277 days in the dark and counting
What has a year of COVID-19, lockdowns, isolation and unexpected deaths taught us about the human trait of resilience?
Life is tough. The hardships that befall us can be morale-snapping. The adversity we faced as hunter-gatherers has been replaced largely by new challenges such as mental illness, chronic conditions and conflict. However in amidst a pandemic, it seems some things never change. We are still at the mercy of nature herself. A fundamental tool that has helped to get us this far lies in the human trait of resilience. Resilience can be defined as the intuitive response to extreme adversity and acute stress throughout life. The resilience of human beings, our ability to adapt and accustom to the most hostile conditions, whether by choice or the natural forces of the world, is fascinating. For many of us, the past year has tested us more than ever before.
“Everything we do before a pandemic will seem alarmist, everything we do after a pandemic will seem inadequate.” — US Health and Human Services Secretary Michael Leavitt in 2007
What COVID-19 has forcefully imposed on us is the blunt reminder of the fragility of some of our basic human-made systems, ruthlessly exposing their flaws. Shortages of masks, PPE, tests, ventilators, and staff have left frontline workers and the public directly vulnerable to the disease. On a wider scale, production, financial and transportation systems, and critically the supply chain, have faced immeasurable impact; it has been a watershed moment for global health and for the global economy.
Insights from halfway across the world
I was born in a small village near a city called Madurai in South India. Nearly all my family live in India, some in that same little village. The sparse and far apart conversations I have had with them over the phone, I realised, revealed larger more meaningful and pervasive issues from their personal experiences.
India had the largest lockdown in the world and was in essence, a failure. In a large population, it is always clear that a lockdown will not work; blindly imitating strategies from different countries such as the UK is an irresponsible act and expecting it to work is even worse. The response begged a more nuanced approach. Misinformation fuelled by fear, stigma and blame impedes education and the reporting of illness, compounding systemic issues in the country.
Thankfully, my family have been safe and careful, even buying extra fish and rice for neighbours and delivering it. Yet not everyone has been as lucky. A close friend of my grandad’s also lived nearby. He was 74, a retired teacher and had 4 children. He most likely caught the virus from his daughter’s wedding and experienced a fever for 10 -15 days. However, the standard protocol for victims of the virus was being taken away to be cremated with no family contact and no funeral rituals. Belief in the afterlife and reincarnation is very prevalent so these traditions are very important to families in this village and most of India. Despite the local doctor urging him to get tested, our friend refused to. The stigma ensuing a positive result, the shame of not being able to see his family again and misperception of treatment in hospital, all meant he refused admittance to hospital. 15 days later, he died in his home. This was nothing short of a tragedy to me. It was simply the lack of information that caused this man to die, a preventable death. Perhaps one of the most virulent effects of COVID-19 has been the misinformation and surrounding stigma.
What we can learn from India is that vaccinating on such a mass scale has been done before to remarkable and inspiring success. The eradication of polio was driven by unprecedented government ownership, innovation in delivery such as maintaining the “cold chain” for the vaccine and “bindi marking” to track who had received it, as well as meticulous planning. At the core of it, it involved going door to door delivering the vaccine, one person at a time. In fact, my father was one of the volunteers in the massive force that helped achieve this. Despite high population density, poor sanitation in areas, inaccessible regions, detached public health system and rampant malnutrition, India triumphed over polio. Feats like this are nothing short of a human display of pure resilience for the pursuit of a greater goal.
Lessons to glean from the pandemic: paying attention and learning quickly from others
In 2015, Bill Gates gave a ted talk saying that “we are not prepared for the next outbreak” and proposed the measure of assembling a force of specialists from different disciplines to rise to the challenges of the next crisis or epidemic. This year, he poignantly noted that although 27 million people viewed the talk, no one in a powerful position heard the message.
Within our complex systems, sudden uncertainty makes it impossible to predict the exact source of the next crisis, but this is not to say we cannot learn the lessons of the past.
We do not live in a Newtonian, linear world where actions lead to predictable and neat reactions. Often crises do not repeat themselves; we have seen and dealt with other coronaviruses in the past, such as the SARS outbreak in 2003. Yet our previous success led to a sense of complacency. Retrospectively, if SARS cases were infectious before symptoms appeared, with a high proportion of asymptomatic cases, it would have been much more difficult to contain. It is simply out of the question to be complacent to other impending crises, notably the climate emergency.
“The future is already here. It’s just not very evenly distributed.” — William Gibson, science fiction writer.
China and other countries hit early by COVID-19 gave us time to learn from them; their present was our future. What made the difference was between countries who paid close attention and acted quickly and others who delayed and hesitated.
The two overarching principles lie in pre-emptive risk management and resilience in the aftermath of the crisis. Acknowledging and accepting uncertainty driving rapid feedback loops following disasters is at the crux of these tenets. COVID-19 confers opportunity to prep for other emergencies, known as “bouncing forward” as opposed to just bouncing back.
Interventions include a “reserve army” of health workers to provide additional support to the workforce and expanding the scope of roles such as nurses to adopt more responsibility and tasks from doctors so they can invest in more complex cases. Strategic reserves of PPE, surveillance, digital diagnosis and new approaches of AI and machine learning also have budding potential during crisis. Wider scale considerations such as public funding for vaccines and avoiding international competition to access vaccines are imperative in ensuring help is supplied where it can have most impact.
Guests at your New Year’s party: sadness, hope and life-changing gratitude
The ravaging of human social behaviours has been disorientating, painful and difficult to recover from. One thing that has crystallised is that a simple touch will no longer just be a touch; basic contact, conversation and company has been snatched away from many, hitting those shielding or with underlying health conditions the most. The genuine impacts of human sacrifice, empathy and understanding transcend “clapping for the NHS” every Thursday evening at 8pm, and any other arbitrary virtue signalling we are prone to.
We are cogs in the complex clockwork of environmental, economic and socio-political systems that are constantly being reconfigured. Our trust in institutions and the willingness of people to follow advice and instructions has been pivotal in this pandemic, the sentiments of communities and countries can clearly influence how a disaster unfolds. The agonies of the pandemic mean we can hopefully walk hand in hand with gratitude, if not our actual family and friends just yet. But I remain hopeful; after all, it is the human condition, to find the proverbial light at the end of the long tunnel.
