October 16, 2014


Underscoring the difficulties faced by CDC and other state and local agencies to contain the threat of Ebola is the largely reactive, rather than anticipatory, nature of the public health measures taken, such as screenings at a small number of ports of entry. The case of Thomas Duncan, the disease’s first victim in the United States, has undermined confidence in self-reporting by travelers as an effective measure. Further, it appears that the government is having a difficult time persuading citizens to follow the public health protocols most likely to save lives. Contacts of Thomas Duncan are reported to have resisted public health officials’ recommendations to self-quarantine. The nurse who treated Duncan also contracted the disease because of a breach in protocol. Asking people to avoid contact with others for as long as three weeks, the disease’s incubation period, is a tall order, especially since relatively few of the people asked to quarantine will actually have the disease. The public may also be confused by the seemingly contradictory nature of the simplest caricatures of public health messages: On the one hand, Ebola is difficult to contract, so don’t worry; On the other hand, if you are suspected to have been exposed to the virus, you could be placed under house arrest for three weeks. . . .

The United States faces a crisis of trust in government less severe than in Liberia, but it is still important to address this problem if we are to be prepared for pandemics. A Pew Research Center survey shows that trust in government is near its all time low. Other major institutions, from schools to unions to business and religion, do not fare much better. Specific federal agencies, however, such as the CDC and even the Department of Homeland Security, show much more favorable views among the public. Just as Americans hate Congress but love their congressmen and women, Americans distrust government to do the right thing most of the time, but they have more faith in some specific agencies to get the job done.

Well, I doubt the CDC will poll as well next time.

UPDATE: Um, what? ‘Who’s the idiot with the clipboard?’ Disbelief and panic as mystery man WITHOUT a hazmat suit helps second Ebola nurse board her plane to Atlanta, disposes waste and then climbs aboard.

The photos are disturbing.

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