Ebola’s Information Paradox

 Steven Johnson at The New York Times:” …The story of the Broad Street outbreak is perhaps the most famous case study in public health and epidemiology, in large part because it led to the revolutionary insight that cholera was a waterborne disease, not airborne as most believed at the time. But there is another element of the Broad Street outbreak that warrants attention today, as popular anxiety about Ebola surges across the airwaves and subways and living rooms of the United States: not the spread of the disease itself, but the spread of information about the disease.

It was a full seven days after Baby Lewis became ill, and four days after the Soho residents began dying in mass numbers, before the outbreak warranted the slightest mention in the London papers, a few short lines indicating that seven people had died in the neighborhood. (The report understated the growing death toll by an order of magnitude.) It took two entire weeks before the press began treating the outbreak as a major news event for the city.

Within Soho, the information channels were equally unreliable. Rumors spread throughout the neighborhood that the entire city had succumbed at the same casualty rate, and that London was facing a catastrophe on the scale of the Great Fire of 1666. But this proved to be nothing more than rumor. Because the Soho crisis had originated with a single-point source — the poisoned well — its range was limited compared with its intensity. If you lived near the Broad Street well, you were in grave danger. If you didn’t, you were likely to be unaffected.

Compare this pattern of information flow to the way news spreads now. On Thursday, Craig Spencer, a New York doctor, was given a diagnosis of Ebola after presenting a high fever, and the entire world learned of the test result within hours of the patient himself learning it. News spread with similar velocity several weeks ago with the Dallas Ebola victim, Thomas Duncan. In a sense, it took news of the cholera outbreak a week to travel the 20 blocks from Soho to Fleet Street in 1854; today, the news travels at nearly the speed of light, as data traverses fiber-optic cables. Thanks to that technology, the news channels have been on permanent Ebola watch for weeks now, despite the fact that, as the joke went on Twitter, more Americans have been married to Kim Kardashian than have died in the United States from Ebola.

As societies and technologies evolve, the velocities vary with which disease and information can spread. The tremendous population density of London in the 19th century enabled the cholera bacterium to spread through a neighborhood with terrifying speed, while the information about that terror moved more slowly. This was good news for the mental well-being of England’s wider population, which was spared the anxiety of following the death count as if it were a stock ticker. But it was terrible from a public health standpoint; the epidemic had largely faded before the official institutions of public health even realized the magnitude of the outbreak….

Information travels faster than viruses do now. This is why we are afraid. But this is also why we are safe.”