Metaphor in a Time of Ebola

On CNN, Sierra Leone channels Hieronymus Bosch; Ambrogio Lorenzetti reflected in Liberia across the front page of the New York Times. The most widespread epidemic of Ebola in history (as of this writing the number of infections surpasses 16,000) has been raging publically throughout West Africa since May 2014 (though the CDC reports the “index case” occurred a year ago in December 2013). Recurring characters of Renaissance depictions — angels, devils, the Grim Reaper, the emaciated walking dead — are recast as nurses in white hazmat suits, hellfire in burning piles of refuse, soldiers with heavy artillery clad cap to boot in charcoal black gear, victims quarantined in slums. There’s an apocalyptic flair to the journalistic coverage that infuses those images, speaking to the epidemic narrative of our sociological imagination, rather than documenting the historical outbreak.

I have been following the Ebola coverage closely since June, not with the same sense of impending doom that flooded my Twitter feed or hijacked my “health & medicine” recommendations on Amazon, but on the contrary, because of it. The surreal gravitation of the general population toward superstition, pseudoscience, conspiracy theory, and apocalyptic Biblical narratives reminiscent of the Dark Ages, in an era where accurate information has never been more accessible, confounds in the most fascinating way.

This is somewhat of a default mode for me. I spent five years working as the communications director of a University-based public health program. On the job, I devoted a considerable amount of time investigating the history of epidemics, some of the very wrong thinking and often wrong science that emerged in response, and even accelerated outbreaks. In response to the 1848 cholera outbreak in London, for example, the belief that miasma (foul air) was responsible for disease resulted in flushing contaminants (read: septic pits) into the Thames to get rid of the smells, which happened to be down river enough to flood and infect drinking wells.

While history is marked with adaptive scientific progress as well, direct and indirect responses to outbreaks of the past — medicine that evolved alongside the virus and bacteria that threaten the species, feats of engineering and technological marvels that shaped modern civilization to broker further protections — the social narrative is one still dominated by fear. The fact that this narrative seems to have changed little in the through line from the plague to the current crisis in spite of these advances indicates some other kind of pattern at work.

During my tenure, it was drilled into me that fear and misinformation were often as deadly, perhaps even more so at times, than an outbreak itself. As cases appeared in Texas, Ohio and New York, the narrative shifts Renaissance to Romero, underscored by growing hysteria. The Crazies seems implicit in the conspiracy theories that Obama ushered the health crisis into America’s borders to justify martial law, as well as the simultaneous xenophobic language that is encoded in the arguments to close borders.

Coverage follows an infected doctor riding a New York city subway to go bowling, a nurse with Ebola who takes a flight to Ohio to try on wedding dresses, a positively diagnosed healthcare worker on a Carnival cruise. Such stories not only eclipse the growing crisis in West Africa, but also bear an eerie resemblance to the narrative unfolding there.

For the purposes of my column, I was more interested in the representation of epidemic, more specifically infectious disease, as it appears in pop culture. No longer relegated to the medical thriller sub-genre (Outbreak, Contagion) that focused on disease itself, contagion spread into mainstream popularity. The astounding success of AMC’s The Walking Dead, which syphoned Sunday Night Football audiences with its season five premiere, reached 17.3 million viewers, the highest ratings ever for a cable show is testament to this fact.

In his PopMatters essay “The Contagious Age: Overwhelmed by Vampires, Viruses and Zombies in the 21st Century”, Dan Dinello does an exceptional job of documenting how contagion displaced the prevailing post-Cold War anxieties. Dinello describes the glut of “viruses, vampires, zombies” that infect pop culture “as the central monster of of the 21st century” reflecting “our culture’s worst nightmares”. He details a metaphor that has been so exhausted on present-day social anxieties, sometimes with scientific backing, that it appears the monsters they are projected upon are no longer effective in containing them.

The more closely I followed the Ebola coverage, the more the simulacra of contagion in fiction, film, and games seemed inextricably woven into the mainstream media. A twisted knot tying the anxieties projected on our cultural monsters, with those monsters themselves by way of metaphor, only to be broadcast on nightly news.

Welcome to media coverage in the Age of Contagion.

Untangling these knots is often a kind of puzzle work, where following individual threads leads to an underlying ideological truth, mostly revealed by its omission. (As Slavoj Zizek put it, coincidentally commenting on Michael Crichton’s techno-thriller The Andromeda Strain about an alien-induced epidemic, “there is the story and then there is what the story is actually about.”) Considering how this exhausted metaphor has served as an impetus to propel us into this strange ignorance of information overload is what had me hunting vampires in the first place.

As Media Matters for America noted in its Ebola coverage analysis, “The truly strange finding was that people who said they were following the story most closely were the ones with the most inaccurate information about Ebola. The more information they consumed about the dangerous disease, the less they knew about it.”

In August, prior to any cases found in the US, a Harvard School of Public Health poll found that “four in ten (39%) adults in the U.S. [were] concerned that there would be a large outbreak in the U.S., and a quarter (26%) [were] concerned that they or someone in their immediate family may get sick with Ebola over the next year” (emphasis added). The survey also found that “two-thirds of people (68%) surveyed believed Ebola spreads ‘easily’ (‘very easily’ or ‘somewhat easily’) from those who are sick with it.”

A Rutgers-Eagleton poll of New Jersey residents conducted in October had similar findings. It showed 69 percent of respondents were at least somewhat concerned about the deadly disease spreading in the US. As the poll director David Redlawsk said in an interview, “The tone of the coverage seems to be increasing fear while not improving understanding, you just have to turn on the TV to see the hysteria of the ‘talking heads’ media. It’s really wall to wall. The crawls at the bottom of the screen are really about fear. And in all the fear and all the talking, there’s not a lot of information.”

Into that void, a chorus of latter day snake oil opportunists flooded Amazon. More than 84 self-published e-books on Ebola written by non-medical amateurs hijacked the bestseller list from July to September. Scribbling for a quick buck, the opportunists packed titles with bogus science, misinformation, and conspiracy theory.

Contagion by definition also refers to the transmission of socio-cultural artefacts. It is as apt a concept for depicting the spread of ideas, artistic movements, and cultural norms as it is biological microorganisms. Connotation then, not analogy, worked the terminology into popular consciousness. As the Internet accelerated the spread of information, it also worked the lexicon of contagion into an everyday occurrence: email quarantines, viral videos, contaminated files, and so on.

Social media revolutionized not only how people create and consume information, but also documented how that information was spread with an unprecedented accuracy. The Internet, in its second incarnation as a vehicle for social connections, illustrated how the cultural contagion of information itself spread contact to contact, connection to connection. It presented the capacity for documenting behaviors, trends, and practices, a shift of ideas often in real time, alongside a means of shifting them.

The process, termed social contagion, initially emerged with a sense of trepidation in 19th century France as a way to understand “collective madness” demonstrated by mob violence, civil unrest, and the psychology of the crowd. To the 21st century mind, though, it has come to represent something much broader.

In 2008, the World Health Organization (WHO) announced the first of its kind action plan for the prevention and control of noncommunicable diseases. In it was an overt call to prioritize behavior-related health issues — diabetes, binge drinking, cancer, smoking cessation, obesity, among others — which the public health establishment began promoting as epidemics. Much of this prioritization was based on norm change that was culled from the frontlines of the battle against AIDS in Africa throughout the ’80s.

In the absence of vaccination or cure, attention turned toward what could be controlled, shifting social norms and changing behavior. In other words, the science that had been applied to the biological variation of contagion, now could be applied effectively to the second variation with staggering results.

When these ideological frames met emerging technology, whole new incarnations of both terminologies were born.

Disease as Terrorist

As a result, beginning in 2009 – 2010, shortly after the WHO publication, it seemed that everything human had gone contagious. From emotions to habits, including those incidents of “collective madness” that first captivated researchers, mob violence and civil unrest were demonstrated as contagious [I worked on three international projects applying the contagion model to the Arab Spring (2011), the London Riots (2011), and the Kenyan election (2013)]. Happiness, depression, loneliness, voting patterns, among others all became subject of social contagion research.

In 2009, sociologist Nicholas Christakis and political scientist James Fowler published Connected, a popularized treatment of collected research findings suggesting behaviors, emotions, and even our body types can be transmitted person-to-person, friend-to-friend like the flu. The researchers have taken some criticism on their determinist zeal, but regardless of the scientific verdict at the end of the data the ideas have gotten out there.

If these trends can be analyzed, behaviors tracked, patterns documented, perhaps they can also be harnessed and shaped. At the end the social contagion continuum — this unique 21st century manifestation — are behavioral economics driven marketers, governmental institutions, and others with a stake in controlling the masses.

Which seems as good a place as any to segue back to zombies.

S. William Hinzman in Night of the Living Dead (1968) (IMDB)

In 1968, when the founding father of the modern zombie mythos, George Romero, launched his six films (and growing) living dead franchise with the iconic Night of the Living Dead (NOTLD), he both avoided the “Z-word” and eschewed explanations. While radioactive contamination from a space probe is alluded to as a possible answer for the reanimated dead, the definitive origins were left intentionally ambiguous. Throughout the films protagonists speculate and sometimes debate causes from supernatural to the scientific, but never settle on a root cause.

In the initial Night of the Living Dead trilogy, which Romero contends was how the story was first conceived each released a decade or so apart, the zombies serve as a metaphor for the social anxieties of each period. NOTLD considers the Civil Rights movement, the Cold War, and revolution; Dawn of the Dead explores mass consumerism, rampant capitalism, and unchecked greed; Day of the Dead explored Reagan-nomics, the military-industrial complex, and bureaucracy. As a result, the ambiguity of the apocalypse origins actually served this technique, allowing zombies to be an ever amorphous and adaptable metaphor always representing us.

By contrast, the viral origins of Resident Evil franchise (2002), 28 Days Later (2002), World War Z: An Oral History of the Zombie War (2006) and The Walking Dead series (2010) are so sophisticated in a sense that they form an alternate microbiology in the same fashion sci-fi narratives might adopt an alternate history. In the unfolding gameplay of the Resident Evil franchise, the bioterror produced zombie virus produces mutations and competing strains (t-Virus, c-Virus), which subsequently result in different kinds of zombies with different symptoms.

The genesis of the blood-borne rage virus in 28 Days Later was a lab where Cambridge scientists were trying to control and inhibit aggression, when a mutated version of Ebola was used as a delivery system it reversed the process creating a hyper-human rabies.

Max Brooks’ World War Z novel initiates with Patient Zero as it follows the global Solanum pandemic, a rather thoroughly drawn and detailed virus that causes the zombie plague. The subsequent World War Z film uses the Solanum virus and the miraculous last minute cure as its primary plot (and, perhaps, the only actual similarity to the novel).

The Walking Dead (poster excerpt) (IMDB)

The Walking Dead is almost completely anchored by the biological. The revelation that all the characters are contaminated, turning into zombies after death whether they are attacked and bitten or not, plays a crucial role in the plot development over the first three seasons (notably revealed by the only remaining CDC physician Dr. Edwin Jenner, named for Dr. Edward Jenner, the inventor of the smallpox vaccine).

In all four examples, contagion becomes integral to the plot. In some cases almost a character itself. It is at once a standalone metaphor and metaphoric stand-in for broader social anxieties in the same way as Romero’s original ghouls. The revelation (and recurring refrain) in the Living Dead franchise is that “they (the zombies) are us (the living)”, which makes social commentary (especially when considering revolution, but also consumerism) all the more poignant. In The Walking Dead the revelation and refrain circles back to NOTLD, but with the inverted element that “we (the living) are them (the infected).”

Some of the more egregious reporting offenses in the media coverage of Ebola reveal the broader pattern not only of mixing metaphors, but straining them. Only a day after CNN accused FOX News of being unscientific in its coverage, the network dubbed Ebola the “ISIS of biological agents”. This hyperbolic Twilight Zone of a statement provides a loop to the Islamophobic motivated conflation of contagion and terrorism.

In the immediate post-9/11 climate there was a need to differentiate the war on terror from preceding American military engagements. Even before any speculation on bioterrorism or Anthrax scares, terrorism as disease metaphors became a means of making this argument. High-ranking officials ratcheted up rhetoric on infection, contagion, and plague, but the intent was not only to create fear, but also to demonstrate how protracted and seemingly endless this war would be from the beginning.

By cribbing epidemiological language and medical concepts, the ideological framework of the war on terrorism became something dramatically distinct from traditional American incursions. This was not an effort to consider violence through a contagion lens, so much as to repurpose and decontextualize the terminology for political aims.

Closing the loop back on Ebola, this time disease as terrorist, completes the ideological knot. The CNN piece was initially taken from Alexander Garza, former chief medical officer of the Department of Homeland Security, arguing in a New York Times contribution that Ebola was “no ordinary communicable disease” and the “response should mirror anti-terrorism efforts.” The argument from CNN, the New York Times, or the Department of Homeland Security secures a false connection between the two concepts.

This conflation is not the only example where the media has fictionalized its coverage. The most bizarre instance I came across involved CNN’s Don Lemmon inviting Robin Cook, horror writer and optometrist, to discuss Ebola. Outbreak, Cook’s 1987 novel (not to be confused with the 1995 film) featured a fictional Ebola epidemic. Ever the fiction writer, Cook not only provided his thoughts on the CDC response, but also speculated on mutations that contradicted the facts.

Mainstream media’s fear mongering is so oft-satirized and totally ubiquitous it seems hardly worth comment, but the handling of Ebola coverage put it on a wholly other level. Factual information that could save lives was often obscured by the spectacle of epidemic as entertainment, while genuine experts took a back seat to the storytellers who could most closely channel the spirit of Armageddon.

And, more than this strange infoglut induced dark age effect, what is absent is a broader dialogue about the weak health systems in developing nations (and solutions that could fix them), social determinants of infectious disease, and the slow response of international organizations and higher-income countries. In their stead, superstition, pseudoscience, conspiracy theory push the social narrative into the realm of fear, not fact. The complexities of scientific and social fact don’t make for a marketable, ratings-centric story.

In the meantime, the metaphor of contagion has been so exhausted on the social anxieties it aims to contain it has become virtually meaningless in its ubiquity. Terrorism, bioterrorism, financial crisis, economic collapse, and civil unrest have all been treated with varying degrees of scientific and pseudo-scientific evidence asserting a contagion model with such unrelenting frequency that the monsters these anxieties are projected upon are no longer effective in containing them.