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      Effectively Communicating the Uncertainties Surrounding Ebola Virus Transmission

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      PLoS Pathogens
      Public Library of Science

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          Abstract

          The current Ebola virus outbreak has highlighted the uncertainties surrounding many aspects of Ebola virus virology, including routes of transmission. The scientific community played a leading role during the outbreak—potentially, the largest of its kind—as many of the questions surrounding ebolaviruses have only been interrogated in the laboratory. Scientists provided an invaluable resource for clinicians, public health officials, policy makers, and the lay public in understanding the progress of Ebola virus disease and the continuing outbreak. Not all of the scientific communication, however, was accurate or effective. There were multiple instances of published articles during the height of the outbreak containing potentially misleading scientific language that spurred media overreaction and potentially jeopardized preparedness and policy decisions at critical points. Here, we use articles declaring the potential for airborne transmission of Ebola virus as a case study in the inaccurate reporting of basic science, and we provide recommendations for improving the communication about unknown aspects of disease during public health crises.

          Author Summary

          Basic scientific research is now considered an integral component of the fight against emerging infectious diseases like Ebola virus. The recent Ebola outbreak, however, demonstrates how the ineffective communication of basic science can stoke public panic more than it provides helpful tools to responders; basic science trades in probabilities and uncertainty, while public communication tends to favor more categorical claims. Here, we discuss the ethics of communicating scientific results, using, as a case study, the recent controversy over whether basic life sciences research demonstrates that Ebola could become transmissible via airborne respiratory droplet nuclei—popularly known as a virus becoming “airborne.” We show how the science does not demonstrate this possibility, despite claims made in the popular and scientific press. We then recommend that uncertain scientific results in the context of public health crises ought to be communicated with humility, an emphasis on what is unknown, and a clear outline of the kinds of evidence that would give proof to controversial claims.

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          Most cited references9

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          Gaining trust as well as respect in communicating to motivated audiences about science topics.

          Expertise is a prerequisite for communicator credibility, entailing the knowledge and ability to be accurate. Trust also is essential to communicator credibility. Audiences view trustworthiness as the motivation to be truthful. Identifying whom to trust follows systematic principles. People decide quickly another's apparent intent: Who is friend or foe, on their side or not, or a cooperator or competitor. Those seemingly on their side are deemed warm (friendly, trustworthy). People then decide whether the other is competent to enact those intents. Perception of scientists, like other social perceptions, involves inferring both their apparent intent (warmth) and capability (competence). To illustrate, we polled adults online about typical American jobs, rated as American society views them, on warmth and competence dimensions, as well as relevant emotions. Ambivalently perceived high-competence but low-warmth, "envied" professions included lawyers, chief executive officers, engineers, accountants, scientists, and researchers. Being seen as competent but cold might not seem problematic until one recalls that communicator credibility requires not just status and expertise but also trustworthiness (warmth). Other research indicates the risk from being enviable. Turning to a case study of scientific communication, another online sample of adults described public attitudes toward climate scientists specifically. Although distrust is low, the apparent motive to gain research money is distrusted. The literature on climate science communicators agrees that the public trusts impartiality, not persuasive agendas. Overall, communicator credibility needs to address both expertise and trustworthiness. Scientists have earned audiences' respect, but not necessarily their trust. Discussing, teaching, and sharing information can earn trust to show scientists' trustworthy intentions.
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            Communicating scientific uncertainty.

            All science has uncertainty. Unless that uncertainty is communicated effectively, decision makers may put too much or too little faith in it. The information that needs to be communicated depends on the decisions that people face. Are they (i) looking for a signal (e.g., whether to evacuate before a hurricane), (ii) choosing among fixed options (e.g., which medical treatment is best), or (iii) learning to create options (e.g., how to regulate nanotechnology)? We examine these three classes of decisions in terms of how to characterize, assess, and convey the uncertainties relevant to each. We then offer a protocol for summarizing the many possible sources of uncertainty in standard terms, designed to impose a minimal burden on scientists, while gradually educating those whose decisions depend on their work. Its goals are better decisions, better science, and better support for science.
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              Virology. Mutation rate and genotype variation of Ebola virus from Mali case sequences.

              The occurrence of Ebola virus (EBOV) in West Africa during 2013-2015 is unprecedented. Early reports suggested that in this outbreak EBOV is mutating twice as fast as previously observed, which indicates the potential for changes in transmissibility and virulence and could render current molecular diagnostics and countermeasures ineffective. We have determined additional full-length sequences from two clusters of imported EBOV infections into Mali, and we show that the nucleotide substitution rate (9.6 × 10(-4) substitutions per site per year) is consistent with rates observed in Central African outbreaks. In addition, overall variation among all genotypes observed remains low. Thus, our data indicate that EBOV is not undergoing rapid evolution in humans during the current outbreak. This finding has important implications for outbreak response and public health decisions and should alleviate several previously raised concerns.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS Pathog
                PLoS Pathog
                plos
                plospath
                PLoS Pathogens
                Public Library of Science (San Francisco, CA USA )
                1553-7366
                1553-7374
                29 October 2015
                October 2015
                : 11
                : 10
                : e1005097
                Affiliations
                [1 ]BioDefense Branch, BioSciences Division, Edgewood Chemical Biological Center, Aberdeen Proving Ground, Maryland, United States of America
                [2 ]Department of Medical Ethics and Health Policy, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
                The Fox Chase Cancer Center, UNITED STATES
                Author notes

                The authors have declared that no competing interests exist.

                Article
                PPATHOGENS-D-15-01302
                10.1371/journal.ppat.1005097
                4626028
                26512988
                c794104b-7136-4bda-8024-03d0e6f01fc6
                Copyright @ 2015

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

                History
                Page count
                Figures: 0, Tables: 0, Pages: 5
                Funding
                AK is supported by the National Academy of Science and DTRA as a National Research Council (NRC) fellow. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Opinion

                Infectious disease & Microbiology
                Infectious disease & Microbiology

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