Who's Afraid of a Little Flu?

The World is a Dangerous Place,
But Not Always for the Reasons We Think

It would be natural to conclude that the human race has a death wish, so swiftly does the emergence of a new strain of influenza virus raise the spectre of fatal illness on a global scale. Or perhaps people have simply seen too many post-apocalyptic movies, like Terry Gilliam's "12 Monkeys", in which a deranged scientist releases a lethal virus into the air against which human beings have no immune resistance. In the film, homo sapiens is nearly wiped out, except for a few "lucky" survivors who happen to be naturally immune. The plot is about a man, played by Bruce Willis, from a (literally) underground society in the mid-21st century, who is sent back in time to the year of the outbreak to try to prevent it from happening. If it sounds like a fairly typical thriller masked in the garb of a cautionary tale, it is; but under Gilliam's direction the film is visually rich, genuinely frightening and very entertaining — even if the prospect of human extinction is not your cup of tea.

The swine flu outbreak has evoked much the same response that audiences of "12 Monkeys" experienced: mortal fear beyond reason. Somehow, the annual death of 36,000 Americans from "regular" flu, and the infection of millions more, doesn't seem to faze anyone, but the appearance of a new virus about which we know little automatically draws comparisons to the 1918 flu that is believed to have killed tens of millions of people. Some, including many public health officials, would say that this is precisely the justification for fear: we just don't know how this flu will behave. But there are thousands of species of microbes out there about which we know nothing. Why should a relatively tiny number of flu cases cause such panic?

Innumeracy certainly plays its part in this hysteria. Most people are simply ill-equipped to gauge the statistical likelihood of an event, and so tend to overreact to remote threats while ignoring more likely ones. How many of us actually know someone who contracted SARS, avian flu or the ebola virus? For that matter, how many of us have ever been attacked by sharks or become deathly ill after eating a tomato? Each of these deadly outbreaks or incidents follows the same predictable pattern: the news media whips the public into a state of anxiety, which is then reinforced by elected officials who are terrified to ignore the neurosis of their constituents at the peril of their political lives. As a result, every panic-of-the-month takes an emotional and economic toll that grossly exceeds the actual danger posed by the threat itself.

While we may be inclined to forgive the average citizen for his ignorance of science and his feeling of helplessness in the face of large-scale calamity, governments have no such excuse. The wholesale slaughter of pigs in some countries is a chapter right out of the Middle Ages. Travel restrictions are self-evidently senseless and absurd, and yet both reporters and legislators have grilled members of the Obama Administration, and even the President himself, about why we haven't closed the Mexican border (an irony unaccountably lost on a nation which hosts millions of immigrants who crossed that very border illegally). Even Cuba, whose public health system is one of the few bright spots in its dismal history of failure, succumbed to the pressure and imposed a ban on its citizens traveling to Mexico. [Perhaps this stunning instance of irrationality is another sign that Cuba is indeed gradually becoming like the rest of the world.]

None of this is to suggest that these various illnesses to which we have reacted incoherently are not serious in themselves. I've had the flu twice in the last six years (the ordinary, seasonal variety, if there really is such a thing), and while it was no picnic, I never for an instant thought I might die. Moreover, even though I got it both times right after taking an airplane trip, it hasn't stopped me from traveling. Even worse, I happen to know someone who contracted West Nile virus some years ago, and even though she survived, the disease altered her life in lasting and dramatic ways. Still, it didn't make me or anyone else of this individual's acquaintance less likely to leave the house in the morning, even when the scare was filling the newspapers daily with stories of a pending public health crisis and filling our heads with images of imminent human annihilation.

When we allow media hype to dictate our response to potential threats, we fall into an even more dangerous trap: we fail to pay attention to other dangers that are much more likely to harm us. The prevalence of West Nile virus is, if anything, greater than it was when it was first identified in the United States in the 1990s, and is found in a far larger geographic area. And yet, we don't think about it much any more because it isn't being pushed into our faces every day. The risk of infection is arguably more serious than ever (though still minuscule in the scheme of things), which means the media's and the government's response was ridiculous at the outset, but pathetic in the aftermath.

Try to imagine yourself as a doctor or nurse working in a health clinic in some remote, forgotten corner of Africa, where you have to stand idly by and watch your patients die every day because you cannot get your hands on enough medicine to treat even routine infectious diseases. Now imagine that you hear on your radio that the American government is investing $1.5 billion dollars to prevent the spread of an influenza virus whose prevalence and deadliness are so far unknown. It would be difficult not to sink into despair. Is this any way to run a global health system? Of course, despite the best efforts of the World Health Organization, and despite the overwhelmingly stupid and erratic international response to the so-called swine flu, we don't yet have anything remotely resembling a worldwide system of public health commensurate with the global reality of modern life.

The Death Cult Theory

While ignorance, media irresponsibility and political fecklessness share some of the blame for the foolish way we decide whether or not a particular virus poses a mortal threat to society, there seems to be something more fundamentally human involved. I took a course in college with a professor of German literature who had a theory that the reason people attend sporting events is to see someone die. (Why a thoughtful and liberal-minded German who grew up in the years after World War II would theorize about human attitudes towards death is not hard to fathom.) He believed that the awareness of mortality is so basic and overwhelming a factor of human psychology that we are fascinated by individuals who risk bodily harm and even death to achieve glory. This would seem to explain the motivation for spectators of bullfighting, auto racing and cliff diving, though perhaps it is not as convincing an argument for less obviously deadly sports like basketball and tennis. Nonetheless, if not for the vicarious "enjoyment" of watching someone put life and limb on the line, sports would probably hold little attraction for us.

Are we intrigued by people who climb mountains and jump out of airplanes because of an innate desire to see death defeated? Is it possible that we see in every newly discovered germ the possibility of the next great plague for the same reason that we are absorbed by horrific tales of human destruction? Is indulging our worst fears merely the flip-side of mastering survival in a world of constant danger? Wherever the truth may lie, the fictitious mass death of "12 Monkeys" was set in the unimaginable future of 1996. You may not have noticed, but we're still here.

May 2, 2009