The Contagion of Fear in the Ebola Crisis

The Ebola crisis as with other crisis' brings up fear; fear of the unknown, uncertainty and of the risks involved in handling the crisis. Fear is an emotion that keeps the focus on the past and or the future and what may happen. Fear is instructive like all emotions and it is not helpful to get stuck in fear. Yes ebola is a deadly virus and the action to take to stay out of hysteria is to keep yourself grounded in the present and what is happening now, learn the facts about the disease along with any risks and take care of yourself. This article briefly touches on the contagion of fear as Ebola makes its way into the US. Nurses Announcements Archive

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Specializes in Leadership Development.

Headlines like this have been the center of our attention, not only in the US, but in the world as well.

Ebola in NYC What You Need to Know

2nd Ebola Case in U.S. Stokes Fears of Health Care Workers

Ebola's Other Contagious Threat: Hysteria

CDC says it should have responded faster to the Dallas Ebola Crisis

For Infected Nurse's Neighbors, Ebola Brings Worry to Doorstep

In addition to the thousands in Africa, a doctor in New York City and 2 nurses in Dallas have been infected with Ebola. The physician who worked with Doctors Without Borders returned to the US was diagnosed with Ebola. Upon arrival to the US, he took his temperature twice a day and reported to the hospital when it was 100.3 and not 103.

In his opinion, the doctor erred on the side of caution. Many people have a problem when one physician makes a decision about this disease that can affect so many others. In an article in the Daily News on October 24, the reporter writes, "As a doctor, he knows he is not contagious without symptoms," explaining why the doctor took the subway, went bowling and took a cab. Where did he get his information about Ebola? The fact that he was diagnosed with the disease implies that this virus is not as predictable as we would like it to be.

Fear escalates in NYC as people wonder about taking the subway. Governor Cuomo is all over the morning shows allaying anxiety stating, "Ebola is not like the flu, it is not airborne... it is not contagious by sneezing."

This is part of the problem and not the solution. Mixed messages are only going to drive fear to hysterical levels when the information presented conflicts with other information. The problem with Ebola is that there have been reports that the virus mutates and it can be carried on droplets. Misinformation is making it difficult to build trust with the CDC and other agencies spreading information. It is confusing when healthcare professionals that have potential exposure are moving about the country. It invokes fear and anger as it looks like there is no one centrally in charge or knows what they are talking about.

As information comes out in bits and pieces, fears escalate. Initial comments by public leaders that there is "no risk" associated with Ebola to implications it was the nurse's "breach in protocol," to a Fox News physician actually saying it was fear that caused the breach only serves to escalate fear.

As long as the information presented is incomplete, the whirlwind of "what if" scenarios will run rampant. It is human nature to want to make sense of all threats and we are hardwired to respond to threats through the primitive survival instinct of fear and the stress reaction. Once the stress reaction is triggered, perspective shifts and the behaviors become defensive rather than proactive. Fear short circuits effective outcomes and promotes more reactionary fear.

Fear more than likely pushed the individual to omit information about exposure in order to come into the US. Was it fear and overwhelm (fear of not being able to handle the problem) within the bureaucracy of CDC causing a slow and inadequate response for accurate information and safe, effective protocols? It is probably fear that now prevents the Texas hospital from sharing information with other experts and facilities that would be helpful moving forward.

Ebola caught this country off guard with most hospitals unprepared to handle the type of isolation required with this disease. More specialized respiratory masks are required along with a very detailed process to put on and take off the protective gear that includes a buddy system to further lessen any risk of exposure. The handling of infectious waste is in itself another challenge along with what it takes to decontaminate exposed areas. Never before has this type of preparation been required or implemented in the majority of hospitals. The fear of being caught unprepared only gets in the way of effective operation. An article in MedPage Today shares the experience of a nurse in Florida who was suspended from her job because she called the CDC to get the precautions and protocols for handling patients with Ebola. How does this reaction by the facility promote readiness, confidence in the staff and in the ability to be prepared in order to do one's job?

Fear and the defensive behaviors and actions that are born out of fear cannot be the driver for healthcare readiness. This current dilemma highlights a need for a shift in how healthcare leadership handles challenges.

Fear is as much of the problem as the actual disease of Ebola. Fear sets up the flight or fight response when what is needed is to embrace the challenges presented in this global issue. What can be done to be better prepared; hospitals, nurses, healthcare workers, along with the rest of the world?

Fear is driving the spread of this disease in Africa as people there believe it is caused by a curse and have actually stoned and killed missionaries and educators who have tried to help the communities stop the spread. On September 22, 2014, CBN.com news story, "Ebola Aid Team Killed in Attack in Guinea." Fear is as much the disease as its' infectious nature.

Facts about Ebola from WHO: World Health Organization

From a fact sheet by the WHO, World Health Organization, the Ebola virus and disease had it first outbreak in 1976, simultaneously in 2 different areas; Nzara, Sudan, and the other in Yambuku, Democratic Republic of Congo. The outbreak in March of 2014 in West Africa has since been the most serious. According to the WHO, fruit bats are natural Ebola virus hosts with the virus introduced into the human population through contact with infected animals (chimpanzees, gorillas, fruit bats, monkeys, forest antelope and porcupines) either by ingesting raw meat and or contact with sick or dead animals.

Ebola then spreads person to person via contact with bodily fluids of infected people or with contact of surfaces, clothing, blankets, bedding, etc contaminated with these fluids. The WHO reports that people can remain infectious as long as the virus lives in their body fluids which include semen and breast milk. WHO report states that "men who have recovered from the disease can still transmit the virus through their semen for up to 7 weeks after recovery from illness." (WHO | Ebola virus disease)

The presence of fear is not the problem. It is a natural reaction to uncertainty. The problem comes when fears are denied, avoided and rationalized rather than faced head-on. The healthcare system (and the country) has to face the fears that are the result of the potential dangers of this disease and then leverage those fears to prepare with facts, the right equipment, training and support within the local healthcare team along with an organized effort globally at containment and treatment.

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Specializes in Peds, Med-Surg, Disaster Nsg, Parish Nsg.

Thank you for this article that gives good insight to the anatomy of fear......such as the atmosphere of the Ebola hysteria now spreading through the United States and the world. Some fear is good as it causes us to move into action. But the fear that causes paralysis or irrational decisions is harmful and needs to be addressed with education, prompt and accurate reporting, and rapid and appropriate action.

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Specializes in Nephrology, Cardiology, ER, ICU.

Thanks much for this very timely article.

Just heard on the news that seven states (IL included) are now quarantining all healthcare workers that have been to Ebola-ridden areas.

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Specializes in Leadership Development.

TraumaRUS I also just heard the Army will also... it seems to be a simple and common sense solution...

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TraumaRUS I also just heard the Army will also... it seems to be a simple and common sense solution...

I’m wondering if I’ve perhaps misunderstood your post :confused: Do you believe that it’s common sense to quarantine asymptomatic non-infectious healthcare workers?

In my opinion quarantine is suitable when a person actually poses a real risk to other people’s health, not when people due to a lack of knowledge are afraid of an imaginary risk.

Isolating someone who’s symptomatic and infectious makes perfect sense. Isolating someone who isn’t, is a violation of that person’s civil liberties and in my opinion only serves to fuel irrational fears.

This is excellent information posted by another member in another thread on EVD.

Bioethicist: 7 Reasons Ebola Quarantine Is a Bad, Bad Idea.

http://www.nbcnews.com/storyline/ebola-virus-outbreak/bioethicist-7-reasons-ebola-quarantine-bad-bad-idea-n234346

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Specializes in Leadership Development.

Yes I do believe that it is prudent to quarantine anyone who has had exposure to ebola at this point in time... later perhaps when more is known about the disease and when EXACTLY one becomes contagious another plan can be implemented = there are cases of contagion WITHOUT a temp increase. Why risk the incredible damage to not only individuals but healthcare SYSTEMS. There is not enough known at this point.

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I agree that fear is the main emotional response to the ebola crisis, but I'm sorry I don't think its rational to come to a set of protocols and rules based on fear. Basing any decision on emotion is only impulsive and does not take into account reason. Of coorifice everyone is afraid and panicking! It is for these reasons the CDC is trying to figure things out as quickly as possible and keep updating healthcare professionals. As stated before, the ebola virus caught us by COMPLETE surprise, I mean we weren't prepared to handle such deadly disease.

I respect both nurses who contacted the disease because they risked themselves to help their patients and at the time were not aware of the serious complications, but because of their "yes I can" attitude, the CDC was able to conclude certain protocols and make adjustments to stop the virus from spreading.

This was a very well written article and it definitely gave me a different perspective but I don't think we should point fingers at emotional decisions. We can't possibly know how hard it is to stop the spread of a tremendously deadly disease from a wide perspective.

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Specializes in Leadership Development.

Rococo I am not saying fear has caused the decisions for any protocols... I am talking about fears that are terrifying people they may catch the disease and causing increased stress. The protocols are based on the facts that this disease as studied has already mutated hundreds of times and one doesn't really know when one is contagious. I really appreciate your comment and thank you for posting!

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Specializes in kids.
trying to figure things out as quickly as possible and keep updating healthcare professionals. As stated before, the ebola virus caught us by COMPLETE surprise, I mean we weren't prepared to handle such deadly disease.

And how shameful is THAT? This has been percolating over there for some time now. We got caught. That there was no proactivity on this is disheartening. I hope we can come to a reasonable, data driven, science backed approach to this. Soon.

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Specializes in L&D, Women's Health.

Can't remember if I posted this on AN or another forum . . . forgive me if I did. If not, or if you didn't watch it . . . for your entertainment

I think the British are laughing at us:D

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Specializes in L&D, Women's Health.
Yes I do believe that it is prudent to quarantine anyone who has had exposure to ebola at this point in time... later perhaps when more is known about the disease and when EXACTLY one becomes contagious another plan can be implemented = there are cases of contagion WITHOUT a temp increase. Why risk the incredible damage to not only individuals but healthcare SYSTEMS. There is not enough known at this point.

I feel that we healthcare providers here in the US do not know enough about Ebola; however, we are learning fast. I do believe that those who have been studying Ebola for decades and that those volunteer providers who have been caring for patients with Ebola for decades actually do know a lot about Ebola. And for all these decades that they have been providing care to Ebola patients and returning to the US, they have followed their own protocol for self monitoring. I would put my trust in them than those two governors. Remember, it was not a healthcare provider that introduced the US to Ebola.

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Ebola Deeply (Ebola News | Ebola Deeply, Covering the Crisis) has been my preferred site for following this epidemic. The hysteria and fear that has emerged in this country has absolutely sickened me. Why are we so worried? The overblown coverage in a 24-hour news cycle does nothing to help people face the hard facts: we have had 4 cases out of 10,000 in our country. And so little focus is placed on the healthcare workers in Sierra Leone and Liberia who are working under the most unimaginable conditions to help those in desperate need of care. Cable news has evolved into a sensationalized reality show with an emphasis on emotion and sensation rather than facts.

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