Fear of Ebola Spreading Faster Than Virus in U.S.

By Brenda Goodman, MA
WebMD Health News

Reviewed by Brunilda Nazario, MD

Oct. 16, 2014 -- Has the fear of Ebola gone too far?

Passengers who shared Frontier Airlines flight 1143 with Amber Vinson, the second nurse to catch Ebola in Dallas, suddenly found their lives upended this week -- not because they were sick, or even likely to get sick, but because of Ebola anxiety.

One woman, the mother of a school teacher who was on the flight, said her daughter was sent home from work.

"She felt a little strange being at school with the kids until she was able to talk to the CDC, and I think the school also felt like she should come home," said her mother, who asked that their names not be used for fear of causing undue panic among parents at the school.

Her mother, who lives with her, was also sent home from her job in retail sales for the rest of the week after her employer caught wind of the situation.

"It's scary for anybody, I think, that this hits very close to home," she said.

Other passengers also found themselves sudden sources of fear.

On Thursday, school districts in Texas and Ohio announced they would close schools for cleaning, because staff members and some students had been on the same plane -- though not necessarily on the same flight -- as Vinson.

The day before, airline stocks sagged amid fears that people would avoid air travel after news broke that Vinson had flown from Cleveland to Dallas with an elevated temperature the day before tests showed she had Ebola. Sales of hand sanitizer and bleach have also spiked.

A college in North Texas apparently sent a letter to at least two applicants from Nigeria denying them admission to the school because they were from a country with confirmed Ebola cases. That's despite the fact that Nigeria has had only about 20 Ebola cases -- all connected to the same patient -- and hasn't had a new case in 21 days, the time it takes people to come down with symptoms of the infection after they've been exposed. The World Health Organization may declare Nigeria's Ebola outbreak over as early as Monday.

And after photos were published showing a man wearing his regular clothing as he took a medical charter flight to Atlanta with Vinson, social media was abuzz with concern for the guy, who was quickly dubbed "clipboard man"." Turns out he's a medical protocol supervisor, and he was not wearing personal protective equipment, or PPE, on purpose. PPE limits what you can see, and it's his job to keep an eye on the flight medics who were in full protective gear to make sure they were wearing it properly since they had direct contact with Vinson.

Keep the Situation in Perspective, Experts Say

So what's going on out there? Has the worry about Ebola overtaken the facts?

Yes and no, says Jeff Duchin, MD. Duchin chairs the public health committee for the Infectious Disease Society of America.

"The world needs to be losing its mind about getting the outbreak in West Africa under control. That continues to be an unprecedented global public health emergency," he says.

"Here, in a country where we basically do not have any risk to the general public, I think the anxiety and fear is out of proportion to the risk," Duchin says. "There is no risk to the general public."

"What we're seeing here, currently, is more of an outbreak of anxiety about Ebola without an actual outbreak of Ebola," he says.

And when people start taking actions that have negative consequences and no real benefits -- like closing schools -- officials should try to stop that from becoming a trend by getting people the information they need to calm their fears, Duchin says.

Another thing that's driving Ebola fear is that people feel like they have no control, says Scott Geller, PhD, a behavioral psychologist at Virginia Tech.

"We lose 45,000 people on the road every year. We don't seem as fearful, of course, for travel," he says.

"The big difference is control. We feel that we're in control of our automobile. There's a sense of personal control and choice, but with Ebola, there seems to be no choice."

But the more the news says that these nurses were exposed because maybe they had exposed skin on their necks, people feel like there's no way to protect themselves against the threat, he says.

Conflicting and shifting information from public officials and health experts hasn't helped the situation, either. But taming the fear is important, experts say, because fear is almost certainly harming more Americans than the disease itself.

To do that, experts say it's important to keep the situation in perspective. While there have been thousands of cases of Ebola confirmed in West Africa, we've only had eight Ebola patients in the U.S., and most of them caught the disease abroad, returning to the U.S. under careful isolation for treatment.

Five of those people have been cared for in specialized units at top-tier medical facilities, with staff specially trained to handle highly infectious patients. All have recovered. None of the health care workers treating them have fallen ill.

Of the other three patients -- who all got sick in Dallas -- one, Duncan, had about 50 contacts who are all being watched for signs of infection. So far, none has shown any symptoms.

Yes, two nurses who treated him have fallen ill. Both nurses were being moved to specialized facilities for care. According to the CDC, 50 other health care workers entered Duncan's room. They're all being watched. So far no one else has shown symptoms.

Congresswoman: 'We Should Not Panic'

By all accounts, mistakes were made in the Texas cases. Those included sending Duncan home after his first visit to Texas Health Presbyterian Hospital on Sept. 25.

"Unfortunately, in our initial treatment of Mr. Duncan, despite our best intentions and a highly skilled medical team, we made mistakes," Daniel Varga, MD, chief clinical officer for Texas Health Services, said in written testimony to the House Energy and Commerce Committee on Thursday. "We did not correctly diagnose his symptoms as those of Ebola. We are deeply sorry."

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Those mistakes were serious, and we should learn from them, said Representative Diana DeGette, a Democrat from Colorado, in the House committee meeting. "But we should not panic."

At the same hearing on Thursday, under fire from congressional leaders, CDC Director Tom Frieden, MD, said it would be a mistake to overreact to the situation in the U.S. by trying to restrict travel to and from countries where Ebola is spreading widely.

For one thing, he said, there are no direct flights from West Africa to the U.S. Most people traveling from African nations are routed through Europe, which would make enforcing a ban extremely hard.

What's more, he said, banning travel from affected countries would likely make the situation in the U.S. worse, not better.

"Right now, we know who's coming in," Frieden said, referring to the estimated 150 travelers from Sierra Leone, Guinea, and Liberia that the U.S. receives each day.

If travelers from those countries were formally banned from entering the U.S., "we won't have the ability to do several things," he said.

"We won't have the ability to check them for fever when they leave or when they arrive. We won't be able to take a detailed history when they arrive. We won't be able to get detailed locating information the way we can now. We wouldn't be able to provide all that information from state and local health departments," he said.

Congressional leaders seemed unconvinced.

One, Representative Phil Gingrey, MD, an Ob-GYN from Georgia, asked Frieden about the definition of a fever consistent with Ebola and whether it was 101.5, as guidelines first stated, or 100.4, or 99.6.

He said with flu season on the way, parents would worry.

"What is elevated temperature? And when should parents be concerned?" Gingrey asked.

"Parents shouldn't be concerned unless the child is in West Africa," Frieden said, "or they've recently had contact with an Ebola-infected patient."

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SOURCES: Diana DeGette, U.S. Representative, First District of Colorado. Webcast, House Energy & Commerce Committee, Subcommittee on Oversight and Investigations, October 16, 2014. Jeff Duchin, MD, chair, public health committee, Infectious Disease Society of America. Scott Geller, PhD, director for applied behavior systems, Department of Psychology, professor of psychology, Virginia Polytechnic Institute and State University.

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