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Ebola Virus Outbreak

Why Are Americans so Scared of Ebola?

Image: A colorized transmission electron micrograph (TEM) of an Ebola virus virion.

A colorized transmission electron micrograph (TEM) of an Ebola virus virion. An American doctor suffering from Ebola was improving at an Atlanta hospital, officials said, as reports emerged 04 August that he had received an experimental serum while still in Africa and near death. The Centers for Disease Control and Prevention (CDC) along with the US State Department, the US National Institute of Health and the World Health Organization (WHO) coordinated the delivery of the serum that Brantly and Writebol received, Samaritan's Purse said. Cynthia Goldsmith / CDC via EPA file

Nearly 40 percent of Americans believe there will be a “large outbreak” of Ebola virus in the United States, and more than a quarter worry that someone in their immediate families will be infected within the next year.

The new survey shows that what people believe is not even close to the actual reality. The Centers for Disease Control and Prevention and just about every leading expert on infectious disease that you can find agrees: Ebola is very unlikely to spread in the United States. Even in a country affected by an outbreak, an individual’s chance of getting it are very low, but in the developed world, they’re virtually zero.

“The risk of Ebola is also lower in more developed countries because they have the resources needed to implement best practices if a case — or suspected case — occurs. Even if an Ebola case were detected, authorities have the ability to quickly handle the case properly and prevent spread in the community,” the group International SOS, which helps evacuate travelers needing medical care in foreign countries, says on its website.

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So why the disconnect? Well, it might be our fault. Us, as in the news media, and the entertainment media. And, experts argue, people are not really responding illogically at all.

“Guess what? Maggie Fox has been doing lots of stories about Ebola,” says Massachusetts-based risk perception consultant David Ropeik. “So it’s available to peoples’ awareness.”

It’s better than watching a zombie movie, says New York based risk communication expert Jody Lanard. It’s frightening and it’s real.

“I actually don’t think people in the West are responding out of proportion,” Lanard said. “They are responding with enormous interest to something that is really scary.”

When news media report on a new threat, even if it’s a distant threat, it feels like it’s close to home, Ropeik says. “It’s called the availability heuristic,” Ropeik told NBC News. “It’s a mental shortcut for making sense of partial information.”

News media have done a good job of accurately reporting the threat of catching Ebola — it’s very high if you are a health care worker in a poor country with limited resources, working double shifts with inadequate equipment. It’s very low if you are not in prolonged, direct contact with someone who is infected, or with the body of someone recently dead from Ebola.

The virus isn’t carried in the air and probably isn’t easily transmitted from objects a sick person may have touched, either. All of those infected have had direct contact with bodily fluids such as blood, diarrhea or vomit.

“Even though your stories may have included the fact that you have to have open sore or direct bodily contact to catch it, that is not the headline to most people here. We have lazy brains. We don’t want to think about things in a lot of detail,” Ropeik said.

This, according to the survey done by Gillian SteelFisher and colleagues at the Harvard School of Public Health, means that 68 percent of those surveyed believe Ebola spreads very easily or somewhat easily.

“We just don’t do all the homework. We never do,” Ropeik says.

It’s human nature to imagine what it would be like if it did come close, Lanard says. “We all kind of imagine catching Ebola because that’s what you do with something new and really, really, really scary, Lanard said.

“It’s not irrational. This is instinctive,” Ropeik adds. “This is just part of how humans do this stuff. It’s not stupid.”

On top of that, people have a background of what they think is knowledge about Ebola, thanks to the entertainment industry. It started with “The Hot Zone,” the 1994 thriller billed as the “Terrifying True Story” of viral hemorrhagic fevers such as Ebola. The novel may be partly based on fact, but writer Richard Preston adds a liberal dose of imagination to his writing, and the 1995 movie “Outbreak,” based on Preston's book, took even more liberties with the truth.

Blood doesn’t pour from the eyes, noses and mouths of victims, although they may hemorrhage, and while many suffer multiple organ failure, their organs do not dissolve in the way that Preston graphically and frighteningly describes.

In 2003, one season of the hit series “24” portrayed an even deadlier and more transmissible virus, one that spread through the air and killed within hours. The main character in the 2011 film “Contagion” manages to spread a new kind of highly deadly virus around the world in a matter of days. And people become infected within seconds by the virus that zombifies them in “World War Z."

People know Ebola doesn’t spread that way. They do know, however, that there is no drug that cures it and no vaccine that prevents it and that it kills anywhere between half and 90 percent of victims.

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“Dying from Ebola does suck,” Ropeik says. “It’s not a good way to go. That makes it scarier.”

It’s what University of Oregon psychologist Paul Slovic calls the dread factor. “There’s something essentially dreadful about this disease,” says Slovic, who is also president of consulting firm Decision Research. “It hits all the risk-perception buttons.”

People also doubt scientists who reassure them that the risk is minimal or zero. For instance, Lanard takes exception with the Centers for Disease Control and Prevention’s repeated assurances that any standard hospital infection control unit could keep a handle on Ebola.

If that were true, she says, hospitals wouldn’t be places where tens of thousands of people catch infections every year, including some pretty deadly ones like methicillin resistant Staphylococcus aureus (MRSA) and Clostridium difficile.

“Unfortunately, we all know how often they violate infection control procedures,” she says.

While the average American may not have all the facts about Ebola, the current outbreak can be a great opportunity to teach them, for instance about infection control and about the need to build up health systems in developing countries, Lanard said.

“People love zombie moves. People love monster movies. They know it is fun to think about. Now there is a new disease that is just as exciting, and even scarier,” she said.

“People find it fun to be a little bit scared about Ebola, so embrace that fear and use it as a teachable moment. I know people who are worried about Ebola and have made donations to Doctors Without Borders,” she said.

“The idea that people are panicking about Ebola is a bunch of baloney.”