Here’s what I’m doing to protect my family

Reposted from Violent Metaphors – Jennifer Raff —  October 23, 2014

We Americans sometimes seem to have only two settings when it comes to public health issues;  “unconcern” and “panic”. (I think the media deserves a great deal of blame for this, but that’s another blog post).  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 forty three 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, don’t seem to make much of a dent in the fearmongering 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.

So given the fact that I live so close to the “Ebola hospital” (just two hours!) I thought I’d share with my readers what 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 influenzais a far bigger threat to our health than Ebola.

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 has 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 these trifling details don’t deter people like Alex Jones from crazed melding of fiction and real life:

Alex Jones is, of course, an extreme example. But truthfully, how are we influenced by our entertainment? 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 Belizebecause 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 policy of rejecting applicants from Nigeria, despite the fact that there have been no new cases in that country since September 8th.

And idiotic conspiracy theories are rampant, as well as quack remedies, and bizzare warnings of ‘psy ops’ about competitors’ quack treatments. (This could make an entire post by itself.)

But the simple truth is that Ebola actually isn’t particularly easy to catch. From the CDC:

From http://www.cdc.gov/vhf/ebola/pdf/infographic.pdf

You can read additional reputable 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.

So how should a reasonable person think about this?

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 fearmongering. 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.


Why the Texas case will not cause an ebola outbreak

I’ve scanned about 500 blog posts tagged #ebola since August 2014 and I can say with confidence that there are a lot of paranoid uninformed Americans out there. These fears are founded on misinformation and suspicion of the system designed to protect the public, not on facts. Here are the facts about yesterday’s case:

The system worked as it should

  • The Ebola carrier left Monrovia, Liberia (Sep 19) without symptoms and arrived in Dallas, Texas (Sep 20) without symptoms. His temperature was taken in both airports and did not indicate a fever.
  • Fever is one of the early symptoms of ebola. If a patient has no fever, he cannot spread ebola.
  • The carrier visited a hospital on Sep 24 with symptoms. This hospital was prepared for ebola, had briefed its staff, and had an isolation ward ready. Because the symptoms were run-of-the-mill flu stuff (no hemmoragic fever), he was sent home.
  • His family brought him back on Sunday, Sep 28 and he was admitted. His blood tested positive for the ebola virus. PCR is a very precise test. Only a 99% exact DNA match will test positive.
  • All people who contacted him during the days he was contagious are being monitored for symptoms. It only included his direct household relatives.

Ebola can only be spread through direct contact. Ebola does not spread through the air. So the only people who could be exposed are known and being monitored.

Why USA is different from Liberia

  • Access to healthcare is much better in America. There is one doctor for every 400 Americans, compared to one doctor for every 20,000 Liberians.
  • Every hospital bed in Liberia has been filled for weeks. Sick Liberians are not likely to visit a hospital anymore, and so the virus spreads faster there. For how the number of beds affects models to count the number of cases and predict disease spread, look at this academic paper. “By September 30, 2014, without additional interventions and using the described likelihood of going to an ETU, approximately 670 daily beds in use (1,700 corrected for underreporting) will be needed in Liberia and Sierra Leone (Figure 2).” There are an estimated 2.5 ebola sufferers for every one that got a hospital bed in September, 2014.
  • Obamacare has reversed the trend of making hospitals only available to the rich and the employed. At the moment, every seriously sick American (citizen or not) will go to a hospital for treatment, making quarantine possible. If large segments of society expect to be turned away from hospitals, denied treatment, they will stop coming, and ebola WILL spread in America.

Here is the CSPAN briefing about the Ebola case in Texas from September 30th: