To the Editor:

When the history of American medicine in the early 21st century is written, the chapter on the "great Ebola epidemic of 2014" will surely be one of the most comical and embarrassing chapters.

A cruise ship is temporarily marooned because a healthy passenger may have worked with a lab specimen from an Ebola patient nearly three weeks earlier.

Scores of individuals were exposed to the only patient dying of Ebola in the US prior to his exhibiting symptoms. Despite assurances from experts, dire warnings about their becoming the epicenter of a US outbreak proliferate. As predicted, none of these folks have developed the disease.

Preening politicians, ever ready for cameras, harass one of the world's most expert public health professionals in a theatrical performance billed as a Congressional hearing.

The anti-immigration lobby, always looking for new ways to justify virulent ethnocentrism, seizes the opportunity to demand closing our borders to travel from certain countries, although not too sure exactly what countries.

A great local university cancels the visit of a famed photojournalist who had been covering the real Ebola epidemic. University spokespersons cited concerns for public safety, despite the fact that the individual was beyond the known incubation period, and up to now had been comfortably going about his personal business in a large metropolitan area.

What has brought about this nonsense? Four American citizens, who acquired Ebola overseas, were brought home and successfully treated. One foreign national came to the country while incubating the disease, was not recognized early, and succumbed despite therapy. Two health care workers caring for him contracted the disease and are being treated.

While concerning, these events are hardly a blip on the radar of public health. Children, including some in Syracuse, die in the US every year from vaccine-preventable diseases. Where are the Congressional hearings demanding to know why parents can "opt out" of immunizations and send their children to school, putting everyone else's children at risk of fatal disease?

Thousands of Americans die of influenza, a disease which can be prevented by immunization and spread through the air. Where are the calls for restrictions on air travel by unimmunized travelers or those with coughs?

Make no mistake about it. Ebola is a horrible disease with the potential for destabilizing a huge swath of Africa. It is not new--outbreaks have been going on for over 30 years. Few Americans cared about it, however, until confronted with a hyped-up threat to themselves.

We know quite a bit about how the disease is spread from studying outbreaks. Casual contact, especially of pre-symptomatic individuals, is not a risk. Every Ebola patient in the US acquired it from directly caring for a sick individual or individuals. Control of spread of Ebola is not complicated. It is one of a host of terrible diseases whose spread is a function of living conditions. There are problems in the US, but having an environment conducive to the spread of Ebola is not among them.

The fallout from this non-crisis may be massive. Our CDC and its director, Dr. Frieden, are respected internationally as the go-to agency for health emergencies. That they are being vilified by politicians, and may even be usurped by an"Ebola Czar" is absurdly tragic.

The diversion of resources in American hospitals necessitated by Ebola concerns may take a long time to comprehend. Unbudgeted expenses for untold millions of specialized items of protective equipment may be difficult to sustain in the context of already-thin margins. The costs of extensive staff preparatory training, not only financial but in terms of other tasks left undone, are difficult to calculate.

The true costs of Ebola, however, are rarely mentioned. Thousands of people living in unimaginable poverty are suffering horrible deaths, their bodies rotting in squalor. The economies of these impoverished regions are drawing to a standstill. The devastation of the disease will be followed by famine and, likely, political and social collapse. Such conditions breed terrorism and even worse political instability. This is the real threat of Ebola, not an American returning from vacation on a plane with a Liberian. This is the face of Ebola, not a stranded luxury cruise liner outside Belize.

Sadly, humanitarian aid to regions such as those harboring Ebola is no longer important for many Americans. Indeed, the very politicians who are castigating our government for their response to the epidemic have been vocal decriers of "foreign aid." The mantle of aiding these unfortunate fellow humans has largely fallen upon NGOs and religious organizations. If simple human decency is insufficient motivation to reenergize America's role in these regions of the world, perhaps self interest will do so.

Thomas R. Welch, M.D.

Professor and Chair

Department of Pediatrics

Upstate Medical University

Medical Director

Upstate Golisano Children's Hospital

