The Sky Is Not Falling, and Ebola Is Not Out of Control

With yesterday’s news that a second nurse in Dallas has tested positive for the Ebola virus, it is quite clear that the story is heading in three distinct directions.

First, the West Africa epidemic is a nightmare of almost unheard of proportions with each new WHO prediction more dire than the last.

Second, for the hundreds of health-care workers in the U.S. who are dealing with the current patients (and the perhaps thousands more who may help care for infected patients in the future), today’s news has caused a justified moment of true fear and doubt.

Third, for the 300 million Americans who are not are not working in hospitals in Omaha, Atlanta, or Dallas, the news is remarkably upbeat—even optimistic. From the moment Thomas Duncan first was diagnosed (and actually for months before), the now-reviled public health authorities promised that the risk of spread to the general public was nil.

And guess what? They were right.

The evidence, including the newest information gathered from our experience with the disease in North America, demonstrates undeniably that—yikes—the public-health authorities know what they are talking about. Say it out loud! They were right! They aren’t inept and bumbling and afraid of their own shadow!

Here are the facts.

First and most importantly, Thomas Duncan was admitted to the hospital about 18 days ago, on Sept. 28. I do not know whether his loved ones were allowed to visit him in the hospital either before his diagnosis on Sept. 30 or after, therefore extending their risk period, but I suspect many were not, including all those children he had spent a little time with. But it is clear that none of them have developed an infection. Though we are three days short of the magic 21-day mark, where the coast being clear becomes a statistical certainty and, in all likelihood, that initial group of family and friends are safe. As such, they emphatically demonstrate the accuracy of the “no risk to public” trope.

But wait there’s more. The same large sigh of relief should be heard from for the large health-care worker staff at the beleaguered Dallas hospital where Duncan was seen on Sept. 25 (when he was sent home) and again on Sept. 28, when he arrived by ambulance quite ill. They too seem to be in the clear. And the people on the airplane with Duncan through Brussels and Washington, D.C. are also in the clear.

Speaking of air travel, the single most important epidemiologic fact arguing for the public’s safety is this: Patrick Sawyer, the American who flew from Liberia to Nigeria while sick with Ebola, spread infection to absolutely no one who shared the plane with him. This information should go a long way to assuring those Frontier Airlines passengers who accompanied the second infected nurse from Cleveland to Dallas this week.

And still more: Spain, where a nurse caring for two repatriated patients dying of Ebola herself developed the disease, has not seen a second case related to these men’s care or the ill nurse’s, despite what has been reported by local groups as a complete lack of preparation and appropriate supplies to minimize the risk of transmission.

Despite a raging, unconscionable epidemic in West Africa, no other cases other than Duncan have appeared unexpectedly outside of Africa. Europe: Zero cases. USA: No further cases three weeks since Duncan’s illness began. Obviously past performance does not predict future returns and the world is not out of the danger zone but for now, the infected traveler is a rare event.

In other words, the rules of transmission in the community are exactly as promised with calm assurance weeks and months ago; and, conversely, the risk of caring for the super sick is every bit as harrowing and dangerous as feared when all of this began.

So why are we all so worked up? It turns out that America loves two aspects of the story.

First, we are addicted in some way to fear. I will leave it to the psychologists to sort this one out, but surely it is something well understood by politicos for whom fear and its provocation is the coin of the realm.

Second, and surely more corrosive, we cherish nothing so much as a hindsight-based blame game, sitting from our comfortable unpressured perch of today and combing back through yesterday’s possible missteps. Yet given the tragedy occurring right now in West Africa and the under-discussed heroism of the health-care workers in Dallas who treated Duncan knowing there was risk and now are willingly treating their own sickened colleagues, the pouting and stomping over what coulda woulda shoulda been done, is more than annoying. In its sanctimony and startling rage, this attitude threatens to efface the remarkable record of humanity exhibited by so many who have died because in their desperate attempt to help another person.