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People have their temperature taken at the Canton Fair in China, 2014. Photo: plavevski, Shutterstock

The $5 billion response to the outbreak of Ebola in West Africa in 2013 was widely criticized, with one panel of experts calling it an “egregious failure” in a prestigious medical journal as the final cases were being laid to rest.

A new study by an international team concludes that quarantines and containment may actually be less helpful to the greater good – a conclusion they concede may be “counterintuitive.”

The cost/benefit analysis, published in the journal Nature Scientific Reports, states that alerting the public, shutting down public places, and restricting travel could actually cause a greater breakdown in services and resilience – leading to economic paralysis and potential social conflicts.

“Containment interventions intended for a straightforward reduction of the risk may have net negative impact on the system by slowing down the recovery of basic societal functions,” write the scientists, from the Ecole Polytechnique Federale de Lausanne in Switzerland, the U.S. Army Corps of Engineers, and Northeastern University.

The method is a computer model – a scale-free network – of a metapopulation of New York City that is hit with an outbreak.

The variables included 10 populations selected at random in the city, with 50 individuals starting as the seed of exposure to the germs. All the other individuals in the population are potentially susceptible. The mathematical equations allowed for individuals to spontaneously change their behavior based on fear of the disease, and also imposed local travel restrictions, among other factors.

Other social factors included in the overall picture of the functioning of the simulated modern population included limiting leisure activities outside, and working from home.

Taken together, they indicate preventing spread of disease may not be the best big-picture option, they conclude – perhaps controversially.

“We quantified a variable that is often difficult to predict,” said Emanuele Massaro, first author of the study, from the EPFL’s Laboratory for Human-Environment Relations in Urban Systems. “The authorities need to understand the risks they create in terms of the system’s resilience if they adopt alarmist media campaigns.

“Above all,” Massaro added, “they need to know the severity of the disease before disseminating messages encouraging people to limit their movements or change their habits.”

The conceptual work – based on “resilience-focused analysis for selecting intervention strategies” – could help construct future outbreak response. But the authors concede that other considerations would come into play as dangerous germs spread. Simply focusing on the greater stability of society may not be the first choice, they explain.

“Cost-benefit analyses and ethical considerations should be included in the analysis of the societal impacts of disease that could lead to long lasting effects or even death of the affected individuals,” they write.

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