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As the national effort ramps up to beat back Ebola, the Obama administration has been taking heat. Critics say the president and top public health officials painted too rosy a picture of the country’s state of readiness. As proof, they point to the infection of two Dallas health care workers who treated the first person to die of Ebola on U.S. soil.
Conservative pundit George Will attacked what to him was the hubris in those early statements.
"The problem is the original assumption, said with great certitude if not certainty, was that you need to have direct contact, meaning with bodily fluids from someone because it’s (Ebola) not airborne," Will said Oct. 19 on Fox News Sunday.
"There are doctors who are saying that in a sneeze or some cough, some of the airborne particles can be infectious." Will also said Ebola could survive on a dry surface "for a number of days."
Show host Chris Wallace cut Will off, asserting that Ebola does not spread like the flu, which does move from person to person when someone with the illness is out in public.
When another guest challenged Will to cite his source, he ultimately referred to scientists at the University of Minnesota.
Here, we’re fact-checking Will’s claim that scientists say a cough or sneeze can spread Ebola. From the context of the discussion, we understand that Will was talking about the risk to the general public.
We reached out to Will and did not hear back but thanks to the rumor website Snopes, we have a pretty good idea where he got his information. In mid September, the University of Minnesota’s Center for Infectious Disease Research and Policy posted a commentary from two University of Illinois professors.
The commentary, co-written by Lisa Brosseau and Rachel Jones, argued that health care workers treating patients with Ebola should wear respirators. Face masks, they said, are not enough.
We asked Brosseau if Will had correctly relayed her work. Brosseau said her views had nothing to do with Ebola spreading among the public at large. The focus was on health care workers treating people in the isolation wards.
"We were concerned about aerosols generated by infected patients in the most severe stage of the disease," Brosseau said.
Will had mistakenly connected the pathway of infection in a hospital room with someone coughing or sneezing in public.
As has been well documented, the first symptom of infection is a fever. As the virus multiplies in the body, vomiting and diarrhea set in. Brosseau had written that it is possible that for patients in that condition, tiny water particles from violent vomiting and diarrhea could get into the air and be inhaled. In a laboratory experiment, monkeys with hoods over their heads could acquire the Ebola virus, but Brosseau said that lab experiments should be put in context.
"We are not aware of any published data about the viability or infectiousness of the Ebola organism in aerosols in the real world," Brosseau told PunditFact. "It appears unlikely that the public will be exposed to infectious aerosols because they are not likely to encounter infected people experiencing the severe symptoms."
Adam Lauring, an infectious disease researcher at the University of Michigan, emphasized that Ebola is not a respiratory disease. Coughing and sneezing are not symptoms in the way that they are with the flu.
Stephen Gire, a research scientist in the Sabeti Lab at Harvard University, said if someone with Ebola sneezed or coughed into your face when you were close to them, that could transmit the virus through droplets.
But, "It’s important to note that this form of transmission does not constitute 'airborne,' " Gire said. "This is still a form of direct contact."
"If you were on a plane, and someone sneezed, you wouldn’t be at risk of getting infected unless you were sneezed on directly within close quarters, and that cough or sneeze transferred droplets into mucosal membranes. This is very unlikely scenario, but not out of the realm of possibility. I think I can count on one hand the number of times I’ve been sneezed on directly, and only one of those times was by someone I didn’t know."
One of the problems with the public debate over Ebola, Lauring said, is that science can’t prove that something will never happen. On the other hand, he also said we ought to look at what has happened.
"If airborne transmission was an imminent concern, one would have to ask why no one in the United States has been infected except for two people who had close contact with the patient," Lauring said. "Importantly, none of the people who were living with the patient prior to his second trip to thee Texas hospital have been infected."
While we are not fact-checking Will’s statement about infectious particles remaining alive for several days on a dry surface, Lauring said he knows of no evidence of that. Gire said it's theoretically possible under the right conditions, though it's highly unlikely.
Will said that some scientists say that Ebola can be transmitted in public by a sneeze or a cough. The source of that was a commentary about the risks to hospital workers treating people in advanced stages of the disease. One of the authors of that commentary said her work applied only to health care workers in those settings.
The medical literature says sneezing and coughing are not part of the disease’s typical symptoms, and experts we reached drew a bright line between what might happen in a hospital isolation ward and a person with early symptoms of Ebola before he or she is admitted.
There is no evidence that Ebola has been transmitted in the general public through coughing or sneezing.
Will took a medical commentary out of context. We rate the claim False.
Update (Noon, Oct. 20): After we published this item, we heard from some folks who disagreed with our ruling. Read our response here.
Fox News, Fox News Sunday, Oct. 19, 2014
Center for Infectious Disease Research and Policy, COMMENTARY: Health workers need optimal respiratory protection for Ebola,Sept. 17, 2014
Center for Infectious Disease Research and Policy,Response to statements falsely attributed to CIDRAP regarding Ebola transmission, Oct. 16, 2014
New England Journal of Medicine, Ebola Virus Disease in West Africa — The First 9 Months of the Epidemic and Forward Projections, October 16, 2014
Oxford Journals, The Journal of Infectious Diseases, Assessment of the Risk of Ebola Virus Transmission from Bodily Fluids and Fomites, 2007
Centers for Disease Control and Prevention,Review of Human-to-Human Transmission of Ebola Virus
World Health Organization, WHO Interim Guidance for International Meetings Attended by Individuals from
Ebola Virus Disease-affected countries, October 3, 2014
Centers for Disease Control and Prevention, Ebola (Ebola Virus Disease), Transmission
World Health Organization, Ebola Virus Disease, September 2014
Snopes, Ebolution of the sheesh-ies, Oct.16, 2014
Email interview, Lisa M Brosseau, professor of environmental and occupational health science, University of Illinois at Chicago School of Public Health, Oct. 19, 2014
Email interview, Adam Lauring, Assistant Professor, Department of Microbiology and Immunology, University of Michigan Medical School, Oct. 19, 2014
Email interview with Stephen Gire, a research scientist in the Sabeti Lab, Oct. 19, 2014.
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