President’s Corner: Ebola a great reminder that good information can counter hysteria

From the Winter 2015 issue of HealthBeat.

Ebola coverage has fallen to a trickle, but the disease is still killing many people in West Africa. And today the concern is that the virus will become a permanent presence, burning on for years in rural areas. It also could flare up again in the United States and Europe, spreading cases across the globe.

Through it all, AHCJ’s, coordinated by managing editor Pia Christensen, has delivered tons of useful advice.

"Ebola virions" by See Source - Charting the Path of the Deadly Ebola Virus in Central Africa. PLoS Biol 3/11/2005: e403 doi:10.1371/journal.pbio.0030403. Licensed under CC BY 2.5 via Wikimedia Commons.

Ebola virions” by See Source – Charting the Path of the Deadly Ebola Virus in Central Africa. PLoS Biol 3/11/2005: e403 doi:10.1371/journal.pbio.0030403. Licensed under CC BY 2.5 via Wikimedia Commons.

Some of these by AHCJ graduate research assistant Kris Hickman are useful nuggets, such as the difference between “infectious” and “contagious” or how quarantine differed from isolation.

Other posts explained that Ebola is much harder to spread than the measles.

And Joseph Burns, AHCJ’s core topic leader on health insurance, wrote an insightful piece showing how Thomas Eric Duncan’s uninsured status may have contributed to his death in Dallas from Ebola.

AHCJ also held a webcast about what reporters need to know about Ebola.

Our website also serves as a reference to good work, from frontline doctors on the BMJ blog, “The Ebola Diaries,” to efforts by ABC News, Scientific American, BBC and The New York Times to understand and document the epidemic.

We all felt a big bolus of fear sweep the country as the first cases appeared in the States. But good information is the first-line treatment for anxiety caused by an epidemic. And things did eventually calm down.

Knowing this could happen again, I wanted to stress some resources that caught my eye. AHCJ has a terrific set of guidelines for reporting on epidemics and emerging diseases.

These guidelines represent a collaboration between AHCJ’s Right to Know Committee, led by Irene Wielawski and Felice J. Freyer (Rose Hoban and Charlie Ornstein contributed), and leaders of the National Association of County and City Health Officials and the Association of State and Territorial Health Officials.

“Openness is paramount,” all parties concluded in the document. “It is an essential component of protecting the public and communicating effectively. Public health officials should strive to release as much information as possible, within the limits of the law.

“Withhold information only when there is a clearly justified reason to keep it confidential.”

The guidelines also noted that journalists “serve as a conduit of information from public health officials to the public, a weighty responsibility in times of crisis. At the same time, the media must maintain their role as watchdogs, monitoring the performance of public health officials and health care providers. Journalists should question what they are told, but also report fairly what is revealed. They should neither exaggerate nor minimize, but strive to determine the truth and report it with balance and clarity.”

One big issue for many AHCJ members was how extensively to cover suspected Ebola cases. The world seemed to be baying for it. The New York Times has had more than 350 stories on Ebola and more than 70 on the front page. The Associated Press acquitted itself well by putting out an advisory describing why it “exercised caution in reporting these cases and will continue to do so.”

“Most of these suspected cases turn out to be negative,” the advisory concludes. “Our bureaus monitor them, but we have not been moving stories or imagery simply because a doctor suspects Ebola and routine precautions are taken while the patient is tested. To report such a case, we look for a solid source saying Ebola is suspected and some sense the case has caused serious disruption or reaction. Are buildings being closed and substantial numbers of people being evacuated or isolated? Is a plane being diverted? Is the suspected case closely related to another, confirmed Ebola case?”

“When we do report a suspected case, we will seek to keep our stories brief and in perspective.”

Another point worth noting: The developed world, including the United States, responded very slowly to the epidemic and did not become fully engaged until after cases were reported here. Local efforts were similarly underfunded, and many hospitals and public health agencies remain vulnerable to a fast-moving epidemic. Texas Health Presbyterian could have been any institution. So it behooves us to look more closely at the local level.

Finally, there were several cases of overreaction against people suspected of having Ebola. This is a predictable result of a novel epidemic.

The Philadelphia Inquirer covered a case in southern New Jersey in which two school children from Rwanda were asked to spend a week home from school because of unjustified fears that they might carry Ebola. Rwanda, it turns out, has had no cases, and is as far from Liberia as Philadelphia is from Alaska.

So the media need to recognize new forms of HIV hysteria as they arise. And, again, good information is the salve.

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