There's just one confirmed case of an Ebola patient reaching the United States, but that hasn't stopped fear of the disease from reaching our shores. And, soon, our emergency rooms are likely to be filled with fearful patients.
A Pew survey found this week that 32 percent of Americans are very worried or somewhat worried that they or a family member will contract Ebola. "The nation is frightened and people are frightened of [Ebola]," HHS Secretary Sylvia Mathews Burwell said Thursday morning. "They're frightened because it has a very high mortality rate. They're frightened because they need to learn what the facts are of that disease."
There have been at least 5,000 Ebola false alarms in the week since Thomas Eric Duncan was diagnosed in Dallas on Sept. 30, as Forbes points out. We know from past outbreaks there will be a lot of unnecessary trips to the emergency room amid heightened fears.
Initial reports of the swine flu pandemic in April 2009 were soon followed by worried parents flocking to the emergency rooms even in communities where the disease hadn't yet appeared, according to a 2010 study in the American Journal of Emergency Medicine. Fear of swine flu alone drove up pediatric visits to the ER by 20 percent in a week of heightened news reports but no evidence of the disease, according to the study of 18 emergency departments. Study author William McDonnell said this phenomenon was similar to the experience around head injuries following Natasha Richardson's death, and the sarin gas attacks on the Tokyo subway in 1995.
"Our 'flu fear' study suggests that people indeed will be visiting emergency departments based on their fears of Ebola, regardless of whether they actually have any real risk," study author William McDonnell told me. "EDs should prepare for this."
Anecdotally, some members of the American College of Emergency Physicians say they have seen early signs of Ebola fears in their hospitals, and others are bracing for broader panic that could change as flu season hits and the outbreak drags on.
One ER doctor in Denver, Eric Lavonas, said there was no Ebola panic yet, while another in the Bronx, Dan Murphy, said several patients came in on Tuesday fearing they were infected. Sudip Bose, an ER physician working in Chicago and Texas, said he's seen an increase in visits after an inbound flight scare in Dallas this week. Hamad Husainy, an ER physician in Alabama, said two people who were recently hired as "scribes" to document patient visits quit those jobs because they feared being exposed to Ebola.
New York-based physician Bob Glatter said he thinks people are still being reasonable about the extremely low risk of contracting the disease in the United States. However, he thinks Ebola fears may start to pick up after Duncan's death on Wednesday and with flu season rapidly approaching.
John Casey, an emergency physician from Ohio, said he doesn't think Ebola will drive up ER visits like swine flu did five years ago. There's no specific treatment for Ebola, while tamiflu was a potential treatment for swine flu. Further, there's greater awareness of Ebola — and a social stigma that comes with it.
"There is such a heightened awareness of Ebola right now, with a long observation window, that I don't think people would come forward and pose that concern unless it was REALLY a concern," he wrote.
The challenge for public health officials here is two-fold. They don't want to inspire undue panic and put unnecessary stress on the health-care system. At the same time, though, they don't want to discourage legitimate potential cases of the disease from coming forward.
"As long as Ebola continues to spread in Africa, we can't make the risk zero here," CDC director Tom Frieden said Wednesday. "We wish we could."
The somewhat good news is that the fear level is still lower than previous recent outbreaks, including bird flu in November 2005 (38 percent) and swine flu in August 2009 (45 percent), according to Pew.
But swine flu, or H1N1, was far more pervasive in the United States. The CDC estimates there were anywhere between 43 million and 89 million cases, resulting in 274,000 hospitalizations and 12,600 deaths between April 2009 and April 2010.