Tag: Ebola

Derek Thompson blames the media for overhyping – and thereby exacerbating – Ebola panic in the US:

For the last two weeks, the American Ebola panic has been relentlessly overstated. When Gallup asked Americans if they were worried about contracting the Ebola virus, just 23 percent said yes in a October 11-12 poll, days after Thomas Duncan was the first person to die in America from the disease. That was up just one percentage point (well within the margin of error) from a similar survey administered one week earlier. Just 16 percent told Gallup that they actually thought someone in their family would likely get the virus, up just two percentage points from a week earlier.

One in six people thinking they’re about to die from Ebola is a serious matter. But you can get about approximately 20 percent of Americans to say all sorts of crazy things in anonymous polls.

Waldman takes on another trope of Ebolisis – that in the words of Republican Congressman Tim Murphy, “we have to be right 100 percent of the time, and Ebola only has to get in once.” It’s the viral equivalent of the one percent doctrine:

The objection some now have to the federal government’s response is that it isn’t enough like our response to terrorism, which is to say it doesn’t reflect that 100 percent perspective. You can find that perspective in some places — for instance, today the New York Times reports on some of the reaction from people who are both terrified and ignorant, like the parents who kept their kids home from school because the principal had travelled to Zambia, where there has been no Ebola despite being in the very same continent as Liberia, Sierra Leone, and Guinea. So why not close all the schools? And while we’re at it, stop all flights in and out of Texas and post Army units at the highways on the state’s border with shoot-to-kill orders on anyone trying to leave? After all, Ebola only has to be right once.

All of this underscores Saletan’s point that when it comes to public health, giving the public what it wants is simply nuts:

Rep. Sam Johnson of Texas is introducing a travel ban in Congress because Obama “is refusing to listen to the American people.” Virginia lawmakers, citing the views of “the American people,” are calling for a ban on travel from West Africa to their state. Behind these initiatives, an army of conservative media outlets is quoting polls and trumpeting what “the American people want” and “the American people favor.”

On some issues, this kind of thinking is healthy. It’s democracy. But on matters of science and medicine, it’s reckless. The reason why public opinion on Ebola diverges sharply from what experts recommend, not just on a travel ban but on everyday behaviors to avoid the virus, is sheer ignorance. Telling health officials to listen to the public, rather than the other way around, is the worst kind of demagoguery.

With Marco Rubio preparing a bill to ban nationals of Liberia, Guinea and Sierra Leone from entering the US, and with vulnerable Dem candidates hopping on the Ebolanoia bandwagon, our political class appears to be warming more and more to an Ebola travel ban. (Ron Paul, at least, has called out such proposals as bad, politically motivated policy). So the point bears repeating that a travel ban is not as commonsensical as its supporters make it out to be. Julia Belluz and Steven Hoffman look back at past epidemics in which travel bans proved unhelpful, including the AIDS crisis:

After HIV/AIDS was discovered in 1984, governments around the world imposed entry, stay and residence restrictions on people with the disease. As one 2008 study notes: “Sixty-six of the 186 countries in the world for which data are available currently have some form of restriction in place.” In the US, the ban — instituted by President Ronald Reagan in 1987 — was only lifted when Obama came into office. But HIV/AIDS managed to spread anyway, reaching pandemic proportions by the 1990s. This 1989 review of HIV/AIDS travel restrictions found they were “ineffective, impractical, costly, harmful, and may be discriminatory.” Prevention of HIV worked better than travel restriction, the authors concluded.

And swine flu:

After the arrival of H1N1 swine flu in 2009, some countries imposed travel restrictions on flights going to and coming from Mexico, resulting in a 40 percent decrease in overall travel volume. A study looking at this event found it “only led to an average delay in the arrival of the infection in other countries (i.e. the first imported case) of less than three days.” So again, reduced travel delayed (by three days!) but didn’t stop disease spread. The authors wrote: “No containment was achieved by such restrictions and the virus was able to reach pandemic proportions in a short time.”

Another common argument against travel bans is that they would seriously harm relief efforts. Jonathan Cohn elaborates on this:

Experts, along with non-profits like Doctors Without Borders, say that they’d have a much harder time getting volunteers into the countries if those volunteers knew they could not easily return. Even with an explicit exception for aid workers, they say, the extra burden and uncertainty of having to get special clearance would dampen enthusiasm. Meanwhile, a U.S. travel ban would almost certainly cause other highly developed countries to follow, dramatically reducing the demand for flights and other transportation options to West Africa. Agencies already struggling to get supplies into the area would struggle even more.

Lots of people wonder, couldn’t the U.S. government just arrange other transportation—maybe a modern-day version of the 1948 Berlin airlift? I’ve put that question to a number of officials and experts and the answer I keep hearing is “no.” In the real world, they say, making these arrangements would be difficult and solutions would be inadequate. It’s not as if assistance is this highly organized campaign, with all the necessary aid workers and their supplies lined up at Dover Air Force base, just waiting for C-17s to take them across the Atlantic. The flow of people and wares into West Africa is a constantly changing, unpredictable blob that’s heavily dependent on freely available commercial transportation. Replacing that would take resources and time, the latter of which the region really doesn’t have.

After its fumbling of the Ebola outbreak, the public has rightly soured on the CDC:

A new CBS News poll shows just 37 percent of American rate the CDC as either excellent or good, while 60 percent rate it as fair or poor — a virtual mirror image of 17 months ago. The worst part: The agency now ranks below the Secret Service, which has dealt with a series of scandals in recent weeks and years. But the CDC is still slightly more popular than the IRS.

Morrissey isn’t surprised:

Back when I worked for a defense contractor in its technical publications department, one worker had a sign in her cubicle which accurately diagnoses the phenomenon in play here: “One aws**t cancels out a thousand attaboys.” It isn’t what the CDC did for the past ten years, but what they’re doing when the spotlight is on them that counts. In fact, the CDC’s performance over the past few weeks will have people questioning just how well they’ve done their job all along, and perhaps they should.

On the other hand, it’s possible that the public perception might be a little too harsh. One amazing aspect of this poll is that the CDC is only seven points up on the VA (30%) and only six over the IRS (31%). Both of those agencies have been embroiled in scandals that involve outright corruption, not just incompetence, and yet they’re almost within the margin of error with the CDC, which to this point is only considered to be well-meaning but failing.

Harold Pollack defends the agency:

Despite the CDC’s budget problems and its recent stumbles, it is a more effective, better-led organization than it was during the Bush years, when five out of six former agency directors publicly criticized the CDC’s managerial hijinks, low morale and lapses from scientific integrity. At that time, the CDC ranked 189th out of 222 federal agencies in workforce morale. It now ranks 49th out of 300 federal agencies on such measures. That’s a striking improvement.

“When the public health enterprise loses political standing,” he adds, “it may not be listened to when it most needs to be heard”:

Almost 40 years ago, the CDC suffered public humiliation when it was perceived as having bungled a massive vaccination campaign for a Swine Flu epidemic that didn’t materialize. Only a few years later, CDC officials tried to sound warnings about a mysterious new pathogen. They were shoved aside, often by government and medical officials who specifically cited the Swine Flu debacle. One unfortunate 1983 Red Cross memo, opposing aggressive measures to protect America’s blood supply, expressed the general mood: “CDC is likely to continue to play up AIDS,” because “CDC increasingly needs a major epidemic to justify its existence.”

Yesterday and today brought a few bits of good news:

According to the BBC, the Spanish nurse who was the first person to contract Ebola outside of West Africa has tested negative for the virus (a second test is required before she’ll be officially free of the disease). And the United States has reached an important milestone: the 21-day monitoring period for the 48 people who had contact with Thomas Eric Duncan, the Liberian man who died of Ebola in Dallas, ended on Sunday and Monday. Aside from the two nurses who cared for him, there have been no new infections.

Things are also looking up in Africa, where two countries have been declared Ebola-free:

On Friday, the World Health Organization announced that Senegal had completely contained the spread of the disease, and now on Monday Nigeria has joined them.

The ruling was made after determining that it has been six weeks without any new cases of the disease. The last reported case was on September 5. Seven Nigerians died of the disease since July, but the country is being praised for swift and decisive efforts to contain the outbreak. In particular, Nigerian officials quickly traced all those who came in contact with the first person to be diagnosed with the disease this summer.

Of course, none of this means the epidemic is over. The CDC is updating its safety guidelines for health workers in order to reduce the risk that other nurses will contract the virus if and when more Ebola patients arrive in American hospitals. And while the news from Senegal and Nigeria is worth celebrating, other West African countries remain in dire straits, with Liberian President Ellen Johnson Sirleaf warning that the disease has brought her country to a standstill:

“Across West Africa, a generation of young people risk being lost to an economic catastrophe as harvests are missed, markets are shut and borders are closed,” the Nobel Peace Prize laureate said in a “Letter to the World” broadcast on Sunday by the BBC. “The virus has been able to spread so rapidly because of the insufficient strength of the emergency, medical and military services that remain under-resourced.”

In neighboring Sierra Leone, emergency food rations were distributed for a third day on Sunday to give a nutritional lifeline to 260,000 residents of an Ebola-stricken community on the outskirts of the capital, Freetown. The Waterloo area in Freetown has 350 houses under quarantine with people suspected of having the Ebola virus and infections in the district are rising, according to the UN World Food Program.

Meanwhile, one new study suggests that the 21-day monitoring period may not always be long enough:

According to Charles Haas of Drexel University, who authored the study, the exact scientific origins of the World Health Organization’s recommended quarantine period for Ebola are murky. The recommendation could be traced to data from the 1976 Ebola outbreak in Zaire and the 2000 outbreak in Uganda, both of which reported incubation periods of 2-21 days, but nobody can be certain.

A more concrete approach is needed to determine an appropriate quarantine period, Haas wrote, so he analyzed data from the 1995 outbreak in the Congo and the current one in West Africa. After examining the newly expanded data set, Haas discovered that the probability of excedence for Ebola incubation was .1 to 12 percent. “In other words,” he wrote, “from 0.1 to 12 percent of the time, an individual case will have a greater incubation time than 21 days.”

Aaron Blake flags a new Kaiser Family Foundation poll showing that most Americans don’t know – or don’t believe – that Ebola can only be transmitted by patients who already have symptoms:

In addition, 25 percent of Americans wrongly think that Ebola can be transmitted through the air, and 37 percent think it can be transmitted by shaking hands with someone who isn’t symptomatic. Both of those are wrong, per the CDC. Could some of these folks be aware of the science and the CDC’s assurances and just not believe them? Sure. There are certainly some doubters out there, even in the scientific community, who think the CDC’s blanket assurances might be premature. But even if those doubters are correct that you can’t quite rule out transmission from a person who isn’t showing symptoms, the lack of a negative doesn’t necessarily prove a positive. In other words, there is still no data to support the belief of 48 percent of Americans, even if you think what they believe can’t be completely ruled out.

The area of northeastern Ohio where Ebola patient Amber Vinson had visited her mother just days before being diagnosed is displaying what officials are calling an “abundance of caution” and others might call an overreaction:

Two Cleveland-area school districts shut down entirely on Thursday, citing one teacher who had unspecified contact with an infected patient and another who was on a different flight “but perhaps the same aircraft” as Vinson — a step that public health officials deemed unnecessary. Ohio health officials also issued new guidelines on Thursday that go well beyond what the Centers for Disease Control and Prevention has recommended: The state says that even those who’ve exchanged a simple handshake with an infected individual should be quarantined for 21 days if they’re not wearing protective gear, even though the disease is not airborne and cannot be transmitted through casual contact. Ohio officials also recommend that those who have been “within a three-foot radius” of an infected individual for a prolonged time should monitor themselves — warnings that could further stoke fears of the disease’s contagion.

America: land of the free and home of the completely terrified at all times. The outbreak, such as it is, has become a bonanza for suppliers of the doomsday community:

In the past week, preppers-turned-entrepreneurs Fabian Illanes and Roman Zrazhevskiy say they have seen sales of gas masks and their harrowing-sounding NBC (Nuclear Biological Chemical) kits skyrocket. “Tripled is probably an understatement,” Illanes says. Their company, Ready to Go Survival, sells prepacked survival, or “bug out,” bags and kits. As fears of Ebola grow, they’ve been filling $1,000 orders of gas masks for whole families.

Illanes, who recently moved to Texas from New York, says he imagines a time when Manhattan might shut down all access into and out of the city. “If I’m in a car with my family and each of us has gloves, masks, and bodysuits, and there’s a regular family in a car next to us—who do you think the people controlling borders are going to feel more comfortable letting through?” he asks. In response to the calls they’ve been receiving, they’re putting together a “pandemic kit” that will provide quick full-body protection and will go on sale late next week.

And then there’s the Halloween industry:

https://twitter.com/perlberg/status/518224465587499008

The latest in hysteria-deflating perspective comes from Philip Bump, who offers a brilliant illustration of just how unlikely it is that you or I will come into contact with the roughly 0.000001 percent of Americans who currently have the virus, and from Max Fisher, who points out that we are more likely to be killed by our own furniture:

Threat to Americans: According to a report by the Consumer Product Safety Commission, just under 30 Americans are killed every year by “tip-over,” which is when “televisions, furniture, and appliances” fall onto their owners. The report also found that over 40,000 Americans receive “emergency department-treated injuries” from tip-over every year.

Worst-case scenario: This is America. We can always find ways to make a bigger, heavier, deadlier TV.

How freaked out should you be: Council on Foreign Relations scholar Micah Zenko found that tip-over kills about as many Americans per year as terrorism does, and injures many more. In theory, then, you should be just as freaked out by tip-over as you are by terrorism. Based on the fatality rate, you should be much more freaked out about tip-over than you are about Ebola.

Then maybe this lady is just trying to protect herself from the chair:

This morning, Obama appointed political operative Ron Klain as his point-person (er, “czar”) to oversee the multi-agency response to Ebola:

Klain, who served as chief of staff to Vice President Biden and former Vice President Al Gore, helped to oversee the 2009 stimulus bill. He will now be tasked with coordinating both the domestic public health response and the international humanitarian and military efforts to stop the virus in West Africa. Klain will work out of the White House’s West Wing. … Republican lawmakers had been calling on the White House to appoint the so-called “czar” for weeks to lead the Administration’s response. The White House had been cool on the subject until Thursday, when Obama told reporters he was considering making such an appointment.

The right is already making hay out of the fact that Klain is not a doctor, has no public health experience, and has an extensive background in Democratic party politics. Ezra, on the other hand, calls him a great choice for the job:

The Ebola response involves various arms of the Department of Health and Human Services (particularly, though not solely, the Centers for Disease Control and Prevention), the Pentagon, the State Department, the National Security Council, the World Bank, the World Health Organization, President Obama’s office, private stakeholders, and many, many more. The “czar” position requires someone who knows how these different agencies and institutions work, who’s got the stature to corral their efforts, who knows who to call when something unusual is needed, who can keep the policy straight. …

Actual government experience is badly underrated in Washington. Politicians run for office promising that they know how to run businesses, not Senate offices. “Bureaucrat” is often lobbed as an insult. But in processes like this one, government experience really matters.

Mataconis is not so sure:

[W]hile Klain certainly has experience in government, to the extent of being Chief of Staff to two Vice-Presidents counts as experience, I’m not sure that he’s the best choice for this position. The fact that his experience is purely political, and heavily so on one side of the political aisle, suggests strongly that the White House was more concerned with picking someone that they were comfortable with than the were with picking someone who would be the right fit for the job, such as, say, a retired General or Admiral or a former Cabinet Secretary of high prominence. At the least, someone with experience at running a multi-agency effort such as this would seem like a better choice. Perhaps Klain will turn out to be just what’s needed for the job, but on first glance this isn’t a very impressive appointment.

Jonathan Cohn weighs in:

Why not pick somebody whose resume includes a stint at the Department of Health and Human Services, Department of Homeland Security, or maybe the Federal Emergency Management Agency? This is not the first time the federal government has confronted a biological menace. An official who’d lived through and worked intensely on responses to SARS, Avian flu, or even HIV might bring critical and beneficial experience to the table. …

Still, the Administration doesn’t lack for expertise on disease and potential outbreaks. The Centers for Disease Control has made some mistakes, but nobody I know questions the expertise of Tom Frieden, CDC’s director, or Anthony Fauci, who is in charge of the National Institute of Allergy and Infectious Diseases. Fauci, in particular, has been working on these sorts of issues since the 1980s, when he was a key player in the government response to AIDS. (If there’s a need for more medical knowledge, perhaps the Senate could act on Obama’s nominee for Surgeon General?)