Q&A: What Has the U.S. Learned From the Ebola Outbreak?

March 19, 2015

Topics: Public Health, Diseases & Conditions, Infections, Emergency Response

President Obama last month announced the withdrawal of most U.S. troops who were deployed to West Africa to help combat the Ebola epidemic.

White House officials in a statement noted that while they are "encouraged by the declining number of new Ebola cases in West Africa," the administration would "continue to pursue our flexible and adaptable strategy, meeting the evolving conditions on the ground until we have reached zero cases."

Currently, the number of new Ebola cases in West Africa has slowed significantly. For example, Liberia as of February was reporting just a few new cases weekly, a marked drop from five months ago, when the country reported an average of 1,000 new cases per week.

For this edition of Expert Explanations, William John Moss, head of epidemiology at Johns Hopkins University's Bloomberg School of Public Health, discusses the evolving epidemic, U.S. efforts to combat the virus and what the country has learned about disease control since the outbreak started last year.

Do you think the U.S. response to the Ebola outbreak was appropriate?

First, I do not think there was a single, monolithic U.S. response to the Ebola outbreak. There were many responses and these responses changed over time.

Second, I think public health officials initially overestimated the capacity of hospitals to care for patients with Ebola, resulting in nosocomial transmission. This was corrected.

Third, I think the US public, fueled by the media, overestimated the risk of Ebola virus transmission in the US. Fourth, I think politicians also overreacted to the risk and made decisions that were not based on the best scientific understanding.

Lastly, the best way to limit the number of Ebola cases in the U.S. is to stop the outbreak in West Africa. I think the global public health community, including the U.S., was slow to respond.

Should the U.S. have done more to respond to the Ebola outbreak domestically?

I think the U.S. could have better informed the public on the nature of Ebola, the level of risk in the U.S. and how the best strategy is to stop it at its source.

Do you think the U.S. public health system is adequately prepared to respond to a large-scale infectious disease outbreak?

A large-scale infectious disease outbreak will strain any public health system. I think the U.S. has a great surveillance system to detect outbreaks and enormous resources that can be mobilized quickly to respond to an outbreak, including a large cadre of public health and health care workers.

What do you think the U.S. can do to better respond to future outbreaks?

First, I think the U.S. could continue to strengthen surveillance systems in other countries to enhance their capacity to identify and respond to outbreaks of infectious diseases.

Second, I think the U.S. could better inform the public about the infectious diseases, how they are transmitted and how to control them, perhaps by making infectious diseases and epidemiology a standard part of the high school curriculum.

Third, as the current measles outbreak shows, the US could do better at attaining high immunization coverage rates for the infectious diseases we know how to prevent.

What can we learn from the Ebola outbreak and global response efforts?

I think one of the major lessons is that the World Health Organization needs to have the authority and resources to respond to outbreaks. These changes have already been proposed. Another lesson that we need to learn over and over again is the importance of understanding local cultural beliefs and practices as part of the response effort.

>> Click here for more about William John Moss

-- Interview by Ashley Fuoco, staff writer