Ebola? Carry On

The first email I received about Ebola came several weeks ago from a friend. She lives in the Midwest and has not traveled since her first child was born over 10 years ago. The next email arrived after two American doctors were evacuated from Liberia to obtain treatment in the U.S. “Dr. Lisa, why won't Americans give the cure for Ebola to Africans?” it asked. I’ve since received an abundance of email with questions about Ebola asking about everything from simple symptoms to conspiracy theories. All this confirmed my suspicion the health messaging about Ebola has somehow gone terribly wrong—and I’d like to set things straight.

First, Thomas Duncan, the first person to test positive for Ebola in the United States, most likely died because he was diagnosed late—not any conspiracy. Those Americans who have survived were diagnosed much earlier than Duncan was. We will likely never know, as some have suggested, if his race contributed to this late diagnosis. What I know for sure is that when Duncan arrived at a Dallas emergency room, Ebola had never been diagnosed in a U.S. health care institution. Healthcare providers are not infallible, and diagnosing rare and unusual conditions like Ebola requires great communication between a patient and healthcare provider. Without this the diagnosis can be nearly impossible .

Second, there is no cure for Ebola stashed away, as some of the conspiratorially-minded have suggested. The doctors who were evacuated to the U.S. and treated survived, not because the U.S. has a cure, but because the disease was caught early and treated with  standard medical equipment and care.

My initial concern, instead, about evacuating American doctors when Africans are dying by the thousands was related to the global optics. What message would we send the world by evacuating Americans amidst such a crisis? Despite the tragedy unfolding in West Africa, for days, the media focused almost exclusively on the two Americans. We didn’t hear much about Africans who survived Ebola infection.

Third, Ebola is only transmitted through bodily fluids. Despite this fact, much skepticism and disbelief remain—some have implemented unprecedented and extraordinary measures to prevent Ebola infection. Earlier this month, school administrators closed schools due to fears of Ebola transmission and a woman reportedly chose to fly in a homemade hazmat suit to avoid Ebola infection. One of my acquaintances phoned and told me he was cancelling his travel because he didn't want to fly until the Ebola epidemic is controlled. These actions, which are unfounded and unnecessary, only incite further hysteria about Ebola transmission.

To contract the virus, a person must somehow touch the bodily fluids of a person infected with Ebola and then transfer the virus to some part of the body where it can gain entry through a cut or membrane. But this can only happen if a person has been exposed to someone symptomatic with Ebola, which is obviously not the case for nearly all Americans.

But also concerning in the American people’s reaction to the virus has been the kneejerk response of politicians and pundits to fault the CDC for healthcare lapses at independent healthcare institutions. The CDC has no authority over medical institutions or over state and local health officials. The CDC produces public health guidelines and policies but by law has no authority to enforce these guidelines and policies at state and local levels. The CDC must first be invited into a state to lead a public health investigation.

At times, health crises may brew for weeks before a state decides to invite CDC experts to weigh in on the public health issue. Given this, the accusations about the CDC’s failure to prevent the infections in Dallas are unfair. As awareness increases about the CDC’s true power, a conversation has begun about the need to expand it limits of authority. In the meantime, the CDC continues to provide a wealth of information and guidance about Ebola. If there were ever a time to defer to the wisdom and science from the nation's premier public health institution, it's now.

Health messaging about Ebola can be confusing. Its mysterious, the symptoms are common and the mortality is in West Africa is frighteningly high. This combination can understandably lead to anxiety and fear. However, I hope we can all pause, take a collective, national sigh, and continue to rely on the facts. Yes, Ebola can be scary but it is by no means among our greatest national infectious diseases health threats. Carry on.

Lisa Fitzpatrick M.D. is a former medical epidemiologist for the Centers for Disease Control and Prevention and an MPA student at the Harvard Kennedy School of Government.