Abstract What happens when death comes knocking at your door unannounced, uninvited and invisible to see.
Back in the Middle Ages the Black Death caused by bad sanitation, unclean water and the culprit the fleas from rats did just that? People panicked, shunned and died coping with the unseen killer.
Today we have a new killer, the A/H1N1 flu that has spread around the world so rapidly, due mainly, to the ease of international travel.
In this paper we will explore the social and individual psychology of how people react to this type of disease and how the media attention to the new flu has effected the cognitive perception of how people behave given a deadly unseen threat.
We will particularly focus on the Chinese experience as the first country to take rapid action to fight the infection.
Introduction Within the last two years a new strain of flu has created a new fear of a Black Death of the 20th century.
Although deaths from winter strains of flu usually only effect the elderly populations around the world this new strain has hit hardest amongst the young and international travellers.
The first alerts to the seriousness of the virus came from Mexico where reported deaths from a new type of flu caused immediate panic in a country ill-equipped to control the outbreak.
Within weeks of the outbreak deaths occurred in other countries where travellers had been in contact with the Mexican strain.
Today in the European Union, the United Kingdom, Germany and Spain are reporting the highest infections and deaths.
This maybe due in part to the huge tourist and business travel abilities of rich Western nations which bring the virus home with them in its early stages.
Asiatic nations have not been exempt from this spread with deaths in Beijing and Shanghai in China causing the government there to restrict some travel and start a massive inoculation campaign ahead of any other country to protect its school children, elderly and medical workers.
Recently the United Nations had have requested all developed countries to donate billions of dollars to combat the spread of the flu to poorer nations, but even though the amount requested is massive in contribution terms the World wide figures to date are 6,000 deaths and millions effected.
Many countries closed schools, banned public meetings in an atmosphere where it has spread to 139 countries so far.
Most medical experts are encouraging vaccination world wide.
China being the first to licence the vaccination for massive inoculation with only two serious side effects from allergic response, but after millions of injections so far it has shown to be effective.
The vaccine only lasts one year and has about 85% protection.
However capacity to produce the doses required is far behind that needed to protect the world's population.
Psychological Insight So how do people react to the news that a deadly flu virus could affect them directly, their children and restrictions to how they live their lives including travel, schooling and infrastructure problems where people gather? The initial common reaction is it is happening to somebody else.
The first news of the virus came out of Mexico so for most people (if you did not live in Mexico of course) felt that it was some body else's concern and too far away to effect me or my family.
This is a normal reaction to dangers seen as remote.
Global warming has a similar reaction in most people while they can see some concern most believe it is not something that directly affects their everyday life.
The second stage of perception comes when the disease arrives in their own country - the re-evaluation usually minimises the danger by framing the situation as local, minor and effecting only exposed people such as returning travellers and their families.
Therefore most once again dismiss it as something that will not affect them directly - it only happens to somebody else.
It is at this point that the Media though the knowledge that a "fear" story sells more advertising and media space than everyday news latch onto the new flu as a public danger.
Inmost cases the media drop the stories as soon as it becomes apparent that the initial concerns did not in fact fulfil there promise of death and mayhem.
However in the case of A/H1N1 flu this did not happen but the initial reported fear stories actually started to live up to and beyond the editorial expectations of the media.
With deaths being reported around the world the World Health Organisation started to become alert to the seriousness of the problem and overnight governments began to discuss what would happen if a pandemic became a reality.
By the time the public caught up with the new situation the third stage of psychological thinking had begun with - "is this something I should be worried about" - but most still failing at this point to believe it would affect them directly.
This is a form of cognitive dissonance in which people tendency is to think I am immune to this danger and it will be others - people I do not know - who will be infected and suffer.
I will simply be an observer of events around me but not part of my life or experience.
In China the average person in the big cities had some experience of a previous pandemic called SARS.
At the time the effects of this disease began to creep into everyday life, people demonstrated their concern wearing face masks (that in fact were no defence against SARS or A/H1N1) this was a visual clue to others that something serious was happening and you should pay attention.
Therefore this is stage four, previous experience had some positive effect on the behaviour of the people and its government - without too much encouragement the Chinese adopted the same precautions as that for SARS and wore masks on the street and public transport.
The Chinese also at street level perceive that all bad things that happen from SARS to AIDS are all Western problems brought to China by foreign travellers (mostly from the USA).
So the Chinese tend to start to avoid foreigners on public transport even in an overcrowded bus or metro train where seats are a premium would prefer to stand than sit to close to the foreign devil.
With this mind-set China was the first country to react positively to the new A/H1N1 virus in providing public advice, checks at airports to passengers from certain destinations and the production of a licensed vaccine.
At this point people enter stage five of cognition and begin to discuss with each other the dangers and fears of this killer virus.
Schools and other educational organisations start to increase sanitation, health regimes and isolation policies based on visible symptoms in children arriving for school.
This in turn affects parents who start to fear for their Childs well-being.
At this stage people are starting to take a personal interest in the News, government pronouncements and the most powerful driver - rumour.
Now everyone knows someone who has had it or knows someone who knows someone.
The media now is at peak interest with special announcements, programming and news alerts everyday warning citizens how to best protect themselves and actions they should take if they have a high temperature and feel unwell.
Unfortunately at this stage the burden to the health systems of most countries becomes over burdened with false cases and long queues of people with a fear response to ordinary colds and winter flu.
Parents in particular over-burned the local hospitals and doctors looking for advice and protection for the family.
At this moment most people have now entered stage six.
This stage is now the latent period where people are wondering if this is real or will like SARS and others pass as suddenly as it appeared.
Many are now seeking inoculation but as was stated earlier the worlds current production of the vaccine is only enough for 10% of the world's population and even rich economies such as the USA say it is impossible to vaccinate even a small proportion of the people who need it.
So most countries prioritise to children, medical staff and the elderly - leaving the most vunerable, the business travellers and holiday makers the most likely to catch and die from the disease.
However at stage six the initial fear starts to wane.
People now better informed realise that the percentage of people infected is very low and if caught at the early stages can be treated without much difficultly.
So people begin to relax again in their attitude to the emergency and while the media continues to talk about the story in fear terms most people have now become desensitized to the message there are hearing.
During this stage it is in fact a return to the stage of cognitive dissonance where they believe while it is a concern they can relax as even if the should catch the disease they can be treated successfully and the only ones that die are those who did not seek help in time.
This psychological rationalisation is very common when faced with something you cannot see, control or plan for.
We have not yet reached stage seven in the scenario of the A/H1N1 flu, that is the survival stage - where panic becomes dangerous, where sacrifice is considered an option in order to stop the spread of the disease through severe methods such as isolation, culling of animals, enforced imprisonment, states of emergency leading to public control of movement and freedoms.
This is the most dangerous stage not from the disease but from each other.
People panic to the point of physical harm to anyone who threatens their own well-being or that of their family.
This stage was certainly reached during the Middle Ages when communities closed ranks, killed outsiders and shunned the family of the dead.
Could this happen in a modern media driven society - well we would have to bear witness to mass hysteria as seen in Nazi Germany during the 1930's which in fact was based on a false premise - i.
e.
the Jews were an enemy to be destroyed at all costs.
When people turn on people things can get out of hand very quickly - when you cannot fight the hidden enemy (A/H1N1) you look for scapegoats in order to feel some locus of control over the situation.
Summery of Psychological Stages Stage One: Distancing and Disbelief (too far away to worry) Stage Two: Cognitive Dissonance (never happen to me) Stage Three: Initial worry (should I be concerned) Stage Four: Action - avoiding, enquiry, attention to (foreigners as dangerous) Stage Five: Action to previous experience (SARS) inoculation / masks Public actions Stage Six: Latent period, danger seems to be passing, government assurances that everything is being taken care of.
People slip back to Stage Two thinking.
Stage Seven: Survival - this is the most dangerous psychological stage - insular thinking, acts against others, and blaming culture of targeting vulnerable minorities, violence and murder.
It is unlikely that in the modern world anyone would reach stage seven but if one thing history tells us that fear, panic and faulty thinking can lead to the direst consequences when it comes to personal survival.
Ordinary people are capable of the most heinous acts when faced with dangerous situations they feel very little personal control.
So in order to make up for the lack of control they seek to control situations they can directly contribute to or be apart of.
In countries where racial disharmony prevail local murder of neighbours you have know for years can happen very easily - see Yugoslavia, Rwanda and many other examples - and most were Media driven hatred campaigns.
Never underestimate the power of panic and fear situations.
End Note: The A/H1N1 flu virus is just another pandemic in a modern world of intense disease driven farming, poor quality controls and over-population mixed with Global economic turndowns, global warming and stage one thinking - it could never happen to me? Pandemics come and go (foot and mouth, BSE) and transference of disease from animals to man is now a common instance of how we need to redefine our lives and culture.
AIDS and HIV were seen as the disease of the immoral but now of course is the disease most likely to cause world mayhem in the future and despite the deaths from AIDS being far in excess of any flu virus people have already entered the stage six process of stage two thinking again.