Conceptagion

A concept contagion can be more difficult to wipe out than one for which the vector of spread is more tangible

An empty airport terminal. Photo by Jeremy Gunawan on Unsplash

Heathrow’s terminal 4 was evacuated yesterday as fire crews were called in to investigate “possible hazardous materials” at the London airport.

After a few hours of halted flights and frustrating inconvenience, emergency services declared that no “adverse substance” had been found anywhere in the airport. People were allowed back into the terminal and normal service was resumed. In the meantime, however, 21 people were said to have “reported an injury”.

So what really happened at Heathrow? To explain these unusual goings on, let me tell you a story I first wrote about in How to Expect the Unexpected.

The autumn of 2001 was a time of extreme tension and heightened emotion in the United States. The September 11^th attacks, the most deadly terrorist incidents the world had ever seen, cost the lives of almost 3000 people and injured thousands more. Just a week later anthrax spores were sent through the post to five newsrooms in New York and Florida and to the offices of two US senators. Five people were killed and many others fell ill.

Against the background of these two momentous terrorist attacks, many Americans were left with a heightened sensitivity to any unusual happenings. Thousands of anthrax false alarms were raised across the United States that autumn, with 1200 of these reports in the state of Indiana alone.

On 4 October, as these events were playing out, another unwanted medical problem was unfolding in Indiana. A third-grade student developed an itchy rash which quickly spread to other students in the class. The rash typically began on or near the face and spread to other exposed parts of the students’ skin. The symptoms of the ailment seemed to dissipate when the children left school each day, only to return when they found themselves back in class, linking the illness quite decisively to the school setting. Strangely, none of the family members of affected children were reported to have been troubled by this seemingly contagious affliction. Although most parents chose not to voice their concerns openly, at the back of many of their minds was the distinct possibility that the outbreak was being caused by an unknown biological agent. Despite extensive investigations, no definitive explanation for the rash was ever discovered.

A month after the initial case, the eighteenth and final student to fall victim to the mystery itch eventually stopped scratching. Just as the enigmatic epidemic was burning itself out in Indiana, another rash of itching cases erupted at Marsteller Middle School, hundreds of miles away in Northern Virginia. This time about forty students and staff members across all the school’s classes were afflicted. The school was forced to close while investigators searched for the cause. Despite public-health crews in hazmat suits hunting for a possible environmental cause, nothing turned up. School officials were left scratching their heads – some literally. Upon reopening the school, after a thorough decontamination, hundreds more students became ill, some of whom had already been affected by the dreaded itch. As public interest in the story intensified, Debbie Files, a parent of one of the seventh-grade students who came down with the rash, voiced her concerns to the national newspapers: ‘You know, the first thing you’re thinking is that it’s anthrax’. Despite these worries, heightened by the recent events, anthrax was quickly and conclusively ruled out.

Over the Christmas holidays, with students off school for a long period of time, reports of the rash in Marsteller students eventually dissipated. But on the return to school in January new and independent flare-ups were reported in schools in Oregon, Connecticut and Pennsylvania. Over the next few months, the school-related itch spread to all corners of the country. By the summer, outbreaks of the mysterious rash had been reported in over a hundred schools in twenty-seven states. There had even been some occurrences reported in neighbouring Canada.

Only very rarely were the rashes accompanied by symptoms like fever or vomiting, which would allow for a more definitive diagnosis. Occasionally, there was a positive test result for something like fifth disease, which can cause a rash and a fever, but typically, there were at most one or two such diagnosed cases in each outbreak. Some outbreaks were attributed, by parents, to the presence of mould in old, damp school buildings and others, more suspiciously, on misguided chemtrail conspiracy theories. The outbreak in one school was even suggested, by some parents, to be linked to the dusty old maths textbooks. Despite these multiple purported but disputed causes, there seemed to be no common thread to link all the outbreaks together, other than the sudden collective onset of an itchy rash and the corresponding reduction of symptoms when the affected children were away from school.

After ruling out other possible causes, the conclusion that public-health officials investigating the majority of the outbreaks were forced to draw was that most of the cases of the rash were psychogenic in origin – that the huge scale of the itching symptoms, which spread across the United States affecting so many students, was a form of mass hysteria.

Such a diagnosis is rarely popular. Naïvely, it might seem that being told there is no concealed environmental threat would provide assurance to those afflicted. But for many, the diagnosis is perceived to be accompanied by the accusation of neuroticism or hypersensitivity. In particular, the word ‘hysteria’ can make sufferers and their families feel as if their genuine symptoms are being diminished by know-it-all doctors insinuating it’s all in their heads. Other more mistrusting individuals feel that their rational concerns are being glossed over as part of a wider-reaching coordinated conspiracy theory. Because psychosomatic illness is typically a diagnosis of exclusion, the people charged with determining the cause of the outbreaks are also understandably reticent to make the call until every other possibility has been ruled out. No one wants to run the risk of being the official who missed the dangerous toxin or dismissed the contagious virus, especially where schoolchildren are concerned.

Nevertheless, despite its unpopularity, mass hysteria was the only tenable conclusion that explained the huge scale of the otherwise unconnected rash outbreaks. It is well known that skin is reactive to stress. Many people feel the hot flush of vasodilation creep up their necks when they are nervous. Eczema can be triggered or worsened by anxiety. Stress can elicit an outbreak of hives. The contagious power of itching against a background of students primed by the fear of anthrax poisoning, and later by the national-media reports of the mysterious rash, seems to have driven the epidemic.

And it seems that this may have been what happened at Heathrow airport. Twenty-one people were assessed by ambulance staff with all but one being discharged at the scene. According to the Metropolitan police, the events of yesterday afternoon were a “mass hysteria” type event with the spokesperson suggesting that the incident may have started with a single individual falling ill and then “snowballed” from there. An airport, after all, is a setting in which heightened awareness and anxiety amongst the people filling the departure halls can provide the ideal conditions for mass psychogenic spread.

Just because an illness is spread by an idea or an emotion, rather than a viral or bacterial vector, it doesn’t make that illness any less real for the communities or individuals affected. The same mathematics that we use to describe the explosive onset of an infectious disease can be used to describe the viral outbreak of an idea – a conceptagion. Scientists have suggested that a hugely diverse range of social phenomena – from generosity to violence and from kindness to unemployment – may be socially contagious. Some scientists have even come full circle by suggesting that diseases like obesity and insomnia, which are typically considered to be non-communicable disorders, may have a strong social component that allows them to spread like a contagious disease. Whether teen pregnancy, for example, is genuinely socially contagious, as some scientists claim, is still hotly debated.

What is clear, however, is that a concept-mediated contagion can be more difficult to wipe out than one for which the vector of spread is more tangible. Even ideas that have lain dormant for hundreds of years can take off – amplified from person to person through a positive feedback loop. Metaphorically, they are the residual vials of smallpox that are held in the lab ready to be unleashed, by the clichéd rogue scientist, on an unsuspecting susceptible population.

Underestimating an idea’s potency, its longevity and its ability to enthral can lead us to misjudge or misunderstand how a situation will play out. One only has to look at the pervasive spread of disinformation throughout the covid-19 pandemic to see the damage that dangerously incorrect ideas – overstating the ‘dangers’ of safe and effective vaccines, underplaying the risks associated with contracting Covid and upselling the effectiveness of unproven treatments – can do. The viral spread of these myths through social media means they can reach far and wide in virtually no time and are, consequently, extremely difficult to counter. We underestimate the snowballing of these pervasive myths at our peril.