The fear within

After some delay following the terrorist attacks on the USA and the subsequent outbreak of anthrax, I can now report that – at least in the health centre in Hackney where I work – we are in a state of maximum alert for all possible manifestations of terrorist attack.

We have received ‘interim guidance on dealing with mail and packages, including guidance on identifying suspicious mail’. This has been supplied by the Public Health Laboratory Service (PHLS), which has adapted it from ‘guidance used by New York City Health Department’. The PHLS has also provided detailed guidelines on how to deal with anthrax, botulism, plague, smallpox as well as chemical agents including nerve toxins and mustard gas.

Our local Primary Care Trust has established an ‘Emergency Preparedness Working Group’ to ‘evaluate organisational emergency planning arrangements’ and to ‘ensure dissemination of important information’. In a cunning ruse to outwit terrorists the working group plans to circulate its proposed ‘weekly emergency communication’ in a ‘different coloured envelope’. It is regrettable that we have yet to be issued with moon suits and gas masks so that we can dress up for the unthinkable as well as merely thinking it.

Meanwhile, the mainstream media, having exhausted the databases on potential agents of biological warfare, has moved on to the spectre of a major nuclear disaster. This might result from terrorists acquiring or manufacturing a nuclear bomb or from a Twin Towers-style jumbo jet assault on a nuclear power plant. Speculations on the scale of such a catastrophe are commonly measured in multiples of Chernobyl, starting at factors of around 100. Our local ’emergency preparedness working group’ has yet to advise on appropriate measures to deal with a nuclear attack, though we would also be uncertain how to proceed if Hackney was hit by a meteor.

The events of 11 September have deepened and broadened the culture of fear in Western society. The popular impact of doomsday scenarios reveals a mindset that is predisposed to panic. It is as though people feel that the events of that day were not bad enough: even worse things could happen. Indeed, numerous authorities are on hand to advise the public that various catastrophic scenarios are not only possible, but quite likely, given the accessibility of lethal technologies to malign individuals.

There is some ambivalence in government attitudes to the culture of fear. On the one hand, there is concern about the dangers of panic and about the demoralising consequences of pervasive public anxieties. On the other, President George W Bush and UK prime minister Tony Blair are keen to maintain a high level of popular awareness of the terrorist threat to bolster support for their military campaign.

At present, the latter consideration is dominant. Western leaders’ recognition of the fickleness of domestic approval for the war against terrorism dictates the need to maintain a high level of popular anxiety. Hence the persistent terrorist alerts in the USA and the determination to link the anthrax outbreak to Osama bin Laden (or Saddam Hussein).

The Channel 4 Dispatches documentary ‘Bin Laden’s Plan of Terror’ on the al-Qaida network (Thursday 1 November) provided further intelligence information confirming the deep roots of key activists in Western society. Profiles of prominent figures revealed talented, educated but disaffected young men emerging from the marginalised immigrant communities of France, Germany, Belgium and Britain. They moved with ease from one Western country to another, learning languages and acquiring technical skills as they needed them, skilfully exploiting the financial system to survive.

A leading French authority, who claims to have provided the US intelligence agencies with information on key suspects in the 11 September events before they happened, warned the Western powers that ‘the enemy is at home’, not in Afghanistan.

The shift of public attention from the hijackers of 11 September to the perpetrators of the anthrax outbreak and other potential threats may result in a loss of focus in the war against terrorism. As we have seen in the USA, fears about infectious disease are more likely to lead to demands for antibiotics and immunisations than pressure to increase the bombing. Furthermore, any objective assessment of biological or nuclear threats to the West leads to the conclusion that these are more likely to originate from internal terrorist groups.

Speculations on the scope for manufacturing biological weapons or atom bombs in the caves of Afghanistan simply reinforce the conclusion that the laboratories of the Western world are a much more plausible source. Such attacks have already occurred, albeit on a small scale, in Japan (with sarin) and in the USA (with the plague and anthrax). The fact that in the USA the bomb scare has largely been overtaken by the hoax threat of biological contamination reflects the growing awareness of the scope of these agents.

The discovery in 1878, by the great French microbiologist Louis Pasteur, of the bacillus that causes anthrax was a decisive event in the development of the germ theory of disease. It was followed three years later by the first demonstration of an effective immunisation against anthrax in sheep. Almost exactly 100 years later, in 1980 the World Health Organisation declared smallpox, one of the greatest scourges of mankind, to have been globally eradicated. Though these – and many other – diseases have been largely contained, if not eliminated, through a combination of improved living standards, clean water, antibiotics and immunisations, the residue of fear of infectious epidemics persists.

This fear was abroad long before the terrorist attacks on the USA: it was apparent in the response to AIDS, the scares over Ebola, resurgent tuberculosis and antibiotic-resistant bacteria. The crisis of self-belief of the Western world has long been expressed in anxieties about health and reflected in the impact of health scares.

The events of 11 September have catalysed the culture of fear and have exposed an internal crisis of authority that will not be resolved by any external adventures.

Dr Michael Fitzpatrick is the author of MMR and Autism, Routledge, 2004 (buy this book from Amazon (UK) or Amazon (USA)); and The Tyranny of Health: Doctors and the Regulation of Lifestyle, Routledge, 2000 (buy this book from Amazon UK or Amazon USA). He is also a contributor to Alternative Medicine: Should We Swallow It? Hodder Murray, 2002 (buy this book from Amazon (UK) or Amazon (USA)).

Read on:

Anthraxiety, by Dr Michael Fitzpatrick

Fear and defeatism infect the West, by Mick Hume

A pox on scientific debate, by Sandy Starr

Over-anxious over anthrax, by Howard Fienberg

spiked-issues: After 11 September