Clumsy Ebola response tests country's faith in health leaders

The American public's deep fears about Ebola and politicians' inflammatory rhetoric following the three U.S. cases in Dallas have prompted public health experts to think about how the country might respond to a more serious infectious disease pandemic, and what lessons can be learned from the current limited outbreak.

Some see parallels to the hysteria during the early days of the HIV/AIDS epidemic in the 1980s. Nonscientific chatter about the Ebola virus abounds on talk radio, in Congress and around kitchen tables, including the alleged threat of infected people coming across the Mexican border and supposed transmission through the air.

Sen. Rand Paul (R-Ky.) recently warned that the 4,000 U.S. troops sent to West Africa to build health infrastructure to combat Ebola could infect each other on transport boats and widely spread the virus when they return to the U.S. Other politicians have demanded a ban on West Africans coming to the U.S., though some have backed off after being told that could heighten the danger.

What's needed, experts say, is stronger leadership from public health and government officials, including the president. “The public has told public health officials what they really need to remain sane and calm,” said Dr. Robert Murphy, director of Northwestern University's Center for Global Health. “They need somebody in charge, they need action, they need a continuous stream of facts that are true and believable.” By contrast, in the current U.S. Ebola situation, “there has really been nobody in charge, and that has left the public floundering and coming to their own conclusions, which are not necessarily based on sound public health policy,” he added. That has helped create an information vacuum, allowing misinformation and hysteria to spread.

Popular anxieties over Ebola have soared since the first case was diagnosed in the U.S. in September. That was related to the federal government's and the U.S. healthcare system's botched responses to the case, which led to the infection of two nurses who treated the first U.S. Ebola patient and the resulting need to monitor hundreds of people.

A poll conducted by NPR and Truven Health Analytics earlier this month found that more than half of the people surveyed thought the U.S. response to the Ebola outbreak had been inadequate. Around 75% said they would prefer the U.S. to implement a travel ban to and from countries affected by the disease.

That's even though President Barack Obama and Dr. Thomas Frieden, head of the Centers for Disease Control and Prevention, have stressed a travel ban would make it harder to ID and track people traveling from affected countries.

Frieden admitted the CDC should have responded more quickly and effectively as soon as the first patient was diagnosed with Ebola at Texas Health Presbyterian Hospital Dallas. “We should have put a larger team on the ground immediately, and we will do that from now on any time there's a confirmed case,” Frieden said Oct. 14.

The contrast between the initial confident, even smug, statements by Frieden and other officials that U.S. hospitals were fully capable of safely treating Ebola cases and preventing the virus' spread, and subsequent events in Dallas have deeply shaken the public's confidence.

Dr. Ashish Jha, a professor of international health at Harvard University, said government officials and the public health establishment will have to work hard to regain the public's trust. “The lesson moving forward is that you have to be very realistic with people, and you have to tell exactly what the risks are, and acknowledge that there might be barriers but that people are on it,” he said.

Follow Steven Ross Johnson on Twitter: @MHsjohnson