The Risk of Unfounded Ebola Fears

Good essay.

Worry about Ebola (or anything) manifests physically as what's known as a fight, flight, or freeze response. Biological systems ramp up or down to focus the body's resources on the threat at hand. Heart rate and blood pressure increase, immune function is suppressed (after an initial burst), brain chemistry changes, and the normal functioning of the digestive system is interrupted, among other effects. Like fear itself, these changes are protective in the short term. But when they persist, the changes prompted by chronic stress -- defined as stress beyond the normal hassles of life, lasting at least one to two weeks -- are associated with increased risk of cardiovascular disease (the leading cause of death in America); increased likelihood and severity of clinical depression (suicide is the 10th leading cause of death in America); depressed memory formation and recall; impaired fertility; reduced bone growth; and gastrointestinal disorders.

Perhaps most insidious of all, by suppressing our immune systems, chronic stress makes us more likely to catch infectious diseases, or suffer more­ -- or die­ -- from diseases that a healthy immune system would be better able to control. The fear of Ebola may well have an impact on the breadth and severity of how many people get sick, or die, from influenza this flu season. (The CDC reports that, either directly or indirectly, influenza kills between 3,000 and 49,000 people per year.)

There is no question that America's physical, economic, and social health is far more at risk from the fear of Ebola than from the virus itself.

Posted on January 13, 2015 at 7:10 AM • 24 Comments

Comments

GreenSquirrelJanuary 13, 2015 8:13 AM

A few weeks ago I was in a health centre in rural mid-Wales (UK), about as far from any routes to Africa as you could imagine.

However, the health centre was plastered with posters about Ebola, the signs and symptoms and what you should do about it.

Madness. Real madness.

Clive RobinsonJanuary 13, 2015 8:35 AM

@ Guest,

Is there an industry whose business model involves creating such stress?

Have you thought about the most expensive --and least effective per dollar spent-- health care system in the western world?

Clive RobinsonJanuary 13, 2015 8:53 AM

@ Bruce,

Whilst I can see what the authors might be getting at with,

There is no question that America's physical, economic, and social health is far more at risk from the fear of Ebola than from the virus itself.

I'm not sure they are right with the economics. I suspect there has been quite a bit of "sunk cost" into Ebola prevention in the US the money involved would have been placed with mainly US suppliers who will have spent this within the US economy. The economic churn it would have created would by the normal estimates added three to ten times the sunk cost to the economy.

Can they show that the "short lived" stress caused in a small percentage of the population has actually had a real negative economic impact.

From what I understand from the medical proffession the emotional stress levels required to cause the lessions in blood vessel walls that lead to heart failure, attacks and the various forms of stroke, take considerably longer than six months in otherwise healthy individuals. Further that the effects of such stress can be considerably reduced by actually doing what the hormones are prepping you for which is "flight" by taking physically strenuous excercise.

Ross HartshornJanuary 13, 2015 8:56 AM

I agree that most of us shouldn't be worried about Ebola. However, there is a 1% (or some such small number) risk that any new strain of any disease can be a mutation that will cause millions of deaths. I don't worry much about Ebola, but I would be more sanguine still if I knew that there was a part of our government that DID worry about such unlikely but still possible events.

I think fear might be less if the government spent less time trying to convince us not to worry, and more time convincing us that the CDC was on this and is taking it seriously. Unfortunately, most of our government seems to be reactive rather than proactive, which is not reassuring. Because, although Ebola is almost certainly not going to be "the big one", sooner or later there will be the big one, and we should be treating each new disease strain that pops up as if it has a small but meaningful chance of being it.

davidJanuary 13, 2015 9:38 AM

This is why Homeopathy is good in this case. You will not have any bad second effects, you will not have dangerous drug interactions, you will just have a nice placebo effect that will effectively make you feel better (because the placebo effects does affect our body the same way the nocebo effect you described affect our body).

By the way, another interesting anecdocte like this one: if a girl think she is pregnant she can catch all the pregnancy symptoms although she is not pregnant. Her ovulations will stop, her belly will become bigger, etc...

vas pupJanuary 13, 2015 10:04 AM

@Clive Robinson • January 13, 2015 8:35 AM.
Bingo!
@all regrading fear. When you evaluate (subjectively) risk/harm of any event my guess it is combined probability of harmful event itself (air crash versus auto crash) and probability to survive in such event.
Even probability to catch flu is substantially higher than Ebola, but death rate when you got Ebola is close to 100% same as death rate when plane crash. Conclusion: psychologically both probabilities evaluated together (subconsciously) giving combined/integral fear factor for each threat.

GweihirJanuary 13, 2015 10:14 AM

Very much this. It is the hallmark of a civilized person that he/she has gotten control of their fear and have mastered and overcome it. Only then can a person become a truly rational being. Unfortunately, most people fail that test, and this is the main reason that "the masses" are so easily manipulated by politicians using all kinds of imaginary or overblown threats. This is also the reason why so many people cannot even get basic risk-management right: Fear grips them before they can apply rationality. This is (besides the greed and lust for power and dominance of a few) the only real problem the human race has. Basically, everything else derives from it.

Or in the words of a master: "Fear is the mind-killer....".

GweihirJanuary 13, 2015 10:22 AM

@Guest: Basically all use it in advertising: "Buy this product or you will be ugly and nobody will love you." Bam, fear! "Buy this technology or you will look clueless." Bam, fear! "Drink/eat this product or you will have no friends/die soon/be ugly." Bam, fear!

The trick here is always to trigger the fear-reflex to kill rationality and at the same time present an easy solution. This goes from selling cloud-computing to selling carpets or beer. It is universally successful, because most people have never learned to master and overcome their fears. And of course, all kinds of "leaders" use this to great advantage in manipulating people into anything and everything they want them to do.

CallMeLateForSupperJanuary 13, 2015 11:29 AM

The ad nauseum "Je suis Charlie" drumbeat triggered fight-or-flight in me after just three days. I fled; I ignore every such article. A happy but unanticipated benefit is that I get through my blogs and newspapers in record time.

OFF topic:
I know little French, barely enough to insult a French speaker - not that I do it; well, once, just to prove it - which is to say I don't "do" French at all well. The consequence of that is, whenever my eyes fell on "Je suis Charlie", my brain percieved "Jesus, Charlie!". I realized the error instantly, but since the latter pretty much encapsulates my opinion of the publication in question, I didn't correct.

albertJanuary 13, 2015 11:38 AM

[required background music: "Wipeout", by The Surfaris]
.
@david
Homeopathy doesn't work by the placebo effect. It's a energy-based medicine that is not understood by modern medical 'science'. The drug companies continue to try put the Homeopaths out of business, because the remedies are too cheap to make, and in fact, can be made by anyone. The fact that they are effective is irrelevant to them. Just look at the side effects of modern drugs. They want us to pay billions of dollars for ineffective drugs that can _kill_ us. Even the rubber-stamping FDA makes 'em say that.
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@Clive
I wish you had expanded your first comment a little. The country you are referring to is, of course, the US. 'Most expensive, least effective' speaks volumes about the relationship between money and quality.
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@everyone
Once you look at a situation in economic terms, everything becomes clear. The basic tenant of capitalism is 'make money at any cost'. As folks become more cynical, less inclined to accept BS, and begin to ascertain root causes, the elite roll out the FUD.
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Fear: After 911, fear-mongering allowed the creation of a security/police/military state of almost unlimited budgets. The virtual elimination of Consitututional protections. The accelerating move toward total elimination of financial and environmental regulations. How about the 2014 flu scare?
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Uncertainty: "Don't worry, be happy." Are we headed for another economic disaster? (short answer, yes). Will I lose my job? My house? Better do what they tell me.
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Doubt: "You might as well trust us, there's no other choice."
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Except for computer security{:-), there are solutions for our problems; they just aren't being implemented.
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The stress factor is critical in assessing health issues, and it just keeps getting worse and worse. Everyone is affected by stress, even the 1%. Somehow, that's no consolation for anyone I know.
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I gotta go...

Bob PaddockJanuary 13, 2015 12:01 PM

Not sure where I picked this up, it is my queue to add to my late wife's wiki:

“The Social Transformation of American Medicine.” This book won a Pulitzer Prize in 1982.
-----------
“If you really want to understand how medicine has become a business instead of a noble profession…”

https://openlibrary.org/works/OL3617562W/The_social_transformation_of_American_medicine

The social transformation of American medicine by Paul Starr; 4 editions; First published in 1982; Subjects: History, History of medicine, Modern, Medical care, Modern History of Medicine, Physicians, Social medicine, United States, In library, Protected DAISY; Places: United States By OpenLibrary.org.
-----------

----

"Medical Economics is a unique business resource for busy physicians, providing the practical information and expert advice they need to successfully manage their medical practices, their personal finances, and their professional careers."

Subscribe here: http://medicaleconomics.modernmedicine.com

Everyone can get the digital edition. Only doctors can get the printed edition

There are many interesting articles there, like the number of suicides of medical students increasing. Doctors leaving the profession in high amounts due to crushing government paper work etc.

----

If you truly want to understand medical fear, *please* read my late wife's Journal. Everyone tells me they are in tears by the end (as am I typing this just now).

Here is an entry of the typical treatment when someone goes to the Emergency Room (ER) with a non-conventional problem:

http://www.kpaddock.com/doku.php/kpaddock/my_story_2012?s[]=blind#duke_er

People suffering from Karen's condition (Actor George Clooney is one of them) must be near death before they will even think of going to the ER because past experience and learning from others have told them the nightmare they would experience.

Like being told to lay on the bench in the parking garage rather than the ER floor!:

http://www.kpaddock.com/doku.php/kpaddock/my_story_2013?s[]=garage#cedar_sinai_er

Karen's Journal is summarized by the local paper here:

http://www.kpaddock.org

"Karen's first-hand account of her illness gave an honest, heart-wrenching depiction of what it is like to live with debilitating pain day-to-day."

----

I'm here to learn about security which is a newish field to me so I don't say much (this is only my second posting), however if you want to know *anything* about the horrors of the US Medical system please get in touch with me. I've been in far to long (as a programmer/user not a doctor):

http://blog.softwaresafety.net/2009/05/when-was-very-first-electronic.html

Bob PaddockJanuary 13, 2015 12:13 PM

"Just look at the side effects of modern drugs. They want us to pay billions of dollars for ineffective drugs that can _kill_ us. Even the rubber-stamping FDA makes 'em say that."

Worse than kill us they can make us suffer for a life time.
If a doctor ever wants to give you or your loved ones any of theses:

Levofloxacin (Levaquin), Ciprofloxacin (Cipro), Moxifloxacin (Avelox), Norfloxacin (Noroxin), Ofloxacin (Floxin), Gemifloxacin (Factive) and Finafloxacin (Xtoro) .

LEAVE their office NOW and never return to it! These drugs should be taken off the market, and the FDA knows it!

Karen spent a year crawling around the house on this construction, skate board like thing so her ankles would heal from Fluoroquinolone poisoning.

The link takes you to FDA reports of the damage (They do know!) etc resources of others that have been harmed and I have a lot more to add to that section of Karen's wiki.

Paul W.January 13, 2015 1:30 PM

"I agree that most of us shouldn't be worried about Ebola. However, there is a 1% (or some such small number) risk that any new strain of any disease can be a mutation that will cause millions of deaths."

There is particular reason to worry that Ebola will do this and cause many millions of deaths, or even a billion or so, and crash the world economy.

The main risk is if a really bad Strain of Ebola evolves to be transmissible by air.

That is almost certainly possible, because Ebola has done exactly that before. Luckily it was a strain that was really bad for monkeys, but apparently not very transmissible and harmful to humans. (Ebola Reston.) We dodged a bullet there.

The chances of a strain of Ebola that's virulent among humans evolving to become airborne depend largely on how many humans get it. The more hosts, the more viruses, and the more chance for mutation.

That's why it's important for everyone to stop or contain Ebola outbreaks while they're as small and local as possible. It reduces the chances of an airborne strain evolving---and that would likely not be containable at all. It would spread worldwide and could kill vast numbers of people.

Everyone needs to know that---even if we in the developed world are selfish, we shouldn't just be worried about whether Ebola is likely to propagate in developed countries with decent health care systems. We should worry about whether it spreads in the third world and keeps evolving until even first-world health systems couldn't limit the damage. (Of course we should be worried about it spreading in the third world because it's a disaster for human beings. But an appeal to selfish interests often works better.)

The CDC is promoting a simplistic threat model that's basically right at one level and completely wrong at another because it ignores the strategy of using an exploit for one system to get information that provides an exploit for another, which is what viruses have always done. (Which is why we get "swine flu" and "bird flu" and so on.)

Ebola is a hacker that has hacked one system (theirs), and hasn't found an exploit for another (ours).

And really, it hacked another system before that---millions and millions of years ago it hacked the monkey immune system, which is almost identical to ours. From there it flourished, and found a way to hack a very similar immune system. (We are 99 percent monkey. Actually we ARE monkeys, just slightly different monkeys than the ones it was used.)

AnuraJanuary 13, 2015 5:17 PM

@Paul W

We are 99 percent monkey. Actually we ARE monkeys, just slightly different monkeys than the ones it was used.

I know this is pedantic, but humans are not monkeys; we are apes, just like our closest living relative, the chimpanzee.

Rac NetsJanuary 14, 2015 1:05 AM

I agree that fear of ebola is certainly irrational (for the time being). And yes, there might also be an industry of fear. However, this post does nothing else, it creates fear: Fear of fear of ebola. With all due respect, I think you argued yourself into a trap and in the worst case into a self-fulfilling prophecy.

WinterJanuary 14, 2015 2:55 AM

@Anura
"I know this is pedantic, but humans are not monkeys; we are apes, just like our closest living relative, the chimpanzee."

Actually, we are the third Chimpanzee species (besides the common chimpanzee and the bonobo). We should be called Pan sapiens.

Paul W.January 14, 2015 11:49 AM

Anura:

"I know this is pedantic, but humans are not monkeys; we are apes, just like our closest living relative, the chimpanzee."

The traditional informal nomenclature (for 50 years or so) has said that, but it makes no scientific sense. Before that, the traditional informal nomenclature didn't make the ape/monkey distinction it does now---it was okay to say that an ape is a kind of monkey.

The informal English-language terminology changed, but NOT because science came up with any reason to say apes weren't monkeys---quite the reverse. It only became clearer that they are.

(So when somebody in the movie King Kong called King Kong a big monkey, he was quite right. Apes were monkeys in the 1930's. No scientific fact has come to light to dispute that, and it's just a difference between 1930's era informal terminology and later informal terminology. In some languages, it's still considered correct to talk about apes as a kind of monkey, and it's right.)

Specifically, apes are a kind of Old World monkey.

Every human being is more closely related to every Old World monkey than any New World Monkey is to any Old World monkey. Old World monkeys (including apes, including us) descended from nearer common ancestors than Old World and New World monkeys did.

More specifically, apes are a kind of catarrhine Old World monkeys. (We apes are more closely related to other catarrhine monkeys than they are to other Old World monkeys, much less to New World monkeys, which are distant relatives.)

If we don't call apes "monkeys," we shouldn't call New World monkeys monkeys either.

And that matters for Ebola. It's an Old World monkey disease, including catarrhines, and we're catarrhine Old World monkeys. Uh-oh. If Ebola comes to the Americas, it's not likely to infect the New World monkeys. It's likely to infect the Old World monkeys that migrated to the New World---us.

The bogus "apes are not monkeys" terminology obscures actual scientific facts like that.

That's why is why primatologists tend not to talk about "monkeys" at all when they're being serious and clear---they talk about "simians." That's the actual scientific name for the monkey group, including us apes.

We dropped the bogus ape/human distinction in English. We should drop the bogus monkey/ape distinction, too.


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