A new semester has just started, and I’m more excited than usual—that is, less depressed that summer vacation is over. The College of Arts & Letters just hired two scholars to beef up our programs in Science and Technology Studies and Science Communication. One is historian of science Alex Wellerstein, who writes the “Nuclear Secrecy” blog and created the creepy-cool “NUKEMAP.” The other is medical anthropologist Theresa MacPhail. I recently started chatting with MacPhail about the Ebola outbreak, and she graciously agreed to share her extensive knowledge with readers of my column. The following Q&A is an abridged version of one on my Scientific American blog, “Cross-check,” http://blogs.scientificamerican.com/cross-check/.
Horgan: Can you describe your experience in infectious-disease epidemiology?
MacPhail: As a medical anthropologist, I study networks of expertise and the production of scientific knowledge. Specifically, I have an interest in infectious disease and the epidemiologists and microbiologists working on infectious disease agents. In 2009, I was lucky enough to be allowed to volunteer and observe inside the U.S. Centers for Disease Control. I worked with a group of global disease analysts there. They are a dedicated team of epidemiologists who pay attention to early disease reports, help make sense of outbreak situations, and play a role in responding to outbreaks in the U.S. and around the globe. Almost everything I know about infectious disease surveillance and response, I learned by watching and talking to them.
Horgan: Has your experience made you more worried about the potential for global epidemics?
MacPhail: Yes and no. As part of the team, I was given access to their outbreak email account, so I got to monitor all the potential threats to our health. In the beginning, when I first started going through those reports, I was terrified. But after a while, as I learned more about what goes on in global health surveillance and response, I felt like we were in incredibly good hands. Outbreaks are going to happen. And there is always a chance that a disease agent like SARS (Severe Acute Respiratory Syndrome) or MERS (Middle East Respiratory Syndrome)–both corona viruses that are airborne and harder to contain than something like HIV or Ebola–will cause a very serious and global epidemic. But I also know that investing in basic public health structures, training local public health workers to respond to deadly outbreaks, and maintaining a high-quality surveillance and response system will make a deadly pandemic less likely. In other words, I trust these people. They are smart, they don’t get a lot of sleep, and they are amazing at what they do.
Horgan: Some Americans were very worried when Ebola victims were brought to the US for treatment at Emory University. Were their fears unfounded?
MacPhail: Absolutely. Ebola is a filovirus and it’s only spread through close contact – from coming into direct contact with an infected person’s blood, mucus, or other excretions. So unless you come into direct contact with one of those things, you’re not going to get this virus. And the people being brought in were under strict isolation, so there was never any danger to the public.
Horgan: Is there a downside to exaggerated reports about infectious diseases?
MacPhail: I think so, yes. I think that when you hype up fears around a single disease agent like Ebola, or MERS or SARS for that matter, you run the risk of masking the true threats to health – which have more to do with how prepared we are to handle ANY outbreak of infectious disease than with any single infectious disease agent. Take bird flu, as just one example. For years, we’ve been preparing for an outbreak of a deadly strain of influenza. All this money has poured into surveillance systems (which is probably good) and planning. But in our myopia about flu, what did we miss? In preparing for a deadly outbreak of a highly infectious disease agent, did we adequately prepare to deal with something like the spread of dengue fever or Chikungunya – both of which are nasty viruses spread by mosquitoes and are making slow but sure advances here in the U.S.? I’m a fan of making people aware of the dangers, but I’m not sure I see how exaggerating the dangers of someone in the U.S. contracting Ebola is going to help us.
Not to be too crass, but there’s always money to be made in fear mongering. I’m sure the click-thru rates go up for a story with a bold title about Ebola.
Horgan: Your bachelor’s degree was in journalism. Do you have any advice for journalists and other communicators reporting on outbreaks of diseases like Ebola?
MacPhail: I think it’s easy to get caught up in the drama of outbreaks. Ebola is a dramatic virus – the havoc it creates is real and the effects it can have on the body are truly horrific. It’s hard, as a journalist, not to focus on those aspects of an outbreak. Ebola is like all our worst nightmares coming true. But as journalists, we need to take a step back and analyze the bigger picture.
Something like Ebola takes the old adage “If it bleeds, it leads” to a whole new level. My advice would be to make sure you ask a lot of questions about the science – understand how the bug spreads and how it works. Also get into the bigger picture issues. Why is this a problem? What political and economic aspects of this outbreak are hampering or helping the public health response? What other factors are contributing to its spread? Answering those questions will automatically put things back into perspective.
John Horgan directs the Center for Science Writings, which is part of the College of Arts & Letters.
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