Fear of Ebola can spread despite facts

The Ebola case in Dallas is playing into many people’s fears — and fear itself can be contagious.

“The story is familiar by now — about how a plane ride could turn a disease outbreak apocalyptic, about how certain places are hotbeds for disease, about who transmits it and how,” said Priscilla Wald, an English professor at Duke University and the author of Contagious: Cultures, Carriers, and the Outbreak Narrative.

“Now it is no longer ‘over there.’ The line between ‘us’ and ‘them’ has been breached. And Americans are starting to panic,” said Wald, who has studied the intersection of myth and medicine as it relates to contagions.

On Wednesday, parents rushed to pull children from a Dallas school attended by classmates who were in contact with the Ebola patient from Liberia — despite a letter from the school noting that the children showed no symptoms and reports that they were at home Wednesday. News reports also emphasized that the virus is spread only by contact with the bodily fluids of victims.

“There is no risk to students attending the schools,” said Brett Giroir, an infectious-disease researcher and CEO of the Texas A&M Health Science Center in Bryan. He said local health officials should keep doing what they’re doing: being transparent and reassuring the public that Ebola cannot be spread by casual contact.

But quelling public concern might be easier said than done.

“Ebola is a very sensational disease — gruesome and brutal — that plays into our post-9-11 national culture of fear,” Theresa MacPhail, a medical anthropologist at Stevens Institute of Technology, said in a telephone interview from Hoboken, N.J. “Ebola seems like all our worst possible fears are coming true.”

But unlike Sierra Leone or Liberia or Guinea, “we have a public health infrastructure to quickly isolate and treat the Ebola patient,” said MacPhail, who has researched responses to disease outbreaks and who wrote The Viral Network: A Pathography of the H1N1 Influenza Pandemic.

Because of an advanced medical system and the nature of the disease, “we don’t need to be worried about this getting out of hand. If this was SARS, Dallas would be in big trouble,” she said, referring to severe acute respiratory syndrome, which killed 775 people, mainly in Hong Kong, in 2002-03.

Trust issues

Just as the culture in Sierra Leone or Liberia may affect the response to the virus, American culture does the same here, MacPhail said.

While some West Africans have resisted health workers because of distrust, some Americans might not accept official pronouncements, MacPhail said. She said mistrust has led some to oppose childhood vaccinations because of unproven beliefs that they cause autism.

U.S. public health officials must also contend with social media such as Twitter and Facebook, which have much potential for misinformation, she said.

MacPhail said public health officials have to walk a narrow line between alerting the public and playing into overblown fear.

In late August, a poll by the Harvard School of Public Health found that 39 percent of American adults were concerned about a large outbreak in the U.S. and that 26 percent were worried that they or someone in their immediate family may be sickened by Ebola over the next year. The U.S. had no known cases of Ebola transmission at the time.

Most worrisome, 68 percent of respondents believe Ebola spreads “easily,” although experts say it is not an airborne illness. The survey showed that the media and public health officials need to better inform Americans how it is spread, said Gillian SteelFisher, a Harvard research scientist whose office sponsored the survey.

“This new case in Dallas may trigger even greater fears among the American public,” SteelFisher said in an email.

The outcome of the North Texas case will go a long way toward shaping public perception about how prepared the U.S. is to handle Ebola and the risks that people face now and in the future, she said.

Why, Wald asks, are we more afraid of Ebola than flu, which kills tens of thousands of Americans a year?

“Statistics on the relative danger of both do not seem to matter. That’s why we have to look to the way we communicate about these matters. We have to think about the associations that are triggered in the public imagination by the images that popular fiction and film, as well as the media, have made familiar.

“We have to think about how they inspire irrational panic and about how they deflect attention from the larger source of the problem,” Wald said. “The story that never gets told is about the relationship of the illness to global poverty and about how addressing the underlying problem is not only possible but sensible.

“We can’t let a crisis mentality keep us from thinking rationally.”