F ew diseases evoke as visceral a reaction as Ebola, which conjures images of uncontrollable hemorrhaging as the virus disintegrates its host into a pool of infectious blood. There is no doubt this revulsion stimulated attendance at the Ebola Symposium at UNC on Friday, where researchers and students packed a sweltering conference room to learn about the current epidemic.
Among the speakers was Dr. William Fischer II, a critical care physician and pulmonary disease specialist with UNC Hospitals. Fischer treated Ebola patients for several weeks in a field hospital in Guinea run by Doctors Without Borders and the World Health Organization. In his talk, Fischer argued that a disproportionate fear of Ebola is hindering efforts to combat it and stressed the need for increased international intervention.
Such fear of Ebola likely originates from sensationalized reports of extreme cases, which can include severe bleeding. In contrast to popular imagination, Fischer observed hemorrhaging in only 50 to 60 percent of cases, with blood loss itself rarely causing death.
Reported mortality rates associated with Ebola are another likely source of panic. While some strains of Ebola have associated mortalities of up to 90 percent, mortality in this current outbreak is reported to be around 70 percent and can be significantly lowered with intravenous fluids, electrolytes and antibiotics to treat secondary infections. Fischer noted that fear itself can prevent the administration of these basic treatments. Health care workers don’t want to risk accidental needle sticks and contact with infectious fluids.
Aside from increasing mortality rates, this lack of treatment makes it more difficult to track and isolate cases of Ebola in the community. If community members don’t believe the afflicted will fare better in a hospital — or that there’s any hope for recovery — it’s less likely they’ll end up there.
These fears undermine any attempts to cultivate trust between citizens and the medical establishment, a trust critical for overcoming an epidemic. If infected individuals are allowed to remain at large, they will continue to spread the disease and perpetuate a vicious cycle of infection and fear.
Finally, fear discourages the international community from engaging in sufficient relief efforts because the situation is viewed as either too dangerous or hopeless. The latter view has led to public cries to isolate infected countries and let the disease run its course. While no one can blame physicians for their reservations, allowing the current outbreak to continue to grow exponentially is a mistake that could cost hundreds of thousands of lives.
To be sure, Ebola is a deadly disease that should not be taken lightly. But narratives that promote fear and ignore the clinical possibilities for managing this outbreak threaten to exacerbate an already dire situation. Thinking soberly about Ebola can promote the progress in the field and international engagement necessary to bring this epidemic under control.
