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Global Health

Ebola 'Still Small Potatoes,' But A Major Menace In West Africa

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Jerome Delay
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AP Photo
FILE - In this Tuesday Sept. 30, 2014 file photo, Nowa Paye, 9, is taken to an ambulance after showing signs of Ebola infection in the village of Freeman Reserve, about 30 miles north of Monrovia, Liberia.

As the Ebola outbreak first emerged in West Africa, some global health experts downplayed it. The virus has flared up here and there since it was discovered in the 1970s, and rarely has its death toll exceeded a few dozen or at most a few hundred.

“I actually was among those who didn’t think it would be that big a deal, and like the previous ones, it would be contained and would burn itself out very quickly,” said Tom Paulson, who has been covering global health for nearly 20 years. “I was dead wrong.”

Paulson, the founder and editor of Humanosphere, sat down with KPLU to talk about why he’s changed his mind and come to see Ebola in Africa as a major menace.

What's Different This Time

Official estimates put the death toll in the thousands. But perhaps more troubling is that health authorities say it’s still nowhere near under control in the three affected countries: Guinea, Sierra Leone and Liberia.

The big difference from previous outbreaks, said Paulson, is that this time it has gotten into urban areas. Past outbreaks have flared up mainly in remote, rural areas, possibly because the virus migrates from other species such as fruit bats in parts of the continent where humans and animals have closer contact.

Now it has reached inside large cities such as Monrovia, Liberia, where the population is dense and the public health infrastructure threadbare.

“They just were not able to respond, and now it’s taken off,” he said.

'It's Not Just A Health Problem'

Ebola in West Africa has killed more than 4,500 people, by official estimates, during its nearly yearlong run. By contrast, said Paulson, HIV “kills the same number of people every day that have so far died from this Ebola outbreak.”

HIV kills 1.5 million people a year. So does diarrheal disease.

“Ebola is still small potatoes,” said Paulson, in terms of directly attributable death and disability.

But Paulson said he’s come to understand that Ebola is deeply damaging to society in ways that go way beyond its direct effects.

“Ebola has engendered this largely exaggerated fear,” said Paulson. “It’s destroying everything. It’s not just a health problem. Schools are closed down. Businesses are closed down. These are poor countries and this is going to take years to recover from ... That’s why I’ve come to recognize that this is a much bigger deal than the numbers would indicate.”

Upside Of Hysteria In U.S.: Aid For West Africa

While Paulson and many others were admittedly slow to recognize the gravity of Ebola in West Africa, fears about Ebola in America have been blown way out of proportion, said Paulson.

“We shouldn’t be hysterical about our risk here in the United States. We shouldn’t be overly fearful,” he said.

However, he added that hysteria has an upside.

“Hysteria is good if it actually produces a positive change. Fortunately for West Africa, when the United States had a couple of cases show up here, that’s when we decided to deploy our military and our public health disease warriors.”

Paulson said he believes the U.S. has an obligation to respond to the crisis in West Africa because the U.S. has the tools, the money and the know-how to do it. And it’s also in America’s national interest.

“If we don’t, this is going to end up being a bigger disease threat,” he said. “It will last a lot longer. It will cost a huge amount. It’s going to really wreak havoc in these countries. And all of that affects us, because we live in a globalized world.”

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