Public education, not panic, best approach to Ebola crisis, says Yale expert

 

The deadly Ebola virus has taken thousands of lives in West Africa and threatens to affect many more people around the world. The first death has been confirmed on American soil, and the Yale community of faculty, students, and staff are taking steps to help tackle this growing global health threat in many different and creative ways.

Lectures, panels, and concerts planned in the upcoming weeks are all designed to  educate the Yale community and the general public about the virus and how it spreads. These educational outreach community events aim to raise awareness and dispel myths and fears about the virus.

See: Yale's "Ebola Response" website

YaleNews recently spoke with public health professor Elizabeth Bradley to learn more about the Ebola virus, how the Yale community can help, and how the world can create better strategies to tackle this and other public health threats we might face in the future. Bradley is faculty director of the Global Health Leadership Institute and a professor at the Yale School of Public Health.

Ebola first surfaced over 40 years ago. Why has it reemerged in such an aggressive way?

There have been Ebola outbreaks in the past, but it never moved as quickly because it never hit a city before. In addition, biology is constantly creating new kinds of pathogens, and mutations are always developing in our world. The ones that survive and do real damage take root in vulnerable areas of the world that aren’t equipped to combat them. Viruses mutate and infect humans to survive — therefore, we constantly need to stay one step ahead of these mutations. My colleagues Kristina Talbert Slagle and General Stanley McChrystal have likened the Ebola outbreak in West Africa to situations where a weakened human system is susceptive to a threat that healthier systems can easily fend off.

Is the United States in a good position to stay a step ahead of this growing epidemic?

In Liberia, the infrastructure to combat such a widespread outbreak is weak. It is not easy to get to a hospital and get rehydrated; there is no tracking system in place to find and notify others who might have come into contact with those who have contracted the virus. Even if you could identify all of these people, there isn’t a humane, reliable way to isolate them from the rest of the community. Missing all of these elements is a “double whammy” to economically vulnerable areas trying to manage such a deadly, fast-moving epidemic. The most important factor in controlling the Ebola outbreak is a strong, well-functioning health system, which we have here in the United States.

Many people feel far removed from Ebola’s spread through Africa and increasingly helpless as the situation worsens. What can the Yale community do to help address this epidemic?

One way we can help is to engage students and faculty who are the purveyors of information. If our students are engaged and understand this, then it becomes something the public is aware of. Social media can also be an effective way for us to promote change. Even with the great infrastructures we have in place in the United States, these viruses can touch us. Knowing that one fact changes people’s opinion. Yale students are historically ready and willing to get involved and assist with global issues. I am inspired by the enthusiasm the students have shown in putting on an upcoming benefit concert (see below), as well as other events.

From a faculty perspective, we can work on the science and create the knowledge to protect ourselves in the future. We also need to develop a larger strategy that can have a broader impact.

What more can the government do to address this situation and prevent other outbreaks?

President Obama has done a good job of mobilizing both financial resources and our military. We all have a vested interest in taking care of this global problem. No country can fix this alone. The only way around this is to have global cooperation. Having the United States support that process is critical.

We also need to recognize how important it is to support United Nations bodies such as the World Health Organization. We need to focus on continuing to fund the public health system — from the federal-level Centers for Disease Control and Prevention (CDC), to local health departments — and to keep the funding strong. When we engage our resources, we become part of the solution.

Facts about Ebola

• Ebola virus disease (formerly known as Ebola haemorrhagic fever) is a severe, often fatal illness, with a case fatality rate of up to 90%. It is one of the world’s most virulent diseases. The 2014 epidemic has taken thousands of lives in Guinea, Liberia, and Sierra Leone.

• Ebola is not transmitted through the air. The virus can be transmitted through direct contact with bodily fluids from an infected person, animal, or contaminated objects.

• Incubation is 2 to 21 days, and symptoms include fever, fatigue, muscle pain, headache, sore throat, vomiting, diarrhea, rash, and impaired kidney and liver function.

• Severely ill patients require intensive supportive care. During an outbreak, those at higher risk of infection are health workers, family members, and others in close contact with sick people and deceased patients.

• Check the Centers for Disease Control & Prevention and the World Health Organization websites for updates on Ebola.

Can you clear up some myths about the virus and the way it has spread?

It is important to note that it is not airborne, and there’s no evidence that it will become airborne. What we do know is that the virus travels in bodily fluids and even a small droplet of fluid can contain the virus. The only way to contain an outbreak is to isolate those who are infected and closely monitor those who have been exposed.

The most important thing to remember is that Ebola is not easily transmitted. We are only seeing rare cases in the U.S. and our healthcare personnel are well-equipped to handle these patients. But taking the classic precautions like practicing good hygiene is always a good rule. In general, stay home if you feel sick and seek care if needed. My fear is overly alarming people, which can do real damage, both psychologically and socially.

What are some simple steps people can take to reduce their chances of being infected with the virus?

Be aware of where the virus is most prevalent and don’t travel to those places. We have to look day-by-day to assess travel safety concerns. The advice see could change depending on what happens, so checking with agencies like the CDC will help keep us informed. No one expects that this will become an epidemic in the United States. Unlike West Africa, we have great surveillance and everyone expects this to be contained very quickly in the U.S.

Some might call for drastic steps like closing our borders or restricting travel from the affected countries. Would this be necessary?

Given the ability to travel easily among countries, restricting travel would not be useful. What we need to do is strengthen screening mechanisms for symptoms of Ebola for passengers getting on planes or boats to the United States.

Would any of the scholarly/research projects you’re working on now have an impact on stopping or managing this outbreak?

My research focuses on improving health systems. So much of what we work on is training and developing inexpensive systems to equip hospitals to be able to efficiently manage routine healthcare needs, as well as outbreaks like this.

We also think strategically about where investments need to be made to ensure trust between caregivers and the community. We have done work in Liberia in the past. The Clinton Foundation has now asked us to think about ways to rebuild the infrastructure in Liberia — how we can equip this and other countries with the proper infrastructure so that this kind of virus can be treated earlier to prevent pandemics.

How can hospitals and health care workers prepare for more cases?

From a technical point of view, our hospitals are prepared to deal with this. Americans have a great way of rallying. There is a lot of technical support and sharing of resources among healthcare systems. Hospitals are obviously on alert for cases and in the U.S. they are generally prepared to handle this challenge. In light of new reports that a health care worker became infected after caring for a person who had Ebola, it is even more imperative that hospitals are vigilant in tightening up their plans for safely addressing more cases and reducing the risk of infection. I understand that many hospitals are practicing quarantine drills to be able to identify possible patients and isolate them quickly.

How can we strengthen the public health system to manage other outbreaks?

The strongest strategy will include surveillance data, which is an underestimated weapon in fighting outbreaks like Ebola. We should also create humane conditions in quarantine where patients with Ebola can get the care they need, and where caregivers have the protective equipment to allow them to provide safe care.

That is not terribly expensive but it takes leadership and coordination to make it happen.

What can you tell those who are worried, if not panicked, about Ebola spreading?

The main thing we can do to help people deal with anxiety about this is to provide clear information. When there is something terrorizing the world like this, constantly sharing accurate and trustworthy information about the risk helps allay fears. People become less panicked when they can do something and that’s what our strategy is here at Yale. Giving people the opportunity to help is fundamental. As in any other type of crisis and emergency response, coming together to keep the community safe is key. It would be absolutely devastating to have this spread, but we could get through it together as a community.

Until we can contain it, this virus will be wreaking havoc on communities for some time. Getting the word out on what is being done to address it is a public health priority.

You and colleagues, working with students, have spearheaded some fundraising efforts. How can people help?

We began with a group of 20 people, and we decided that the best thing we can do is to engage the community. It needs to be on people’s minds even though we can’t go to the hardest-hit areas. We have identified three partners that we think are the best donation channels, including Doctors Without Borders, Americares, and Partners in Health. A website has been created to accept donations.

 

Campus events aim to raise awareness about, funds for Ebola crisis

The Yale Ebola Task Force will kick off an Ebola educational and fundraising campaign on Thursday, Oct. 16 with a panel discussion about the epidemic. More information on this and other events can be found below:

Panel

“Beyond the Headlines: Understanding the Ebola Epidemic and Crisis Relief Initiatives”
Thursday, Oct. 16 — Linsly Chittenden Rm. 101 (63 High St.), 4–5 p.m.

The panel will be moderated by Elizabeth Bradley, faculty director, GHLI, professor, Yale School of Public Health. Panelists include:

Kristina Talbert-Slagle, senior scientific officer at the Yale Global Health Leadership Institute and a lecturer at the Yale School of Public Health. Talbert-Slagle will discuss the epidemiology of the Ebola virus — including why the outbreak has reached such a crisis level in West Africa, how Ebola looks very different in the United States, and why the Ebola virus has very little chance of ever becoming airborne.

Susana Edjang, economic, social and development affairs officer, executive officer of the secretary-general, United Nations, and a 2014 Yale World Fellow. Edjang is an international global health and policy expert expected to address the United Nations’ response to large-scale outbreaks such as Ebola in West Africa. She is a co-author of “Working in International Health.”

Christopher Lockyear, operations manager, Medecins Sans Frontieres (Doctors Without Borders), and a 2014 Yale World Fellow.

Lockyear is responsible for the strategy and implementation of MSF’s humanitarian response and has led operations across African and Asia including in Somalia, Pakistan, South Sudan, and Chad. He plans to discuss how the international community should respond to outbreaks like Ebola.

The event is being sponsored by the Yale Global Health Leadership InstituteYale World Fellows Program, and the Yale Undergraduate Association for African Peace and Development.

Lecture

“Ebola: How Dangerous Is It?”
Monday, Oct. 27, The Anylan Center Rm. N-107 (300 Cedar St.), 5:30–7 p.m.

The featured speaker will be Jamie Childs, senior research scientist and lecturer in epidemiology at the Yale School of Public Health His talk is part of the Global Health Seminar, a weekly elective course for students in the health professions to develop an understanding of key aspects of global health research and practice. Childs is expected to discuss the etiology of the virus and how Ebola affects the human body, transmission, containment, and challenges. Read his Q&A on Ebola first published in August. 

Fundraising concert

Saturday, Nov. 8, 8 p.m., Battell Chapel, corner of Elm and Prospect streets.

Program and performers to be announced.

 (Image via Shutterstock)