When Thomas Duncan, a Liberian man who lived in Texas, was diagnosed with the Ebola virus, the reaction in the community and the press was strong, surprisingly strong. I had anticipated fear when a case came to the US (something that was nearly inevitable), but not this level of fear.
Even as I write this, the headline story on the Drudgereport is Ebola is ‘disaster of our generation’ says aid agency. There are countless stories discussing every step Mr. Duncan took and the thousands of people he might have come in contact with. Unfortunately, Mr. Duncan died of Ebola. The news would have ended there except that two of his nurses have since contracted the virus. With fresh fervor, the hysteria reasserts itself.
This fear is out of proportion to the danger. It is no surprise that a patient gets Ebola and some of his caregivers get it. certainly there were serious failures of the health care system in this case, but if the total price we pay for those mistakes is only two infections, then we should feel fortunate. After puzzling over this for some time, I think there are a few explanations for this deep fear we feel as Ebola walked onto our shores.
1. We Overestimate Dramatic Deaths and Underestimate Boring Ones
Humans are terrible at estimating danger. We fear snakes when mosquitos kill a million people every year. We are afraid of bears when white-tail deer kill about 130 people a year. We fear flying when about 1.24 million people are killed in car accidents every year worldwide. We fear Ebola, which has killed about 5,000 people so far and yet ignore influenza which kills about 250,000 to 500,000 every year.
Ebola is definitely the diva of the deadly viruses. Symptoms such as vomiting blood, uncontrollable fever and shaking, terrible diarrhea, and bleeding from the eyes and ears make it a virus out of a zombie movie. If drama makes for great news coverage, then Ebola makes great coverage.
2. We Fear that Ebola will Spread in the US like it does in West Africa
One good watching of the movie Outbreak would make me fear Ebola too. While Ebola is not the virus in the movie, it is clearly based on Ebola. Dustin Hoffman is telling us to close the US border, right?
The fact is that Ebola is not as contagious as advertised. The lengths we are going through to establish Ebola as an airborne threat indicate how difficult it has been to show Ebola spreading through the air. But it does not spread like influenza or a cold virus.
Close physical contact accounts for most if not all of Ebola spread. Think of who got Ebola from Thomas Duncan, it was two nurses who had, you guessed it, close contact with Mr. Duncan. To worry that it is spread by casual contact is to borrow trouble. Certainly it is possible, but it doesn’t seem to be happening. If you are a nurse caring for an Ebola patient, an abundance of caution is justified. If you are a member of the general public in the US, any fear you have of getting Ebola is unwarranted. You should be more concerned about white-tail deer.
3. We Fear the Unknown
Ebola is very other. It is foreign to us: far-away. Ebola epitomizes the dangerous jungle illness that has never been seen on our shores. This frightens us.
Now that Ebola is here, among us. We’re not sure what to do. There is this feeling that we shouldn’t have to face this. It ought to be someone else’s problem. The fear of this unknown drives us to feel silly things like that we should be immune or protected from it simply because we are here and it should stay over there.
While understandable, the only cure for fear of the unknown is to get to know it. Knowing Ebola doesn’t cause panic, but like anything dangerous, we learn to treat it with respect. Far from being unknowable, Ebola can be known. We just need to take the time to learn.
4. It is an Election Year
Ebola has a great marketing plan going. It chose to arrive in America in the months leading up to a Federal election. There are countless candidates looking for a stage to be heard from. There are very few stages more popular than one that pretends to protect the public from a dangerous disease.
Playing on our fears to get our attention, many have blamed the Obama administration not primarily because they care about public health, but because blaming the administration is what one does to the opposition party in October.
This is understandable, but very frustrating when it aggravates some of our most uninformed fears. What galls me the most is that it is working? Certainly the CDC and the hospitals involved should have done a better job, a much better job. But by reading the headlines you would have thought hundreds or thousands had Ebola in the US, not just three.
5. There is a Deep Distrust of the Health Care Establishment and Politicians
There is a deep and growing distrust of the health care establishment and of politicians. After years of wondering if cancer treatments really help, if vaccines are safe, should we really have antibiotics in our meat, and asking just when they figured out that this drug has a tragic side effect, the casual observer has a general distrust of the health care establishment.
It is worsened when Dr. Friedman, the head of the CDC, represents both politicians and medicine. It is further aggravated when he does the tried and true political process of providing the same talking points answers no matter what the question is. We feel manipulated because we are being manipulated.
But just because he is playing politics does not mean he is wrong. I wish he would give the straight answers to the questions. No, he should not be fired. Yes, the CDC was too slow. No, closing the US border to West Africans would not help. Yes, America is safe from a large outbreak of Ebola. Maybe the political environment makes such straight answers impossible, but I wish he would give them.
To Love People, We Need to Calm Down
Most of the fear we are experiencing over Ebola is not justified. We are reacting to our own anxieties and prejudices and not to the situation we are in. Ebola is not a serious threat to public health in the U.S. Heart disease is, but it lacks the drama that Ebola brings to the table.
The fear we experience is preventing us from considering carefully how we should proceed. There is a chorus of voices demanding that people from West Africa be prevented from entering the US. This might prevent some US cases of Ebola and it would certainly sentence tens of thousands to millions of West Africans to die. Ebola has been successfully contained throughout Africa for decades and even recently the outbreaks in Senegal and Nigeria have not had a new case in weeks.
The fear of Ebola is causing people to demand that health care workers who have cared for Ebola patients be quarantined for 21 days. This sounds like a grand plan unless you are the health care worker who has bills to pay and a life to live. By placing this artificial requirement, you make it very difficult for nurses to provide care for these patient. It does not protect the public and it is a bandaid political solution to a non-problem.
We need to accept that some people in the US will get Ebola. Some of them will even be cute ladies with dogs. Some might even be nice people we would like. Ebola will be spread to a few in America and it will stop there.
The same cannot be said for West Africa. If you are there you should be afraid. You should be cautious in public places. They face the prospect of living through Ebola and starving in the famine that is coming. They are dealing with homes where mom and dad have died and children are left to survive on their own. We should see through the blindness of our fear and have compassion on these people. They are in danger and we are not.
The Image Above is courtesy of Jason Scragz and used with permission.