Covid Spread Threatens Democracy But (Almost) No One Cares...Except Billionaires?

Public health is public wealth, a historian reminds us in a new book. Accepting preventable disease and death undermines democracy and society's capacities to cope with future challenges.

Image Source:Orlando_Furioso_frontispiece_of_canto_XVII.jpg (Wikimedia)

There’s been much ado recently on social media about Covid precautions at this year’s World Economic Forum (WEF) conference held last week in Davos, Switzerland. This annual forum convenes statesmen and women, including the UN Secretary-General, global multinational CEOS, journalists, and environmental activists.  The forum’s Covid mitigations included PCR testing required for admission, HEPA air filters in meeting rooms, and brisk ventilation. The WEF’s “Guidance on Health Measures”  explained its Covid protocols, encouraging participants—who were strongly advised to arrive already vaccinated against Covid—to use the venue’s complimentary masks and rapid antigen Covid tests.  The goal of these precautions was simple:  to stop transmission of Covid, something not being done almost anywhere else in the world.

None of this is surprising.  If you’re familiar with the WEF, you know that its annual Global Risks report is its flagship product which assesses key risks facing the world.  Consider how embarrassing it would be for its producer to host a super spreader event infecting thousands of the world’s government and business leaders because it failed to anticipate the risks involved!  Respecting known and unknown risks is the currency of global strategic assessments such as those produced by the WEF.

Similarly, for anyone with time to read medical science reports about the rapidly mutating SARS-COV2 virus (which includes almost no one with a job and/or children to tend to), none of the mitigations at the WEF would be surprising. That rare observer knows that the precautions evident at Davos should by now be visible in every train station, school, place of worship, hospital, and airport of the world.   Yet for the bulk of humanity, there are no precautions in place despite Covid’s impact as  “the greatest mass-disabling event in human history.”  Vaccine nationalism has excluded more than a quarter of the world’s population from receiving a single Covid vaccine.  Amid this global inequality, which most harms traditionally vulnerable and marginalized communities, Covid has taken at least 15 million lives so far, and at least 65 million people are afflicted with Long Covid. And there’s evidence that children’s bodies respond differently to the virus and may be more at risk from reinfection. And this is just the beginning, not—as many would have us believe—the end; Long Covid has been called the “silent pandemic” or a pandemic within a pandemic.

The Covid pandemic is one of the first truly global crises in our modern era, penetrating every household and institution. Emerging in our new epoch of climate upheaval, and stemming from the same entangled root causes of ecosystem destruction, the pandemic has exposed global incapacities for dealing with the very risks the WEF’s annual report assesses. (Twenty years ago, a French microbiologist warned about the inevitable “infection of society” due not to the behaviors of microbes but to modern society’s selfish and shortsighted norms.) It’s true that leaders of global institutions, such as the United Nations (UN) and the World Health Organization (WHO), recognized early in the pandemic that “no one is safe unless everyone is safe” and that inequities in vaccine access would prolong it—adding to its human and economic toll.  But it wasn’t long before their pleas for a globally coordinated pandemic response ceased.

Playing Covid Roulette In place of these global leaders’ entreaties for international pandemic cooperation—which in any case were undermined by the WHO’s failure to clearly and publicly identify that transmission of the SARS-COV2 pathogen is airborne (just like the original SARS)—emerged a resolutely contrary reaction:  a doubling down on business-as-usual.  From northern Europe to Australia and from Canada to the United Kingdom and the U.S., senior public health officials have provided nearly identical disease-minimizing talking points to media outlets.  The message is that widespread and repeat infections are inevitable: “you do you” and we’ll all get back to normal. This guidance defies the evidence known from the pandemic’s outset, and which only has mounted since, of potentially long-lasting Long Covid injury due to even a single Covid infection. Such public health pronouncements seemed fatalistic but pushback has been minimal; one notable rejoinder has come from a group of experts recently interviewed on an Australian media network, while another from a prominent British writer and activist who warns that we are all “playing Covid roulette.” 

International leaders’ retreat from serious efforts to thwart Covid have spread not only disease but complacency, exacerbated inequality, ensured a greater human toll from accelerating epidemiological risk, piled more work onto already burned-out healthcare systems and workers, and widened openings for anti-vaccine conspiracy theorists and ethno-authoritarian backlash. One almost gets the sense that there has been global cooperation of a sort, an agreement to actually facilitate the infection of global society, though such an unimaginably anti-public health stance beggars belief.

Despite this lost momentum for needed transformation, the stark realities of the pandemic make the need for a dramatic course correction hard to conceal.  At least, this is clear if you’re closely following what scientists are learning and sharing with each other on social media about the disease’s effects.  One alert reader is the Substack newsletter writer, Jessica Wildfire, who has compiled on an online bookmarking app dozens of science papers documenting COVID’s effects on the human immune system, among other topics. But as far as most of the public is concerned, other news dominates the headlines—grave crises that also require our attention and concern, such as Russia’s ongoing assault on Ukraine.  Closer to home, most are tired of hearing about a pandemic they want to believe is over.  Our for-profit media system caters to our preferences by mostly ignoring it too.

Leveraging the “Ostrich Effect” as Public and Media Policy This lack of media attention affects our risk perceptions; if the media is not discussing Covid, we assume the disease must be of little concern. Such circular reasoning has led to a situation of disease denial and mass delusion not to mention also a numb and occasionally callous indifference to the suffering of people whose lives have been ruined (or lost altogether) due to Covid, a preventable disease. Such indifference can mushroom quickly into atrocities as the late Holocaust survivor and Nobel Laureate Elie Wiesel warned.

Oftentimes to avoid such hard truths and regain a sense of normalcy we paper over reality. The truth of the pandemic, particularly with mounting evidence of Covid’s lasting damage to the human body, can feel overwhelming, and this may explain why so few public health officials even talk about it.  In an exception, soon after returning from the WEF meeting, German Health Minister Karl Lauterbach told a German newspaper that anyone infected with Covid is at risk of developing “incurable” immune deficiency; he later tried to walk back use of the word “incurable” but his warning remains. The virus that causes Covid, SARS-COV2, continues to surprise, but many people act as there’s nothing to worry about so long as we’re vaccinated. (Vaccinations are essential to reduce one’s risk of hospitalization and death from Covid, and may, according to the Centers for Disease Control, reduce its transmission.) There’s rarely any concern expressed about Covid’s medium- and long-term implications. This hubris endangers everyone.

The human tendency to be overwhelmed by issues one cannot individually control leads to a self-protective cognitive salve that, multiplied through a society, increases public passivity.  The course of the pandemic is all out of our hands, we say, preferring to blindly trust that the future will take care of itself.  We choose to limit our exposure to negative information, a cognitive bias sometimes called the “ostrich effect.” We don’t question the good news that the pandemic is over.

Unfortunately, we cannot end a pandemic by declaring it over, avoiding the topic in our conversations, or avoiding scientific discussion of it in our newspapers.  (By contrast, US business journals, such as Fortune and Forbes, have been noticeably more forward-leaning and accurate in their coverage of Covid-related risks for human health and the economy.)  There’s already evidence of a broken labor force due to Covid deaths and illness, and no reason on the current path to think this situation will improve.  Other Covid-related consequences include the impact of labor shortfalls on unemployment rates, sharply dropping life expectancy, rising maternal mortality, and millions of children around the world left orphaned by loss of a parent or guardian. Much of this was predictable though public health officials mostly remained mum; one exception was a warning on her personal Twitter account by the WHO’s Chief Scientist Soumya Swaminathan, shortly before she announced plans to resign, that countries affected by Covid-19 “need to prepare for large increases in cardiovascular, neurological, and mental health disorders.”

Unchecked Disease Transmission Threatens Democracy   Unchecked disease transmission makes a society more susceptible to other setbacks, including in the geopolitical sphere. This leads to paradoxes that few apparently recognize in their desire to move past Covid.  A disease-ridden society with no collective mitigation efforts, let alone a shared factual basis of what risks it faces, cannot maintain its institutions, ensure adequate standards of living, or pursue its interests abroad.  It is, after all, the hallmark of fascism, as noted by Yale professor and historian Timothy Snyder, in his book, The Road to Unfreedom,  not only to suppress facts but to “put factuality itself in question,” to rewrite history and narratives of present reality, all while preemptively quashing the ideas of progress and a better future based on knowledge.   Information overload, disinformation, and disease minimization play into these dangers.

Such new realities emerging from the Covid crisis are reshaping the contours of our world in ways we would be foolish to ignore.  In such a world-changing event, some of the pandemic’s biggest surprises and shocks are still ahead, practically guaranteed in fact by the reality that many of us are distracted by more recent and visible crises, as the WEF’s recent Global Risks report notes.  Global Risks 2023 points to “pandemic fatigue” to explain a decline in risk perceptions about Covid among executive opinions it surveyed. But, the report warns, “silent crises with cumulative impacts can quickly outpace a one-off catastrophic event.”  All the more reason to invest in anticipating potential second- and third-order effects of the pandemic. All the more reason to learn from history.  The experience of past public health crises and their intersection with politics and world affairs is too little understood.   

The 1918 Flu Pandemic The U.S., for instance, has frequently responded to public health disasters in ways that sought to advance primarily political, commercial and even military objectives. In the run-up to entry by the United States into the Great War, known today as World War I, an influenza broke out that would kill at least 50 million and possibly as many as 100 million people worldwide, 675,000 of them Americans, according to epidemiologists today, writes John M. Barry in his account in The Great Influenza: The Story of the Deadliest Pandemic in History. Although bodies of the dead were stacked so high in towns across America that morgues could not keep up in processing them and undertakers ran short of coffins, there was no acknowledgement of the crisis from government officials.  There also was a shortage of healthcare workers; in Philadelphia alone, 850 doctors and nurses were away in the military.  Instead, intent on mobilizing Americans for the war effort, Wilson made criticism of the government on any subject, even if what was said was true, punishable by twenty years in prison.  Thousands of posters and advertisements encouraged people to report anyone who spreads “pessimistic stories…”   Conscripts packed into overcrowded barracks and then railcars on the way to ships that would take them to Europe were easy targets for the virus. Barry notes that the flu spread rapidly among the troops in these confined conditions, and many died of it before they ever got to Europe.

For Americans facing a novel virus causing illness with terrifying symptoms that killed mostly young adults, there was nowhere to turn for reliable information. Newspapers were no help.   Instead of providing explanations for what the public was experiencing, hundreds of newspapers, day after day, provided variations on the reassurance that “there is no cause for alarm if precautions are observed.”  Some said that the Spanish influenza “is nothing more or less than old-fashioned grippe,” while others said nothing at all. According to Barry, “the more officials tried to control [public information] with half-truths and outright lies, the more the terror spread.” Society is ultimately based on trust, Barry concluded.  He recommended that in such a crisis: “Those in authority must retain the public’s trust.  The way to do that is to distort nothing, to put the best face on nothing, to try to manipulate no one.”

“The City of Death” A century earlier in New Orleans, elites used recurrent yellow fever epidemics to consolidate their power and wealth and to justify slavery as essential to developing the region of the just-acquired Louisiana Purchase. In her book, Necropolis: Disease, Power, and Capitalism in the Cotton Kingdom, historian Kathryn Olivarius describes how yellow fever became socio-economically endemic in New Orleans through a phenomenon she calls “immunocapitalism.” 

Olivarius’ book is a timely reminder that economic ideology has been created on the backs of exploited people threatened by poverty and disease throughout the history of the US (and well beyond, of course, as it’s the story of capitalism).  Her account of the little known history of New Orleans’s struggles with yellow fever epidemics—particularly in the antebellum period when it was the deadliest city in America with triple the average national mortality rate—is frequently shocking.  It describes horrors that befell victims of yellow fever in such graphic detail that they are burned into the reader’s mind.  Also unforgettable are her accounts of the city’s leaders’ disinterest in reducing the human toll of a status quo that was making them wealthy.

 “Immunocapitalism,” as Olivarius explains, provided “ideological legitimation for vast inequality” in 19^th century New Orleans, which she describes as a stinking hellscape of squalor and suffering. Its population was wracked with recurrent yellow fever epidemics and livestock were butchered in the streets, their entrails left to rot in the sun.  White elites used the poorly understood disease, which killed half of its victims, to justify the expendability of poor White laborers’ lives and the enslavement of Black workers about whom they constructed a myth of natural immunity to yellow fever to justify slavery. The city leaders maintained that only Black people could transform the swamps into profitable sugar and cotton plantations, according to Olivarius. The rest of the city’s hard labor supporting its commercial activities could be done by White immigrants whose bodies, if they succumbed to yellow fever, often would simply be dumped into the Mississippi River like “dead hogs,” according to an eyewitness written account from the times. Surviving yellow fever, however, would give the White newcomers an entry into society’s better jobs and opportunities for marriage. Being “acclimated” was a credential, Olivarius explained in an interview on her book, much as a college degree is today.

New Orleans’ elites counted on a constant stream of such young and naïve White workers from the north.  New Orleans attracted them with advertisements that minimized disease risks and instead presented work life in the city as a pathway to riches. Young people who took the bait soon discovered that they were outsiders in New Orleans’ society and entirely disposable unless they survived yellow fever and became “acclimated,” according to Olivarius.  Despite the ever-present risk of death due to yellow fever, New Orleans’ leaders insisted that “the state had no responsibility for the health of its inhabitants. Instead, it was the individual’s personal duty to get acclimated.” (Sound familiar?) The city’s leaders were, moreover, completely disinterested in public health or supporting hospitals and charity workers who took care of the sick; they viewed such expenditures as wasteful since they could count on an easily replaceable work force.  (Hmm.) Some of them did take steps to relocate their enslaved workers, whom they considered valuable property, to Mississippi to get them away from the diseased city.

The system of immunocapitalism, according to Olivarius, depended on the success of elites in pitting the people in New Orleans against each other in their scramble for survival.   Immunocapitalism thus practiced hardened the South’s defenses of slavery and the “diseased status quo” which in turn fueled southern secessionist grievances leading up to the Civil War, writes Olivarius.

The New Orleans elites’ refusal to explore alternatives to the status quo because it was working for them finds parallels in the present crisis.  Through a contemporary optic, we can perceive that the significance of the Covid-cautious meeting in Davos is not that the elites undertook precautions for themselves, but that the rest of the world has become acclimated to not expecting the same protections of clean indoor air (!) for themselves or their children. This acquiescence to individualizing all responsibility for mitigating a disease that requires a collective counterresponse effectively enables immunocapitalism in our times.

Olivarius’s work reminds us of the dangers of becoming indifferent and calculating, like the New Orleans elites almost 200 years ago, about the preventable suffering of others. New Orleans was called “Necropolis” and “City of Death” by outsiders.  From this we can extrapolate a future vision of global society on the path it’s on now and it’s a dark one. When we accept that at least ten percent and upwards of thirty percent (or more) of people infected with Covid suffer potentially life-long disabilities as a result, what else will we accept? When this happens in a pre-existing context, moreover, of unequal access to quality healthcare and other inequities, it’s easy to see the widening of what Steven Thrasher, calls a “viral underclass,” in his insightful book, The Viral Underclass: The Human Toll When Inequality and Disease Collide.

Today, however, many have accepted the idea that Covid has been neutralized when in fact the opposite is true; so far the virus’s evolution into new variants has outpaced the capacities of the world’s major pharmaceutical companies to produce updated vaccines.  With more countries winding back their monitoring of the virus’s genomic evolution, moreover, there’s growing risk of an incomplete epidemiological picture.

There is no elected leader anywhere, apparently, questioning whether viable alternatives exist to the current path of unmitigated disease transmission.  No one is presenting public policy alternatives (except for the example of #DavosSafe at the WEF last week) to the current policies facilitating widespread death, suffering and mass disabling of millions of people. The upshot must be that it’s past time to quit the make-believe world of neoliberalism that brought about such flawed thinking and legitimized dehumanizing values, but what will replace it?

Looking to Covid’s known and unknown risks, it’s clear that societal self-harm fails the test of even a pretense at a social contract between government and people.  Short-sightedness means we ignore what such unmitigated disease spread means for our economic and international security, our children’s futures, our democratic freedoms, national security, public safety and food security, and our capacities for decency and respect for each other and human rights generally. Do some people—our modern-day “immunocapitalists?”— think they’ll escape the worst?

In sum, there’s almost no bigger deal right now than what this virus is doing to the world of human affairs. Ours is a world already facing global threats to democracy and straining to deal with intensifying climate disruptions. These challenges need to be considered holistically because they are “polycrises”—interconnected with and amplifying each other’s effects. (I recently published a piece related to this.)

We need to think about the bigger picture, drawing different disciplines and voices not usually engaged regularly into the mix. We also need to be open about root causes: even children can see through the self-defeating nature of leadership responses to Covid. And it’s a big deal if we’re surrendering to Covid because it suggests we won’t fight to protect public health in the climate-disrupted epoch that we already live in. And in such a turbulent world of new and old challenges, what’s important if human health isn’t?

As Olivarius notes in her book, New Orleans eventually discovered that “public health is public wealth” and that’s what we need to re-learn today. More disease outbreaks, including pandemics, due to higher temperatures and habitat loss scrambling global biodiversity are now inevitable.  We need to know the consequences of prioritizing our need to “get back to normal” today over preparing our societies for the challenges of tomorrow. We need to expect more of ourselves:  more imagination, foresight, and compassion for starters.  We must confront the realities of Covid by taking it as seriously as billionaires do.