Peter Sandman, a longtime expert and consultant on risk communication based in Brooklyn, New York, wasn’t especially shocked when he first heard about the patient’s case. “My first reaction was: Well, it had to be somewhere. Better Dallas than Mumbai,” he says. But Sandman says the past week has been a missed opportunity. The Dallas case could have been used to explain to Americans what makes Ebola a global threat, he says. “ ‘This was a spark to a place that knows how to extinguish sparks. What is terrifying us is that there are going to be sparks to places that don’t know how to extinguish them.’ That should have been the main message,” Sandman says.
As public health officials and scientists tried to reassure the public that there was no danger and to address the Texas hospital’s mishaps in dealing with the case, they missed that chance, Sandman says. “So far it’s more a distraction and distortion.”
In a long e-mail to ScienceInsider, Sandman and his wife and colleague Jody Lanard discuss what years of work in risk communication have taught them, and where they think government officials as well as journalists are failing. Two big mistakes in how the Dallas case was handled—sending the patient home when he first sought medical care and keeping the family under quarantine in the potentially contaminated apartment for days—have raised questions about how well prepared the United States really is for Ebola. That question has become the focal point of media coverage of Ebola.
“As long as U.S. media are justifiably fixated on ‘exposing’ what went wrong and what keeps going wrong and what might go wrong in Dallas, the conversation here won’t turn to West Africa, where it belongs,” Sandman and Lanard write in their e-mail. “The screw-ups in Dallas need to be acknowledged and apologized for—repeatedly,” they argue. “The more officials continue to sound like cheerleaders, ignoring or minimizing what goes wrong, the more the media will focus on knocking them off their high horse.“
A more detailed response from Peter Sandman and Jody Lanard covering important topics like border closings and flight restrictions:
Teach the world why “spark suppression” – reducing the number of Ebola sparks emanating from West Africa – is essential to buy time for the desperate attempt to find a vaccine. Don’t settle for the false dichotomy – the claim that since border closings never work perfectly, there’s no point in inhibiting travel. Foster a thoughtful debate about various proposals for reducing the number of sparks, and thus reducing not just the burden of extinguishing those sparks but also the chances of Ebola establishing itself in additional countries. Help assess which proposals will probably backfire, which will do little good at great humanitarian cost, and which will do comparatively more good at comparatively lower cost.
I encourage you to read the full piece. Hopefully, our discussions here about border closings and flight restrictions have and will follow suit.
And same authors (personal communication) on airborne possibilities:
We think we’ve been a little too careless when describing communication about the remote possibility of “airborne Ebola.”
The angry anxious debate among experts has come across as: “It could” versus “It couldn’t — so don’t talk about it.”
We think it should be recast as a debate between: “It could, though it’s very unlikely,” versus “It could, but it’s very very very very very unlikely.”
Scientists hate to get pinned down into saying 100% certainty about anything, and “very unlikely” is more accurate than “it can’t”. It’s also more reassuring to hear people avoid complete certainty and to discuss the topic rather than avoid it.
Still, a key point in all of this is recognizing mistakes made in Dallas (see below), apologizing for them, and learning from them.
More politics and policy below the fold.
