Ambiguity, uncertainty and the fog-of-pandemic – the dominant themes of our time. There is no unifying public sphere with sufficient authority at this point to settle any of it for people who are not of a particular persuasion.
But on a global level, Covid hasn’t stopped “coming back to try the door”. Herein notes from just a few books I read over the recent holidays.
17 January 2022 (Paris, France) – When I had Covid, at the end of August 2020, I spent four weeks in bed with an intermittent fever and a strong feeling that my body was dealing with something unfamiliar. It would develop into long Covid which did not abate until March 2021.
But I was lucky: it was only the “moderate” version of Covid as my doctor told me and he had some thoughts on getting me through long Covid (a bunch of pills + I fled to the sea and sun in Crete).
But it wasn’t much fun. I had the semi-delirious sense that my body knew it was dealing with a new illness. I would feel OK and then not OK, in waves. The image that stuck in my mind was that of a writer who also was struck down and said on his blog:
It was like being in a room in a not very good hotel where somebody keeps trying to open your door, rattles the lock for a while, then gives up and goes away, only to come back and try again a few hours later. It felt as if Covid was repeatedly returning to try the lock. It was a sensation I’ve never had with any other illness: the feeling that Covid had intentions, and that they were not benign.
On a global level, Covid hasn’t stopped coming back to try the door. I have read numerous books about the crisis – and many, many, many, many yards of journalistic commentary – for 2+ years now. As my regular readers know, my media team and I (6 full-time staff with an added 6 freelancers) had jumped into “everything-coronavirus” in February 2020 and produced 100+ articles and private client memos (most of these pieces are freely available here).
Yes, there was a tsunami of material to read. With a high level of complexity. The unprecedented uncertainty amid the coronavirus pandemic (especially the data) had decimated our carefully laid plans and unsettled our minds at equal pace. This coronavirus, with its health, social, scientific and economic impacts, had made the content production engine of this world go into overdrive, leaving most of us struggling within an infodemic.
Also, I was venturing onto ground where I had no guarantee of safety or of academic legitimacy (a second, minor university degree in physics, of all things, but an avid reader of all-things-science my entire life) so it was not my intention to pass myself off as a scholar, nor as someone of dazzling erudition. It was enough for me to act as a messenger for those who did have the knowledge, and offer my own reflections on that knowledge. As I wrote at the time:
No doubt the old dream that once motivated Condorcet, Diderot, or D’Alembert has become unrealizable – the dream of holding the basic intelligibility of the world in one’s hand, of putting together the fragments of the shattered mirror in which we never tire of seeking the image of our humanity. But even so, I don’t think it’s completely hopeless to attempt to create a dialogue, however imperfect or incomplete, between the various branches of knowledge effecting and affecting this pandemic.
Now my team and I are onto other things but I still receive the weekly updates from the Johns Hopkins Coronavirus Resource Center.
Quite frankly, Covid is an almost impossible subject to sum up, because we don’t know where we are in the story. The books written by frontline medics after the first wave of the pandemic – Rachel Clarke’s Breathtaking, Gavin Francis’s Intensive Care and Jim Down’s Life Support – are vivid accounts of what the battle against the disease was like for doctors, but they are very painful to read now, because we know what they couldn’t: that Covid was only just getting started. Every one of the books I’ve read is situated in a moment in time, and in every case, whether it was the second wave and the Alpha variant, or the third wave and the Delta variant, the disease came up with a new narrative, a new set of unpleasant surprises. Countries, indeed entire continents, which were praised for their successful response would, months or sometimes just weeks later, become epicentres of fresh disaster.
And then that “new variant of concern”, Omicron, arrived with a large number of mutations. Now (we think) it just brings a lower level of severity but an increased rate of transmissibility, and a high risk of reinfection. A variant with the capacity to escape vaccines was anticipated. What was unknown was when that variant would appear. We had hoped the surprises were over, and that we were closer to the end of this than to the beginning. But we now know (or think we know) we are in the 3rd year of at least a 5 year process.
As I pointed out in an earlier essay, for most of history, infectious disease has been one of the central realities of human life. Jared Diamond’s Guns, Germs and Steel (1997) is overly deterministic, but the basic point it makes about the importance of contagious illness to human history remains valid. And so it was continually in the Global South, and the Far East.
But, of course, the “other” world – Western, educated, industrialised, rich and democratic – responded poorly to Covid, and part of the reason is that the “other” world had been existing at a distance from this central reality of human history. As Adam Tooze points out in his brilliant book Shutdown, 91 per cent of deaths in the contemporary West are from noncommunicable diseases like cancers and strokes and heart attacks, many of them illnesses associated with modern lifestyles. The equivalent figure in sub-Saharan Africa is 34 per cent. We have a generation of leaders in the West who have no visceral understanding of the risks posed by infectious illness. In addition, as David Runciman has pointed out in numerous essays in The Guardian, The New York Times, and countless magazines, politicians and government don’t get credit for the disasters and failures they prevent. But get rightfully and properly reamed when obvious things go wrong. The combination of these two factors – generational obliviousness and the bias away from the good governance of prevention – goes a long way to explaining why the US government and the UK government, despite having had the possibility of pandemic at the top of its risk register since that register was instituted in 2008, were so woefully unprepared for an event it was its job to predict and either prevent or mitigate. Consult my archive (link above) for the details.
Since a good number of my readers are data jockeys, I’ll just look at two books I read over the recent holiday period that provide a “Big Picture” look and Covid “by the numbers”.
Lockdowns were seen to be a panacea. But they were not. They are clearly damaging, but there is a mysterious absence of evidence as to just how much harm they cause. I don’t mean economically – we can see the rough impact in the contractions of GDP all over the world – but to health and well-being.
NOTE: I am not really going to cover her book but Rachel Clarke in “Breathtaking” does a fabulous job documenting how hospital attendance for non-Covid illnesses crashed during the pandemic, causing doctors to wonder, in the words of Clarke looking around her empty hospital, “Where, we keep thinking, is everyone else?” Waiting lists grew ever longer: there are currently a record 6.8 million people waiting for NHS treatment in England in the latest NHS report. That is a huge load of misery indirectly caused by Covid. I wonder, though, whether the deepest cost of the pandemic, after the immediate burden of illness and death, won’t be in the area of mental health.
And if you have any kind of COVID API streaming into your news feed, you know the endless stories of the young who have had their education and their socialization disrupted, with consequences that may take years to play out – that may, for all we know, be irreversible. Covid has involved an upturning of the contract between the generations: children have been conscripted to protect adults, and have paid the price. To protect people from a disease whose median victim was 83 years old, children missed 18 months of interacting with one another, at the stage of life when they need it most.
This increase in intergenerational unfairness has been one way in which Covid has worsened already existing social tensions. The pandemic has been vividly summed up as “middle class hiding while working-class people bring them things” – and the data supports that idea. In David Spiegelhalter and Anthony Masters’s excellent collection of Covid statistics, Covid by Numbers, we learn that three of the jobs with the highest UK levels of Covid mortality were chefs, cab drivers and bus drivers. No surprises there. The less well-off people are, the less likely they are to work from home; the more likely they are to have to work in jobs involving close contact with other people and to live in crowded housing. This feeds into shocking ethnic disparities in outcomes: in the first wave, the Covid death rate for women of Black African ethnicity in the UK was three times higher than for the white population, and four times higher for men.
NOTE: this data is matched almost perfectly in the U.S. as developed by Meagan Dooley of The Brookings Institution. Her book should be out later this year.
There doesn’t appear to be any inherent difference in ethnic susceptibility to the disease, so these outcomes are determined by already existing social and economic inequality. Meanwhile the rich – surprise! – have got richer. In the U.S., Congress passed $2.7 trillion in economic support through the CARES Act, but as Tooze points out, less than a third of that, $610 billion, went to households; most of the money went to business. The CARES Act was “the largest slug of fiscal support ever delivered to an economy – anywhere”. The result was a huge boom in asset prices – and who has the most assets? Duh: the rich. U.S. household wealth rose by $18 trillion. Amazon hired 628,000 new employees, and the growth in its share price made Jeff Bezos the richest man in the world.
The fact that Covid has worsened existing tensions is a global theme, not just a UK or U.S. one. Yes, the British government’s response to Covid (and the U.S. response) have been poor, but it has not been uniquely so. The double failures of spring and winter 2020 have been counteracted by success in the area of vaccines and science: the randomized Recovery trial of Covid treatments has saved a million lives globally, and the UK leads the world in the genetic sequencing of Covid variants. The NHS teetered but did not keel over, mainly thanks to the efforts of its staff, leaving the UK squarely mid-table in the rankings of excess deaths: 25th in Europe.
But we can’t entirely rely on official data to measure the impact of Covid. The official global death toll is five million+, which we can be sure is an underestimate. The Economist’s data team, studying the raw numbers from a range of sources, put the real death count at 17.5 million. Europe is not the hardest hit continent. Covid feeds on inequality, so it is no surprise that Latin America, “the most unequal continent in the world”, in Tooze’s words, currently has the highest death toll. Peru has the world’s worst official Covid death rate: its large informal workforce had no choice but to keep working as the pandemic raged. Mexico, Bolivia and Ecuador have also been devastated.
Just a few more numbers from Covid by Numbers :
• We learn that three of the jobs with the highest UK and U.S. levels of Covid mortality were food service workers, cab drivers and bus drivers
• One glimmer of relief is some of the developing world has not been hit as hard. Sub-Saharan Africa, in particular, hasn’t suffered as much as Europe and the Americas. It’s not entirely clear why but there are a few clues. Africa is the world’s youngest continent, which helps: the median age of the population is 19.7, against a Western European median of 43.9. Since the risk of dying from Covid doubles with every six years of age, it follows that, everything else being equal, the median European Covid sufferer is 16 times more likely to die than his African equivalent.
• Africa also did well overall because it has more experience of infectious disease than the rich world. The continent’s traumatic recent experiences with Ebola are relevant: African governments did not need to be reminded how frightening new zoonotic diseases can be.
• The East Asian experience of Sars had a similar impact on Asia’s governments: they took Covid seriously right from the beginning, and have the lower death rates to prove it.
The best book about Covid from a global perspective is Tooze’s Shutdown. He focuses on the economic impact of the disease and the economic response to it. When the pandemic hit, 95 per cent of the world’s economies contracted at the same time. At one point the global economy had shrunk by 20 per cent, an unprecedented number, but hardly surprising when you bear in mind that three billion adults had been furloughed or were working from home, and 1.5 billion children were prevented from going to school. Nothing even vaguely like this has ever happened before. The world’s capacity to absorb this degree of economic punishment is, as Tooze points out, a sign of how rich the world now is. During the darkest days of lockdown I often found myself wondering what the pandemic would have been like if it hadn’t been for the internet. The answer can only be that we would have pushed on through as best we could, and very many more people would have died.
Both Shutdown and Covid by the Numbers clock the big, simple thing that helped the world economy recover: money. Huge amounts of money. At the peak of the crisis, the US Treasury was buying back its own debt at the rate of $1 million a second. The total stimulus measures in the global economy were estimated by the IMF to have hit $14 trillion by January this year. Even Germany finally allowed the EU to turn on the money taps and create a €750 billion Next Generation EU package.
NOTE: those of you who have an interest in the workings of the global financial system will find in Shutdown an unsurpassably clear and comprehensive account of the way the world responded to the pandemic, how macroeconomics works.
There is a huge problem here, though. The economic response to Covid has been a technocratic masterpiece, saving the world from what could easily have been worse than the Great Depression. But it has done so by ripping up the economic rule book, the “Washington consensus” which has been central to the running of the world economy for the last four decades. In order to create the necessary economic stimulus, central banks have been buying back their own debt with newly created money.
It works like this: imagine I’m the central bank. You have $100 million of my debt, paying an interest rate of, say, 2 per cent. I say: I’ll take that back off you, and in return, I’ll electronically create a new deposit in your name to the tune of $100 million. That’s money you can go out and spend, and that spending is what will stimulate the economy. This is called monetising the debt: turning government debt into cash. It’s ingenious, but it’s also the exact opposite of what central banks are supposed to do, according to the neoliberal economic rule book. Tooze has a wonderful quote from the prominent MIT economist Rüdiger Dornbusch from 2000: in the past twenty years, he says:
the very rise of independent central banks [has been] all about getting priorities right, getting rid of democratic money, which is always short-sighted, bad money”
Central banks, according to this system, are explicitly forbidden from monetising debt, because that would make their actions subordinate to the impulses of politicians. But now, it turns out, the thing that was completely banned – monetising government debt – is actually fine. Central banks can’t print money for political reasons, but it’s perfectly OK for them to print money when it’s necessary to keep the system running. It’s sometimes said that a certain kind of technocratic insider wants to keep democracy safe for capitalism. This is what that looks like: banks and governments doing things for economic reasons they would be forbidden from doing for political reasons. Printing money to keep the system running? Fine! Printing money to fulfil democratically mandated political objectives? Verboten!
Edward Luce (the Financial Times U.S. National Editor who has become a good friend) has written reams on the global financial crisis and he often uses this parable:
The tribe had an idol sitting on an altar, and had been taught, and had come to believe, that the idol was permanent, immovable, and that they had to worship it, because the idol was the embodiment of all immutable truth. Then one day there was a great rumbling noise and the immovable, permanent idol fell off the altar and landed on the ground with a huge crack. There was a terrible silence. The tribe shuffled their feet and looked at one another and didn’t know what to think. The silence stretched. Eventually, some members of the tribe, embarrassed and baffled, picked up the idol and put it back on the altar, and they all went back to worshipping it because they couldn’t think what else to do.
I asked him to explain that and he said:
The financial crisis exposed the fact that the central tenet of neoliberalism – markets can be trusted to regulate themselves, and the most important thing government can do is get out of the way of the market – was untrue. But nobody knew what else to believe, or how else to think: they had grown so used to a particular package of economic doctrines that they had come to accept them as fundamental principles of reality, instead of merely a description of the way some segments of the world economy had operated for a short stretch of time. So they went back to acting as if what had just happened hadn’t happened. They put the idol back on the altar. The economic response to Covid has seen that idol fall off the altar again, and this time it hasn’t just cracked, it has actually split in half. We can’t be about to put it back on the altar again, can we? Can we? Uh, oh”.
Tooze’s account of this whole process is both admiring of the technocratic competence involved in the economic rescue … and alert to the troubling void of ideology and politics it exposes. The idea that we’re going to lurch along from one crisis to the next and rely on the technocrats to fix problems when everything blows up, while inequalities rise and the rich get ever richer – is that really the best we can do? Is it? Uh, oh.
He ends Shutdown with an unusual and rather moving admission that he has been writing ‘in medias res“, a Latin expression and concept all writers and editors will immediately recognize. With Covid, there’s no mistaking that the planet is in medias res. Much of the poorer parts of the world are still susceptible to the disease, and as long as it is, many more people will die, and the risk of new and more dangerous variants will remain. In May 2020, the estimated cost of vaccinating the entire planet was $25 billion. That’s a lot of money. People gasped. Except, on the other hand, $20.2 billion is what the U.S. military spent on air-conditioning each year in Afghanistan and Iraq.
It might turn out to have been a very stupid $25 billion for the rich world to have saved. Covid is still here, 44 per cent of the world’s population is unvaccinated. The lock is still rattling.