Apocalypse Soon: our love affair with health scares

There’s nothing we like more than a good apocalypse — or, to be more precise, a good apocalyptic vision. We like being frightened by danger, so long as we believe that the danger is sufficiently unreal. The moment it becomes real, of course, the pleasure disappears. If the world were full of vampires, we should take no joy in films about Dracula.

That is why severe acute respiratory syndrome (SARS), a disease of unknown causation that has so far claimed the lives of nine victims, most of them in China, has so caught our imagination. It offers an apocalyptic vision without convincing anyone as yet that it will turn into a genuine apocalypse. We secretly enjoy imagining a mysterious disease sweeping across the globe and thinning out the ranks of the population, particularly those whom we detest, though in our wildest thoughts we do not conceive of ourselves as being a victim. Good people like ourselves will be spared.

We love to read about the end of the world. The publisher Jonathan Cape once said that there were only two things you needed to know about publishing, the first being that books about Nelson never made a loss, and the second being that books about South America never made a profit. Nowadays, he might have replaced Nelson as a subject by the forthcoming untreatable plague that will wipe out the human race. Of course, the imminent end of the human race does not inhibit authors from collecting their royalties.

Apocalypse Soon is also a useful concept for bureaucratic groups such as the World Health Organisation that, always threatened by budget cuts and unpaid contributions, need to project themselves as defenders of humanity against disaster.

And the latest apocalyptic epidemic is likely to prove particularly effective in strengthening the WHO’s position. The symptoms of the disease are both vague and common, and therefore many thousands of people will imagine that they have caught it. They will ask their doctor whether they could have SARS, and the nearness of their miss will haunt them for some time to come: until the next health scare, in fact.

Because of the ease of travel to the tropics, for example, we have been warned that epidemics of diseases caused by exotic viruses, such as Ebola, could scythe their way through the unprepared populations of Europe and North America, whose folk memory of epidemic disease is almost extinct, so secure from epidemic — with the partial exception of Aids — have they been for a number of decades. You can tell that no one really believed in the threat posed by Ebola virus, because a thriller was made about it. No one would have made such a film (had the technique been available) about the arrival of the Asiatic cholera in Britain in 1831 or 1848, after which scores of thousands died.

Many diseases have been put forward recently as the agent of apocalypse. Multiple drug-resistant tuberculosis is one example: the white plague, or the Captain of the Men of Death as it was once known, is making a comeback. No one should underestimate the seriousness of the recrudescence of TB, of course, but it is worth remembering that tuberculosis declined as a killer disease well before there was any specific treatment for it. Thus the appearance of untreatable TB does not mean that we shall all contract it, though it might mean the death rate will go up. Most of us still enjoy the improved social conditions that probably led to a decline in the disease’s incidence.

Then there is humble influenza, the disease that killed many more people in the aftermath of the Great War than died in the war itself. We still don’t know what the strain – called Spanish Lady at the time – was, and epidemiologists have suggested that there is no reason why such an epidemic should not occur again. The great thing about such a prediction is that it can never be proved wrong: just because we escaped last year doesn’t mean that we shall again next year. We can go on being pleasantly frightened for ever.

It isn’t only apocalyptic diseases that we like: we like extinction by asteroid and by climatic change as well. Some people may be old enough to remember the time when not global warming, but global cooling, was what was going to put paid to us. Robert Frost was right when he wrote:

Some say the world will end in fire,/ Some say in ice./ From what I’ve tasted of desire/ I hold with those who favour fire./ But if it had to perish twice,/ I think I know enough of hate/ To say that for destruction ice/ Is also great/ And would suffice.

A few years ago we were, in the opinion of the best futurologists, threatened by famine because of overpopulation. Wars would break out over scanty and declining grain supplies. Now our health is threatened more by a superfluity of food than by a lack of it, in spite of the vast increase of population that has occurred since those predictions were made. The means may come and go, but the end — that is to say the apocalypse — goes on for ever.

I don’t argue for complacency, of course. Even the worst of epidemics has to start somewhere, on a small scale. Presumably the Black Death had a first victim. Old World diseases decimated (and worse than decimated) New World populations when first they collided. I can still remember the days when Aids seemed to be confined to a few cases in San Francisco, manifested by the rare skin condition of Kaposi’s sarcoma. Look at Africa now: in many of its countries, life expectancy has almost halved.

Still, we like a good apocalyptic health scare. We are so fundamentally healthy that a distant epidemic is for us what a Grimm fairy story at bedtime is to a child. We love to be snug, yet feel ourselves to be in danger. It is the only way to appreciate snugness.

The writer is a doctor and author of Mass Listeria: The Meaning of Health Scares

From The Times

March 19, 2003

 Sofia.