is close to the same milestone, and that the two nurses who treated Mr. Duncan, Amber Vinson and Nina Pham, are doing much better, doesn't seem to make much of a dent in the fear-mongering I've seen in recent weeks.
And now with the report that a physician with Doctors Without Borders, who recently returned to his home in New York City from West Africa, has tested positive without Ebola, the "Ebola panic" is just going to get worse.
Given the fact that I live so close to Dallas (just two hours!), I've been getting a lot of questions from friends and readers about whether I'm nervous about Ebola. So here are the precautions I'm taking to protect my family's health:
1. I've gotten a flu shot (and encouraging my friends and family to do the same), because influenza is a far bigger threat to our health than Ebola, and the vaccine is a safe and effective way of protecting myself and my family.
2. I am donating to Doctors Without Borders, because the crisis is in West Africa and it's critical that we stop it there. Those brave physicians and nurses are on the front lines of the battle against Ebola, and they need our support. Strangely, while stopping the outbreaks in West Africa is absolutely crucial, there's almost no public charitable response to this crisis, in contrast to the many campaigns we see after natural disasters. I just came across #tackleEbola on Twitter, and that seems to be another good effort. I hope it takes off.
3. I am calling out misinformation that's being spread to provoke a panic response. One of the reasons why we're so excited by this particular infectious disease despite the fact that it is FAR FROM the most dangerous threat to our health is because the media have stoked fears of it, with sensationalistic coverage, and we citizens have allowed ourselves to be entertained (yes, entertained!) by epidemics. Remember "The Hot Zone"? "Outbreak"? Any zombie movie, ever? Turns out they're scientifically inaccurate, but they unfortunately influence the way we think about infectious diseases. We love a good "outbreak" story -- they're deliciously scary. But this is the real world, and there are consequences when we allow our fantasies to inform our decision making. Epidemics are not entertainment, and treating them as such, ironically, allows them to get much worse.
Furthermore, the panic that we are indulging in has hurt many people unnecessarily. Schools in Texas and Ohio have closed. A cruise ship was sent back home to the United States from Belize because it was carrying a Texas hospital lab worker (the worker was following CDC protocol and 19 days had passed since any possible exposure; she posed no credible danger to her shipmates). Despite health experts' recommendations politicians and the majority of the public favor a travel ban from West Africa. A Texas college has a new policy of rejecting applicants from Nigeria, despite the fact that there have been no new cases in that country since Sept. 8.
And idiotic conspiracy theories are rampant, as well as quack remedies. Instead of that nonsense, I urge you to read reputable, scientifically accurate information about Ebola here, and from Doctors Without Borders. Despite irresponsible rumors to the contrary, Ebola isn't airborne, nor is it likely to become airborne in the future through mutation. If you're not taking care of an infected person, you're extremely unlikely to contract it. The simple truth is that Ebola, compared to the flu or measles, actually isn't particularly easy to catch, and you are in far more danger from the "familiar" infectious diseases.
So how should a reasonable person think about this? Keeping things in perspective will help you avoid fear:
It is absolutely appropriate to criticize the CDC and Texas Health Presbyterian for their initial mishandling of the first infections. But there is a difference between criticism and fear-mongering. I have spoken with a Texas physician who was extremely critical of Texas Health Presbyterian, but told me that physicians' and nurses' training has drastically changed in recent weeks to include live simulations, supervisors, and other critical measures. He feels a lot more confident that their hospitals will be able to competently handle any cases, and was convinced that this wouldn't have happened had they not learned from their earlier experiences. I hope that this is true nation-wide.
I think we should be mindful of how our popular media has influenced us and alert to the possibility of the press stoking our fears for attention. I think we need to think carefully about who constitutes a credible source of information here -- who are the experts? -- and listen to what they're saying, rather than conspiracy theorists seeking to profit from our fears.
By cutting through the hype and panic, by thinking critically about Ebola in the context of relative risks, we can make much more rational decisions to protect ourselves and our families.
You can read a longer version of this post and join in a discussion on the author's blog.