Can you help me set my friend's mind at ease about ebola?
September 6, 2014 11:06 PM Subscribe
My friend, who lives in a very safe place in the United States, is unusually scared about ebola. More than really makes any sense. Ebola has appeared sporadically every several years since it was discovered in the 70s. Most years, there are zero cases worldwide. Is it right to say that the current outbreak is likely to be another case of ebola flaring up and then disappearing?
From what I've read, the course of the disease is fairly short compared to, say, AIDS. Within a month or two of infection, you're either dead or cured.
Is it correct to say that ebola is unlikely to become the sort of disease where there's always somebody suffering from it at any given time? That this outbreak is just like the couple dozen that have come before it (that most people never worried much about), only bigger?
What's the best way to say that?
If what I've said above isn't true, what's the best way to help somebody understand the disease without making it seem scarier than it is?
From what I've read, the course of the disease is fairly short compared to, say, AIDS. Within a month or two of infection, you're either dead or cured.
Is it correct to say that ebola is unlikely to become the sort of disease where there's always somebody suffering from it at any given time? That this outbreak is just like the couple dozen that have come before it (that most people never worried much about), only bigger?
What's the best way to say that?
If what I've said above isn't true, what's the best way to help somebody understand the disease without making it seem scarier than it is?
The BBC took a look at this and may not be exactly reassuring.
posted by BungaDunga at 11:48 PM on September 6, 2014 [9 favorites]
But there are is also a fear being raised by some virologists that Ebola may never be contained.I'd argue that Americans don't have to worry about Ebola for the same reason we aren't overly worried about cholera, malaria or rabies. Our health system might as well be another planet compared to those in Liberia, etc. We have orders of magnitude more resources to deal with infectious diseases, even ones which have no treatment or cure.
Prof Jonathan Ball, a virologist at the University of Nottingham, describes the situation as "desperate".
His concern is that the virus is being given its first major opportunity to adapt to thrive in people, due to the large number of human to human transmission of the virus during this outbreak of unprecedented scale.
...
Prof Ball said "it really wouldn't surprise me" if Ebola adapted, the death rate fell to around 5% and the outbreak never really ended.
"It is like HIV, which has been knocking away at human to human transmission for hundreds of years before eventually finding the right combo of beneficial mutations to spread through human populations."
posted by BungaDunga at 11:48 PM on September 6, 2014 [9 favorites]
I think the SARS epidemic might be a good reference. It was a highly virulent disease that spread in major urban areas of developed countries, but it was stopped before growing to a catastrophic scale because of vigilant temperature scanning in transportation hubs, information dissemination that created near-universal awareness, and quarantining of patients and exposed individuals. Ebola may be more virulent, but it seems such measures (enhanced by the continued growth of the internet and social media since SARS and the the perception that Ebola is an even more horrible disease), along with sophisticated first world medical infrastructure, makes the spread of Ebola to the first world unlikely. I believe Ebola requires fluid contact to spread, and it would seem that people in the general population who are concerned about being infected can generally find ways to avoid fluid contact with other people if they know a disease is spreading rampantly and it's a life or death matter to avoid fluid contact.
posted by Dansaman at 12:08 AM on September 7, 2014 [2 favorites]
posted by Dansaman at 12:08 AM on September 7, 2014 [2 favorites]
I read in the paper that WHO expects the vaccine to be ready in November. (Couldn't find a link in English, sorry).
Regardless, it is most unlikely Ebola will ever spread to the US. How would that even happen? Maybe you could ask your friend how they imagine the disease spreading to America, and then going through that as in a platonic dialogue?
posted by mumimor at 12:43 AM on September 7, 2014
Regardless, it is most unlikely Ebola will ever spread to the US. How would that even happen? Maybe you could ask your friend how they imagine the disease spreading to America, and then going through that as in a platonic dialogue?
posted by mumimor at 12:43 AM on September 7, 2014
I think influenza kills more people than Ebola. Influenza is less lethal but a lot more prevalent. And lot more infectious. Influenza is an airborne virus... Ebola is not.
posted by evil_esto at 1:06 AM on September 7, 2014 [1 favorite]
posted by evil_esto at 1:06 AM on September 7, 2014 [1 favorite]
It's easy to be anxious about things that you know nothing about. Your brain will create all kinds of logistical leaps and outright nonsense to protect you from a threat.
Point your friend at some articles that explain the life cycle of the disease, how many deaths per year, how many of those were in America, what the treatment rate is like, etc. Hard proof that while Ebola is a very very awful thing, that they're very unlikely to get it and if they do, there are treatments available.
Here's a list of Ebola outbreaks. Note the vanishingly small numbers of people who got it, compared to the amount of people who die every time we have an outbreak of influenza. Ebola is a scary thing, but I'd be more bothered about being somewhere there is a car nearby.
Sometimes, it can help to have the person who is catastrophising think about how a thing could possibly happen and have them think about things that would prevent that from happening. For example, Ebola is rare to begin with. To get Ebola, you have to touch the skin or bodily fluids of an infected person. You have to have the symptoms to be able to spread the disease.
Compare that with influenza, where the illness can be aerosolised and left handing around on surfaces like door handles, grab rails, poles on buses/trams/trains, etc, for several hours after the initial released. Most of the people who get Ebola are those who work in close contact with the unwell, or who are close family members caring for the sick. If your friend is working closely with the infected, they might want to take precautions. I'm guessing that they aren't, though, which massively reduces the risk.
If your friend wants to take some concrete actions about this, have them donate to a relevant charity. Maybe one working towards a cure for Ebola, or something that will help the medical workers who are putting their lives at risk to help stop the outbreak.
posted by Solomon at 1:42 AM on September 7, 2014
Point your friend at some articles that explain the life cycle of the disease, how many deaths per year, how many of those were in America, what the treatment rate is like, etc. Hard proof that while Ebola is a very very awful thing, that they're very unlikely to get it and if they do, there are treatments available.
Here's a list of Ebola outbreaks. Note the vanishingly small numbers of people who got it, compared to the amount of people who die every time we have an outbreak of influenza. Ebola is a scary thing, but I'd be more bothered about being somewhere there is a car nearby.
Sometimes, it can help to have the person who is catastrophising think about how a thing could possibly happen and have them think about things that would prevent that from happening. For example, Ebola is rare to begin with. To get Ebola, you have to touch the skin or bodily fluids of an infected person. You have to have the symptoms to be able to spread the disease.
Compare that with influenza, where the illness can be aerosolised and left handing around on surfaces like door handles, grab rails, poles on buses/trams/trains, etc, for several hours after the initial released. Most of the people who get Ebola are those who work in close contact with the unwell, or who are close family members caring for the sick. If your friend is working closely with the infected, they might want to take precautions. I'm guessing that they aren't, though, which massively reduces the risk.
If your friend wants to take some concrete actions about this, have them donate to a relevant charity. Maybe one working towards a cure for Ebola, or something that will help the medical workers who are putting their lives at risk to help stop the outbreak.
posted by Solomon at 1:42 AM on September 7, 2014
You will not want her to read Laurie Garrett's article You Are Not Nearly Scared Enough About Ebola.
posted by yclipse at 5:17 AM on September 7, 2014 [3 favorites]
posted by yclipse at 5:17 AM on September 7, 2014 [3 favorites]
Best answer: Ebola is one of those things I am terrified of and therefore compelled to read everything about in order to scare myself silly.
This epidemic is really bad and I think it will get worse before it gets better. But as an American, you don't actually have to worry too much. You aren't contagious until you have symptoms, which is good. It passes by contact with bodily fluids -- and American hospitals already use "universal precautions" to prevent that, and have the ability to use much more stringent protections. And the US has the ability to track down all 240 people who were on an airplane with someone with active TB within 24 hours, and then monitor those people for two years for infections developing. It is highly unlikely to escape into the "wild" in the US, especially once our public health infrastructure mobilizes to track it.
This outbreak isn't good and it is scary. (And hemorrhagic fevers are just terrifying no matter what.) But for Americans, it's very unlikely to affect us in any substantial way because of our robust and modern health care and public health systems.
posted by Eyebrows McGee at 5:59 AM on September 7, 2014 [3 favorites]
This epidemic is really bad and I think it will get worse before it gets better. But as an American, you don't actually have to worry too much. You aren't contagious until you have symptoms, which is good. It passes by contact with bodily fluids -- and American hospitals already use "universal precautions" to prevent that, and have the ability to use much more stringent protections. And the US has the ability to track down all 240 people who were on an airplane with someone with active TB within 24 hours, and then monitor those people for two years for infections developing. It is highly unlikely to escape into the "wild" in the US, especially once our public health infrastructure mobilizes to track it.
This outbreak isn't good and it is scary. (And hemorrhagic fevers are just terrifying no matter what.) But for Americans, it's very unlikely to affect us in any substantial way because of our robust and modern health care and public health systems.
posted by Eyebrows McGee at 5:59 AM on September 7, 2014 [3 favorites]
Best answer: I'd say the way to deal with this is to harmlessly channel their fears.
Tell them if there is an ebola outbreak in their vicinity to avoid bodily fluids.
That way they can get on with their lives but still feel they are doing something by being vigilant and having a prepared strategy.
posted by srboisvert at 6:08 AM on September 7, 2014 [1 favorite]
Tell them if there is an ebola outbreak in their vicinity to avoid bodily fluids.
That way they can get on with their lives but still feel they are doing something by being vigilant and having a prepared strategy.
posted by srboisvert at 6:08 AM on September 7, 2014 [1 favorite]
Best answer: Has she read any of the more in-depth articles by more or less reputable outlets on the outbreak? Here's one that just appeared on the Blue for example. One thing they make clear is that the outbreak is due to culture and infrastructure just as much as it is the virus itself. Many people in the affected countries simply do not trust health workers for various reasons, so when they or a loved one get infected they hide it rather than report it and be sent into quarantine, and then they infect all of their untrained, unprotected caregivers. This is how a whole village can get infected. It's just a totally different world, health infrastructure wise, than the US.
It's very rational and human to be upset at the economic and educational inequalities that contribute to the epidemic in Africa, and if your friend has never thought about this sort of thing before it can be kind of a shock. It's an easy jump from "How can this happen in 2014?" to "We're all in danger." Focusing on the non-virological reasons why this epidemic has spiraled out of control might be no less upsetting, but it could put some of the "I'm in danger now!!" feelings to rest.
posted by oinopaponton at 6:31 AM on September 7, 2014 [3 favorites]
It's very rational and human to be upset at the economic and educational inequalities that contribute to the epidemic in Africa, and if your friend has never thought about this sort of thing before it can be kind of a shock. It's an easy jump from "How can this happen in 2014?" to "We're all in danger." Focusing on the non-virological reasons why this epidemic has spiraled out of control might be no less upsetting, but it could put some of the "I'm in danger now!!" feelings to rest.
posted by oinopaponton at 6:31 AM on September 7, 2014 [3 favorites]
I found this article in Boston.com very helpful, especially the flow-chart at the end.
Why You Won’t Catch Ebola.
posted by alms at 6:41 AM on September 7, 2014 [3 favorites]
Why You Won’t Catch Ebola.
posted by alms at 6:41 AM on September 7, 2014 [3 favorites]
People with irrational fears often tend to respond better to having a game plan if their irrational fear comes true, rather than to someone trying to explain away their fears.
So I would focus on researching and talking through with her what she would do if Ebola does come to her area (taking precautions against contact with bodily fluid, what symptoms she should look out for) and what she would do if she noticed symptoms in herself (which hospital would she go to, what would they do for her). Having a realistic plan, even for an unrealistic fear, might at least give her some sense of control.
posted by jaguar at 8:29 AM on September 7, 2014 [1 favorite]
So I would focus on researching and talking through with her what she would do if Ebola does come to her area (taking precautions against contact with bodily fluid, what symptoms she should look out for) and what she would do if she noticed symptoms in herself (which hospital would she go to, what would they do for her). Having a realistic plan, even for an unrealistic fear, might at least give her some sense of control.
posted by jaguar at 8:29 AM on September 7, 2014 [1 favorite]
Your friend may have a form of anxiety that's expressing itself in this way. If the anxiety is actually affecting their life (e.g., refusing to fly home for a family occasion, not eating food others have touched, losing sleep, etc.), they might be better off seeking anxiety treatment.
posted by wintersweet at 11:46 AM on September 7, 2014
posted by wintersweet at 11:46 AM on September 7, 2014
Not an epidemiologist, M.D., or psychologist.
But it sounds as if your friend might have read The Hot Zone and freaked out. She might be helped by reading a takedown of Richard Preston rather than by learning about the epidemiology of other diseases, which might transfer her phobia from Ebola to influenza, which would be a really crippling phobia because influenza is common in the U.S.
posted by bad grammar at 5:39 PM on September 7, 2014
But it sounds as if your friend might have read The Hot Zone and freaked out. She might be helped by reading a takedown of Richard Preston rather than by learning about the epidemiology of other diseases, which might transfer her phobia from Ebola to influenza, which would be a really crippling phobia because influenza is common in the U.S.
posted by bad grammar at 5:39 PM on September 7, 2014
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See also people fearful of vaccines.
posted by modernnomad at 11:24 PM on September 6, 2014 [9 favorites]