Dear Readers, I know there must have been some particularly malignant alignment of the stars when I find myself agreeing with the Daily Mail. I pride myself on the extent to which I and the Mail oppose each other with implacable hostility. The only way this agreement could have happened, you may be thinking, is if some entity even more noxious has emerged from under a rock, and the Mail and I both shudder with revulsion. And Dear Reader, she has.
Katie Hopkins was just interviewed on Radio 4. Who her? Her is that most loathsome media creation, a ‘television personality’. This is someone who is famous for having been on television. They have no other qualification to excite our interest. (In fairness, she does now write a newspaper column too. But that came later.) In the radio interview she was trying to defend her publication of some explicitly hateful tweets. Two in particular caught my attention. This is the first:
Much has already been written elsewhere about the repugnance of treating a volunteer nurse, who flew to one of the poorest nations on earth in order to try to combat the spread of one of the most frightening diseases on the planet, as nothing more than a ‘sweaty Glaswegian Ebola bomb’. Since it’s self-evidently a horrible way to talk about someone, I don’t feel the need to further elucidate that particular ghastliness. What I do want to talk about, though, is the idea that these comments are defensible as ‘jokes’, and that they speak to a wider political point about Scottish Independence and the health service. This is the defence Ms Hopkins has mounted but, unlike someone risking their life to treat victims of a haemorrhagic fever, it just doesn’t wash.
I know, as it happens, quite a lot about infectious disease and epidemiology. I wrote a book on the subject. And one of the things I learned is the incredible specialisation, both of training and equipment, required to safely treat someone infected with a Level-4 biological agent. (A BL-4 agent is one that is highly contagious and for which no vaccination or cure exists). This specialisation, naturally, comes at a significant financial cost. In the UK we are fortunate in that we have no endemic viruses that are this dangerous. The risk, therefore, that these things will afflict the population is relatively small, and comes exclusively from people or objects (‘vectors’) travelling into the country from abroad. As was the case with Pauline Cafferkey, the nurse who arrived in Glasgow.
Arriving into Glasgow is not, however, the most common point of entry into the UK for international travellers. That would be Heathrow, on the outskirts of London. London is also the largest city – and, therefore, the biggest potential reservoir into which a disease could slip. So because the infection of London represents the biggest threat, and the traffic a Heathrow represents the biggest risk, it makes complete sense to have the expensive, specialised facility required to combat rare infectious diseases at the place where these things are most likely and most dangerous.
Going a little bit further, one could argue that London’s dominance and Heathrow’s pre-eminence (the things, in other words, that make them the biggest risk factors in starting an epidemic) are due to the way in which money, and hence economic growth, is distributed. Much has been said about the ‘North/South’ divide in England; the division is even more pronounced between England and Scotland, and until very recently the reason for that was because of the extent to which politicians in Westminster, not Holyrood, governed Scotland’s economic affairs.
Which leads me back to Ms Hopkins ‘jokes’. The problem with them is that there is no way to deconstruct them and still find them funny once you know the background. The humour rests on a foundation of ignorance – not knowing how diseases work, not knowing how treatment centres work, and not knowing how epidemiology works. Douglas Adams once commented scathingly on such humour, and he had the right, since he built an entire career out of being funny while at the same time being extremely clever. However, once ignorance is negated, once you know the facts, the only way to re-construct the Twitter comments is as follows: “Not so independent when you need the facilities that, for historical and practical reasons, you have not had any need for due to your being economically sensible, eh Jocksville?” and “Sending terminally ill patients to the one facility on the landmass that stands any chance of being able to cure them due to healthcare decisions made in Westminster? Scottish NHS would require different capabilities if it were independent, but since it isn’t, the point is moot.”
Equally as unfunny as before, but at least this time they’re not contemptibly mean-spirited. It’s a start.
Your moment of (somewhat sweary) Zen: