By Hoyt Hilsman
Beyond the medical questions about transmission, treatment and protocols for dealing with the Ebola virus, there are bigger questions that remain unanswered. For example, when the virus spreads to the Middle East, Latin America or Asia — and it appears this is a matter of when rather than if — does the United States have a plan to deal with that scenario?
Specifically, if Ebola breaks out in those countries, which presumably are less able to contain it than the United States, how will we prepare for an influx of travelers from those additional areas? Especially when we are apparently unable distinguish those suffering from early stages of Ebola from a host of other diseases, including influenza?
We certainly can’t rely on travelers themselves to voluntarily disclose their exposure to Ebola, particularly since they may not know whether they have been exposed to Ebola or some other more benign virus. And checking everyone for fever or other symptoms would not only exclude thousands of non-Ebola sufferers, it would essentially bring international travel to an effective halt.
Even if there were only a few dozen cases of Ebola that presented in the United States, that could result in many hundreds or even thousands of contacts, each one of each would have the possibility of coming down with the virus and in turn infecting thousands of others. Does the public health system really have the resources to track down all those contacts? And even so, can those contacts be relied upon to truthfully report their symptoms and reliably follow the protocols? As with the case of the Texas nurse who climbed on a commercial airline after being exposed to Ebola, it is doubtful that this protocol can be strictly enforced.
Beyond the impacts on travel and the transportation system, one can imagine more extensive impacts on American society. If there are thousands and thousands of potential contacts, would it not begin to impact workplaces, schools and other community gathering points? One can also foresee an impact on all levels of infrastructure, including delivery of food and supplies, not to mention real woes for the financial markets.
None of this is by way of panicking in response to the fairly modest outbreak so far. And while some accuse the media of fanning the flames of fear, it does seem reasonable for the press and others to be asking these larger questions of the social and economic impact of a potential epidemic, even if it is still fairly remote. If the average citizens are beginning to raise these questions, isn’t it fair for public health officials to come up with some answers, even if it calls for a bit of informed speculation?
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