Monday 13 October 2014

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.

How we’ll know if Ebola hits our borders
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

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