Fear Factor: The High Hidden Cost of the Ebola Epidemic

By Jamie Friedlander

The “cost” of an epidemic such as Ebola usually targets the dollar toll in hospital fees and economic downturns. But the loss of lives and the measure of suffering remains a lasting and growing cost.

“In terms of the cost in Liberia, it’s not dollars and cents. It’s the death of a generation,” said Robert A. Weinstein, MD, professor of internal medicine at Rush Medical College, in reference to the recent Ebola outbreak in West Africa.

When it comes to an epidemic, huge, less tangible costs mount in human suffering, the loss of human life and, in the U.S., misguided anxiety, Weinstein said.

Weinstein joined a health economist, a health communication specialist, a bioethicist and a reporter for a program Wednesday evening at the Harold Washington Library in Chicago’s Loop to discuss both the economic and human costs of epidemics such as the recent Ebola outbreak in West Africa.

The worry in West Africa continues, with good cause. The most recent outbreak is the 20th Ebola outbreak since 1976 and infected roughly 20,000 people, resulting in roughly 8,000 deaths.

The panelists also discussed why the U.S.’s fear of Ebola is misguided when other domestic health threats are more pressing.

Panelist Catherine Belling, associate professor in medical humanities and bioethics at Northwestern University, looked at the cost of misguided worry in the U.S.

“The cost of worrying about one thing even though it is unlikely is that you fail to pay attention to something that might be more probable,” said Belling.

 “In terms of the cost in Liberia, it’s not dollars and cents. It’s the death of a generation,” – Robert A. Weinstein.

Both Belling and Weinstein pointed out that the risk in America for antimicrobial resistant infections, such as MRSA and other drug resistant bacteria, is far greater than the threat of Ebola.

More than 2 million people in the United States have a drug resistant illness each year, according to the 2013 Threat Report of the Centers for Disease Control and Prevention. Of those, roughly 23,000 die, the CDC reports. Only 10 cases of Ebola were recorded in the U.S. during the most recent outbreak, according to the New York Times.

Panelist Bruce Lambert, the director of the Center for Communication and Health at Northwestern, also said he believes infections pose a greater threat to U.S. hospitals.

“If we haven’t been able to prevent these acquired infections that are routinely harming large numbers of people and killing large numbers of people, one has to be skeptical about whether we would – in an urgent and emergent situation with such a frightening infectious agent – be able to respond rationally and effectively,” said Lambert.

“So what is it about Ebola that has this disproportionate effect?” Belling questioned.

Belling thinks one of the reasons could be sensational stories that exaggerate the symptoms of Ebola, such as “The Hot Zone” by Richard Preston, published in the 1990s. The New Yorker republished excerpts from this book in July 2014, which Belling she believes could have exacerbated the public’s fear. She also said that the hazmat suits that people wear when caring for Ebola patients threaten human connection – people get scared that they cannot simply hug each other.

Lambert thinks another reason why Ebola could be so exaggerated in the U.S. is because of the general public’s low literacy on health issues and inability to understand probabilities.

“The fact is human beings are terrible at understanding probabilities, including health professionals,” said Lambert, explaining that this makes it even more difficult for us to know “how worried” we should be.

Both Belling and Lambert did address the question “how worried should we be?” and both agreed that there is no correct answer for that.

“Somehow our fear is supposed to be proportional to the probability of being infected or dying,” said Lambert, adding that that is hardly ever the case.

Health economist Rena Conti, assistant professor of hematology and oncology at the University of Chicago, also spoke on the panel. WBEZ reporter Odette Yousef moderated the post-panel discussion.

“The Cost of Health Crisis” panel was sponsored by the Illinois Humanities Council and the Chicago Public Library.