Long shadow of fear in an epidemic: fearonomic effects of Ebola on the private sector in Nigeria

Abstract

BackgroundThe already significant impact of the Ebola epidemic on Guinea, Liberia and Sierra Leone, was worsened by a fear of contagion that aggravated the health crisis. However, in contrast to other Ebola-affected countries, Nigeria fared significantly better due to its swift containment of the disease. The objective of our study was to describe the impact of Ebola on the Nigerian private sector. This paper introduces and defines the term fearonomic effect as the direct and indirect economic effects of both misinformation as well as fear-induced aversion behaviour, exhibited by individuals, organisations or countries during an outbreak or an epidemic.MethodsThis study was designed as a cross-sectional mixed-methods study that used semistructured in-depth interviews and a supporting survey to capture the impact of Ebola on the Nigerian private sector after the outbreak. Themes were generated from the interviews on the direct and indirect impact of Ebola on the private sector; the impact of misinformation and fear-based aversion behaviour in the private sector.ResultsOur findings reveal that the fearonomic effects of Ebola included health service outages and reduced healthcare usage as a result of misinformation and aversion behaviour by both patients and providers. Although certain sectors (eg, health sector, aviation sector, hospitality sector) in Nigeria were affected more than others, no business was immune to Ebola's fearonomic effects. We describe how sectors expected to prosper during the outbreak (eg, pharmaceuticals), actually suffered due to the changes in consumption patterns and demand shocks.ConclusionIn a high-stressor epidemic-like setting, altered consumption behaviour due to distorted disease perception, misinformation and fear can trigger short-term economic cascades that can disproportionately affect businesses and lead to financial insecurity of the poorest and the most vulnerable in a society.

Trust, fear, stigma and disruptions: community perceptions and experiences during periods of low but ongoing transmission of Ebola virus disease in Sierra Leone, 2015

“…29 Additional concerns around accountability, oversight and training of HCWs may have also negatively influenced community perceptions of the healthcare system. 30–33 This convergence of fear, avoidance and misunderstanding has been shown to contribute to community mistrust in healthcare systems. 24 30 34 As the outbreak shifted, HCWs became more responsive (likely due to training and additional resources) and community members returned from ETUs.…”

Fear and culture: contextualising mental health impact of the 2014–2016 Ebola epidemic in West Africa

“…Nearly one-fifth of participants in the Sierra Leone sample reported symptomology that met the definition for probable post-traumatic stress disorder (PTSD) diagnosis if screened in a clinical setting. 23 In this editorial, we examine recent published research 10–12 23 24 to provide contexts for better understanding of the mental health impact of Ebola. We discuss the unique role of fear-driven behaviours and the influence of culture on mental health outcomes, possible implications for future outbreak responses, and whether current measurement tools are sufficiently reliable and valid to assess mental health impact during large-scale epidemics.…”

Knowledge and attitude towards Ebola and Marburg virus diseases in Uganda using quantitative and participatory epidemiology techniques

“…A total of 28,646 people were reported to be infected with Ebola virus in the recent outbreak in West Africa in 2014, out of which 11,323 died [ 1 ]. Apart from causing morbidity and mortality, outbreaks of VHFs cause panic among the public, interfere with global travel and have a devastating socio-economic impact [ 2 , 3 ]. Uganda has reported five (5) Ebola virus disease (EVD) outbreaks and three (3) Marburg virus disease (MVD) outbreaks since 2000.…”