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Reviewed by Bob Kerrey, former Governor and US Senator from Nebraska I write these words on the very day that multiple bombings occurred on London's transit system. It is hard not to feel personally threatened, particularly when the aftermath becomes the focus of worldwide attention and nonstop media coverage. And therein, unfortunately, lies the power of such destruction, as the terrorists well know. After such news, we are reminded yet again of the fragility of life and the depth of love we feel for friends and family. We offer grave concern and heartfelt prayers for the dead and injured. We vow to find better ways to heighten security. We do what we can to calm ourselves and not be overtaken by fear physiology. In these days of great uncertainty, it is reassuring to learn that some of our worst-case scenarios will not necessarily come true. Such is the premise of Dr. Siegel's False Alarm. To put alarmist tendencies in perspective: over 58,000 soldiers died or were missing in action in Vietnam; on average over one million people are killed annually—and another 50 million injured—in traffic accidents around the world. In the United States, traffic accidents remain the leading cause of death for Americans under the age of 35.Though it is little consolation to anyone understandably concerned about their loved ones in today's climate, it is nonetheless true that the likelihood of being involved in a terrorist incident is remarkably low. One is more likely to get killed crossing the street. Affected as we all were by the events of September 11, and subsequently inspired to study "the process by which dangers were manufactured and provoked," Siegel has compiled a remarkable response to what he calls our "newfound vulnerability" and the "ongoing doom-and-gloom of the daily news. "The title of Siegel's exploration, False Alarm, is a powerful, provocative and well-chosen oxymoron. Highly qualified and deeply motivated, Siegel has conducted an intensive and much needed study of the ramifications of living in a time of pervasive fear, when we are constantly threatened with the prospect of biological and/or nuclear warfare. With so much attention paid to that which we cannot control, it is easy to lose sight of, and neglect, behavioral and lifestyle choices that clearly impact the quality of our lives. In addition, important, global health issues tend to get swept under the rug, while hysteria multiplies. Legitimate concerns go unaddressed, and valuable resources are wasted. Siegel has done us a great service. His thorough research illuminates the biological, political, psychological and sociological facets of this important topic, and offers an alternative to the current landscape of perpetual high drama and pathological fear. I enthusiastically endorse his efforts, and urge readers to take his message to heart. This is a terrific and groundbreaking book. Bob Kerrey is president of The New School, a former governor and senator from Nebraska, and member of the 9/11 Commission Excerpted from the Los Angeles Times: Fear's not just a factor, it's a major player By Benjamin Barber "THIS changes everything, forever," the media repeated in the aftermath of the terrorist attacks on Sept. 11, 2001. Perhaps they were right, but not necessarily in ways they had in mind. The most insidious and long-lasting effect of the attacks seems to be the paralyzing and politically corrosive anxiety. Saddam Hussein and the Taliban are gone, but fear remains, spreading and intensifying. After two rounds of bombings last month in London, the police killed an electrician on his way to work, fearing he was another suicide bomber. In its summer issue, the normally staid journal Foreign Affairs featured a piece headlined "The Next Pandemic?," warning that millions may soon die of avian influenza (jumping from chickens to people) and that, unless the world jolts itself into action, doom may loom. The politics of fear has long since overtaken the threats raised by disease and terrorism. Under these hysterical circumstances, two recent books prudently offer contexts for the anxious atmosphere in which we live. In "False Alarm: The Truth About the Epidemic of Fear," Marc Siegel, a practicing internist and contributor to The Times' Health section, tries to reduce the hysteria quotient with a straightforward recitation of facts and statistics. He says that anthrax, severe acute respiratory syndrome, bird flu and Iraq's so-called weapons of mass destruction have been transformed by exploitative politicians and a pandering media into prompts that raise our anxiety levels much higher than the statistical likelihood of these threats happening. Siegel notes that obesity, alcohol, smoking and physical inactivity take millions of lives every year, and we hardly worry about them at all. On the other hand, we stockpile Cipro (against anthrax), develop yellow-orange-red alert codes, body-search old women at the airport and perform random bag checks of a few hundred New York subway riders every day (on a system that carries millions to and from work) in response to threats whose most harmful effect is our level of fright. Recalling the famous Orson Welles broadcast of "The War of the Worlds," Siegel tries all too sensibly (and one suspects futilely) to assess risk accurately and respond only to "plausible" threats such as the vulnerability of our container ships or "loose nukes" in former Soviet republics. Fear, biologically wired in, has been a protective adaptation that has allowed the human species to survive. But today, as Siegel suggests, it is counter-adaptive. Take terrorism. Terrorists are by definition powerless: That is why they resort to terror. They have only the indirect power that comes from manipulating the strength of their enemies. The Sept. 11 perpetrators had only box cutters, but they turned American planes into missiles. They did their dirty work in a single horrendous morning, but we have been busy damaging ourselves for years. By producing a politics of fear in the face of Al Qaeda's deeds, we scare ourselves into abandoning our ideals and polarizing our politics. Benjamin Barber is Kekst professor of civil society at the University of Maryland, director of the New York Office of the Democracy Collaborative and the author of several books, including "Fear's Empire: War, Terrorism and Democracy." Excerpted from the Washington Post: [...Davis concludes his jeremiad by castigating the Bush administration for its misplaced priorities. The United States "lags shockingly far behind its peers" in stockpiling the new antiviral drug Tamiflu and in building vaccine capacity, he notes. But he neglects to mention that Tamiflu reduces flu symptoms by only a day and that the experimental vaccine now being rushed into production may not be effective against the strain that eventually emerges. Though his story finishes in mid-2005, he would probably endorse the Bush administration's recently announced plan to spend $7 billion on avian flu, largely on stockpiling vaccines and pharmaceuticals.] To which Marc Siegel, a practicing physician on the faculty of New York University School of Medicine, would reply, "You're wasting our money." In "False Alarm," Siegel weaves his personal experiences with patients who want to hoard drugs for use against various health scares into a story line that essentially accuses public health officials of acting like Chicken Little. He repeatedly castigates Julie Gerberding, director of the Centers for Disease Control and Prevention, for "public displays of worrying [that] always made us worry more." He also heaps scorn on the media, which gladly race from one disease "outbreak" to another in search of readers and ratings without evaluating the actual risk faced by individuals or society. In 2002, for instance, the nation was gripped by media-driven fear of West Nile virus, which took fewer than three dozen lives. The next year, the disease killed four times as many people with scarcely a mention in the nation's press or, for that matter, pronouncements from leading public health officials. What changed? The focus had shifted to SARS, even though that disease never killed a single American. Siegel sees bird flu as being no different from previous alarms. While a pandemic is always possible, he admits, the chances are remote, and public health authorities should work to dampen concern while monitoring the threat. "An epidemiological need to track an emerging disease before it gets out of hand," he writes, "is not the same thing as saying the entire public is already at risk." It takes resources to beef up and empower our public health infrastructure. The issue isn't whether we should be investing more in the fight against emerging disease threats, but how best to spend the money. Excerpted from the New York Times: In ''False Alarm,'' Siegel, a doctor and associate professor at the New York University School of Medicine, says we waste a lot of energy and money being disproportionately afraid of terrorists, hurricanes, anthrax, SARS and so on... His book arrives as people in London are still unsure how often
they can expect bombs to go off in their subways; His most interesting
proposition is that our leaders exploit our innate fear mechanism to keep
themselves in power and their Excerpted from the New York Post: Dr. Marc Siegel's new book, "False Alarm," seeks to combat a purportedly ubiquitous mindset, one that finds danger everywhere and produces an enervating, and ultimately damaging, sense of fear. Siegel, an Internist, surveys the neurological and psychological bases of fear: fear of terrorism, fear of illness, fear of infections and fear of death while mostly blaming the government, the media, the pharmaceutical industry, the Centers for Disease Control and a collection of other organizations for this dilemma. Siegel believes this fear is a source of both mental and physical illness and is used by some of the instigators for personal gain. It all comes down to assessing risk and dealing with it in a rational and useful fashion. The impact of widespread fear and anxiety is a highly relevant topic. Excerpted from Psychology Today: Siegel makes a passionate argument that the only thing we have to fear is, indeed, our own paranoia. Reason, he says, is the best vaccination for this epidemic. Manufacturing high Anxiety: A doctor demystifies our culture of fear By Greg Guma “Are you and your family at risk?” Almost anyone who watches television has heard that teaser during the news. The answer is often no, but the question itself has the power to set off a panic reaction that leads people to rush out for the latest cure or recommended precaution. Several years ago, Dr. Marc Siegel, a practicing internist in New York and frequent guest on TV news programs, began to notice what he calls “free-floating communicated fear” was causing his patients to personalize risks that were actually quite remote. In his new book, False Alarm: The truth about the epidemic of fear, he has assembled a convincing case that, misdirected by political opportunists and irresponsible media, we too often worry about the wrong things, and that fear itself poses a greater risk than any “bug du jour.” Part of the problem lies in our brains, specifically the amygdala — the central station for processing emotions like fear, hate, love, and bravery. Once it detects a threatening situation, it pours out stress hormones. But if the stress persists too long, it can malfunction, overwhelm the hippocampus (the center of our “thinking” brain), and be difficult to turn off. Most animals tend to react only to real, direct threats. In humans, however, chronic fear can be triggered by words and symbols — the perception of danger that may stem from hype, fragmented information, uncertainty, or misunderstanding. Siegel’s book attacks the situation in three parts. First, he looks at how our “fear biology” can wear us down rather than protect us, inducing paralysis and even making us susceptible to diseases that we might otherwise resist. He also links the reaction to the current “war on terror,” charging government, media, and drug companies with encouraging people to be unreasonably afraid. The media’s obsession with the bug du jour — the scare of the moment — can lead to misinformation and divert attention from real dangers. Malaria and AIDS kill millions every year, but receive relatively little publicity, Siegel notes. Meanwhile, public health resources are transferred to the latest potential threat. The public is urged to obsess over bacterial and viral warfare, and yet there is no training for radiation poisoning, the Coast Guard is understaffed, and seaports are mostly undefended. As a strategy for making money, fear-inducing propaganda can be tracked back to the early 1980s, when pharmaceutical companies began advertising heavily to convince us that their drugs were essential to good health. Siegel tells the story of Ira Lassiter, a popular journalist whose arthritis made him eager for the latest cure. By the 1990s, he was persuaded by a TV ad to switch from Motrin to Vioxx. Before that was taken off the shelves, another ad — this one by a competitor seeking to discredit Vioxx — convinced him to try Celebrex. Then tests showed that prolonged use of that drug was linked to heart disease. “The pendulum swung from panacea to panic, and drugs that were misperceived as lifesavers instantly became villains,” Siegel writes. Lassiter became a self-proclaimed arthritis drug addict, but what finally gave him relief wasn’t anything in Siegel’s supply closet. To deal with a cold, he took aspirin and discovered that it also worked for his sore hips. Siegel calls aspirin the “antifear drug,” mainly because it is highly useful without being misperceived as a panacea. The Greeks found it in the bark of the willow tree. Centuries later, a chemist isolated Sodium salicylate and, in 1897, Bayer employee Felix Hoffman found that acetylsalicylic acid could be effective in reducing pain. But even aspirin can’t counteract the “universal fear epidemic” that Siegel describes in part two. Beginning with the anthrax scare that followed the 9/11 attacks, he illustrates how government and media have repeatedly colluded to convince us to fear something “that didn’t truly threaten us. Then, once we were worried, we saw that our federal agencies weren’t functioning effectively, which worried us further.” This section of the book is filled with startling anecdotes and corrective information. During the West Nile virus scare, for example, the possibility was raised that the U.S. blood supply wasn’t safe. Siegel explains that “blood supply” is a misnomer, since it suggests that a bug can move from one donor into all our transfused blood. The rule is “one donor, one recipient, with no large-scale pooling of transfused blood.” In 2003, when the focus was on chemical weapons and a possible Iraqi nuclear attack (a hype in itself), scam companies pushed potassium iodide pills, claiming that they would prevent thyroid cancer. But a thyroid filled with potassium iodide won’t protect the heart, lungs, and bone marrow, so such pills are like “going out into a snowstorm wearing only a scarf.” Various chapters look at the misinformation (and actual risks) associated with public health alerts over the past four years, including anthrax, smallpox, SARS, influenza, Mad Cow disease, and avian flu. In the process, Siegel charges that the government can sometimes be a greater danger than the supposed threat, mishandling the evidence and building high-security labs that provide an opportunity for home-grown fanatics to gain access to human pathogens. In 2001, a study found that most germ attacks were conducted by former or current researchers. In part three, Siegel looks at ways to heal fear. Basically, this involves countering false beliefs. For some, faith or religion can help, he admits, but quickly adds that “religion has become overloaded with today’s obsessive worry.” Another approach is simply to turn off the TV. Still another — not one he recommends — is the possibility of a new drug that blunts fear memories. But the main advice is reeducation that puts risks in a more realistic perspective. That means less focus on the unlikely, less exaggeration of potential impacts and, with the help of people who have real knowledge, a psychological purge of the “high-pressure misinformation that is being shot into our brains.” Some of his suggestions sound like simple common sense. Get regular sleep, meals, exercise, and entertainment. If you’re worried about the flu, wash your hands more often and isolate those who have it. Ignore and resist those who push the wrong danger and then worry us more by bungling the response. Replace unreal fears with real courage. To that list, you might add maintaining a sense of humor. Two years ago, in the midst of the SARS scare, I posted a notice in my house calling for entries to a list of “101 things to be afraid of.” As the responses accumulated, we found that the sheer number and diversity tended to make each one look less threatening. From asbestos, mosquitoes, and dengue fever we moved on to losing your keys, barcodes, drunk drivers, being impaled, Tammy Faye Baker, and indifference. Everyone is afraid of something, but laughter sometimes helps to trip the amygdala’s off switch. Overcoming fear is easier said than done, of course, especially when leaders, experts, and businesses feel the need to engage our instinctual apparatus for their own purposes. But if the home truths and myth-busting information in Siegel’s book reach enough people, they could be part of the antidote for this media-induced epidemic. The first step is to realize we have been conned and learn how to realistically assess risks. After that, Siegel concludes, “Each step away from false worry is a step toward true health.” The Birds is coming! By John Meakin Do you remember when Alfred Hitchcock’s The Birds went on public release? Many people first learned of the movie through a highly effective poster campaign that carried the simple but enigmatic warning, “The Birds Is Coming.” It caught people’s attention, partly, of course, because the grammar appeared to be wrong. Hitchcock’s fatalistic flick dealt with out-of-control birds taking over a community. Well, it seems the birds are back! Except now the birds are dying in large numbers as a result of a virulent strain of avian flu, or through preventive culling. The worry is that birds may spread their flu to humans, and then humans may spread it to fellow humans and kick off a full-blown pandemic of incalculable disruption and devastation. Although the media headlines don’t seem to be screaming at us with the same volume and regularity as a few months ago, the fear that the monster of a flu pandemic is hammering on our door, just waiting to spring across the threshold to engulf us, is still widespread. Scary comparisons are made with the worst pandemic in recorded history, the 1918 outbreak of Spanish flu, when between 30 and 100 million people around the world are thought to have perished in just a few months. That devastating flu bug is now known to have originated in birds, raising concerns that the current strain of highly pathogenic avian influenza might become a brand new strain of deadly human disease and claim the lives of multiple millions. All this begs a fundamental question: Are we being told the truth about the threat of a global pandemic, or is it overblown to create fear and bolster the reputations of hard-pressed governments, swell the coffers of health-care agencies, and create even more profits for the pharmaceutical industry? Where does the balance lie in communicating such threats? Too little information breeds complacency and lack of preparedness. Too much can cause quite unnecessary fear and panic, which leads to cynicism, anger, and finally disbelief as long as the pandemic fails to materialize. We explore these important issues through two authors who address themselves to different aspects of a potential flu pandemic. Mike Davis and Marc Siegel have written compelling books that come from starkly opposing viewpoints. Davis reasons generally from all the disturbing facts relating to global flu and wants to stimulate us to specific action; Siegel, as a medical doctor, reasons from specific local experience in his New York practice: he sees all the unwarranted and excessive fear about the flu stirred up generally in his patients and wants to calm them down—and us too. Which author’s view represents the wiser approach, or are the two in fact compatible? PROPHET VS PHYSICIAN Davis, described variously as “a brilliant maverick scholar” and “a prescient Marxist prophet of end-of-the-continent doom and gloom,” catalogues a dizzying and often disturbing welter of information. He uses hyperbolic language to engage our emotions, and we are in turn shocked, dismayed, frightened, angered and outraged by a litany of stories outlining human ineptitude, corruption, ignorance and incompetence. His motivation, fueled by his admitted Marxist ideology, arises from his conviction that “our government and others [have failed] to protect the world from the imminent danger of an almost unfathomably dangerous influenza outbreak.” He warns that “the hour hand on the pandemic clock ominously approaches midnight. . . . Now, with a real Monster at our door—as terrible as any in science fiction—will we wake up in time?” Siegel, on the other hand, a practicing New York physician, wrote False Alarm in the wake of the September 11 destruction of the World Trade Center. In the months that followed, he became increasingly troubled by the “newfound vulnerability” of the American public. “We grew afraid more easily than before, misinformed by our leaders and provoked by the news media.” Siegel believes that health-care issues in America are “blown out of proportion to the real danger,” and his aim is “to try to offer perspective and a salve of reassurance” by explaining the nature of irrational fears and how they can be combated. In Bird Flu, Siegel takes issue with what he sees as excessive hysteria whipped up by the media and so-called experts, and he passionately wants us “to see bird flu as the theoretical threat it is in the larger context of disease and public health.” APOCALYPTIC SUPERLATIVES The cover of Davis’s polemic evokes a feeling of the sensational movie trailers from the 1950s. The dustcover proclaims that “avian influenza is a viral asteroid on a collision course with humanity,” “a viral apocalypse in the making.” This is heart-stopping, lurid writing at its best. Some readers will find themselves emotionally unable to deal with such language—no doubt just the sort of unwarranted discourse Siegel objects to? As the book unfolds, Davis describes the virus with such phrases as “unfathomably dangerous,” “nightmarish virulence,” “most ferocious of man-eaters,” “extraordinary shape-shifters,” “stunning evolutionary capabilities” and “the next great pestilence.” Though his stated motive is simply to spur officialdom to concerted action before it is too late, one is bound to wonder what degree of hype might be involved, especially because he has been taken to task over his somewhat creative and selective use of facts in earlier works. For example, assuming the maximum (though by no means widely accepted) figure cited for the 1918 pandemic of 100 million fatalities worldwide, Davis extrapolates to today’s world population and arrives at an equivalent of 325 million likely fatalities from the current virus. He then expands his extrapolation, claiming that with the virulence of H5N1 it could yield a worst-case scenario of 1 billion dead. Mortality on such an inconceivable scale would place this flu firmly in apocalyptic territory: the book of Revelation pictures the four horsemen of the apocalypse, combining ideological wars, famines and diseases, and killing one fourth of humanity (Revelation 6:1–8). Davis explains the essence of the avian flu threat in sensational terms: “A mutant influenza of nightmarish virulence—evolved and now entrenched in ecological niches recently created by global agro-capitalism—is searching for the new gene or two that will enable it to travel at pandemic velocity through a densely urbanized and mostly poor humanity. This is a destiny, moreover, that we have largely forced upon influenza. Human-induced environmental shocks—overseas tourism, wetland destruction, a corporate ‘Livestock Revolution,’ and Third World urbanization with the attendant growth of megaslums—are responsible for turning influenza’s extraordinary Darwinian mutability into one of the most dangerous biological forces on our besieged planet.” He sees our modern vulnerability exacerbated by urban poverty, the pressures caused by fast-food industries, corrupt and inept governments, neglect of vaccine development, and the deterioration or collapse of national public-health infrastructures. All these themes are examined in detail throughout his book. LET’S CALM DOWN Siegel’s two books are closely related to each other in their themes. False Alarm is about what he sees as the unwarranted fear that was triggered throughout American society by the September 11 terrorist atrocity in his home city. He rails at unreal threats that are hyped by media and government. He sees the results in his practice: fearful, neurotic patients in great need of reassurance and a sane-minded reality check. This book is a concerned plea from a committed community doctor to stop overplaying risks to society that only stir up excessive worry and fear, which he and others then have to deal with. Siegel divides his material into three parts. In the first section he effectively discusses the chemistry of the flight-fight response and the impact of fear. He then discusses various diseases, contrasting the numbers of those affected by malaria, dengue and AIDS with the numbers of those affected by anthrax, SARS, West Nile virus, mad cow disease and smallpox. Siegel is concerned that the funds for combating known killers will be diverted to fight the specter of a disease which may never appear. He concludes with a section on how to resolve our fears, giving examples of how fear can itself make people sick. Despite the threats, he claims that Americans have never been safer, with life spans 60 percent longer in 2000 than in 1900, and with the odds of being killed in a terrorist incident in 2002 put at 1 in 9 million. In contrast, he cites the odds of dying in a traffic accident at 1 in 7,000. Yet Americans still feel afraid, and “if our fears aren’t real,” he says, “we invent them.” Siegel’s experience amounts to a sad commentary on American society, politics and media. He sees a fear-obsessed, overly medicated society of hypochondriacs, materially pampered, yet living in fear of illness and death, and dominated by unrealistic concerns that are excessively played to by media and government. “In twenty-first-century America, we worship the god of wealth. We medicate ourselves with the emotional anesthesia of materialism, but our fears seep in and overtake us anyway.” And this doctor’s advice? “To conquer fear we must return it to its primitive place as an instinct. We must stop overpersonalizing it. We must regain our footing with regular sleep, regular meals, regular entertainment, regular exercise, and regular work. We must resist those who choose the wrong danger, hype the need to respond, and then bungle the response—making the threat seem even more real. We must replace our unreal fears with real courage.” Siegel points out that other nations are not nearly so obsessed with health issues: they manage to react to their circumstances with a great deal less fear, despite the fact that some face an almost constant threat of terrorism or other major disruption. The first half of Siegel’s second book, Bird Flu, focuses on sorting out the facts of bird flu from the fiction. He then examines how the United States has arrived at its unhealthy levels of fear. He advocates replacing fear with courage and worry with faith: “Faith takes the worry away and transfers it to a higher Being who is controlling the world. Any sense of control we have is illusory.” His concluding comments effectively sum up his book: “What bothers me most as a physician is that I see my patients being harmed, and there’s little I can do to stop it. Fear is infectious, and the fear of bird flu has become particularly virulent. There is a vaccine for this fear: it is called information mixed with perspective. Since there is a shortage of this vaccine, fear has begun to spread throughout my community and yours. That is a chilling foretaste of the horror of a true epidemic.” TO HYPE OR NOT TO HYPE? Davis’s book contains a comprehensive notes section, which is especially useful for the reader who wants to look deeper and separate fact from hyperbole. The Monster goes into greater detail than Bird Flu, as Davis describes the intricacies of the influenza virus and the shortcomings of dealing with it. But Siegel’s Bird Flu also does a creditable job of laying bare the basics of the illness. In addition, he offers a comprehensive and helpful question-and-answer section and ends with a thorough bibliography. The book lacks an index, however, which is a pity—perhaps a result of his rush to get it into print only months after False Alarm (various chunks of Bird Flu are acknowledged as having appeared in False Alarm as well). Neither author seems aware of the other’s material. Each would undoubtedly benefit from such contact for the different perspective provided. We should wish Siegel every success in helping to combat irrational fears. His point is well taken: we should not fear excessively, as that can only do more harm than good. And we are certain that Davis, given his history as a political activist, will continue his combative crusade to stimulate officialdom to more effective action. Different as their viewpoints are, Davis and Siegel agree that U.S. Homeland Security funding to combat bioterrorism in response to the World Trade Center attacks has been misallocated: planning for threats like smallpox or anthrax has taken precedence over research and planning for malaria, tuberculosis and influenza. Why spend billions on hypothetical threats, they ask, when far greater and more likely threats are looming, with not nearly enough being done at either the national or global level to confront them? Both express hope that we can learn from our past mistakes in this area. Davis and Siegel agree on another point: both feel the public has been misled by government and the media. But while Siegel believes the facts are overstated, Davis, whose passionate pleas are noticeably inflamed by his political views, takes to task the highest levels of government for downplaying the magnitude of the problem. Both authors are right to be concerned. Governments, health-care agencies and drug companies need to get their collective acts together and become more effective if the world is to be properly prepared for a pandemic that may indeed be imminent. On the other hand, people need to take personal responsibility and do what they can on an individual level instead of expecting the government to do everything for them. At the very least, people need to control their very human fears of threats that are not yet a reality and may never be. A BALANCED RESPONSE To return to our original question: Davis himself asks whether WHO has exaggerated the threat of H5N1 avian flu, although by this point in the book, it is clear to the reader what his answer will be. Because of all the factors he outlines, he concludes that various subtypes of the flu virus are “slouching towards Bethlehem with bright prospects of producing pandemic offspring. All the major candidates, in addition, appear to be increasing their evolutionary fitness to spread rapidly through new avian and mammal species. . . . Even if humanity miraculously dodged H5N1, we would soon be under threat from other virulent avian subtypes.” As both authors and other experts acknowledge, the threat isn’t only from H5N1 but from the flu bug’s capacity to rapidly mutate and reassemble in different forms, aided and abetted by unwitting human interventions. Davis’s biting criticism of the state of world public health preparedness evokes memories of a previous iconic disaster: “In the face of the peril of avian influenza, as with HIV/AIDS earlier, world public health resources are organized rather like the lifeboats were on the Titanic.” If these statements are true, then Siegel at times seems to border on the complacent, not fully aware of the seriousness of the threat, merely reacting to the more neurotic occupants of his waiting room and excessively talking up the problem of fear. Or are we overhyping the threat after all? Is Siegel right in alleging that this kind of language only stokes up unnecessary fears? So far in 2006, the number of human cases of bird flu has not risen dramatically, defying the doomsday prophets who had anticipated a rapid spread of the disease with this year’s annual avian migration. Does this signal the end of the story? Only the fullness of time will tell. In the meantime, while we wait to see whether the birds really are coming, let’s be sure we mount the best-informed and most effective response, and don’t fly off into an unnecessary epidemic of fear that in the end may do more damage than the flu itself. Perhaps we should pray that we get the substantive health care and emotional balance right, replacing fear with courage and worry with faith, so we are ready if the ogre of another flu pandemic should rear its ugly head. |
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Copyright © 1990-2007 Marc K. Siegel, M.D. |