Ebola in the United States: How infrastructure will keep it at bay

amybucherphd.com With the first handful of Ebola diagnoses in the United States, many Americans are panicking about the possibility of an epidemic. To be sure, Ebola is terrifying. However, the good news for Americans is that we are very unlikely to experience an outbreak remotely as serious as the one in West Africa. And the reason why has little to do with culture; it’s really about infrastructure.

Here are a few key differences between the United States and the western African nations where Ebola has reached epidemic levels, all related to infrastructure, that will prevent Ebola from spreading with such ferocity here:

Better food and water distribution systems. As some news stories have pointed out, people under quarantine in Liberia and Sierra Leone may find themselves stranded without adequate food or water. They may venture outside the quarantine in order to secure a meal or clean water, in the process exposing themselves or others to the virus. While there is certainly food insecurity in the United States, there is also a much more robust infrastructure to deliver supplies to those in need.

More health care professionals per capita, and more hospitals. In Sierra Leone, there were 0.03 doctors per 1000 people in 2004, compared to 2.3 per 1000 people in the United States that year. CNN estimates that right now, there are only 1 or 2 doctors per 100,000 people in West Africa. In 2010, there were 0.4 hospital beds per 1000 people in Sierra Leone,  compared to 3 per 1000 people in the United States. The US is simply better equipped than countries like Sierra Leone to offer medical care to people who contract Ebola, which will help limit its spread.

The more expansive health care system here will also help with another issue in West Africa, which is that when people are ill with Ebola at home, it is near impossible for family members to obey medical advice not to touch them. Aside from cultural norms of physical contact, it is emotionally distressing to watch a loved one (especially a child), die without a comforting hand. Having hospital care for the ill will remove primary care responsibilities from the family.

Better infrastructure for handling and burying the dead. In Liberia, it is often impossible to immediately bury the bodies of those killed by Ebola. This is particularly dangerous because the bodies remain carriers of the virus after death, meaning that they can continue to transmit Ebola. A more mature funeral industry in the United States should essentially eliminate this particular risk here.

Better roads and transportation infrastructure. Another issue in West Africa is that what resources do exist may be highly centralized. That is said to be the case with the few physicians working in the area. Add in poorly constructed roads and limited availability of vehicles, and it is unlikely many citizens in the area can actually access those resources when needed. While the US also has its rural and hard-to-access regions, inability to quickly reach a care facility is not the norm here.

Many commentators have begun compiling lists of diseases or disasters offering a greater risk to the average American than Ebola. One such list from Salon includes:

  • Cancer and heart disease
  • Obesity
  • Car accidents
  • The flu
  • Binge drinking
  • Gun violence

The point is to keep calm; while we should be vigilant and prepared to deal with Ebola if it happens in the US, it’s not a threat worthy of panic. In fact, we may be doing ourselves a disservice by diverting resources from more likely domestic killers to American Ebola prevention efforts.

On a lighter note, a number of Twitter comedians have pointed out another threat more probable than Ebola: