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Pandemic Times?

A pandemic like Coronavirus does not merely change the way we view our health; it changes many more fundamental assumptions that we make about our lives and asks confounding questions about things that we haven’t needed to think about for a long time.

In parts of Italy for instance, the explosive growth in the number of patients has overwhelmed the healthcare system to a point where doctors are having to choose who should be given potentially lifesaving treatments and who should be left to die. Wrenching ethical questions are being thrown up- who has more years to live, who is needed more by their family, who is more ‘useful’ to society?

The UK approach is radically different from that being pursued in most other parts of the world. The Chief Scientific Adviser for England, Sir Patrick Vallance is on record arguing that at least 60% of the population needs to contract COVID-19 in order to develop ‘herd immunity’ to prevent transmission in the future. The logic employed is that in any case, in will be impossible to prevent this from happening regardless of what actions are taken today. Strict lockdowns might work temporarily but as soon as these are relaxed, the coronavirus is likely to make a strong comeback, the argument goes. Once a majority of the population gets infected and thus becomes immune to the disease, then the virus loses its contagiousness and could get permanently controlled.

Apart from an extraordinary position to take from an ethical standpoint, it is an extremely high-risk bet for a number of reasons. It is all very well to want to protect the older and more vulnerable, but there aren’t that many practical ways of doing so. They reside in families and communities and are in many cases being looked after by younger caregivers. There is no easy way to isolate this group so as to protect it. Also, a fundamental assumption being made here is that getting the flu once confers immunity thereafter- and this has not yet been established definitively. While this is the dominant view, there have been a few cases reported in China and in Japan where recovered patients have shown signs of being re-infected. In time we might find out whether this approach was brilliant or utterly callous.

Apart from ethical challenges not faced before, there is so much that is unknown and unfamiliar. We do not have a way of treating this ailment except by controlling its symptoms and hoping to ride out the period of the infection. We don’t know whether temperature plays a role in slowing down the transmission of the virus. We don’t know whether the containment and mitigation strategies being deployed currently will work on a sustained basis. Once we allow travel and ease other restrictions, will the virus come roaring back or will it die out?  At an individual level, there is still great uncertainty that surrounds testing, the treatment of the virus, the need for hospitalization, the availability of requisite facilities in case one turns critical.

And then are things that we know but cannot comprehend. The progression of this epidemic takes place at a speed that doesn’t make sense to us. The human brain struggles to understand the concept of the exponential. When the number of people doubles every 3 or 5 days or grows a thousand-fold in 3 weeks as it did in Italy, the problem escalates from being marginal to devastating in no time. We understand linear growth; all the key concepts that we work with are based on the implicit idea that growth is a fraction of the base amount, and that things reproduce with civility and restraint. The exponential offends our sense of order, for it multiplies in multiples.

Such a rapid progression demands of us a reaction that seems utterly disproportional. What we need to do today is to act exponentially in reverse, to do a lot more than seems reasonable to our minds that are accustomed to think in a linear fashion. This is truly difficult for the kind of actions that have some chance of slowing down the pandemic are of a kind that disrupt our regular lives dramatically, which is why we are seeing so many countries struggle with taking the steps that many experts are recommending.

We are being asked to give up so much of what is essential to being human. Travel, meeting people for work or pleasure, shopping, eating out, even touching other people, surfaces or even ourselves. Any kind of contact with anything outside of ourselves is potentially contaminating. We need to retreat into ourselves and shrink our world dramatically in order to survive.

As the coronavirus is teaching us, what we know and can deal with is a fraction of what lies out there. Along with the benefits, the costs of human progress are escalating. The coronavirus is a product of human action, as are the problems unleashed by climate change. As we venture into new forms of technology that hand over even greater control to non-human intelligence, the danger of other ‘viruses’ catching us by surprise is only growing.

What the current crisis has done is to bring us face to face with is the thinness of our knowledge and the fragility of our way of life. We have created such an intermeshed and intricate structure that is poised precariously on a set of assumptions that we have become blind to.  We have taken our survival as such a given and based so much of way of life on that premise that a shock like this catches us completely unprepared. It takes very little, just a tiny microbe to make us rethink everything all over again. This pandemic is an opportunity for us to re-evaluate everything, and to set a new course for ourselves, The next few months will be crucial, but it is what happens once this threat is dealt with that will really shape our future.