The scale and speed of the Covid-19 disease are unsettlingly apocalyptic. A now-familiar question is: have you ever seen anything like this in your lifetime? The short answer is no.
I have lived through the assassination of John F Kennedy when we were sent home from school; the 9/11 event, when business meetings were suspended; and the original SARS, which all look like child’s play now.
This one has rattled us. We are forced to face our impotence and the vapour-like nature of our life. Neither money nor status can protect or insulate us. Our pride is crushed, and we see our handiwork threatened by insolvency, if not our death.
Crises usually unearth three large problems: organisational chaos, media pressure and inaccurate information. Few organisations are ready to spring into action when this type of incident happens.
The significance of this threat was downplayed by many governments. Some had forecasted it while others dismissed it as not being imminent.
Our sense of vulnerability is heightened by the jostling of the mainstream and social media, as we observe the players in real time. This Covid-19 crisis is especially dynamic and chaotic, presenting itself as an uncertainty requiring urgent action.
Have we considered the number of organisations that must be coordinated and the fact that this cannot be controlled in a top-down fashion? The margin of error is potentially huge. This is an hour-by-hour high-wire exercise, involving sleep-deprived participants.
Yet in these crises, trust is of profound importance. We are literally dealing with life and death issues that may affect each of us directly. More information may be interpreted as being transparent, but it can heighten paranoia and increase the risk of the ‘blame game’ between our races and classes.
The health professionals need these data more than the news reporters, who may, through no fault of theirs, misinterpret. Should we revisit the rules that govern patient privacy? What is the correct balance?
The grilling by the reporters in the press conference after the first reported death and the visible frustration of Dr Roshan Parasram brought to mind the disdainful remark from Michael Gove, a key ally of Boris Johnson, that ‘the people of this country have had enough of experts’. We know how that ended.
To beat Covid-19, experts are not only necessary but important. In a health crisis, doctors become sleuths. Nothing is certain. An important life lesson: the more you know, the more acutely aware you become that you do not know everything.
You make decisions based on an assessment of known facts and projections. The stakes are high, and everyone is guessing. Some use statistics and medicine and others, the closest conspiracy theory.
The chief medical officer for England, Professor Chris Witty, schooled those who argue for a state of emergency, saying: “… everyone knows that the kinds of things you consider—reducing mass gatherings, school closures—may or may not be appropriate for this particular virus. We don’t know yet. We need to find out what is the evidence base like? What is the social cost of this … the implications of that are non-trivial … we need to think that through.”
Dr Anthony Fauci reported yesterday that in ‘intensive’ meetings with US President Donald Trump, he managed to get the planned NY quarantine off the table in favour of what he called a ‘strong advisory’ (the stay at home/cutting non-essential travel approach).
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He drily remarked: “And the reason for that is that you don’t want to … create a bigger difficulty, morale or otherwise, when you could probably accomplish the same goal.”
While we accuse Dr Parasram of possibly hiding information, the evolving nature of the disease brings new revelations. We hear that a baby died, contrary to expectations. We now hear that in the ICU units in the hospital environment, the aerosol-generating processes can make the virus airborne.
Were the global authorities hiding? Discovery of new facts is patient work and requires all to approach with an open mind. Dr Parasram was at pains to tell us that they were piecing together the data. We chose to ignore that.
The social costs to be paid to corral this crisis make it a political decision. Indian Prime Minister Narendra Modi has belatedly acknowledged this. Those who argue for a state of emergency are those among us who are better prepared to face that kind of lockdown.
We are not all equal. Some of us buy food daily. Some of us cannot tell our employers that we cannot come to work.
The Ebola history is instructive: politics breeds distrust that leads some to heed fewer precautions and to be less compliant, causing deaths (Blair et al, 2017). The current US situation confirms this. People will die because of their faith in their political leaders since they would believe that the other side is lying.
A lack of community spirit reduces our ability to act selflessly. This is a natural outcome of the erosion of trust in our institutions and in each other. Every decision is questioned and poisoned by the characterisation of the other as ‘evil’.
In the melee, seeds of doubt are sown about the advice provided by medical professionals. We criticise the government without a pause and without acknowledging their dependence on the professionals.
In this thankless job, both the professionals and the government must put public safety first, even as others swing from ‘too much, too soon’ to ‘too little, too late’ without a twinge of regret and with brazen effrontery. The professionals have to prepare for the worst while others seek to score points.
We lose sight that it takes a disaster to prepare for a disaster (reading about driving does not make you a competent driver). governments have to make the best decisions on the run, with incomplete information. Mistakes will be made, but a lack of charity is distinctly unhelpful.
The objectives must be to bring things back to normal and preserve—not destroy—even with the real risk of folk running to the courts. Compassion has to be run by logic to prevent costly precedents.
Taking off our political lens, how are we doing, Trinidad and Tobago?