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Shep Smith Is Wrong: Why You Should Be Concerned About Ebola

Those of us who are inclined not to worry are rightly concerned when the people who are promising, "We got this" keep demonstrating that they don't actually got this.
POTUS ebola

Fox News' Shep Smith delivered a soothing monologue on the Ebola outbreak yesterday, and while he and the "Bitch, be cool" crowd are mostly right, they're also partly wrong: There are legitimate reasons for Americans to be concerned about Ebola. Most of what Shep and company (including the CDC, the Texas Health Presbyterian Hospital staff, and all the other people you see giving press conferences) are saying is correct, but Shep was wrong to say "you should have no concerns about Ebola at all."

That is not to say you should be crapping your pants (especially since this is a great way for your pants to spread Ebola), but there is a middle-ground between abject panic and the pet shop owner in the Parrot Sketch. Here's one thing that has people legitimately concerned: President Obama, who doesn't cancel anything ever, canceled his trip to New Jersey yesterday, and canceled all of his travel for today as well. I heard Chuck Todd suggest, yesterday, that this was some sort of nod to "optics," but that's absurd; the last "optic" we need right now is the president dropping everything if he doesn't need to be dropping everything. At yesterday's White House daily briefing, Major Garrett asked Press Secretary Josh Earnest about that very thing, and Earnest's response was telling in its not-tellingness. Even though Garrett gives Earnest several great ways to explain why the president had to drop everything yesterday, Earnest doesn't really have an answer:

What Garrett asked, essentially, is whether the cancellations constitute "creating a false sense of crisis," and Earnest's out-loud answer was "No," but the unspoken part of the answer is that it creates a very real sense of crisis. The president would not be hunkering down like this unless he thought that the necessity of it outweighed the impression it would give. In his follow-up question, Garrett well summed up some of the legitimate causes for public concern:

"Can you understand that the public watching this story play out can have a genuine sense of either skepticism or possibly alarm because they hear, “we know how to deal with this; we are taking all the proper steps; all the precautions are being implemented,” and then yet someone who has it, doesn’t show symptoms, gets on a commercial aircraft, even though the exposure risk is minimal, everyone on that plane has now been in contact. That creates at least a low level sense of alarm by everyone that was on that plane, everyone who knows a person on that plane, and everyone who remembers hearing just a couple of days ago, 'well, that’s not going to happen, we’ve got this under control.' Do you understand how the public is becoming less confident and possibly more alarmed as the story plays out?"

What he's getting at is that for every unhinged, panic-inducing cable news graphics package, there have been public health and government officials distorting the public's expectations in the other direction. Those of us who are inclined not to worry are rightly concerned when the people who are promising, "We got this" keep demonstrating that they don't actually got this. When you promise to stop something in its tracks, two transmissions and a possible exposure of 132 people on an airplane are genuinely alarming. Smith and Garrett are right, the risk to those passengers is small, but Amber Vinson actually did have a fever when she got on that plane, and the CDC told her it was okay for her to get on anyway.

Instead of telling people they shouldn't worry about future transmissions, we should be telling people to expect some, because if just one of those passengers becomes sick, that takes the concern to a new level. Instead of continually responding to questions about these screwups by saying how expert we (which earnest was still doing at yesterday's briefing) are at not screwing up, we should be telling people that the nature of the disease and the first-world infrastructure we have in America give us a lot of wiggle-room to contain Ebola. It's much more comforting to know that we can screw this up six ways to Sunday and still not have a wildfire outbreak. It's not an easy disease to transmit, and when people do get it in the U.S., they don't die from it if they're treated right away.

The good news is that, if you read between the lines, it looks like the very real crisis the president is dropping everything for is the specter of Ebola, and not the disease itself. The news of Amber Vinson's exposure to a planeload of people, as minimal as that risk may be, is unnerving, and it is beginning to have an effect on the stock market. That this news sent Obama into a two-day huddle with his cabinet is also unnerving, but there was a comforting bit of information that many overlooked at yesterday's briefing. At the very top of Earnest's presser, he announced that he had to leave promptly at 3:25pm, so he could be in that meeting. What that tells me is that this is more a public information crisis than a substantive health crisis. If they were going to be discussing secret concerns about a widespread exposure, for example, then they wouldn't want to have Earnest in the room.

After the meeting, Obama delivered an update on the situation, including this subtle shift in rhetoric (emphasis mine):

"This is not a situation in which, like a flu, the risks of a rapid spread of the disease are imminent. If we do these protocols properly, if we follow the steps, if we get the information out, then the likelihood of widespread Ebola outbreaks in this country are very, very low."

So we've gone from "it shouldn’t reach our shores," to an extraordinarily unlikely single outbreak, to copiously disclaimered plural outbreaks, and that's a good thing. As the disease rages through Africa, we are going to see more cases here, and people should expect that, but unless something very bad happens, it won't spread, and most people here won't die from it. It would also be helpfull if health officials were a little bit more realistic about the way Ebola is transmitted, because when people hear "direct contact with bodily fluids," it sounds like a pretty easy thing to avoid. I haven't touched vomit in weeks, maybe even months.

That's comforting until there's a transmission that doesn't fit that impression. Most people don't know that "direct contact" includes being sneezed on, and contact with contaminated surfaces. We should be preparing people for an unexpected, low-risk transmission, so if/when it happens, people don't freak out. If someone on that plane ends up getting it from, say, a sneeze, people need to know that doesn't mean the disease has "gone airborne."

There is a low risk of "aerosolized transmission" of Ebola, which means droplets sneezed or coughed by a symptomatic person gets into the eyes, nose, mouth, or broken skin of another person. The CDC says the risk is limited to a one-meter distance from the patient, and requires prolonged exposure, but even if there's a transmission outside those parameters, it's not the same as "airborne transmission," which means a disease can be transmitted through the air even in a dried state, and can persist in the air for prolonged periods of time.

While there's no reason for hysterics, a reasonable level of public concern is a good thing, because as Obama said several weeks ago, the longer this outbreak continues in Africa, the farther we get into uncharted waters. Ebola has only been studied for about as long as Star Wars has been around, and as of this year, there were more Harry Potter movies than Ebola outbreaks. This current outbreak has killed four times as many people as every other outbreak combined. The Keep Calm crowd is right, there are lots of things that kill more than Ebola, but that doesn't mean we should ignore it. We spent 40 years worrying about bombs that no one ever ended up using, partially because we spent so much time worrying about them. We shouldn't want the media to cover Ebola less, we should want them to cover it better.

Here's President Obama's full statement on Ebola Wednesday night, from the Cabinet Room of the White House: