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The Guardian view on Ebola: fighting fear, as well as infection The Guardian view on Ebola: fighting fear, as well as infection
(about 3 hours later)
The lay person is forever wary of being “blinded by science”. But to students of disease, the laws governing the natural world look far simpler than the chaotically unpredictable reaction that their work can often provoke. Panics, manias and crashes attract the attention of economists. There is less systematic study of the way in which crowds react, and over-react, to information in the non-financial realm.The lay person is forever wary of being “blinded by science”. But to students of disease, the laws governing the natural world look far simpler than the chaotically unpredictable reaction that their work can often provoke. Panics, manias and crashes attract the attention of economists. There is less systematic study of the way in which crowds react, and over-react, to information in the non-financial realm.
As the rich world belatedly grapples with the singularly nasty, but reasonably well-understood, outbreak of Ebola in Africa, fear itself is becoming the primary problem in Europe and America. The pressing need of the victims, who are almost exclusively in Guinea, Liberia and Sierra Leone, is plain. They don’t require Live Aid-style charity donations but many more medical workers. So, too, do the far greater number of potential victims in the region, whose contact with the stricken will leave them prone to the frequently fatal virus until sufficient quarantined facilities are up and running. The contrast with Nigeria, which is also poor but has – through more organised care – contained Ebola thus far, illustrates the importance of both the volume and the coordination of personnel. But as anxiety in Britain rises to the point where a nine-year-old Sierra Leonean boy is banned from a Stockport school, despite the headteacher being satisfied that he is not infected, volunteers may be put off from venturing overseas.As the rich world belatedly grapples with the singularly nasty, but reasonably well-understood, outbreak of Ebola in Africa, fear itself is becoming the primary problem in Europe and America. The pressing need of the victims, who are almost exclusively in Guinea, Liberia and Sierra Leone, is plain. They don’t require Live Aid-style charity donations but many more medical workers. So, too, do the far greater number of potential victims in the region, whose contact with the stricken will leave them prone to the frequently fatal virus until sufficient quarantined facilities are up and running. The contrast with Nigeria, which is also poor but has – through more organised care – contained Ebola thus far, illustrates the importance of both the volume and the coordination of personnel. But as anxiety in Britain rises to the point where a nine-year-old Sierra Leonean boy is banned from a Stockport school, despite the headteacher being satisfied that he is not infected, volunteers may be put off from venturing overseas.
Thursday’s row, about Britain’s initial refusal to follow the American lead and “screen” for Ebola at airports, illustrates the dilemma. The virology here – non-airborne transmission, incubation of up to 21 days, early symptoms indistinct from many infections – puts a premium on rooting out the problem at source. Imagining that quickfire border checks can somehow keep the virus at bay in Europe as it becomes entrenched in Africa, is deluded. The evolving Downing Street line reflected the pressure; it must be hoped that there is more constancy in the policy than the presentation, since some of the checks being demanded come with big practical problems. Temperature scanners would pick up countless “false positives” with other fevers. More damaging still would be the false reassurance produced if the all-clear were given to any genuine Ebola cases where symptoms were still to show up. Questionnaires about where travellers have been and what contact they’ve had could be more useful, but these are not failsafe. Thomas Duncan, who died of the virus in Dallas this week, had falsely responded to such inquiries, denying he’d been in contact with anyone affected by it. Thursday saw a hasty refinement of the British approach. Initially, the UK had refused to follow America’s lead and screen for raised temperatures at airports. The UK’s immediate reservations were well-founded. Ebola’s virology – non-airborne transmission, incubation of up to 21 days, early symptoms indistinct from many infections – puts a premium on rooting out the problem at source. Quickfire border checks cannot be relied on to keep the virus at bay in Europe if it becomes more entrenched in Africa. Then there are more specific objections to temperature scanners: the countless “false positives” with other fevers that would be picked up, and the even more damaging false reassurance that would be produced if the all-clear were given to genuine Ebola cases where symptoms were still dormant. Subsequently, however, Downing Street signalled that – at selected entry points only – the UK would be running questionnaires about where travellers had been, and what contact they’d had. Checks of this form could be more useful, but they are certainly not failsafe. Thomas Duncan, who died of the virus in Dallas this week, had falsely responded to such inquiries, denying he’d been in contact with anyone affected.
If there is one cardinal “don’t” in navigating between the science of risk and public anxiety, it is running ahead of the available evidence about what it is, in fact, possible to guarantee. Recall John Selwyn Gummer feeding his daughter a beefburger to demonstrate that BSE posed no risk to humans to see why. What of the “dos”? Providing west Africa with the support it needs, including not only the troops already announced but medical practitioners too, is one. The overwhelming importance of on-the-ground resources vindicates David Cameron for, like Gordon Brown and Tony Blair before him, championing international aid. Like all the most important threats facing humanity, viruses are no respecter of borders, and so safety at home requires engagement and generosity overseas. At the same time as readying the NHS to deal with the worst possibility of Ebola’s arrival and transmission within the UK, it is also important to calm popular fears, and more particularly the anxieties of those who might be considering joining the relief effort. David Miliband, now president of the International Rescue Committee, has shown the way. Simply by turning up in Freetown, he makes the point that this is not an infection that lays waste every passing visitor, but rather a disease spread through direct contact, whose progress can be controlled by careful hygiene drills.If there is one cardinal “don’t” in navigating between the science of risk and public anxiety, it is running ahead of the available evidence about what it is, in fact, possible to guarantee. Recall John Selwyn Gummer feeding his daughter a beefburger to demonstrate that BSE posed no risk to humans to see why. What of the “dos”? Providing west Africa with the support it needs, including not only the troops already announced but medical practitioners too, is one. The overwhelming importance of on-the-ground resources vindicates David Cameron for, like Gordon Brown and Tony Blair before him, championing international aid. Like all the most important threats facing humanity, viruses are no respecter of borders, and so safety at home requires engagement and generosity overseas. At the same time as readying the NHS to deal with the worst possibility of Ebola’s arrival and transmission within the UK, it is also important to calm popular fears, and more particularly the anxieties of those who might be considering joining the relief effort. David Miliband, now president of the International Rescue Committee, has shown the way. Simply by turning up in Freetown, he makes the point that this is not an infection that lays waste every passing visitor, but rather a disease spread through direct contact, whose progress can be controlled by careful hygiene drills.
The virulence of Ebola is not in doubt. No prescription to deal with it will do much good, unless honesty and calm are part of the mix.The virulence of Ebola is not in doubt. No prescription to deal with it will do much good, unless honesty and calm are part of the mix.