To the casual observer, it seems that a new case of Ebola is diagnosed in the U.S. every day, that the disease will soon explode in a terrifying outbreak. Both of these observations happen to be false — most initial reports of Ebola have turned out to be false positives and, because of the United States' modern health infrastructure, it's exceedingly unlikely the disease will spread. But that hasn't prevented a fair amount of hysteria and misinformation from taking hold, and the very social-media tools that could help bring people accurate, panic-suppressing information about the virus are in many cases doing just the opposite.
"Ebola's the kind of disease that zombie movies are made out of," said Abdulrahman El-Sayed, a researcher at Columbia's Mailman School of Public Health. "It's the kind of thing where if you're not close to the science and don't understand the epidemiology of it, it's a very scary-sounding disease — you bleed all over the place, it kills more than 50 percent of the individuals who contract it, it's spreading like wildfire in West Africa." And given that we live in an age in which everyone is just a few keystrokes away from gruesome images of Ebola's symptoms and victims — not to mention from less-than-rigorous news sources stoking hysteria over the disease — experts face unique challenges in communicating key information about the virus to the public.
It is an inherently tricky task from a communications perspective. Ebola is, after all, a deadly and vicious disease. But the conditions that facilitated its spread in West Africa simply aren't present in the U.S., meaning its arrival here, while potentially tragic for those afflicted and their families, does not augur a larger outbreak.
Experts have actually known for a while that Ebola was going to show up in the U.S. Ever since the scope of the West African epidemic became clear, said El Sayed, American public-health officials have been hammering home the same message: "'There is gonna be an Ebola case here, but there's probably not going to be a transmission.'"
But before experts can effectively explain this, they first have to face down the biggest, scariest images of the disease lodged in the public's imagination thanks to both fictionalized accounts and sensationalistic news coverage. "You have to address everybody's worst fears before you can have a logical conversation about it," said El-Sayed.
Sandro Galea, also at Mailman, stressed that "Clear, consistent, honest communication is essential," especially now, during the early days of this outbreak's presence in the U.S., when rumors are running rampant, fueled by a lack of concrete information. "There's no question that uncertainty allows the space for misinformation to spread," said Galea, "which is why those in positions of authority need to be honest when there are things we don't know."
If officials don't get the message out effectively and misinformation and panic do spread, the results are unlikely to be rioting in the streets or toppling of the government (as opposed to the hardest-hit parts of West Africa, where Ebola really has caused varying degrees of societal upheaval), but they can still be damaging.
Galea said a primary symptom of panic over a disease is what he called "Flooding of the health-care system with the 'worried well'" — that is, folks who don't have the disease in question, but who think they do. "Something we learned from the SARS epidemic was that there were many more people who presented to emergency departments and their physicians because they were worried about having SARS than there were who actually did," he said. When these fears escalate, they can be dangerous in their own right, straining the health-care system with hypochondriacs "at a time when you want the system to be robust and able to respond to actual burdens."
There are reasons such straining is more likely to take place in 2014 than it might have been in, say, 1974. As Dietram Scheufele, a science-communications researcher at the University of Wisconsin pointed out, Americans get their health news and information in a vastly different way now than they did in the recent past.
"The big problem that agencies [like the CDC] have is that they, in most cases, can't communicate with audiences directly," he said. According to Scheufele, this was less of a problem back in the days when there were more reporters immersed in public-health and epidemiology beats, he said — and back when Americans had fewer sources of information. Today, though, he thinks there are fewer competent "middlemen" positioned between experts and mainstream audiences, and there's also a lot more social media — which is, by its nature, agnostic on the question of which information is accurate.
So yes, one can argue — as El-Sayed and Galea did — that the CDC's recent Twitter Q&A, in which it addressed some pretty scary questions, was an effective, modern way of cutting out the middleman altogether and communicating with the public directly. But Scheufele pointed out that there might be limits to this approach: "What's the Twitter following of the CDC? I'm sure it's much less than what Jenny McCarthy has, who routinely writes against vaccinations and everything else." (He's right: TheCDC has 378,000 followers, a number dwarfed by McCarthy's 1.23 million.)
It cuts both ways: People have as much access to information — including from trusted sources — as ever before, but they are also are enmeshed in networks, on Facebook and elsewhere, that might serve them heaping doses of panic rather than some much-needed perspective.
"On the one hand, the internet has democratized everything, which is excellent," said El-Sayed. "On the other hand, science is one of those places where there is a right answer. We don't always know it, but it's not a matter for public debate and conversation and opinion."