Our team’s picks for the latest and greatest news, topics and information you should know about.
October 2, 2014
Posted in: Hot Topics
On September 30th, the first case of Ebola was diagnosed in the United States. The patient, who is currently being treated in Dallas, had recently traveled to Liberia, and was back in the country for a few days before symptoms began.
Understandably, the coverage of this news is pervasive. Although it seemed inevitable that a case in the United States would eventually emerge, the story still ignites a fair bit of hand-wringing among just about everyone who has learned of it.
Additionally, our country has experienced some novel infections that have ignited increased concerns in recent weeks. Enterovirus D-68 has made its way across the nation, causing severe cold-like symptoms, and, in some children with conditions such as asthma, the need for hospitalization. There’s also a potentially new contagion on the horizon that appears to cause varying degrees of muscular paralysis, and may or may not be related to Enterovirus D-68.
But, as public health officials are eager to stress, a nuanced and thoughtful approach to these issues has been as necessary as it has been fleeting. Experts agree that our medical infrastructure is well-equipped to handle even a virus as scary as Ebola, and some doctors are quick to point out that viruses like respiratory syncytial virus (RSV) and influenza are much more likely to cause harm than these new ones.
This raises a critical point:
Ebola, as scary as it is, poses a relatively minor threat to the United States; and, the current cases of Enterovirus D-68 are far out-numbered by the RSV and influenza cases we experience on a yearly basis. Furthermore, the currently-unknown contagion that appears to cause paralysis has only happened in a very small population of kids.
So, why the massive reaction in the media and among worried parents? Intellectually, at least at this point, all indications point to little danger for our children and ourselves. Why, then, do we get so frightened?
Well, let’s start with this confession: We’re frightened.
We know, intellectually, that the threat is minor. But, when has intellect played a leading role in the emotionally-driven process of threat assessment? And, especially with regard to infectious disease, when has anyone other than the most statistically-driven scientist been able to preserve perspective? We’re not saying that we should massively worry, or even that we’ll be changing our instructions to our kids or our patients on how to behave with these new bugs dancing around.
What we’re saying is that germs, especially new germs, are scary. We have a long and probably evolutionarily-derived tendency to fear disease, and when new ones rear their head, we get a bit shaken up.
We know that we as a society think about germs a lot—and nowhere does that play out more than in Hollywood. The 1954 novella I am Legend has been made into no less than three movies (The Last Man on Earth, The Omega Man, and the more recent movie of the same title as the written work). You can rattle off other movies as well—there’s Dawn of the Dead (in 1978 and again in 2004), Outbreak, Carriers, Contagion, The Crazies (in 1973 and again in 2010), Quarantine (and Quarantine 2),and most recently World War Z.
Movies are a double-edged sword in these circumstances. We need stories to put our fears into displacement so that we can better grapple with our darkest concerns, but these stories also provided fertile ground for our imaginations when real diseases emerge. In fact, sometimes the tail seems to be wagging the hysterical dog; the news coverage begins to look a lot like the movies themselves.
And, this all stems from our biggest fear of all.
When Steve had his first child, he asked his Aunt Mary when he could stop worrying.
“You don’t,” she said, smiling. “Not ever.”
In that sense, we’re writing this post as much for ourselves as for our readers. We need to break down what happens when threats emerge with such frightening and dramatic imagery.
Social scientists have defined mass hysteria in different ways, and to that end, it wouldn’t be prudent to refer to the current concerns as actual hysterical reactions. However, many of our current responses to the recent news of these diseases bare all the hallmarks of classic mass hysteria. Most important is the cognitive process of catastrophic thinking. This describes the over-reaction that we all seem prone to engage in despite our ability to know better. Catastrophic thinking is, in fact, a defense against the worst possible scenario. None of us want to be caught unprepared should things really, however unlikely, go south.
Gene vividly remembers the polio epidemic in 1952. From then through the late ‘50s he was not allowed to go swimming in friends’ pools. It’s not as if kids didn’t go swimming in the 1950s; it’s just that Gene’s uncle had polio with subsequent paralysis of his legs. While he actually overcame his challenges and managed to become a physician, Gene’s parents knew of the many thousands who had become paralyzed or passed away from the disease. They just wanted to protect him—and before the advent of chlorine, they were probably doing the right and rational thing. Still, to this day, the concerns about polio and its ravages scare the living daylight out of Gene. Importantly, Gene finds himself scared despite the fact that he “knows” better.
In fact, Gene has to actively remind himself that soon after his parents’ prohibition against swimming, we had the famous Salk vaccine, followed by the Sabin oral vaccine. In short order, polio was largely eliminated from the United States and much of the world in less than a decade.
What does this tell us?
We’ve seen many horrible epidemics, and we’ve seen miraculous efforts toward prevention—from vaccines, to anti-viral medications, to sound and careful approaches to treating and diminishing spread of infection. We have seen, especially in our country, effective ways of treating patients in isolation and preventing the spread of infection.
But, how do we respond to these events and still not succumb to the Doomsday Preppers’ messages on reality television? As parents, how do we talk with our kids about the dangers of infectious disease, and Ebola in particular?
Tips for Parents:
Your information and reaction will clearly have a powerful effect and impact on your children. So, it’s really important to remain positive and take stock of your emotional tendencies (remember that anxiety is “contagious,” and that even the youngest of children can pick up on it). If you stay calm, your kids will in all likelihood feel reassured.
It’s a good idea to restrict young kids from media and news stories about Ebola. You can decide what information you want to share, but remember that kids think what they see on TV is happening outside their doors. Help them to understand where, in fact, these stories are taking place.
Adolescents, on the other hand, need to know the facts, but may want to ask additional questions and engage in conversations. Look for them to be curious about:
Then, let your teens drive the conversation. If they ask questions that you don’t know the answers to, seek them together by going to reputable sources such as the CDC.
For kids who are especially anxious, limit media exposure, particularly media that sensationalizes stories about Ebola and illness. Some may not fare well watching horror films, particularly those involving contamination. Certainly a zombie film is far different than an Ebola outbreak, but it’s not terribly difficult for anxious teens to make the leap from World War Z to the current Ebola outbreak. If they do make this connection, carefully remind them of the clear differences.
As parents, we’re always concerned about the well-being of our kids. And, when it comes to infectious diseases—particularly when it appears at first that there is little we can do—the knee-jerk reaction may well be unbridled fear.
But, we’re not doing ourselves or out patients any favors if we remain terrified. We need to keep in mind that this is not the first contagion threat we’ve encountered, nor will it be the last. At the end of the day, medical advances and sound public education have been impressively effective in containing these illnesses.
Most importantly, our children rely on us to remain calm. This means that it is incumbent on us to remain well-informed and willing to talk with our children in developmentally-appropriate ways. This is, of course, no different than the job of any parent. It’s just that in this case, we have to keep our own irrational fears in check.
The authors wish to thank Stephen Calderwood, MD, Chief of the Division of Infectious Disease at Massachusetts General Hospital, and Mark Pasternack, MD, Chief of the Pediatric Infectious Disease Program at the Massachusetts General Hospital for Children for their invaluable review of and editorial suggestions for this blog.
A version of this post originally appeared and was written by the authors (Beresin and Schlozman) on WBUR’s CommonHealth on October 2, 2014.