We’re all gonna die (maybe)

The Kaiser Family Foundation polled the American public to see if anyone actually understands how you get Ebola. The short answer? No, no they do not. I am a health literacy advocate and I can tell you that this did not come as a surprise to me at all, but it did (I hope) shed some light on the truly pervasive epidemic of low health literacy in the United States.

That being said, I can explain Ebola to you in a way that you will understand and will not be condescending or patronizing and will actually provide you with informed, actionable information. That’s what health literacy is meant to do.

How to Get Ebola

Step One: Know Someone With Ebola

The first step to contracting Ebola is to know, live with or be treating someone who is infected.

Step Two: That Someone Has Symptoms

The person is not able to give you Ebola until they start showing symptoms. This usually starts with a fever, then they start throwing up and having diarrhea. They have these symptoms because Ebola wants the body to spread the virus to as many new hosts as possible so it can keep living and evolving. The virus particles are in the fluids — so, the puke, the poop, the blood, the spit and the semen. Though, my guess is no one with Ebola feels up to nookie. That all being said, the time that passes between when Ebola virus particles enter someone’s body and then makes them able to spread it to other people is usually a couple of days to a week — but it can be as long as 21 days, which is why people are quarantined for that long.

Step Three: Get That Person’s Puke, Poop, Blood, Spit or Semen on Yourself

If you are taking care of someone with Ebola and they throw up all over you, poop on you, bleed on you, spit on you or ejaculate on you, then you have been exposed to the virus. Viruses are not killed by hand sanitizer. The only way to get a virus off you is to use water, soap and the friction of rubbing your hands together to get the virus off your hands and rinsed down the drain of a sink. This is the only. way. to. get. viruses. off. you.

Not just Ebola, another common puking virus, Norovirus, lives on surfaces for an obscenely long time and you only need a few particles of virus to get sick. That’s why frequent hand washing is the best way to prevent it: you are actually rinsing the virus particles off your hands and down the drain where they will finally die an agonizing death.

Let’s say you’re caring for someone with Ebola, or even just within puking radius of them, and you get some barf or poop on your hand. Then you touch your face. Or eat something. Or wipe it on your clothes. All of these things are bad things to do. The virus wants to get inside you. It will do so by way of your mouth or nose or eyes, because those are moist areas that are particularly comfortable for viruses. Warm and wet means it can grow.

Step Four: Don’t Wash Yourself Off, or, Touch Yourself Before You’ve Cleaned Off Properly

This is where people run in to trouble: if you have had the yuck on yourself and you, as mentioned, introduce those virus particles into your body before you have a chance to get cleaned up, then you’re probably doomed. Keeping that in mind, if you were on an airplane, a row or two away from someone who had Ebola and was, perhaps, shitting themselves, if you sat in your seat and did not move the whole flight, did not clean up said poop and did not eat or drink, touch your face or do that mouth-finger-whistling thing before you had a chance to wash your hands, you’re fine. Ebola virus particles can’t fly. It’s not like a cold that travels at the speed of light out of your nose when you sneeze. Though, if someone is standing across the room from you and they shit/puke projectively in your general direction then yes, in that sense, it could be “airborne” —but that is a very loose interpretation of the term.

So, having been educated on this, you are probably poised to ask me, “So why did those nurses in Dallas get Ebola?” I admit, I can’t say for certain, but I have a theory. The CDC and the hospital in Dallas is being kind of mum on the subject, likely since they don’t want to give an answer only to have it turn out to be entirely false (because that’s already sort of happened a lot). The nurses, however, are being pretty transparent because they don’t think it’s fair (and it’s not) for the nursing staff to be blamed for the spread of the virus. From what we know, it would seem that even though the healthcare workers who were treating the first patient—Thomas Duncan, a Liberian man who came to the U.S. to stay with his son, in an attempt to outrun the outbreak in West Africa—were “geared up” in PPE(personal protective equipment) they didn’t really know how to use it properly, how to work in it, and perhaps most importantly, how to remove it.

I am trained in HAZMAT Ops by FEMA. I can tell you, from direct and at least annual experience, that getting out of a HAZMAT suit is not something that you ever attempt to do by yourself. The reason behind this is that your outer layers are contaminated — and that’s okay, they’re supposed to be, that’s why you’re wearing protective gear—but if you start removing your gear and you haven’t been trained in the very specific method of doing so (which involves a partner to help) you are essentially making the whole suit moot — what good did it do you to wear the suit in the room with the patient if you’re only going to take it off, and then take your soiled gloves off, and inadvertantly rub up against the very layer that was supposed to be protecting you?

You might be thinking, “Well, I’d be extremely careful, that wouldn’t happen!” But I’ll say, it’s like that game Operation, where if you touch the sides the buzzer goes off. You think you’re doing just fine and then, all of a sudden, you get just a brush of your finger on the outside of a boot, or your mask, or whatever, and that’s it. It can happen in an instant — especially when you’re exhausted, suffering from heat stroke, have low blood pressure from being dehydrated, are terrified and have never been properly taught and had the chance to practice.

There is no reason why every single hospital in the U.S. shouldn’t run annual drills, using real PPE, with staff at least once a year. There is no reason that they should not employ the buddy system when “doffing” the gear. There is no reason why this training shouldn’t be made part of an employees orientation, and why the continuing education opportunities shouldn’t be made available and enforced in every hospital in the world.

The real epidemic in America right now isn’t Ebola, it’s chronic acquired ignorance — and quite frankly the prognosis doesn’t look good.