Nation & World

'Epidemic of fear' has driven Ebola debate, experts say

In his 30 years as director of the National Institute of Allergy and Infectious Diseases, Dr. Anthony Fauci has seen his share of public health scares.

When AIDS exploded in the 1980s among gay men, Fauci recalls that some people didn’t want gay waiters to serve them in restaurants. And during the anthrax scare that followed the 9/11 terrorist attacks, many were afraid to open their mail.

But when it comes to Ebola, “This one’s got a special flavor of fear,” Fauci said at the recent Washington Ideas Forum, sponsored by The Atlantic magazine and the Aspen Institute, a nonpartisan policy group.

The growing death toll in West Africa has helped create “an epidemic of fear” in the U.S., Fauci said, even though most experts feel the likelihood of a widespread outbreak in this country is minimal.

James Colgrove, a public health professor at Columbia University, said the chances of an outbreak in this country are “extremely remote.” Pamela Cipriano, president of the American Nurses Association, went even further. “What we know right now would suggest that there is no risk of an epidemic,” she said.

Enhanced screenings of West African visitors allow U.S. health officials to “very quickly identify and sequester and evaluate and care for anyone who shows any type of risk,” Cipriano said. “That’s a very high level of control.”

Even in Dallas, where Liberian Ebola patient Thomas Eric Duncan triggered the nation’s first potential outbreak, only two nurses contracted the virus after direct contact with Duncan while he was desperately ill. That’s out of 70-plus health care workers and 48 family and community members who interacted with him.

Despite the flawed federal and local response, the Dallas episode proved what Fauci and other experts have said all along: Ebola is tough to catch and even tougher to spread when contact tracing, patient isolation and quarantines are in place.

But rather than validate experts’ calls to trust the science and impose public health precautions that reflect actual risk, the Dallas scare triggered a policy backlash driven by fear. Individual states imposed mandatory quarantines for all health care workers returning from Ebola-stricken West Africa, even if they had no symptoms and weren’t contagious.

Kaci Hickox, a Doctors Without Borders nurse who treated Ebola patients in Sierra Leone, was, upon returning, kept in an isolation tent for a weekend by New Jersey officials, even though she showed no symptoms of the virus.

She was permitted to return home to Maine, where officials tried to legally quarantine her. A judge ruled in her favor, requiring only that Hickox monitor herself for signs of Ebola for 21 days, which ended Monday night.

“The fear is trumping science,” said Dr. Georges Benjamin, executive director of the American Public Health Association.

Lawmakers continue to call for outright travel bans from West Africa, which, experts say, would only cause people to seek alternative entry while discouraging U.S. caregivers from helping out in Africa.

Fauci said the severe responses are simply good-faith efforts by politicians to protect fearful constituents.

“You have to respect the fear of people,” he said. “You can’t denigrate it and say, ‘Why are you afraid?' You’ve got to try and explain to them and you’ve got to do it over and over. … It’s just that as a health person, as a physician and a scientist, I would say you look at the data, and it tells you what the risk is.”