Ebola is a hot topic in the media right now, with multiple cases being reported outside of West Africa and much confusion among the general public around the reality of the danger. So, are the fear and sensationalism warranted?
RMS models infectious diseases and recently developed the world’s first probabilistic model for the current West African Ebola outbreak. While Ebola is indeed a very scary and relatively deadly disease, with a case fatality rate between 69 and 73 percent according to the WHO, RMS modeling shows that it is unlikely the outbreak will become a significant threat globally.
The spread of Ebola in West Africa is in part due to misconceptions and fear surrounding the disease and a lack of public health practices. Ebola can be passed solely via bodily fluids; the risk of unknowingly contracting the disease is low.
Fear is prevalent among some West African communities that Ebola is a lie or is being used purposefully to wipe out certain ethnic groups, causing them to hide sick family members from healthcare and aid workers. Customary burial practices, in which family members kiss and interact with the dead, also have contributed to Ebola’s spread. Getting the populace in these countries to trust foreigners who are telling them to abandon their customs has been an uphill struggle.
In more developed countries where health care is more advanced and understood, the chances of transmission are exponentially smaller due to the fact that extreme containment measures are taken. Controlling the spread of the disease comes down to a question of logistics; if the medical community can control the existing cases and trace the contact made with carriers, spread is much less likely. For example, the case in Texas can be contained to one degree as long as every single person in contact with the patient is tracked.
There is also a (speculative) fear of the virus mutating into an airborne pathogen; the fact is, the chances of the virus changing the way it is transmitted, from fluid contact to airborne passage, are very low and of a similar order of magnitude to the chance of emergence of a different highly virulent novel pathogen.
Vincent Racaniello, a prominent virologist at Columbia University wrote:
“When it comes to viruses, it is always difficult to predict what they can or cannot do. It is instructive, however, to see what viruses have done in the past, and use that information to guide our thinking. Therefore, we can ask: has any human virus ever changed its mode of transmission? The answer is no. We have been studying viruses for over 100 years, and we’ve never seen a human virus change the way it is transmitted.”
The tipping point in the modeling of a virus like Ebola is the point where the resources being used to mitigate the threat outpace the increase in new cases. Trying to get ahead of the epidemic itself is like a race against a moving target, but as long as people get into treatment centers, progress will be made in getting ahead of the illness.
So, while Ebola is a very scary and dangerous illness, it is not something that we expect to become a global pandemic. However, while the current outbreak is not expected to spread significantly beyond West Africa, it still has the potential to be the most deadly infectious disease in a century and could have drastic economic impacts on the communities that suffer from Ebola breakouts. In fact, the economic impacts are likely to be worse than the actual impacts of the disease, due to negative impacts to trade and inter-community relations.
The key is to contain it where it is, reach the tipping point as quickly as possible, and to promote safety around existing infected persons. Through travel control measures and the development of several new drugs to combat the virus, the danger of epidemic should be drastically reduced in Africa and, as a result, the rest of the world.