Corona-blues: A Brief Reflection on the Challenges of Managing the Coronavirus Pandemic
That the new coronavirus has taken the world by storm is no longer a surprise, causing significant casualties worldwide as well as civil unrest and disrupting economies, with ever grimmer prognoses. Much has been said about both the humanitarian impact as well the myriad effects it had on the political, social and economic levels. From a healthcare perspective, one might expect the world’s most developed economies to fare far better than their developing counterparts. Yet a quick look at the numbers reveals a rather intriguing picture: out of the world’s over 13.5 million confirmed cases of contamination, over 4 million come from some of the world’s most developed economies, such as the United States, the United Kingdom, Italy, Spain, France, Germany and Sweden. These same countries account for more than half of the deaths caused by the virus. Of course, these are absolute numbers that we are talking about, but even if we switch to looking at relative measures, such as the number of deaths or infections per 1 million people, developed countries still rank at the top.
The bigger they are...
A more detailed analysis was carried out by Professor Cezar Mereuţă, resulting in a rather unsettling discovery, namely that 12 countries (less than 6% of the total number of countries) account for over 80% of the total deaths caused by the coronavirus. Of these 12 countries, 8 are among the world’s top 10 economies by GDP as per 2018 data and amount to about 73% of all coronavirus-related deaths. The author concludes that a) the pattern of deaths caused by the coronavirus is correlated with the power structure and hierarchy of the world, and b) that these 12 countries need to undergo an analysis of their medical infrastructure and the policies enacted to manage the pandemic to outline what could be done better in this regard. This is indeed surprising given that the world’s most developed economies tend to have high quality healthcare. Indeed, even if we focus only on the previously cited countries, the CIA World Factbook lists them as having some of the strongest figures regarding the sophistication of their healthcare systems, with expenditures on healthcare averaging over 11% of their GDPs, near-universal access to improved sanitation facilities, as well as an average of 3.5 physicians per 1000 and 4 hospital beds per 1000 inhabitants. There are several reasons why this has happened, of which are the focus of our article.
Much can be discussed about whether or not the figures invoked above are in any way relevant in light of the scope of the virus, or if the virus could have been contained even with the available resources. Given the fact that there have been some ethically sensitive debates on physicians being forced to choose whom to save in this outbreak, I believe it is rather safe to say that, in terms of medical infrastructure and logistics, none of the countries were prepared to face a crisis of this magnitude. However, pondering how much would have been enough would be a pointless exercise at this moment. With a virus of this contagion rate at large, it is inevitable that there would be a point where even the best-equipped state would find itself overwhelmed. Prevention and containment remain the best strategy while research for a cure is underway. Furthermore, as ABC News points out, there is no single, one-size-fits-all explanation, nor are we beyond any reason to doubt that the statistics might underreport the number of deaths caused by the coronavirus. That said, there are a number of common themes that can provide a good viewpoint on why even the countries with some of the world’s most sophisticated healthcare systems, well-represented democracies and highest levels of education among the general populace were hard-hit by the outbreak.
The fog of an invisible war
The most important cause for the ravages of the coronavirus is also the simplest and, unfortunately, the least satisfying: we do not know all that much about it. Despite the fact that the virus has been out in the open for over half a year, there is still so much we have yet to learn about it, and what knowledge we have gleaned in this time about its symptoms, healing rate, vulnerable populations and lethality has changed quite a lot and caused greater uncertainty. This is further compounded by the fact that the virus appears to be mutating into various strains, which does not help speed up research efforts, nor does it make the search for a cure any easier. Although this might look like stating the obvious, it is this very lack of knowledge which led to most of the problems we have witnessed to date.
First of all, not knowing at first what it was or how it manifested exactly meant it was difficult to mobilise the existing resources to effectively contain the virus by isolating infected people and caused a delay in producing a reliable strategy to test the population in order to better assess the spread and effects of the virus. Even today, there is some controversy as to the validity and accuracy of the tests used. As such, by the time it became clear that we are dealing with a grave issue, infected people had already had the chance to move freely domestically and abroad, thereby infecting several others who, in turn, had also travelled both domestically and abroad. This was made worse by the Chinese authorities’ attempts to withhold the extent of the contagion in China for fear of a negative economic impact which backfired in a tragic stroke of irony. Due to the initial lack of knowledge of the symptoms, its transmission, its incubation period and the medicine it can respond to, it was hard to tell how long a patient should be kept in a hospital unit, how to adequately protect others from the contagion, what people were at risk, how to handle people who were suspected of being infected, which led to the delayed response and, at times, poor coordination between medical institutions and public authorities. This also meant that tracing the movements of infected people in order to more accurately determine which zones were most at risk of accelerating the transmission of the virus was greatly hindered. Altogether, this meant that hospitals and physicians everywhere had little time to prepare for what came.
Secondly, in many countries there was a complete lack of administrative and legislative tools for public authorities and lawmakers in order to enact measures to control the situation. Simply put, there was no ready-made procedure on how to deal with this kind of pandemic. Unfortunately, this outbreak has provided most countries with the very first opportunity to reassess and refine their strategies for counteracting pandemics. In the absence of any solid knowledge of the virus, this could only mean one thing: trial and error until a proper strategy was uncovered. This was also hampered by an issue highlighted in a previous article, namely that policymakers had to contend with the issue of ensuring their response to the outbreak was not disproportionate with regards to the threat which, again, due to the lack of knowledge, was hard to accurately assess by professionals, let alone laypeople. Too strong a response in the sense of restricting people’s rights to contain the virus, the danger of which was not immediately apparent, and the population’s view of the governing faction would have soured over suspicions of using the virus as a pretext to exercise more power through restrictive measures. Too weak a response leads to the virus spreading and spiralling beyond the authorities’ ability to control it, mutating into more violent strains and overall posing greater risks of all kinds.
Disinformation, distrust, discontent
This conundrum was also brought about by the people’s own lack of knowledge regarding the virus, and their uncertainty made large segments of the population susceptible to all manner of competing opinions; on the one hand, many thought the virus was nothing more than a different type of flu that would come and go, meaning that they did not take seriously the recommended measures of self-confinement and physical distancing from their peers. On the other hand, several speculations circulated, some of which involved Bill Gates being the mastermind of the virus, or as an excuse for the implementation of 5G technology for perpetual surveillance. Still some more believe it to be one giant charade carried out by shadowy groups of interest. Amidst these allegations, the overall economic downturn affecting millions worldwide with dire prognoses, the mixed success of the containment measures and still no cure or end in sight for the virus, the population’s trust in public authorities dropped precipitously, with people beginning to doubt the effectiveness and legitimacy of confinement and distancing measures. The economic effects caused by the anti-pandemic measures greatly contributed to people’s discontent, as the hardships brought about by the coronavirus and the measures against it rendered life more difficult for sizable segments of the populations (e.g. unemployment due to businesses shutting down, salary cuts, the increased cost of essential goods and medical supplies).
Furthermore, a study by the University of Kent showed that people with a stronger collectivistic drive were more likely to comply with these measures than people with stronger individualistic tendencies, which can thus be extrapolated at a cultural level, where countries with a marked bent towards individualism faced greater challenges in instating their containment policies, thereby lending empirical support to a thesis stated in one of our previous articles. As many of the economically strong countries with advanced healthcare systems tend to also be culturally individualistic, this meant that their efforts to counteract the virus were hindered by their own citizens’ distrust.
In many cases, this growing frustration coupled with restricted opportunities to relieve some of the tension caused by the lockdown focused on a target to act as an outlet; the image of the virus, as stated, is to date quite fuzzy which gives rise to doubts regarding how dangerous it actually is, in spite of testimonies from survivors. As a result, it is hard for people to draw causalities between the current misfortune and the virus which is neither visible nor fully understood, while it is easier for them to see the enemy in the form of the public institutions who enacted those measures. The psychological toll of prolonged lockdown, economic uncertainty and the sharp interruption of the habitual way of life flared tempers; public disapproval ranged in its expression from disobedience to outright protests, with notable outbursts in France, Germany, the United Kingdom, the United States, Israel and Serbia. Most notably, the killing of George Floyd on 25 May 2020 by a police officer caused a powerful backlash against the US authorities, with latent resentments over racial issues, the perception of police brutality and a general perception of institutional incompetence surfacing in the form of violent protests. That the murder was caught on camera made for a much more powerful emotional impact.
Old habits die hard
Thirdly, the crisis has been heavily politicised the more the virus began to spread. In a time like this, politicians of all factions – both those in power and their opponents – should have put their grievances aside and worked together to ensure the most effective measures are taken to contain the spread of the virus. It was the time for them to remember that they serve the same common interest and that they ought to set an example for the citizens that collaboration and concerted action are indispensable to safely weather the crisis. So, naturally, politicians everywhere used the virus as ammunition to fuel their campaign against their rivals and turn the mayhem caused by the coronavirus outbreak into a fruitless rhetorical and bureaucratic slugfest. This led to marked delays in effective and timely action, while also exacerbating public distrust as well as overall economic uncertainty.
Finally, the search for a vaccine to the coronavirus has failed to provide thus far any viable candidate to stand clinical trials. The only medication the virus is known to respond to is Remdesivir, originally used against hepatitis C and Ebola. The antiviral medication shows promise as it apparently speeds up recovery time, which made demand for it increase; however, towards the end of June, the United States bought all of the Remdesivir stocks from its producer, leaving the rest of the world understandably incensed. On the one hand, one may argue this is perfectly normal market behaviour; on the other hand, one may question whether it is ethically appropriate to speak of market behaviour and opportunism in matters of life and death and a global pandemic driven by a virus which, by all accounts, is highly dangerous. Plus, given the unprecedented impact of the coronavirus recession and the sanitary crisis it causes as the affected countries’ medical resources are spread thin, this spells all sorts of bad news in terms of widening global economic inequality (as the countries who need the medicine the most would barely be able to afford it without major geopolitical and/or economic concessions), countries at risk of sovereign defaults and, in the more unstable countries, societal unrest and potentially civil wars.
As far as the quest for a vaccine goes, the world’s most important research centres, laboratories and universities are hard at work to find a cure, but, to this day, their efforts have not yielded anything remotely feasible. It is worth noting, however, that there is a markedly low level of international collaboration between these research centres in their search to find a vaccine, and it was only on 15 July 2020, more than six months since the virus began to spread internationally, that a significant step was made towards global collaboration. While we may concede that there is a certain tactical merit to each centre pursuing an independent thread of research as more options can be investigated simultaneously, the splintered, decentralised focus of the research also hint towards a geopolitical overtone: whichever country would be the first to find a viable vaccine for the coronavirus would gain immense prestige – both diplomatically and academically – as well as a not inconsiderable geopolitical leverage in the form of the vaccine itself. Not only that, but if we consider this along with the US move to buy all the remaining Remdesivir supplies and China’s attempts to conceal the truth about the onset of the virus in its early phases, this serves to further highlight the basic geopolitical reality of each state’s prime imperative to look out for itself first and foremost; it is the geopolitical version of the prisoner’s dilemma.
Of shadows and silver linings
In the end, it was a combination of the general lack of knowledge, distrust, political (and geopolitical) bickering, economic discontent and disruption, disunity and uncoordinated action that contributed to the virus becoming the planet’s number one cause for concern. Whatever statistics and rankings we can peruse regarding each country’s medical infrastructure and resources, in the end the decisive factors were timely action, fluid coordination and cooperation, as well as the sanitary culture of the citizenry (habitual mask wearers in East Asia fared best). Where these were present, the brunt of the crisis was met with better preparation and recovery was easier; where they were lacking, all those numbers became meaningless and the pandemic struck harder. In hard times such as these, it is perhaps merely human nature to seek solace and safety within the group one associates most closely with at the expense of the benefits of wider collaboration; it may also be why, in such times, the darker side of humanity emerges, and people vilify and demonise those they deem as belonging to “inimical” or “harmful” groups, hence the sharp increase in manifestations of racism and xenophobia fuelled by the pandemic as people of different races and ethnicities are used as scapegoats and outlets for the ire of others.
The damage caused by the coronavirus – economically, sociologically and psychologically – is likely to endure even if a vaccine is found. For all we know, assuming we will have this vaccine, it may well take a good two, maybe three years at best for life as we know it to go back to what could be deemed “normal”, and even then it is likely that a certain measure of caution and suspicion will persist for a few more years, the exact number of which may vary by country. If a vaccine is not found, our best bet is to hope that the virus does not mutate into more aggressive and deadly forms, and that stronger medicine will be available to alleviate symptoms and enhance recovery. In this grim scenario, we will be forced to heavily reconsider the definition of normality for the long run, with everything it implies in terms of economic activity, entertainment, interpersonal relationships, education etc. Let us hope this will not be the case.
Photo Credit 1: Business photo created by master1305
Photo Credit 2: Business photo created by master1305