Essay

Lower the alarm (We've been here before)

THERE'S NOTHING LIKE a good plague to get the blood moving. When you look at plagues past it is hard to escape the conclusion that there is a hard-wired human response: fear and blame, dread and outrage.

Plagues have been a recurring event since the 14th century. The Black Death hit hard in the mid-1300s. It was, however, the second pandemic of bubonic plague. The first was the Justinian plague of the fifth and sixth centuries. But the impact of the Black Death was far greater, fuelled by decades of famine, pan-continental wars and increased foreign travel for trade. The Black Death lasted for 300 years.

In the late 15th century, a dreadful skin disease appeared in Italy and spread like wildfire through Europe. It killed many quickly, hung around in some destroying their nervous systems and was passed on to unborn children. Syphilis was to last forever.

In the 18th century, a special form of madness was described for the first time. It hit people in their late teens and 20s and ended badly. Schizophrenia, too, was here to stay and filled jails – and institutions like Bedlam – for 200 years.

In the 19th century, cholera devastated Europe spreading fear and pandemonium. It had never been seen before outside Asia.

And in recent memory we've had HIV-AIDS and now SARS.

With each of these plagues people responded similarly, fearfully trying to make sense of the unknown. Draconian laws were enacted; strangers were murdered, incarcerated or moved on; quarantine was invented; barriers were thrown up around towns and scapegoats, identified by their difference, were persecuted.

With syphilis, the French blamed the Italians and everyone else blamed the French.

With cholera it was the poor and Asians who were vilified, prompting the rich and educated, powered by utilitarian philosophy, to entrench the concept of hygiene.

The response to the 'Spanish' flu of 1918 and the 'Asian' flu of 1957 exploited fear of difference. HIV-AIDS scored bullseyes on all fronts. What could have been more mysterious and fearful than the world of gay men? Where else could such a virus have arisen but the heart of Africa?

The response of the Chinese authorities to SARS – denial – followed by acknowledgement and blame including the imprisonment of suspected SARS carriers, would be instantly recognisable and no doubt warmly approved by the Medicis of medieval Florence.

 

THERE IS A large body of high-quality psychological research that suggests the key to understanding the source of irrational fear is emotion. We are more likely to act when aroused and, according to Harvard University child psychologist Jerome Kagan, change and difference turn the key.

Imagine you're a hominid on the forest edge, exposed to dangers on all fronts.

Your nervous system would collapse if you had to respond to every possible threat. The most successful hominids were probably those who were good at monitoring the routine in the environment and not worrying about it until something unexpected happened: a new animal or a strange group of wandering hominids appeared, an unusual sound, an angry cloud in the distance or a wind carrying a curious smell.

For the unprotected hominid trying to survive, what counted most in the short term was unknown change, especially coming from the most dangerous threat – other hominids. Hominids evolved only to live in the short term, so that near-sighted view made sense.

In the 21st century, such short-sightedness becomes maladaptive. It explains a host of phenomena from bad investment decisions to political expediency. It explains why we become obsessed by the risks of radio waves from mobile phone towers but are not concerned about the physical dangers for those constructing them, why we agonise over the relatively low mortality from SARS, yet barely register the deaths each year from flu or the two jumbo jet crash-equivalents a week who die from smoking.

When it comes to emotion and clouded perception, last year's Nobel Laureate in Economics, Princeton psychologist Professor Daniel Kahneman, says that dread and outrage are the main drivers. We have a loose concept of "disaster"; there is more dread and outrage at man-made accidents than natural ones and more dread and outrage at low-probability, large-scale events than high probability ones and chronic situations like smoking.

Take, for example, the Exxon Valdez disaster in 1989 which killed hundreds of thousands of marine animals and billions of fish. There has never been so much media coverage of a natural disaster affecting wildlife. People suffered more psychologically from the Exxon Valdez because someone was to blame. It helped that the captain had been drinking and that a large faceless multinational was involved. Nothing triggers a sense of outrage more than private profit. It strengthens the finger of blame.

In general, people are more sensitive to small changes in risk where somebody else is responsible. In part it is an issue of personal control. The less control one has, the worse the risk is perceived. Policy-makers rarely acknowledge this.

We comfortably wallow in a sea of risk and don't notice the extent of the dangers until, without consultation, another risk is added to the mix. The introduction of genetically modified foods and the use of pesticides are contemporary examples. Assuming rationality in public responses is misguided; people are more likely to be driven by emotion.

Bureaucrats sometimes try to assess the public impact of a risk by inviting people to assign a dollar value to it. This rarely works. One study asked participants how much they would be prepared to pay personally to clean up the local environment and then larger and larger areas. The results showed they were prepared to pay about the same amount regardless of the size of the problem.

With lives it is the same. People will pay a lot for a single life but not much more for 20 lives. It is a truism to note that the media pays as much attention to the death of one Australian as a thousand foreigners.

 

A LOT OF this assessment of risk and danger is based on the ways we frame situations and the distortions created by the media. Paul Slovic of Oregon, one of the most respected researchers in this field, asked people to judge the frequency of certain causes of death. Americans believe, quite erroneously, that there are more homicides than suicides. Murders are reported, suicides aren't.

If I were to ask you what percentage of Americans sue after accidents where other people could be at fault, I wonder what you'd answer. In fact it's surprisingly small. We just think it's higher because of the publicity lawsuits are given and our perception of America as a litigious society.

One of the most important factors involved in our perception of risk is that the threat of loss is more potent than the idea of gain. We have very different attitudes to changes in our lives depending on whether these changes relate to gains or losses. People may view gains with indifference but losses rather tragically.

Consider these scenarios: you're walking down the road and find two $100 notes. Try to imagine the pleasure of the discovery. Now imagine you are in a shop and open your purse or wallet, which had $200 in it, and find the money has gone. Try to imagine the pain of loss. Which produces the greater emotional change, the find or the loss? For most it's the loss.

People will not agree willingly to increase risk as the potential loss is greater than any gain. This explains why gamblers hang on at the tables hoping to recoup their losses. One study showed supermarket customers a $10.99 can of pesticide with a label which said that 15 out of 100,000 uses caused a toxic reaction. The shoppers were then asked to nominate the price they would be willing to pay for pesticide where the risk was reduced to 10 or five in 100,000 uses or to nothing. The researchers also asked the consumers what discount was worth an increased risk.

The people wouldn't take the can with an increased risk, even if it were free, and would only pay more if there was no risk at all. These are the same people who hang-glide, skydive, go on scary rides at fun parks and smoke.

Once alert to risk, it's hard to let it go. It is not that we want risk-free lives. We just don't want someone else to make the calculation, especially if part of the calculation is profit.

Some information has more impact than no information. People tend to forget that they could apply the statistics that they carry in their heads, but most don't think concretely about the situation in hand.

Loss-adverse people are more cautious. Kahneman won the Nobel Prize in part because his analysis showed what this means. Most people sell on a falling market and buy on a rising one, when the smart money's usually going the other way. In finance you don't want a loss-adverse person running your money; you need someone who can make balanced, emotion-free decisions.

These days accountability has increased but the ability of decision-makers to act rationally has decreased. Loss aversion and the media have pushed them to caution and expediency.

But even though there are risks in information, it's better to have it than not, because the more out of control a person feels, the more risk is perceived.

The lack of understandable information made the Cryptococcus water crisis in NSW worse. People had no idea what risks they confronted. Their fear was exacerbated when senior representatives of the corporation hesitated to drink a glass of Sydney water.

We will face new plagues and our psychological evolution will tend to make us overreact emotionally. There are no easy answers but, as China is hopefully discovering belatedly, the first step in managing fear of the unknown is transparency. There is no substitute for openness.

 

References:

Kagan J. Three Seductive Ideas, Harvard University Press 1998.

For details on the impact of the Exxon Valdez spill, see the website of the Exxon Valdez Oil Spills Trustees Council,

Kahneman D & Twersky A, Choices, Values and Frames, Cambridge University Press 2000.

Twersky A Kahneman D, "Rational choice in the framing of decisions" Journal of Business 59(4):251-278.

Slovic Paul The Perception of Risk, Earthscan Publications 2000.

O'Keefe A (ed) The Australian Media's Treatment of the Developing World: How Does it Rate? Canberra 1989.

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