Thursday, October 02, 2014

Be Very Very Afraid. The Reason, Right Now, Is Ebola.

It has taken me a few hours to recover from the mistake of trying to absorb today's news and tweets and soundbites, because the overall message I get (whether that is the message that's being sent) is to panic.  And today we are to panic about Ebola in the US.

Panicking is the mature and adult reaction, my friends*.  Or at least the headline writers believe that clicks will rise if a bit of panic is in the air.  Thus, even  sound and rational articles about the Dallas Ebola case have headlines which  ask whether we should all panic or at least describe people who are not sure if they should panic**.  And some articles can barely squeeze in a few facts about Ebola. 

Why not just give all the information about how one can catch Ebola and how one cannot catch it?  To their credit, most articles try to do some of that (though not all), but the information is often buried deep in the body of the article or qualified by terms such as "health authorities claim."

And few write-ups seem to understand the public health actions of tracking and containing.  For example, that Daily Male Mail's screaming headline "Up to 100 exposed already in Dallas Ebola shambles" is such utter rubbish.  The point is to create panic.  This is what that 100-people figure actually represents: 

The immediate priority of health officials is contacting all those who might have come into contact with Mr. Duncan after he became symptomatic, which is when the disease can spread.
Health officials said to think of the contact tracing as moving in concentric circles. Health officials focused first on those who had the closest and most intimate contact with Mr. Duncan after he became symptomatic because they are at the greatest risk of infection. That group includes at least four family members and three medics who are being isolated.
 The next group includes those who had more casual contact with Mr. Duncan after he grew sick. More than a dozen people in this category will monitored by the authorities for 21 days, which is the longest documented time it has taken for this strain of Ebola to begin to cause illness.

All bolds are mine.  The point is that hundred people most likely have not been exposed.  The reason they are identified is for the public health authorities to define the largest possible circle within which any possible new cases could come from, so that action can be swift and future spread of the disease can be stopped. That's how epidemics are fought.

So.  Whatever the problems in the treatment of the first Ebola case in the US in Dallas (and there were problems), we are not all going to die of Ebola and we cannot get it from asymptomatic individuals who happened to have been in the same airplane with us.  Come to think of it, the ordinary flu is killing a lot more people right now in this country, I'd bet.

I understand that new threats trigger an odd primitive reaction of this type in us humans (remember SARS?)***, while we can comfortably live with pretty high risks of death from traffic accidents or the flu.  But we could override that primitive reaction by vaccinating ourselves with all the relevant facts.

On the other hand, things could be much, much worse.  For instance, libertarians could be in power in Texas.  Here's a libertarian opinion on the proper role of the government in controlling communicable diseases:
Carla Howell, National Libertarian Party Political Director, says “governmental bureaucracies” involved with epidemic control are ineffective compared to private and voluntary efforts, in addition to costing too much money and violating individual rights. 
"The sole purpose of government is to protect our life, liberty and property from harm caused by others in those few instances where the private sector cannot do a better job," Howell writes in an e-mail to Newsweek. “Containing Ebola in Africa is best left to private charities such as Doctors Without Borders rather than the NIH [National Institutes of Health] or the CDC. Screening is better handled by airlines and private hospitals that are both liable for damages and fully free of government red tape. (Sadly no such hospitals exist today in the United States).”
Mmm.   Bolds are mine.  The point Howell misses is that the control of epidemics is  one of those areas where everyone  agrees that we need the government.  Even arch-conservatives agree.

That Howell doesn't  suggests to me that she is unaware of the public goods/private goods dichotomy.  The private sector cannot do as well as the public sector in controlling epidemics, because of that public good aspect.  This is true of for-profit firms but it's also true of nonprofit organizations, because they lack the enforcement ability which is necessary when patients must be quarantined or areas closed off or entrants to a country checked.

Isn't it nice that the many panic topics for today don't include libertarians running the US public health system?

*As that silly rhyme tells us:  "When in doubt or danger, run in circles, scream and shout. " It should really be "When in danger or in doubt, run in circles, scream and shout."  Rhymes better.

**Inside this story, for example,  the relevant information can be found, but you have to search for it:

None of the children have symptoms, and the chances that they passed the virus to other people at the school are extremely low, health officials said. Even when people are infected with Ebola, they are not contagious until they get develop symptoms. And even then, the virus can be transmitted only through bodily fluids and close physical contact.

***It has several characteristics.  One is the fear caused by not-knowing, the fear of something new, a sinister monster rising from the fog, suddenly.   Another one is an odd insistence for zero risks as the only acceptable ones (when we accept positive risks in most areas of life), the refusal to be reassured by an expert stating that something has an almost-zero probability of occurring.  A third one is the near-total focus on the new threat.  All these are probably useful behavior patterns when a new wild predator, say, entered the area where prehuman humans (heh) lived, but is less beneficial when it is applied to ISIS, SARS, bird flu, Ebola and so on, especially by those who are far away from the actual threats and get the reaction triggered by news.