Friday, June 16, 2006

Epidemic, pandemic, or just bad decisions?

I think I may have come a long way since I teased a friend who was studying etamology by claiming that she was learning about bugs (entomology). Now I'm probably more dependent on Latin & Greek words than she....

The topic that comes to mind today is the modern habit of describing things as "epidemics" or "pandemics." When any disease or behavior gets to the point of killing or maiming a large number of people (gang warfare, AIDS, etc..), it is inevitable that it will be first described as an epidemic or pandemic. But is this true?

Etamologically, both words mean about the same thing. "Epidemic" comes from "epi demos," or "on the people." "Pandemic" comes from "pan demos," or "all the people." Applied to medicine, it historically refers to outbreaks of communicable diseases which are easily transmitted and, well, affect all the people in a given area. Historic examples are smallpox, polio, the bubonic plague, and influenza. Pandemic, of course, refers to an especially bad epidemic.

Thankfully, apart from avian flu, most of us don't worry about these diseases anymore. So we start to apply these words to our problems today. Hey, it's recycling, right? What could be wrong with it?

Well, for starters, most of the "epidemics" today aren't epidemics, and using the wrong word inevitably leads to the wrong response. Why? Well, a true epidemic has no clear root causes apart from the pathogen, and hence true epidemics are treated with quarantines, mass vaccinations, and other measures directed at the population at large, as the word's etamology would indicate.

But what if the "epidemic" is not actually epi demos? What if it's actually behaviors practiced only by a significant minority?

In that case, of course, we'll quickly find that we're wasting a lot of time and effort "treating" a nonexistent condition in the majority. For example, AIDS prevention has wasted billions of dollars warning heterosexuals of small dangers while downplaying the huge dangers of AIDS to homosexuals and drug users--killing tens of thousands annually. Anti-violence campaigns have used the epidemic approach to disarm the law-abiding (the victims), making the world safe for gangsters. Ouch.

The fact of the matter is that most of the diseases that plague us today--heart disease, diabetes, cancer, STDs--are widespread, but not epidemics or pandemics. Using the wrong word tends inevitably to lead to the wrong solutions.

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