http://www.nytimes.com/2014/10/16/health/ebolas-other-contagious-threat-hysteria.html 2014-10-15 23:50:20 Ebola’s Other Contagious Threat: Hysteria With three cases of Ebola having been diagnosed in the United States, psychologists say the next few weeks are crucial in containing public anxiety. === As health officials scramble to explain how two nurses in Dallas became infected with Ebola, psychologists are increasingly concerned about another kind of contagion, whose symptoms range from heightened anxiety to avoidance of public places to full-blown hysteria. So far, emergency rooms have not been overwhelmed with people afraid that they have caught the Ebola virus, and no one is hiding in the basement and hoarding food. But there is little doubt that the events of the past week have left the public increasingly worried, particularly the admission by Dr. Thomas R. Frieden, director the of the On Wednesday, the C.D.C. offered up the latest piece of bad news, announcing that the second infected nurse in Dallas had flown to Cleveland and back a day before developing symptoms. Even before the announcement, two-thirds of the respondents to a Experts who study public psychology say the next few weeks will be crucial to containing mounting anxiety. “Officials will have to be very, very careful,” said Paul Slovic, president of Decision Research, a nonprofit that studies public health and perceptions of threat. “Once trust starts to erode, the next time they tell you not to worry — you worry.” The risk of Ebola infection remains vanishingly small in this country. The virus is not airborne, not able to travel in the way that, say, By contrast, in some years, the “We’re familiar with Experts said the most recent precedent of the Ebola risk, psychologically speaking, is the Some duct-taped windows and stayed away from work. In pockets of the country — in Tennessee, Maryland and Washington — people reported physical symptoms like headaches, nausea and faintness. Ultimately they were determined to be the result of hysteria. “I was in college then, and I remember they evacuated the business school building because someone saw white powder in the cafeteria,” said Andrew Noymer, a sociologist at the University of California, Irvine. The powder turned out to be artificial sweetener. Ebola has arrived at a different cultural moment from the anthrax attacks. In 2001, fears of imminent terrorism were all too real. Still, perception of risk is far from a strictly rational calculation. Psychologists have known for years that people judge risk based on a sophisticated balance of emotion and deduction. Often the former trumps the latter. Instinctual reactions are quick and automatic, useful in times when the facts are not known or there is not enough time to process what little is known. Analytical reasoning is much slower and much harder; if we relied on analysis alone, decisions about risk would paralyze us. In everyday life, the mind juggles the two methods of risk assessment. Research into this process, some of it by the Nobel laureate For example, most people appreciate that a chance of infection of one in a 100 million is near zero. But if a friend says he knows an infected person, then our instinctive risk-assessment system is much more likely to focus on numerator than the denominator. Am I the one in 100 million? Me? “The system often flips from one extreme to another, from ignoring risks altogether and then overreacting,” said George Loewenstein, a professor of economics and psychology at Carnegie Mellon University. The Ebola outbreak has many of the elements that could quickly stoke instinctual panic, experts note. It is invisible and deadly, a point graphically communicated in nonstop pictures and videos from Africa. Like SARS, and more recently These elements are precisely those that are most likely to cause contagious anxiety, researchers have found. Add to this the fact that death from Ebola is so gruesome, and people can become fearful very quickly. “It’s the same reason we’re terrified of airplane accidents, because we can’t imagine what those last moments might be like,” Dr. Lowenstein said. At the moment, health authorities are struggling to retain the public’s trust, a crucial brake on runaway anxiety. The most important factors, Dr. Slovic said, will be competence and fairness: communicating the risks clearly; reporting all cases as quickly as possible; and treating each infection with the maximum level of care. Officials will be walking a fine line, he said. “This could tip very quickly.”