Tag Archives: Ebola

Ebola: What went wrong?

The current Ebola crisis has claimed over ten thousand lives in West Africa, and continues to cause hundreds of new infections every week. Yet, media coverage of the crisis had been meager up until the summer of 2014, an entire half-year after the start of the outbreak in late 2013. The world’s delayed reaction has generated criticism for both public ignorance and for lackluster government response. But where did we go wrong? What could we have done differently that may have changed the course of this epidemic?

To get a better understanding of these difficult questions, we spoke with Princeton University’s Adel Mahmoud, a professor in both The Woodrow Wilson School of Public and International Affairs and The Department of Molecular Biology. Professor Mahmoud’s research focuses on the causes and emergence of infectious diseases, as well as the discovery, development, and global deployment and use of vaccines.

Question: What was the biggest shortcoming of the US and West African governments’ response to the Ebola crisis?

Answer: We were coming from behind in the response. This is a virus that we have known to exist since 1976. Continue reading Ebola: What went wrong?

The Politicization of Disease

By Cailin Hong

Senator and 2016 presidential hopeful Ted Cruz (R-TX) made media waves this October when he criticized the Obama Administration’s response to Ebola cases reported in the US.

“I remain concerned we don’t see sufficient seriousness on the part of the federal government about protecting the American public and doing everything possible to ensure that people infected with Ebola do not come to the Unites States,” he said, advocating for an air travel ban for those coming to the United States from regions afflicted with the virus.

“The administration is not treating [the outbreak] with the gravity it deserves.”

Cruz was just one of many Republicans – including Senator Rand Paul (R-KY) and Governor Rick Perry (R-TX) – denouncing the current administration’s ineffectiveness at the height of what was a highly competitive, highly partisan midterm campaign season.

The debate has now become progressively polarized, with Republicans blaming the president for being unauthoritative and Democrats arguing that the GOP-pushed NIH and CDC budget cuts were the true causes of U.S.’s unorganized response to the outbreak. Analysts from Politico, CNBC, and local news sources suggested that Ebola could play a decisive role in the weeks leading up to the midterm election, which was exactly what happened as Ebola became the highlight of many divisive debates.

Political polarity surrounding disease is nothing new, particularly in the partisan U.S. With the global outbreak of avian flu in 2006, a whopping 76 percent of Republicans were confident in the Bush Administration’s response to the crisis, compared to just 52 percent of Democrats. In 2009, however, Democrats were nearly twice as likely as to support the vaccine for the influenza strain H1N1 (“swine flu”) proposed by the Obama Administration as compared to Republicans. The trend continued in 2014, with 76 percent of Democrats confident in Obama’s Ebola response compared to 54 percent of Republicans.

This pattern suggests an informational gap, or even misinformation, on half of the American public, and a tendency to defer to the authority of ideologically-aligned political leadership. This trend also extends into non-health related issues, with Republicans and Democrats tending to support the policies of their respective administration. Thus, contrary to the suggestions of Ebola-focused political commentators, although elections may raise the stakes and drive politicians to increasingly partisan rhetoric to differentiate themselves from the opposing side, the partisan history of public health perception suggests that, at least for the American public, political allegiance trumps support for specific disease policies.

When the public gets their views on disease outbreaks from the rhetoric put forth by politicians, the claims made by politicians and their incentives for making those claims become more important than ever. The real danger, therefore, lies not in the polarization of disease, but in its politicization.

The archetypical case comes from the 1976 fiasco, in which President Gerald Ford hastily ordered a massive nationwide vaccination campaign against swine flu, the largest vaccination campaign in US history. Rushed and haphazardly organized, the vaccine was prematurely approved and linked to over fifty cases of Guillain-Barre syndrome, a paralyzing neurological disease associated with vaccination. Although studies by the CDC only found that the vaccine increased occurrences of the syndrome by one case per 100,000 individuals, the fiasco caused a long-lasting distrust of federal public health initiatives.

Arthur M. Silverstein, professor of ophthalmic immunology at Johns Hopkins, argues that the poor planning and unprecedented, even uncalled for, sense of urgency was a failed attempt by Ford to shed his pusillanimous image and secure his re-election by taking swift, authoritative action. Contrarily, Ford’s political opportunism compounded by the financial and medical blunder of the H1N1 campaign provoked large public criticism, which gave him a reputation for incompetence that cost him the election.

Ukraine provides a more modern example when, in 2009, Prime Minister Yulia Tymoshenko led a series of quarantines, school closures, and bans on mass gatherings in response to what she touted to be the plague of the century (again, swine flu), despite statements to contrary by the World Health Organization. Tymoshenko was concurrently running for president, and the crisis gave her an opportunity to demonstrate her competence and decisiveness. Conversations with her campaign advisors later revealed Tymoshenko deliberately exaggerated and politicized fears of the strain to portray the presidential hopeful as a “white knight” and distract the public from the government’s failure to improve Ukraine’s dismal economy. During a chaotic period in which citizens were forced out of the public sphere and paralyzed by fear on an impending pandemic, even international media defaulted to the politician’s hysterical campaigning over the word of the WHO.

The political ramifications of disease and pandemics’ utility as a political tool are undeniable. A deep scare can create a sense of urgency that forces the public to put faith in their central leadership and divert attention from other government failures. The consequences could range from long-lasting damage to the legitimacy of public health concerns, as was the case with Ford, to political manipulations that undermine democracy, as seen with Tymoshenko.

This is not to suggest that all disease outbreaks are securitized threats constructed by ruthless politicians; rather, the severity and sensitivity of political rhetoric surrounding disease should underlie the importance of a transparent, informative public health policy that transcends popular sound bites and media frenzy.  Striving to understand the political stakes a party may have in presenting epidemic in a certain light should help the public cast a critical lens over the extent to which popular rhetoric may be trusted.

So where does Ebola lie in all this? Recently, Media Matters reported that news coverage of Ebola dropped from nearly 1,000 segments in the month leading up to the election to 49 in the two weeks that followed. While Ted Cruz is right to warn the public of the political handling of Ebola, exactly which of these two we should be more concerned about—the politics or the disease—remains to be seen.

Endnotes:

[1] http://dallasmorningviewsblog.dallasnews.com/2014/10/rick-perry-vs-ted-cruz-on-ebola-whos-exhibiting-stronger-leadership.html/

[2] Shephard, Steve. “Democrats in danger over Ebola.” Politico. Web. 20 Oct 2014. http://www.politico.com/story/2014/10/politico-poll-ebola-democrats-112017.html

[3] Myrow, Stephen. “Will Ebola affect the outcome of the election?” CNBC. Web. 17 Oct 2014. http://www.cnbc.com/id/102098189#.

[4] Memoli, Michael. “Ebola scare is the latest issue to cloud midterm election debate.” LA Times. Web. 17 Oct 2014. http://www.latimes.com/nation/politics/politicsnow/la-pn-ebola-politics-20141017-story.html

[5] Nyhan, Brendan. “The Partisan Divide on Ebola Preparedness.” The New York Times. 16 Oct 2014. http://www.nytimes.com/2014/10/17/upshot/the-partisan-divide-on-ebola-preparedness.html?abt=0002&abg=1

[6] Baum, Matthew. “Red State, Blue State, Flu State.” Web. http://www.hks.harvard.edu/fs/mbaum/documents/RedStateBlueStateFluState_JHPPL.pdf

[7] Nyhan

[8] Sencer, David and Donald Miller. “Reflections on the 1976 Swine Flu Vaccination Program.” National Institute of Health. Web. Jan 2006. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3291400/

[9] Sencer and Miller

[10] “Guillain-Barre Syndrome.” CDC. Web. 22 Oct 2014. http://www.cdc.gov/flu/protect/vaccine/guillainbarre.htm#what3

[11] Spitzer, Robert. “Review: Pure Politics and Impure Science” Adminstrativ Science Quarterly, Vol. 29, No. 2. Web. Jun 1984. http://www.jstor.org/stable/2393193

[12] Ioffe, Julia. “Ukraine’s Phantom Flu.” Foreign Policy. http://www.foreignpolicy.com/articles/2009/11/25/ukraines_phantom_flu

[13] Ioffe.

[14] Gertz, Matt and Rob Savillo. “Ebola Coverage on TV News Plummeted After Midterms.” Media Matters. Web. 19 Nov 2014. http://mediamatters.org/research/2014/11/19/report-ebola-coverage-on-tv-news-plummeted-afte/201619

Public Ignorance and Ebola

Clipboard-Guy

In mid-October, a man – soon to be known as “Clipboard Guy” – was seen alongside four other health officers in hazmat suits, wheeling an Ebola patient for transfer from Dallas to Atlanta. He was wearing no protective gear, carrying a clipboard, and helping the HAZMAT-suited individuals with the patient. It caused an uproar on sites like Twitter, with people wondering why safety protocols seemed to be breached, why the virus was being taken lightly, and whether or not the man was infected and now a risk to society. As can be seen in this incident, mass hysteria is easily spurred by the media. As such, a lot of speculation about the Ebola virus has been based in ignorance and the human tendency to sensationalize.

Dr. Anthony Fauci, the head of the National Institute of Allergy and Infectious Diseases, was asked to explain the audacity of the man in a CNN interview. Continue reading Public Ignorance and Ebola

Quarantines in Newark and Princeton

Recently, there have been concerns that Ebola, the deadly virus that erupted in West Africa causing hemorrhagic fever, has made its way to Newark, New York, and Princeton. One such story is that of Ebola nurse Kaci Hickox who has been placed in quarantine for 21 days at the University Hospital in Newark, New Jersey because she helped to treat Ebola patients in Sierra Leone. However, she has been tested and has not contracted the disease. Still, New Jersey governor Chris Christie and New York Governor Andrew Cuomo require that anyone has who worked with or come into contact with Ebola patients must be quarantined, no matter how healthy they may appear.

This policy came into being after a recent New York City doctor was diagnosed with Ebola on October 23. Continue reading Quarantines in Newark and Princeton

Uncertainty of Ebola Concerns Princeton Citizens, Prompts Policies

The Ebola outbreak has resulted in global panic, making citizens question the safety of everything from public transportation to crowded events. Recent developments have brought the crisis directly to Princeton.

On October 1st, NBC cameraman Alexander Mukpo contracted Ebola while cleaning a car that had transported dead Ebola victims in Liberia. Continue reading Uncertainty of Ebola Concerns Princeton Citizens, Prompts Policies

Editorial: Ebola

The American public, along with state and federal government officials, had sufficient cause to be frightened when the first case of Ebola knocked at its doorsteps. Amidst the panic and frenzy in response to the Ebola outbreak, a controversial quarantine was issued against 33-year-old nurse Kaci Hickox, who had served Ebola patients in West Africa before being held under a 21-day quarantine after her arrival in Newark.

The Princeton Public Health Review’s editorial board believes that while the principle behind issuing a mandatory quarantine against nurse Kaci Hickox was a valid one, the haphazard manner in which the Model State Emergency Health Powers Act was carried out suggests the need for enforcement to be improved and better amended to deal with the health risk at hand. Continue reading Editorial: Ebola