EBOLA IN THE U. S.: An Abundance of Caution Can Prompt Excessive Fear

No doubt you’ve heard that an Ebola case has developed in New York City, that of Dr.  Craig Spencer, who had worked with Ebola victims in Africa.  Of course, that has prompted another media frenzy (“first Ebola case reported in New York!”) that is supposed to calm our nerves but makes us more nervous (think of the teeming million of potential victims).

But not me.   So far, here is what the Ebola crisis has added up to in this country, one Ebola death of a man who came to the U. S. with the disease and two infections of nurses who treated him after he had full blown symptoms, and they did so in a hospital that was not prepared to deal with a surprise visit of that virus (which seemed true of most of our hospitals at the time).

The good news is that was a wake up call.

From articles I’ve read, training for dealing with a walk in Ebola case has sky rocketed since then, with Belleview Hospital where Spencer has been treated, an excellent example.  In my previous post, I pointed out that only four hospitals were considered specialists in dealing with an Ebola case, but prompted by the Dallas debacle Belleview seems to have upped it s preparedness enough to become a “designated Ebola Center”.

I have read about three Maryland hospitals  that have attained the same status, and are “listed as second options for the treatment of Ebola patients who are unable to go to one of the federal health facilities.”   I suspect a number of hospitals in other states have followed suit.

To me, that is the big news as to what is going on with Ebola, not a doctor who has been monitoring himself twice daily and finds he has a fever (100.3, not the 103 initially reported) and is taken into Belleview for treatment immediately.    From what I can tell, his chances of infecting anyone prior to having that fever are virtually nil (note, despite even his having a fever no one close to Thomas Eric Duncan in Dallas, including his fiancee, caught Ebola and all are now cleared of quarantine).

The problem is that with each case of Ebola we go into maximum response mode with quarantines and watch lists of anyone who might have had some contact with the victim, implying a sense of wide spread danger when really it is the hospital workers who deal with vomit and diarrhea who are much, much, much, much more likely than anyone else to catch the virus.  The doctors who wind up on TV say as much, or at least imply it.

The reason they don’t stress it more adamantly is that no matter how unlikely, it is theoretically possible the disease could spread through casual contact, so they tout the value of an “abundance of caution”, while simultaneously producing an excess of fear fueled by the media’s always implying they will share special insights and news just after the next commercial, which is seldom more than a rehash of what they have repeatedly covered.

There is an element of c.y.a. in all of this, of course, as a doctor who criticized all the attention paid to the wrong things would be crucified if someone did happen to get Ebola in a surprising way.   So, from this self-protective angle too, better to show an excessive amount of caution.

Ashoka Mukpo, a free lancer from  NBC and another who caught Ebola in Africa and is now cured, is no doctor, but I think he got to the nub of this issue better than most doctors in a recent tweet:  “People get Ebola by being around very very sick people.  Not people who felt a little funny and then became symptomatic later that night.”

Again, the only two people who have caught Ebola in this country fit that bill.

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(1)  The national CDC offers a guideline for the possible transmission of the Ebola virus, located here.    If you read the page you can see how it is conceivable that someone could catch Ebola from touching the same surface as did an Ebola victim, but from what I can tell that victim would have had full blown symptoms for this to possibly happen.

By the way, some of the fear regarding Dr. Spencer’s case stems from that initial report that he had a temperature of 103 when contacting the hospital, implying that he might have had a temperature well before that.   Now it seems it was 100.3, a big difference because by all reports the chances of contracting the virus get much greater as symptoms worsen.

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