Influenza A (H1N1): From the reasonable to the ridiculous

In case you haven’t noticed yet, there is some concern spreading about the potential pandemic caused by the Influenza A H1N1 virus. The reactions range from complete indifference to utter hysteria - a wide range to say the least.

I think this might be a good time to examine the nature of human anxiety when it comes to this and similar events or situations.

As I wrote in a previous post, anxiety is a necessary protective emotion. When we are in a dangerous situation, such as in the presence of a predator, our natural instinct is to feel anxiety. This anxiety gives us the strength to run away or to defend ourselves. This is known as the fight or flight response. Anxiety is the alarm that pushes us to act on the danger and to control it.

But there are two important aspects of anxiety that interact. The first is that there is a price to pay for fear. It severely restricts us. The second aspect is that most dangers cannot be avoided completely or with complete certainty. These two aspects work together and sometimes clash. Here’s how it works:

When we sense a threat, we act to control it (run away or defend ourselves). In some cases, this completely eliminates the threat. For example, if I were being chased by a bear in a forest and managed to shoot it dead, I would no longer be in danger. Perfect! No more anxiety and no need to do anything else in response. But what about a case where some threat remained, such as if I was out of bullets and I didn’t know if the bear had a mate still lurking. In such a case, how do I respond to my anxiety? Do I decide never to leave the safety of my cabin? If I did so I would likely soon starve to death.

The problem with most efforts to control threats is that they are not absolute. Washing hands reduces risk of infection but is no guarantee. There is no getting around the fact that bad things can still happen. This doesn’t imply that we shouldn’t care. But it does oblige us to take a relativistic approach to threats rather than an absolute one. Anxiety has the effect of REDUCING risk, not of ELIMINATING it. (see also The relativity of risks, and The salience of risks)

There are problems created by not having enough anxiety and there are problems created by having too much anxiety. Let’s take fire drills and car alarms as examples.

Fire drills are extremely important. An escape plan that is well-designed and, more importantly well-rehearsed, is essential to saving lives. Those who do not pay attention or don’t care to practice (those with too little anxiety) put themselves, and sometimes others, at risk.

But what would be the effect of having a fire drill every week? Would we not soon produce an atmosphere of complacency where people would eventually stop practicing the drills, thereby putting new employees at risk?

What about those now ubiquitous car alarms? When was the last time one of them got your attention enough to take action? Crying wolf too often is dangerous.

Some people are of the attitude that it is better to be safe than sorry. This may sound wise, especially if this H1N1 virus is the real thing. The problem is that if it isn’t, we may increase the risk of not taking a future virus, one that could turn out to be the real thing, very seriously. The danger of an exaggerated response is to produce complacency.

I think that our public health officials are acting rationally and responsibly by issuing travel advisories and advocating for hygienic practices. They are not under-reacting nor are they over-reacting. Their main message is that they are monitoring the situation for clearer signs of what we are really dealing with. Without further data, we cannot tell if this is an ordinary flu (the one that still kills many people annually), a stronger than normal one, or one strong enough to be as deadly as the 1918 Spanish Flu.

It would be a lie to say that we have nothing to worry about. Unfortunately, it is simply too early to tell. We have no choice but to live with the fact of not knowing. Any effort to overcome the uncertainty by taking extreme measures, such as Egypt’s decision to kill all the pigs in the country, will do little more than create a false sense of security, severely restrict everyone’s normal functioning, and result in a more complacent response in the face of possible future pandemics.

Washing our hands will have a significant impact on the spread of viruses. It is sound advice that will likely prevent any large scale tragedy. It is a rational response to the threat posed by this virus as we currently know it.

Any stronger response at this time will only border on the ridiculous. Let’s not go there! Remember, when anxiety is fed by our fertile imaginations, things could quickly get out of hand. At this point there is no need to act as if the sky is falling.

By remaining rational, we will be far better prepared to deal with the situation in the event that it does deteriorate. Let’s hope that doesn’t happen, knock on wood.

Tagged as Anxiety, health worries, Influenza A H1N1, public panic, swine flu.

Posted in Anxiety.

Posted on 05 May 2009