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Why Ebola Is Not A Threat To The U.S.


The threat of Ebola to the United States is a scintilla of what it is in Africa. But this week questions were raised about the response of U.S. hospitals and the Centers for Disease Control. We're joined now by Kent Sepkowitz. He's an infectious disease specialist and the deputy physician-in-chief at Memorial Sloan-Kettering Cancer Center in New York City. He joins us from New York. Thanks much for being with us.

KENT SEPKOWITZ: Thanks for having me.

SIMON: I feel the need to put this to you - this bluntly. Is there a serious threat of Ebola breaking out in this country?

SEPKOWITZ: Not at all. There's certainly a threat for the occasional case like we're seeing in Dallas right now, but the notion that we would have the type of out-of-control, almost biblically tragic outbreak that's going on in West Africa right now is really not feasible.

SIMON: Well, how are we different? Why are we so confident about that?

SEPKOWITZ: We have health care here. We have the CDC. We have health care infrastructure. We have all those things that tax dollars have been supporting all this time, but more than anything else, we have a tradition of getting supplies to and from places. We have enough rooms. We have enough beds. We have enough gloves. We can afford the type of over-the-top waste creation that of taking care of an infectious patient can make.

SIMON: At the same time, I'll bet there are a lot of Americans who are thinking now of instances in which the health care infrastructure has holes and we all know of individual cases where people slipped through the cracks. And that's got to concern people.

SEPKOWITZ: Surely. That happens, but there is enough redundancy in the system - if we were talking about smallpox, if we were talking about flu, my answer would be entirely different because those are highly contagious infections.

SIMON: And Ebola - maybe we can't emphasize this too much - Ebola's not airborne, right?

SEPKOWITZ: It is not airborne. I think that the simplest way to think about it is that with the flu outbreak of 2010, about 50 million Americans were infected within a matter of few of a few months. That's an outbreak. What we're seeing in West Africa now is over an eight-month period somewhere in the order of seven to 15,000 cases. That's a very slow-motion outbreak. It's certainly an epidemic, but it demonstrates how much more difficult it is to transmit this infection.

SIMON: There are some people who are now calling for travel from affected countries to be stopped. Is this something the U.S. should consider?

SEPKOWITZ: Not at all. The practicality is that most flights from Africa go through other airports outside of the U.S. and to actually track every person leaving Africa through the airports in Belgium, Amsterdam, London, et cetera, strikes me as an impossible task. The humanitarian argument I think speaks for itself and the likelihood that we would really snuff something that way also seems misguided.

SIMON: I feel moved to ask you a specific question about the case of Thomas Duncan, the patient in Dallas. And recognizing that obviously there's still a lot to be investigated and discovered about the case, the hospital is suggesting that he simply didn't give them correct information when he filled out the forms. And you know, this raises the whole question as to whether or not - should we rely on just forms for something like this?

SEPKOWITZ: I think that with any outbreak or with any infectious disease, the first case is almost always going to be missed, even when there's an outbreak you know, across the Atlantic. It's almost axiomatic that somehow the light bulb is just not going to go on. I've certainly seen that many times. You know, the first flu of the season always fools me, the first this or that. So I think that we're setting an incredibly high bar. We're all geniuses in retrospect in terms of what that hospital could've, should've done. It seems like they made a real mistake, there's no question about it. But I think that the first one of the season, first one in history - boy, that's a tricky business.

SIMON: Kent Sepkowitz is an infectious disease specialist and the deputy physician-in-chief at Memorial Sloan-Kettering Cancer Center in New York. He's also a contributor to The Daily Beast. Thanks for being with us.

SEPKOWITZ: Thanks for having me. Transcript provided by NPR, Copyright NPR.

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