Censorship Doesn’t Just Stifle Speech — It Can Spread Disease

In October, Saudi Arabia will host millions of travelers on the hajj, the annual pilgrimage to Islam’s holy sites. The hajj carries deep meaning for those observant Muslims who undertake it, but it also carries risks that make epidemiologists blanch. Pilgrims sleep in shared tents and approach the crowded sites on foot, in debilitating heat. They come from all over the world, and whatever pathogens they encounter on the hajj will travel back with them to their home countries. In past seasons, the hajj has been shown to foster disease, from stomach flus to tuberculosis or meningitis.

The Saudi Arabian government has traditionally taken this threat quite seriously. Each year it builds a vast network of field hospitals to give aid to pilgrims. It refuses visas to travelers who have not had required vaccinations and makes public the outbreaks it learns about. This year, though, the Saudis have been strangely opaque about one particular risk—and it’s a risk that has disease experts and public-health agencies looking to October with a great deal of concern. They wonder if this year’s hajj might actually breed the next pandemic.