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Dr Bill Durodié

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FACING THE FEAR OF BIOTERRORISM
The logic of our times is: Never mind the evidence, just focus on the possibility.

'An imaginary cause is capable of producing the most serious and mischievous effects.' (The Decline and Fall of the Roman Empire, Edward Gibbon)

At a recent forum in London, a member of the security service informed an audience of bankers that, while it was true that the probability of a chemical, biological, radiological and even nuclear terrorist attack was low, this could not be ruled out (1) . It was suggested that groups such as al-Qaeda may have relatively poor capabilities in such techniques, but their intention to develop these was clear, and if they did the consequences might be devastating.

This captures the logic of our times. Never mind the evidence, just focus on the possibility. This allows entirely vacuous statements, such as that of an official after the supposed discovery of the chemical agent ricin at a flat in north London, who was reported as saying: 'There is a very serious threat out there still that chemicals that have not been found may be used by people who have not yet been identified.' (2)

But undiscovered threats from unidentified quarters have allowed an all-too-real reorganisation of everyday life. The US government has provided $3billion to enhance bioterrorism preparedness (3) . Developed nations across the globe have stockpiled smallpox vaccines. Health advisories to help GPs spot the early signs of tularemia and viral haemorrhagic fever have cascaded through the UK's urgent alert system. And homes across the land are receiving the government's considered message for such incidents: 'Go in, stay in, tune in.'

There is a rational kernel behind these concerns, but it is distorted by our contemporary cultural proclivity to assume the worst. It is the fear of bioterrorism that is truly contagious, and it is a fear that distracts us from more plausible sources of danger, diverting social resources accordingly, and exposing us all to greater risk (4) . It is also a fear that has bred a cynical industry of security advisors and consultants, out to make a fast buck by exploiting public concerns, and thereby driving those concerns still further.

There is a long history of bioterrorism incidents, from the throwing of people infected with bubonic plague over the walls of Kaffa by the Black Sea in the mid-fourteenth century, through to the anthrax attacks on politicians and the media in the USA in 2001 (5) . At best, these are tactical devices with limited consequence; but they are not strategic weapons. It is the more recent, if overstated, possibility of genetically engineering agents to target biological systems at a molecular level, which is now held to pose a new challenge (6) .

Few commentators point to the difficulties in developing, producing and deploying biological agents. It was the failure of the Japanese cult Aum Shinrikyo in this regard a decade ago that led it to settle for the more limited impact produced by the chemical agent sarin, despite the cult's resources and scientific capabilities (7). The Tokyo subway attack that ensued had rather more impact in our fevered imaginations, than in reality.

As with the anthrax attacks, this incident suggested that bioterrorism is more likely to originate among malcontents at home, due to greater access and capabilities in developing such weapons there. Advanced economies are also better placed to deal with the consequences of bioterrorism, which creates more difficulties for outsiders. Nevertheless, suicidal foreign malefactors bent on undermining Western democracies continue to be presented as the greater threat.

Recognising the extremely low probability and limited consequences of such incidents, many point to the longer-term psychological impacts of attacks as being more important (8). Psychological casualties are a real phenomenon. In certain emergencies these can rapidly overwhelm existing healthcare resources and thereby undermine the treatment of those more directly affected (9). But they can also become a self-fulfilling prophecy. In a recent book, the sociologist Frank Furedi indicated how, by increasingly framing problems through the prism of emotions, people have been incited to feel powerless and ill (10) .

The arrival of television cameras or emergency workers wearing decontamination suits act as powerful confirming triggers for the spread of mass psychogenic illness (11) . So too can psychosocial interventions, such as debriefing subsequent to an incident (12) . These can undermine constructive and rational responses, including the expression of strong emotions such as anger (13) . Despite good intentions, psychiatrists can become complicit in shaping social ills. This is because few people are prepared to question the dominant cultural script emphasising social and individual vulnerability, and the need for professional intervention and support.

Rather than critically questioning the framing of the debate, a recent Royal Society report on chemical and biological agents took the 'greater prominence' of 'the threat' as a given (14) . While scientifically rigorous in content, this failure to address context further enhanced the credibility of the threat the report's authors assumed. As elsewhere, there is little understanding of how our exaggerated sense of risk is historically contingent, predating 2001 quite significantly - and culturally determining in setting the agenda.

In an insightful analysis, the medical historian and epidemiologist Nicholas King notes that 'experts were using the threat of novel diseases' as a rationale for change long before 9/11, and that contemporary responses draw on 'a repertoire of metaphors, images and values' (15) . He goes on to suggest that 'American concerns about global social change are refracted through the lens of infectious disease'. This coincides with the view of the writer Kenan Malik, who sees bioterrorism as providing a powerful metaphor for elite fears of social corrosion from within (16) .

Despite incidents since 2001 pointing to terrorists' preferred use of car bombs, high explosives and poorly deployed surface-to-air missiles, the authorities have continued to hype weapons of mass destruction. This is despite the fact that terrorists' capabilities are pathetic compared to our own, and that the consequences of any attack would be more likely to devastate them than us. We have stockpiled smallpox vaccines, but notably have run out of influenza jabs. And in the extremely unlikely eventuality of a terrorist incident, we assume that the public will panic and be unable to cope without long-term therapeutic counselling.

In an age gripped by morbid fantasies and poisonous nightmares, nothing embodies the pathological projection of our own isolation much better than the fear of bioterrorism. All of this rather begs the question as to who is corrupting civilisation the most: the fantasy bombers or the worst-case speculators?.

1. Banking Security Forum
Canary Wharf, London, 13 October 2004

2. Chemical weapons factory discovered in a London flat
Financial Times, 8 January 2003

3. Medical preparedness and response to terrorism with biological and chemical agents: present status in USA
Noji E., International Journal of Disaster Medicine, Vol.1, 2003

4. Facing the possibility of bioterrorism
Bill Durodiť, Current Opinion in Biotechnology, Vol.15, 2004

5. Biological and Chemical Terrorism
Morse SS., Technology and Society, Vol.25, 2003

6. Biotechnology: impact on biological warfare and biodefense
Petro, JB et al, Biosecurity and Bioterrorism, Vol.1, 2003

7. Biological warfare and bioterrorism
Beeching NJ et al., British Medical Journal, Vol.324, 2002

8. Responding to chemical, biological or nuclear terrorism: the indirect and long-term health effects may present the greatest challenge
Hyams KC et al., Journal of Health Politics, Policy and Law, Vol.27, 2002

9. The psychological impacts of bioterrorism
Hall MJ et al., Technology and Society, Vol.25, 2003

10. Therapy Culture: Cultivating Vulnerability in an Uncertain Age
Frank Furedi, Routledge, London, 2003

11. Unforeseen consequences of terrorism: medically unexplained symptoms in a time of fear
Hassett AL and Sigal LH., Archives of International Medicine, Vol.162, 2002

12. Psychological debriefing is a waste of time
Wessely S and Deahl M., British Journal of Psychiatry, Vol.183, 2003

13. Effects of fear and anger on perceived risks of terrorism: a national field experiment
Lerner J et al., Psychological Science, Vol.14, 2002

14. Making the UK safer: detecting and decontaminating chemical and biolgical agents
Royal Society policy document 06/04, April 2004

15. The influence of anxiety: September 11, bioterrorism, and American public health
King NB., Journal of the History of Medicine, Vol.58, 2003

16. Don't panic: it's safer than you think
Malik K. , New Statesman, 8 October 2001

Published on Spiked, 9 November 2004