Notes on Emerging Precedents: Part I
A growing disconnect between the causes of illness and the allocation of resources, particularly in relation to infectious diseases
One of the more curious features of modern public health is the widening gulf between what actually kills people and what captures official attention, political urgency and media panic.
The causes of death in England and Wales are neither mysterious nor especially fashionable. According to the Office for National Statistics, the principal killers in 2023 were:
Dementia and Alzheimer’s disease (AD)
Ischaemic heart diseases (such as heart attacks and coronary artery disease)
Chronic lower respiratory diseases (including COPD and emphysema)
Cerebrovascular diseases (mainly strokes)
Lung cancer (malignant neoplasms of the trachea, bronchus and lung).
The list changes little across Europe or North America. Nor is it surprising that many patients suffer several of these conditions simultaneously. Mortality statistics are rarely tidy: Old age, frailty and multimorbidity seldom arrive one at a time.
One might therefore imagine that public spending, political focus and journalistic energy would be directed overwhelmingly toward these burdensome chronic illnesses. Instead, much of modern health reporting resembles a rolling audition for the next contagion thriller.
Recently, the media became transfixed by Hantavirus, a disease that has killed precisely nobody in the UK.
Elsewhere, breathless headlines warned of meningococcal meningitis, often reported with such scientific illiteracy that one suspects the pathogen itself was edited for dramatic effect.
This is not to argue that infectious disease is unimportant; it plainly is, but proportionality matters.
To put the Hantavirus panic in perspective: since 2006, the Department for Transport reports that at least 425 cyclists in Britain have been killed or seriously injured because of defective road surfaces. Potholes, it turns out, remain considerably deadlier than exotic rodent-borne viruses.
Yet potholes lack one crucial attribute: they do not generate fear theatre.
Beyond the paywall looks at why governments and media obsess over exotic outbreaks while dementia, heart disease and chronic illness — the real killers — remain fragmented, underfunded and politically neglected. From avian influenza vaccines contracts to the absence of a coherent dementia strategy, the article follows the money, the incentives and the headlines.
