Trying to make some sense of the Covid-19 pandemic

In times of stress, I turn to writing as a way to process and gain some semblance of order.  After the 9/11 attacks, I started a file labelled “World War III.” This didn’t fully come to pass, although we are still fighting in Afghanistan nearly 20 years later.  Since then, I have focused more on the harm and prospects of catastrophe from climate change and other aspects of life in what is now being called the Anthropocene.  In regard to either the war on terror or climate change, I have tried to get a sense of just how bad these situations are, and so again now with the COVID-19 pandemic.  As we approach the 50th anniversary of Earth Day, what might have been an opportunity to redouble our efforts on behalf of saving the planet, has instead found us in the midst of the unexpected.  The randomness of evolution and viral mutation, zoonosis (this year’s vocabulary word, meaning the transfer of disease from animals to humans), the contingency of life, has again become readily apparent.  It is a time for the serenity prayer, a time for helping each other out, and a time to reflect and, for me, to write.  The realities change so rapidly that what I have to say here will be undoubtedly be out of date in a week.  What the world looks like in a year?  Well, we will see.  On March 13th I was in Chicago visiting friends, thinking I might be heading south to New Orleans.  By March 15th I was back home and scrambling to get classes online.  In the meantime, this is one attempt to make some sense of the past month.

What, in timely fashion, Karen Hirschfeld terms the “microbial insurgency” has arrived.  Like fugitives from the law (of nature), we hide away in our compounds, hoping the invading viral commandos don’t find us, as even ISIS tells its commandos to avoid COVID hotspots, and the mighty U.S. aircraft carrier Teddy Roosevelt has to evacuate its crew, with a third of them infected with the virus.  Everything from terrorist attacks to traffic and air pollution are down, and we are in the midst of another historical “boundary event” marking the transition from the post-9/11 era into the post-COVID-19 age (see Ben Rhodes, 4/4/20 article in Atlantic).  Hirschfeld writes “Since the end of the Cold War . . . there has been a dramatic reconfiguration of governance in many parts of the world, and these macro-level changes are accelerating ecological destruction and fueling armed conflict in ways that will reduce the range and effectiveness of public health methods and prevention technologies that were successful during the 20th century. The combined effect of these institutional and environmental changes will increase global pandemic risks in the Anthropocene, even for infectious diseases that are easily preventable today.”  To this we can add that many of the same dynamics that have ushered in the Anthropocene and climate change are contributing now to the pandemic (Vijay Kolingavadi, 3/30/20 Op-ed in Al Jazeera).

Thus the pandemic is not so much a manifestation of the Anthropocene per se as it is a manifestation of the vulnerabilities of  an increasingly interconnected, hyper-mobile, urbanized global system.  This increased level of human mobility and trade and the increased disruptions of wilderness areas (thus bringing more humans into contact with novel pathogens) can lead to the rapid spread of a virus, if it has the right characteristics.  COVID-19 has that set of characteristics—airborne and deadly, but not too deadly.  As the global population has sky-rocketed, humanity has come to constitute a very inviting set of 14 billion petri dishes (our lungs), all connected by the dense web of pathways that constitute globalization.  Once the lung-loving virus makes the jump into the human community crammed together in cities and coughing on each other, then it is off to the races.  Given how much more closely we now bump up against the natural world (to the extent that there is even any boundary at all), the chances for new infections likewise increase.  As invasive species have devastated native species in ecosystems around the globe, the Corona virus now constitutes humanity’s “invasive species.”  We have crossed a tipping point of sorts, as humans now constitute their own kind of “mono-crop.” Lacking biodiversity, we are opened up to biological attack, just as the huge mono-crop fields of corn, soybeans, urban elm tree forests, and cotton are so susceptible to pathogens.  We have already been living in what Anna Tsing has called the condition of precarity and this has only added to this sense that we live a “life without the promise of stability.”  The pandemic has led to the latest “hockey stick” graph, that will peak and eventually recede (and in some places has already done so, at least in the “first wave”).  This is then overlaid on top of all the other such graphs of the “Great Acceleration.”

(As of Apr. 18th, new deaths in the U.S. have finally begun to level off, at least for now.  It remains to be seen what kind of “second wave” happens once we start to gather again and go back to work.)

With inadequate social safety nets and public health infrastructure, we now face a microbial foe without the adequate tools or institutions to respond.  The most at risk are those living at the margins in countries with inadequate public health systems.  China now has one of the lowest per capita rates of infection, a remarkable feat in some sense given that it was the site of the first outbreak, and reflective of the high level of state control and powerful norms around individual sacrifice for the public good.  The U.S., in contrast, has seen the disease run wild in its urban centers, hitting communities of color—who already bear the burdens of many chronic health conditions—particularly hard.  This is the result of some abysmally poor choices, ineptitude, and lack of preparation on many levels, most notably from the Trump Whitehouse.  But the roots of this problem go much further back, and reflect decades of underinvestment in public health and social safety nets.  We should point out, for instance, that the $650 billion annual defense budget has almost nothing to offer us in this “war” (witness the woefully inadequate role of the naval hospital ship in NY harbor).  Although this is nothing new, that obscene amount of spending seems woefully misplaced, never more so than now.

Putting this into some kind of perspective

What constitutes a crisis?  (Well, I guess we know now.)  How bad is this one?  How does it compare to other problems out there?  For those, like my sister, working on the frontlines in the healthcare system, this is all to scary and real and immediate and personal.  For almost everyone, this is indeed frightening.  For all those who have lost family, friends, or loved ones, there is, of course, sorrow and loss, as with any deaths, particularly those that come in the midst of such uncertainty.  Listening to first-responders in New York City will lay to rest any doubts that this is far from a regular flu season.  These recently released graphs of the higher than normal number of deaths in the hard-hit areas, certainly show that this is a deviation from the norm.”  For instance, as shown in this graph of deaths in Spain so far this year, normally there might be around 8,000 deaths in a week, in late March there were almost double that number.  This rapid spike is what has overwhelmed the healthcare system and hospital capacity.

Viewed from a perhaps overly philosophical standpoint, in any given year around the globe about 60 million people die (and, we should note, 130-140 million are born).  Currently, lifestyle-related diseases (like heart disease and diabetes) are the leading cause of death, and, for example, 1.3 million people die in car accidents each year.  We consider these deaths normal—as non-events, or at least certainly not crises.  Almost none of these deaths made headlines in 2019.  The typical annual flu kills around 250,000 – 500,000 globally.  The Our World in Data site reports that “the annual number of deaths from influenza are around 400,000 deaths per year . . . [or about] 0.0052% of the world population – one person out of 18,750.”  As of April 18, COVID-19 has killed 150,000, with the eventual death toll still very much uncertain.  The University of Washington’s Health Data site (very useful, if grim, reading), predicts around 60,000 COVID-related deaths in the first wave in the U.S. (global figures are much harder to predict, given the lack of good data about the situation in many countries).  Should the virus take hold in India or Nigeria (densely-populated countries with few ICUs or ventilators), the number of global deaths could quickly start to rise again.  In the U.S. the death toll could be as low as 40,000 or as high as 140,000—pointing to the importance of sticking to current efforts at social distancing to keep that number as low as possible.  How does this compare to the annual flu outbreaks and to the 1918 flu pandemic?  In the U.S. the annual flu seasons leads to between 10 – 60,000 deaths.  Even in comparison to the low estimate for the death count of the Spanish flu (17.4 million) this pandemic, more than a century ago, caused a death rate that was 182-times higher than today’s baseline. This amounted to a total of somewhere between 1-4% of the world’s population at the time.”

As but one point of comparison, total deaths in World War II were around 60 million (20 million soldiers and 40 million civilians).  Today, absent the draconian social distancing practices now in place, according to the epidemiologists at the Imperial College London, COVID could have infected up to 7 billion people and led to 40 million deaths—a staggering figure by any measure.  Is this an over-reaction? alarmism?  We are currently far from this level, but that is almost certainly only because of the global lock-down now in place.  Opening up the economy again would undo that certainly lead to another rapid spike.  Numbers like that should provide enough motivation for us to put down any guns we might be tempted to pick up, and get the hell back into our houses and start sewing face masks.  Please.  As of April 18th, existing measures appear to have dramatically slowed the spread of the virus with the increase in global cases beginning to slow:

Another way to look at this is in terms of “Years of Life Lost” (YLL), defined as “the number of deaths multiplied by a standard life expectancy at the age at which death occurs.”  Similarly, Disability Adjusted Life Year (DALY) “is a health gap measure that extends the concept of potential years of life lost due to premature death (PYLL) to include equivalent years of ‘healthy’ life lost by virtue of being in states of poor health or disability.”  This site gives a variety of ways in which this can be represented and has helped me to get a sense of the relative burden of various diseases or causes of death (given that we’re all going to die sooner or later).  The death rate for humans is, after all, 100%.  The things we need to be concerned most about are those that lead to untimely deaths.  Although we do not have any calculations of the DALY for COVID-19, given that it tends to kill the elderly and those with pre-existing conditions, its impact in terms of the “disease burden,” will be relatively low compared to other conditions that disproportionately strike the young and otherwise healthy.  So, this is obviously a bad situation, and one that would be much, much worse if not for the all the current heroic efforts to limit the spread of the disease.

Although there are far too many unknowns and, if the past month has taught us anything it is that we should not get too confident in what the future holds, but it seems now that the total deaths from the first wave will not exceed one million globally, amounting then to something like 2-3 times the typical flu death toll, but a small fraction of those lives lost in the 1918 pandemic.  In 2020 we will likely have a slight increase in the global deaths (going from a total of 60 million dead in 2019 to, say, 60.5 dead in 2020), which is to say this is not the Black Plague (which killed off a third of Europe) or like the plague of diseases introduced to the Americas by the “Columbian Exchange,” which nearly wiped out the entire indigenous population of the Americas; so not World War III, but likewise not just another flu.  Unfortunately, the press and public discourse have a decided tendency to swing to one extreme or the other, viewing this in either apocalyptic terms, or brushing it off as nothing to worry about. It is somewhere in the middle, requiring a response proportionate to its severity. Is this any consolation?  Hopefully this might allow us to respond with an appropriate level of vigilance and concern, avoiding both the Scylla of paralyzing panic and the Charybdis of foolhardy complacence. Things are bad, could certainly be better, but also certainly could be worse.  We should be worried, and mourn the dead, and take this seriously and respond appropriately, and also know that life will go on, that there will be good work to do, and perhaps take some comfort in knowing that, despite this particular virus’ ability to damage our lungs, we humans are still very good at replacing ourselves.  Even COVID-19 won’t stop there from being something like 60 million more people living on the planet by the end of this year than when we started.

On denial, reality, and the partisan divide

Given the aforementioned number of young lives lost in things like car accidents, gun deaths, “deaths of despair,” and other preventable deaths resulting from poverty and structural or “slow” violence, it is strange that we respond so differently to these dangers.  All these deaths are bad and terrible losses, but we respond to them very differently.  Poverty and lack of adequate supplies of potable water and basic healthcare kill millions each year as well, mostly children, and yet this has come to be little more than “background noise” in the daily lives of most people, relegated to some brief mention buried in the paper or news feed.  Part of the difference could be that we accept car accidents as the price for the glories and benefits of mobility and speed (and that certainly is how they have been sold to us through the multibillion-dollar ad campaigns).  We accept deaths related to our unhealthy lifestyles (from obesity or smoking), since these are things we willingly choose to do (and, by extension, could choose not to do) rather than things that are forced upon us.  “Live free and die young from making bad choices!” would seem to be the slogan.  A big part of why COVID-19 is a crisis and there is pandemonium could well be that this is just new and unknown, and is not something happening “over there.”  As such, it pierces the veil of willful denial of our mortality, the existential dread lurking always in the deep recesses our mind and which we manage to ignore during normal times.  The 60 million deaths that normally occur each year are cognitively quarantined; they rarely make the headlines, and, if they do, it is in terms of the deaths of “others” about which most of us (particularly the privileged classes) don’t really have to worry.

In the 19th Century, communities facing typhoid or yellow fever, thinking that these diseases were spread by poisonous miasmas or “foul air,” would fire cannons into the air in the vain hope that this would somehow drive away the pestilence.  In a move that seemed to share some of the same causal logic, the April 17th “patriotic protests” in Michigan, Minnesota, and elsewhere by gun-toting Trump supporters was a particularly troubling and vivid manifestation of the political right’s response to the crisis, and speaks to this right-wing populist response to a range of “new realities.”  Would those guns allow them to magically drive away the corona virus?  They see the government as the proxy for the virus itself, eliding the difference between the message and messenger.  There is fear and anxiety there, and a particular way of responding to that fear.

A fair amount of this kind of response comes, I think, from the fact that the pandemic is layered now on top of a number of other longer-term trends that are particularly unsettling for those whose way of life is grounded in the mainstream culture constituted by things such as the manufacturing economy, blue collar jobs, and heteronormative patriarchy.  This demographic, which forms a large part of the Trump base (and in similar ways the support for other right-wing populist governments in Brazil, Hungary, the Philippines, etc.), have already experienced a decline in their standard of living, and have a sense of foreboding about what the future portends for their basic values and way of life.  As Arlie Hochschild puts it, they are “strangers in their own land.”  For American Indians, African Americans, and other marginalized and historically persecuted peoples, this is nothing new (see Kyle Whyte’s writing on Colonial Déjà vu).  No one knows better the havoc that a new disease can wreck than the original inhabitants of the Americas.  Again, these marginalized communities of color are bearing the brunt of the COVID pandemic, with African-American communities having infection and death rates close to triple those in the population in general.  The response in these communities is not one of willful denial, but déjà vu and long familiarity with suffering.  And it is these communities that should be the highest priority for healthcare resources.

But conservatives and Fox viewers have consistently downplayed the threats (see Dave Roberts Vox piece on the partisan differences in response to the pandemic), and continued to deny the seriousness of the crisis, as they have with climate change (and problems of poverty, mass incarceration, and economic inequality).  For conservatives and those attached to the “traditional” values of white, heteronormative patriarchy, property rights, and free market capitalism, the future is troubling.  Resonant of Reagan’s turn to the supposed glories of a mythic American past, they want America to become “great again,” and somehow believe that by ignoring the trends and pretending that we can go back in time that they can make it so.  But the trends, far from being some left wing conspiracy foisted upon the public, are the result of global economic, demographic, and technological changes that are clear and evident—increasing diversity, erosion of patriarchy and heteronormativity, challenges to traditional religious authority by secular cosmopolitan liberalism, the digital revolution, shifting economy leading to more unemployment and underemployment, climate change and mass extinction, and the beginnings of our transition away from fossil fuels.  In the face of these facts, the only way to engage in the cognitively conservative practice of denial is to deny science itself.  So, rather than reading the writing on the wall and adapting to changing cultural norms and environmental realities, many on the right now create their own social-media-fueled alternative facts and reality.  Belatedly, the corona virus has come to constitute a kind of scientific reality that even Trump cannot ignore, even though he continues to want to do so and keeps tweeting out wishful thoughts that imply that none of this really happening.

Eventually climate change, and the other demographic and cultural shifts at work, will get to this point of crisis, requiring action as well.  We are not there yet, but we are getting closer, and can take some solace in the fact, that for every gun-toting white guy calling for “freedom!” there are hundreds more who recognize the seriousness of the current situation and are responding appropriately to minimize the loss of life, gaining new-found appreciation for the sober facing of facts, and helping each other out.

What might come out of this pivotal moment?

As happened during 2008 with the so-called “Great Recession” (which now pales in comparison to what we’re heading into now), we are seeing a rare downturn in carbon emissions as the carbon-fueled global economic freight train temporarily hits the breaks, and people get a little feel for what a post-carbon world might feel like, at least in certain respects (see Gambuto’s Apr. 10 piece in Medium).  Nothing short of a pandemic (or similarly dire global crisis) otherwise seems to have the ability to slow down the fossil-fuel-chugging consumer capitalist juggernaut, further highlighting the urgency of decoupling our economy from fossil fuels and other sources of environmental damage.  We are now in a moment of uninvited disruption that opens up both dangerous and potentially hopeful and game-changing new ways of living.  If Trump, Bannon, & Co. came into office with a disruptive agenda, we are certainly in a moment of unexpected disruptive change now.  This is one of those rare moments of potential transformation, and everyone will be scrambling to shape what comes out of this.  As happened after 9/11, we can expect about a year or so of heightened public spirit, followed by a return to something approximating the status quo ante.  But this could help bring about some longer-lasting changes.  For those not in the confused vortex of anger, blind faith, and mindless denial, there is likely to be some greater respect for scientific expertise and our shared responsibility for each other.  The social media-fueled “post-truth” era we live in won’t be killed off by the virus, with trolls, propagandists, and partisan bloggers still able to sow seeds of doubt and discord; but it may lose a little steam.

On the more mundane level, it appears we will have an increase in online and virtual work, travel, and teaching now that we have all gone down that rabbit hole, gotten somewhat accustomed to it, and seen some of the value in it (as well as its serious disadvantages).  The separation and isolation (bowling alone and streaming our movies in the privacy of our living rooms) that has eroded our store of social capital in the past decades is being accelerated.  This will be another challenge to take on as we get back to being able to work and socialize in person.  Perhaps having seen more clearly how impoverished our lives have felt during the “stay-at-home” period, we will have a greater appreciation for the rich communities to be found under the cosmopolitan canopy.  In all this, there is room for us to shape the world that comes out of this.  We have a moment of pause here, have had to give up many things we normally took for granted, and have now the opportunity to reclaim and strengthen those parts of our communities and lives that we perhaps see more clearly now as important.

At a minimum, with some leadership and any luck (and depending a great deal on the outcome of the U.S. election in November) we should see some meaningful improvements in global health preparedness (particularly needed in poor areas), a “medical reserve corps,” a ready supply of face masks and other PPE, testing, equipment (like ventilators), and more lab and hospital capacity.  We won’t be able to avoid future outbreaks, but we can at least do our due diligence in being prepared with increased global coordination, if not actual a working global public health system.  This would include heightened monitoring of future bio-threats and infectious outbreaks with varying levels of social distancing called for to modulate the spread of any future pathogens.

The current crisis highlights the need to increase our resilience, so that we are better prepared for the next one, and for the impending crises that will accompany climate change and the range of other global stressors, as population grows and resource scarcity and cost of living continue to increase.  Andrew Zolli (who spoke at Augsburg last year) outlines some of the characteristics of systems and people that can respond to shocks while maintaining core values.  Characteristics of resilient systems include real-time, accurate monitoring; early response systems; informal networks and systems redundancy; and a rich diversity of ideas, sources, species in any given system.  Successful navigation of crises such as this one, Zolli argues, requires deep trust and authentic relationships, and “translational leaders”—those that weaving together the wisdom and resources in our communities and develop adaptive forms of governance.  We need to collaborate in response to a crisis and need to think about the “connected whole” (inter-scalar) living systems as models of resilience.  Whether we come out of this crisis with more resilience or not is yet to be determined, but if there was anything we should be focusing our policy making now, it would be this.

The economic downturn has “exceeded expectations” (to the extent that there were any expectations to begin with).  To have oil trading at negative $40 a barrel is certainly “novel” as well!  The lack of resilience in the economy, trade, and vulnerabilities of so many people living on the fringes of the economy has been striking, to say the least.  It’s complicated, and there is much more that could be said about this, but the roar of the global capitalist machine has ground to near halt, brought low by a microscopic bundle of RNA.  Lo, how the mighty have fallen! as the usual titans of industry come back begging for multi-billion hand-outs from the government trough once again.  Were this pandemic on the order of the worst-case 1918-version, the economic consequences are hard to imagine.  But suffice it to say that a more resilient set of economic communities, with great local self-sufficiency and much stronger social safety nets, will also have to developed coming out of this crisis.  We should be working hard on building an economy that could weather future such pandemics (or other disruptions).  Should we muster the political will and groundswell of grassroots support for such efforts, we could really move the needle here on creating an at least marginally more equitable economy.  One can dream.

But, as Naomi Klein argues, as in past periods of disaster, capitalist imperatives remain and there is also likely to be a gold rush in health-related and other disaster profiteering.  This can be countered by a corresponding increase in government power, both to restrict this economic opportunism and exploitation, but also to improve public health and social safety net infrastructures.  With the authoritarian tendencies in many capitals around the globe, there are already signs that the crisis is being used as a pretext for a ratcheting up of state power.  The tracking and surveillance of the general public’s movement and health, such as is being done via smartphones (although understandable from the perspective of public health) begins to look downright Orwellian.  An army of big brothers is watching.  Big data, big data companies, and the national security apparatuses around the globe are rapidly gaining access to a rapidly expanding torrent of data that can be put to all sorts of uses, either benevolent or totalitarian.  On this front, vigilance and care for our freedoms and democracy are more than warranted (thought strangely the libertarian right seems less concerned on this front).  So, we should all take care, rest up, stay safe, stay connected, and get ready to do all we can coming out of this painful period to realize whatever good can be built up from this period of disruption, and guard with all the vigilance we can muster against the potential for the kind of troubling developments that likewise lie waiting, like a political corona virus, ready to spread among an unwitting and complacent public.

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