A hands-on doctor tries to get public officials to recognize infestations as bubonic and pneumonic plagues. Can a novel's depictions inform discussions about Ebola?
The Plague
Oran, Algerian coast. 1946.
There's high fever and delirium; spasms, prostration, then convulsions; vomiting, blood-stained sputum, more bleeding; swelling, suppuration, pus - stench and death. City officials and commercial interests resist declarations of the obvious: "The public must not be alarmed."
Albert Camus' narrator notes that most townsfolk were "humanists" and thus "disbelieved in pestilences" - the comforting assumption (delusion) was that pestilences were "impossibilities and bad dreams that would pass away."
The novel is regarded as presenting a metaphor for the Nazi military and ideological pestilence that invaded and occupied France during World War II. Camus (a Nobel Laureate) delivers what can be read as cautionary tales about inattention and complacency: Pestilence "does not pass away and, from one bad dream to another, it is men who pass away, and the humanists first of all, because they haven't taken precautions."
In Oran, there was "reluctance to face the facts." Officials thought it "unwise to jump to conclusions" - "the great thing was not to take an alarmist view."
A physician prescribes precautions
A hands-on doctor summons the courage to contend that the prefect's "wait-and-see" policy is "unwise." This doctor (Camus' witness) explains that while "contagion is never absolute," to avoid catastrophe preventative measures should be put in place: "It's not a question of painting too black a picture. It's a question of taking precautions.... rigorous prophylactic measures."
Despite warnings, despite mounting deaths, authorities (including some doctors) still did not "face the situation squarely" - "one had the feeling that many concessions had been made to a desire not to alarm the public."
Non-perturbing symptoms; justification for resuming composure
The narrator observes that officials continued to hold the view that "the symptoms were not so marked as to be really perturbing" - "the authorities felt sure they could rely on the townspeople to treat the situation with composure."
In denial, the risks and consequences were not appreciated or were minimized with wishful thinking. Grudgingly, new reporting requirements were announced, isolation wards were established, and compulsory disinfection procedures were adopted for sickrooms and the vehicles in which patients traveled. But it became "lamentably clear" that even those measures were "inadequate."
More and more buildings had to be turned into quarantine hospitals; stadiums were transformed into isolation camps. Burials had to be stringently supervised. Household quarantines were imposed as well. Finally - finally - the town had to be closed and the pestilence literally contained within its gates.
Staying in touch, without touching
Today, patients presumably can convey longings and regrets via cell phone, Internet, e-mail, Facebook, Twitter.... In Camus' Oran, letters were deemed to carry contagion, so those trapped ("the prisoners of the plague") could resort only to "the banal formulas of a telegram" - "the phrases one can use in a telegram are quickly exhausted."
Containment, but "no final victory"
As to chancing the odds that a plague has exhausted itself and its mutations all expired, Camus' narrator observes: "history proves that epidemics have a way of recrudescing when least expected."
Even as Oran's plagues seem to have "retreated... after being hounded down and cornered.... prophylactic measures were to remain in force for another month.... at the least sign of danger, the standing orders would be strictly enforced and, if necessary, prolonged."
Informed fear noted that "the executioner" might reassert itself and go on the offensive after "slinking back to the obscure lair from which it had stealthily emerged."
Caregivers, risk-takers, luck
Exhaustion took its toll, for "oftener and oftener" caregivers, transporters, and burial teams lapsed in taking necessary precautions. The growing and overwhelming demands made it difficult for them to return to the few sanitary-service-stations for disinfecting precautions and injections.
"There lay the real danger; for the energy they devoted to fighting the disease made them all the more liable to it. In short, they were gambling on their luck, and luck is not to be coerced."