Travis Chi Wing Lau //
To mangle Clausewitz yet again, was prophylaxis a continuation of politics with other means or were politics shaped by the imperatives of prevention?
In the lead-up toward the recent midterm elections, my inbox was bombarded by links from colleagues to a recent Fox News segment in which a former ICE agent, David Ward, claimed that members of the migrant caravan represented an urgent public health threat to the US:
“We have these individuals coming from all over the world that have some of the most extreme medical care in the world. They are coming in with diseases such as smallpox and leprosy and T.B. that are going to infect our people in the United States.”
The incoherence and outright falsity of Ward’s comments aside, these weren’t the only such concerns conveniently circulating before election day: Sidney Powell, on Lou Dobbs Tonight, similarly blamed this “invasion” of migrants for the current outbreak of acute flaccid myelitis (which she claims is inexplicably “causing polio-like paralysis of our children”), and right-wing magazine The New American ran the headline, “Will Migrant Caravan Kill Your Child—With Disease?” This xenophobic language of parasitism and infectious disease is all too familiar; we don’t even have to look back to the events of the Holocaust or the 1918 flu epidemic to see how metaphor becomes literalized. The recent responses to Zika and Ebola deployed the same inflammatory rhetoric framing immigrants as perpetual outsiders and interloping vectors of disease. Despite the global eradication of smallpox since the 1980s, false equivalences between infectious disease and foreignness remain viral.
While articles covering the recent Fox News interview mostly responded to its obvious xenophobia meant to fire up the right-wing voter base, what struck me most about Ward’s comments was his framing of the caravan issue in terms of three tenets: national security, public safety, and public health. Ward’s justification for increasing armed defense of the border involves an understanding of the U.S. as itself a body at risk: its permeability is a liability because its “ports of entry” can be easily exploited. For Ward, it’s not just that foreign bodies may enter; his anxiety is about a loss of control over these ports and the potential contamination of the U.S. national body as a result of migration—a fear of the national body being rendered insecure, unsafe, and unhealthy. These anxieties surrounding the porousness of national boundaries and individual citizens’ bodies has a much longer political and cultural history.
Since the nineteenth century, public health has been the means by which the state could govern the social body at a moment in which industrialization ushered in new forms of human risk. Medicalizing the nation as a physicalized entity composed of individual embodied subjects meant that the nation could be diagnosed, dissected, and defined. The British state came to view itself as the administrator of a social body, whose primary task was to oversee and regulate citizens who represented fleshly risks roaming through urban space. The rise of “surveillance medicine,” as David Armstrong calls it, involved theorizing and enacting strategies for risk containment that were justified as necessary for the reassurance and security of the greater public. In my current book project, I am interested in literary manifestations of these strategies of risk management and containment—what I term prophylactic fictions—that variously imagine risk’s relationship to the social body.
By framing the national population in terms of its bioinsecurity, or in terms of how citizens’ bodies are ever-vulnerable to biological threats for which there may be no cure or even palliative treatment, security states like the U.S. operate within a prophylactic paradigm. Characterized by virtual disaster modeling, tabletop simulations, and the proliferation of agencies like the Department of Homeland Security, this mode projects threat by highlighting the insecurity of bodily health in the face of diffuse threats like terrorism or global pandemics. Counterterror measures executed as positive public health initiatives—like Bush’s Smallpox Vaccination Program, or epidemic surveillance programs like BioWatch (which has installed air sensors in thirty American cities to provide early warnings for potential airborne biological threats) or FluNet (part of the World Health Organization’s Global Influenza Surveillance and Response System)—exploit civilian insecurities about unseen contagions that seem more and more difficult to diagnose, treat, and prevent. To put this tension in J. Peter Burgess’s words, “security is, in the end, reflexive. It is as much about those who live the threat as it is about the threat itself.” Because the members of the migrant caravan are marked as nationless threats, they are not afforded a right to health security, the security of the state’s fictions which might see them as bodies to be defended.
Biosecurity narratives, specifically those of preemption and prevention, are also unique temporal narratives. Brian Massumi notes that preventative measures operate by
acting on the time before: the time of threat, before it has emerged as a clear and present danger…. [P]reemption does not idly pose these problems concerning the nature of time, perception, action, and decision: it operationalizes them. It weaponizes them.
Massumi identifies the peculiar temporality of preemption as disrupting the linear unfolding of events and logics of cause and effect. Instead, preemption creates what he calls a “time slip,” which makes imagined futures palpable and material in the present. In order to act before threats occur, security’s anticipatory mode often conjures potential futures in the present through “imaginative techniques, creating visions of the future dangers so terrifying that they need to be warded off in the now.” This is Ward’s call to action, the scare tactics of epidemic emergency. By proliferating possible futures, such alarmist discourses of security have the capacity to create “alternative presents, or fictions, disguised as possible futures” both speculative and prescriptive. The consequence is precisely the disturbing dissonance we see now between radically different visions of American immigration and national identity.
John T. Hamilton, in his philological survey of security’s semantic mutations, remarks that if the “root sense of security names a state or condition where concern has been removed (se-cura), then we must grapple with the consequence that discourses of security continue to generate more and more causes of worry, including concern over the meaning and function of security itself.” While security affords nations the ability to act preventatively, preoccupations with security can produce, intentionally or not, the very threats they seek to identify and handle in advance. The affective mode of security is paradoxically an insecure one, ever likely to “generate more and more causes of worry, including concern over the meaning and function of ‘security’ itself.” Framed differently, security as the fantasy of total “freedom from care” hinges on insecurity because states and their vulnerable subjects cannot ever truly stop caring. Ever-changing risks to security prevent its stable definition, and its incoherence enables the state’s “bulking up of new forms of vulnerability within invisible spheres” to justify its surveillance and control.
In America today, then, there will always be another caravan, another MS-13, another prophylactic fiction, and another David Ward to peddle them.
 Contagion and the State in Europe, 1830–1930 (Cambridge: Cambridge UP, 1999), 2.
 https://www.mediaite.com/tv/fox-news-guest-claims-migrant-caravan-will-infect-americans-with-leprosy-host-issues-correction/; https://www.thedailybeast.com/fox-news-commentator-says-migrants-are-carrying-smallpox-a-disease-eradicated-in-1980; https://www.vox.com/science-and-health/2018/11/1/18048332/migrant-caravan-fox-news-disease-smallpox-outbreaks-vaccines-xenophobia; https://www.wired.com/story/calling-the-caravans-migrants-diseased-is-a-classic-xenophobic-move/; https://www.huffingtonpost.com/entry/brian-kilmeande-fox-friends-caravan-diseases_us_5bd70a85e4b0a8f17ef9e965
 See François Ewald, “Two Infinities of Risk,” The Politics of Everyday Fear (Minneapolis: U of Minnesota Press, 1993); Mary Poovey, Making a Social Body: British Cultural Formation, 1830–1864 (Chicago: U of Chicago Press, 1995); Elaine Freedgood, Victorian Writing about Risk: Imagining a Safe England in a Dangerous World (Cambridge: Cambridge UP, 2001)
 “The Rise of Surveillance Medicine.” Sociology of Health & Illness 17.3 (1995): 393-404.
 For more on Bush’s SVP and about my book project in progress, see https://medhumdosis.com/2016/11/28/anti-vaccination-and-bioinsecurity/
 J. Peter Burgess, The Ethical Subject of Security: Geopolitical Reason and the Threat Against Europe (New York: Routledge, 2011), 133.
 Brian Massumi, Ontopower: War, Powers, and the State of Perception (Durham: Duke UP, 2015), vii.
 See Massumi’s “Fear (The Spectrum Said)” (Positions 13.1 : 36) and “Potential Politics and the Primacy of Pre-emption” (Theory & Event 10.2 : 1–21) for further elaboration on the temporal logics of preemption and preparedness. Eugene Thacker has similarly described the perverse temporality of preemption: “Preparing-in-advance, getting-ready, ready-at-hand, watching-over, ready-to-act—this almost Heideggerian vocabulary situates the epidemic as an event, an event of infection, contagion, transmission, communication, vaccination …. Everything is centered around a certain relation to time, to prediction and predictability, forecasting and foresight—in short, an ‘epidemic time’ that will, in a sense, have already passed” (137). See his “The Shadows of Atheology: Epidemics, Power, and Life after Foucault,” Theory, Culture, and Society 26.6 (2009): 134–52.
 Joseph Masco, “Preempting Biosecurity: Threats, Fantasies, Futures,” Bioinsecurity and Human Vulnerability, eds. Nancy Chen and Lesley Sharp (Santa Fe: School for Advanced Research Press Advanced Seminar Series, 2014), 5.
 Lindsay Thomas, “Forms of Duration: Preparedness, the Mars Trilogy, and the Management of Climate Change,” American Literature 88.1 (2016): 164.
 John T. Hamilton, Security: Politics, Humanity, and the Philology of Care (Princeton: Princeton UP, 2013), 9.
 Nancy N. Chen and Lesley A. Sharp, “Introduction: Biosecurity and Human Vulnerability,” Bioinsecurity and Vulnerability, eds. Nancy Chen and Lesley Sharp (Santa Fe: School for Advanced Research Press Advanced Seminar Series, 2014), xxviii