Lessons from Ebola
While Ebola outbreaks are not new, the latest outbreak has provided some important lessons. These lessons are actually nothing new, but the outbreak does provide a focus for discussing them.
The first lesson is that most people are very bad at risk assessment. In the Ebola hot spots it is reasonable to be worried about catching Ebola. It is also reasonable to be concerned about the situation in general. However, many politicians, pundits and citizens in the United States are greatly overestimating the threat presented by Ebola in the United States. There are only a few cases of Ebola in the United States and the disease is, the experts claim, difficult to catch. As such, the chance that an American will catch Ebola in the United States is extremely low. It is also a fact Ebola outbreaks have been contained before in countries with far less medical resources than the United States. So, while it is prudent to prepare, the reaction to Ebola has greatly exceeded its actual threat in the United States. If the concern is with protecting Americans from disease and death, there are far more serious health threats that should be the primary focus of our concern and resources.
The threat of Ebola is overestimated for a variety of reasons. One is that people are rather susceptible to the fallacy of misleading vividness. This a fallacy in which a very small number of particularly dramatic events are taken to outweigh a significant amount of statistical evidence. This sort of “reasoning” is fallacious because the mere fact that an event is particularly vivid or dramatic does not make the event more likely to occur, especially in the face of significant statistical evidence. Ebola is indeed scary, but the chance of infection in the United States is extremely low.
Another reason is that people are also susceptible to a variation on the spotlight fallacy. This variant involves inferring the probability that something will happen based on how often you hear about it, rather than based on how often it actually occurs. Ebola has infected the 24 hour news cycle and hearing about it so often creates the psychological impression that infection is likely.
As I have consistently argued, threats should be assessed realistically and the response should be proportional to the actual threat.
The second lesson is that the politicians, media and pundits will exploit scary things for their own advantages. The media folks know that scary stories and fear mongering get viewers, so they are exploiting Ebola to the detriment of the public. Ebola has been made into a political issue, so the politicians and pundits are trying to exploit it for political points. The Republicans are using it as part of their narrative that Obama is an incompetent president and thus are emphasizing the matter. Obama and the Democrats have to strike back in order to keep the Republicans from scoring points. As with the media, the politicians and pundits are exploiting Ebola for their own advantage at the expense of the public.
This willful misleading and exaggeration is clearly morally wrong on the grounds that it misleads the public and makes a rational and proportional response to the problem more difficult.
The third lesson is that people will propose extreme solutions without considering the consequences of those solutions. One example is the push to shutdown air travel between the United States and countries experiencing the Ebola outbreak. While this seems intuitively appealing, one main consequence would be that people would still come to the United States from those countries, only they would do so in more roundabout ways. This would make it much harder to track such people and would, ironically, put the United States at greater risk.
As always, solutions should be carefully considered in terms of their consequences, costs and other relevant factors.
The final lesson I will consider is that the situation shows that health is a public good and not just a private good. While most people get that defense and police are public goods, there is the view that health is a private good and something that should be left to the individual to handle. That is, the state should protect the citizen from terrorists and criminals, but she is on her own when it comes to disease and injury. However, as I have argued elsewhere at length, if the state is obligated to protect its citizens from death and harm, this should also apply to disease and injury. After all, disease will kill a person just as effectively as a terrorist’s bomb or a criminal’s bullet.
Interestingly, even many Republicans are pushing for a state response to Ebola. I suspect that one reason Ebola is especially frightening is that it is a disease that comes from outside the United States and was brought by a foreigner. This taps into fears that have been carefully and lovingly crafted during the war on terror and this helps explain why even anti-government people are pushing for government action.
But, if the state has a vital role to play in addressing Ebola, then it would seem to have a similar role to play in regards to other medical threats. While Ebola is scary and foreign, it is a medical threat and thus is like other medical threats. However, consistency is not a strong trait in most people, so some who cry for government action against the Ebola that scares them also cry out against the state playing a role in protecting Americans from things that kill vastly more Americans.
The public health concern also extends beyond borders—diseases do not recognize political boundaries. While there are excellent moral reasons for being concerned about the health of people in other countries, there are also purely pragmatic reasons. One is that in a well-connected world diseases can travel quickly all over the globe. So, an outbreak in Africa can spread to other countries. Another is that the global economy is impacted by outbreaks. So, an outbreak in one country can impact the economy of other countries. As such, there are purely selfish reasons to regard health as public good.