UB experts weigh in on Ebola outbreak

The Ebola outbreak has killed thousands of people in West Africa and exposed critical shortcomings in the American health care system’s ability to fight infectious disease.

This month, several UB experts took time to discuss the epidemic. They talked about current problems and provided insight into how advancements in fields from medicine to geography could improve the country’s response to illness.

The challenges of diagnosing Ebola

Are hospitals really prepared to diagnose Ebola and distinguish the disease from other ailments, such as the flu?

That’s the question many Americans were asking after a Dallas hospital failed to recognize Ebola in a man who had recently flown to the United States from Liberia, a nation hit hard by the epidemic. The patient, initially sent home, was later admitted and died.

With Ebola able to cross borders via air travel, John A. Sellick, associate professor of medicine, says taking detailed medical histories on each patient presenting with fever, gastrointestinal symptoms, headache or muscle aches is a top priority for hospitals and medical providers.

“The travel history is critical,” says Sellick, an infectious disease specialist and hospital epidemiologist. “It now must be a key part of every interaction a health care worker has with each patient.

“Providers can no longer assume because of what someone looks like, that a patient probably hasn’t traveled out of the surrounding neighborhood,” he adds.

Modeling Epidemics

Computer models that simulate the spread of infectious disease could help governments, health care workers and others identify, prevent and conduct intervention strategies to control epidemics.

The latest technologies exploit contact networks — akin to social networks — to predict and dissect how diseases spread in the population, says Ling Bian, professor of geography and director of the National Center for Geographic Information and Analysis at UB. She has assisted the National Institutes of Health in developing models simulating outbreaks of Ebola and the flu in U.S. metropolitan areas.

The advanced “individual-based” models she uses analyze when — and where — people interact with one another. The age and occupation of individuals in a city or region are all taken into account, along with factors like the times of day when they stay home and go to work.

Simulations can help determine “whether we have an epidemic and identify communities or locations that are particularly vulnerable,” Bian says.

She adds that the new generation of technologies is promising to offer even more insight, leveraging mobile phone data, Twitter and other social media to provide a real-time look at how disease is spreading.

Perceptions of risk

Ebola began to pop up in the news earlier this year as the epidemic spread in West Africa, but it wasn’t until the past few weeks that the disease became a top story in U.S. outlets.

Janet Yang, assistant professor of communication and a health and risk communications specialist, says one reason Americans are suddenly paying attention to Ebola is because of “how close and frightening” the outbreak now appears.

“The public’s perception of risk comes from a reduction in psychological distance,” she says. “A few weeks ago, when we didn’t have any confirmed cases, people were less concerned that they themselves would be affected.”

Through a new study sponsored by the National Science Foundation, she is studying:

• The public’s emotional and cognitive response to the current Ebola outbreak.
• How individuals share and seek information.
• How willing people are to give money, food and support to government initiatives to fight the disease.

Coping with fear and stress

As fears about Ebola spread in the United States, one key to reducing stress is having accurate knowledge about Ebola, says Larry Hawk, professor of psychology, who studies the role of basic motivation and cognitive processes in health and illness.

Ebola poses risks, “but they are predictable and controllable with knowledge and reasonable precautions,” Hawk says.

“The risks of Ebola for the average American are also much smaller than the risks of everyday life, such as contracting the flu or motor vehicle accidents,” he says. “Does this mean we shouldn’t worry? No. But in the big set of things to worry about, the typical American should put Ebola way down on their list of concerns.

“When the same Ebola coverage is blasted at people for the 100th time, they should consider stepping away from the story, remind themselves of the facts, then take a walk, play a game, get a flu shot or do some other health-promoting activity,” he says. “It will likely be a far better use of time.”

Kristin Gainey, assistant professor of psychology who studies adult mood and anxiety disorders, and emotion regulation, also recommends stepping away when stress becomes unmanageable.

She says staying up to date on information about the disease can help reduce stress, but it’s possible “to be overly concerned with preparation in a way that is not productive and is likely to increase anxiety.”

Protecting people in the health care setting

One area where risks can be genuinely high is in the health care setting.

In Dallas, two nurses who helped care for the Ebola patient from Liberia also were diagnosed with the disease, raising questions about whether American hospitals are prepared to deal with a pathogen akin to Ebola.

And in West Africa, many of the outbreak’s victims have been health care workers, including some of the region’s most prominent doctors.

Patient-to-patient transmission is also a major concern.

Susan Grinslade, clinical professor of nursing, and Joann Sands, clinical assistant professor of nursing, say that there are steps — based on recommendations from the Centers for Disease Control and Prevention — that health care providers can take to help prevent the spread of infectious disease.

“Patients suspected of having contracted Ebola should be placed in a single room, should have all of their visitors sign in and should wear personal protective equipment (PPE), such as a gown, gloves, mask and face shield,” Grinslade says. “It is crucial to properly don and remove PPE to avoid contamination.”

“All necessary medical equipment should be taken into the room and remain there,” Sands adds. “Staff should limit use of needles and other sharps, and aerosol-generating procedures should be avoided.”

“In addition, nurses know that the best way to prevent the spread of microorganisms is hand-washing,” Sands says.