In 2006, fear of bird flu reached fever pitch in the American media. According to one poll, 35% of Americans felt they would be infected with the virus over the next year, and 50% of those felt that someone they knew would die from it. Laurie Garrett wrote about how the altered terrain of the modern world rendered it an instant breeding ground for killer scourges, while Dr. Michael Osterholm pointed out the similarity between the 1918 Spanish flu virus that killed more than 50 million and the then-current H5N1 bird flu virus.
Slowly the hype and hysteria died down, as it became apparent that predictions of a massive bird flu pandemic by soothsayers and hysterics were overblown.
Three years later we get Philip Alcabes, associate professor of Urban Public Health at Hunter College, and his new book “Dread,” which lays open the claim that we are inflamed by fear rather than actual disease. “A deeper answer to the question about why hype about epidemics doesn’t line up with the scale of damage has to do with fear and besides our dread of death, we are frightened by the prospect of social disruption,” Alcabes argues. His well detailed account lays out our historical obsessive fascination with epidemics.
“Dread” is at its best when it describes the history of ancient epidemics and suggests them as underpinning of our fear of pestilence going forward. “We do not merely allude to the Black Death when we talk about plagues today,” Alcabes writes, “it is the basis for real expectations about contemporary epidemics.” He says that in using the Great Plague, which killed millions in a matter of months as a standard, we conceive of even the worst epidemics as having a beginning and an end, and we justify a massive public response no matter how misplaced.
The book is less convincing, however, when it paints all health concerns with the same brush. Alcabes doesn’t distinguish real killers like obesity, from theoretical over-hyped ones like bird flu.
Though fear is certainly central to the spread of both imaginary and real epidemics, Alcabes does a disservice to real scourges like obesity, AIDS and tuberculosis. He says “the obesity epidemic amounts to a far smaller number of deaths than the hype about it would suggest.” But obesity is insidious. And at a time when almost a third of us are obese, the effects should also be measured indirectly in the sequelae of hypertension, heart disease and stroke.
Alcabes makes a more convincing argument about how much fear of HIV has spread based on misinformation and prejudice. “The paranoid mentality that came to define our reaction to AIDS was plainly evident in February 2005, when the health commissioner of New York City raised a public alarm without a single new case of AIDS.” But he doesn’t succeed in convincing the reader that AIDS itself, which kills over a million people every year worldwide, is overblown. As opposed to SARS, the public health effort has helped to control AIDS in the US.
Similarly, Alcabes contention that “unlike in 1918, [today] we command considerable knowledge of the workings of the influenza virus” is a weak argument compared to the more convincing realization that we can’t and shouldn’t be in the business of predicting contagion without compelling evidence.
Marc Siegel is a Fox News medical contributor
Dread
How Fear and Fantasy have Fueled Epidemics from the Black Death to the Avian Flu
by Philip Alcabes
Public Affairs