Dr. Craig Spencer of New York-Presbyterian/Columbia University Medical Center went to Guinea in September to help combat the Ebola epidemic. He returned to New York City on Oct. 17. He rode on the subway, went bowling, and basically led normal life until his temperature went up to 100.3⁰F. It turns out that he was infected with the Ebola virus while in Guinea. He is the first Ebola patient in the megalopolis of New York City.
The incident triggered a storm of controversy. What’s interesting is that there seems to be a distinct class aspect to it. Common Americans, as well as populist-leaning politicians are up in arms demanding that all flights from West Africa must be immediately stopped. On the other hand our political elites seem to be relatively blasé about the whole thing. One gets an impression that they are simply going through the motions, because there is an enormous popular pressure to do something.
There are two possible explanations about this “class divide” on Ebola policy: the cynical and the benign. Let’s start with the cynical one.
Historically, the elites were always less vulnerable to epidemics than common people. Here’s what I wrote in my book, War and Peace and War about the epidemic of Black Death:
In general, epidemics always cause a higher mortality among the poor, who suffer from malnutrition, greater crowding, and a lack of bedcare and medicines. But in the case of the plague the best way to avoid it was flight. While the urban poor died in droves, the rich had their country estates to escape to, like the young aristocrats in Decameron who left Florence for a pastoral palace “removed on every side from the roads” with “wells of cool water and vaults of rare wines.” It is generally estimated that the first outbreak of plague in 1348–9 carried away some 40 percent of the English population. Monks who ministered to the dying suffered an even greater mortality. The mortality of tenants-in-chief, on the other hand, was only 27 percent. At the top of the social pyramid, the peers lost barely 8 percent of their number. The only reigning monarch who died from the pestilence was king Alfonso XI of Castile.
There were around 30 states in Europe in 1348 (ignoring a lot of microstates like German Imperial cities and tiny Italian principalities), so one dead head of state translates into a 3 percent estimate of the probability of a European head of state dying from Black Death.
Europe during the 14th century
This results in the following table:
Mortality rates (%) of various social classes in England during the years of plague outbreaks, plus an estimate of the mortality of European heads of state. (From Table 2.11 in Peter Turchin and Sergey Nefedov. 2009. Secular cycles. Princeton University Press.)
|Social class||Mortality, %|
|Heads of State||3|
Monks had a higher mortality rate probably because they were likely to minister to patients struck by the plague.
Extreme Unction Rogier Van der Weyden
After that there is a clear effect of social rank on the probability of dying.
Returning to our cynical explanation, the elites, whether they are the Bishops and Peers in Medieval England, or CEOs and top government officials in modern America, simply are not worried about the epidemic in personal terms. The chances that they or their family members contract it are vanishingly small. On the other hand, they value their ability to flit around the globe, and they really wouldn’t want to restrict it.
So that’s the cynical explanation. What’s the alternative? Well, Ebola is a very deadly disease, killing between 50 and 90 percent of those who contract it. But it is not a particularly infectious disease. As the following graph shows, it is nowhere near as bad as, for example, measles.
This means that fairly elementary methods of public sanitation would be sufficient to prevent a serious outbreak. For example, quarantine. In fact, could someone explain why Dr. Spencer wasn’t quarantined for 21 days on his arrival in New York? Whoops, I am afraid I am backsliding to the cynical explanation, again.