Costs of War: The Fear Virus
By Shaun Waterman for ISN
One of the key challenges for government in any public health emergency is the calibration of its messages to the population. Panicked residents can easily overwhelm the health services of any town or city if enough of them only think they are sick; so officials are supposed to stick carefully to the script government scientists and doctors prepare for them to ensure the delivery of a consistent and credible message to the public.
Since the 26 April external pagedeclaration of a federal public health emergency in relation to the emergence of a new strain of influenza virus - Novel A H1N1, initially popularly called swine flu - US officials have been carefully following the expert playbook. Secretary of Homeland Security Janet Napolitano and other cabinet members have been external pagebriefing the press daily alongside top government scientists and medical officials. The administration’s advice on limiting the virus’ spread - regular hand washing and the use and disposal of tissues - has even become fodder for late-night TV comedians - a sign of cultural ubiquity, if not necessarily success.
So Vice President Joseph Biden’s external pagecomments on NBC Television last Thursday morning must have had a few people choking on their coffee.
“I would tell members of my family - and I have - I wouldn't go anywhere in confined places now. It's not that it's just going to Mexico, it's that you're in a confined aircraft,” Biden replied when asked what advice he would give to a relative who planned to fly to Mexico, where the outbreak began. “If you're out in the middle of a field when someone sneezes, that's one thing. If you're in a closed aircraft or a closed container or closed car or closed classroom, it's another thing.”
To be fair to the vice president, the interview was conducted over the subtitle “Swine flu outbreak: Is the US doing enough to stop the spread?” and he was asked why the administration had no plans to close the border.
At this point, the number of confirmed deaths from H1N1 in Mexico was about a dozen, from 100 or so confirmed infections - although “estimates” in the news media ran as high as 160 fatalities. But with dozens of confirmed cases - and only a single death - in the US, the question was already being posed: Why the different death rates? Why did the disease seem to be so much more deadly there than at home?
But the figures from Mexico were - and still are - far from comprehensive, and greatly over-state the occurrence of serious illness and death, because the initial tests were all done on hospitalized patients, “the sickest of the sick,” Acting Director of the US Centers for Disease Control Richard Besser external pageacknowledged during the weekend.
The disease had been much more widespread than those numbers would suggest, Besser said. “Initial reports really were looking at flu that was all presenting as hospitalization, high rates of mortality,” he told NBC’s Meet the Press. “As we're looking more, we're seeing that that may have actually been the tip of the iceberg, with a large number of cases that were less severe [...] it appears that they have had widespread flu across their country.”
“As we learn more about how widespread this is,” he continued, “it may be that the rates of severe disease in Mexico will end up being not different than what we see here.”
In other words: Why was H1N1 so much more deadly in Mexico? Answer: It wasn’t.
In retrospect, Biden’s comments, unfortunate as they were, are starting to look like the rhetorical turning point of a week marked by the kind of endless hyperventilation and breathless speculation about crucial unknowns that only wall-to-wall cable news coverage can provide.
“The administration’s plan for any terrorist attack should prioritize moving [Biden] to an undisclosed location,” jokes Jim Harper, director of information policy studies at the libertarian Cato Institute. “Not for his security or for continuity of government, [but] so he won’t appear in the media!”
On Friday, President Barack Obama himself took care to stress the precautionary character of all the administration’s actions - including $2 billion in external pageemergency spending in the war supplemental for this year; external pageadvice to close schools where the disease is detected for up to 14 days; and the external pagerelease of 11 million courses of anti-viral treatment from federal drug stockpiles to state and local authorities.
In Mexico, he said, “relatively young, healthy people” had died. “So that's why we're taking it seriously. We have not yet seen those same kinds of fatalities here in the United States among young, healthy people … but we want to make sure that we're preparing appropriately.”
Calling it a “cause for concern, but not alarm,” Obama concluded, “We are essentially ensuring that in the worst-case scenario we can manage this [...].
“Obviously,” he said later in the day making a similar point, “we hope the precautions we’re taking prove unnecessary, but better safe than sorry.”
The problem with governing in accordance with the precautionary principle lies in what it might cost to be “safe,” and to deal with the inevitable, occasional miss-calibrations of the message.
“Even the precautions that you take against this kind of global flu pandemic could knock about 1.9 [or] 2 percent off global [economic production]. That’s about a trillion dollars,” external pageaccording to journalist Martin Walker, who cited World Bank figures from a study last year.
The Economist external pagereported last week that the crisis in Mexico was costing Mexico City’s service and retail industries $55m a day - not because of the handful of deaths but because of people’s reactions. And that was even before the national suspension of non-essential public activities called for this week by the authorities there, which was expected to double that cost.
In the US, the Washington Post external pagereported Monday that businesses in the capital and its suburbs were bracing themselves for the effects of spreading school closures, which “appeared likely to create a ripple effect for employers across the region as parents drew up plans to take off work if they cannot make other arrangements.”
Following Biden’s comments, there were external pagereports of US carriers cutting schedules to Mexico and external pageother travel being canceled or postponed.
The Air Transport Association, which represents the big US airlines, says it won’t have figures on the industry-wide impact for three weeks or so, since the numbers are generally only available a month in arrears.
“It’s too soon to tell,” Elizabeth Merida, the association’s spokeswoman told ISN Security Watch. And she said it would be hard to isolate the impact of any particular event or remarks from the cost of the public reaction.
Perfect calibration will always be beyond the grasp of policymakers, even the best-intentioned and well-disciplined of them, because of the lopsided impact of the different kinds of messages.
“Fear is much more virulent than statistics,” Cato’s Harper told ISN Security Watch. In the early stages of the crisis that the emergence of Bovine Spongiform Encephalopathy - better known as mad cow disease - provoked in Britain in the mid-1990s, Agriculture Secretary John Selwyn Gummer staged a photo-op where he fed his two young children beef-burgers to drive home the point that the meat was safe.
He was excoriated by the press and public opinion, but his fate illustrates the problem policymakers face. “It’s very hard to calm people with numbers,” pointed out Harper.