According to the World Health Organization, the Ebola epidemic in West Africa is probably far worse and more widespread than reports to date suggest. Of course, in a season of remarkably catastrophic world news headlines, this fact might not bubble to the top of people’s information diet.
Enter Laurie Garrett’s front-pager in Foreign Policy, with the super-understated headline, “You are Not Nearly Scared Enough About Ebola.” Here’s how it opens:
Attention World: You just don’t get it.
You think there are magic bullets in some rich country’s freezers that will instantly stop the relentless spread of the Ebola virus in West Africa? You think airport security guards in Los Angeles can look a traveler in the eyes and see infection, blocking that jet passenger’s entry into La-la-land? You believe novelist Dan Brown’s utterly absurd description of a World Health Organization that has a private C5-A military transport jet and disease SWAT team that can swoop into outbreaks, saving the world from contagion?
Wake up, fools. What’s going on in West Africa now isn’t Brown’s silly Inferno scenario — it’s Steven Soderberg’s movie Contagion, though without a modicum of its high-tech capacity.
Now if you read the whole thing., Garrett pivots to what the international community should do to alleviate the epidemic in West Africa. They’re all excellent, sober suggestions. But here’s the thing: That opening is pretty much the opposite of sober. It’s scare-mongering of the first order.
Garrett implies in that opening that Ebola is about to go global, that it will spread via the airlines, and that it will overwhelm public health authorities. The latter point is true, but it’s only specific to West Africa, which is where the epidemic is concentrated. Indeed, it is worth comparing and contrasting Garrett’s opening with Julia Belluz’s Vox explainer. Both stories make it clear that the epidemic has gotten worse, but the latter specifies that it’s gotten worse in West Africa, not that it’s going to go global. Indeed, the World Health Organization has been trying to tamp down overwrought concerns that Ebola could spread by air travel:
The chance of having someone who is sick with #Ebola getting in a plane is small
— WHO (@WHO) August 14, 2014
Now maybe this is just Garrett’s way of trying to get attention, but I fear it runs deeper than that. In her next paragraph, she writes:
Last week, my brilliant Council on Foreign Relations colleague John Campbell, former U.S. ambassador to Nigeria, warned that spread of the virus inside Lagos — which has a population of 22 million — would instantly transform this situation into a worldwide crisis, thanks to the chaos, size, density, and mobility of not only that city but dozens of others in the enormous, oil-rich nation. Add to the Nigerian scenario civil war, national elections, Boko Haram terrorists, and a country-wide doctors’ strike — all of which are real and current — and you have a scenario so overwrought and frightening that I could not have concocted it even when I advised screenwriter Scott Burns on his Contagion script.
Sounds very scary — but I was listening in to Campbell’s comments that Garrett linked to, and he was not quite as apocalyptic as Garrett suggests. He acknowledged that an Ebola outbreak in Lagos would be catastrophic — but he also said this:
Lagos also has — some estimates are now — 22 million people. It’s one of the very largest cities in the world. And it is also one of the poorest. And yet in Lagos, a highly effective governor has been succeeded by another highly effective governor. And something approaching a social contract in Lagos is now emerging, a social contract in which people pay taxes and hold their governments accountable for providing services.
In Lagos, the response to the arrival of a victim of Ebola who has since died [Patrick Oliver Sawyer] was to put into effect immediately tracing operations to find everybody that he’d come into contact with and also a quarantine. Now, right now, the Lagos picture looks good. The question has to be, how long that that will last?
Events since Campbell’s comments back up his reason for cautious optimism. We know that of the 11 confirmed cases in Nigeria so far, only one is from someone who didn’t have direct contact with Sawyer, and she seems to have had secondary contact with a nurse who treated Sawyer before they realized he might have Ebola. Obviously, that’s not good for the 11 victims. But it’s actually a good sign for outbreak control, and a good sign that Governor Fashola’s efforts in Lagos seem to be working. And as easy as it is for outsiders to treat all of West Africa as an undifferentiated mass of poverty and state collapse, it’s worth remembering that Nigeria is not Liberia or Sierra Leone — its doctor-to-patient ratio is 30 times higher than Liberia’s.
So are there reasons for concern? Absolutely. Are there reasons for Garrett’s rhetoric? Well …
To be fair, Garrett is trying to get others to pay attention to a worsening situation. And let’s be honest here: The thing about this Ebola outbreak is that while it’s been far worse than previous ones, the effects have nevertheless been limited to residents in West Africa and the aid and emergency workers there. And even if the pathogen leaves that region, the likelihood of it spreading uncontrollably in places with modern health infrastructures is pretty remote. So Garrett is trying to get people to pay attention to a very, very bad problem that’s confined to a region that doesn’t rank all that high on the radar of most Americans.
I admire Garrett’s desired end. Her means, however, seem really problematic to me. Or as medical anthropologist Adia Benton pointed out in a conversation yesterday:
I don’t want to underestimate the importance and significance of this disease and of this outbreak. I’ve been worried about being alarmist, without — but also being able to sound the alarm, because the panic — we have to also keep in mind that we don’t want people to panic. We want people to do the jobs that need to be done, which is to have an influx of health workers who can actually do the job, who understand how to work in an outbreak situation and who know how to do infection control (emphasis added).
So Americans should be scared about what Ebola is doing to fragile states in West Africa. But they shouldn’t be as scared as Laurie Garrett wants them to be.