Thinking Like the Plague

The Ebola panic in the American media seems uncannily familiar to me, in the worst possible way. Anyone who studies Renaissance literature for a living has read many accounts of terrible epidemics, and many stories of epidemic hysteria. (In fact, some people have written learned and illuminating books about literary responses to the plague; I can't pretend to be one of them.) Smallpox is a terrible affliction. Bubonic plague is worse. But human responses to those diseases often made them more dangerous, just as today's hysteria about Ebola threatens to make Ebola more dangerous.Of course, dangerous diseases require precautions. But there is a panicked mindset that poses as a defense against the plague but makes it works. It is plaguethink: the plague's herald and accomplice. Even when the disease itself is controllable, plaguethink can lay entire communities to waste.

Plaguethink has two basic precepts:

1. A conviction that nothing can be done to stop the disease.

2. The idea that you can save yourself by abandoning the sick.

From those two ideas often come two emotional responses:

3. A phobic horror of the infected, leading to stigmatization and poor treatment.

and, not often but not always:

4. A tendency to interpret the disease as a carrier of religious or moral meaning.

The important thing to remember is that none of these ideas has EVER been true. There has NEVER been a completely unstoppable and invincible disease. If there had been, we would not be here. There have been terrible, terrible diseases. But the "superbug" is a fantasy. Even before modern medicine was developed (and believe me, European Renaissance medicine could be spectacularly ineffective), there was NEVER been a disease where there was absolutely nothing you could do.

An epidemiologist once told me that most bubonic plague patients were not contagious. (The minority who were contagious were very contagious, but most sufferers were basically not contagious at all.) And most of those people would have recovered and lived if they just got basic nursing care, by which I mean basic 14th-century nursing care: someone to give them food and water and occasionally change their sheets. For most people that didn't happen because people decided, incorrectly, that fighting the disease was hopeless and that abandoning the sick is the way to safety.

Now, the abandon-the-sick idea perverts a common-sense idea (you need to take steps to avoid contagion) into something inhumane and destructive. "Try not to catch the disease" is reasonable. "Save yourself and let the sick die" is something else entirely. Leaving the sick to die alone, and running out of town to keep yourself safe, is unnecessary and unhelpful.

It is not even a plan. "Just don't get it yourself" is not a plan, and it will not keep you safe. It leaves the disease unfought, which keeps the disease alive and dangerous. Letting the disease flourish but hoping it stays away from you will NOT work over time. You cannot keep out disease with a wall, or a moat, or a retreat to your country house, or with a border. The disease will get around all of that sooner or later. You cannot keep yourself safe by sacrificing other people to the illness. The outbreak itself has to be defeated, or no one is safe.

I mean, Elizabeth I, who theoretically owned everything she saw unless she went to the beach, actually came down with smallpox. (Her doctors nursed her through it, and she rode it out.) even the most powerful person in the country could not throw up real barriers against contagion.

During outbreaks of bubonic plague, people would leave the sick to die alone in their houses, and abandon that house, or that neighborhood, or simply flee town. What do you think that did? It left the disease alive and kicking, ready for the country-house crowd when they got back. And, well, that epidemic was spread by rats. Deserted neighborhoods full of dead bodies didn't make that problem any better. Plaguethink helped the disease spread. It always has.

During the 1980s, you could hear people talk about AIDS with the same terrified plaguethink. Put all of the infected on an island somewhere! That would be as pointless as it would have been inhumane, but the people who said those crazy things weren't thinking of fighting the disease. They were offering it a sacrifice to appease it.

Today, the voices of plaguethink are roaring on the media every day. Travel ban! Stop the flights! But those measures are counterproductive. They will not stop Ebola. They will let it plague us. You cannot keep out a sub-cellular organism with airport screenings. Of course you can't.

If we actually want to be safe from Ebola, we have to stop the outbreak in West Africa. Letting the outbreak flourish, because we've deluded ourselves that it's hopeless to fight it, will let it remain a danger forever. And the idea that we can't fight the outbreak, which people in the media take for granted, is an obvious lie. Nigeria has contained the outbreak in Nigeria. It can be done. And in this country it really is under control, no matter how it's being spun. The epidemiological forest fire in Liberia needs to be extinguished, and that will require outside help from the United States and Europe. But it can be done, and has to be. Letting Ebola run amok in Western Africa and trying to keep it out of this country is hopeless, especially when you define "keeping it out" as zero cases a year. You wouldn't build a fire-break to keepmamwildfire away from your house but not have anyone fight the wildfire. That. Would eventually fail. So the travel ban, and the stigmatization of health workers who fight Ebola in Africa and come home, is the worst possible thing. It is the 21st-century equivalent of letting rats feed on dead plague victims. 

Worst of all is the stigmatization, the ritual humiliation, of health workers who have put themselves at risk. It is a disgraceful instance of brave and mature people being attacked by the childish and terrified. Those health workers are not a danger. They are our best hope. "Quarantining" them in medical tents without a toilet or shower makes no medical sense. (Ebola spreads through body fluids, jerks: anyone who might be carrying it shouldn't be kept away from a toilet.) Worse, it actively takes the disease's side against the health care workers. It is a declaration of unthinking allegiance to the plague.

Ebola needs to be fought. But it is not a terrible god. It is a pest. It cannot be appeased; it can only be fed and allowed to flourish. It is not a messenger of divine or immanent truth. Itis a sub-cellular parasite, a strand of DNA with an adjustment problem. It is not a great danger to the United States. But plaguethink could make it one.

Cross-posted from dagblog