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28 April 2003updated 24 Sep 2015 12:16pm

Apocalypse probably postponed

Theodore Dalrymple advises that we still have more to fear from flu and heart disease than from Sars

By Theodore Dalrymple

When I was a child, there were men who would walk up and down Oxford Street wearing sandwich-boards that warned that the end was nigh. I didn’t believe it: I reasoned that no one who really thought that the world was coming to an end would spend his last few days walking up and down Oxford Street with a sandwich-board. Besides, they looked supremely happy, these scaremongers, in a smug kind of way.

Man, in fact, is the only animal capable of deriving enjoyment from the prospect of his own total annihilation. There is a great deal of pleasure to be had in a good imaginary apocalypse, as Hollywood knows only too well. But these days, now that mankind is at last fully rational and subject neither to superstitious awe nor to unreasoning flights of fear, we like our apocalypse to come with a patina of respectable science. No more marks of the beast for us: we prefer viruses. Sars fits the bill perfectly.

Oh, how we love a good scare, provided it is sufficiently distant and unlikely to materialise! A couple of weeks ago, I read in the Daily Telegraph that an eminent professor was giving the human race only a 50-50 chance of surviving the 21st century. A few months before that, there had been the asteroid scare – a heavenly body that threatened to make dinosaurs of us all. And a few years ago I read a book by an eminent physician about emergent viruses. He was comparatively optimistic, however, believing that only 99.5 per cent of the human race was destined to die out.

Sars is to these apocalypses as Ronald Reagan was (when he was still only a movie actor) to Clark Gable: decidedly in the minor league. After all, Sars does not seem to be very contagious; and if contracted, it kills about 6 per cent of those who have contracted it, often people with other, concurrent health problems. By the standards of many previous plagues in history, it is pretty feeble.

Myths about it have spread faster than the disease itself. I was in a taxi the other day and the driver, on learning that I was a doctor, at once began to express his fears.

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“Is it true,” he asked, “that there’s no treatment for it?”

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“Essentially, yes,” I said.

“So once you’ve got it, you’re a goner.”

“That’s not quite the same thing,” I said. “Just because there is no effective treatment for a disease doesn’t mean that it’s invariably fatal. There’s no treatment for the common cold, but colds haven’t always ended in death.”

“But if there’s no treatment, then surely everyone that gets it must die?”

One begins to see how panic is conjured up out of comparatively little. So far, roughly 230 people have died of Sars, yet already there is talk of the world economy, particularly in Asia, being severely damaged by the epidemic, worse than by the south-east Asian economic implosion of 1997. Trade and tourism will be much reduced; hotel bookings in Toronto, where there have been 14 deaths in a city of several millions, are down by 50 per cent. By contrast, the average flu epidemic causes about 4,000 deaths in Britain alone.

Panic is not without its practical consequences. The surgeon Wilfred Trotter pointed out in a letter to the Times in 1940 that the Luftwaffe had caused hundreds of deaths in London before it had even dropped a single bomb on it, because of the increased incidence of road crashes during the blackouts.

The response to the Sars epidemic proves just how small the world has become, but also just how tender our imagina- tions have grown. On the one hand, we believe ourselves invulnerable to epidemic disease, having all but forgotten – for example – what childhood epidemics were, though they ceased within living memory; on the other, a couple of hund-red deaths exposes our pretensions to invulnerability and causes us to think at once in almost medieval terms of quarantine and preventing travel and the passage of goods.

A single death from Sars, even one that takes place ten thousand miles away, is more real to us than the 600 deaths that take place daily from cardiovascular disease in our own country. We are used to people keeling over and dying of heart attacks and strokes, as half of us will do; but a picture of a Chinese child with a face mask causes us to quake in our boots.

When children avoid the cracks between paving stones, they do not really believe that they are warding off the crocodiles that are lying in wait for a misstep. We don’t really believe that we are going to die of Sars, either: but we like to pretend that we think that we might. As human beings, we need both danger and safety: while in our hearts we know that we are safe, we pretend that Sars is a threat to us all.

Theodore Dalrymple is a prison doctor