Coronavirus: An alternative model

Beyond COVID-19

Three facts about viruses: Viruses outnumber cellular life at least 10:1; viruses drive global biogeochemical cycles, and are part of cellular life on earth; and, some viruses are beneficial, others are sources of pathogens, and not all viruses make you sick – as Prof Vincent Racaniello, Columbia University, notes in his lecture “What is a virus?”

Coronavirus SARS-CoV-2, which causes COVID-19, is here to stay. It will add one more virus to the millions of viruses to which our bodies are already host, whether or not humans develop herd immunity to it. Further, as permafrost melts due to global warming, thawed vegetable and animal matter may release ancient viruses, to which modern humans are not immune. Over time, humans may develop herd immunity to these, too.

The problem faced by humanity is not so much about viruses per se, or about virus-caused disease or death, but more about their social, environmental and economic effects.

Causes of deaths

Deaths due to COVID-19 have crossed 284,000, and counting. However, the Institute for Health Metrics and Evaluation at University of Washington shows global causes of deaths as: Cardiovascular diseases (17.79 million), cancers (9.56-M), respiratory diseases (3.91-M), lower respiratory infections (2.56-M), dementia (2.51-M), digestive diseases (2.38-M), neonatal disorders (1.78-M), diarrhoeal diseases (1.57-M), diabetes (1.37-M), liver diseases (1.32-M), road injuries (1.24-M), kidney disease (1.23-M), tuberculosis (1.18- M), … heat & cold exposure (53,350), terrorism (26,445), natural disaster (9,603).

The World Health Organisation (WHO) shows that of the annual 56.9-million deaths worldwide, 54% are due to the ‘top-10’ which are, in order of magnitude: Ischaemic heart disease, stroke, chronic obstructive pulmonary disease, lower respiratory infections, Alzheimer’s and other dementias, cancers, diabetes, road injury, diarrhoeal diseases and tuberculosis.

Both sources show that by far, the major causes of death are life-style diseases. These are typical of an era of high consumption of all kinds, but especially of fossil fuels for industrial processes and products, which cause high environmental degradation and great economic inequality, both causing downstream social ill-effects. These produce the co-morbidities and lowered immunities which contribute to COVID-19 deaths. Thus, for long-term results, remedying high environmental degradation and growing economic inequality will have a salutary effect on mortality rates.

Healthy society

“Health” is about how we live, and the quality of life within the society in which we live. It’s not about the absence of disease in an individual, but about life within the family and, along with family, in the wider community. Viewed holistically, health concerns the individual within a healthy society.

The Directive Principles of State Policy in the Constitution of India require the State to assure people justice, liberty and equality, and promote fraternity among them. It is precisely about creating a healthy society, which values social qualities such as fairness, freedom, security and tolerance, and clearly ranks them above economic concerns, while providing every individual dignified labour with economic and social security.

In the present times, the health sector worldwide is corporatised (with the possible exception of Cuba), and uses yardsticks of numbers of hospital beds or doctors per thousand population. Japan stands first with over 13 hospital beds and India has only 0.58. Hospitals are focussed on ill-health, curing or managing disease and treating injury. They are very expensive, demand cash up-front before admission, and closely linked with the pharmaceutical, bio-engineering and medical insurance businesses. They are out of reach for people of the lower economic sections and, in any case, have little to do with health except when viewed through the narrow perspective of absence of disease. They make little contribution to building a healthy society.

Looking forward

The COVID-19 pandemic has resulted in a lockdown to ensure “social distancing” and this has had very serious economic consequences on vast numbers of the poor, with direct and indirect effects on their health. As the workforce suffers, so does the national economy. Governments are struggling to cope with the consequences, but indications are that attempts are directed at restoring the earlier economic order, which is characterised by inequality, inequity and iniquity.

This is not to point at any particular government, but at the present development model of perpetual economic growth year-on-year. As architect Prem Chandavarkar wrote on Medium.com, “Our development model assumes an economy that must grow whether or not we thrive, whereas we need an economy that makes us thrive whether or not it grows”.

This model exacerbates economic inequality, heightens intra- and inter-societal tensions and conflicts, and destroys the environment upon which all life depends. It does not need proof that the result is increasingly unhealthy human societies within which life-style diseases are by far the biggest killers of humans, as shown earlier. Public health is a casualty of the development model, yet the talking-heads only debate COVID-19 infection, death and vaccine, while governments struggle to re-establish the same development model and grow bigger economies (the $5 trillion GDP by 2024 dream, for instance). This can only make society more unhealthy than it already is. When philosopher J Krishnamurti said, “It is no measure of health to be well adjusted to a profoundly sick society”, he spoke of the society of decades ago. Society has only sickened more since then.

Societies worldwide need an alternative development model to create a healthy society which, as Richard Horton noted in The Lancet, “...is much more than a community in which the causes of disease are minimised. It is one where, at the very least, human creativity is free to flourish, individuals have the liberty to be who they wish to be ... and the spirit of all life, and not merely human life, prospers”, and in which, “the mind is without fear and the head is held high, ...and [society is] not broken up into fragments by narrow domestic walls”.

In the Indian context, the coronavirus crisis demands an “alternative” development model, which is already enshrined in the core principles of the Constitution of India. But do leaders have the awareness and comprehension of this amidst their myopic quest for power or pelf?