10/03/2014 11:14 am ET Updated Dec 03, 2014

Through Ebola's Eyes

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As you no doubt know, Ebola has been brought to the U.S. The latest news, as the man who brought the virus back with him from Liberia recovers at Texas Health Presbyterian Hospital in Dallas, is that as many as 100 people may have been exposed between his flight home, and his hospitalization.

Predictably, this one case diagnosed here in the U.S. has resulted in a media feeding frenzy, rumination, recrimination, and the familiar blend of hyberbole and hysteria that tends to populate those infamous 15 minutes during which any given crisis holds our attention.

No, we are not suddenly at risk. As the media coverage spells out, the man was apparently asymptomatic on the flight back to the States. With Ebola, asymptomatic (i.e., not yet sick) means non-infectious as well. So, based on the information currently in circulation, fellow passengers were not exposed, and not at risk.

Much the same seems to be true of the growing number of people with whom Mr. Duncan had any degree of contact before his hospitalization. Most of that group will also prove to be unexposed. Transmission to any of them seems unlikely at this point, but is a possibility for anyone who had genuinely close contact with Mr. Duncan after he became sick. Diligent surveillance is now under way to make sure this group is monitored carefully, any transmission is detected immediately, and any further transmission is preempted entirely.

As has been noted, then, the intense concern in the one case "brought home" to us is wildly exaggerated in comparison to the persistent, relative apathy directed toward the actual source of the problem. The New York Times reported on conditions in a hospital in Sierra Leone -- called "a hospital from hell" -- in an article that was almost too painful to read. You should read it just the same -- or as much of it as you can stand.

This, then, is the real issue. One case "here," in a modern hospital, carefully contained -- tops the news. Devastation, destitution, and chaos that strain the limits of the imagination over "there" fall below the crease.

Our problem is a failure to see through Ebola's eyes. Or the eyes of any virus for that matter. Or the eyes of whatever pathogen may next exploit our biological real estate.

Viruses are blind to all of the differences that matter so much to us. Through the eyes of a virus, there is no us and them. There is no here and there. There is no black and white. There are no geopolitics or borders.

There is just a species with an accommodating, penetrable genome.

In fact, the blindness of Ebola extends further. This virus can invade the genomes of other species, too. Colleagues concerned with wildlife have long tracked Ebola in species other than our own, and warned of the likelihood of the crisis now playing out. But, of course, no one was much inclined to listen, because the problem was "over there," and in "them."

Ebola, however, is blind. There is no us and them. There is simply a global expanse of vulnerable flesh.

This invites reflection at the interface of public health science, and pop culture science fiction. As it happens, I am a fan of both.

In the latter camp, at least, I seem to have plenty of company, judging by the popularity of movies that have our little, blue planet overrun by interstellar aliens. The inevitable allure of these tales, along with the swashbuckling, the explosions, the special effects and CGI -- is the effect of that overriding menace on us. Faced with a threat from without, we see past the superficial differences that divide us. We embrace our common humanity, to confront our common foe. And so it is -- spoiler alert -- that we overcome. So it is that we win. Our common humanity and common cause saw us through in Independence Day; it saw us through in Edge of Tomorrow.

The pleasure in such fantasies is that the menace is imagined. Ebola, alas, is all too real. But it, too -- and all of the pathogens with comparably virulent potential, both known and unknown, already here or awaiting the next unfortunate mutation -- is a common threat. It, too, menaces all of us, and our common humanity.

As global exchange of every variety shrinks our planet and repudiates the relevance of distance, the great paradox of modern public health ensues. We persist in our perceptions of us and them, here and there. We persist in the notion that we can take care of "our people" preferentially. We persist in dissent and discord, fractious ideologies and archaic prejudice. We see differences to which Ebola is blind.

We don't need the common menace to come from beyond the stars. It can come from Liberia. It is already here.

That invites a consideration. Perhaps Ebola sees us just fine; and we are blind.


David L. Katz, MD, MPH, FACPM, FACP

Author, Disease Proof

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