Big Numbers, Business As Usual
— “I’m mad, I’m mad, I’m angry” — Bobby McFerrin
Ah, March/April 2020. Seems like it’s All Covid-19 All the Time. It’s relentless; not just the virus, but the coverage. The daily clamour of fear, uncertainty, bloviation, urban mythopoeia, political posturing, mind-numbing statistics, and even, dear reader, opportunistic advertising (!) is inescapable except by unplugging. Yet most of us are feeling too derailed and isolated to unplug: the internet is our lifeline for human contact. Bored and restless, I have nothing better to do right now than write down some of the musings I’ve had far too much free time to dwell on.
[Disclaimer… I have no living elderly relatives and am not myself in the highest risk group; I haven’t been on a plane for 2 years; also, I live remotely and quietly in a far-off island on the coast of Canada (not exactly an epicentre of viral transmission, though locals are freaking out just as loudly as urban folks). I live on a modest pension, so needn’t fear sudden unemployment. I’m well aware that this is a super-luxurious position, involving all kinds of privilege and good luck. Well, not quite as luxurious as Mr Geffen’s position, but you know what I mean: unlike millions, I am relatively safe and have time to reflect.
Also, I’m getting old… and spent my career years in Big Science… So I’ve lived through a few “end of the world as we know it” media circuses, and am more accustomed than your average bear to thinking about large numbers and long time spans. Or maybe I’m just in denial, who knows? Maybe I should be panicking, but I’m not (yet). At any rate, I hope readers will forgive my ability — or inclination — to take a big-picture view. My intent is not to dismiss or minimise whatever crisis or grief you may be coping with right now; every death is the end of a world. Still, I think it’s the responsibility of every person to try to make sense of our time, while we have breath and space to do so. I have breath and space right now, so I go on thinking.]
One of my first reactions to the Covid-19 response from national governments, I have to admit, was anger.
Not just anger because some nation-states responded late, or in naive or incompetent ways — South Korea being as of this writing the poster child for smart, pro-active, effective response and the US pretty much the opposite. Not just anger at the Chinese government for its initial, time-wasting efforts to suppress news of the outbreak in Wuhan. These were mere cynical head-shaking irritations, compared to a far deeper anger. If you have a moment, let me share a few big numbers with you…
In China, some analysts estimate, the advent of Covid-19 may have saved more lives than it ended. Why? Because in many Chinese cities air quality is so poor — due to industrial pollution — that the temporary lockdown imposed to contain the virus was actually net-beneficial. WHO estimates that about 7 million premature deaths occur every year due to ambient air pollution. Just over one million of those, in an average year, occur in China. While some sources offer a lower estimate of “only” about 6 million dead people annually, it’s still a Big Number. Every year.
Every year about 3.4 million people die from waterborne diseases. Per UNICEF, more children are killed annually by lack of access to clean water than die in wars: almost 90 thousand children under 15, every year. All-ages mortality from unsafe drinking water is estimated by some as high as 1.2 million premature deaths per year.
About 9 million people annually die from hunger, or diseases directly related to malnutrition of the “not enough food” kind (as opposed to the “too much bad food” kind).
Meanwhile Centre for Science in the Public Interest, collating data from other sources such as CDC, estimates that in the USA alone, almost 680,000 premature deaths per year can be ascribed to unhealthy diet (too much bad food, junk food, over-processed food): diabetes, obesity, heart disease, and some cancers. Per CDC also, tobacco smoking kills about 480,000 Americans every year… and about 7 million people worldwide.
It’s a wide error bar, but Harvard’s Global Health Institute thinks that between 3 and 8 million people die every year just because of low-quality medical care: “the care they receive is ineffective and often does more harm than good.” [In the US, some 45,000 people die annually because they had no health insurance and could not afford medical care. A very small number on the global scale, but surely there’s an obvious fix. Many can (barely) afford the medical care, but their lives are shattered: over half a million Americans declare personal bankruptcy every year due to unpayable medical bills.]
AIDS? somewhere between half a million and a million people per year.
And what about climate change? Forecasting its effects is difficult and controversial, but the New England Journal of Medicine (hardly a radical green pamphlet) thinks WHO’s estimate of an additional 250,000 deaths per year is too low: their projections suggest that food shortages alone could lead to an additional 529,000 adult deaths per year. For the foreseeable, that is; no end in sight.
Deaths from Covid-19 so far, world-wide: about 50,000 as of this writing. And rising, yes, I know. Rising every day.
I do realise it could get a lot worse, possibly very fast. Ebola could have got a lot worse very fast, and so could SARS. I was around for both of those. So I don’t believe that Covid-19 will inevitably go Doomsday-shaped. The Doomsday scenarios are based on a lethality rate that, so far, seems a bit soft and fuzzy due to the (criminal, imho) shortage of test kits and aggressive testing programmes. Current lethality estimates are probably inflated, but we don’t know by how much because we have no idea how many people are actually infected. We’re flying blind here, absent any statistically useful (i.e. massive) testing programmes.
I’m not saying that it’s no big deal, or that we shouldn’t be alarmed, or that we shouldn’t care, or that we shouldn’t be careful, or that it will be over soon, or that we aren’t likely to lose a lot of people before it’s over. Maybe even a Big Number of people. That’s not it, not at all.
What I’m trying to say is this: during my fairly long life I have consistently seen nothing decisive done about particulate air pollution; very little done about the provision of safe drinking water to the world’s poorest and neediest; I’ve seen junk food machines installed in US schools (!) and witnessed a steady decline in the quality of food available to average North Americans; and I’ve seen absolutely no meaningful action taken on carbon emissions and climate change. OK, there has been some feeble attempt to reduce smoking in selected countries, but obviously it’s not working too well: the Big Tobacco lobby is still a real power around the world and 7 million people are still dying annually from cigarettes.
Let me re-emphasise that the butcher’s bills I’ve been summarising above are annual death tolls, not one-time catastrophic events — not an earthquake, not a war that might kill over 2 million Iraqis but is eventually (sort of) over, not a virus that burns its way through a host population and then dies out as the survivors acquire immunity. These are premature, preventable deaths that happen every year, like clockwork, apparently forever. They are not even news. They are the background noise of our lives. The whole internet is not chattering about them. They are business as usual. No one’s eyes are glued to the latest updates on them, outside of a few doggedly determined NGOs and activist communities.
When those NGOs and activists bring pressure to bear on governments of various flavours to remedy these causes of mass mortality, they seem to get the same answers every time. We can’t afford to. It would cost too much. We can’t intervene in the free market. We can’t make people’s choices for them. We can’t shut down filthy, polluting industries, because they employ people: we have to protect jobs. The American Lifestyle is not negotiable. We can’t rewrite trade treaties. We can’t reduce our national economic growth rate. We have to protect the stock markets. We have to protect the banks. We can’t force industry to install smokestack scrubbers, it would reduce their profitability. People will never change their consumption habits. This is a shareholder society. We can’t afford, we can’t do, it’s not possible, it’s unrealistic... Action on climate change, in particular, is consistently rejected as “too expensive,” “too disruptive,” “unacceptable.” The economy, we’re told, always has to come first.
Then along comes Covid-19, and suddenly, overnight, it’s OK to ground the planes, close the borders, shut down businesses, lay off millions of workers, put whole populations under soft house arrest, restrict travel, tank the stock market. Suddenly action is possible, and governments are behaving like governments instead of like timid handmaidens to corporate power. Why do you suppose this is? Why are decisive, disruptive actions suddenly possible, that were impossible just weeks before?
On the local scale, as on the global scale, what a change we’re seeing. Suddenly, the cities of Vancouver and Victoria are providing shelter for homeless people, who previously were considered an “insoluble problem” which we “couldn’t afford” to address. But now that they are seen as a potential reservoir of transmissible Covid-19, there’s concern about them; hotels are being rented or bought to house them. Medical care is being provided. Before Covid, did anyone care all that much that homeless people were squatting in parks and on power cut lines, under bridges, in cars? Other than the merchants who wanted them “moved on” out of shopping areas, that is?
I can only come to one sad and angry conclusion. Covid-19, unlike many of the causes of mortality listed above, affects everyone. It doesn’t just happen “over there” or “far away” or to poor people or to brown people. In fact, it visibly and notoriously affects the class of people who buy cruise ship tickets and airline tickets. Its lethality curve is actually weighted towards elderly males. This is a threat like few others in our world today, one that can actually touch old, rich white men: the kind of old, rich white men who run governments and have power and make policy decisions. The kind of old, rich white men who have staunchly done absolutely nothing about the steady mass mortality statistics that affect demographics other than their own.
And this is why I started out, and remain, quietly but deeply angry. The response to Covid-19 proves that we are capable of responding. We are capable of governing. We are capable of saving lives. We are quite capable of parking the planes, working from home, ignoring the stock market, radically changing our habits, to save lives — so long as they’re the important lives, the lives that matter. We’re capable (in the US) of printing money generously to bail out banks and corporations, yet we never “had enough money” to stop polluters, fund our medical systems properly, reduce our carbon emissions, and so on.
A dear and very old friend of mine, now several years dead, lived through the Great Depression. He also lived through, and served in, WWII. One of the things that opened his eyes — and radicalised him for life, so that he was still a Socialist firebrand at 92— was that the same government that couldn’t afford to help millions of people bankrupted and desperate during the Depression, suddenly — magically — had all the money it needed to build bombers and arm soldiers. I always understood what he meant; but today I really know how he felt.
If we can do all this today — because we fear millions of people might die — why haven’t we been doing more yesterday, and last month, and last year, and the year before that, when every year millions were actually dying from preventable causes? And when the threat from Covid-19 recedes and rich old white men are safe again, will we go right back to Business As Usual?
