Don’t worry about Ebola in the U.S. You’re almost definitely not going to catch it, but here’s why you should care anyway.
There is no getting around the fact: The Ebola virus is bad news. The current outbreak in West Africa is several times larger than any that has occurred before, and it is anticipated to get worse before it gets better. This event is having a very real and very devastating impact on hundreds of thousands of people, with wide-ranging and likely long-term social and economic consequences. Schools are closed. People are dying from preventable and routine illnesses, because the health centers are overwhelmed and overflowing.
Fear, stigma and misinformation are rampant, leading to the ill hiding out at home and passing Ebola to family members. Attacks, sometimes fatal, disrupt health care teams, and there are recent reports of an underground demand for survivors’ blood. (That blood is reportedly being used for illicit transfusions, and while unproven as a treatment or prevention against Ebola, this is an excellent way to spread blood-borne pathogens like hepatitis or HIV.)
Here in the States, we are far removed from the everyday realities of this crisis, and anxiety is spreading much more quickly than germs. Regionally, news of Emory University Hospital’s taking in multiple Ebola cases was met with alarm and dismay. Even locally, concern and interest in Ebola is apparent, as demonstrated by the 300-odd attendees who turned out to UGA’s Health Sciences Campus on Sept. 25 to attend an open forum on the disease jointly hosted by UGA and Athens Regional Medical Center.
This anxiety is primed to get worse, given news of the recent case in Texas—the first not knowingly and purposefully imported into this country. However, a case (or few) in Texas does not make an outbreak, and while Ebola is certainly a serious and even alarming disease, that particular individual (and any of the few people he may have infected) are going to receive prompt and excellent care, and that’s going to be the end of this particular scare. A sustained outbreak in the United States just isn’t possible, even as the situation in Guinea, Sierra Leone and Liberia is dire. Here’s why.
The difference is primarily due to resource-availability and infrastructure, but to understand this, it’s useful to have some background on the disease itself. Ebola is caused by a virus, like a cold or the flu, but unlike these, it can’t be passed through the air by a cough or a sneeze. The isolation wards and the infamous suit-like protective covering of health staff are used not because this virus spreads more easily than most, but because it is so often fatal. Ebola transmission requires direct contact with infected people’s bodily fluids, through cuts on the skin or mucous membranes, and even then only after they start showing symptoms.
A person who has died of Ebola is still highly infectious and must be handled carefully. West African burial practices that involve bathing or touching deceased relatives have been identified as likely amplifiers in the current outbreak.
As with other viruses, treatment with antibiotics is worse than useless. No antiviral drugs have been found to be effective, and no vaccine exists at this point, either, although multiple possibilities are in the works. It will be several months at best, however, before any of these checks out for safety and effectiveness.
The best treatment for Ebola currently consists of keeping a patient hydrated, making sure his or her oxygen levels and blood pressure stay normal, and treating other infections as they come. The Centers for Disease Control and Prevention suggest that this can significantly improve a patient’s chance of pulling through, if started early enough. This type of treatment takes prompt medical attention, however, at a health care facility with trained personnel who have access to proper equipment and supplies. All of these elements are in ready supply throughout the U.S. but are much scarcer in the countries where Ebola is currently out of control.
Take doctors, for instance. The most recent estimates from the Word Bank put the doctor-to-patient ratio at 2.5 per 1,000 people in the United States. For reference, that’s an average of 300 doctors for a population the size of Athens. These same estimates suggest 0.014 doctors per 1,000 people in Liberia. At a population of around 4.3 million (about half the size of New York City), that is a grand total of 60 doctors to serve the entire country. That is just one example, and a simplified one, but the fact is that we have ample resources to treat patients quickly and to contain any spread no matter where it happens in this country. Despite significant and continued international support, those in West Africa do not, and while this outbreak won’t last forever, containing it is going to be a long and difficult process.
Ebola doesn’t spell doom for our country, or really even pose a threat as the next pandemic. What’s important, though, is that a disease like it may be a bigger cause for concern, and those are going to keep coming. Ebola, like many diseases that have made headlines in recent years—SARS, “swine” and “bird” flus—doesn’t originate in humans, but in wild-animal populations. As the human population continues to grow, our cities are going to keep growing, and our livestock and agricultural requirements, too. This expansion is going to put us into increased contact with wildlife, spreading our diseases to them even as we catch theirs.
Ebola has already been linked to deforestation. It’s anyone’s guess as to when and where a new outbreak might occur, but given that the other side of the world is just a plane-ride away, it’s clear that something that starts in one part of the globe may not stay there.
Don’t lose sleep over it, though. Experts around the world and in many different professions are already on guard around the clock to identify any diseases that might pose a threat and stop them before they stop you.
Mertzlufft is a former CDC epidemiologist and geographer who is studying zoonotic diseases for a PhD at UGA.
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