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“But if the public health problem is not necessarily as extremely alarming as it is presented in the media, why then is this epidemic treated as an issue that deserves almost exclusive attention and real-time monitoring? COVID-19 is not only a global health problem, but also a problem with other interconnected economic, ecological and social faces. These make it, in fact, a systemic and political problem on which it is convenient to reflect ”.
The new coronavirus (SARS-Cov-2) has many faces. The health-related aspect has been thoroughly examined, or rather scrutinized, by the media for weeks. From the last week of January until the time of this writing, on March 9, the coronavirus has recognized more than 114,000 people in more than 100 countries, caused the death of more than 4,000 individuals, and is more that several thousand more deaths are likely to swell in the coming weeks or months in what is already expected to be a pandemic.
Without a doubt, it is a serious health problem, but not the most important, perhaps not even the most urgent. An example of this is the fatality rate, estimated at 3.4%, which can be compared to 11% for SARS (severe acute respiratory syndrome) or 34% for MERS (Middle East respiratory syndrome). ). Let us also think that each day more than 1,100 people die in Spain from very different causes, and that the common flu causes between 6,000 and 15,000 deaths annually in our country. We do not know how many people are infected by the coronavirus, but it seems very likely that a high percentage of cases go unnoticed, with inadvertent or unrecorded symptoms, which would imply that the real fatality rate would be much lower than that registered so far.
This does not mean, however, that the coronavirus is not a relevant or even worrying health issue.
In the first place, the mortality generated by COVID-19 in the most advanced age groups or in people with previous pathologies is high (about 15% in those over 80 years of age) and its morbidity and general health affectation can be important .
Second, it is highly contagious, creating a prominent public health problem in many countries and potentially for all. China, South Korea, Japan, Iran and Italy are so far the most affected. And, although the risk of mortality is low, given that the potential number of affected could become very high, this could imply a very high total death count.
And third, the impact of the epidemic on the health system can be very relevant for various reasons: the incubation period in which people are contagious is five days; the number of cases is exponential; a high percentage will require hospitalization either due to their clinical situation, surveillance or isolation; patients should be isolated until they are no longer contagious, which requires fine-tuned screening systems, a high volume of sample processing at referral centers, and an integrated governance of clinical and public health decisions to identify patients screened, positions in quarantine and if this should be done at home or in a hospital.
Furthermore, an important part of the work of many Spanish health professionals is being devoted to addressing the current emergency. To this is added that health personnel are the group most exposed and at the same time the one with the greatest risk of infecting individuals who are particularly vulnerable to infection, so the burden is double.
Scientific societies of different medical specialties have produced very valuable joint protocols and informative documents. However, the complexity and cost associated with these exceptional measures are high and pose a high stress for the health system, which translates into a non-negligible risk of overflow or even collapse if hospitals act for a prolonged period as the main front of containment of the epidemic.
Finally, the probability that, at least in the short term, it is a “recurring” epidemic that may repeat itself every year is also cause for concern. It seems likely that SARS-CoV-2 is here to stay, and that it remains among the viruses that routinely affect humanity as happened with influenza A.
In addition, epidemics of similar origin to the current coronavirus or even much more serious may appear that could generate a pandemic with a much higher global mortality. Do not forget that the cause of the current epidemic outbreak - and previous ones such as SARS-CoV in 2002, avian flu (H5N1) in 2003, swine flu (H1N1) in 2009, MERS-CoV in 2012, Ebola in 2013 or Zyka (ZIKV) in 2015) - lies, to a large extent, in the complex transmission through animals related to the development of intensive agriculture and poultry farming and a growing market and consumption of wild and exotic animals. Added to this is the current capacity to spread epidemics due to the lack of hygiene and adequate resources invested in public health, urban density, and tourism globalization, among other factors [1].
Globalization has transformed the relationship between humans and viruses, where the local is global and the global is local. And many countries do not have effective public health systems to meet the challenges that arise, nor is there an appropriate global public health system [2].
In any case, most countries with effective public health resources and that have implemented drastic measures, such as China, where the city of Wuhan, with 11 million inhabitants, in the Hubei region (58 million), has been since the end of January in a draconian quarantine, or Japan that has closed schools for weeks, or Italy and Spain that are progressively expanding the territory of control and containment of the coronavirus, should be able to contain the epidemic in a relatively short time, thus avoiding the impact in collective health it worsens over time.
A very different situation can occur in many poor countries, with very weak health systems and very poor social determinants of health (poverty, urban overcrowding, faulty or non-existent wastewater systems, negligence of the pharmaceutical industry, weak public health systems , poor diets, etc). This is the case in many African countries, where the risk of the epidemic causing very notable or even extreme damage is high.
But if the public health problem is not necessarily as extremely alarming as it is presented in the media, why then is this epidemic treated as an issue that deserves almost exclusive attention and with real-time monitoring? COVID-19 is not only a global health problem, but also a problem with other interconnected economic, ecological and social faces. These make it, in fact, a systemic and political problem on which it is convenient to reflect.
From an economic point of view, according to numerous analysts, consultants or auditors such as Deloitte, the IMF, or the OECD [3], the epidemic has contributed to slowing down the economy, generating lower growth and a decrease in production, trade, consumption, tourism and transportation, or even the stock market crash. Factories and businesses close; millions of people do not make their usual trips; teleworking, videoconferencing or the possibility of increased local production is promoted to protect supply chains; as well as a sharp rise in the prices of products such as disinfectant gels or masks. In an economy as interdependent, chaotic and fragile as capitalism, where uncertainty, speculation and the constant search for profit are essential, the complex future systemic consequences are unknown, but everything points to the possibility of a near and serious economic recession .
From an ecological point of view, closely connected with the economy, the economic slowdown has reduced the consumption of fossil fuels, the emission of CO2 and air pollution. For example, in China oil consumption and gas emissions have been reduced by 25%. The same will happen in many other countries.
Its obvious negative effects on health, society and the economy, in the short term, are beneficial for the climate and ecological crisis, and perhaps also for health, in the medium term
The impact of the coronavirus epidemic may seem paradoxical: its obvious negative effects on health, society and the economy, in the short term, are beneficial for the climate and ecological crisis, and perhaps also for health, in the medium term. As in any economic crisis, by slowing down industrial activity and transportation, mortality and morbidity associated with accidents at work, traffic, environmental pollution, etc. are reduced.
This apparent paradox is cleared up when it is understood that the logic of exponential growth and many of the characteristic developments of capitalism are highly detrimental to the homeostasis of the planet and social development and, therefore, to collective health.
From the social point of view, we are facing an epidemic of panic, whose origin we can trace in some of its essential characteristics: it is not a highly lethal epidemic but it is new and of an origin that has not yet been fully clarified; we cannot predict its evolution, which creates great uncertainty; there is no effective treatment or vaccine; It has spread rapidly in the richest countries on the planet and, surely, in all kinds of social classes; the media and social networks have magnified their impact among a population that mostly feels risk phobia; the epidemic is an opportunity to degrade and isolate China, while generating racist and xenophobic responses locally.
But, in addition, the COVID-19 crisis raises two additional important issues. On the one hand, the essential role of governments, services and public investigation to control in a coordinated way both the epidemic itself and a probable 'epidemic of authoritarianism', visible in China with extreme surveillance and control measures to detect cases of inadvertent infection and the application of restrictive measures that are not very transparent, if not directly repressive. The lack of clarity in the information disseminated is also reflected in a blind media of immediacy, tied to the power of large corporations, that seek an audience through immediate emotional impact and entertainment, and that are incapable of transmitting a critical and systemic diagnosis of what what happen.
Second, the current ‘media epidemic’ of the coronavirus represents an opportunity cost, in a sense well known to many politicians: when one does not want to talk about an annoying topic, attention is distracted by talking about another [4]. Examples are Clinton's attacks in Sudan and Afghanistan to cover up hisaffairwith Monica Lewinsky, or Berlusconi's release of politicians on corruption charges on the same day that Italy qualified for the final of the soccer world cup. By talking almost exclusively about the coronavirus for so many weeks, we are not talking about other much more serious problems that go unnoticed. As the philosopher Santiago Alba Rico has pointed out: “Since Covid-19 exists, nothing has happened anymore. There are no more heart attacks or dengue or cancer or other flu or bombings or refugees or terrorism or anything. There is, of course, no longer climate change ”. Or also the economist Fernando Luengo when he said that there is no longer talk of the "high indebtedness of non-financial private corporations, the umbilical cord that links the policy of central banks to large banks and corporations", or "the increase in inequality, wage repression ”, nor the drama of“ refugees on Lesbos, crushed by the Greek police and the extreme right ”, or“ the murders of women ”. Nor, of course, does it speak of the atrocious ecological crisis that we are experiencing, which endangers life on the planet and the very existence of humanity, or of the massive job insecurity suffered by billions of people in the world, including the Italian researchers from the University of Milan and the Sacco Hospital who isolated the coronavirus strain.
COVID-19 is a complex trigger of the systemic crisis of capitalism, in which all the above factors are strongly interconnected, without being able to be separated from each other. Everything seems to indicate that this epidemic may represent an ideal occasion to justify the capitalist economic crisis that seems to be approaching [5]. Fear produces a sharp drop in demand, which lowers the price of oil, which reverts to the emergence of a crisis announced so far. Most likely, the coronavirus is not solely responsible for the falls in the stock markets, as they say, nor for a slowing capitalist economy, with stagnant corporate profits and industrial investment, but it is the spark of a postponed economic crisis where the poor health of the economy long predates the epidemic.
As various critical economists have pointed out, such as Alejandro Nadal, Eric Toussaint or Michael Roberts [6], although the stock markets are unpredictable, all the factors of a new financial crisis have been present since at least 2017. The coronavirus would be just the spark of a financial explosion but not its main cause [7]. In addition, the role of the giant shareholders (investment funds such as BlackRock and Vanguard, large banks, industrial companies, and mega-millionaires) in the stock market destabilization experienced in recent weeks should not be underestimated. These agents would thus reap the benefits of recent years and avoid losses, investing in the safest but less profitable public debt securities, and demanding that governments once again use public resources to mitigate economic losses.
The propaganda of the large economic and media groups hides reality and prevents a proper understanding of what is happening. Transforming the complex social structure of a train without brakes, like capitalism, requires imagining a different society and making a radical change with systemic global policies in ecology, economy and health, which design and experiment alternative ways of life in a productive and fairer, homeostatic, simple and healthy consumption. A necessary first step is not to fool ourselves with the incomplete, emotional or toxic information of the hegemonic media story of the coronavirus and to try to understand the systemic crisis it hides.
Joan Benach is a professor, researcher and health worker (Grup Recerca Desigualtats en Salut, Greds-Emconet, UPF, JHU-UPF Public Policy Center), GinTrans2 (Transdisciplinary Research Group on Socio-ecological Transitions (UAM).
Notes:
[1] It is produced by a chain reaction, with positive feedback from disasters, which is common in poor countries. See: Mike Davis.The Monster knocks on our door. [Translation by María Julia Bertomeu with a foreword by Antoni Domènech]. Barcelona, Old Topo, 2006.
[2] Idem.
[3] The OECD warns about the possibility that Covid-19 will halve world economic growth in 2020, which could go from 2.9% to 1.5% of GDP. See: Michael Roberts. Coronavirus, debt and recession. Without permission.
[4] See for example: Christenson DP Kriner DL.Mobilizing the public against the president: Congress and the political costs of unilateral action. American Journal of Political Science2017; 61 (4): 769-785; Djourelova, M and R Durante (2019),Media Attention and Strategic Timing in Politics: Evidence from US Presidential Executive Orders, CEPR Discussion Paper 13961; During R, Zhuravskaya E.Attack when the world is not watching? US media and the Israeli-Palestinian conflict. Journal of Political Economy2018;126(3):1085-1133.
[5] Since this recession is not caused by a lack of demand but of supply (loss of production, investment and trade), Keynesian and monetarist solutions will not work. The main cause of stagnation is the decline in profitability of capital. Huge debt, particularly in the corporate sector, is a recipe for a serious collapse if profitability on equity were to drop sharply. The epidemic ends up weakening a financial system that has the potential to trigger a new debt crisis that could lead to the collapse of companies and the financial world. Coronavirus, debt and recession. Without permission.
[6] See: Eric Toussaint. No, the coronavirus is not responsible for the falls in the bags. Rebelliouson; Alejandro Nadal. Interest rate: coronavirus vaccine? Without permission; Michael Roberts. G20 and COVID-19. Without permission; Michael Roberts. Coronavirus, debt and recession. Without permission.
[7] Before the appearance of the new coronavirus, disturbing indicators had already been manifested in the world economy such as the inversion of the yield curve (the yields of shorter-term securities exceed those of long-term securities), which is an indication of how bad investor expectations are. An example of this type of distortion is the various conventional evaluations of the last few quarters in the stock market that reveal how the market has become cheaper relative to the yield of 30-year bonds. And that is not a new phenomenon: the inversion of the yield curve in European markets has been going on for years and in recent years has been approaching record levels. See: Alejandro Nadal. Interest rate: coronavirus vaccine ?.Without permission.
