ARC: CONCEPT WORK
Minor Vice: Hype

 

Steven Johnson, the author of the popular science book The Ghost Map about John Snow and the 1854 London cholera epidemic, recently announced that the current Ebola epidemic involves a "paradox":

            "Information travels faster than viruses do now. This is why we are afraid. But this is also why we are safe."

Johnson's argument rests on a comparison with the 1854 cholera outbreak as described in his own book.  In London of those years, Johnson claims, news traveled slowly: "It took two entire weeks before the press began treating the outbreak as a major news event for the city."  Meanwhile, inaccurate rumors spread wildly, such as claims that the epidemic was spreading across the city (it wasn't).

Today, according to Johnson, we can rest assured that we will know quickly about outbreaks of disease.  "Compare this pattern of information flow to the way news spreads now. On Thursday, Craig Spencer, a New York doctor, was given a diagnosis of Ebola after presenting a high fever, and the entire world learned of the test result within hours of the patient himself learning it." 

What is curious about Johnson's piece is its total neglect of the ongoing epidemic in Africa.  Whereas in London he talks about the time from the point-source of the outbreak to its recognition in the city's media, in the case of Ebola he refers only to the arrival of a case in America.  Indeed, once we expand the purview of the epidemic to include Africa we find that the self-congratulations awarded the news media ring hollow. 

Johnson would probably respond that the African epidemic actually confirms his view: " As societies and technologies evolve, the velocities vary with which disease and information can spread. "  Africa, he might say [if he even bothered to mention the place], remains in the 19th century or worse in terms of information technologies, and the world therefore wasn't aware that an epidemic was spreading until it was too late.  

But we did know.  The Ebola epidemic probably began in December of 2013 in the Guéckédou region of Guinea.  On March 10, 2014, hospitals and public health services in Guéckédou and Macenta reported unexpected numbers of an unknown hemorrhagic disease to the Ministry of Health, and two days later, to Médecins sans Frontières (MSF) who had a team already in the region working on an unrelated project.  The virus was isolated and identified as Ebola and the World Health organization was also notified in March (Baize, et al 2014).  By the end of June, MSF reported that the outbreak was "out of control." Yet the WHO only began to develop its response plan to intervene in the region over a month later (Lancet 2014). 

The news media also reported the outbreak, although initially skeptical of its significance (New York Times published an editorial by David Quammen, the flowery prosaic author of Spillover , entitled "Ebola is not the next pandemic" (Quammen 2014)).  Yet such reports, and the information reported by MSF and others in the region, did little to prompt an international response.  It is not that we didn't know, it is rather that nobody made the commitment to act.  Reading Johnson's editorial, I first found it hallucinatory that he could bound the epidemic to a case in New York and thereby declaim that information "makes us safe."  But something more vicious is at stake here.  The hype about the power of information obscures the fact that basic inequalities of access to medical care and treatment are the major conditions of mortality in the Ebola epidemic.  I am not even talking about access to special drugs like ZMapp.  Rather, I am referring to the fact that basic acute care (ie. the life support, rehydration, stabilization technologies available in an Intensive Care Unit in most US or European hospitals) is enough to drastically reduce mortality.  The reason this is not possible in West Africa, according to one report, is not because of a lack of material resources, but because of a lack of skilled health care workers (Lamontagne et al 2014). 

            This is, perhaps, the true Ebola paradox: while the hype machine both raises the specter of uncontrollable pandemics and praises the role of information in alerting us to threats, basic medical care would be enough to significantly reduce mortality.  Yet this is still inaccessible to many of the Africans sick with Ebola. 

            The phrase hype came from underworld slang meaning to "swindle by overcharging or short-changing."  Indeed, here it is the excess attention given in the media to the alleged importance of the media, the hyping of information, that causes neglect of attention to the preventable fates of others, and is morally suspect. 

 Works Referenced:

Baize, Sylvain et al, "Emergence of Zaire Ebola Virus Disease in Guinea."  New England Journal of Medicine September 29, 2014.

Johnson, Steven,  "Ebola's Information Paradox."  New York Times.  October 24, 2014.

Lamontagne, Francois et al, "Doing today's work superbly well-Treating Ebola with Current Tools." New England Journal of Medicine,September 29, 2014.

Quammen, David. "Ebola is not the next pandemic." New York Times April 10, 2014.

WHO Ebola Response Team, "Ebola Virus Disease in West Africa--The First 9 Months and Forward Projectsion" New England Journal of Medicine September 29, 2014.

 

 

1 comment

 
Gaymon Bennett wrote 2 years 46 weeks ago

A Nod to the Capital Vices

One is tempted to turn to the capital vices. Sloth springs to mind: "Sloth is defined as spiritual or emotional apathy, neglecting what God has spoken, and being physically and emotionally inactive. It can also be either an outright refusal or merely a carelessness in the performance of one's obligations, especially spiritual, moral or legal obligations. Sloth can also indicate a wasting due to lack of use, concerning a person, place, thing, skill, or intangible ideal that would require maintenance, refinement, or support to continue to exist." (Wikipedia)

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