epidemic

Did we tell the wrong story about swine flu?

We live in a ludicrously complex world. Stories help us to make sense of this convoluted reality by allowing us to distill our experiences into coherent narratives. These narratives explain how ‘A’ leads to ‘B’ which leads to ‘C’, and suddenly the world seems to fall into place. But a narrative is more than just a story; it’s a story with purpose and consequences. There will always be more than one way to tell a story about any issue, and which story you choose to tell will greatly alter how that particular issue gets framed. Ultimately, the narrative that gets told about a problem will shape that problem’s response – and some people will gain, while others will lose. What counts as a problem, and who gets blamed, all depends on who tells the story.

Priscilla Wald, a Professor of English at Duke University, has analysed the narratives of an extensive collection of pandemic disaster classics, including Ebola-thriller Outbreak, science fiction film Invasion of the Body Snatchers, literary thriller The Hot Zone, and the HIV/AIDS best-seller And the Band Played On. In her work “Contagious: Cultures, Carriers, and the Outbreak Narrative”, Wald identifies a formulaic ‘outbreak narrative’ that is repeated across film, literature and in the media. The outbreak narrative “begins with the identification of an emerging infection, includes discussion of the global networks throughout which it travels, and chronicles the epidemiological work that ends with its containment.” Wald fleshes out the stock characters that appear: the malicious Patient Zero, heroic scientists, and infamous superspreaders. In such narratives, the virus emerges from a “primordial” far-away land and is anthropomorphized, taking on human form in a battle against scientist-heroes.

Wald details how the concept of the Third World arose during Cold War. In the outbreak narrative, the ‘Third World’ countries from which communicable diseases emerge are “wild and primitive landscapes”, struggling in need of modernization. Through communicable disease, the Third World becomes a threat to the First World as the microbes cross the borders into the developed land. The virus performs ‘thirdworldization’, as the Third World enters the bodies of the First World through the monstrous microbes that turn “us” into “them”. By representing the developing countries as “primitive” or “primordial”, the outbreak narrative portrays them as being something from the past, and thus asserts the danger of putting the past in the geographical vicinity of the present.

These fictional outbreak narratives construct communicable diseases in particular ways. They can scapegoat and stigmatise people, and make moral judgements about ‘unsanitary’ lifestyles and ‘depraved’ sexual practices that lead to disease.  When the outbreak narrative spills over into the real world, this can have profound implications for who is blamed for a pandemic and what should be done about it. Narratives about disease are therefore intertwined with issues of power. A disease becomes a problem when it emerges from the faraway developing lands into the developed world, but many millions of people are affected by schistosomiasis, onchocerciasis and many other neglected tropical diseases that respect the borders of the developing world. The perspectives of people living with the disease in developing countries are often ignored. Furthermore, we become obsessed with disease containment approaches such as vaccines, drugs, and national border patrols and quarantine, but these conventions of the outbreak narrative often obscure alternative approaches to dealing with the problem of pandemics. These approaches include improving healthcare in developing countries, and combating the problem of poverty that catalyses pandemic spread.

The swine flu pandemic of 2009/2010 followed the outbreak narrative par excellence. The virus pole-vaulted from the faraway lands of Mexico, and superspreaders shed the virus amongst the population. The government predicted 65,000 deaths, and spent over £1 billion on antivirals and vaccines. We compelled scientist-heroes to make us a vaccine, and embarked on a witch-hunt for the index case who imported the disease. But the eventual death toll was just 457, and the government’s reaction was largely considered an over-reaction. There’s always more than one way to tell a story – did we tell the wrong one about swine flu?

Tim Peplow is currently studying for an MSc in Science Communication at Imperial College London.
Image credit: Microbe World (via Flickr)
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