Rage and Response: How Epidemics Spark Public Outrage

A few weeks ago I spoke with my colleague Declan Walsh, who was reporting from the heart of the Ebola outbreak in the Democratic Republic of Congo. He recounted the intense anger he witnessed towards many healthcare workers who were endeavouring to contain the crisis aliment .

This scene echoed what I saw in Germany during the COVID‑19 pandemic, where opposition was frequently directed at those trying to protect public health. Across the country, weekly protests against restrictions erupted, ending in violence on several occasions, and even a gas‑station attendant was killed after urging a patron to wear a mask.

So why do health emergencies provoke such rage? Today’s colleague, Sheri Fink, will explain why anger towards medical professionals is a century‑old challenge that many societies continue to wrestle with.

The first attempts to control Ebola in the Democratic Republic of Congo were fraught. Patients fled a treatment centre after community members set the facility ablaze, and residents even assaulted a burial crew, forcing its members to surrender a coffin.

At first glance, one might attribute such unrest to a lack of public knowledge about disease transmission. Yet the hostility that arises during epidemics spans centuries, continents, and socioeconomic conditions. Throughout the coronavirus pandemic, medical staff worldwide received both applause and death‑threatening backlash; some people denied the existence of COVID‑19 even as the disease claimed lives.

Experts argue that outbreaks trigger a triphasic response. Initially, denial of reality and refusal to adopt preventive behaviours prevail. Next, the public demands explanations, often scorningly blaming individuals, groups, or the medical establishment. Finally, actions—both violent and constructive—emerge.

In the Democratic Republic of Congo, when armed community members remove a child from an Ebola treatment unit, observers might view the action as irrational, ill‑ogical, and anti‑science. “This is about far more than mere disbelief,” says Megan Schmidt‑Sane, an American medical anthropologist briefed on the current outbreak. “It concerns history, culture, politics, and the way families care for sick relatives.” Only by recognising these underlying drivers, she and other scholars contend, can such resistance be navigated.

Disease breeds distrust

Before the germ theory of disease was widely accepted, humans sought explanations for recurring waves of illness and fatality. In 1349, during the Black Death, European societies blamed Jews, Catalans, and other minority groups for poisoning wells, leading to mass massacres.

Even after scientific progress demystified pathogens, social divisions over the nature and control of disease persisted. Today, we can image the smallest viruses and decode their genomes, yet profound uncertainty remains about how they emerge, spread, and decimate populations.

Conspiracy theories spread more rapidly in the age of digital media, but their roots run deep in epidemic history. Samuel Cohn, a medieval history professor at the University of Glasgow, documented how, during 19th‑ and 20th‑centuryฤศจ cholera outbreaks, impoverished populations in New York City, tsarist Russia, and other locales devised similar narratives blaming elites of a intent to cull the poor. Such mistrust led to the killing of medical staff, the systematic destruction of hospitals, and the deliberate sabotage of treatment equipment. In some cases, governments themselves propagated blame: the Ottoman authorities endangered Armenians by alleging typhus spread, while the Nazis accused Jews of doing the same. In recent decades, modern data networks allow these malign beliefs to travel faster than the diseases they fear.

In the Democratic Republic of Congo, the prevailing mistrust towards health facilities stems from the disease’s rapid progression and incurability. Many patients entered hospitals seemingly healthy, only to deteriorate swiftly, amplifying fears of transmission.

“Medicine and humanitarian aid have historically been wielded to further external agendas,” notes Myfanwy James, a professor of international development at the London School of Economics. “Those enduring suspicions find their roots in explicit, historical injustices.”

Breaking through

Drawing on lessons from prior epidemics, health workers in the Democratic Republic of Congo are modifying burial customs to honour local beliefs while mitigating infection risk. They also relocated an isolation unit’s entrance to prevent patients from passing a morgue, alleviating community concerns.

These efforts demand painstaking work with uncertain returns. In just two months, new Ebola cases continue to climb faster than in any prior outbreak, and more than half of those infected die without contact from Ebola response teams.

Where health workers succeed in conveying the true nature of the threat, more residents seek assistance. As Julienne Anoko puts it, “When people realise the virus is killing them, they fear death and consequently come forward for help.”

Read Sheri’s full story here.

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