We Might Be Over Ebola, But Ebola Isn’t Over

ebola-graph

Eric Posner offers the above chart as evidence that the furore over Ebola is dying down. But risk-communication experts Jody Lanard and Peter Sandman fear that Americans underestimate the still-serious risk of the outbreak reaching pandemic proportions in the developing world:

The two of us are far less worried about sparks landing in Chicago or London than in Mumbai or Karachi. We wish Dallas had served as a teachable moment for what may be looming elsewhere in the world, instead of inspiring knee-jerk over-reassurance theater about our domestic ability to extinguish whatever Ebola sparks come our way. We are glad that Dallas at least led to improvements in CDC guidelines for personal protective equipment and contact tracing, and belatedly jump-started front-line medical and community planning and training. But it doesn’t seem to have sparked the broader concern that is so vitally needed.

Americans are having a failure of imagination – failing to imagine that the most serious Ebola threat to our country is not in Dallas, not in our country, not even on our borders. It is on the borders of other countries that lack our ability to extinguish sparks.

Maryn McKenna seconds that:

Being someone who has a professional specialty of covering epidemics (HIV, the anthrax attacks, SARS, H5N1, H1N1, lots of smaller outbreaks), I reluctantly have to conclude: Lanard and Sandman are not being alarmist here.

Imagine that Ebola cannot be contained; think back to the events of this weekend; and then imagine that reaction multiplied thousands of times. It isn’t a big leap to the suspicion, disruption and expense that will then be triggered in response to any travelers from the region. From there, it isn’t much of a further leap to closed borders, curbs on international movement, disruption in global trade, cuts in productivity, even civil unrest and the opportunities that unrest offers to extremist movements. None of that is far-fetched, if Ebola is not controlled.

Michele Barry reflects on the systemic failures that allowed the outbreak to spiral out of control. From her perspective, “the solution to this Ebola crisis is not drugs, mass quarantine, vaccines, or even airdrops of personal protective gear”:

The real reasons this outbreak has turned into an epidemic are weak health systems and lack of workforce; any real solution needs to address these structural issues. When one physician or nurse is caring for forty to fifty patients, mistakes happen. WHO’s legally binding International Health Regulations (2005) requires wealthier countries to mobilize financial and technical support to help contain an outbreak such as Ebola, for which the Director General has called an international public health emergency.

Yet workforce scale-up has been disturbingly slow. NGOs like Médicins Sans Frontières were not equipped to deal with Ebola, and have been overwhelmed by the outbreak. Workforce volunteers for these NGOs have been slow to mobilize and fearful US hospitals have set up barriers by insisting that their employees taking unpaid leave or vacation time and then return to mandatory 21-day quarantines, often without pay.

But the governor of New York, for his part, has pledged to compensate any lost pay. Perhaps the federal government should step in with actual financial incentives – cash money – to encourage health workers still on the fence to head to West Africa.