(Dr. Celine Gounder is an internist, infectious diseases and
public health specialist and medical journalist. The opinions
expressed here are those of the author.)
By Celine Gounder
Aug 14 The Ebola outbreak continues to spread in
Guinea, Liberia and Sierra Leone, the countries hardest hit by
the disease. More than 1,000 people have now died from the
virus. The Centers for Disease Control and Prevention has issued
its highest-level alert for a response to the Ebola crisis. The
World Health Organization has declared the outbreak a Public
Health Emergency of International Concern. The disease is
intensifying in West Africa, but the epidemic poses minimal risk
to Americans. So why are we so afraid?
Scientists think about the risk of Ebola in terms of how
likely someone will get it and die. That probability of someone
in this country dying from Ebola is miniscule. But how the
average person thinks about risk is more complicated. Other
factors - including fear of the exotic, dramatic and gruesome -
heighten our anxieties and capture our imaginations.
The Zaire strain of Ebola out of control in West Africa is
the most virulent form of the virus and comes from the "heart of
darkness" itself. Many Americans still think of Africa as a
failed continent plagued by disease, poverty and war - and we're
afraid of it. There's a certain xenophobia to our fear of Ebola.
Representatives Phil Gingrey (R-Ga.), Todd Rokita (R-Ind.) and
Larry Buschon (R-Ind.) have gone so far as to voice concerns
that the children from Central America crossing the U.S.-Mexico
border might be carrying the Ebola virus. Gingrey is an
obstetrician and Buschon a heart surgeon. But there is no Ebola
in Central America.
We picture the disease liquefying organs and its victims
spewing blood and other bodily fluids, eventually bleeding to
death. But Ebola kills by lowering blood pressure and weakening
the immune system. When vital organs don't receive enough blood,
they fail and die. When the immune system is impaired, the risk
of other infections increases. Ebola can cause problems with
blood clotting, but this typically causes oozing not massive
We're far more likely to die of heart disease, stroke or
diabetes in this country, but these diseases are familiar and
don't terrify us like Ebola. It is, to some extent, normal to
downplay the risks that we have to live with everyday. We
continue to smoke, eat poorly and not exercise even though these
behaviors put us at real risk. More than 50,000 Americans die of
influenza and pneumonia each year, but we still don't get our
We've learned about Ebola from the news media and our social
networks, but this information is skewed. The media cover
accidents, threats and rare or dramatic events. I have been
asked if HIV is still a problem because it's not in the news
anymore. About 1.5 million people annually die of HIV worldwide,
and almost as many die from tuberculosis. But this isn't new, so
it rarely makes headlines. "Scary" health stories make for
better news. The media are bombarding us with dramatic,
minute-to-minute coverage of the Ebola epidemic, which fuels our
anxieties. And once we're scared, it is hard to "unscare" us.
Meanwhile, our social networks, the power of which has been
amplified by the rise of social media, tend to validate and
magnify our fears.
The CDC, the government agency leading the U.S. response to
the Ebola crisis, is doing what it can to help us understand the
disease and what is being done to control it. But the agency has
a public relations problem. For one thing, its work is highly
technical and poorly understood by the public. You also don't
hear about everything the CDC does right to protect the nation's
health. You only hear about what goes wrong.
Earlier this year, the CDC inappropriately shipped the
deadly H5N1 strain of influenza to a Department of Agriculture
lab. (No one was exposed.) In June, agency employees were
exposed to anthrax due to mishandling of laboratory specimens.
And in July, we learned that vials of live smallpox virus had
been discovered in a Food and Drug Administration laboratory,
previously operated by the National Institutes of Health. These
events eroded public trust in the nation's health agencies at a
time when we most need to trust them.