Co-Written by K Rajasekharan Nayar, Muhammed Shaffi & Anant Kumar
When human beings face uncertainties, they invent justifications to overcome the anxieties that accompany them. The COVID pandemic is especially characterized by such a phenomenon which affected not just ordinary people but even the scientists and governments.
The science of the infection played a major role in shaping our response to the disease. It shaped not only the worldviews of the people but even the official responses including preventive actions. A large proportion of such science could be called as just speculations, assumptions and hypothetical statements based on available understanding. Some of them are also falsities in the name of science which would have induced panic among population.
The same applies to many aspects of the COVID 19 pandemic. The last two decades have seen an increasing number of Zoonotic infections, some of them already known and some of them completely new. It took time for ‘scientists’ to understand the science of transmission in many of these infections. We should expect the same story with COVID.
When Nipah was first reported in Malaysia, it was primarily transmitted through close contact with infected pigs which led to wide-scale pig-culling to stop the outbreak. While a few years later, when people reported exactly similar symptoms in Bangladesh, later confirmed as Nipah, confusion arose as there was no way to relate Nipah to pig-farming in Bangladesh. But then going backward, scientists knew the role of bats in producing the disease even in Malaysia. Bats were frequenting the trees near the pig farms. Scientists had identified the virus from those bats as well. But, it was not easy to link neither bats with the cases in Bangladesh through traditional epidemiological methods. Then we had social science coming to the rescue. Detailed interviews and field observations by anthropologists identified the missing link. Most of the people who were affected in Bangladesh had some link to index cases who all, in turn, had one thing in common. They all had a history of drinking date palm sap typically collected in clay pots that are attached to the trees. Nipah test for these samples turned positive confirming the route of transmission. Further investigations by epidemiologists and chiropterologists (those who study bats) confirmed that the bats transmitted the virus to the sap through its urine. That meant, the people were drinking sap mixed with bat urine! How the story unfolds. Years later, in 2018 when south Indian state of Kerala, where most doctors haven’t even heard of the disease, reported a mysterious illness, it took a few days for physicians in a private hospital to consider Nipah as a possible infection. Further investigations led to the source, the bats and possible routs of transmission included eating of fruits partially consumed by bats and using water from wells inhabited by bats.
For COVID, the understanding of the transmission dynamics also changed from the time we first detected the disease. From being an infection which was not considered to have ‘human to human transmission’, it became one of the fastest spreading human to human pandemic in a matter of few weeks. From being a classical symptomatology of fever, cough, and running nose, it transitioned to a disease with a widely varying and sometime very particular symptoms like loss of smell and taste.
Prevention and control measures of no diseases might have gone into controversies like that happened for COVID. Confusing, ‘unscientific’ and often misleading statements by people ranging from even heads of nations to traditional practitioners to movie actors, made the scene complicated. Decision of the US government to purchase hundreds of thousands of doses of Chloroquine, a drug which no scientific study has shown to be effective till now will remain a classic case in pandemic history.
The term ‘social distancing’ drew the ire of many including doctors, sociologists and politicians. Though classically defined as “keeping at least 6 feet (about 2 arms’ length) from other people outside of one’s home, avoiding gathering and staying out of crowded places”, even agencies like CDC have to re-write their documents either substituting with or adding the word ‘physical distancing’ after the wide spread discussion in news media about the ‘wrong message that the word may spread’.
Another major controversy was with the use of masks. WHO and most speciality physician groups still maintain that masks are not to be routinely advised for general public as an effective prevention measure. Instead, the focus should be on social or physical distancing, hand washing, and test, isolation and treatment strategies. However the media and social media erupted with discussion following the reports of a couple of papers from institutions with big names, saying that the virus particles can travel as far as 27 feet! This was without going into the merit of the paper, which even was criticized by the top scientist who lead the COVID response in the US as very misleading.
The arts and science of the pandemic is indeed novel like the Corona virus!
This is largely an unusual phenomenon in recent history when parents, grandparents, and children spending so much time together within their houses. This might have led to new familial relationships, understanding and responses including conflicts when children might have learnt new things about their parents and vice-versa during the extra ordinary length of lockdown time. It could be both positive and negative with respect to the family dynamics. The lock down and the confinement within homes initially were difficult. It led to considerable release of negative emotions which were addressed through the social media in the form of both panic-inducing and other messages especially through the WhatsApp and other social media platform. It appears that a lot of energy of the people was expended and this probably led to a fear syndrome. In all such situations, there is a tendency among people which is can be called as the ’not me’ attitude. It is a belief that the infection may not affect them and they are outside the pandemic circle or have nothing to do with it. The sudden rush of people on to the streets when there is some relaxation is partly due to this syndrome but also due to a need for ‘jail break’. This will be an important dimension to be controlled during future relaxation strategies. There is no doubt that helping the survived and those who lost the dear ones are important actions that governments should initiate even from this moment. The art of COVID also needs to understand the forms of emotional disturbances among the different age groups of people. The pandemic has also transformed the thinking and worldview of people when they started seeing others as potential carriers of infection. At many places, it led to a strong and stringent monitoring mechanism in Mohallas, housing societies and villages to watch and restrict the movement and behaviour of others. The pandemic has significantly influenced the social and psychological fabric of the society where everyone is fearful of getting infected despite the ‘not me’ syndrome. This ‘dichotomised worldview’ needs further scrutiny.
The politics in the case of this pandemic is closely intertwined with Arts and Science. International politics is a permanent feature of all such pandemics. This was extremely dominant during the Spanish flu. The name of Spain was wrongly added to the infection although it never originated there. Conflicts between several European countries were evident during that time and even China was also implicated during that time. This was also visible during the plague epidemic or the Black death of London at various time periods. In 1625, the Great Plague killed 40000 people in London. It is known that this originated from mice brought by ships from Alexandria in Egypt. In fact, many sailors in ships also died during the epidemic and a repetition could also be observed in the present pandemic as well to a lesser extent. It is officially estimated that about 69 thousand people died during the 1664 epidemic but unofficial figures place it as 100000 deaths out of a population of 400000 in London. It was believed that cessation of the epidemic was spontaneous and some even attributed it to the London fire. It is also a fact that during the epidemic, King Charles II and his court fled from London and did not return for many months. This time, it is the turn of Prince Charles and the Prime Minister who did not flee but got affecte!.
In the present pandemic as well, international politics is evident but this is focused on China and various conspiratorial theories are already going on regarding the role that the country played in spreading the infection. It is also interesting that the US, a close ally and business partner of China did not explicitly blame China for the current situation. It is a near certainty that Chinese goods and devices will not be able to find a market for some time. This is especially after the kits for the diagnosis of Corona virus in India were found to be faulty. The recent threat to suspend contributions to the WHO by the US is also a part of the international politics but it is an indication of helplessness and erosion of confidence. Political leadership is also an important issue during crises like these especially when people’s life at stake but these are also dictated by science.
The domestic politics has also played some role especially regarding decisions regarding preventive measures such as lockdown strategy etc. One or two states especially West Bengal did not initially support Centre’s advisories. Domestic politics also rides supreme within states between ruling and the opposition and this largely applies to transparency of data but the real politics is regarding a synergistic action between different levels and organizations in the society. At least, it is a great relief that not so much conflicts have arisen in many problem states in North India. Politics is a permanent feature of all relief and rehabilitation measures in India even at the time of natural hazards and tragedies. In the case of COVID as well, this is going to recur especially during the post-COVID period. Bringing back several lakhs of immigrants and travellers stranded in foreign countries and migrants within countries also have larger political dimension as it involves decisions of those governments. This has to be carefully carried out. It is clear that unilateral decisions and actions can always worsen the scenario in such situations and especially when governments have a larger role in ensuring livelihoods and income through immediate social protection, employment measures and facilitating economic recovery for employment.
A social audit taking all these factors and a verifiable evidence-based strategy as against tentative and event-driven approach which may or may not hit the target will only facilitate smooth sailing.
(Professor K Rajasekharan Nayar is affiliated to Global Institute of Public Health and Santhigiri Research Foundation, Trivandrum, Kerala. [email protected]; Dr. Muhammed Shaffi is a Research Analyst with the Boston University School of Public Health. [email protected]; Dr. Anant Kumar is an Associate Professor with the Xavier Institute of Social Service, Ranchi, Jharkhand. [email protected])
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