Fearing flu

‘Doomsday plans have been drawn up by the government to cope with an influenza pandemic’, reported The Times (London) on 24 January. Fearing that an outbreak of a new and deadly flu virus, probably imported from South-East Asia, is ‘overdue’, Whitehall has reportedly drawn up plans for quarantine centres for sufferers, a makeshift mortuary for hundreds or more dead, and the evacuation of entire cities (1).

In recent months, the threat of some new flu pandemic has become an intermittent international scare story. ‘Only Ralph Nader appears to be fully awake to the peril’, wrote radical American commentator Mike Davis in September 2004, in an article entitled ‘The monster at the door’ (2). The monster peril in question is H5N1, the lethal avian influenza virus that first emerged in Hong Kong in 1997.

At the outset of the American presidential election campaign, Nader wrote to warn President George W Bush that ‘The Big One’ was coming, and to urge a ‘presidential conference on influenza epidemics and pandemics’ to confront ‘the looming threats to the health of millions of people’. Davis quoted official estimates that a new flu pandemic would infect 40 to 400 million Americans: ‘multiply that by a 70 per cent kill rate and ponder your family’s future.’

The spectre of a flu epidemic on the scale of the global outbreak that killed 20million people in 1918-19 has joined a growing list of nightmare scenarios, from global warming to terrorist apocalypse, that haunt the popular imagination (2). ‘Ironically’ wrote Davis, ‘in our “culture of fear”‘ dominated by the fear of bioterrorism, ‘the least attention is given to the threat that is truly most threatening’.

Old radicals like Nader and Davis prefer scaremongering about flu to terrorist alerts because this allows them to ride a number of hobbyhorses – about the factory farming conditions alleged to foster avian flu, about drug companies’ lack of interest in producing low-profit vaccines, about complacent governments and the impoverished communities in developing countries that are likely to bear the brunt of any epidemic (as well as offering a bridge to our cities).

No doubt there is some truth in all these claims. But in practice, raising the alert over flu will do little to change any of the conditions that encourage the global spread of the virus. The consequences of scaremongering about flu are the same as those of scaremongering about bioterrorism: intensified popular anxieties and diminished resistance to whatever authoritarian measures governments introduce under the banner of ‘homeland security’ and public health and safety.

How real is the threat of a flu pandemic? Nobody knows – which provides scope for speculation that can be enthusiastically exploited by publicity seeking public health officials and virologists, politicians in search of a cause and journalists eager for a sensational story.

Speaking after the 1968 epidemic of Hong Kong flu, the Harvard epidemiologist Alexander Langmuir observed that ‘influenza predictions are like weather forecasts’. His cautionary approach was powerfully vindicated by the scandal of the 1976 ‘swine flu’ epidemic in the USA (3). Following the death of a young army recruit in New Jersey from what appeared to be the same strain as the one implicated in the 1918-19 pandemic, public health authorities panicked and, anticipating an outbreak that would cause one million deaths, launched a major vaccination campaign. In the event, the New Jersey death turned out to be an isolated case and the flu epidemic never happened. However, more than 1000 people developed Guillain-Barre syndrome (generalised muscle weakness) from the vaccination, and around 50 died.

The threat of a flu epidemic is one of many problems facing scientists and public health authorities. It calls for the sort of research and discreet preparations (such as the development of vaccines and anti-viral drugs, contingency planning for an outbreak) that delivered such impressive results in response to the emergence of Severe Acute Respiratory Syndrome (SARS) in 2003.

With a high level of international collaboration, the cause of this outbreak was rapidly identified and its spread effectively contained with, by historical standards, a remarkably small number of fatalities. By contrast, public alarums about monsters, perils, nightmares and the proliferation of metaphors of doom are likely to produce a social paralysis more debilitating than Guillain-Barre syndrome.

Dr Michael Fitzpatrick is 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).

Read on:

spiked-debate: Plagues of the future?

(1) ‘Plans made for “overdue” flu disaster’, The Times, 24 January 2005

(2) The monster at the door, Common Dreams News Centre, 30 September 2004

(3) The politics of fear, by Frank Furedi

(4) The Coming Plague: Newly Emerging Diseases in a World Out of Balance, Laurie Garrett, Virago, 1994, p153-192