Health & wellness

Daily Dose

Why Americans have irrational Ebola fears

An estimated 36,000 Americans are expected to die of the flu this year, but, if history is any indication, the majority of us will skip the recommended yearly vaccine. We’d likely, however, be lining up around the block to get an Ebola immunization if one was available — even though only one person has died of the infection in this country so far.

Irrational fears about Ebola have become more contagious than the virus itself. About half of American adults are concerned that there will be a large outbreak of Ebola inside the United States within the next year, according to a Harvard School of Public Health poll conducted earlier this month. More than a third are concerned that they or someone in their immediate family may get sick with Ebola.

Twitter hastags like #EbolaFear and #EbolaCrazy this week documented the ridiculous lengths some people have gone to in an effort to avoid infection like the tweeted photo of an airline passenger who wore a homemade hazmat suit to Dulles airport in Virginia. Tweeted links to news stories told of a Maine teacher placed on a 21-day leave demanded by parents because she recently attended a conference in Dallas — the same city where the Ebola patient Thomas Eric Duncan died on Oct. 8 — and a Mississippi principal who was banned from his school for attending his brother’s funeral in an African country, 3,000 miles away from the nearest Ebola case.

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Researchers who study risk perception say they’re not surprised by the epidemic of irrational Ebola fear that has swept our nation. “This is a disease of mysterious origin with a really high death rate and scary symptoms,” like explosive diarrhea and bleeding from the eyes and mouth, said Arthur Caplan, head of the division of bioethics at New York University Langone Medical Center in New York City. “Even the name of the virus sounds like it comes right out of a Stephen King Novel.”

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A few missteps by federal and local health officials have stoked our insecurities. After Duncan was admitted to Texas Health Presbyterian Hospital in Dallas, officials from the Centers for Disease Control and Prevention initially reassured the public that the hospital staff had been fully trained in Ebola infection control skills — until, that is, two nurses got infected. While the CDC now treats Ebola patients at better equipped facilities and issued updated guidelines this week for donning and removing personal protective equipment, those early flubs can’t be erased from the public’s mind.

“There’s an appearance of incompetence,” Caplan said, “and just one or two mistakes creates a fear that authorities can’t do what they say they can.”

Once the anxiety begins, it spreads. “We’re wired to transmit fear to each other, and from an evolutionary standpoint, you can see how it would be beneficial to scare us into avoiding those with contagious illnesses,” said Joshua Epstein, an emergency medicine professor and director of the Center for Advanced Modeling at Johns Hopkins University.

In the age of social media, fear can spread much faster than the actual disease, he added, without any contact with infected people, triggering panicked over-reactions.

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While Epstein believes public health officials act in good faith when they reassure us that they can contain any future Ebola cases in the US, he said they should take all precautions to make sure we’re not shocked if, say, a traveler infected with Ebola slips through an airport screening. “Don’t give people the idea that rigorous screening will catch everyone,” he said, “because surprise sets people up for over-reactions.”

Fear tends to be generated more by magnitude — whether an event is salient or arresting — than by the likelihood or probability of the event actually happening to a single individual. Rapid associations we make when a surprising, horrific act occurs can trigger collective panic, said Epstein who creates research models to explain how individual events trigger mob violence, manias, and other over-reactions.

We’re more afraid of Ebola than seasonal flu for this reason. The flu is familiar, and most of us recover from it, whereas Ebola, rare as it is, has a horrifyingly high death rate.

Still, I’m wondering, why all this panic over three cases?

Once we had a single case of Ebola in our country, the disease went from the impossible to the possible in people’s minds, said Valerie Reyna, a professor of psychology and director of the Human Neuroscience Institute at Cornell University. “People understand that it’s a small number of cases, but another part of their mind encodes impossibility and possibility,” she said. Once a terrifying prospect is now possible, we naturally become more fearful.

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We’re also attuned to sudden change and when Ebola cases ballooned in Sierra Leone and Liberia at a non-linear rapid rate, we felt a lack of control over a dangerous situation. The ballooning of news coverage added to our fears since research suggests the amount of news coverage correlates with public concern.

“We want the spigot back in the off position,” Reyna said, “which is why people argue for closing our borders.” Ethical or not, that tactic won’t work to end the Ebola epidemic, she added, and could likely cause more cases by delaying treatment to countries devastated by the outbreak.

What’s needed most, she added, is transparent risk communication where Americans are kept informed on why and how Ebola transmissions occur. “People need to understand why their government is taking certain actions and that there’s some level of uncertainty as to how well these actions will work,” Reyna said. “That’s a tremendous challenge, to provide meaningful information that eases fears.”

Deborah Kotz can be reached at dkotz@globe.com. Follow her on Twitter @debkotz2.