Ebola: probably not the BCP risk you are thinking of

Ebola is a terrifying disease. Starting with initial flu-like symptoms (headache, sore throat, fever and muscle pain) the disease progresses through vomiting and diarrhoea to internal and external bleeding and death. With the current state of medicine, it kills about half of the people it infects. It's scary, and I continue to be impressed by the courage of the medical staff dealing with the current outbreak.

But despite the serious outbreaks in West Africa, Ebola is unlikely to become a world-wide pandemic:

• The disease is transmitted through bodily fluids (as well as surfaces contaminated with bodily fluids). Transmission is therefore much less likely from casual contact than is the case with airborne pathogens (such as influenza).
• Victims are only infectious when they become symptomatic, and the symptoms are quite severe. This means that victims are quite likely to self-quarantine (stay at home), rather than continue spreading the disease. Those at most risk are therefore family, visitors, and medical staff.

The recurrent outbreaks in West Africa are thought primarily to be due to the presence of the virus in fruit bats (which carry the disease but are not affected by it), with transmission to the human population due to the consumption of bush meat. Methods of caring for the sick and handling of the dead are believed to have contributed to the spread of the disease.

If a pandemic is unlikely, and we aren't living in an affected area, what risk should we consider?

This risk we need to consider is the collateral damage caused by actions taken due to the fear of Ebola.

So far we have seen:

• Morocco cancelling the Cup of Nations (a major international football tournament) over fear of Ebola.
• Canada banning travelers from affected countries. (This is especially ironic considering that Canada campaigned against this type of travel restriction following the outbreak of SARS in Toronto in 2003.)
• The United States screening travelers from affected countries at a number of United States airports. (This sounds like a good idea, but for this screening to detect anybody they must have been asymptomatic when they got on the plane - where they are already screened - and developed major symptoms in-flight. Experience with previous disease outbreaks has shown airport screening to be costly and completely ineffective).
• Cancellation of hotel bookings and major reductions in tourism in places in Africa as far away as Cape Town (3000m or 5000km from Liberia), apparently due to the limited geographical knowledge of many tourists.
• Collapses of local economies in West Africa in areas with or near outbreaks, due to fear of contagion as well as government restrictions on trade and movement.
• International companies with operations in or near the affected countries are having to operate their own charter aircraft to be able to ensure their staff can travel or be evacuated since standard air carriers are restricting or stopping flights.

Thus the risk of disruption due to fear of contagion needs to be considered even if the actual chance of contagion remains low. Some questions we might ask ourselves include:

• Does our supply chain ultimately extend anywhere near any of the affected areas?
• What should happen if a member of staff has to or wants to visit an affected area?
• If a member of staff returns from a visit to an affected area, should they be asked to work at home or given time off for the quarantine period of the disease?
• What should happen if a member of staff being develops Ebola-like symptoms? How will the fears of other staff be handled?

To adapt Franklin D. Roosevelt's famous quotation:
The only thing we have to fear is fear itself — and we need to plan for that.