EbolaEbola discussion in U.S. driven by fear, not science: Infectious disease experts

A significant part of the Ebola debate in the United States has been driven by fear, not science, according to infectious disease experts. Dr. Anthony Fauci has spent thirty years as the director of the National Institute of Allergy and Infectious Diseases. He has experienced the AIDS outbreak of the 1980s, and the post-9/11 anthrax scare, but when it comes to Ebola, “This one’s got a special flavor of fear,” Fauci said at the Washington Ideas Forum, sponsored by the Atlantic magazine and the Aspen Institute.

Most of the fear around Ebola is driven by the growing death toll in Guinea, Sierra Leone, and Liberia, despite assurances from medical experts that the United States is unlikely to suffer a widespread outbreak. James Colgrove, a public health professor at Columbia University, and Pamela Cipriano, president of the American Nurses Association, both agree that the chances of an outbreak in the United States are extremely remote. “What we know right now would suggest that there is no risk of an epidemic,” Cipriano said.

Current control measures set in place include enhanced screenings of West African travelers, which allow U.S. health officials to “very quickly identify and sequester and evaluate and care for anyone who shows any type of risk,” Cipriano said. “That’s a very high level of control.” Health officials point out that despite the transmission of the Ebola virus from patient Thomas Eric Duncan to two nurses at Texas Health Presbyterian Hospital in Dallas, U.S. hospitals are prepared to deal with Ebola. The Alaska Dispatch News points out that out of seventy-plus healthcare workers and forty-eight family and community members who interacted with Duncan, only two nurses became infected.

Yet, the general public continues to be fearful of an Ebola outbreak in the United States. Some states have imposed mandatory quarantines for all healthcare workers returning from Ebola-stricken West Africa, even if they show no symptoms. “The fear is trumping science,” said Dr. Georges Benjamin, executive director of the American Public Health Association. Fauci suggests that lawmakers are simply responding to the concerns of their citizens. “You have to respect the fear of people,” he said. “You can’t denigrate it and say, ‘Why are you afraid?’ You’ve got to try and explain to them and you’ve got to do it over and over. … It’s just that as a health person, as a physician and a scientist, I would say you look at the data, and it tells you what the risk is.”

Public health officials also bear the blame for the public’s extreme concern about Ebola. Tom Frieden, director of the U.S. Centers for Disease Control and Prevention, initially said U.S. hospitals were ready to care for Ebola patients, when many in fact were not. “Some of the missteps have eroded some of the trust that the public has had,” said Cipriano. “I think that it certainly has added to the sense of, ‘Well, who do we trust?’ ”

Colgrove recommends that when dealing with public concern about an infectious disease, “You want people to be worried enough that they give you the resources that you need to do the job, but you don’t want them to be so worried that they do stupid things. It’s a very, very delicate balance that he has to walk. That any public health official has to walk.”