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Massachusetts Medical Society's Physician Focus

June 2016

Infectious Disease: Fear vs. Evidence


  • Within the last decade, the world has seen several outbreaks of infectious disease that have tested the response of public health agencies and dramatically raised the fears of the public.
  • Severe Acute Respiratory Syndrome (SARS) , H1N1 bird flu, Middle East Respiratory Syndrome (MERS), Ebola, and Zika have all captured the attention of news media.
  • Intense media coverage of an infectious disease outbreak can sometimes be disproportionate to the actual threat of the disease, thus raising public anxiety rather than lowering it.

The outbreak of an infectious disease is one of medicine’s most difficult challenges. At the same time that public health agencies must contain the infection, they must also try to quell the public’s fears – a difficult task in today’s world of instant communication and constant media attention.

“What we saw in the United States was a hugely disproportionate response to the actual number of cases being transmitted,” says Steven Hatch, M.D., commenting on the recent Ebola outbreak, “because there were only two cases of Ebola that occurred in the United States, when there were thousands of cases in West Africa.”

Dr. Hatch, an infectious disease specialist at UMass Memorial Medical Center and an Assistant Professor in the Division of Infectious Disease at UMass Medical School in Worcester, shares his perspective of the reaction to infectious disease outbreaks in the United States by the news media and the public in the June edition of Physician Focus. Hosting this edition is primary care physician Bruce Karlin, M.D.

Dr. Hatch brings personal experience to the issue: In 2014, he spent five weeks in Liberia with the International Medical Corps treating patients stricken with Ebola and subsequently returned to that country multiple times to treat patients.

He describes vastly different reactions between West Africa and the United States with regard to the Ebola outbreak. “In Liberia, I knew exactly what my role was, the patients knew their role, my fellow workers knew their role, and everybody went about their business normally.”

Yet, he says, as he was watching the reaction in the U.S. on his laptop from a hillside in Liberia, he saw “paranoia sweep the countryside of the U.S.” in the media coverage of Ebola, and just as he was about to come home.

“What I was concerned about was that the fear that people had about Ebola, which was easily visible just from reading the news stories on the internet, was going to then apply to me and that I was going to become an object of derision, possibly violence. I wasn’t sure what awaited me when I came home.”

When he did arrive home, Dr. Hatch says, it was something of a revelation. “When I did come home, my experience was that, when I was in active observation, easily was an anxiety-provoking time, and it proved to me that you can get a very warped perception based on what the media provides in terms of information and how it chooses to couch the information.”

Dr. Hatch believes that the lesson from his experience is an important one for people to grasp.

“When people get worked up over these viruses,” he says, “what happens is you get this difference in risk perception… We get this very dramatic warping of our perception of what actually represents a real harm to us in life.”

He notes that while two people in the United States became infected with Ebola, many more in the same time period died from heart disease, lung cancer from smoking, and gunshots – just to name a few of the prevalent diseases and dangers in the U.S.

Everyone, he says, get focused on what can be relatively minor threats, and “that’s actually quite sad,” he notes.

“You can do something about modifying your lifestyle decisions,” says Dr. Hatch, “but people don’t really get that message as purely and in as undistilled manner as they could.”

Watch the video for additional discussion, including conversation about what public health agencies must consider in reacting to infectious disease outbreaks, Dr. Hatch’s perspective on the latest threat of Zika, and additional comments on how the media covered the Ebola outbreak in the U.S.

MMS/Richard Gulla

World Health Organization

U.S. Centers for Disease Control

The Mayo Clinic

Infectious Disease Research Institute

Left to right: Bruce Karlin, M.D.; ...
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