by Barry Edelson
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Nothing Happened, This Time


Zero Tolerance Seems to Have Worked with Ebola,
But We Can't Rely on It


For all those who have just about given up on the ability of public institutions to do anything right (namely, everyone), the effort to stop the Ebola virus from spreading through the American population ought to stand out as a remarkable success (so far). Unlike the daily depiction of a bumbling federal bureaucracy that accompanied the Ebola story over much of the late summer and fall, the government's actual response has been nearly 100 percent effective in keeping people in this country safe from this particular infectious disease. Apart from two nurses who were infected in a Dallas hospital — supposedly because of inadequate sanitary protocols, which have since been revised — not a single person in the general population has contacted Ebola on this side of the Atlantic. Every known case of Ebola has involved someone who brought the virus with him from West Africa, and all but two of them have recovered.

What is most unusual about this episode is not that we were able to muster our forces and effectively confront a deadly threat to public health. We've done it before. Many nationwide campaigns of vaccination and education have been waged successfully against a variety of formerly common and frequently lethal diseases: polio, measles, influenza, pertussis, diphtheria, etc. What is striking about the Ebola threat is that we somehow decided that even a single case is one too many. It is hard to think of another example of such a consensus, or of such monumental efforts to isolate every individual case of a disease. We barely even notice 20,000 to 30,000 deaths each year from the lowly flu virus. Dozens or even hundreds die annually from rare insect-borne diseases like Rocky Mountain spotted fever and West Nile virus. In fact, since the death rate for locally contracted Ebola in the United States is currently zero, any cause of death greater than zero poses a greater risk to public safety than Ebola. For example, electrocution from Christmas lights, or falling, with one's house, into a massive sinkhole.

In truth, our response to uncommon threats like Ebola is so irrational as to nearly defy explanation. On the one hand, we pay little mind to hundreds of things that could very well kill us, while on the other, we become fixated on the threat-of-the-month regardless of its likelihood to do us harm. There are at least two ways of looking at this sociological phenomenon: (1) most of us understand that life comes with many risks but that most of these risks are negligible, and that it wouldn't be worth living if we obsessed about them all the time, or (2) most of us haven't the vaguest idea how to assess the risk of anything, and are therefore inclined to ignore significant risks (e.g., not wearing a seatbelt while driving) and become anxious only about those threats that rise to the level of mass hysteria.

Or perhaps something else is at work here. The only other threat to public safety that comes to mind about which we have adopted a policy of zero tolerance is terrorism. Nearly every day, we are accosted by the grim news of homicidal explosions in faraway places. On Friday last, dozens were blown up at a mosque in Nigeria. The body counts from Afghanistan, Iraq and other blood-spattered nations is unrelenting. Death is so common in Syria that the world has literally lost count of the victims. But in the U.S., a single explosion is deemed too horrible to contemplate. The bombing at the Boston Marathon, awful as it was, would barely register on the meter of awfulness in much of the Middle East. This has not stopped us from spending trillions of dollars since September 11, 2001 to build a gargantuan national security apparatus, the effectiveness of which no one can measure but which poses a very real threat to our privacy and civil liberties.

If one didn't know better, one could come to the conclusion that our zero tolerance policy for terrorist attacks is designed for failure. In other words, it's not so much the actual threat to the nation and its people that motivates policy makers in Washington, but the near-certain political fallout from another major attack. This is not to say that there aren't a lot of very good and dedicated people who aren't working day and night to keep us from being sprayed by shrapnel every time we go the grocery store. Or that some high government officials do not genuinely lose sleep over the prospect of biological warfare and dirty bombs. What is worrying is that we have somehow come to expect a level of perfection that is unattainable in the imperfect world in which we have no choice but to live. The party in power — whichever it happens to be — is doomed to live from now on with an all-out assault from the opposition, and its respective cheering section in the news media, any time anything happens that it can't control with technocratic flawlessness.

This is to be expected from politicians, given the political climate of the present era, and from a fear-mongering information industry that goes to the bank on every last bit of dissent, controversy or official ineptitude. But when did the rest of us sign up for this ride? In addition to guaranteeing continual disappointment in the less-than-superhuman heroes we elect to office, this unaccountable demand for error-free action is an astounding leap of hypocrisy. What is it about a bombing or a case of Ebola that leads to demands for high-level resignations and rapid passage of essential legislation that other national emergencies do not? Would it not be wonderful if we could mass similar energies behind efforts to stop teen suicide and childhood cancers? Why do we not have zero tolerance for vehicular fatalities, environmental disasters and workplace safety accidents? Why is infringement of freedom an obstacle to reducing gun violence, but not to the quarantine of doctors and nurses returning from Liberia or Sierra Leone?

The complete absence of consistency, clarity or circumspection about the relative harm of all the many dangers that confront us reflects a cult of immediacy that undermines our judgment. Our culture has long been addicted to the new, but when our craving for the next big thing infects our thinking about things that really matter; when the way we decide what to buy and what to wear becomes indistinguishable from the way we calculate risk and who we can trust to protect us; when we surrender our limited attention spans to stories about shark attacks and killer bees but ignore larger concerns that could actually have an impact on our lives — then we have ceased to be seriously engaged in finding solutions to the problems that plague us. If our decision-making is so easily influenced by whichever voices are able to grab our attention today, this hour, this minute, then all the information that is available to us as never before is utterly wasted.

Moreover, expecting the impossible from those in charge is a recipe for constant failure. If Ebola does in fact break out in the United States, in spite of our best efforts to contain it, will that really be the fault of anyone in the government? Does it make sense to blame public health officials more for Ebola than for an outbreak of any other microbe that knows no borders? It may make some people feel better, and will make great sport for political junkies, to rake someone over the coals, to make a cabinet secretary sweat in front of the cameras, or to have the head of the director of the Centers for Disease Control and Prevention. But it won't do a thing to protect you from any real threat that's lurking over your shoulder. Let's face it, fellow citizens: even if few of these government types are in fact devoted public servants but are, to the last apparatchik, nothing but creatures of craven self-regard, they're the only thing standing between us and calamity. So far, our public health system has been good, and we have no Ebola crisis. Maybe we've just been lucky, but luck isn't always going to save us. If we continue to treat perfection as the enemy of mere competence, we are playing with fire. Worst of all, we will continue to scare away most of the decent people who could help to put the fire out.

In the meantime, be careful with those Christmas lights.


November 29, 2014


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