— The Economist (@TheEconomist) October 28, 2014
Poniewozik characterizes cable news coverage of the Ebola outbreak as a struggle between the “story” and the facts:
Thursday night, the facts were: Someone in New York City had Ebola. Dr. Craig Spencer, who had been volunteering with Doctors Without Borders treating patients in Guinea, had come back to Manhattan. He’d followed the accepted guidelines for self-monitoring, checking his temperature twice daily, and watching, per the medical organization’s guidelines, for “relevant symptoms including fever.” When he detected a fever that morning–before which, he would not have been infectious–he went to the hospital.
But then there’s the story! The story was that the day before Spencer went to the hospital, he went bowling! He rode in an Uber vehicle! He went jogging and ate at a restaurant and walked in a park. He rode the subway–the crowded subway! None of this, according to medical science on Ebola, presented a danger from a nonsymptomatic person. But it felt wrong in people’s guts. And that makes a better story.
Only when the disease literally landed on American soil did it suddenly become news. Yet, coverage of the disease has remarkably become less negative over the past seven months, transitioning from graphic descriptions of the disease’s symptoms to the “miraculous” interventions of modern medicine and stories of survival. As William Randolph Hearst famously noted, conflict sells newspapers; yet in the case of Ebola it seems that coverage has trended towards emphasizing recovery than end-of-the-world panic. Even the level of anxiety, while trending higher in news reports, has not spiraled out of control.
A reader feels that much of the media commentary has actually been too blasé:
More people have died so far this year from Ebola than the entire history of the Ebola (first known human case is 1976). Prior to last year, 1,590 people died from Ebola. So over the last 40 years and 24 outbreaks, we have had 1,590 deaths. We are already past 5,000 this year.
Ebola is extremely infectious (it takes a very small amount of the virus to infect you, as little as a single virus) but only moderately contagious. Because only poor people in Africa have previously died of Ebola, and in very small numbers when compared to other illnesses, Ebola hasn’t been studied at the level that rich person illnesses have. This is why I’m less than fully convinced that researchers have enough information to be 99% sure about how contagious Ebola is at any stage of illness. There just are not that many data points, and those they have (with regards to humans anyway) are under less than ideal conditions.
So, is there some middle ground between full quarantine and partying like it’s 1999? Maybe not locked in their house, but also not allowed to go to restaurants or bowling alleys or mass gatherings of people or use mass transportation systems?
For more on the devastating nature of the disease, and how it could spiral out of control, check out Richard Preston’s disquieting piece in The New Yorker. On the “extremely infectious” nature of Ebola:
Experiments suggest that if one particle of Ebola enters a person’s bloodstream it can cause a fatal infection. This may explain why many of the medical workers who came down with Ebola couldn’t remember making any mistakes that might have exposed them. One common route of entry is thought to be the wet membrane on the inner surface of the eyelid, which a person might touch with a contaminated fingertip. … In a fatal case, a droplet of blood the size of the “o” in this text could easily contain a hundred million particles of Ebola virus.
On its ability to travel through the air:
Khan worked long hours in the Ebola wards, trying to reassure patients. Then one of the nurses got sick with Ebola and died. She hadn’t even been working in the Ebola ward. The virus particles were invisible, and there were astronomical numbers of them in the wards; they were all over the floor and all over the patients.
There are two distinct ways a virus can travel in the air. In what’s known as droplet infection, the virus can travel inside droplets of fluid released into the air when, for example, a person coughs. The droplets travel only a few feet and soon fall to the ground. The other way a virus can go into the air is through what is called airborne transmission. In this mode, the virus is carried aloft in tiny droplets that dry out, leaving dust motes, which can float long distances, can remain infective for hours or days, and can be inhaled into the lungs. Particles of measles virus can do this, and have been observed to travel half the length of an enclosed football stadium.
Ebola may well be able to infect people through droplets, but there’s no evidence that it infects people by drying out or getting into the lungs on dust particles. In 1989, a virus known today as Reston, which is a filovirus related to Ebola, erupted in a building full of monkeys in Reston, Virginia, and travelled from cage to cage. One possible way, never proved, is that the virus particles hitched rides in mist driven into the air by high-pressure spray hoses used to clean the cages, and then circulated in the building’s air system. A rule of thumb among Ebola experts is that, if you are not wearing biohazard gear, you should stand at least six feet away from an Ebola patient, as a precaution against flying droplets.
And finally, on the volatility of the virus:
A sample of the Ebola now raging in West Africa has, by recent count, 18,959 letters of code in its genome; this is a small genome, by the measure of living things. Viruses like Ebola, which use RNA for their genetic code, are prone to making errors in the code as they multiply; these are called mutations. Right now, the virus’s code is changing. As Ebola enters a deepening relationship with the human species, the question of how it is mutating has significance for every person on earth.
Read the whole riveting piece here. (Preston wrote the 1994 bestselling book, The Hot Zone: The Terrifying True Story of the Origins of the Ebola Virus.) One more reader:
If you want to read the scary stuff about where Ebola could be headed, here it is (and the primary source for the article is here). If we can’t find the strength to help Africa contain this, it could get much, much worse for the rest of the world. We shouldn’t be worried about isolated cases showing up in NYC or Chicago or Dallas. We should be worried about Mumbai and Karachi and similar places with similar slum populations.
Follow all of our Ebola coverage here.
(Photo via Getty)