2/3/00
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TABOOS: A critical look at the conventional wisdom on social, moral and sexual issues.

Ebola panic: pulp fiction

Far from the third world threatening humanity with an Ebola pandemic, the meltdown is in the West says Toby Andrew

'Doomsday bug: 3 in alert here.' The Daily Mirror front page on 19 May informed Britain that we were all at risk from a lethal new virus carried by a Zairean woman 'hiding out in Hackney'. The Mirror branded the Ebola virus 'Liquid Death...a million times more contagious than Aids', and warned that 'countries across the globe have been put on alert for victims'. ATimes editorial made the same link between Ebola, Aids and black Africa, stating that 'the Ebola virus is not the first mysterious virus to emerge from the dark heart of Africa' (12 May 1995). 'Disease fights back', ran the Economist's front page, picturing a skull growing in a petri-dish (20 May 1995). Scare stories even arose in Japan that the Aum cult, accused of the gas attack on Tokyo commuters, had got hold of the Ebola virus (Independent, 25 May 1995).

Ebola does appear truly frightening. Starting with innocent flulike symptoms, the disease rapidly deteriorates into a severe fever until 'by the sixth day, blood flows freely from the eyes, ears and nose, and the sufferer starts vomiting the black sludge of his disintegrating internal tissues. Death usually follows by day nine' (Newsweek, 22 May 1995). The lethal nature of the virus was confirmed by one professor of medicine who told the Sunday Times that 'if I were to inoculate 100 people with Ebola, three weeks later 88 per cent of them would be dead' (14 May 1995). Faced with such dangers, the government's Chief Medical Officer, Kenneth Calman, issued a public-spirited health warning that anyone suffering from fever or diarrhoea within three weeks of visiting Zaire should consult a doctor.

The message of the Ebola coverage was that we are all at risk. It made little difference to the unfolding panic that the Zairean woman's doctor announced the same day that she and her two children were only suffering from flu. Nor did the panicky discussion seem to be influenced by the known facts about Ebola, which suggest that we were never at risk at all.

In the unlikely event of becoming infected, the virus is undoubtedly lifethreatening, and in the worst cases there are horrific symptoms before death. But unless you are an unprotected hospital worker in the Zairean town Kitwit, Ebola is virtually impossible to catch. The virus is not transmitted by air and infection is believed to require the exchange of body fluids.

Ebola is not a mysterious product of the 'dark continent'. It is an 'African' disease in one sense; its success relies on conditions created by poverty and poor health services. The widely quoted mortality rates of 53 and 88 per cent are based on two previous outbreaks in 1976 in southern Sudan and northern Zaire. In both cases, medical treatment was either limited or non-existent. Patients, however, do survive if given hygienic care and rehydration treatment. For example, the technician at Porton Down, Britain's biological warfare facility, who stuck himself with an infected needle and the Swiss zoologist studying chimps in the Ivory Coast both lived because intensive care was immediately available.

There is nothing 'mysterious' at all about previous Ebola outbreaks. According to David Simpson who led the World Health Organisation (WHO) team investigating the 1976 outbreak in Sudan, the northern Zaire epidemic was caused by some 200 people being injected for malaria and typhoid, using the same contaminated syringe. If sterilised syringes had been used, the epidemic would never have happened.

Ebola is a relatively minor medical problem even in Africa. By the end of May, out of 205 cases thought to be Ebola, 153 ended in fatality (International Herald Tribune, 31 May 1995). As aNew Scientist editorial rightly pointed out, more Zaireans than that die of sleeping sickness or in car crashes everymonth in the capital Kinshasa ('Whose nightmare?', 20 May 1995). British fears of the disease are certainly not motivated by any humanitarian concern for the well-being of people in the third world. At the same time as the Ebola story, 400 people in Bangladesh died from an outbreak of diarrhoea and more than 50 000 were infected following a three-day storm that devastated the country. Yet there were no front-page headlines about them.

It is clear that we are not all at risk from Ebola, and that those few who are could be medically protected. Even the worst scaremongers had to admit in small print that Ebola was not really about to wipe us out. 'Could the virus reach a critical mass in a third world capital, then engulf the globe? Could Ebola mutate into some airborne form? Could coughs and sneezes become agents of mass death?'. 'Not likely' is how Newsweek answers itself on the next line. Last year a similar panic came and went about an outbreak of plague in India (see 'Plague spread by media rats', Living Marxism, December 1994). This time the Ebola scare could barely be sustained for three weeks before the WHO had to admit the epidemic was over (International Herald Tribune, 31 May 1995). So much for the pandemic. >

But if we are not at risk from Ebola, then what has been driving the irrational response to this obscure disease?

Entitled 'Outbreak of fear', the Newsweek article quoted above gave a clue. The authors argued that the significance of Ebola is not so much that the disease itself is a threat, but that it is a 'potent emblem' of disasters to come if man continues to 'interfere with the environment'. They argue that, as humanity interacts with nature through 'people encroaching on untouched land, faster travel or reasons still unknown', new conditions are inadvertently created in which new and deadly viruses can emerge.

In the minds of today's experts, it seems that we are increasingly threatened by incomprehensible forces unleashed by our own actions. The discovery of Ebola has now prompted speculation that other diseases may 'emerge' as rainforests are cut down to accommodate expanding populations. Dr Robert Ryder, a virologist at Yale University argues that 'it is almost as if the virus is saying to man, "I'll leave you alone if you leave me alone, but as soon as you step on my turf I'm going to get you"' (Times, 12 May 1995).

It is almost as if medical experts are abandoning their discipline for a morose new sociology. 'The primary problem is no longer virological but social', explains Stephen Morse, another widely quoted virologist. According to Morse, human activities as diverse as farming, urbanisation and jet travel can now unleash new diseases. As society develops, he claims, the clearance of land, the concentration of people and the growth of international travel all threaten to give rise to health disasters. Diseases are no longer perceived as a problem of nature which development must overcome; instead, development itself is now seen to be threatening humanity with disease.

The main culprit in alarmist minds is urbanisation, especially in the third world. Take Zaire, where 44 per cent of the country's estimated 43m people live in cities, but only 14 per cent have access to clean water. Such insanitary conditions mean diseases can break out and spread fast. Yet the authors of the Newsweek article which cited these figures implicitly blame outbreaks of disease on the process of urbanisation in the third world, rather than the lack of clean water. They clearly feel that to prevent a disease 'reaching a critical mass in a third world capital', people in places like Zaire should remain stuck in preindustrial villages. For Newsweek, urbanisation and development in the third world are synonymous with disease. The solution it offers is not the development of a clean water and a sewage system in Zaire, but a system of monitoring outbreaks in the third world in order to contain the global spread of disease.

The consensus today is that any human activity is inherently risky, which makes the only realistic policy one of damage limitation in response to disaster. For example, agriculture used to be considered an unproblematic source of food. Now it is retrospectively being reinterpreted as a source of unforeseen health hazards. One example often cited to illustrate the problem is that of Argentina after the Second World War, where farmers ploughed under grasslands for cornfields. With the cornfields came field mice harbouring the virus Junín, which caused an epidemic among farmers in the 1950s, killing one in five of those infected. The conclusion drawn from this today is that agriculture is the problem, rather than the mice or the need for a vaccine. The perception is that there are no longer any solutions for humanity, only competing risks. AsNewsweek asks, 'when building a dam is the only way to grow crops, is the prospect of a new mosquito-borne illness more daunting than [that] of famine?'.

In a 'shrinking world' jet travel is also seen as a problem, speeding up the spread of unknown diseases, even though lethal pandemics have yet to occur. It is migration that strikes the strongest chord of fear. The Ebola headlines revealed dovetailing concerns about a burgeoning world population, mass migration of the world's poor into the West, and threats of disease 'from over there'. So Newsweek's front cover asked, ostensibly in the name of medicine: 'Beyond the Ebola scare: what else is out there?' (22 May 1995)

According to the new medicosociologists, disasters are now being brought about by urbanisation, farming, international travel, migration and people moving into the countryside. In other words, just about everything we do in the cause of development. The suggested solution to all these man-made problems is that people should stay put, stop consuming and fear for our lives. The nightmare alternative offered is that humanity will be destroyed by its own interference with nature. In his best-selling novel, TheHot Zone, about an Ebola-type virus threatening to become airborne and wipe out the USA, Richard Preston presents his own apocalyptic worldview. 'The earth is attempting to rid itself of an infection by the human parasite. Perhaps Aids is the first step in a process of clearance....Aids is the revenge of the rainforest.' (p321)

Fact merges into fiction with books such as The Hot Zone, The Coming Plague and the film Outbreak. But for Preston such pulp fiction is an entirely positive public awareness exercise, reflecting the 'geological shift in scientific perceptions'. For him the response to Ebola is not irrational, but a 'classic warning' of threats to come. Even the New Scientist editorial concludes that Ebola 'bears watching' given the experience of Aids. There is a growing consensus that 'emerging' viruses like Aids and Ebola should now be regarded as the primary threat to world health. 'The puncturing of an almost Victorian belief in inevitable medical progress has created a humbler and more fearful view of viruses.' (Times, 12 May 1995)

For agencies such as the WHO, combating Aids or even Ebola has become more important than tackling the world's biggest killers - tuberculosis and malaria. Well-known diseases such as TB are less suited to the doomsday mood of our times, less dark and mysterious than the modern 'plagues' which signal, in the words of the Times, the return of 'the black horseman that loomed so large in medieval thinking'. Of course a cure is known for mass killers like TB, but the development of healthcare systems and the availability of antibiotics are not considered realistic for the third world. Diseases which are curable elsewhere are implicitly viewed as an inherent feature of third world societies. Meanwhile, attention focuses on scare stories about the spread of new viruses from the 'dark continent' to the West.

Not everybody has been taken in by the panic. Many saw the far-fetched Ebola scare as a bit of a joke. Even the Sun ran an uncharacteristically sensible editorial on Ebola: 'Forget it. Listen to the medical experts, not the alarmists. Don't panic.' (13 May 1995: although that didn't stop the same paper running a front-page story a week later about the 'horror bug' being brought into Britain by the Zairean woman with flu. Never let the facts interfere with a good antiimmigrant tale.)

The only people who seemed fully taken in by the irrational scare about Ebola were the scaremongers themselves. What they really fear is the future.

Reproduced from Living Marxism issue 81, July/August 1995

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