Elite panic won't help protect Australia from Ebola

The recent decision by the Australian government to suspend visas to those travelling from the West African countries most affected by Ebola could reflect a worrying development in responses to the current outbreak. The motives behind such a move seem rather dubious, as it again appears to be more the need for politicians to be seen to be doing something as opposed to a clear and present threat to the Australian population (so far there have been no confirmed cases of Ebola in Australia and I would guess that the numbers of those currently seeking visas from the affected countries in West Africa are probably negligible) In this blog-post, I will argue that such visa bans are unlikely to provide significant health benefits, could very well be counter-productive and may even risk increasing xenophobia, especially if other countries follow suit.

Over-reactive & ineffective?

The visa ban has caused anger in the affected region, and sparked criticism, with Amnesty Australia saying it has no public health justification (because visa applicants to Australia are already screened for illnesses and so would provide limited extra protection) and that; "all it does is ensure that already exceedingly vulnerable people are trapped in a crisis area and sends a signal about Australia's commitment to actually dealing with this crisis in a responsible way as a member of the international community." Sierra Leone's Information Minister has called the ban "absolutely counter-productive", and a Ugandan government spokesman even claimed that: "Western countries are creating mass panic which is unhelpful in containing a contagious disease like Ebola". Now while I would take issue with the idea that ‘mass panic’ may happen, I would agree that some of the preventive measures we have seen so far are often of little clinical benefit, and tend to be implemented by governments against expert advice in response to what they feel is political pressure to do something. In my last blog I looked at how the UK government’s recent decision to introduce border checks for Ebola were criticized by public health experts as having little clinical benefits and I suggested that they could be an example of elite panic, whereby the authorities over-react because of a misplaced fear of ‘mass panic’ in the general population. Such actions can also create a self-fulfilling prophesy in that telling the population not to worry about a crisis can create the very crisis the authorities are trying to avoid. The 2012 UK fuel crisis is a perfect example of this; when the Cabinet Office Secretary, Francis Maude was widely blamed for a wave of ‘panic-buying’ of petrol, after advising people to stock up on petrol at home in an attempt to undermine a proposed strike by fuel tanker drivers.

Australia's Immigration Minister, Scott Morrison

Increased stigmatisation and prejudice?

Another concern is that restrictions on travel from Ebola zones imposed by the largely unaffected developed countries could feed into any local xenophobic attitudes, which could generate more prejudice towards those perceived (often wrongly) to be at risk of spreading the outbreak. For instance, Australia’s Immigration Minister was reported as telling his parliament that "the government's systems and processes are working to protect Australians" I find statements like this deeply troubling, as they could all too easily feed into nationalistic narratives, and a fear of others who are ‘different’. Furthermore, measures by some US states to quarantine health workers returning from the Ebola affected region have drawn criticism after a US nurse complained that she was treated like a criminal. Reuters also reported the head of the U.N. Ebola Emergency Response Mission as criticising this decision as potentially counter-productive as it may put off people volunteering to help; "anything that will dissuade foreign trained personnel from coming here to West Africa and joining us on the front-line to fight the fight would be very, very unfortunate". The UN Secretary General, Ban Ki-Moon also spoke out on the plight of returning volunteers, saying they "should not be subjected to restrictions that are not based on science. Those who develop infections should be supported, not stigmatised."

Travel bans from Ebola areas may have limited short-term populist appeal, but are unlikely to provide long-term health benefits

Conclusion:

As I have previously said, we should not be complacent about Ebola and there may yet need to be other measures introduced to tackle the current outbreak in West Africa and prevent its spread if the situation deteriorates further. However, any restrictive measures need to be based upon sound scientific advice and not by short term populist measures driven by political rather than public health considerations- something I fear we are currently witnessing. By far the vast majority of cases have been in Western Africa, so it seems at best disproportionate (and at worst, racist) for Western countries to bring in visa bans that are unlikely to bring any increased health protection. Furthermore, the risk of a major outbreak in the developed world, so far seems minimal. People are not contagious until they develop the symptoms of Ebola, and the highest risk of contagion is when people are in the final stages of disease (and often too ill to walk, let alone get on intercontinental flights), so those most at risk are the brave volunteer health workers who look after the victims. Stigmatising such people on their return with over-restrictive measures are of dubious health benefits and could even be counter-productive if they deter them and others from going to help. Finally, the international community desperately needs to work together in a unified way, and unilateral attempts to raise the drawbridge (like Australia has done with its visa ban) risks fracturing such unity and may harm collective international efforts to defeat Ebola.

The UK Disasters & Emergencies Committee has now set up an appeal for donations to combat Ebola- the first time this has been done for a disease outbreak

Ebola outbreak- Keep calm and carry on, or 'panic' and freak out?

Introduction:
The current Ebola outbreak has so far seen over 8300 cases, with at least 4000 fatalities-the vast majority of these being in the three West African countries, Liberia, Sierra Leone, and Guinea. However, there has been a media  frenzy focusing on the tiny minority of cases seen so far in the developed world, with reports that a nurse in the US has contracted Ebola after working with the Liberian national (Thomas Duncan) who died of the disease- the first case of transmission on US soil. Here in the UK, call handlers on the NHS non-emergency 111 phone-line, staff will now be asked to conduct checks for Ebola amongst callers. The UK's Chief Medical Officer (CMO) has announced that we should expect a 'handful of cases' in the UK, which seems to be an effort to help prepare the population for what now seems an inevitable spread of Ebola in this current era of global trade and transport. Throughout this latest outbreak, I have noticed different narratives emerging which I think reflect interesting (but also sometimes concerning) aspects of how Ebola is being represented in social discourse, and these often include reference to the terms 'fear' and 'panic'.

Ebola & strategic uses of 'panic'

First of all, a recent blog by John Drury looks at how responses to Ebola can illustrate the strategic functions that use of the term 'panic' can serve, such as apportioning blame to those who are displaying over-reactive or maladaptive behaviours. Regular readers of this blog will be familiar with how I argue that 'panic' is often used (wrongly) to describe what outside observers of mass emergencies see as maladaptive crowd responses. A paper I co-wrote with him on the Hillsborough disaster (Cocking & Drury, 2014) looked at how survivors used 'panic' to describe their experiences, but they also rejected the notion that they were somehow to blame, and the term was frequently used to apportion responsibility onto others (e.g. they would argue that the Police 'panicked'). The term elite panic (Clarke 2008) has also been used to describe the authorities' distrust of the population to behave 'rationally' in mass emergencies and the measures they can impose in the mistaken belief that 'mass panic' will be the predominant response to any incident. John Drury also raises the issue of whether the current responses by the UK authorities show elements of elite panic, such as the decision to begin screening for Ebola at UK border entry points. For instance, the CMO has admitted that such screening for Ebola is "unlikely" to pick up many cases, "if any", begging the question of whether it has been introduced more because of a political need to be seen to be doing something, than because of a belief in its clinical efficacy. For example, The BBC reports that a doctor at Public Heath England has said in a leaked e-mail that screening was a "purely a political gesture, unlikely to provide public health benefits". This appears to fit with advice from the UN Co-ordinator for Ebola David Nabarro, who said that screening was more effective at the point of departure from Ebola affected areas, as those testing positive could then be prevented from leaving and thus spreading the disease further.

Entry checks for Ebola may have little more than a placebo effect 

Fear of & fascination with Ebola?

David Nabarro also told Channel 4 News that the current outbreak was worse than a movie, which may not help dispel public anxieties, and perhaps also inadvertently mirrors the strange mixture of horror and cultural fascination that we have with Ebola. For instance, this August, the BBC Radio 4 programme Summer Nights featured a very good general discussion about the outbreak (which at the time was largely confined to West Africa), but it also explored why there was a kind of perverse curiosity with diseases such as Ebola. Guests discussed how people often have a fear of, but also a fascination with conditions that have graphic symptoms, and that there were possible similarities with other cultural manifestations of this fascination. For instance, horror movies, such as Danny Boyle's 28 Days Later (where the UK is ravaged by the accidental release from a government laboratory of a super-virulent disease called 'Rage' which is spread by blood and saliva, and turns those infected into violent zombies) plays upon themes of distrust of the government and fear of strangers, both of which are present in the current Ebola outbreak. One guest even described Ebola as 'a Hammer Horror virus’, and made the point that it may be more sensible to fear airborne or insect transmitted diseases (such as the flu, or malaria), as they are easier to catch and potentially much more deadly (globally over 600,000 people die annually from malaria). However because Ebola has such graphic symptoms, people tend to fear it more, hence the popularity of films like 28 Days Later.

In 28 days later, victims with the 'Rage' vomit blood onto others, which rapidly spreads the infection

Ebola & the fear of fear
While I would reject descriptions of public responses to the current outbreak as 'mass panic', it is clear that fear of Ebola and its potential spread is influencing how it is being represented in social discourse, which can in turn result in some worrying public responses. For instance, there are concerns that xenophobia and prejudice could increase because of the outbreak, and Reuters have reported that in Dallas, African immigrants are worried about the backlash from the recent death of Thomas Duncan. Closer to home, a planned visit to a school in Stockport, near Manchester by a nine year old boy from Sierra Leone was recently cancelled after the Headteacher declared that there had been 'misguided hysteria' by some parents about the risks to their children from the visit (which seemed to be negligible as there was no evidence the boy had been in contact with anyone infected with Ebola). Tom Clark from Channel 4 News argues in his blog that the fear over the current outbreak is spreading faster than the disease itself, but that this is also ultimately counter-productive;

If there’s one lesson from west Africa, it is that fear is a far more efficient contagion than Ebola itself. Ignorance, mistrust and terror have only made things worse. Worth bearing in mind as Ebola slowly, but perhaps inevitably, makes its way here. 

Conclusion:

There is much that is concerning about the current Ebola outbreak and its potential to spread, and more resources need to be provided urgently to assist those West African countries currently being decimated by the disease. Furthermore, governments and the media in the developed world should take a measured approach when dealing with this outbreak, by not adopting knee-jerk alarmist responses that may not allay public concerns and could be counter-productive in the long term.  However, public fears about Ebola may be more based upon lack of awareness about the disease and distrust of the authorities, as opposed to any inherent public 'irrationality'. So, rather than simply implementing short-term measures that politicians think may serve a populist agenda (such as screening people on entry to the UK), it might be better in the long-term to engage with and address any public concerns about the outbreak through better education about the disease and how to prevent its spread (such as early detection of symptoms and washing with soap and water after coming into contact with infected bodily fluids). Being open about the risks, not withholding information, and treating the public as potential partners in preparation for, and the response to Ebola may also be part of this education process which could contribute towards preventing the further spread of this terrible disease.

To donate to MSF who are on the front-line of tackling Ebola in West Africa, click here

References:

Clarke, L. (2008) Elites and Panic: More to Fear than Fear Itself. Social Forces, 87 (2): 993-1014.

Cocking, C. & Drury, J. (2014) Talking about Hillsborough: ‘Panic’ as discourse in survivors’ accounts of the 1989 football stadium disaster. Journal of Community and Applied Social Psychology, 24 (2) 86-99. http://onlinelibrary.wiley.com/doi/10.1002/casp.2153/abstract

Hong Kong policing & Britain's colonial legacy

An article I wrote for The Conversation on Hong Kong Policing can be found here, which is a shortened version of the piece below.


Introduction: 
The recent mass demonstrations in Hong Kong that have been calling for greater democracy saw the Police initially responding with riot squads, tear gas and pepper spray against peaceful protestors. However, this authoritarian response merely caused the protests to grow, leading to the temporary withdrawal of the Police. On Sept 30th Human Rights Watch called for the authorities to avoid using excessive force, and there was a stand-off during the national holiday to celebrate the founding of Communist China. Protestors had planned to occupy government buildings if the Chief Executive CY Leung didn't stand down by midnight Oct 2nd, resulting in a heavy police presence outside the Chief Executive's building.  In a recent Press Conference, CY Leung still refused to quit, but has offered to hold talks and this offer has been accepted by protestors. The situation currently appears to be calmer, although many protestors are still on the streets.

Historical contexts:

There are interesting and rather ironic historical antecedents to how the current situation has been dealt with by the authorities that date back to Hong Kong's colonial past. For instance, Chris Patten (who was the last governor of Hong Kong when it was handed back to China in 1997) has accused the Chinese authorities of reneging on commitments to uphold democratic principles. However, the way in which the Hong Kong Police Force initially dealt with the protests owes much more to when it was a British colony, and this style of policing doesn't seem to have changed significantly since the British handover in 1997. So, their recent use of riot squads with short shields, tear gas, (with rubber bullets in reserve) is nothing new, with this approach being developed in the 1960s to deal with the colonial administration's fear of rebellion by Chinese Communists and/or local Trade Unions. Furthermore, the way they respond to public order incidents has also influenced policing closer to home. Gerry Northam's 1989 book- Shooting in the Dark argued that British policing shifted in the 1980s from a policing by consent model, to a much more coercive and para-militarised approach, based upon how the colonial Hong Kong Police were organised. He recounts that after the riots in the summer of 1981, (which saw the most significant urban disorder in England for a generation), the Association of Chief Police Officers (ACPO) invited the Director of operations at the Royal Hong Kong Police to their private annual conference, to advise UK police on how they dealt with crowd disorder. From this conference, ACPO set up a working group to review their riot control tactics and develop a national training package for all UK forces. This resulted in the development of the ACPO Public Order Training Manual, a secret document which only emerged during the trials resulting from one of the largest set-piece confrontations of the 1984-5 miners' strike.

Hong Kong Police short shield unit September 2014

The Battle of Orgreave
The Battle of Orgreave happened when 10,000 striking miners were confronted by up to 4000 police officers from across the country at the Orgreave coking plant in South Yorkshire, resulting in running battles between pickets and police, with 93 arrests and over 100 injured from both sides. This incident was significant because it saw the first major public display of the new paramilitary tactics that British police had learnt from their colleagues in Hong Kong, with Waddington (2011) arguing that the police planned a set-piece confrontation rather than reacting to violence from pickets as was suggested by the media. During the day police in riot gear would stand in formation holding long shields, and periodically part their lines to allow mounted police and officers with short shields to charge at the crowd, with snatch squads making arrests. In 1985, the  BBC produced a documentary about Orgreave and interviewed John Alderson, a former Assistant Commissioner in the Metropolitan Police. This was his response on seeing footage of the fighting at Orgreave;

'This is a carbon copy of the Hong Kong riot squad…The British people should never accept colonial style policing. It isn't democratic policing, it’s forceful, repressive policing. Instead of exporting the developed British tradition to the colonies, we are now importing colonial policing into Britain. The question that now faces us all is now this- if we've seen the Hong Kong Police tradition used in Great Britain in 1984, what are we going to see in future on the streets of our big cities?’ 

(quoted in Northam,1989 p.59-60 )

The Battle of Orgreave may have happened over 30 years ago, but I find this quote rather prescient, given the trend towards increasingly militarized policing in Britain that has happened since (especially since the 2011 riots)-something I argued against in a report I wrote regarding the introduction of water cannon and that is also summarised in a previous piece I wrote for the Conversation.

Battle of Orgreave 18/6/1984

British double-standards?

We shall see how the situation in Hong Kong develops, and hopefully there will not be a bloody crackdown by the People's Liberation Army (PLA) similar to Tiananmen Square in 1989. So far the Chinese authorities seem to be relying on the Hong Kong Police to manage the situation, perhaps fearful of the reputational and economic damage that could follow from sending in the PLA. However, if the Police do decide to take a more repressive approach to the protests (which seems possible given the recent admission that they have begun stockpiling rubber bullets and tear gas at the Chief Executives' Office), then those in the UK should think carefully about how they respond. For, while any brutal repression of the predominantly peaceful protests in Hong Kong should rightly attract international condemnation, it may be slightly hypocritical for British politicians to criticise the actions of a police force that was originally set up by a colonial British administration largely because of the fear of rebellion amongst the local population, and this force's public order tactics have directly influenced to this day how our own police deal with public order situations in the UK.    

References:

Gerry Northam (1989) Shooting in the dark: riot Police in Britain. Faber & Faber: London

David P. Waddington (2011): Public order policing in South Yorkshire, 1984–2011: the case for a permissive approach to crowd control, Contemporary Social Science, 6:3, 309-324