90-Second Read: Dr. Michael Fine: What’s crazy about Hantavirus and Ebola

Over a thousand known cases of Ebola, with 17 confirmed and about 240 suspected deaths. Excellent public health work appears to have contained the outbreak of Hantavirus by quarantining exposed people. Ebola is a very virulent disease, and easily transmissible, but is not known to spread through the air, so careful attention to sanitation and disinfection can usually control outbreaks. Ebola spreading in the Democratic Republic of Congo and in Uganda.

That said, we as a nation and as a world population face many challenges when it comes to preventing and controlling outbreaks and epidemics. Viruses can become less virulent, but we never hear about those situations because those changes don't cause disease or epidemics.) Human beings have become much more numerous, and we travel a lot, which means we have become the perfect medium to help viruses evolve and spread. Other countries vary in their public health, and the US has, until recently, done its best to compensate for that variation, doing what helps protects us but lets others depend on us instead of depending on themselves. A virus that doesn't spread in the air may develop the capacity to do so.

Viruses are constantly evolving in us and in other animals and can spread from people to animals and back. A virus with an incubation period of 18 days, for example, may turn out to be able to survive longer than we thought, and spread out of the incubation period. China failed to prevent the spread of Covid-19, and there were no repercussions for that failure, beyond the deaths of millions of people. That means public health folks need to walk a fine line, recommending restrictions on individual liberties when the science strongly supports them, but not recommending them until such a time, and always making sure that they are pursuing the outcomes people want.

That said, there are times when we need travel restrictions, masks, mass immunization campaigns and other measures to prevent the spread of infectious disease. Preventing transmission of a disease that isn't dangerous for most people isn't such an outcome. We need to support public health with both recognition and resources, so we have the capacity to respond when the time comes.