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.
