Anthrax: Extracting Fact From Fear

Everyone wants to take common-sense precautions against anthrax, says Dr. J.W. Boyd. But statistics show there's no reason to let fear rule your life

BY JON WESLEY BOYD, M.D. <mailto:jreaves@timeinc.net>

TIME: Homeland Insecurity <http://www.time.com/time/magazine/article/0,9171,1101011029-

180476,00.html>

TIME: Are Truck Bombs the Next Big Threat? <http://www.time.com/time/magazine/

article/0,9171,1101011029-180491,00.html>

Monday, Oct. 22, 2001

It sounds counterintuitive at the moment, but that doesn't make it any less true: As it stands today,

anthrax is not a major public health threat, says Dr. Jon Wesley Boyd, a psychiatrist at Harvard Medical

School and Smith College.

Figuratively, anyway, anthrax is in the air. It dominates the headlines and a significant portion of almost

any newscast these days. But we're worrying for nothing. Remember: On September 11 the terrorists

attacked the highest-profile targets they could find in America. Anthrax has mostly turned up in highprofile

places. Even though everyone seems to feel like they're living in the crosshairs of the terrorists'

scopes, I must break the bad news: Almost none of us matter to the terrorists. We don't count. (This even

applies to the governors of Midwestern states who have begun keeping their itineraries secret out of fear

of terrorist assaults.)

Nonetheless, we feel targeted, even though the reality is that thus far anthrax is virtually a non-threat.

The risk of dying from it is infinitesimal. If you are one of the exceedingly few people who comes in

contact with anthrax and you get it on your hands, wash them — just like your mother always told you

to do — and most likely you've killed the anthrax. If you're a bit unlucky and a skin infection actually

takes hold, you take some cheap, curative antibiotics. If you go with Penicillin instead of Cipro, you can

probably cure yourself of anthrax for under $10. (If you have a good insurance plan, you might get away

with only a $3 co-pay.)

I'd rather get a case of cutaneous anthrax (the kind most people have been diagnosed with) than come in

contact with poison ivy or break an arm, neither of which can be cured (easily and cheaply, I might add)

with infection fighting medicine and both of which are probably a lot more painful than anthrax.

Thus far one person in the entire country has died from anthrax. He unfortunately inhaled an

overwhelmingly large number of anthrax spores. Had he inhaled fewer spores, his body probably would

have successfully fought off the anthrax without him even knowing it. Since there are about 300 million

people in our country, your chances of dying of anthrax at present are roughly 1 in 300 million.

The statistics speak loud and clear: You're almost definitely going to die from something else.

Cigarette smoking kills 400,000 Americans prematurely every year. Poor diet (read: high fat) and poor

health habits (read: little exercise) kill over 300,000 people every year. Alcohol consumption kills

125,000 people a year. These deaths result from choices people freely make in their own lives

(excepting those, of course, who die from secondhand smoke or those who are killed by drunk drivers).

These numbers that would be mind-numbingly attractive, by the way, to even the most sanguine

terrorist.

And even among causes of death that we don't bring on ourselves, anthrax does not rate as a killer.

20,000 people die every year from influenza. That's a big killer. Even your regular lunch break poses

more of a risk on your life than anthrax: The likelihood of getting hit by a car while crossing the street,

or being killed by a drive-by shooter, or being struck by lightning, or dying from the smoke and exhaust

we inhale every day, are much more real threats on our lives.

Does this mean that you don't walk to lunch or drive downtown? Of course not, because you realize the

likelihood of these events is sufficiently small so that you're not too worried (except in certain

exceedingly rough, urban areas, where people should be appropriately cautious).

The same should be true with anthrax. I'd be appropriately cautious if I worked in a high-profile place

like the upper tiers of the federal government, major media outlets and large multinational American

corporations. In these situations, reasonable precaution should be taken with the knowledge and

understanding of the true risk of anthrax.

Should you rush to take prophylactic antibiotics just in case you've been exposed, when there is no

objective basis for your fear whatsoever? Absolutely not. Anytime you take antibiotics there is a chance

of having a severe allergic reaction and possibly dying or of creating antibiotic resistant bacteria within

your body that could make you sick and possibly kill you.

So why all of the hype about anthrax? Because tobacco, bad driving, and virtually all of the other things

likely to kill any one of us are boring. Terrorists, on the other hand, make excellent press. They generate

amazing amounts of fear. In their current incarnation, terrorists are dark, mostly foreign, and (according

to most Americans) believe in the wrong God. People want desperately to look outside themselves for

threats to their well being. It is much easier to look outside ourselves for threats, because if we look

inside ourselves and see something we don't like, we might have to make deep and fundamental changes

in the way we live our lives. That can require a lot of soul-searching and pain, something most people

are loath to do. (This isn't to say the terrorists haven't already caused a hideous amount of death, pain,

and destruction, but it is to put those things into some perspective.)

So in spite of the lack of almost any real threat, until some new attack, we'll continue to see anthrax

hyped and fear everywhere. Over time, the fear of dying from anthrax will dissipate. With a little

knowledge we can take back our lives. We can win. It doesn't even require bravery. Just a small dose of

reality.