SARS as a 'health scare'

Abstract

Epidemics of fear, perhaps also of disease: here are two of our most prominent anxieties. By ‘us’ I mean the various academics, experts and professionals, who in the ‘western’ nations of North America, Europe and Australia have ongoing conversations on these subjects. We certainly worry about disease. Health professionals genuinely fear the possibility of a vast outbreak of a new or re-emerging infectious disease; some are worried about being deliberately attacked with biological weapons; and there are many who fear the ‘urban health penalty’, the disease burdens consequent on polluted urban environments with weak social network resources to limit their occurrence (Fitzpatrick and LaGory, 2000). But they don’t just worry about these events – they (we) also worry about fear-mongering, as well. Many health professionals worry about the enormous impacts that public fears may have on economies and societies: ‘the problem with SARS,’ I have heard several in Canada say, ‘was not SARS itself, but fear’ (Skinner, 2003). By this they mean that the disruptions of SARS were vastly disproportionate to its body count of 44 deaths, a very small number in comparison with the mortality rate commanded by, inter alia, smoking, drinking, driving and not getting a flu vaccine. I know they recall, and would like to prevent, other situations where public worries unjustified by scientific evidence - say, of radiation from powerlines (Abt, 1994, Campion, 1997) - caused much social upheaval and a great expenditure of public money that could have saved many lives if it had been spent on hospital beds rather than on calming unfounded fears. Yet they seem to make little professional effort to trace the tensions between their fears and their fears of fear (Lupton, 1999, Gordon, 2003). And so we who sardonically observe the antics of public health from the padded balconies of the humanities worry and wonder about their (our) worrying: is ours a ‘risk society’ (Adam et al 2000, Beck, 1999), a ‘culture of fear’ (Furedi, 2002)? In this chapter I will join this - these - conversations to reflect on current concerns about, and responses to, the threats of infectious disease, specifically in an urban context. First, I will situate these concerns and reactions in a more general conceptual framework, concerns about ‘health scares’ – events in which there is a strong social reaction to a specific hazard that appears to threaten the health of a significant portion of the population. This is, if you will, the problem of not-disease-but-‘fear itself’ that was mentioned above. I briefly discuss concerns with epidemics of new and re-emerging infectious diseases as a particular category of health scare. In asking how we can analyse, predict and, perhaps, prevent or resolve health scares I then turn to the ‘social amplification of risk’ framework and to the role that networks – actor-networks that link humans and non-humans in specific responsive alliances, and social networks, including intra-urban networks, professional networks and global cities networks – may play in the amplification or attenuation of risk issue signals and so to the resolution or otherwise of health scare situations. In the remainder of the chapter I show how networked social amplification and attenuation effects played out in the outbreaks of SARS in Toronto in the spring of 2003. I conclude with comments on the central importance of social and professional informational networks and connectivity in the ecology of the urban landscape for successfully managing health scares in the future.