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E.coli, and Fear of E.coli -- Both Are Dangerous

Posted: 06/ 6/11 09:50 AM ET

The outbreak of food-borne disease in Europe offers an interesting lesson in the psychology of risk perception, and how that psychology can contribute to the overall risk. To be sure, the danger from this outbreak is real. It has tragically killed nearly two dozen people so far, and sickened more than 2,000, hundreds of whom may suffer lifelong kidney damage. In addition there is the possibility that this is a new and more dangerous strain of harmful E. coli, a reminder of the constant battle we wage between medicine and public health and the phenomenal ability of germs to mutate to resist our controls.

Certainly this risk is far more real than, say, the hypothesized human health risks from genetically modified foods, or the disproved risk that vaccines can cause autism, other threats that demonstrate how our response to risk is more emotional than purely evidence-based. The number of dead and ill from the food-borne disease outbreak is already higher than the likely lifetime mortality and morbidity caused by the Fukushima nuclear power plant accidents in Japan, based on what we know so far about the dosages of radiation released (though that event is still unfolding).

But the actual danger to any vegetable-eating European, even in Hamburg or other places where the cases have been concentrated, is low. Statistically. Scientifically. But then, we don't just use the scientific evidence or statistical probabilities to figure out what's dangerous, and how to protect ourselves. Risk perception is a mix of facts AND feelings, intellect AND instinct, reason AND gut reaction. And in many cases, the feelings/instinct/gut reaction has the greater influence. This is neither right nor wrong, smart or stupid, rational or irrational. It's simply the reality of how we go about protecting ourselves, using the few facts we have, and applying a set of subconscious mental tools and instinctive risk perception 'fear factors' that help us gauge, quickly and subconsciously, how scary those few hints and clues feel.

The problem is, as good a job as this instinctive system has done getting this far through evolution's gauntlet, it can make mistakes. Dangerous mistakes. We can fear too much (vaccines), or too little (particulate pollution from coal-burning power plants), based on the evidence, and our perceptions can create risks all by themselves. Excessive fear of vaccines is allowing previously nearly-eradicated diseases to spread. Inadequate concern about coal as a fuel for electricity generation has contributed to energy policy in the past few decades that has favored coal over scarier nuclear power and raised the risk for millions of sickness and death from particulate air pollution.

So watching this living lesson of "Killer Cucumbers On the Loose" is important, and instructive. Why, if the actual risk for any given person in this case is so low, does it feel so scary to so many? The study of risk perception has found:

· Uncertainty raises fear. We are uncertain about this risk for two reasons. First, science doesn't have all the answers, about which foods are risky, and where they came from, etc. Second, any invisible/odorless/tasteless risk like this that we can't detect with our own senses is scary because we don't know all we need to know to protect ourselves. And in this case there is great uncertainty because of the unknown nature of the organism, and the difficulty in tracking down where it originated. That's a lot of unknowns, which make the risk scarier.

· If you think a risk can happen to you, it doesn't matter what the numbers say! Many risk communication experts (Gird Gigerenzer, Steve Woloshin, Lisa Schwartz) work hard to find clearer ways to help people understand risk numbers, as though that will make us think about those numbers more rationally, but if a risk is only, say, one in a million, but you think you could be the one, you are likely to worry at least a little, because your job is to keep yourself alive, not the other 999,999.

· High awareness increases fear. Subconsciously, the danger detection systems in brain gives extra weight to information that's coming in all the time, or that can be readily recalled. This "availability heuristic" then feeds on itself in a positive feedback loop (what Cass Sunstein has called 'Availability Cascades'). We pay more attention to information that could mean we are at risk, and the information media, in fierce competition to bring us information we want, feed this appetite, and feed our fears.

These are just three among many specific components of our affective/instinctive risk perception system that can lead to what in my book I call "The Perception Gap", the gap between our fears and the facts which can be a risk in and of itself. How so, in this case? There are a lot of people who aren't eating vegetables, any vegetables. That's not good for their health. Hundreds of thousands of people are more worried than necessary, and more worried than normal, and chronic worry (that lasts more than several days) produces the myriad damaging health effects of stress (including a weakened immune system, which makes us more vulnerable to the very bacterial infections about which people are worried in the first place). This outbreak will cost a huge amount of money, and damage the livelihoods, and lives, of thousands of people engaged in the produce and food industries across Europe.

Again, this is not a criticism that people are irrational about risk. No, this is not a purely fact-based way of assessing things, but that's not how we do it. Judging risk perception as irrational is irrational in and of itself, because it denies all that science has taught us about how inescapably instinctive/emotional the system is. But it is valuable to observe, using this current teaching moment, that the way we perceive and respond to risk can actually be a risk in and of itself. Understanding that, and understanding the specific elements that make a given risk more or less frightening than the facts alone suggest, is the first step toward avoid the dangers of the Perception Gap, and making healthier choices for ourselves and for society.

(This post originally ran on The Guardian)

 
 
 

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HUFFPOST SUPER USER
deminmo
just looking for answers
12:40 PM on 06/07/2011
David,
Google 1918 flu, Navy research facilities, germ warfare research and many others
and you will find that many super bugs these days are made to be more deadly,
including bird flu.
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10:24 AM on 06/07/2011
Do we need more evidence to show that no matter what steps are taken there is just no way we can insure a safe food supply without using harsh chemicals or fully cooking. We need to move forward and start with irradiation of our food to insure it causes no more harm to people. Irradition is safe, it is in use today and needs to be used more frequently.
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HUFFPOST SUPER USER
raker
08:02 AM on 06/07/2011
On one hand, we have the media trying to hype fear of everything. It is a staple of "sweeps months." We laugh every February, May and November when the local news has wall-to-wall stories of how your remote control, your dishes, everything in your house is dirtier than your toilet. "Is your baby's crying killing you?" Cash Cab is more edifying. Fear makes this silliness possible. Fear is toxic.

On the other hand, we have an under-regulated factory farm food production system that puts contaminated meat and produce into the food supply. People die wretched deaths from e-coli poisoning every year. It is perfectly reasonable to be concerned and cautious about e-coli contamination.

When I was a kid, the most toxic things in the house, the things you'd never let your child touch were in cans under the sink; today, it's the stuff in the meat drawer of the refrigerator. We should channel our anxiety into rage at politicians who've shepherded the degradation of our food supply. Demand regulation. Let fear propel us to demand change. Fear will save us. Three cheers for fear!
05:53 AM on 06/07/2011
And the media hyping any danger as a cataclysmic crisis helps a bit.
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HUFFPOST SUPER USER
David Rozgonyi
Writer and traveler
05:03 AM on 06/07/2011
From one who lives in Europe, I think it is more simple. I hear that certain veggies in certain states may give you a chance of a rather nasty disease, with complications ranging from a real bad week to permanent kidney failure to death. If removing these veggies from my diet for a few weeks can basically eliminate my risk of these, why not? I'm not so addicted to cucumbers or sprouts that I can't go without for a little while. Thorough washing is always done; so I've cooked tomatoes instead of having them raw. Big deal. When they've made some progress or it's died out, I'll go back to them. I will never give up my motorcycles because of how much enjoyment and use I get out of them, despite the high risk (mitigated as well as I can). But raw tomatoes? Yeah, I can skip those for a week. :)
Ana4
neutrino alert, just passing through
09:41 PM on 06/06/2011
This strain, mutation of E-coli is more dangerous than genetically modified foods?
What about the possibility that this mutation is DUE to genetic anomalies via "modification?" ???
Yes, fear can kill, but does anyone yet know that "frankenfoods" are safe? No, because it's too early to tell, and factory farming might be a likely reason that fecal matter contaminated the vegetable crop in the first place.
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05:38 PM on 06/06/2011
If anything, we should be more concerned with food-borne pathogens than we currently are. One theory - which I have found to be true for me - is that the plague of "irritable bowel syndrome" is nothing more than chronic low-level food poisoning spread by bad practices in restaurants and fast food chains. Try not eating that stuff for a couple of weeks and see if you don't feel much better. Everything you suspect about what goes on in restaurant kitchens is true.
HUFFPOST SUPER USER
deminmo
just looking for answers
04:39 PM on 06/06/2011
E coli can be manipulated into a more dangerous entity. It can also
be found where wildlife feed and can get into water supplies. This
E coli in Germany has been termed a "super bug" so I don't think
it occured naturally.
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HUFFPOST SUPER USER
David Rozgonyi
Writer and traveler
05:05 AM on 06/07/2011
Unfortunately, super bugs do occur naturally, quite easily. They are simply those bugs that we haven't experienced yet, like swine flu (new "super" flu) or bird flu etc, and we can't react to them properly yet. Like swine flu, once we get a handle on it physically, it becomes "milder". Give us 100 years more and I bet aids will be able to be handled by a normal immune system too. But bacteria and viruses evolve far faster than humans, and therein lies the rub.
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01:29 PM on 06/06/2011
What more reason do we need before we start insuring our food safety by irradiating our food? There is no method available to protect us from food borne illness. Our food would have to be cleaner than an operating room for this to become reality and it's just not possible to do without harsh chemicals or fully cooking food first.
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HUFFPOST SUPER USER
David Rozgonyi
Writer and traveler
05:05 AM on 06/07/2011
You can grow your own! ;)
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10:25 AM on 06/07/2011
Still you can't insure contamition from wild animals.
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RMankovitz
Researcher, inventor, entrepreneur, author
12:57 PM on 06/06/2011
This article does not make sense to me. My background is steeped in science, and I come to conclusions very different than the author.

The author had defined a %u201Cperception gap,%u201D as the gap between our fears and the facts. From my perspective, the perception for many is that the %u201Cfacts%u201D are not the facts at all, when it comes to research in the medical and health fields. Here is what others have to say about it:

Lies, Damned Lies, and Medical Research: 90% of Medical Research Is Wrong?
http://www.theatlantic.com/magazine/archive/2010/11/lies-damned-lies-and-medical-science/8269/

Why Scientific Studies Are So Often Wrong: The Streetlight Effect - http://discovermagazine.com/2010/jul-aug/29-why-scientific-studies-often-wrong-streetlight-effect

Correlation or causation? In research, bet on the former - http://latimesblogs.latimes.com/booster_shots/2010/02/correlation-or-causation-in-research-bet-on-the-former-.html

Peer review: a flawed process at the heart of science and journals
http://jrsm.rsmjournals.com/cgi/content/full/99/4/178

Instead of the perception gap, I encourage the Precautionary Principle:
http://en.wikipedia.org/wiki/Precautionary_principle

Roy Mankovitz, Director
Montecito Wellness
A research organization
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Cuyahoga
I asked Hank Williams, how lonely does it get ....
11:06 AM on 06/06/2011
Cattle are meant to be grass eater. They are now mostly fed corn and corn products and that greatly increases the e-coli problem. If the cattle were put back onto grass only, 80% of the e-coli problem from cattle would go away. I learned this from a PBS program shown last night on our corporate food.
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05:43 PM on 06/06/2011
Some of us have a much broader understanding of science, which - among other things - tells us that e. coli is everywhere, it's necessary, and it's not the problem. The transmission of e. coli is the issue here. PBS is cool, but it isn't a substitute for a real education.
06:08 PM on 06/06/2011
You make a valid point but so does Cuyahoga. Their valid point is, I think, that if you start messing with Mother Nature then bad things can happen. Jeez...didn't anyone see Jurassic Park?