We’re already barreling toward the next pandemic: Ed Yong

‘This one is far from over, but the window to prepare for future threats is closing fast...

“To be ready for the next pandemic, we need to make sure that there’s an even footing in our societal structures,” Seema Mohapatra, a health-law expert at Southern Methodist University, in Dallas, told me. That vision of preparedness is closer to what 19th-century thinkers lobbied for, and what the 20th century swept aside. It means shifting the spotlight away from pathogens themselves and onto the living and working conditions that allow pathogens to flourish. It means measuring preparedness not just in terms of syringes, sequencers, and supply chains but also in terms of paid sick leave, safe public housing, eviction moratoriums, decarceration, food assistance, and universal health care. It means accompanying mandates for social distancing and the like with financial assistance for those who might lose work, or free accommodation where exposed people can quarantine from their family. It means rebuilding the health policies that Reagan began shredding in the 1980s and that later administrations further frayed. It means restoring trust in government and community through public services. “It’s very hard to achieve effective containment when the people you’re working with don’t think you care about them,” Arrianna Marie Planey, a medical geographer at the University of North Carolina at Chapel Hill, told me. 

Read here (The Atlantic, Sept 29, 2021)

India’s health system has collapsed

‘As human tragedy unfolds, there is a shortage of everything — oxygen, drugs, beds, vaccines, even cremation space...

“We have collapsed, Maharashtra is sinking and other states will follow.” The starkness of these words from Dr Jalil Parkar, a top pulmonologist in Mumbai’s Lilavati Hospital, silenced me in a way that little has through 2020 and 2021, when most of my journalistic energy has been spent on reporting the Covid crisis on the ground. “This is worse than World War Two,” Parkar said, lashing out in rage and hurt at how doctors and health workers are still targeted by angry and distraught families as well as armchair commentators “who sit behind their laptops and in their ivory towers”.

Read here (Hindustan Times, Apr 17, 2021)

Cuban socialist internationalist medicine puts capitalist countries to shame: Black Agenda Radio with Margaret Kimberley and Glen Ford

‘So few of its own citizens have [died from] Covid-19 – less than 300 — that Cuba must test its vaccines in other countries, said Dr Layla Brown-Vincent, professor of Africana Studies at the University of Massachusetts at Boston and author of “The Pandemic of Racial Capitalism: Another World is Possible.” Cuba “is helping control this global pandemic in ways that none of the capitalist countries attempt to do,” said Brown-Vincent.’

Listen here (Defend Democracy Press, Mar 22, 2021)

After a year of MCO, recovery is in sight

‘On March 18, 2020, the first Movement Control Order (MCO) was imposed and there was much uncertainty among the public and business community over what would happen next. One year on, the SARS-CoV-2 virus has taken 1,177 lives and infected 314,989 people in the country (as at March 10). Despite the grim circumstances, many see light at the end of the tunnel as Malaysia rolls out its National Covid-19 Immunisation Programme (NCIP).

‘Speaking to experts, we identify three main areas that beckons attention — healthcare, economy and last but not least politics. Covid-19 is still raging on globally, and the challenge is to vaccinate the community as quickly as possible so as to not allow the more transmissible variants to get a foothold in the community. Meanwhile, vaccine effectiveness is seen as one key driver for economic recovery. When that has effectively been executed, the focus should be on repairing the damage that has been caused by the pandemic.

‘Many also believe that political stability is one challenge Malaysia will face. There is a need to exit from the emergency rule and for the country to be given a clear mandate from a stable government.

‘In the accompanying stories, we take a look at the winners and losers in the post-pandemic era. Will pandemic winners such as the glove and technology players continue to prosper? Will the tourism, retail, hospitality and manufacturing industries as well as small and medium enterprises move away from the dire conditions brought on by Covid-19 anytime soon?

‘Nonetheless, it has been a fruitful year for local equities since the pandemic outbreak, with healthcare and technology stocks being the top gainers. What can we expect for the rest of the year after stock prices for most sectors rebounded significantly from their lows last year? We speak to heads of research to find out what they think about the market direction.’ 

Get the full story in this week’s issue of The Edge Malaysia.

Read here (The Edge, Mar 13, 2021)

What’s ahead in the second year of Covid-19?

‘When COVID-19 began its insidious march across the globe more than a year ago, it disrupted every industry and forced fast innovation as business leaders worked to adjust to a new world order. Last year, in Wharton’s Fast Forward video series, several of the School’s faculty offered their insight into what the second half of 2020 would look like during the pandemic. That insight is needed even more this year as the ground keeps shifting, vaccines are rolled out, and new coronavirus mutations emerge.

‘Much has changed since the start of the pandemic, from consumer behavior to health care delivery to working from home. What changes are lasting? And what lessons have we learned? We’ve asked some of our faculty to analyze what’s in store for the rest of 2021. Their responses appear below:

• Will working from home become permanent for nonessential employees?
• What’s the outlook for the stock market and the economy this year?
• How will the pandemic continue to change the delivery of health care in the U.S.?
• What crisis management lessons will business leaders keep going forward?
• What changes in retail and shopping will become permanent?
• What is the future of the gig economy in the U.S.?

Read here (Wharton@Knowledge, Mar 8, 2021) 

Fighting the medical monopoly: Mobilising for Zero-Covid and decommodified healthcare

‘As I have discussed in an article on Interferon 2b and Cuba’s other treatments for COVID-19, decommodified universal healthcare is the alternative to monopoly-driven healthcare ravaging countries around the globe. Not for profit production and delivery of all health related goods responding to general and specific human needs of the majority of any given country is the only means to assure quality health for all, in pandemic as well as non-pandemic times.

‘More concretely, decommodified universal healthcare is ecologically sound, public sector production of everything from food to psychological support, medicines to medical technology, and medical care. Rather than results based management and other corporate models adopted by most state owned enterprises globally in the past four decades, such public production would be designed and managed democratically by citizens, health professionals, scientists, and the range of other workers involved.

‘Taxation of corporations and rich individuals would be the primary means of financing decommodified universal healthcare. Due to the social importance of health related goods, and high employment potential given the extent of need in most countries around the globe, decommodified universal healthcare would constitute a significant segment of needs based, ecologically sound, nationally focused economies.’

Read here (The Bullet, Mar 4, 2021)

Developing countries struggling to cope with Covid-19

‘The ongoing COVID-19 pandemic is adversely impacting most developing countries disproportionately, especially the United Nations’ least developed countries (LDCs) and the World Bank’s low-income countries (LICs).

‘Years of implementing neoliberal policy conditionalities and advice have made most developing countries much more vulnerable to the COVID-19 pandemic by undermining their health systems and fiscal capacities to respond adequately.’

Read here (IPS News, Feb 23, 2021)

Medical services restored to pre-Covid-19 level in Uttar Pradesh

‘Following the continuous decline in the number of Covid-19 cases and active infections, the Uttar Pradesh government has directed state medical colleges and institutions to fully restore all outpatient and in patient services.

‘The order issued by the chief minister’s office on Friday has to be implemented with immediate effect. “Following the decline in the prevalence of coronavirus pandemic, all outdoor and inpatient services must be restored at the earliest so that people in need can have access to the required help.” 

Read here (Times of India, Feb 13, 2021)

Covid-19 pandemic has shown humanity at its best – & at its worst: WHO DG before the UNICEF Executive Board

‘Ultimately, our fight is not against a single virus. Our fight is against the inequalities that leave children in some countries exposed to deadly diseases that are easily prevented in others; Our fight is against the inequalities that mean women and their babies die during childbirth in some countries because of complications that are easily prevented in others;

‘And our fight is to ensure that health is no longer a commodity or a luxury item, but a fundamental human right, and the foundation of the safer, fairer and more sustainable world we all want.

‘History will not judge us solely by how we ended the COVID-19 pandemic, but what we learned, what we changed, and the future we left our children.’

Read here (IPS News, Feb 11, 2021)

Tribal health providers have figured out the key to Covid-19 vaccine success. Here's their secret

‘It's important to note that there are 574 federally recognized tribes, making it difficult to broadly characterize how the vaccine rollout is going across Indian Country. Native people get their health care from a patchwork system of Indian Health Service facilities, tribally-operated clinics and urban Indian health centers, and vaccination efforts have varied from tribe to tribe and state to state.

Still, the successes of some tribal health providers offer lessons for communities struggling to vaccinate their populations efficiently. Here are some of them.

• They tailored their messaging to build trust
• They have the autonomy to decide who gets priority
• This health system is owned by its people
• They made big investments in health care
• Ultimately, success depends on the nation's vaccine supply

Read here (CNN, Feb 9, 2021)

As system buckles, MOH cuts down testing of close contacts

‘With the healthcare system at breaking point due to the surge in the number of Covid-19 patients, the Ministry of Health is trying several new approaches to ease the burden. Yesterday, the ministry issued a new circular containing changes in contact tracing and priority for swab tests.

‘According to Health Ministry sources, they would no longer test every individual identified as close contacts to Covid-19 positive patients and instead only test those with symptoms. "All close contacts must be identified, ordered to undergo isolation and monitoring at home. However, Covid-19 screening test would be done only on close contacts who are symptomatic," said the notice sighted by Malaysiakini.’

Read here (Malaysiakini, Jan 14, 2020)

The racism that undergirds global public health

‘With his thin volume (143 pages of text, with 46 pages of notes) Epidemic Illusions: On the Coloniality of Global Public Health, Eugene Richardson takes to task the discipline of epidemiology, and with it, global public health. Utilizing the West Africa Ebola epidemic of 2013-2016 as his canvas, Richardson paints a picture that highlights the racism that undergirds the conventional medical and public health perspectives.

‘Richardson is an infectious disease specialist and an anthropologist. He has extensive experience responding to health crises around the globe, including joining Partners in Health to care for those suffering from Ebola in Port Loko, Sierra Leone.’

Read here (Counterpunch, Jan 5, 2021)

The governance of Covid-19: Anthropogenic risk, evolutionary learning, and the future of the social state

‘We consider the implications of the Covid-19 crisis for the theory and practice of governance. We define ‘governance’ as the process through which, in the case of a given entity or polity, resources are allocated, decisions made and policies implemented, with a view to ensuring the effectiveness of its operations in the face of risks in its environment. Core to this, we argue, is the organisation of knowledge through public institutions, including the legal system. Covid-19 poses a particular type of ‘Anthropogenic’ risk, which arises when organised human activity triggers feedback effects from the natural environment. As such it requires the concerted mobilisation of knowledge and a directed response from governments and international agencies. 

‘In this context, neoliberal theories and practices, which emphasise the self-adjusting properties of systems of governance in response to external shocks, are going to be put to the test. In states’ varied responses to Covid-19 to date, it is already possible to observe some trends. One of them is the widespread mischaracterisation of the measures taken to address the epidemic at the point of its emergence in the Chinese city of Wuhan in January and February 2020. 

‘Public health measures of this kind, rather than constituting a ‘state of exception’ in which legality is set aside, are informed by practices which originated in the welfare or social states of industrialised countries, and which were successful in achieving a ‘mortality revolution’ in the course of the nineteenth and twentieth centuries. Relearning this history would seem to be essential for the future control of pandemics and other Anthropogenic risks.’

Read here (NCBI, Dec 4, 2020)

MMA says private healthcare underutilised in battle against Covid-19

‘The Malaysian Medical Association (MMA) has called on the government to incorporate private healthcare in its fight against Covid-19, saying that the sector's capabilities are being underutilised. "Our government healthcare facilities should not be taking on this battle all on its own. Private healthcare, an important component in our country’s overall healthcare system, can be an added strength in managing Covid-19 but is still underutilised.’

Read here (Malaysiakini, Nov 23, 2020)

‘No one is listening to us’

‘More people than ever are hospitalised with COVID-19. Health-care workers can’t go on like this...

‘For many health-care workers, the toll of the pandemic goes beyond physical exhaustion. COVID-19 has eaten away at the emotional core of their work. “To be a nurse, you really have to care about people,” Neville said. But when an ICU is packed with COVID-19 patients, most of whom are likely to die, “to protect yourself, you just shut down. You get to the point when you realise that you’ve become a machine. There’s only so many bags you can zip.”...

‘As hard as the work fatigue is, the “societal fatigue” is harder, said Hatton, the Utah pulmonary specialist. He is tired of walking out of an ICU where COVID-19 has killed another patient, and walking into a grocery store where he hears people saying it doesn’t exist. Health-care workers and public-health officials have received threats and abusive messages accusing them of fearmongering. They’ve watched as friends have adopted Donald Trump’s lies about doctors juking the hospitalization numbers to get more money. They’ve pleaded with family members to wear masks and physically distance, lest they end up competing for ICU beds that no longer exist. “Nurses have been the most trusted profession for 18 years in a row, which is now bullshit because no one is listening to us,” Neville said.’

Read here (The Atlantic, Nov 13, 2020)

Johns Hopkins calls for papers on Covid-19 and systemic racism

‘The Johns Hopkins Center for Health Security’s journal, Health Security, issued a call for papers for an upcoming Special Feature on systemic racism in the context of the COVID-19 pandemic (scheduled for May/June 2021). The COVID-19 pandemic’s impacts on health, economies, and social structures have disproportionately impacted racially marginalized populations. Racial and ethnic minority communities are experiencing elevated COVID-19 morbidity and mortality, stemming in part from ineffective response efforts and longstanding barriers to accessing healthcare and public health programs and services. Evidence-based and peer-reviewed research is urgently needed to examine the root causes and impacts of systemic and pervasive racial and ethnic inequities in the context of COVID-19 as well as how systemic racism manifests in the practice of health security, including in preparedness for, response to, and recovery from COVID-19. The journal is actively encouraging submissions from women, underrepresented minority scholars in health security, and scholars with disabilities.’

Read here (Johns Hopkins Center for Health Security, Oct 23, 2020)

‘No longer groping in the dark’: NCID doctors share how Covid-19 is being treated in Singapore

‘So far, 28 people have died of COVID-19 in Singapore - one of the lowest mortality rates in the world. In the US, where there have been about 8 million cases, more than 200,000 people have died. As of Saturday (Oct 17), 37 COVID-19 patients remain hospitalised in Singapore, with none in intensive care. More than 99 per cent of those infected have been discharged, while there are 41 in community care facilities.

‘But it wasn't always like this. Three National Centre for Infectious Diseases (NCID) consultants told CNA how treatment of the novel coronavirus has evolved here and how NCID has kept the number of critical cases low.’

Read here (Channel News Asia, Oct 18, 2020)

The long shadow of the pandemic: 2024 and beyond

‘Even when the world returns to ‘normal,’ the legacy of Covid-19 will transform everything from wages and health care to political attitudes and global supply chains...

‘One impact of the Covid-19 pandemic may be that society will begin to take scientists and scientific information more seriously. In medieval times, the manifest inability of rulers, priests, doctors and others in positions of power to control the plague led to a wholesale loss of faith in corresponding political, religious and medical institutions, and a strong desire for new sources of authority.

‘It is possible that the inability of our political institutions to fight the virus will have similar implications. The public’s expectation of effective state action will likely rise in the immediate and intermediate periods, if deaths continue or accelerate. And if the response continues to be incompetent, confidence in existing political institutions will fall. The many failures of American government at every level in confronting the pandemic, especially when compared with other countries, may result in a shift in political preferences aimed at undoing the existing order.’

Read here (Wall Street Journal, Oct 16, 2020)

China got better. We got sicker. Thanks, Trump

‘Public health expert Dr. David Katz argued in a New York Times op-ed and in an interview with me back in March that we needed a national plan that balanced saving the most lives and the most livelihoods at the same time. If we just focused on saving every life, we would create millions of deaths of despair from lost jobs, savings and businesses. If we just focused on saving every job, we would cruelly condemn to death fellow Americans who deserved no such fate.

‘Katz argued for a strategy of “total harm minimization” that would have protected the elderly and most vulnerable, while gradually feeding back into the work force the young and healthy most likely to experience the coronavirus either asymptomatically or mildly — and let them keep the economy humming and build up some natural herd immunity as we awaited a vaccine.

‘Unfortunately, we could never have a sane, sober discussion about such a strategy. From the right, said Katz, we got “contemptuous disdain” for doing even the simplest things, like wearing a mask and social distancing. The left was much more responsible, he added, but not immune from treating any discussion of economic trade-offs in a pandemic as immoral and “treating any policy allowing for any death as an act of sociopathy.”

Read here (New York Times via Salt Lake Tribune, Oct 15, 2020)

Offline: Covid-19 is not a pandemic -- It is a syndemic: Richard Horton

‘The most important consequence of seeing COVID-19 as a syndemic is to underline its social origins. The vulnerability of older citizens; Black, Asian, and minority ethnic communities; and key workers who are commonly poorly paid with fewer welfare protections points to a truth so far barely acknowledged—namely, that no matter how effective a treatment or protective a vaccine, the pursuit of a purely biomedical solution to COVID-19 will fail. Unless governments devise policies and programmes to reverse profound disparities, our societies will never be truly COVID-19 secure. 

‘As Singer and colleagues wrote in 2017, “A syndemic approach provides a very different orientation to clinical medicine and public health by showing how an integrated approach to understanding and treating diseases can be far more successful than simply controlling epidemic disease or treating individual patients.” I would add one further advantage. Our societies need hope. The economic crisis that is advancing towards us will not be solved by a drug or a vaccine. Nothing less than national revival is needed. Approaching COVID-19 as a syndemic will invite a larger vision, one encompassing education, employment, housing, food, and environment. Viewing COVID-19 only as a pandemic excludes such a broader but necessary prospectus.’

Read here (The Lancet, Sept 26, 2020)