The Paradoxes of the Pandemic and World Inequalities
Abstract
:1. Introduction
2. COVID-19 in Perspective
With a hypothetical 1 million COVID-19 deaths, it is possible to portray the epidemic as unimaginably large—the biggest killer in American history—or small, reducing our remaining life by less than 1 part in 1000. However, when the loss of life is put into a comparative perspective, we can see that the scale of an epidemic with 1 million deaths would be as large as that of the recent opioid and HIV crises, but much smaller than that of the Spanish flu. The 1918 epidemic killed more people relative to population size and it also caused a much greater loss of remaining life expectancy because those who died were so young.38
There are no historical observations or scientific studies that support the confinement by quarantine of groups of possibly infected people for extended periods in order to slow the spread of influenza. A World Health Organization (WHO) Writing Group … concluded that “forced isolation and quarantine are ineffective and impractical”.The interest in quarantine reflects the views and conditions prevalent more than 50 years ago, when much less was known about the epidemiology of infectious diseases and when there was far less international and domestic travel in a less densely populated world. It is difficult to identify circumstances in the past half-century when large-scale quarantine has been effectively used in the control of any disease. The negative consequences of large-scale quarantine are so extreme (forced confinement of sick people with the well; complete restriction of movement of large populations; difficulty in getting critical supplies, medicines and food to people inside the quarantine zone) that this mitigation measure should be eliminated from serious consideration.43
[T]hose of us who have, with heavy hearts, embraced the restrictions on our freedoms, are not merely aiming at our own biological survival. We have welcomed the various institutional limitations on our lives… and we have urged our friends and family… to do the same, not to ward off “the danger of getting sick”, not for the sake of our bare life, and indeed not for the sake of the bare life of others, but out of an ethical imperative: to exercise the tremendous powers of society to protect the vulnerable, be they our loved ones or someone else’s…. [We] are not making sacrifices for the sake of anyone’s mere survival. We sacrifice because sharing our joys and pains, efforts and leisure, with our loved ones—young and old, sick and healthy—is the very substance of these so-called “normal conditions of life”.45
3. “Normal Conditions of Life” and the Privileges of Wealth: African Realities
- The net number of South Africans in the workforce dropped by 5.2 million during the second quarter of 2020.
- The poorest 50% of workers—those who live hand-to-mouth—were affected ten times worse than the richest.
- GDP dropped by 16.4% between the first and second quarter, leading to an annualized growth rate of −51%.
- In April, 47% of respondents in a national survey indicated that they had no money for food by the end of the month.
- Businesses all over South Africa closed their doors for good, as lockdown restrictions made operations impossible, forcing them into bankruptcy.53
Scarring has been the legacy of past pandemics: mortality; worse health and education outcomes that depress future earnings; the depletion of savings and assets that force firm closures—especially of small enterprises that lack access to credit—and cause irrecoverable production disruptions; and debt overhangs that depress lending to the private sector. For example, in the aftermath of the 2013 Ebola pandemic, Sierra Leone’s economy never recovered to its pre-crisis growth path.58
4. Vaccines, Inequalities and Diplomacy
Advance COVID-19 vaccine purchases by many rich country governments are not only greatly in excess of their population requirements, but also not made in a transparent manner conducive to improving equity.Unsure of the efficacy and effectiveness of the often still experimental vaccines, some booked, paid for and now demand far more than needed by their populations. Thus, COVAX has been subverted by rich country government actions.97
5. COVID: The Continuous Absence of Global Solidarity
Funding
Conflicts of Interest
1 | |
2 | (World Health Organization 2020c). French President Emmanuel Macron and his wife Brigitte exemplified the rather cavalier attitude of political leaders to the virus; on March 6, both went to the theatre to demonstrate that there was nothing to fear from COVID-19. At that time, Macron was opposed to lockdowns which he would ultimately espouse; see: (Lachasse 2020). American President Donald Trump banned noncitizens from entering the country from China on January 31, but in mid-March he compared COVID-19 to the common seasonal flu (see: (Montanaro 2020)). |
3 | |
4 | (Davis 2020a). |
5 | |
6 | (Ibid., p. 16). |
7 | (Achcar 2020). |
8 | (Davis 2020b). |
9 | Cited as quoted in (Ibid). |
10 | (Bavier 2020). |
11 | (Reuters 2020); see also, (Zafar 2021). |
12 | |
13 | |
14 | The pandemic of 1957 is estimated to have caused 1.1 million to 2 million deaths worldwide; see: (Sino Biological n.d.; Centers for Disease Control and Prevention 1957). The pandenic of 1968 killed one million people worldwide; see: (Centers for Disease Control and Prevention 1968). |
15 | According to the Johns Hopkins Coronavirus Resource Center, the timeline for the development of a typical vaccine is 5 to 10 years. In Covid’s case it took less than a year. See: (Coronavirus Resource Center 2021). |
16 | Tedros Adhanom Ghebreyesus, WHO’s chief executive expressed fear that “even as vaccines bring hope to some, they become another brick in the wall of inequality between the world’s haves and have-nots”. See, (UN News 2021); see also, (Apuzzo and Gebrekidan 2020). |
17 | This is not to say that there should be a fetishism of the mask. Most governments initially discouraged actively its wearing. The scientific evidence for its effectiveness was not overwhelming and public health officials feared that recommending its usage by the general population would lead to a serious and dangerous shortage. As Thomas V. Inglesby and his colleagues pointed out in their analysis of the George Bush administration’s strategic plans against a potential influenza pandemic: Masks and other personal protective equipment (PPE) are essential for controlling transmission of influenza in hospitals… Patients would be advised to wear surgical masks to diminish the number of infectious respiratory particles being dispersed into the air, thereby diminishing the likelihood of further spread… But studies have shown that the ordinary surgical mask does little to prevent inhalation of small droplets bearing influenza virus.56 The pores in the mask become blocked by moisture from breathing, and the air stream simply diverts around the mask. There are few data available to support the efficacy of N95 or surgical masks outside a healthcare setting. N95 masks need to be fit-tested to be efficacious and are uncomfortable to wear for more than an hour or two”. (Inglesby et al. 2006). |
18 | |
19 | |
20 | |
21 | |
22 | |
23 | The African continent seemed to have experienced in July 2021 an increase in both Covi cases and death; the evidence, however, was not conclusive and may not be as alarming as feared. See, (Mwai 2021). |
24 | (Davis 2020b). |
25 | (Goldstein and Lee 2020). See also: (Winning 2020). According to a 2019 United Nations report, “62% of sub-Saharan Africa’s population was under 25 and just 3% 65 or over. In the U.N.’s Europe and North America region, 28% were under 25 while 18% were age 65 and up” [(Winning 2020)]. |
26 | |
27 | |
28 | |
29 | On the controversial use of chloroquine as a therapy to fight Covid see: (Rich 2020; Schaedel 2020; Davey 2020a, 2020b; AFP 2020; Soumaré and Darras 2020; Mehra et al. 2020; Davey and Kirchgaessner 2020). |
30 | (Flegg et al. 2013). As Flegg and her co-authors explain (p. 857): Chloroquine (CQ) was the most frequently used first-line therapy for uncomplicated Plasmodium falciparum (P.f.) malaria from the 1940s through to the 2000s. As a result of its high efficacy, good safety profile, and low cost, CQ was a key part of the 1950s Global Malaria Eradication Program. However, factors including funding constraints, lack of political support, and the emergence and subsequent spread of resistance to CQ and the pesticides used in vector control hampered eradication plans. |
31 | Eleanor Maeresera and Adrian Chikowore. Oxfam acknowledges the assistance of Helen Bunting, Taurai Chiraerae, Marc Cohen, Nadia Daar, Heidi Fritschel, Joab Okanda, Julie Seghers, and Deborah Simpson, “Will The Cure Bankrupt Us? Official Development Assistance and the COVID-19 Response in Southern African Countries”, Oxfam, December 2020, Available online: https://oxfamilibrary.openrepository.com/bitstream/handle/10546/621134/bn-aid-covid-19-southern-africa-181220-en.pdf?sequence=1&isAllowed=y (accessed on 3 January 2021). |
32 | |
33 | (Chamie 2020). |
34 | (Ibid). |
35 | |
36 | |
37 | |
38 | |
39 | (Whelton 2020). |
40 | |
41 | |
42 | |
43 | |
44 | See: (Agamben 2020); see also from a British conservative perspective: (Sumption 2020). Sumption writes: During the COVID-19 pandemic, the British state has exercised coercive powers over its citizens on a scale never previously attempted. It has taken effective legal control, enforced by the police, over the personal lives of the entire population: where they could go, whom they could meet, what they could do even within their own homes. For three months it placed everybody under a form of house arrest, qualified only by their right to do a limited number of things approved by ministers. All of this has been authorized by ministerial decree with minimal Parliamentary involvement. It has been the most significant interference with personal freedom in the history of our country. |
45 | (Berg 2020). Simon Clarke, from the conservative political spectrum, advanced a similar argument for significant public intervention and against the so-called “herd strategy” that would let the virus infect a very large proportion of the population (What Lockdown Sceptics Get Wrong 2020): Why? Because the virus is simply too dangerous to be left unchecked. I don’t believe a vaccine is imminent … which means, for the foreseeable, we’re going to have to “learn to live with this virus”, as the dreary phrase goes. So the question is: how can we best do that? One suggestion is that we let the virus work its way through the nation’s respiratory tracts so that we reach levels of herd immunity. “is, I’m afraid to say, is a fanciful and dangerous notion. |
46 | (Howard and Han 2020); see also: (Howard 2020). |
47 | |
48 | |
49 | |
50 | (Agamben 2020, pp. 1–2, emphasis in original); see also, (Owen 2020). |
51 | |
52 | |
53 | (Ibid). |
54 | |
55 | |
56 | |
57 | |
58 | |
59 | As the IMF Managing Director, Kristalina Georgieva, has put it (IMF Managing Director Kristalina Georgieva 2020): [L]ow-income and fragile states continue to face a precarious situation. They have weaker health systems. They are highly exposed to the most affected sectors, such as tourism and commodity exports. And they are highly dependent on external financing. There is also now the risk of severe economic scarring from job losses, bankruptcies, and the disruption of education. Because of this loss of capacity, we expect global output to remain well below our pre-pandemic projections over the medium term. For almost all countries, this will be a setback to the improvement of living standards. |
60 | |
61 | |
62 | (Zumbrun 2020). |
63 | (Ibid). |
64 | |
65 | |
66 | |
67 | |
68 | (Ibid). |
69 | (BBC 2021b). |
70 | (Tampa 2021); see also, (Burke 2021b). |
71 | (Mattes et al. 2020), p. 5. |
72 | (Mwai 2021). |
73 | (Ibid). |
74 | |
75 | (Johns Hopkins Coronavirus Resource Center 2021b); see also, (Fink 2020). |
76 | |
77 | |
78 | |
79 | By late January 2021, only one country of the world’s poorest 29 managed to get some of its people vaccinated. Guinea vaccinated 55 of its citizens with the Russian Sputnik V vaccine which had yet to get WHO’s official seal of approval. At that time, just two African countries—Seychelles, and Morocco—had begun to vaccinate their populations. At best, some 20% of Africans can expect to get vaccinated by the summer of 2021. See: (Taylor and Paquette 2021; Horner 2021). |
80 | (Lynn 2021). |
81 | This British vaccine was at the center of a European controversy as the European Union recommended that it should not be used on people aged 65 or over. The British government maintained that the AstraZeneca-Oxford vials were entirely safe and had used it on its own population. See, (Oltermann 2021). French President Emmanuel Macron described the Oxford/AstraZeneca jab as “quasi-ineffective”, even though the European Medicines Agency approved the vaccine for use in all countries irrespective of age. See, (Belgian regulators advise against giving AstraZeneca Covid vaccine to over-55s 2021). |
82 | |
83 | As Mariana Mazzucato, Henry Lishi Li and Els Torreele argued in late December 2020 (Designing vaccines for people, not profits 2020): While the international purchase and distribution platform COVAX represents a momentous step forward, its impact is being offset by massive bilateral advance-purchase agreements by rich countries that can afford to bet on multiple vaccines. For example, high-income countries have already bought close to 80 per cent of the Pfizer/BioNTech and Moderna vaccine doses that will be available within the first year. All told, rich countries have laid claim to 3.8 billion doses from different vaccine makers, compared with 3.2 billion (which includes around 700 million doses for COVAX) for the rest of the world combined. In other words, high-income countries have pre-ordered enough doses to cover their populations several times over, leaving the rest of the world with potentially too few to cover even their most at-risk communities. |
84 | (Edward-Ekpu 2021b); see also, (World Health Organization 2020a). |
85 | (Burke 2021c). |
86 | |
87 | |
88 | |
89 | |
90 | As Selam Gebrekidan and Matt Apuzzo have reported [(Gebrekidan and Apuzzo 2021)]: “Russia and China, meanwhile, have promised to fill the void as part of their vaccine diplomacy. The Gamaleya Institute in Moscow, for example, has entered into partnerships with producers from Kazakhstan to South Korea, according to data from Airfinity, a science analytics company, and UNICEF. Chinese vaccine makers have reached similar deals in the United Arab Emirates, Brazil and Indonesia”. |
91 | On 25 February 2021, the U.S. Food and Drug Administration updated an “alternative temperature for transportation and temporary storage for frozen vials before dilution” that would allow the Pfizer vaccine to be “transported and stored at conventional temperatures commonly found in pharmaceutical freezers for a period of up to two weeks”. Nonetheless, it is only an “alternative to the preferred storage of the undiluted vials in an ultra-low temperature freezer between −80 °C to −60 °C (−112 °F to −76 °F)”. See, (U.S. Food and Drug Administration 2021). |
92 | |
93 | (Campbell 2020). Campbell claimed that the apparent popularity of Sputnik V in Africa was due to Russian “disinformation” which had misleadingly taunted the efficacy of the vaccine: Non-Russian media’s support for the Sputnik V vaccine and its clinical trials originates in large part from a targeted Russian disinformation campaign in countries with former and current ties to Russia and the Soviet Union. Sputnik V seems to be as much about public relations and Russian soft power as about stopping the spread of COVID-19… Sputnik V’s popularity in African media is troubling, considering the vaccine has not undergone the same rigorous clinical trials as other contenders. The success of Russia’s disinformation and public relations strategy stems from the Kremlin’s ability—and willingness—to disseminate and emphasize its message about Sputnik V’s effectiveness. A more sympathetic and yet condescending tone for Russia’s development of Sputnik V is evidenced in an article published in the New Yorker, see: (Yaffa 2021). |
94 | |
95 | (Grover 2021). |
96 | |
97 | |
98 | |
99 | |
100 | |
101 | (Douglas 2021). |
102 | (Hassan 2021). |
103 | |
104 | (BBC 2021a). |
105 | |
106 | |
107 | |
108 | (Ibid). |
109 | (Tai 2021). |
110 | |
111 | (Tai 2021). |
112 | |
113 | (BBC 2021c). |
114 | (Amaro 2021). |
115 | |
116 | (Amaro 2021). |
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Fatton, R., Jr. The Paradoxes of the Pandemic and World Inequalities. Soc. Sci. 2021, 10, 332. https://doi.org/10.3390/socsci10090332
Fatton R Jr. The Paradoxes of the Pandemic and World Inequalities. Social Sciences. 2021; 10(9):332. https://doi.org/10.3390/socsci10090332
Chicago/Turabian StyleFatton, Robert, Jr. 2021. "The Paradoxes of the Pandemic and World Inequalities" Social Sciences 10, no. 9: 332. https://doi.org/10.3390/socsci10090332