Saturday, 20 June 2020

Interpreting Covid-19 as a Disaster


Image: US National Institute of Allergy and Infectious Diseases

In terms of its scope, Covid-19 is like no other disaster that has occurred in the last 100 years, since, in fact, the influenza pandemic of 1918-1920 killed more people than both world wars combined, and contributed to the end of the First World War. Despite this, the 2020 pandemic has obvious similarities with previous outbreaks of viral diseases and with many other kinds of disaster.

Distribution of vulnerability. Plenty of evidence exists to show that disasters have a disproportionate impact upon poor and vulnerable people. Covid-19 is no different in this respect. 'Front-line' workers include those who serve in hospitals, work in care homes, run public transport and deliver essential items. Many are poorly paid and few have had a choice about whether to come to work of stay at home. Suddenly it is clear that their work is essential to the running of society. They are the 'human infrastructure' on which we all depend. Paradoxically, this has not particularly strengthened the position of so-called 'key workers' in the hierarchy of labour or enabled them to negotiate better pay and conditions. Their increased exposure to infection has taken a considerable toll in terms of morbidity and mortality.

The role of emergency planning. The scenario for a major pandemic was developed over the period 2003-2009 and was first incorporated into emergency plans close to the start of this period. It followed the beginnings of a revival of interest among historians of disease and medicine in the (misnamed) 1918 'Spanish influenza' pandemic, which began at the end of the 1990s. By 2008, the scenario was more or less complete, with the exception of the recovery phase, which has remained difficult to predict ever since (recovery from the 1918-1920 pandemic took about five years, but it included recovery from the First World War and it led into the Great Depression of 1929).

Since the start of Covid-19 we have seen the failure of emergency planning, which is an indication of failure to provide foresight. Improvisation is permissible only where it is a necessary form of adaptation to those circumstances that genuinely could not have been foreseen in advance and which constitute the unique part of a disaster. Instead in many countries there has been frantic and often unsuccessful improvisation and a little basic analysis easily reveals that it could have been avoided by good planning. It remains unclear whether this lesson will be learned. Will we see the renaissance of emergency planning, and its widespread acceptance as a discipline to be taught and practised, or will we return to haphazard ways of confronting disaster? The failure of emergency planning is perhaps the greatest error made in the management of the Covid-19 disaster.

Failure to make proper use of emergency planning has thrust both politicians and medical scientists into the role of emergency planners. In some countries we may add the military authorities as well. This makes a mockery of decades of patient and progressive demilitarisation of emergency planning. Meanwhile, the scientists are manifestly ill-equipped to take on the role of emergency planners. Their position is further undermined by the difficulties of understanding the disease and its behaviour both as a medical phenomenon and as something that disseminates itself according to social behaviour.

In emergency planning terms, many of the medical and epidemiological questions reduce to a simple 'yes' or 'no'. If neither answer can be confidently made, then the emergency managers simply have to do without a response. The difficulties begin with the logistics of managing the disease, for example, with the challenge of sourcing, acquiring and distributing personal protective equipment and antibody tests. Exigencies like this that are not conditioned by the scientific evidence derived from monitoring, analysing and publishing on the day-to-day progress of the disease. They relate to matters that can and should be sorted out years in advance.

Welfare and social discipline. We live in an age that is increasingly dominated by individualism and the concept of entitlement. It has been evident for decades now that these two traits are unsustainable. Covid-19 has taught the world an enormously important lesson about how to manage a crisis. Before the event, welfare was in decline, social relations were fractious in many places, and solidarity was under threat by exploitative forms of economics and hegemony. That is still perfectly true, but a geat lesson has emerged. Those countries that have weathered Covid-19 best have better welfare systems, more capable and responsive leaders, and populations that understand the primacy of social relations over individualism during times of existential crisis. Under duress, democracy means commonwealth rather than entitlement. The freedom of necessity tells us to sacrifice individual liberties in favour of collective protection. In this process, government shall not usurp its position as the servant of the people but must respond to the collective need, and people must support it.

This, of course, is a counsel of perfection under the conditions that prevail in the modern world. Identity politics should be subsumed by collective solidarity: instead it is reinforced as people retreat into their factions. The neuroses created by the things we have to do in order to survive the disease, in particular suffer lockdown and closure of productive activities, feeds discontent and protest. The leaders of some of the world's largest countries have consistently shown an inability to make rational, consistent and intelligent decisions about Covid-19. A close analysis of the data would no doubt be able to connect their decisions to preventable death tolls.

Democracy in action (or not). Disasters are participatory events. If people do not want to participate in the response to them, circumstances will usually force them to do so. Covid-19 has been the litmus test of democratic deficit. In each country, the intelligence and responsiveness of leadership and the comprehension and responsiveness of the people have defined the progress of the crisis. Risk management is suddenly revealed to be an imperative, a daily task and the responsibility of everyone. Those who opt out of it undermine the response to the crisis.

Sadly, another casualty of Covid-19 has been international relations. The emergency has been managed resolutely at the national level, irrespective of whether that is the right or wrong geographical scale at which to tackle it. At more local scales, we see blanket measures applied to regions with widely varying needs generated by the progress of the disease. Alternatively, we see how intelligent decentralisation improves that picture, but we also see the tremendous challenges of harmonising responses across regions, and we will increasingly see the difficulties of managing interregional transfers. Internationally, the greatest lesson of the previous SARS pandemic (2002-2004) was that international cooperation was the key to reducing its impact. Instead, Covid-19 has had negative impacts on some aspects of international exchange. While scientists have worked without boundaries to understand the disease and provide remedies, politicians have retreated into unilateralism, to the detriment of the very organisations that are best placed to provide the international coordination, such as the World Health Organisation.

Existential threats. It is evident that the world faces challenges at a different order of magnitude to many previous risks. Climate change is at the root of some of them. Covid-19 has shown that a new form of organisation is needed to tackle such risks. To be ready for existential threats, the world needs foresight, planning, welfare, greater equity, better governance, cooperation, decentralisation but internationalism, and better democracy of both the participatory and representative kinds.

In conclusion, Covid-19 is both unlike other disasters and so like them as to be an amalgam of many of their characteristics. As a result, it provides strong lessons for the management of all disasters, large and small. It also provides a warning about what is to come. Will climate change reach a critical juncture first, or will their be an influenza pandemic before that happens...?

Further reading

Alexander, D.E. 2020. Building Emergency Planning Scenarios for Viral Pandemics. UCL-IRDR Covid-19 Observatory. IRDR Report 2020-01. Institute for Risk and Disaster Reduction, University College London, London, 53 pp. Downloadable from
https://www.ucl.ac.uk/risk-disaster-reduction/news/2020/may/emergency-planning-scenarios-viral-pandemics-new-irdr-working-paper-published

Alexander, D.E. 2020. Failing to plan, planning to fail. IAI News. Institute of Arts and Ideas, London, 5 pp. Downloadable from
https://iai.tv/articles/failing-to-plan-planning-to-fail-auid-1551

Thursday, 9 April 2020

More on the Covid-19 Academic Gold Rush


A few days ago, I was accused of "putting the careers of trainees and junior faculty at risk" because a member of my editorial team was slow to complete the review process on a paper that had been submitted to the journal I manage. This reminded me that perhaps 70 per cent of academic publishing is for personnel reasons (to get a job, keep a job, obtain a salary raise, or achieve promotion). I cleave to the old-fashioned view that publishing should take place to further the sharing of good ideas. Nevertheless, I cannot ignore the breakneck speed with which papers are propelled into [digital] print nowadays.

In this context, I salute the thoughtful work of Christopher Gomez, Dierdre Hart and JC Gaillard (Gomez and Hart 2013, Gaillard and Gomez 2015) on the phenomenon of the "disaster gold rush". When a major disaster occurs there is an almost reckless desire to be first in print. This also exists outside the academic field. Indeed, someone ought to do a study of the "book of the disaster" and see who gets the award for the earliest "instant book" to commemorate the damage, destruction and casualties. Gomez and his colleagues drew attention to the worst traits of the "gold rush", namely potential abandonment of ethics and rationality in pursuit of a first-past-the-post research gain.

The Great East Japan Earthquake, Tsunami and Nuclear Release (GEJET), as it has come to be known, produced at least 2,000 papers, and a variety of books, during the first three years of its aftermath. This is probably a substantial underestimate. Thereafter, more and more continued to appear. Currently, as an editor I am dealing, nine years after the event, with two or three new submissions on this disaster. However, the GEJET publication surge is beginning to pale into insignificance next to the Covid-19 gold rush. We confront a new phenomenon: intra-disaster research publication.

Between 1st January and 3rd April 2020, 6,659 papers on Covid-19 were published. Some 83% were in peer reviewed journals and 17% (1,135) came out as unreviewed pre-prints. According to a leading researcher (Erica Bickerton), "keeping on top of which preprints ... are relevant and have robust methodologies is one of the key challenges emerging from the scientific response to Covid-19" (Baker 2020). It is of note that many of the articles were in fields other than medicine, genetics and epidemiology, such as sociology, psychology, jurisprudence and international relations. In short, papers on Covid-19 are coming out at the rate of 67 a day. It is highly probably that the flow will amply exceed 100 a day once research really gets into gear. It is predicted that, in the short term, the proportion of pre-prints will rise.

Much of the research that appears will be repetitive, short on insight, premature and lacking in rigour and scientific testability. Hence, these are some good criteria for presenting Covid-19 research to a potential readership.

Rigour. Does the research conform to the standard tenets of the scientific method: reproducibility, verification, completeness?

Novelty. Will the paper add anything to the debate on Covid-19, or our knowledge of the disaster, that is not already known and present in some of the many other articles that are available?

Utility. Will anyone read the paper? Will the benefit from it in any way? How can a potential readership be convinced to read the paper rather than the other 66 that came out on the same day?

Transformation. Is there any way of measuring or monitoring the take-up of ideas that come from this paper?

There is still much value in papers that have no "pathway to impact". Moreover, it may be that the real impact of a piece of research is not being measured, because to do so is difficult or impossible. In that case, there needs to be another kind of justification for publishing the paper.

As the university world undergoes a radical metamorphosis and transfers its activity to remote working and distance learning, we are all asked to "do more" to achieve this seismic shift. One of the greatest failings of the modern university is its utter lack of appreciation that time is not an elastic commodity. If we are asked to do more, it must be at the expense of some other activity. Paradoxically, "doing more" reduces our productivity, because it forces us to do less important–but more urgent–tasks in place of those that produce a more enduring, positive legacy. The compensatory mechanism involves providing evidence of productivity by going hell-bent for the "quick fix". The most absolute casualty is the time to read and bring oneself up to date with the latest developments.

Major disasters usually lead to a substantial increase in information flow. Covid-19 may be different because information may well become available to a geater order of magnitude than ever before.

It is obvious that much of what is written will be read by practically no one beyond the authors and perhaps a couple of referees. What use is it then? One should bear in mind that in older neglected literature there may be nuggets of gold that escaped the rush, if we only care to go back and look for them. But beyond that, the only valid survival technique is to try, perhaps vainly, to learn how to be ultra-selective on what one does read.

References

Baker, Simon, 2020. Huge Covid-19 output prompting ‘sea change’ in access to research. Times Higher Education, April 9, 2020.

Gomez, C. and D.E Hart 2013. Disaster gold rushes, sophisms and academic neocolonialism: comments on ‘Earthquake disasters and resilience in the global North’. Geographical Journal 179(3): 272-277.

Gaillard, J-C. and C. Gomez 2015. Post-disaster research: is there gold worth the rush?  Jámbà: Journal of Disaster Risk Studies 7(1): 1-6.

Friday, 27 March 2020

Covid-19 and the Disaster Research Gold Rush


As I write, the Covid-19 pandemic is ramping up in many countries. So is the response by academic authors. In 2015 Gaillard and Gomez published an interesting paper on the "disaster research gold rush". It was inspired by some thoughts expressed in 1967 by eminent sociologists of disaster on problems associated with researching transient events (Dynes et al. 1967). In the life-cycle of a disaster, when is it appropriate to do such research?

Disasters give rise to many imperatives. They also generate 'perishable' data that, if they are not collected, will disappear without trace. By common consent, disaster researchers rarely go to events in the early stage of the crisis. To interrupt vital life-saving efforts with social surveys or demands for data would be unconscionable. However, it is a different matter if the researcher can work without visiting the site, putting a foot in the door of the emergency room or stumbling across the path of rescuers.

I am the editor-in-chief of a large international academic journal. The Covid-19 gold rush has already begun. The trickle of papers threatens to turn into a raging torrent, and the disaster is not yet half way through the crisis phase. This points to a conflict. On the positive side, academics wish to throw light on the problems caused by Covid-19, suggest solutions and launch valuable new initiatives. They also wish to capture experience and preserve it as evidence on which to base future policies and plans. On the negative side, there seems to be an urge to be the first in the field with a paper, as if this were are race to be won.

Authors can write in haste and repent at their leisure: editors can rue the day. Much of what is written will need to be reconsidered in the light of the outcome of the pandemic, which is months away, and the post-event debate that follows it. I admit that this is equally true of the present blog, but my criticism is not aimed at those who express an opinion. Debate is healthy, even when there is a need for national and international solidarity. However, any analysis based on half the story is likely to be suspect.

A positive side of the urge to publish is the desire to contribute to the debate before it lapses because attention is diverted to other issues. However, there is a prevailing question about how soon in the sequence of a disaster is it appropriate to take stock? This depends on how easy it is for earlier conclusions to be invalidated by the progress of events. The question is then, to what extent is this predictable or likely to create exigencies that cannot be included in the present analysis?

The Covid-19 pandemic is distinguished by high levels of uncertainty in many of the tenets that anchor the scenario: infection rates, geographical spread, case-fatality rates, government policies and their impacts, public discipline or indiscipline in the face of emergency measures, and repercussions on the economy and people's livelihoods. These factors militate against an over-hasty academic response. So when you read academic papers written in the thick of Covid-19, caveat lector!

References

Dynes, R.R., J.E. Haas and E.L. Quarantelli 1967. Administrative, methodological, and theoretical problems of disaster research. Indian Sociological Bulletin 4: 215-227.

Gaillard, J-C. and C. Gomez 2015. Post-disaster research: is there gold worth the rush? Jàmbá: Journal of Disaster Risk Studies 7(1), Article no. 120, 1-6.

Thursday, 26 March 2020

Interpreting the Pandemic for Decision Making and Action



As the Covid-19 pandemic progresses, causing distributed crises in one country after another, it is like watching all I have taught about for the last four decades flash past in a sort of speeded-up film.

In disasters of this kind, three attitudes are common. Normalcy bias, the tendency to accept the most reassuring interpretation of a situation, tells people that it will not be as bad as it seems. The syndrome of personal invulnerability tells them that the worst can only happen to other people. This leads to cognitive dissonance, simultaneous belief in two incompatible ideas. All of these are misleading states of mind, perhaps dangerously so, and especially when found in politicians and decision makers. Other states of mind combine with the three syndromes to worsen the environment of reaction to the crisis.

For a century, the Hollywood model of disaster has been widely disseminated in disaster movies. The underlying precept of this is that beneath the civilised veneer of society pervasive anarchy lurks, which in cases of extreme disruption would bring out the "savage" in ordinary people, a tendency to safeguard their own interests by all conceivable means, including extreme violence. The Hollywood model relies on heroes and villains. In disaster movies the villains either have rapacious ulterior motives connected with power and greed, or they are immune to common sense. The hero (almost always a man, not a woman, who is invariably his loyal supporter) is a young, fit, active, misunderstood visionary, the only person who can see the truth and is prepared to fight for it. Against all odds, he wins. What nonsense! In reality, fighting disasters is a collective effort that places complete reliance of developing enough consensus for measures to work. It demands meticulous prior planning and the development of detailed scenarios before the phenomenon strikes. While anti-social behaviour does not disappear, especially where it is ingrained in society, there is often an upwelling of social participation, which the sociologists know as the therapeutic community.

For Covid-19 we had the scenarios. I have taught them at least once a year for more than a decade. My primary message was that a pandemic is as much a socio-economic and behavioural problem as a medical and epidemiological one. There was nothing visionary about my approach. It was based on material that has been well publicised and freely available since the second half of the first decade of the century. Normalcy bias, fiscal stringency and the ideology of profit conspired to stop preparations from being effective. Dire warnings were given by emergency planners and epidemiologists. There were ignored or underrated, largely because dire warnings tend to be discounted. They do not encourage decision makers to assume responsibility.

What is now fascinating about the consequences of this is that improvisation is being used frantically to cover the yawning gaps in preparedness. Improvisation cannot be totally avoided in disaster, but failure to prepare leads to avoidable deaths and suffering. Hospital beds, medical staff, personal protective equipment, ventilators, vaccines, antivirals, palliative medicines, economic subsidies, payment for holidays, substitute wages, organised assistance, the policing of social distancing, the reorganisation of public transport and basic services, emergency communication, they are all being improvised. It is rather too much and hence the task is simply overwhelming.

For many people, the Hollywood interpretation, familiar as it is, was the only model they had recourse to in order to understand the workings of this disaster. It rapidly proved unserviceable and has been abandoned by many, thank goodness. However, it has been followed by catastrophism. We might see this interpretation as one of the "orderly breakdown" of society, in contrast to the anarchic version propounded by Hollywood. Inasmuch as there is a model, it is the 1920s, a dire period that led, through mass unemployment, general strikes and failure to care for demobilised servicemen, to the Great Crash of 1929, and ultimately the Second World War. Perhaps the overriding question is "after Covid-19 has finally abated, to what extent will the world be the same as it was?" There is little sense that it will be a better, stronger, more prosperous place.

A related question concerns whether the lessons of this pandemic will be learned. The indications are, at best, mixed. There is often a tendency to assume, once a disaster has passed and recovery is well underway, that it is "all over", an episode that will not be repeated. One of the greatest lessons is the imperative need to take emergency planning and preparedness more seriously. I hope that this will be received in full, resources will be supplied and major effort will be expended, but I am not going to bet on it.

In previous posts, I have suggested that disasters need to be understood with more emphasis on their context. I suggested the "egg model", in which the yolk is a set of causal factors directly related to disasters and the white is all the factors that impinge on the yolk without being direct causes of disaster. In another model, general vulnerability encapsulates specific vulnerability to disasters. We will need to look long and hard at the context of future susceptibility to disasters and chart the interaction in a world that will inevitably bear the marks of this major upheaval. Until some form of stability is reached, progress on this important task is likely to be very restricted.

Sunday, 15 March 2020

Covid-19: An Address


Once upon a time in Tuscany, when my son was very young, I lamented to a friend that all he seemed to have learned at school was how to swear and blaspheme. My friend put on a wise expression and said, very sagely, "David, you must remember that swearing and blaspheming are an ancient tradition in our countryside here." I mention this because, in AD 1244, a group of men in a bothy decided that they were swearing and blaspheming too much and each time they did it they would put a groat in a jar. At the end of the year they would open up the container and spend the proceeds on a feast. As it happened, when they came to open the jar there was so much money in it that they hadn't got the nerve to spend it on food and drink for themselves. So they founded a rescue and care society. Thus was born the Venerable Company of the Misericordia. After 776 years it is still headquartered in the same building, situated next to the cathedral in central Florence. In the small Tuscan town in which I live, the Misericordia did not arrive for a further 291 years (in 1535, precisely), but what are a few centuries between friends?

An organisation of this kind obviously has very deep roots. And there is great pride in it. Moreover, it started a process of creating associations that proliferated to the point that volunteer organisations are the backbone of the Italian civil protection system and there are 3,600 of them. They connect the world of emergencies with the general population. In the last four earthquakes in thed affected areas there were more rescuers than population, which is a remarkable achievement, especially as they are trained, organised and equipped. Most importantly, they are a full part of the system.

In times of grave crisis, we need solidarity, but where are we going to get it? The Covid-19 pandemic ought to teach us the importance of both preparedness and social participation. With regard to preparedness, emergency response consists of planned activities, standardised procedures and improvisation. Too much of the last of these is tantamount to negligence, because it shows up the lack of planning and preparedness. Social participation is about the democratisation of emergency response. Civil protection is us–all of us. It works best where people are protagonists and assume some responsibility for their own destinies. Participatory civil protection is prudent. It draws in the beneficiaries of the system as actors and protagonists, but it, too, needs to be organised in advance, with foresight.

Different countries have different attitudes to emergency preparedness and the protection of the general public. These stem from their administrative and legal systems and cultures, and from the attitude of the holders of power to direct democracy. Cyclone Nargis devastated Myanmar and killed 136,000 of its citizens, in part because they had no role in creating resilience against such an event.

In Britain, there is a culture of "leave it to the experts", or perhaps, given the anti-intellectual wind blowing through the country, disdain for experts (a paradox, indeed). Since the stand-on-your-own-two-feet privations of the Second World War, there has been a gradual and sustained retreat from personal respomsability in favour of leaving the work to officialdom–and blaming officialdom when there are shortcomings in its response. There has also been the ideological assault of Thatcherism, a retreat from social provision and a gradual abandonment of the idea of participatory democracy. "There is no such thing as society," she said, and did her best to make it a self-fufilling prophecy. At the same time, control of the country's assets became ever more centralised.

Britain does not lack a social conscience, or sensitivity to social issues. Many people labour ceaselessly to provide what the state has increasingly turned away from. When there is a major crisis, the response is generally to revive what sociologists call the 'therapeutic community'. But it has been weakened. Britain follows, not the continental European model of solidarity, but the American model of individualism, and this is particularly true in civil protection. It is a pity, as the United States have lost the lead in this field–if they ever had it. The coup de grâce was the response to Hurricane Katrina in August 2005. It was a model of inefficiency and failure.

Commentators and officials used to say that "Britain does not have disasters". We have instead, "major incidents". Why we should be so reticent about calling them disasters is a mystery to me, for that is what they are. Covid-19 is rather more than a "major incident". It is a gargantuan civil contingency that will leave its mark for decades to come–among those who survive it.

There was a period in the decade of the 2000s and early 2010s in which pandemics were the focus of emergency planners' attention. They were then supplanted by a renewed emphasis on counter-terrorism and that in turn was overlain by frantic preparations for the supply-chain disaster of Brexit (emergency response is very much a "flavour of the month" business, just like ice-cream shops). Looking at the current British response to Covid-19, it is difficult to see quite where all that effort on pandemic emergency planning went. Perhaps the answer is that it is too difficult to plan a system that has been decimated, after eight years of Draconian budget cuts. However, it is not exactly easy to organise an alternative system in the thick of the emergency. Voluntarism comes in three types: spontaneous, organised and organised-and-incorporated. The last of these makes a real civil protection system. The first is inefficient because it is shorn of training and equipment, it is not adequately absorbed into the emergency response machine, and it has to be organised with much effort on the spur of the moment. That is what we are currently seeing in Britain. But at least we are seeing an attempt to generate solidarity, even if it is not of the optimum kind.

Emergency planning is something that needs to be done in times of quiescence and peace, but it also goes on throughout the emergency, as the provisions that were made in advance have to be adapted to the dynamic, evolving situation. Much use is made of scenarios. A scenario is not a prediction of the future. In this context, it is a systematic exploration of a range of possible future outcomes. For pandemics, we use parametric models. These are simply sets of equations in which, on the basis of–often flimsy–assumptions and a minimal amount of data–coefficients are set and calculations are made. Garbage in-garbage out if the sum total of the data and the assumptions are not adequate. And the trouble with pandemics is that there is truly massive uncertainty: disease transmission rates, infectiousness, survival rates, social behaviour, the effect of emergency measures, healthcare response–they are all infinitely mutable.

Under such circumstances, two elements of strategy are to be recommended, neither of which has been properly practised in Britain. One is not to discuss the worst case scenario unless there is a very strong practical reason for doing so. The other is to devote very substantial resources to early preparedness, as a precautionary measure and a demonstration of prudence. "Normalcy bias" makes us assume that it won't be that bad. It might be, so we must be ready to fight it.

Besides Covid-19, the shadow of another phantom stalks us. That is the Hollywood model of emergencies. Research (including my research) shows that it is remarkably resilient, not only among the general public, but also among the emergency response communty and the political classes. In essence, the Hollywood model is one in which a destabilising emergency causes the breakdown of society, revealing the essentially selfish, self-seeking egotism of its members. The antidote is marshall law. There have been rumours about preparations for this in Britain, a country which tends to look upon emergencies as public order problems. If we ever arrive at such a situation it will be a sad, sad indictment of British society. It would presuppose that, by and large, people have no social conscience and that the fabric of society is completely threadbare. As that seems unlikely, I think the model should be dropped like a hot potato. It is as well to remember that outbreaks of looting tend to occur strictly where there are substantial preconditions for them. They do not happen spontaneously in a completely unpredictable manner. Nor do other forms of antisocial behaviour. In this, we reap what we sow.

Disasters need to be seen in the contexts in which they occur--I nearly said the context in which we generate them, for they are not natural. Identity politics, scapegoating, contraction in the welfare safety net and public services, all these impinge, negatively, on the developing disaster scenario. For many people, Covid-19 is a bolt from the blue. It either is or will become a major source of anxiety and destabilisation in their lives. Yet what is happening is predictable and was predicted, comprehensively and repeatedly. The question is who was listening? And who was willing to act? There is now a major opportunity to rethink the tenets of modern life and refound them on the basis of prudence, solidarity and participation. And let us not forget that for the inhabitants of Syria, Yemen and all those places where grinding poverty routinely overwhelms people, existential threats have been the normal way of life. The influenza pandemic of 1918-1920 killed most of its victims in developing countries that entirely lacked health-care systems. That is a sobering lesson. Amartya Sen wrote that health care is a prerequisite of development: never more than now.

Wednesday, 11 March 2020

Covid-19: Elements of a Scenario



It is now more than ten years since there was a general push to induce countries to plan for pandemics (WHO 2005). In some quarters, it had an immediate effect (e.g., US Homeland Security Council 2005, UK Government 2008), while in others it did not. In 2020, some confusion arises from the fact that much of the planning refers to influenza, whereas the SARS category of diseases is not strictly a 'flu virus, but most of the planning principles are exactly the same, so this is mainly a labelling issue.

In the wake of the WHO report, Professor Ziad Abdeen of the Palestinian Health Authority said about pandemics: "My task is to tell you things you don't want to know, and ask you to spend money you haven't got on something you don't think will happen." About the same time, 2007, Dr Michael Leavitt of the US Department of Health and Human Services wrote: "We don't know when a pandemic will arrive. However, two things are certain: everything that we do before will seem alarmist; and everything that we do afterwards will seem insufficient." Nevertheless, Dr Margaret Chan, then the Director of the Communicable Diseases Section of the WHO, stated "For the first time in human history, we have the ability to prepare ourselves for a pandemic before it arrives. Therefore, the world community must take action immediately." That was at a time when an influenza pandemic with devastating consequences was greatly feared. When it came, in 2009, it was less deadly than expected, but that does not negate the possibility of a highly contagious disease with a case fatality rate equivalent to that of SARS in 2003, namely 10%.

Major epidemics and pandemics (what is the difference?) are crises which have to be managed simultaneously at several levels, from international to local. They also involve very high degrees of uncertainty. The mathematical models that are used to predict the diffusion of diseases tend to be parametric and to depend on simple but debatable assumptions (e.g. Mathews et al. 2007). If the progress of the disease is linear or simple non-linear, that is acceptable. However, aggregate human behaviour and many local factors, including prevention measures, can modify the prognosis.

I have no magic answers to the problem of the SARS-CoV-2 virus. One thing we know about pandemics is that the socio-economic effects, not only the medical ones, can be profound. Vast mutations in society, economy and social behaviour are possible. Although we hope that they will be temporary, they may well have some lasting effects. For example, civil aviation is particularly vulnerable. Based on SARS 2003 and early infection rates, a projection for the effect of Covid-19 on the airlines shows a dip for six to nine months (Pearce 2020). However, this depends on whether companies manage to remain solvent during and after the crisis. The civil aviation landscape could change drastically in the longer term.

The figure above is an attempt to summarise the issues connected with the Covid-19 pandemic. In each of the five categories there are opposites or alternatives. Thus, the vulnerability and fragility of people and society need to be seen in the light of socio-economic changes induced by the epidemic. Here is how I would classify the impacts and challenges. This is intended as the basis for possible scenarios of the outcome of the pandemic.

Severe negative impact:-
  • transportation, especially civil aviation and trains
  • hospitality and tourism
  • catering
  • the entertainment industry and cultural attractions
  • general medicine
  • ill and handicapped people
Under severe duress:-
  • decision making systems and decision makers
  • police
  • hospitals
  • civil protection forces
  • social welfare systems, including non-governmental ones
  • insurance
  • prisons
  • civil liberties?
Under duress:-
  • food supply and supermarkets, including supply chain
  • general consumption of consumer goods and consumer durables
  • distribution systems
  • IT systems
  • manufacturing
  • basic infrastructural services
Presenting opportunities:-
  • sanitary items, pharmaceuticals
  • vaccine research, production and distribution
  • security industry
  • information services (mass media, social media)
Changing and needing to adapt:-
  • mass media
  • the financial system
Intangible effects:-
  • trust in authorities
  • medical ethics (in the apportionment of and priorities for healthcare and vaccination)
  • difficulties associated with work
  • difficulties associated with social interaction (family, recreation, etc.)
  • difficulties associated with procuring reliable, intelligible information
  • being in the wrong place at the wrong time
  • general uncertainty in the evolution of the epidemic
These, then, are the possible building blocks of scenarios that could be used for future planning. It is important to ensure that emergency planning measures are balanced among society's and people's needs. This is where scenarios can help by providing the broad overview of demand for help. It is also important to remember that the Covid-19 pandemic occurs in the context of other developments. These include post-recession recovery, polarisation and wealth distribution issues, and the pressing need for climate change adaptation. In Britain, they also include the Brexit negotiations and the shape of the post-Brexit economy that will emerge after 2020.

A very important question to be answered is how a country functions amidst a general shut-down, something that is looking increasingly necessary in a number of places. This matter has to be examined from the point of view of citizens, workers, decision makers, crisis responders, and other stakeholders. Perhaps comparisons with the general strike of 1926 might yield some insights. However, it is important not to overdo historical comparisons, as we know from looking at the effects of the 1918 'Spanish' influenza (Spinney 2018).

Finally, another aspect to take into consideration is the politicisation of disease. The 'Spanish flu' was so called because Spain was liberal in its control of information, yet the virus came from China. Wherever a disease comes from, and whoever brings it, there is no justification for creating scapegoats. One has the impression that in 2020 the world needs to relearn the practice of solidarity between nations and between communities. This brings us back to context, and the potential role of identity politics, a corrosive role if ever there were such a thing.

References


Mathews, J.D., C.T. McCaw, J. McVernon, E.S. McBryde and J.M. McCaw 2007. A biological model for influenza transmission: pandemic planning implications of asymptomatic infection and immunity. PLoS One 2007:2(11): e1220, 1-6.

Pearce, B. 2020. COVID-19 Updated Impact Assessment of the Novel Coronavirus. International Air Transport Association, Geneva, 14 pp.

Spinney, L. 2018. Pale Rider: The Spanish Flu of 1918 and How it Changed the World. Jonathan Cape, London, 352 pp.

US Homeland Security Council 2005. National Strategy for Pandemic Influenza. US Government, Washington DC, 12 pp.

UK Government 2008. Pandemic Flu: UK International Preparedness Strategy. United Kingdom Cabinet Office, London, 27 pp.

WHO 2005. Global Influenza Preparedness Plan: The Role of WHO and Recommendations for National Measures Before and During Pandemics. Department of Communicable Disease Surveillance and Response, Global Influenza Programme, World Health Organisation, 49 pp.

Thursday, 6 February 2020

Community Resilience or Community Dystopia in Disaster Risk Reduction?


In disaster risk reduction circles, there is an almost desperate reliance on 'community' and a strong growth in studies and plans to "involve the community" in facing up to risks and impacts (Berkes and Ross 2013). The intentions are laudable, as DRR needs to be democratised if it is to function. However,'community' is contentious concept (Barrios 2014).

The many places in which I have lived have had highly varied levels of expression of community. For example, I spent many years frequenting a small town in the mountains of Southern Italy. It was founded 3,770 years ago and has suffered many vicissitudes over the better part of four millennia. The current urban form was largely given to it by Norman invaders 940 years ago. It is an architectural paradise of which the inhabitants are, rightly, fiercely proud. Yet, faced with natural hazards, relative isolation, economic deprivation and cultural decline, it badly needs social solidarity, and that is something it lacks. Boredom and the accumulated malaise of centuries of oppression, envy, division and exploitation have divided the community into invisible factions. It may be an exaggeration to talk of Edward Banfield's 'amoral familism' (Banfield 1958), but in such an environment community cohesion is a highly relative phenomenon.

At the other end of the scale, I reside in the most multi-ethnic and politically homogeneous district of London. It is an area with a shifting population of migrants, students, temporary workers and those who soon move on to greener pastures. Unfortunately, some of its most defining characteristics as a community relate to drugs, homicide, homelessness and terrorism. In this, I do not exaggerate, as the record of recent events in London demonstrates the connections quite clearly. Community can just as well be defined negatively as positively.

Several arguments can be marshalled against the idea of community resilience:-
  • The concept of 'community' has no inherent geographical scale. A group of like-minded individuals spread across the globe might just as well be a community as a collection of people in a local neighbourhood.
  • If some form of social cohesion defined communities, they do not necessarily have it.
  • In modern cities, neighbourhoods may well have a shifting, rootless population that lacks common ground.
  • Identity politics can split communities (considered as the population of an area) into factions.
  • In a local area, the population may have different, perhaps conflicting objectives
  • 'Community' is not an efficient way of using people's skills.
With regard to the last of these points, it is worth considering the criticisms of the concept of social capital, which is often used in conjunction with community-based DRR (Haynes 2009, Inaba 2013). I need not repeat them here.

Moreover, in many places the 'community' is dominated by the most powerful people in the area, or indeed by a single person. The manifestation of community may simply be an expression of the will of the powerful. The weak and the marginalised may be deprived of a voice or not listened to. In the worst cases, they are effectively invisible outside their own circles. Hence, 'community' is about influence. At its most benign, it is about relative influence (Barrios 2014).

The struggle to create community resilience pits organised collective action against individualism. The latter was perhaps best articulated by Margaret Thatcher in an interview in 1987. "There is no such thing as societeigh", she said in that false plummy, slightly hectoring, distinctly overbearing voice (Tice 2010). She went on to make that pronouncement a self-fulfilling prophecy by conducting war on social institutions until they failed or were dismantled. To soften the blow, she added "It is our duty to look after ourselves and then, also, to look after our neighbours." The door had been left open for voluntarism to compensate for the retreat of the state. Altruism had been put in its place. Queen Elizabeth II said in one of her Christmas addresses to the nation that, in a lifetime of visiting and meeting, the happiest people she had encountered were those who were helping others. Does this confirm the Thatcherite view of the social order or contradict it? A more useful question for those who wish to create community resilience might be "what stands in the way of collective action?"

Sociologists have long known that disaster creates community by spontaneously knitting people together into a social grouping that they term a 'disaster subculture' (Granot 1996). This is an association of people from diverse backgrounds whose cohesion derives from an overwhelming emphasis on a common aim. For example, the survivors of the Grenfell Tower fire of June 2017 are united in their quest for justice and decent living conditions. But how does this translate into community resilience?

In any manageable geographical unit there are likely to be associations of citizens: faith groups, voluntary associations; recreational, political and business groups. But do they add up to a community? Perhaps under the disaster subculture, they do, but that does not help preparedness.

And then there is community dystopia. 'Community', a word apparently absorbed into the English language from French after the Norman invasion, is the subject of numerous definitions in the Oxford English Dictionary. Many involve the idea of a shared destiny or common ground. Some require uniform ethnicity or belief, or some form of fellowship. At least one makes a distinction between officialdom and the laity (i.e., ordinary people). Community-based DRR necessarily requires the two parties to collaborate, but what if the relationship is antagonistic rather than symbiotic? And what if the community is fragmented? How does one initiate a dialogue with the community if it has no centre, no identifiable single representation? Who leads the community in a crisis?

From this we may conclude that the community, if it exists, is heterogeneous, not homogeneous. It is likely to be polycentric (hoping that I am not taking too metropolitan view of the phenomenon). It may be therapeutic or it may be dysfunctional.

Rioting and looting occurred in London in 2011 and in Concepcion, Chile, after the 2010 earthquake and tsunami. Such behaviour is a result of the spontaneous abandonment of both property norms and the canons of reasonable behaviour (Alexander 2013). It does not stem from inability to involve community in DRR, but it can be fuelled by a general sense of marginalisation and lack of justice. Once again, involving people in DRR will not solve such problems, as the broader context has to be addressed. That is why rioting has continued in Chile, a decade after the disaster.

In many modern cities, the development of a collective consciousness is hampered by the problems of urban living: expensive, sub-standard housing, which is in short supply; exploitation through poor, badly remunerated working conditions; pollution, overcrowding, and so on. Social participation often decreases when people are under duress, although communal protest may revive it.

Another factor to consider in any assessment of community-based DRR is culture. Britain has long had a culture of secrecy, especially in official dealings. This is allied with the pervasive concept of "leave it to the experts" that only recently has been challenged. Despite attempts at openness, for example by passing laws about disclosure, secrecy has survived remarkably well, and it is strongly backed by Draconian libel and slander laws. The UK Official Secrets Act (1989) defines vaguely what information is protected but is quite clear about the consequences of sharing such information: "the person into whose possession the information, document or article has come is guilty of an offence if he discloses it without lawful authority knowing, or having reasonable cause to believe, that it is protected against disclosure" Cultural change is a slow, progressive process that requires much persistence and prodigious resources. Britain needs to be levered out of its obsession with secrecy towards a form of emergency management and disaster risk reduction based on disclosing information, not withholding it. That is the route to the democratisation of DRR. Secrecy has its place, but that place should be well circumscribed–by common sense, a spirit of openness, and a desire to share information for the betterment of society. Progress has been made, but much more is needed.

Another aspect of culture is its role in creating community identity. In London it is now extremely rare to hear someone speak with a London accent. In Florence, by contrast, there is a living, active concept of fiorentinesimo. Various well-patronised websites promote it through reviving dialect and other traditions, many ceremonies and cultural events promote it as well. Individuals such as the actor Roberto Benigni give it a high profile. This should be a point in favour of defining the community. However, it is as well to note that in Florence there are two quite separate communities: Florentines and others (including tourists).

In my opinion, initiatives that rely on trying to inculcate or promote community resilience are hanging their strategies on the wrong hooks. Rather than searching for the 'community', I advocate identifying, utilising and developing specific mechanisms. The DRR community has to be created, not discovered. It will be hard work, and even more hard work will have to go into making the result sustainable as society continues to change at an ever accelerating rate.
  • Alternatives to 'community engagement in DRR' do exist:-Organised voluntarism can be incorporated into the official civil protection system.
  • The vigorous promotion of equity, and a greater degree of equality, would make society healthier and happier.
  • Working with specific groups and networks will encourage participation and ensure that it fits with DRR needs.
  • The barriers to positive action between official and unofficial forces need to be reduced.
  • The social groups involved in DRR need to be recognised by officialdom.
Returning to Thatcher, I would argue that there is such a thing as society but in many places "there is no such thing as community". Nevertheless, DRR requires social democracy and social participation. It is the antithesis of neoliberalism and rank individualism. If 'community' is to overcome the factionalism of identity politics, there must be a shared identity and a sense of shared destiny. This must be stronger than factionalism in the constituent population. The challenge of the 21st century is to involve people and organisations in managing their own risks.

[This is a publication of Sceptiques Sans Frontières (SSF), home of the Rapid Scepticism Force.]

References

Alexander, D.E. 2013. Looting. In K.B. Penuel, M. Statler and R. Hagen (eds). Encyclopedia of Crisis Management. Sage, Thousand Oaks, California (Vol 2): 575-578.

Banfield, E.C. 1958. The Moral Basis of a Backward Society. Free Press, New York, 188 pp.

Barrios, R.E. 2014. 'Here, I'm not at ease': anthropological perspectives on community resilience. Disasters 38(2): 329-350.

Berkes, F. and H. Ross 2013. Community resilience: toward an integrated approach. Society and Natural Resources 26(1): 5-20.

Granot, H. 1996. Disaster subcultures. Disaster Prevention and Management 5(4): 36-40.

Haynes, P. 2009. Before going any further with social capital: eight key criticisms to address. Ingenio Working Paper no. 2009/02. Ingenio (CSIC-UPV), Polytechnic University of Valencia, Valencia, Spain, 22 pp.

Inaba, Y. 2013. What’s wrong with social capital? Critiques from social science. In I. Kawachi, S. Takao and S.V. Subramanian (eds) Global Perspectives on Social Capital and Health. Springer, Berlin: 323-342 (Chapter 13).

Tice, A. 2010. 'No such thing as society'. Socialist (25 November 2010), p. 10.