an essay in the series science perspectives

January 8, 2021 leave a comment

The COVID-19 pandemic and its handling in different cultures and societal segments illuminates structures, values, believes, and capabilities, and it puts them to a test. By the end of 2020, the results – measured in cumulative cases and deaths, but also in economic impact – are shockingly different. So different indeed that Western cultures still grapple to even accept, let alone to critically evaluate them.

The situation at large has a multitude of aspects and we are very far from having an even handed and objective overview, if that exists at all. The one on the current public mind in the West – the population’s current health – is rivaled by that of the economic situation and its prospect. Looming behind those immediacies are long-term public health, both in light of the current pandemic and of foreseeable future ones, health beyond just the body, long-term redistribution of wealth between social groups but also of resources between different societal sectors, activities, and issues with diversity, environmental change, mobility and travel, science and technology, education and opinions, as just some assorted glitters.

Here, we will not plow through that jungle of important and interrelated aspects, but aim for a much larger perspective, the current phase of humankind’s cultural evolution as it is illuminated by the COVID-19 pandemic.

a pandemic’s spotlight on our cultures

Let us first take a quick look at aspects of our cultures in the spotlight of COVID-19.

some numbers

In China, where this pandemic emerged, records show less than 100’000 cases so far, less than 1 in 14’000 persons, with less than 5’000 persons dead because of the virus. Furthermore, the disease was under control within some 5 months of its outbreak, by April 2020. The most severe measure, a lockdown, indeed was imposed for a much shorter time. In Wuhan for instance, where the disease started, it lasted for just 76 days. The picture is essentially the same across much of Eastern Asia.

In contrast, reports for the much smaller USA show numbers of cases exceeding 20 millions – about 1 in 16, compare that to China’s 1 in 14’000! – and numbers of deaths approaching 400’000, both increasing at record rates also 8 months after the undeniable outbreak in the country, and some 12 months after the first solid warning. Admittedly, the situation in the USA, and in a few other states as well, is largely determined by personal incompetence and deficits of the political leaders – by current social standards – and by the inability of the political establishment to moderate the situation.

It cannot all be dumb incompetence, however.

Continental Europe, with its apparently much more moderate, more scientifically open leadership, and with the extraordinary capacity of its health system at large, it did not fare much better. Total cases, excluding the UK, approach 15 millions with almost 400’000 deaths, and some 12 months after the first undeniable outbreak the community is still struggling.

Looking at two very small and extraordinarily wealthy states – Singapore with 5.7 million inhabitants and Switzerland with 8.5 millions – reveals a comparably stark contrast as the comparison between China and the USA. Singapore reports less than 60’000 total cases so far with just some 30 dead, the globally lowest per capita death rate, and the pandemic appears under control after some 7 months, despite the outbreak of a second wave. In contrast, the total number of cases in Switzerland approach 500’000 with more than 8’000 deaths, and the disease is far from being controlled also 10 months into the outbreak in this country.

what is different?

As a preliminary, by January 2020 the pandemic was on the news in many countries worldwide and by February it was known what worked to containing it – masks, tests, and strict containment of infected persons and of their contacts –, even though many details where still in the dark. Some consequences of those measures were also very clear: a disruption of the economy at large and of most social environments together with a severe restriction and control of individual freedom.

It appears fair to assume that in face of the unfolding pandemic, all functional governments attempted to steer an optimal course for their countries, optimal given their

• cognitive capabilities
• judgement of the situation, and
• capabilities to act.

There are a few noteworthy exceptions to this, most prominently the USA, that can readily be related to a governing structure that did not aim for the country’s good, not according to current cultural standards.

Focusing on well-intended governments only, the observed qualitative differences of COVID-19’s impact must result from differences in cognition, judgement, and action.

cognition

For COVID-19, cognition does not appear to be a significant differentiator between states. Signs of an unknown flu-like illness emerged in the middle of December 2019. A first internal report was filed on December 27, by a doctor who had been involved in the SARS epidemic and recognized the similarity of symptoms. Two days later, on December 29, officials of the Wuhan Center for Disease Control and Prevention had been informed and the next day the first public message had been issued, reporting a total of 27 cases. The information spread internationally at latest by December 31 when the World Health Organization (WHO) had been informed and the international press had picked up the issue.

At the latest by January 3, 2020, authorities worldwide were aware that “this (outbreak) is a very big deal”.

Beyond the rapid, albeit naturally still vage information for the specific case, there already was a general awareness of the threat posed by pandemics. This is manifest in various documents like the International Health Regulations of the WHO, a legally binding document that was last modified in 2005 in response to the SARS outbreak and signed by 196 countries. Another example is the National Strategy for Pandemic Influenza of the USA, also of 2005. The corresponding master plans were first exercised to cope with the 2009 swine flu that supposedly originated in Mexico. That epidemic indeed went undetected for a fairly long time, exposing the local cognition bottleneck there.

In another realm of cognition, or awareness, that of the population, there is a difference, however. In Western societies, local epidemics were still a distant memory in 2019, and more associated with Africa and Eastern Asia. The widespread presumption was that at home, the Western health system could readily cope with any such challenge. Indeed, past epidemics lent some support to that presumption: the swine flu in 2009 claimed just some 3’000 lives across all of Europe, SARS, in 2002-2004, less than 800 globally, 80% of which in Asia, and the much more severe Asian flu with 1…4 million global deaths affected Europe only moderately, and that was already far back, in 1957 to 1958.

The situation is very different in Asia, where epidemics played an important role in shaping the modern societies [Peckham 2016].

judgement

In the early phase, judgement of the situation was apparently very different. China rushed to build “instant hospital”. In Wuhan, construction of the first such hospital started on January 23, was completed 10 days later, on February 2, and it opened the next day with a capacity of 1’000 beds. Five days later, a second new hospital opened, with 1’500 beds. Between February 3 and 18, 16 such “instant hospitals” were built, each with a capacity exceeding 1’000 beds. This allowed to hospitalize and isolate also mild cases and thus reduce the spread of the disease. By March 10, all those hospitals were again closed as the epidemic was under control of the regular health system. In stark contrast, governments throughout Europe and the USA ascertained that their health systems were ready to take the challenge. This turned out to be a massive misjudgment that wasted a lot of valuable time, and eventually lifes.

Once the epidemic’s outbreak was undeniable, the next level of judgment had to assess the consequences of effective countermeasures, which in the most reduced form boils down to public health vs economy, specifically to how many hospitalized or dead vs percentage of economic decline?

Fortunately, there is no fundamental uncertainty with respect to the overall effect of the required drastic measures, and indeed no contradiction between different goals.

Previous epidemics already showed that a quick and resolute reaction led to lower total loss of lives, lower health costs, and a quicker economic recovery. In the course of time, this also proved to be correct for the current pandemic.

However, there is a differentiation between different economic branches and also between different societal segments. Air travel took a huge hit, for instance, while online services and the pharmaceutical industry soared. In analogy, workers who depend on machinery faced a very hard time, while others were essentially unaffected or even profited. This differential impact apparently was a major cause for the severely delayed and crippled actions seen in Western countries and communities, and it continues to play a strong role.

action

The capability to act is the third and, in my view, the most differentiating aspect for a society’s response to a challenge like COVID-19. Who comes up with the vision and decides on the specific steps and measures? Who influences these decisions? Who executes them? Who controls, adjusts, and relates to the larger vision? What power do the respective bodies have to realize what they deem necessary? This assortment of questions reaches far beyond the current focus and we can only touch a few aspects. Fortunately, in what follows neither details nor a comprehensive perspective are all that important. What matters is that there are structural differences between states and cultures. Let us just glimpse at two positions in this large field: China and Western states, two conglomerates of comparable size, one often perceived as a single and uniform state, the other one as a group of dynamically organizing state units. That perception, of course, refers to a time span of a few hundred years, which appears relevant for the past development and dynamics of states.

China, first and foremost, is a very old civilization that developed in an essentially unbroken succession over more than 2’000 year. It is this civilization Chinese people identify with and it is this civilization that is protected and promoted by the state. As the guardian of the population’s identification, the state has an outstanding legitimacy, one that is far greater than that of any Western state, one that has nothing to do with democracy. As a consequence of its superordinate focus, the state has an extraordinary mandate, and power, not just over the population as such, but over all aspects of the civilization, from industry to culture. China thus has been called a civilization state and contrasted with the nation states of the West [Pye 1990, Jacques 2012].

Western states are all fairly young, even though they do have old roots, and they are predominantly built on the concept of democracy. Democracy originally was based on individual persons and the individual continues to play the central role, at least in the societal narrative. However, as population sizes increased, as a consequence also the complexity of societal challenges, democracy evolved towards a system of representations for a dynamically changing set of power-groups. These groups are fairly disparate, each following a limited range of interests within the larger civilization, and they are only partially transparent, at best. Examples of such groups are political parties, special interest groups like environmentalists, or the various industries.

In contrast to a civilization state, the Western state has no superordinate aim to which an overwhelming part of the population would agree, except maybe for mantras like “democracy” and “individual freedom”. Rather, the state balances particular interests of its power-groups, none of which is guided by an all-embracing perspective or claims to be so. Indeed, the very functioning of democracy hinges on individual groups pursuing their specific interests with the anticipation that this leads to a good overall solution for a diverse society with multi-facetted value systems and facing a kaleidoscopic environment. Naturally, the state thus has no universal mandate or power and all its actions can be challenged by any part of its constituency.

The capability for swift actions that touch a large part of society, actions as they are required to respond to a pandemic, is thus fundamentally different between civilization states and democratic states. A functional civilization state can rely on its legitimacy and on the trust of its population to implement also drastic measures that may not be understood immediately by everyone. Illustrative examples in the context of COVID-19 include first of all China, but then also Taiwan, Vietnam, or Singapore. In contrast, a democratic state that follows the narrative of each individual having the capacity to judge any situation on his or her own, at least in principle, and of acting accordingly, such a state will respond very slowly. It first has to educate, persuade, even coerce its constituents before a concerted action becomes feasible and this action is typically not optimal against the threat but a compromise between the power-groups. Illustrative examples here include France, Italy, Germany, or Switzerland.

…to be continued

references

Jacques, M., 2012: When China Rules the World: The End of the Western World and the Birth of a New Global, Penguin Books, New York, 2. edition.

Peckham, R., 2016: Epidemics in Modern Asia, vol. 15 of New Approaches to Asian History, Cambridge University Press, Cambridge.

Pye, L. W., 1990: China: Erratic state, frustrated society, Foreign Affairs, 69, (4), 56–74.