Rabid Opposition to Ebola: Epidemiology Meets Hyperbole


mentalfloss
#1
I wanted to make a separate thread for this because it seems that people (and the media) are exaggerating the severity of this situation and we need a shot of context.



Rabid Opposition to Ebola: Epidemiology Meets Hyperbole

To be quite blunt about it, Ebola is a very scary disease. Among those infected, the mortality rate is, as is perhaps now widely known, an appallingly high 90 percent. That would seem a very good reason to keep our borders closed to this scourge- and the consequences to the poor souls who already have it be damned. That, apparently, was just the kind of thinking behind at least one rather high-profile tweet.

But perhaps we might characterize this thinking as the subjugation of epidemiology to hyperbole. And like all rabid opposition, it is the product of anxiety rather than analysis.

And speaking of rabies, that is a virus already well established here in the U.S. with a case fatality rate of either 100 percent, or something very close to it. In other words, rabies is a more lethal virus even than Ebola. Yet we don't live our lives in fear of rabies for an obvious reason: we are very unlikely to get it. Rabies is not the common cold; a sneeze is not going to transmit it.

The transmission of rabies almost always involves the bite of an infected animal. Most human cases involve dog bites, not because there is much rabies in dogs -- but because humans are more likely to come into contact with infected dogs than the species in which rabies is more prevalent, including raccoons, skunks, bats, and foxes.

But let's move on, because my aim here is not to wade into rabies esoterica but to make a general point. Rabies is a horrendously bad disease, but we don't live in fear of it because we take some basic precautions, like vaccinating our pets, and know we are unlikely to get it. We do not deport those rare individuals infected with it to some foreign land in the name of homeland security; we treat them here. And, to my knowledge, even Donald Trump has not called for the deportation of our raccoons.

The Ebola virus is nearly as lethal, and thus nearly as scary, as rabies. Like rabies, it is rather hard to catch. Direct contact with infected body fluids is required. There is, to date, no known case of respiratory transmission -- meaning Ebola is not spread by coughing or sneezing. Conceivably, the virus could evolve so that changes; but in theory, the same is true of rabies. Fear of an Ebola outbreak in the U.S. is only justified among those who avoid the woods for fear that a skunk might sneeze.

What makes Ebola such a devastating disease in Africa is the lack of medical facilities to contain it. When family members in remote villages tend to one another, there is -- of course -- routine and rather copious exposure to infected body fluids, including blood. This is the very thing the gloves and gowns in routine use in every hospital in the U.S. are intended to prevent. When isolation precautions are taken, the degree of personal protection is considerably greater still. When need be, we have recourse to even more extreme forms of quarantine. Tuberculosis patients, for instance, can be treated in negative pressure rooms that preclude the release of any potentially infected air droplet.

To my knowledge, there are no negative pressure rooms in Sierra Leone. More importantly, there are few modern medical resources of any kind. Ebola spreads, as it is doing now in West Africa, when unprotected family and village members do the best they can to care for one another without recourse to gloves, gowns, masks, or perhaps even clean water. It is neither feasible nor reasonable to bring every Ebola-infected person to the U.S. for treatment in a state-of-the-art facility, but if it were, the current outbreak would come quickly to an end. There would be some risk of infection among the health care professionals directly involved, but that has always been one of our occupational hazards, and the risk is very, very small with suitable precautions. There would be no risk to anyone else.

So there is certainly no basis for either fear of, or opposition to, the on-going treatment of an infected American doctor in Atlanta. We may instead all be thankful that in return for the courageous service he was providing in Liberia, Dr. Brantly is now receiving an American standard of medical care himself.

Perhaps the exaggerated fear of Ebola is in part due to the vanishingly remote likelihood of an outbreak here in the U.S., and the fact that there has never been one. When it comes to risks, familiarity does seem to breed contempt. We Americans routinely dismiss, for instance, the perils of eating badly or want of exercise -- which will be the leading causes of premature death among us. We are dismissive about the threat of flu as well, because the virus is familiar. Our perceptions often distort risk, hyperbolizing the exotic and trivializing the mundane. As Jared Diamond pointed out, there is considerable risk involved in taking a shower -- to say nothing of crossing a busy street.

If we were at all rational about health risks, we should certainly consider closing our borders to tobacco. We would close them to soft drinks as well if a considered assessment of net harm were the basis for our actions. And maybe we would even do something to stave the trade of high-capacity, semi-automatic weapons.

Exhortations about the risks of Ebola in the U.S. are not the product of rational assessment. They are the product of excitement and exaggeration, and fear of the exotic. They are born of hyperbole, not epidemiology. They represent opposition of the rabid, knee-jerk variety.

If you don't avoid the woods for fear that a fox might cough, we have no basis to deny any small contingent of Ebola-infected Americans an American standard of care. An effort is under way to approximate those standards in West Africa, and I'm sure we are all hoping for its prompt success. The brave participants should be secure in the knowledge that while most of their countrymen might be disinclined to join them over there, we won't be over here clamoring to close the border to them.

The current Ebola outbreak, bad as it is, will come under control. In the interim, we should all keep calm and carry on rendering the best care we can to those among us who bravely confronted risks abroad from which we are, thankfully, reliably defended here at home.

-fin

David L. Katz, MD, MPH, FACPM, FACP is the founding director of Yale University's Prevention Research Center. A specialist in Internal Medicine and Preventive Medicine/Public Health, he has co-authored 4 editions of a leading epidemiology textbook.


Rabid Opposition to Ebola: Epidemiology Meets HyperboleÂ*|Â*David Katz, M.D. (external - login to view)
 
Twila
#2
Ebola is NOT hard to catch. Ebola isn’t as contagious as a colds. It spreads to people by contact with the skin or bodily fluids of an infected person or animal. Then it moves from person to person the same way. Those who care for a sick person or bury someone who has died from the disease often get it.

However, unlike a cold bug that can be killed easily sanitization the ebola virus is not killed so easily and can live longer on surfaces then the cold or influenze virus. This is what makes it much more dangerous then rabies. Because a rabid dog coughing on you or a table will not spread rabies. A person infected with ebola can spread the disease even after they die or if they cough, sneeze, or bleed.

I think it's worth being overly cautious about.
 
mentalfloss
#3
Nah.

The numbers speak for themselves on how overblown the hype is.
 
Twila
#4
Quote: Originally Posted by mentalflossView Post

Nah.

The numbers speak for themselves on how overblown the hype is.

Not overblown. A warning. A signal that preparation not repair would be wise.
 
mentalfloss
#5
Quote: Originally Posted by TwilaView Post

Not overblown. A warning. A signal that preparation not repair would be wise.

WHO is declaring it an international crisis.

It's overblown.

Consider that less than 2000 people have been infected in a region of 10 million.

And the main reason it exists at all is because that region didn't invest in the necessary facilities to contain it, but most other places can.

This cannot, and will not, be anywhere near H1N1.
Last edited by mentalfloss; Aug 8th, 2014 at 07:52 AM..
 
Twila
#6
Quote: Originally Posted by mentalflossView Post

WHO is declaring it an international crisis.

It's overblown.

Consider that less than 2000 people have been infected in a region of 10 million.

And the main reason it exists at all is because that region didn't invest in the necessary facilities to contain it, but most other places can.

This cannot, and will not, be anywhere near H1N1.

I agree with you on this. It's horrific. It has the potential to be catastrophic should we be stupid and not contain it. OR it mutates.
 
gore0bsessed
#7
Quote: Originally Posted by TwilaView Post

Not overblown. A warning. A signal that preparation not repair would be wise.

I think a lot of why it's spreading the way it has is lack of education. Everyone is going crazy thinking the people helping them are actually infecting them, and they're running spreading the disease with them. It's difficult to contain in that case, because the people infected need to be quarantined.
 
IdRatherBeSkiing
#8
I agree that the current strain of Ebola is not a crisis. It's a poor virus as it kills its host at a high rate and quickly and does not spread via air. Now should any of that change, then it would be a crisis.
 
gore0bsessed
#9
The current strain is the deadliest we know of Ebola.... It honestly doesn't matter how quickly it kills as long as there are plentiful hosts around for it to invade. I mean when a person dies and people take the body and bury it, they then infect themselves and that cycle continues until education intervenes.
 
Twila
#10
Quote: Originally Posted by gore0bsessedView Post

The current strain is the deadliest we know of Ebola.... It honestly doesn't matter how quickly it kills as long as there are plentiful hosts around for it to invade. I mean when a person dies and people take the body and bury it, they then infect themselves and that cycle continues until education intervenes.

And since the virus doesn't die when a host dies...or when left in the air...it can survive for a long time. That's what makes it scary.
 
gore0bsessed
#11
Here's a video of an ebola patient being transported off a plane in Spain

Video First Ebola victim arrives in Spain under tight security - YouTube

 
Twila
#12
Quote: Originally Posted by gore0bsessedView Post

Here's a video of an ebola patient being transported off a plane in Spain

Video First Ebola victim arrives in Spain under tight security - YouTube

wow. Those are some pretty serious hazmat suits they're wearing...
 
Locutus
#13
yup. there's nothing to see here. go about your business citizen.
 
IdRatherBeSkiing
#14
Quote: Originally Posted by LocutusView Post

yup. there's nothing to see here. go about your business citizen.

Looks like a typical Air Canada exit to me.
 
Locutus
#15
Quote: Originally Posted by IdRatherBeSkiingView Post

Looks like a typical Air Canada exit to me.


and many of the *ahem* 'meat' departments in our strip mall 'grocery' stores.
 
mentalfloss
#16
Ebola overreaction will do more harm than good - experts - Vanguard News (external - login to view)

Yet virologists believe the virus that causes Ebola poses little threat of a global pandemic as it doesn’t spread easily and can be easily killed with water and soap.
It much less infectious than influenza and less deadly than malaria.

- ‘Irrational fear counter-productive’ -

Irrational fear can only hamper efforts to curtail it, say the experts, and education is key.

There have been reports of scared relatives removing ill family members from hospital — putting themselves and others at risk of catching the virus, and of villagers barring access to health workers they suspect of making people sick.

Fear has also raised its head in the West, like American business magnate and television personality Donald Trump arguing that a doctor who contracted the virus while helping patients in West Africa should be barred from returning to US soil.
 
darkbeaver
#17
Quote: Originally Posted by mentalflossView Post

Nah.

The numbers speak for themselves on how overblown the hype is.

They said the same thing about the Black Death, relax get your garlic and your cross, the best medical advisors of the time said over and over till they were dead.

Quote: Originally Posted by mentalflossView Post

Ebola overreaction will do more harm than good - experts - Vanguard News (external - login to view)

Yet virologists believe the virus that causes Ebola poses little threat of a global pandemic as it doesn’t spread easily and can be easily killed with water and soap.
It much less infectious than influenza and less deadly than malaria.

- ‘Irrational fear counter-productive’ -

Irrational fear can only hamper efforts to curtail it, say the experts, and education is key.

There have been reports of scared relatives removing ill family members from hospital — putting themselves and others at risk of catching the virus, and of villagers barring access to health workers they suspect of making people sick.

Fear has also raised its head in the West, like American business magnate and television personality Donald Trump arguing that a doctor who contracted the virus while helping patients in West Africa should be barred from returning to US soil.

I hardly think they would have spent millions developing an infectious agent which would succumb to soap and water, do you?
 
mentalfloss
#18
Quote: Originally Posted by darkbeaverView Post

They said the same thing about the Black Death, relax get your garlic and your cross, the best medical advisors of the time said over and over till they were dead.

This is no worse than H1N1.
 
darkbeaver
#19
Quote: Originally Posted by mentalflossView Post

This is no worse than H1N1.

That information is brought to you by the same disgraceful press that convinced millions to tolerate sixty continuous years of war for peace.

Quote: Originally Posted by mentalflossView Post

- ‘Irrational fear counter-productive’ -

Irrational fear can only hamper efforts to curtail it, say the experts, and education is key.

Unless irrational fear was the intended product.
 
Twila
#20
Quote: Originally Posted by mentalflossView Post

Ebola overreaction will do more harm than good - experts - Vanguard News (external - login to view)

Yet virologists believe the virus that causes Ebola poses little threat of a global pandemic as it doesn’t spread easily and can be easily killed with water and soap.
It much less infectious than influenza and less deadly than malaria.

There is definately contrary information being spread. I've heard on the radio that is is NOT easily killed with soap and water.

Makes one nervous to think there is no correct and easily accessible information.
 
mentalfloss
#21
I think that article meant before infection.
 
Twila
#22
Quote: Originally Posted by mentalflossView Post

I think that article meant before infection.

yes, I understood it to mean that. But I'd heard that washing your hands with soap and water is not going to kill the virus if it were on your skin. The reporter had been speaking with a nurse who'd said that disinfection was difficult because the virus was not easily killed.
 
mentalfloss
#23
Ebola Outbreak Preventable Through Proper Hygiene, Washing with Soap & Water; Spanish Priest Confirmed to Have Virus - International Business Times (external - login to view)

The world is now going fearful over the spread of the deadly Ebola virus among four west African nations, plus two Americans and now one Spanish priest. But while this year's outbreak is its worst, experts highlighted passing on the virus from one person to another is highly preventable through the time and tested soap and water solution.
 
Locutus
#24
brilliant.
 

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