A Covid-vaccine mustn’t be hoarded.

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On July 20, researchers at Oxford University’s Jenner Institute released preliminary Phase I data on the immune response of their vaccine candidate, ChAdOx1 nCoV-19, in The Lancet. These findings are helpful and bring a glimmer of hope that perhaps a vaccine could be found to prevent (severe) COVID-19, caused by the virus SARS-CoV-2. On the same day the World Health Organisation (WHO), cautioned the world that indigenous peoples in the Americas, the current epicentre of the pandemic, are particularly vulnerable to the virus and its severe ramifications. This only strengthens the urgency with which we must avoid hoarding a potential vaccine or treatment for COVID-19 away from the most vulnerable in the world.

As we have seen over the last months, this virus and the disease it causes does not hit every one of us equally. The epidemic’s epicentre has shifted from China to Europe, and is now currently in the Americas. What we have seen is that many vulnerable people have borne the brunt of the pandemic, with the burden of mortality mainly shouldered by minoritised and racialised communities in Europe and the United States and key workers in general (many minoritised and racialised communities are also more likely to be frontline workers), as well as those with lower socio-economic backgrounds. As mentioned in the previous paragraph, Dr Tedros, the Director General of the WHO, has recently mentioned how indigenous communities in the Americas are currently most at risk of suffering the effects of the Covid surges throughout the continent. Presently, the spike in SAR-CoV-2 infections in recently contacted indigenous peoples in the Amazon have raised alarm. Furthermore, although some countries with weaker health systems have seemingly been able to relatively contain the virus, it has nonetheless been a terrible strain, especially in countries that are also still dealing other communicable disease outbreaks such as a recent Ebola and measles outbreak.

Recently, the United States bought up most of the world’s supply of Gilead’s remdesivir which, other than the drug dexamethasone, is currently the only hopeful candidate treatment for COVID-19. Even though there is as of now limited evidence for remdesivir, and the cheap drug dexamethasone at time of writing seems more promising, the move by the United States sets a worrying precedent.

As I have stated so many times on this blog, health is a human right. To ensure accessibility and equity in healthcare we have to act accordingly. When countries with relatively strong healthcare systems and strong scientific infrastructure to research and produce vaccines and medicines to prevent or treat COVID-19 end up distributing, or even hoarding, these vaccines and treatments for their own populations, there is a strong possibility that countries with disadvantages, many incurred because of a history of colonialism and extractive capitalist exploitation, will end up holding the metaphorical baby. Within these countries the poorest and those made most vulnerable (including indigenous peoples) will suffer the most. Beyond vaccine hoarding, the selling of vaccines or treatments for profit by pharmaceutical companies will also disadvantage the world’s poorest and those in (mainly) Global South countries. Moreover, there are some concerns that neocolonial approaches to vaccine and medicine testing will end up using the African continent as testing ground.

Dr Tedros has reiterated in the daily briefing that a potential vaccine should be a public good. It must be continually emphasised that access to healthcare is a basic human right. Many countries have pre-existing issues with being able to reach their most vulnerable communities and provide them with appropriate healthcare, and while the pandemic has exposed the vulnerability of all of our health systems, some countries and some people will be more disadvantaged than others. It is imperative that countries with more advanced health systems do not return to an ‘each man for himself’ mentality, but act in the spirit of solidarity.

A post-Covid world could – indeed should – be one where healthcare is accessible, health is treated as a human right, and our approach to global and public health is one of internationalism and solidarity.

A vaccine or treatment must be freely accessible to all people. The importance of healthcare as a human right must underpin every step our governments take moving forward. The pandemic has shown us that in an increasingly connected world, our health systems are really only as strong as the weakest link. In a neoliberal capitalist world it is progressively common to see everything, including our human rights, through the lens of profit margins and winners and losers. Austerity, the privatisation of healthcare, and growing inequality have direct impact on global and public health. We cannot, then, in good conscience apply the ‘logic’ of the market to a global pandemic where many vulnerable people are needlessly losing their lives and suffering. A post-Covid world could – indeed should – be one where healthcare is accessible, health is treated as a human right, and our approach to global and public health is one of internationalism and solidarity. What better way to laud in the new world than to use these principles as the way out of the pandemic? What better way to increase equality, health access and diminish the possible catastrophic effects of a next pandemic than to work together to make vaccines and treatments freely accessible? It is not just a nice thought; I would go as far as to say that this is our moral duty. The time for complacency is over and the time for solidarity is now.

Science communication in the time of pandemics

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Recently, science communication (scicomm) has gained a lot more respect within the scientific community than it historically has had. Young (mainly, but not exclusively, female) PhD students and recent graduates have been using social media platforms like Instagram to communicate their research and other scientific findings to the general public in a more accessible, bitesized way. Many posts including selfies or science related makeup looks. Both this new wave of young (mainly female) scicommers using unconventional methods, and the more traditional scicommers have faced critique from within the hallowed halls of academia. At the same time, science communication has been taken more seriously, is seen as an integral part of a scientist’s job, and has even been turned into university courses. It seems that, perhaps especially during the pandemic, the scicommers have their work cut out for them.

Throughout this pandemic, many countries’ politicians have been criticised for unclear and muddled communications surrounding the novel coronavirus. Beyond social distancing rules and lockdown regulations, the uncertain and novel nature of SARS-CoV-2 and the disease it causes means that the scientific evidence is ever changing and expanding as days go by. It is a “truth” universally acknowledged that the uncertainty that goes along with the scientific process, particularly when not or poorly communicated, can sometimes cause people to throw the towel in and disbelieve everything scientists say. Even in the best of times scientists and science communicators (these categories sometimes but not always overlap) have trouble communicating uncertainty. This task can sometimes seem Sisyphean in a pandemic caused by a virus we are learning more about in real time.

The science communicators, science journalists, science podcasters, and scientists with Twitter accounts have their work cut out for them. The task of monitoring a virus, the resulting illness, explaining the science, and at times informing government policies is for many an unenvied position to be in. Muddled communication, such as that surrounding the use of face masks by the general public or the initial uncertainty surrounding the human-to-human transmissibility of the virus, can cause resentment and distrust in the general public. But at the same time, some science journalism and science communication by the new rockstars of the scientific world (that is: virologists and epidemiologists) has showed us how important scicomm is in times like these.

Scientists are used to talking amongst each other in terms of uncertainty. There is discussion on ‘suggestions’ ‘probabilities’, ‘confidence intervals’ and ‘statistical significance’ with an ease that makes it more difficult to communicate to the general public when you become so used to speaking in jargon. Yet, as we can see, communicating science effectively can have life or death consequences when it pertains to public health. Research suggests that being clear about uncertainty does not necessarily harm the public’s perception of science and scientists, and so perhaps the best way to deal with uncertainty in the midsts of this unprecedented crisis is to be honest and to embrace it.

Uncertainty is a fact of life, albeit an uncomfortable one, and is just as much a byproduct of the scientific process as it is of living.

It seems that whether we use Instagram, find newfound fame on Twitter, use traditional print media or communicate science to just the people around us, the one undeniable fact is that there is so much we do not know yet about the current crisis we find ourselves in. The only thing we can do is take on board the changing science and eventually we will likely be able to have a fuller and more accurate picture of what is happening surrounding the pandemic. Scicommers are, as a whole, already more adept at communicating science’s uncertainty, but the SARS-CoV-2 induced pandemic adds another level of pressure to get it right – or at least as right as possible. Uncertainty is a fact of life, albeit an uncomfortable one, and is just as much a byproduct of the scientific process as it is of living. Scicomm is hard in the best of times, but as laypeople and non-experts perhaps, however hard it is, the best thing we can do is embrace the in-between.

The shakiness of our foundations

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Karl Marx wrote that ‘the history of all hitherto existing society is the history of class struggle’. To many people the idea of class struggle seems archaic and belonging firmly to the 20th century. An equally 20th century idea is that of living through a deadly pandemic – a scenario that has for most of us only been conveyed through history books, and a scenario in which we have collectively been thrust by the once-in-a-century unprecedented COVID-19 pandemic. This current pandemic is exposing the problems within our current economic and social systems, and most importantly exposes the fragility of the human right to health. It turns out that the emperor is naked.

Inequalities in access to healthcare between Global North and Global South countries have, rightfully, long been the focus of conversation surrounding global health. Soon after the WHO declared a public health emergency of international concern (PHEIC), the Director General, Dr Tedros, pointed out that this virus could be most lethal and dangerous for countries with weaker health systems, largely (though not uniquely) corresponding to the Global South. Beyond ‘developing’ and conflict-heavy countries with weaker health systems, the current pandemic has exposed the health inequalities that exist within the Global North as well. In many Global North countries, in the years after the crashing down of the neoliberal order, austerity (to varying degrees) has been the go-to policy with public sector jobs being cut, and many people being thrust into unemployment and even poverty. This has had many consequences on health (both mental and physical) and has caused many of our countries to be woefully underprepared for something as catastrophic as a pandemic.

In recent weeks, governments have been calling on ‘essential workers’ and their skills. Many people across the world have been applauding their healthcare staff from their windows, balconies, living rooms and their palaces. We have, rightfully, been supporting ‘essential workers’, but what does that mean when essential workers have been devalued for years within our societies? When many of the people we have elected have been the ones to systematically cut funding for healthcare and the minimum wage is still not necessarily a living one. Many essential workers are in low-paying jobs, and additionally many essential jobs are traditionally feminised roles such as caring professions and domestic and service jobs. This exacerbates already exiting inequalities where they exist.

One of the most effective ways to slow the spread of infectious disease is through social – also called physical – distancing measures such as working from home, staying at home as much as possible, and avoiding close physical contact with other people not part of one’s household. However, for many people, many of whom economically disadvantaged and/or marginalised, this is nearly impossible, increasing the burden of mortality for this group. For many these people working from home is impossible because of the nature of their jobs, staying at home would mean a loss of income and livelihood, and there is a lack of paid sick leave and no (affordable) available childcare.

But beyond income inequality and depletion of resources for many of our health services and the low-wage nature of many essential jobs,, there are other vulnerable groups who will be suffering from increased difficulty in accessing healthcare during the pandemic. An example of this are the homeless who will not have the opportunity to social distance in the same way those with a home do, and who will often not be able to access quality healthcare as easily. Another example of a vulnerable group who might experience more difficulty are prisoners. Prisons are often not adept at containing major infectious disease epidemics. Thirdly, immigrants and refugees who are currently living in dire conditions in camps and settlements, particularly as these people will likely live in crowded places with poor sanitation and more difficulty to access healthcare. Beyond the elderly and those with underlying conditions, there are so many other people who might be particularly at risk in this time. Many of whom have been neglected by society, but all of whom are particularly at risk of having their human rights abused.

This global pandemic has shown us that, even though health is a human right, it is only as viable and attainable as the strength of our health systems and our care for the most vulnerable in society are.

Health is a human right as recognised in the Universal Declaration of Human Rights. The decade of systematic cuts to our health systems and the secondary effects of austerity of thousands of people working in precarity and dealing with failing living standards have caused us to be woefully unprepared for a catastrophic event like this. This global pandemic has shown us that, even though health is a human right, it is only as viable and attainable as the strength of our health systems and our care for the most vulnerable in society are. In a world where the rich are able to self-isolate in mansions or second homes, and get access to tests even when others can’t, it seems difficult not to imagine there might be an aspect of class strife involved. It seems clear that we won’t be able to return to normal after the pandemic is over. The shaky foundations our systems are built on are not likely to survive in tact after this. It is then up to us to decide what’s next and to prepare for the next pandemic – which will come – in more comprehensive ways such as defending the right to healthcare, increasing its access, funding our health systems, implementing fairer labour policies, and redistributing wealth. We must applaud our essential workers, but we must also not forget them when this pandemic is over and they ask for more than just verbal appreciation. We, after all, are only as strong as the weakest link and at the moment the tower is crumbling.

On the (possible) return of community

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The world has been under the spell of the novel coronavirus (COVID-19) first discovered in Wuhan in 2019, which has quickly transformed from a semi-local epidemic to an unprecedented global pandemic. The disease’s epicentre has rapidly shifted from China to Europe, with Italy being the first domino to fall on the continent and many countries following swiftly. At this point Spain and France are (almost) in complete lockdown, and other European countries are contemplating the best course of action.

Public health officials have advised a measure called ‘social distancing‘ – perhaps better called physical distancing – where we are encouraged (or mandated) to avoid large gatherings, work from home, stay home as much as possible, and in many cases are closing schools and businesses altogether. Social distancing has as its main goal the reduction of the spread of disease, and ‘flattening the curve’. ‘Flattening the curve’ is, not unlike ‘social distancing’, a term that has got more attention in the media and popular culture (the graph has gone viral…pun not intended) lately. It refers to how the social distancing measures we take – in particular staying at home – can effectively spread out and slow down the number of infected cases so our health systems can still operate at capacity rather than overburdening the already fragile systems.

These unusual and drastic measures have in many cases, for example in Wuhan, Italy and Spain, brought out the best in people, with neighbours singing and chanting in unison, and neighbourhoods applauding their brave healthcare workers. At the same time, this pandemic has also brought out the internalised hyper-individualisation many Western societies have been experiencing for a long time. Many countries are experiencing empty shelves in supermarkets as people are hoarding products, and people across Europe and the United States are still not quite taking the pandemic seriously and are still going to bars, cafés and other events with a large number of people around.

Indeed, it seems like we are at a juncture where we can either increase our sense of community and solidarity and turn a new leaf, or we can get more entrenched in our internalising of the neoliberal lie that it is every man for himself. In a pandemic situation where community solidarity is essential to our mutual survival, it seems to me clear what the best course of action is. This means, perhaps ironically, to limit physical contact with other people as much as possible. This means checking in on our loved ones and the most vulnerable in our communities (that is: the elderly and those with underlying conditions). The current circumstances can, and in some cases already do, bring us together. In a world of constant distraction, it is perhaps an uncomfortable but nonetheless perfect time to return to the heart of what matters to us as human beings: love and community.

For many Christians around the world, the pandemic coincides with the Lenten season where we deny the flesh, contemplate our fleeting mortality, and try to give alms and care for those in our communities. Contemplation is an essential facet of the Lenten fast. However, beyond the religious, many people have a longing for something more; people long for the knowledge that there is more to life than can be found amidst the hectic and distracting nature of our societies and constant competition within our hyper capitalist contexts. In that moment, a pandemic that asks of us to isolate ourselves and return to our core out of community solidarity, might cruelly be the thing that can bring us back to ourselves and our communities. This is the best possible time to do some shopping for your infirm or elderly neighbours, to spend more time reading, with family, or alone in silence. Now is the time for self-reflection and for deciding how it is we can bring back our connection to our local communities and our central humanity.

Even though it might seem easier, or more pleasant, to be amongst each other in bars, pubs, shops, clubs and cafés instead of at home at a physical distance from our friends, there is little to despair. The act of isolating as much as possible at this time is an act of profound love and care for the least of these, for our neighbours, for those who are working in healthcare and are trying their best to save as many people’s lives as possible.

Within the Latin Church there is an antiphon that is chanted during Holy Thursday which proclaims: ubi caritas et amor, Deus ibi est – where charity and love are, there God is. Even though it might seem easier, or more pleasant, to be amongst each other in bars, pubs, shops, clubs and cafés instead of at home at a physical distance from our friends, there is little to despair. The act of isolating as much as possible at this time is an act of profound love and care for the least of these, for our neighbours, for those who are working in healthcare and are trying their best to save as many people’s lives as possible. Even if you are alone, remembering that where charity and love are, there God is, should bring a sense of profound peace, whatever ‘God’ means to you. So, please, stay at home whenever possible – binge your favourite Netflix shows, read, sit in silence, spend quality time with your loved ones if they live with you. But also check in on your elderly relatives and neighbours, help your chronically ill family, friends and neighbours out with groceries. Help and care for each other. Fight against the voice in your head that says it’s every man for himself. Stand in solidarity…from a sensible distance and without shaking hands!