KONG 'Irrational exuberance" is an occasional trait of stock
markets; "irrational fear" seems increasingly endemic in the popular
and media mind. So much so, when it comes to viruses and terrorism,
that it may be time to apply Franklin Roosevelt's dictum: "The only
thing we have to fear is fear itself."
The most infectious of
fears is that of the unknown. In the case of bird flu, health
authorities and others may be spreading that fear by talking up the
possibility of a major pandemic killing millions. Asia in particular
is being bombarded with such warnings, even though a flu pandemic is
unlikely to make geographical distinctions. The daily warnings may
spur governments to what their authors hope is preventive action,
but they also spread irrational fear.
Before changing or
travel or eating habits in response to the "bird flu threat,"
perhaps we should remember SARS. Justifiably feared when it first
appeared and its infectiousness uncertain, it eventually caused
fewer than a thousand deaths worldwide. Most of those were of the
elderly. SARS now appears to have vanished, but it left behind a
trail of personal anxiety and economic loss throughout Asia and
beyond, which affected countries that had not a single case.
Bird flu does kill
humans, and every effort should be made to limit its spread by
culling flocks and so forth. But there are plenty of other often
fatal diseases that fall into a similar category, killing perhaps a
few hundreds worldwide each year. For example, Hong Kong has had
recent deaths from a pig-meat infection that is endemic in China.
Dengue fever and encephalitis are regular killers in Southeast Asia,
and hepatitis B is endemic in the region.
Is there really a good
reason now to suggest that we are threatened with a flu pandemic of
the proportions of 1918 or worse? For sure, some such pandemic is
probably inevitable sometime, just as last year's Asian tsunami was
always predictable "sometime." But is there really much evidence to
suggest that we are in more danger now from a pandemic of a new and
more dangerous flu virus than we were two or five years ago?
The H5N1 virus is very
dangerous but has been around for several years. It killed six
people in Hong Kong in 1997 - but just one here since. Most cases
since then have been in Vietnam and Thailand. Of course, it "might"
morph into a virus easily transmissible between humans. But is there
any reason to suppose that this is more likely now than it was in
2000? Is it not at least as likely that the virus itself will
attenuate gradually? Or that in becoming capable of human-to-human
transmission it will lose much of its potency? Generally, viruses
become less virulent over time.
The fact is that we do
not know the future of this or any other flu-type virus. So we can
plan in a general sense to keep a close watch, to develop new
vaccines and treatment drugs, to have public health plans in place
for responding to an epidemic. Fine.
But in addition we are
now treated almost daily to "estimates" about the possible losses
from bird flu. The World Bank claims that a human pandemic triggered
by bird flu could cost the world economy as much as $800 billion.
The Asian Development Bank estimates that regional output would fall
by 6.5 percent on the assumption that an epidemic hit 20 percent of
the population and killed 0.5 percent. One could equally well argue
that the next flu virus will kill 20 percent of the world's
population - the approximate percentage of Europeans killed by the
Black Death in the 14th century - or, at the other end of the scale,
that it will cause no more deaths than SARS.
It is not clear why the
development banks are so keen to come up with their guesstimates,
other than to be seen to be addressing the tabloid headline issues
rather than focusing on environmental hazards that are killing tens
of millions slowly and which - unlike the evolution of viruses - the
banks are actually capable of addressing.
There is one issue the
banks don't address - the economic cost of spreading fear. One can
already see the seeds of the fear mentality that gripped Asia during
SARS. Stock markets are down "because of bird flu." Bird flu stories
dominate the local news. Nervous governments have warned of the bird
flu risks of travel. Australians are advised to consult their doctor
before going to Hong Kong, among other destinations. In Hong Kong
itself there has even been talk of such futile exercises,
reminiscent of 19th-century plague quarantines, as closing borders.
Of course there are
risks of a flu pandemic. But there always were. Official responses
at present, however, suggest that, to quote one epidemiologist,
"humans tend to amplify virtual risk while ignoring real risk." For
now, the flu risk is minimal compared with that involved in driving
a car - and the risk of that debilitating disease, fear itself.
Philip Bowring: Fear is the new
|By Philip Bowring
International Herald Tribune |
MONDAY, NOVEMBER 7,