Previously on this blog, I cited to Stuart Rennie's level-headed appraisal of the Andrew Speaker incident, and I added that the tendency to stigmatize infectious disease sufferers is an ancient one in Western history. To wit, I said:
Reading the early articles on the story, I was fascinated to find buried way down in many of the articles a terse, almost grudging admission that Speaker was not likely to be very contagious at all, seeing as how he wasn't coughing, had no fever, and displayed no other symptoms of illness.
This is not to make light of a dangerous strain of TB. But as medical humanities scholars of various stripes understand, studying a society's response(s) and meaning-making strategies in the face of disease reveals a wealth of information about that society's practices and beliefs. And I personally found the response to Speaker's case vastly more interesting -- in a rueful sense -- than the fact that Speaker has XDR TB.
The latest development in this case was the revelation that Mr. Speaker apparently is not infected with XDR (extremely drug resistant) TB, but a less dangerous strain of TB, MDR (multi-drug resistant) TB.
Mr. Speaker was villified in the popular media and the blogosphere as behaving criminally, let alone negligently, for daring to take a transatlantic flight with an infectious disease where the risks of infecting others -- even with XDR TB -- were quite low given that he displayed no signs of illness, was not coughing, etc.
Mr. Speaker was stigmatized in the technical sense: he was marked out first as different, and then as deviant, as negative, as a criminal. As far as I can tell, the fact that he is a plaintiff's attorney did not endear him further. In the process, a federal quarantine law of dubious constitutionality that had not been used in approximately forty years was utilized against Mr. Speaker.
The CDC has pointed out that the public health policies it pursued during the incident would be the same regardless of whether the relevant strain was MDR-TB or XDR-TB. And in that respect, I agree that the mere fact that the strain was diagnosed as XDR-TB is not in and of itself reason for criticizing the public health response.
I nevertheless maintain that the response to the incident -- both public and private, professional and lay -- reveals much about our attitudes to infectious disease and our propensity to stigmatize, and that this is (sadly?) the most intriguing aspect of this entire incident.
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