Policy The state response to Ebola should be a coordinated communications effort. This will serve a number of purposes. First, it will maintain fiscal discipline. Second, communication is key to maintaining public order should there be an outbreak of Ebola. Third, communication helps to reduce the risk of an outbreak, because all members of our community will know how to avoid spreading Ebola.

The recent revelations that the World Health Organization and others botched their response to the Ebola outbreak in West Africa has done little to calm the public here at home regarding this disease. A government that deals in evidence and has a realistic world view does not need to address irrational panic, but the fact that global and national-level bodies seem challenged to come up with a plan to deal with Ebola places the onus on the state to devise such solutions. Already, some states, such as New Jersey, are developing their own responses to a potential Ebola outbreak (CBS, 2014). This is best practice -- there are many resources available at the state level that can be put into action in the event of any crisis, and disease outbreaks are just one of many crises that can emerge. The reality is that if the plan is not in place prior to an outbreak, it will be possible to address this issue once an outbreak has begun, owning to the fast-moving, fluid nature of such events.

Criteria

The policy regarding an outbreak of Ebola in our state should be measured on medical terms. This means containment, limiting the spread of the disease should it occur. All other objectives are secondary, and may be the subject of different policies (i.e. communications policy). Ebola containment requires a coordinated effort from a number of agencies, including health care officials, communications and media, transportation and other major public services. The spread specifically, when measured in terms of number of infected, number of deaths, is primarily medical in scope, and should be limited to those in the health care profession. One of the most important success criteria will be to keep number of infected down as close to zero as possible, and that no member of the general public should contract the illness.

One of the biggest threats with respect to Ebola is the hysteria that occurs among members of the public, and the risk of panic and a decline in general social order. When the disease presents itself on American soil, there is a heightened anxiety among members of the public about its potential spread. This is in part because there is a low level of information about how it is spread, but also in part because many do not see their civic leaders as having a solid plan for containing the spread of the disease. When the public realizes that containment procedures are often antiquated, their fear is not entirely irrational -- part of the success criteria of this strategy is to minimize the sort of destabilizing panic and irrationality that facilitate the spread of the disease, as has occurred in Africa (Dixon, 2014).

Finally, we can also use public awareness measures, tested through surveys, to understand how effective communication has been. Communication is essential to the control of Ebola because the disease does not spread easily. People in the community need to understand how Ebola spreads in order to a) feel safe and b) avoid the spread of the virus. A higher level of public awareness and education should be correlated with a lower risk of spread of the disease, should it enter the state. Furthermore, education and information should reduce some of the chaos, anxiety and anarchy that could occur when misinformed people start to panic.

Alternatives

There are two major alternatives. The first is a communications-heavy package and the second is a health-care heavy package. A third option, which essentially cedes having a serious plan to federal authorities, is also a possibility but has been ruled out for political considerations -- as a state we should have a say...

Funds will be set aside for education in particular under this plan. This option allows health care facilities to set their own policies for dealing with the outbreak, with state emergency funding available but limited state official assistance. This leaves health care response to health care professionals, rather than state officials. The state under this alternative primarily focuses on communication with the public. The response will include both preventative education prior to any outbreak, but will also contain pathways and funding for direct communication with the public in the event that an Ebola case is on our soil. This alternative establishes a chain of command, and provides for direct communication and communication via conventional media with the public. The public will be informed through routine communications under this plan, including steps that members of the public can take to keep safe.
The second alternative takes from the WHO directives that demand a coordinated effort to contain Ebola. This alternative is costlier and more involved, and will require the state officials to work not only with health care officials but also with federal officials who will no doubt be engaged in the containment process as well. The state's role under this alternative is greater, and will include not only the provision of funds but directing of actions at the health care, transportation, and law enforcement levels. This alternative is more comprehensive because it includes provisions for a scenario where there is the risk of Ebola getting out of health care and into the public, which dramatically increases the risk of its spread.

Projected Outcomes and Tradeoffs

State officials will doubtless face criticism should an outbreak occur, and in particular if a member of the general public contracts this disease. So there are huge costs -- in terms of public health and in terms of public relations -- to an outbreak and the state therefore should take steps to mitigate this. The more preparation is done -- under the second alternative, especially, the lower the risk. When preparation is relatively minimal, criticism from stakeholders prior to outbreak sets the stage for major crises after an outbreak -- consider that in Canada that nation's plan for Ebola has already come under criticism for its inadequacy (AP, 2014). Stakeholders need to see in advance that public officials are dealing with this seriously.

The major tradeoff with respect to preparedness is the cost. The actual risk of Ebola outbreak in our state is very low, but the cost of full preparedness will run into the millions. The state already has a stretched budget, and such requisitions will strain our finances even further. Given that the federal government and health care agencies have their own plans, there is the risk that this money will go mainly to redundant efforts. Only in the communications is there an opportunity to use funding wisely, and this does not preclude having some contingent funding in the event of an actual outbreak.

Recommendation and Discussion

The public needs to see that state officials are taking the Ebola threat seriously, but public hysteria over the disease vastly outweighs the risk. Precautions should be taken, but there is definitely the risk that too much money could be spent on preparing an Ebola crisis response when there is almost no chance that an outbreak will even occur here. Given the mandate for a balanced budget, it is important that the state strikes the right balance between genuinely protecting its citizens and spending money to improve the appearance of action.

It is therefore recommended that the state adopt alternative #1, which will require mainly an intensive communications effort. Other stakeholders in health care facilities and the federal government are developing their own response plans, and…