Covid Lectures Part 10: Make Love, Not War with the Queen of Viruses
Covid Lectures Part 10: Make Love, Not War with the Queen of Viruses
Contents:
10.1 Introduction; 10.2 The Highly Clustered Nature of Covid Transmission; 10.3 The Confusion about Case Data and Mortality Rates; 10.4 Disease Data is a Quagmire of Estimates; 10.5 The Confusion over Testing; 10.6 What We Should Have Done; 10.7 What the Experts Need to Do; 10.8 Toxic Thinking in Science and Social Science: The Price Exacted by the Neo-Welfare State; 10.9 Let's Forget about Covid!
10.1 Introduction
This will be the last lecture in the series, but let us not stop the discussion here. I invite any of you who might be interested in talking or writing about the Dodgy Science and Woeful Ethics of Covid-19 on my blog to get in touch, by leaving a comment here or on Facebook.
Yesterday we ended with a discussion some of the puzzles and paradoxes in Covid-19 transmission in different settings. We talked a bit about how some of the facts and events indicate that the virus does not transmit, as the epidemiologists argued in a seamless chain from one person to the other in the same line of contact, until you intervene to break the chain of transmission. I suggested that we need to look into this because the whole “flatten-the-curve” approach propounded by the epidemiologists, the World Health Organisation and public health experts was premised on the assumption that any kind of encounter with an infected person in a 2 meter radius would result in transmission. That is how they got their billions of modelled case predictions. 7.8 billion cases, is what they said, leading to 40 million deaths, and we have been resuming social and economic activity for three months and more all over the world, with nothing like these numbers anywhere in sight.
Today we will continue to look at some of the anomalies of Covid-19 transmission. But before we do that, I want to talk to you a bit about why this is important. The reason is this: in order to conquer, you can go to war. But there is another path to conquest, and that is with love. What do I mean by this? How can you love a virus? Especially one that wants to kill you! Well, it does not have to be this way.
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Let me take you away from the thoughts of death that have haunted you all these months, to thoughts of love. When we fall in love with someone, we are acutely aware of their every word and gesture. We are fascinated by every line of their face, every nuance of expression, every inflection of voice. We have to do something like this with Sars-CoV-2, the reigning Queen of Viruses today; as we all know, 'corona' means crown.
Instead of thinking of the coronavirus as this dreadful adversary; as this demon of death that we can hardly bear to look upon, we should make this virus an object of fascination for ourselves: what is this, what makes it so strong, how does it find us, what does it want from us, can I feed it in a different way than with my death, can I calm it down, can I distract it.
Maybe, instead of engaging in war with Sars-CoV-2, we can engage it in play, in some form of give-and-take, like the passing of a ball between players in a tennis match, maybe we can find some kind of exchange, if you like, with Sars-CoV-2 that will allow us both to live in harmony.
War is not the only possibility. And anyway, let’s face it, the war has been won by Sars-CoV-2, hasn’t it? We went into an unprecedented lockdown and took other extreme measures. In places like India we did this at a few hundred cases and now we have over 12 lakh cases. Containment has been a success only if you take the epidemiologists’ claims of billions and billions as the standard. The war on Covid-19 has been lost, let us find other ways of dealing with it, beginning with trying to really understand this disease. This is what I have tried to do in this lecture series, bringing you to the point where we left the discussion yesterday looking at some of the anomalies and paradoxes of Covid-19 transmission.
10.2 The Highly Clustered Nature of Covid Transmission
Continuing in this
vein, another aspect of Covid-19 that deserves closer attention is its clustered
nature. Writing in 2006 on influenza pandemics, Neil Ferguson and colleagues argue they would spread homogenously in a place like Great Britain because of “its relatively small size and frequent long range travel”, and in the US, early spread would be “focal around seed infections (typically in urban areas) imported from overseas, but rapidly becomes almost homogenously distributed across the whole population”
But this is not at all how Covid-19 spread in the UK where, even as late from the start of their outbreak as the first week of July, 85% of the cases and 90% of the deaths have been in England. Within England, the outbreak has not been homogenous. Going by rates of hospitalisation, London, followed by the Midlands, is showing the highest cases compared with other regions; and the South and East of England are lesser affected than other regions (185).
In the USA, from the end of March to early May, save for a few weeks at the very beginning when there were more cases in Washington and Louisiana, the greatest number of cases per million and in absolute terms were in New York. New Jersey had the second highest cases in the same period, again both in cases per million and absolute terms, but the total count has been a quarter to a third of those in New York. Other US states with significant Covid-19 outbreaks such as California, Michigan, Illinois and Pennsylvania accounted for about 3 to 5% of the total US cases till early May. The picture began to change only in June, over two months from the start of the outbreak, with California overtaking New Jersey and Texas reaching New Jersey levels, in absolute cases but not deaths or cases per million. Three months from the start of the US outbreak, in early July, cases per million vary from about 21- to 20, 000 in New York and New Jersey, to just under 16,000 in Massachusetts and Rhode Island, to under 15,000 in the District of Columbia, about 13,000 in Connecticut and Louisiana and 9 to 11,0000 (about half that of New York) in Illinois, Arizona, Maryland, Delaware, Nebraska and Mississippi. So what you have here is different states growing at different rates and in significantly smaller measures than the big epicentre of New York for over a three month period. This is not homogenous growth.
The pattern of cluster transmission can be seen all over the world. In Italy, between April and July, Lombardy accounted for about 40 to 50% of the cases and just under half the deaths, the second highest cases and deaths were in Emilia-Romagna and Piedmont, each at a third of the cases and a fourth of the deaths compared with Lombardy. Throughout the Italian outbreak, the Northern provinces of Lombardy, Emilia-Romagna, Piedmont and Veneto accounted for 70% of the cases and about 80% of the deaths.
In Japan, from late March to early July, the same three prefectures had the highest number of cases: Kanto, Kansai and Chibu; and within these prefectures, the highest number of cases were consistently found in the cities of Tokyo, Osaka, Hyogo and Aichi. By early July, Fukuoka in Kyushu Prefecture had more cases than Aichi and Hyogo, but otherwise, this relative distribution of cases has held consistently. Overall, Kanto has consistently accounted for over half the cases and deaths, with Tokyo having the biggest share of the cases in this region. Overall, Tokyo has, till early July, had the most cases in Japan, double those in the entire prefecture of Kansai, and several times more than any other city.
In Spain, from the end of March to the end of April, the bulk of cases were in the Commune of Madrid, followed by Catalonia. In Pakistan, from April to early July, the bulk of the cases have been in the provinces of Sindh and Punjab; with the cities of Karachi and Lahore having the most cases within these provinces, respectively.
In India, from March to early July, this has been almost entirely a big-city disease, with first Mumbai and Ahmedabad, and then Delhi and Chennai showing the most cases. Each of these cities is in a separate state in an entirely different part of the country – Delhi being in the North, Chennai in Tamil Nadu in the South and Mumbai and Ahmedabad in Maharashtra and Gujarat in the West. As of the date of this paper, Chennai has over 60% of the cases in Tamil Nadu and Mumbai has over 40% of the cases in Maharashtra. Out of 29 states in India, Delhi, Maharashtra and Tamil Nadu together account for 60% of the outbreak and Maharashtra has double the number of cases of Delhi and Tamil Nadu. Gujarat has a third of the cases than Tamil Nadu and Delhi, and less than 20% of the cases in Maharashtra. Rajasthan, Telangana and West Bengal have just under 20,000 cases each, being two-thirds the count in Gujarat. In Telanga, the city of Hyderabad accounts for 77% of the cases. So, again, we have a scenario where different states are getting cases at different rates, and within each state, cases are clustered around particular cities in a pattern that has held consistently for several months. Also, the early epicentre, of Maharashtra, as in many other countries, has a case and death count that is several times higher than that in states coming in second place.
There is no place here to go into all the examples, but the pattern of clustering is to be observed in many other countries as well. So while the cases grow and spread to different cities, they remain concentrated for a long time in a few places and cities. Even within cities, spread is clustered, moving from neighbourhood to neighbourhood and, in general, holding to early trends in terms of where the most cases appear. Some of the clustering, and consistency in trends can be accounted for by lockdown, but given the difference in the timing and quality of lockdown from place to place, there is a strong indication that, unlike the epidemiologist’s predictions of homogenous growth, Covid transmits in a series of clusters, with, in most cases, each new cluster being smaller in size and density than the previous ones.
The clustered nature of Covid transmission has implications for deciding on the best ways to tackle it. For example, given the clustered progress of the disease, there should be more attention to sharing medical resources and giving other assistance at the inter-state and inter-district level, and even between neighbourhoods. This has not happened to any great degree in most countries. The Chinese were able to send large teams of doctors from other provinces into their Covid-19 epicentre of Hubei. This ability to call on doctors from other provinces was a great strength of the Chinese response to Covid-19. Unfortunately, it did not occur to the same measure in other countries.
In India, there is no drive to co-ordinate doctors and other health workers between states. The New Delhi state government, revealing its focus on numbers over people, tried to issue a rule barring people from outside the city from coming here for treatment. This was struck down by the Central Government, but its motivation was more political than humane - to show up the Delhi Government which is run by an Opposition Party. This kind of political one-upmanship between national or federal governments, on the one hand, and provincial or state and city-level governors and mayors, on the other, were played in countries all over the world from Japan to the US to Brazil. By making Covid-19 into a game of numbers, we are not giving the right incentives to our politicians to care equally about each life everywhere. We are encouraging them to take heartless action like locking borders or refusing treatment to outsiders or hoarding medical resources, just to show that their numbers are lower than their rivals in other jurisdictions. We need to start thinking nationally rather than locally when it comes to treatment and assistance for Covid-19.
10.3 The confusion about case data and mortality rates
The confusion in the minds of the supposed experts about Covid-19 was compounded by wide public misunderstanding, generated by a clueless media, about key epidemiological concepts like the Infection Fatality Rate (IFR) and Case Fatality Rate (CFR). The IFR of a disease is the ratio of the number of deaths from that disease to the number of infections in the entire population. This is to be distinguished from the CFR, which is calculated by diving deaths to cases at any point in time. The CFR does not give a population-wide picture of the fatality resulting from the disease for a number of reasons. For instance, owing to the delay from infection to symptom onset, you may miss the true number of cases at a given point in time, which would lead to an overestimation of the overall death rate. On the other hand, the CFR would not include cases that have not yet had an outcome, which could result in an underestimation of the overall mortality rate, depending on what the outcomes eventually are. So the CFR is not a measure of the overall mortality rate of a disease.
Also, depending on where and when you are looking, the CFR may change. So, for instance, China reported a CFR of 17.3 to 0.1 as its epidemic progressed (13). For this reason, the initial CFR rates calculated while an outbreak is ongoing are also called “crude” CFRs. So the popular media was wrong to quote CFRs as if they were a population-wide estimate of the expected mortality from Covid-19. One such figure was what was called the “WHO’s” CFR of 3.8% for China which sent shockwaves through the reading public as the mortality rate from the ‘flu and other similar illnesses is a fraction of that. But this is because the IFR, which is based on a population-wide range of cases, is usually a fraction of the CFR which is based on a subset of the cases in a population.
About the IFR, we also have to understand that there is no direct counting of the number of infections in a population. So epidemiologists need to estimate this. Estimates again! For their estimation, epidemiologists use the data from “serological surveys”, which is sampling for antibodies in the blood. The Imperial College epidemiologists estimated the IFR from the CFR (9, 5). This is quite a questionable way of going about the IFR estimation as it basically collapses the difference between the IFR and CFR, but no one noticed.
Even serological surveys are not completely reliable. In serological surveys blood serum from a sample of the population is tested for the presence of antibodies related to the particular disease. So we have a double estimation - one in the selection of the sample for serological analysis, and the second in the calculation of the IFR.
10.4 Disease Data is a Quagmire of Estimates
Serological surveys are useful to the medical community as they alert them to the pathogen strains found in the population and their reactivity to different drugs. So, for instance, the Indian medical authorities periodically put out reports based on serological surveys for different strains of bacteria and viruses found in laboratory samples, with reports on which drugs are effective against them and which pathogens seem to be developing drug resistance. This is why it is called serological “surveillance”. This is a method of surveillance for what pathogens are circulating in the population.
So the prime use of serological surveys is not to estimate disease prevalence (or how many people are infected by a disease) or infection fatality rates, even though epidemiologists and the WHO use them to estimate these things. There are two things to understand here. One, that any IFR, then, is subject to all the uncertainties and possibilities of being mistaken as we discussed at the start about epidemiological modelling. The more important lesson is that in the normal course we do not follow disease in real time, counting cases and deaths as they emerge, and estimating severity from there. This is important because all the numbers that went flying around, and are still being bandied about, on Covid-19, really only make sense if there is something to compare them with.
This is a problem because a number by itself gives very limited information, and numbers that are very small or very large can be misleading if taken simply by themselves. For example, if I tell you that Iceland has only 100 deaths from infectious disease a year, that tells you one thing. If I tell you that Iceland overall has only 2000 or so deaths a year, that tells you another. If I tell you that India has 12 lakh Covid cases, that tells you one thing. If I tell you that India has over 31 lakh tuberculosis cases a year, that tells you another thing. If I tell you that India has 26,000 Covid deaths, that tells you one thing. If I tell you that India has 2.7 to 4.0 lakh tuberculosis deaths, 10 lakh diarrhoeal disease deaths and 6 lakh respiratory disease deaths, a year, that tells you several other things. If I tell you that the USA has 30 lakh Covid cases, while its annual tuberculosis and HIV cases are 10 lakh each, that tells you something. When I tell you that the US typically has 60 thousand deaths a year from respiratory infections and the death toll from Covid is 1.4 lakh and counting, that tells you something else. If I tell you that the US has 22 to 24 lakh deaths a year from non-infectious diseases, that tells you yet a third thing.
So, in order for us to really speak intelligibly about the Covid numbers, we have to know something about what the numbers are for other diseases. But here we run into the difficulty that in the normal course, we do not have outbreak curves for any other disease because these are never plotted in real time as they were done for Covid-19. So we never had an outbreak curve from another disease with which we could compare the Covid ones.
We also have no actual counting of cases for other diseases. In order to determine the case incidence or mortality rate for any disease epidemiologists need to do estimation. Yes, estimation again! So anything you hear about the number of cases say for tuberculosis, AIDS or malaria in any country are not actual counts, or even rough aggregations or averages of cases. They are modelled estimates, which are, therefore, subject to all the uncertainties and inaccuracies that we discussed at the start of this lecture series about epidemiological modelling.
This means that we are all punching in the dark when we are trying to figure out exactly what the Covid numbers mean. It is a quagmire of estimates.
Even WHO mortality data needs to be placed in context in the same way. If you study the notes to the WHO world mortality data, you will discover that there are varying degrees of certainty as to the accuracy of deaths reported under different heads of disease (140F). For a given year there may be no data at all, and the figure reported is…you guessed it….”estimated” again!
The WHO makes these estimates even for countries with no death registration data for the year under study, or with no information on the cause of death. The estimation is made from various things like projections based on available mortality data for a previous period, or estimating deaths by looking at the demographic profile of a country. Even the disease to which the deaths are attributed is done by estimation for the year under study, or with no information on the cause of death, or with no data for a particular disease. Even the disease to which the deaths are attributed can be done by estimation! The estimation is made from various things like projections based on available mortality data for a previous period, or estimating deaths by looking at the demographic profile of a country, “interpolation/extrapolation of number of deaths of missing country-years”, “scaling of total deaths by age and sex to previously estimated WHO all-cause envelopes”, estimating adult mortality from child mortality and a key called the “WHO modified logit life table system”, and so on.
The WHO does not even carry out its own estimations every year. Mortality estimates are carried with gaps of about two or three years, and take several years to be finalised. The 2008 estimates, for example, were updated in 2011, after taking comments from all counties. For later years, for the moment, all that the WHO seems to have are modelled estimates by the American epidemiological institute called the Institute for Health Metrics and Evaluation (IHME). The WHO estimates from after the year 2008 do not say whether they have been circulated to countries for comments, and there is nothing to indicate that anyone from IHME, which is headquartered in the remote State of Washington in the USA, has ever been to countries like India for which they have done these estimations.
10.5 The confusion over testing
There is no escaping the uncertainties of disease estimation, even with large-scale testing. Led by WHO’s exhortation to “Test, test, test”, people everywhere have insisted on more and more testing as a way of containing Covid-19. But even though some countries tried to do real-time testing to assess disease-prevalence, no country had the resources to test everyone. By the middle of May, Iceland had conducted the highest numbers of Covid-19 tests per million in world, but this amounted to only about 16% of their population. Being a small and remote country, it was able to keep its Covid numbers down with a combination of testing and case isolation. But this is not a feasible response for big countries.
By early June, the USA had conducted the most tests in the world - over 3.7 crore - but this covered only about 11% of its population. Monaco was able to test the maximum percentage of its population, 41%, but this amounted to only 16,200 tests. The richer Arab countries like the United Arab Emirates and Bahrain were able to test 35% of their population. They, and some of the other small and well-off countries like Luxemburg, Denmark and Singapore were able to use testing to significantly contain the virus. But, in absolute numbers, their tests were a fraction of the tests conducted by countries like the UK (over 1 core), Russia (over 2 crores) and the USA (140G).
Even population-wide testing can only give you a snapshot of the infections at the moment. To keep tabs on disease prevalence via universal testing over a period of time, the entire population would have to be tested periodically. Testing and contact tracing might be a worthwhile expenditure of resources while there is still hope of disease containment. But today, months on, it is clear that this is not possible anymore, if it ever was, and we should be thinking seriously about saving resources for treatment.
For bigger nations in the middle of their outbreaks, besides the cost of population-wide testing, there is also a question of the massive infrastructure and manpower needed for this. In South Korea, to find a few hundred Covid-infected, when their second outbreak was traced to some night clubs, tens of thousands had to be contact-traced. A few weeks later, a case occurred involving a woman who went to a park, and there was a scramble to locate every single person who had visited there.
The South Koreans may have found that this approach made sense to them, but it is not an obvious model for other countries. Before prescribing it to ourselves in India, we also have to understand the full nature of the South Korean response, which heavily relied on information technology, and went to the extent of providing lower income families with Samsung tablets to continue their children’s education, and so on (46). The cell phone network they used for this was already in place as an emergency response system. In all likelihood it came up in context of their historical situation with North Korea. So, the lesson from South Korea is not so much the use of testing and contact tracing, but to do as they did in terms of intelligently identifying and then leveraging what you have locally in conceiving a practical, sensible and effective response to the disease.
10.6 What We Should Have Done
I now proceed to my conclusion. I have shown you the many ways in which the epidemiologists, the WHO and public health experts proceeded on a wrong scientific understanding of the pandemic. From the start we underestimated the speed and global spread of this disease. This led us to take up a containment strategy that was doomed to fail. Being fixated on society-wide containment measures and saving hospital resources, we failed to notice, for too long, the discrete places where disease clusters actually took root, and the channels through which they mainly transmitted.
What is much more useful and reliable is what we can see, not through the crystal ball of epidemiological modelling, but what we see and have seen from the start with our own eyes, which is that many people were falling ill and dying fast from Covid-19, and that it was not amenable to conventional treatments. That is really all the information we needed to start thinking and responding intelligently to this disease. Instead of being fixated by how big the outbreak would be and trying to pre-empt that with an untested hypothesis about pandemic control, which in the end failed, we should have focussed on following the outbreak as it happened, trying to keep it within clusters, where possible, dispersing it instead of locking down where we found it to have concentrated, as in the case of old age homes.
We should have been a lot more focussed, not on social distancing, but on international travel, which was the first and most effective driver of this disease. The community awareness efforts for Covid-19 should have been on encouraging people who had had a history of international travel since January to practice quarantine, special hygiene and social distancing and, for business travellers to conduct their meetings online where possible. The logic for these measures should not have been containment, but for individuals that did not have pressing business travel needs to gain some time while doctors came to grips with this novel disease.
We should have immediately starting working with the tourism industry to find ways of mitigating and dispersing travel-related Covid transmission, in a respectful and voluntary way, by offering medical services and warning people to watch out for symptoms of cold or fever. We should also have thought about giving high quality masks and face visors to the travel guides, drivers and hotel staff, who are most at risk of contracting infection from foreign clients.
In countries like India, instead of locking down slums and basically imprisoning poor people, we should have taken measures considering the basic fact of Covid transmission that emerged very early on, which was that households with family members having a history of foreign travel were the main theatre of transmission to slums typically via domestic help. This is essentially what seems to have happened in places like Mumbai. Instead of shutting down construction work, street hawkers, and all the other activity that keeps slum-dwellers and migrant workers in employment, we should simply have requested people coming in from abroad to give their non-live-in domestic staff a few days' holiday while they quarantined.
Regarding foreign travel, as I explained in detail earlier in this paper, we should not have been solely focussed on Wuhan and China. We should have kept in mind the key message of pandemic research before Covid-19, which was that pandemics come from many countries at once. We should have remembered that in a globalised world, by the time you see an outbreak in one place, you have to assume that it is in many other places already. On being alerted to the mushrooming outbreak in Wuhan, we should have focussed on shoring up our medical resources so as to be able to do our best by whoever fell ill, that is all. We should not have set out on the foolhardy and unscientific mission of pre-empting the virus with containment measures.
10.7 What the Experts Need to Do
Not only did the containment strategy fail, it caused damage and destruction of many more kinds, including death and sickness, and to many more people than would ever have been caused by Covid-19 alone. The hysterical fear that has been created around this disease will inhibit a return to normalcy in many areas of life for years, if not decades, to come. Every sphere of life that functions around the gathering of people, especially the arts and festivals, will be especially repressed, and for the longest time. We have, quite literally, taken the colour and music out of our lives.
Other than the death, hunger, suffering, loss of livelihood, forced displacement and economic and social disruption from containment measures, we failed to understand that such measures are inherently unjust, stigmatising, divisive, and fall hardest on the poor and marginalised among us.
All these wrongs must be accounted for. WHO Director-General, Tedros Adhanom and Health Emergencies Director, Mike Ryan must resign. There has to be an independent and public inquiry into the manner in which the WHO has conducted itself throughout, not just during the Covid saga, but also in other epidemics, such as Ebola and bird flu.
The Imperial College of London must suspend its epidemiology department and face an ethics enquiry - not just of Neil Ferguson and his team, but of the entire management of that University. In fact, all the big Universities around the world need to show that they have understood and taken seriously this crisis of weak thinking and woeful ethics in the sciences and social sciences. All of you professors and researchers in your comfy positions in your Universities, you
10.8 Toxic Thinking in Science and Social Science: The Price Exacted by the Neo-Welfare State
Public health experts must introspect over the devastation that has been caused by their over-simplistic and numerical approach to health issues. They need to throw away all their lists of health indicators and epidemiological modelling. They have to find a way of weaving the humanity back into public health thinking, and never letting it go, ever again.
A good way of keeping their feet on the ground, is to abandon utopian thinking on health issues. The idea of eradicating disease and injury altogether from our lives is bizarre and self-defeating. It is this which has led to the soul-destroying use of the precautionary principle in social welfare thinking. We must stop second guessing life. We should go back to basic ideas of giving assistance when the need for it appears. Chance is part of life. You, public health experts, you cannot subtract chance from life. That is not how the mathematics of life works. All you end up doing is cutting off life in order to stop it from running into chance. As a member of the lay public, as an ordinary citizen of the world, as a mother, I say to your grand schemes of global control over disease, death and luck, enough! Give me back my life, and I will take my chances.
Whenever we humans make blindingly obvious mistakes, and allow blatant injustices and foolishness to pass, as we have done with Covid-19, then we have to also look at the three fingers that point back at us, when we point to the persons who led us in these mistakes and injustices. All this folly took place within the framework of a certain wrong way of thinking in science and social welfare that we have all come to accept, and even to celebrate.
Science has left its roots in theory too far behind, and now seems to spend all its time playing games with mathematical modelling and super computers. This is not the way to produce good science. All this epidemiology and these super-computers are taking us away from science, and not towards it. If we are relying more on super-computers than on our brains to do science, then we should assume that there is something wrong with our science. The brain must lead the machine. Numbers are an adjunct to thinking, not a substitute for it. That’s when you have science. Anything else is just a rarefied form of accountancy.
Public policy and social development also have to end their romance with modelling and numbers. You are killing common sense and humanity with your indicators and projections-based approach. Like public health experts, you are forgetting the people behind the numbers. You are also not conscious enough, when you design interventions for the betterment of society, of the danger of using the state as your ally in so doing. In recent years, there has been a general tendency in welfare thinking, to ignore the adversarial aspect of the relationship between state and citizen. The state is seen as the engine for delivering welfare, for helping those left behind, and, therefore, to be accepted and trusted by all good-hearted and responsible citizens. Anyone standing in the way is seen to be violating their responsibility both to society, and to themselves. But we are seriously undermining the very freedoms and liberties on which we rely to keep our society just and fair by giving in too completely to this way of thinking.
The assumption when using the state to intervene on welfare grounds must be that things could go wrong in unpredictable ways, and also in the predictable ways of state overreach, corruption and incompetence. Instead of digging their heels in on one or other side of various social development models, or blaming the government for not acting strongly enough, or blindly asking for more money to be pumped into welfare schemes that go toxic, social development professionals should be vigilant about interventions that go bad. They should be at the forefront of moves to stop or change course. Right now, there is too much of a superior attitude in the social welfare field about these things. Social development professionals, NGOs, activists and philanthropists are so caught up in the nobility of their mission to save the world, that they are not willing to accept that they themselves might be creating and perpetuating the inequalities and injustices that they set out to conquer.
As I came to the end of writing this paper, I found a fascinating debate between Noam Chomsky and Michel Foucault from the 1970s, that reflects upon these issues (172). Chomsky, the progressive, argues that we must intervene to constantly improve society, to make it just and fair, and that such an approach is in turn founded upon an idea of the ideal man in all his goodness, creativity, and other potential. Foucault, the post-modernist, says that structures of power will inevitably influence how you articulate the principles of a just and fair society, and how you conceive of the ideal man; and so any intervention carries the possibility of perpetuating the very imbalance of power that produced the injustice or other social-ill that you set out to correct (191).
Foucault here is not really arguing against social action. Foucault was pointing towards what the right philosophic approach to social action must be. He was saying, what we saw him say in The Birth of the Clinic, about the role of social and economic dynamics, and even of chance, in forming systems of thought or practice.
If you have social action that is not reflective about this, that will not concede this, that questions the motives of people who try to point this out, that is when it becomes oppressive, and just another form of the unjust exercise of authority and control over others. And that is where we are today with social welfare interventions of all kinds, of which lockdown has only been the most dramatic and widespread.
My own interest in this matter comes from the field of child protection, where I have for years been witnessing the brutal snatching of children by the state from loving families for no good reason, and with an absolute refusal on the part of the child rights field to do something about it. I first witnessed this system in the Nordic countries of Norway and Sweden, and was struck by the widespread support in these societies of their child services. Everything I saw in the way child protection functions in these countries - the intrusiveness, the punitive approach, the lack of transparency, decisions being taken by executive power, the lack of due process - all this contradicted the openness and freedoms for which these societies are so famous.
It was in struggling to understand this contradiction, that I had at first approached simply as lawyer concerned about basic principles of due process and administrative accountability, that I saw the full extent of the pact which binds people to the state in the Nordic welfare model. I saw that when you rely on the state to take care of you, it really does take care of you, in the sense that you are subject to its interference to a much greater degree in the areas of life where it intervenes, than in those where it leaves you to your own devices.
In the United Kingdom, I saw the same aggressive interventionism in the fields of child services, elder care, the provision and withholding of certain types of medical services, and the sectioning of the mentally ill. Though the British have in general retained their sense of irony, and the distance that implies, towards the state in all areas other than these, in Sweden and Norway I have found a degree of respect, obedience and solidarity with the state-as-government, not as nation, that would be more in place in authoritarian regimes. Scandinavians are highly conformist and amenable to authority when it is expressed in terms of their welfare. This is the true context for understanding the so-called “no lockdown” policy of Sweden. They did not need it, because Swedes could be depended upon to follow government advice on social distancing.
Let us look at the facts on the ground in Sweden. By mid-April about half of Sweden’s workforce was reported to be working from home (187), from mid-March onwards there was a 50% drop in the use of public transport in some counties (188) and a 30% drop in Stockholm in the use of cars (189). Inter-state travel over Easter was down by 80-90% (190). Therefore, movement was substantially reduced, more than in many countries with mandatory lockdowns. So whatever else the Swedish response to Covid-19 was about, it was not about people having more freedom in Swedish society. If anything, it was symptomatic of the degree to which certain freedoms have been ceded to the state by Swedes a long time ago.
And it gets more and more interesting as you keep thinking deeper about the Swedish response to Covid-19. Note how the Swedes did not attempt to justify their strategy by pointing out that they did have a voluntary near-lockdown in place. Clearly, they are not willing to disclose just how compliant their people are to the merest suggestions of the authorities.
But what is even more noteworthy is how the de facto lockdown of Sweden did not satisfy pro-lockdown advocates elsewhere in Europe and the USA. This really shows the twisted psychology of the pro-lockdowners. They were not so much concerned about whether there had been an effective suspension of social and economic activity in Sweden for the sacred “flattening of the curve”. What was really getting the lockdowners’ goat was that Swedes were being permitted even the theoretical right to decide not to stay-at-home. This is where public welfare thinking really reveals itself for the nakedly repressive and dogmatic thing that it has become. These people want nothing less than our blind obedience. We need to tell them to get lost!
10.9 Let's Forget about Covid!
The philosopher Slavoj Zizek wrote recently about Covid-19 that governments, I presume he meant Western governments, because no one in our part of the world spoke of this, when speaking of herd immunity were like the cat in the cartoon that walks off the precipice, and keeps walking so long as he does not look down, but when he does, he falls (171)! In fact, these Western governments were not so innocent as that cat. They suggested herd immunity to cover up their inability to save their people from Covid-19, and when the people objected, they punished them with lockdown.
I will end with Zizek’s metaphor of the cat. Are we not all like that cat? We are even more pathetic than it, because we never have even a second’s doubt of the abyss that yawns right before us. Each day, is not even a wager against death, because we know that death is certain. We simply shrug it off, and carry on. We laugh in the face of death. We have snatched meaning and joy from the unrelenting silence and randomness of the Universe around us. This is our genius. Let us forget about Covid -19. Let us get back to life.
Suranya Aiyar is trained in mathematics at St. Stephen’s College, India and law at Oxford University, UK and New York University, USA. She lives in New Delhi, India, with her husband and two children.
This was presented live on Facebook on July 24th, 2020. Watch the video here. Listen to the podcast here.
This is the last lecture in the series, but let us not stop the discussion here. I invite any of you who might be interested in talking or writing about the Dodgy Science and Woeful Ethics of Covid-19 on my blog to get in touch, by leaving a here or on Facebook.
NOTES AND REFERENCES
a. 1 lakh = 100,000; 1 crore = 10 million
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(28) Police kill three people in three days of lockdown. This is normal for South Africa, GroundUp, 1 April 2020. Link: https://www.groundup.org.za/article/police-kill-three-people-three-days-lockdown-normal-south-africa-data-reveals/
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(31) Plague Warriors: The Deadly Ebola Outbreak in Zaire, Laurie Garret, Vanity Fair 1 August 1995. Link: https://archive.vanityfair.com/article/1995/8/plague-warriors.
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(35) Italian mayor claims the true death toll from Covid-19 likely to be much higher, euronews.com, 21 March 2020. Link: https://www.euronews.com/2020/03/21/italian-mayor-claims-the-true-death-toll-from-covid-19-likely-to-be-much-higher
(36) ‘India has tremendous capacity to combat Covid-19’: WHO Executive Director, 24 March 2020. Link: https://www.youtube.com/watch?v=bydILYTQUsA
(37) Covid 19: Tablighi Jamaat attendee attempts suicide from 6th floor of Delhi Hospital, PTI, Deccan Herald, 2 April 2020. Link: https://www.deccanherald.com/national/covid-19-tablighi-jamaat-attendee-attempts-suicide-from-6th-floor-of-delhi-hospital-820254.html
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(39) Kya WHO ne lockdown ka sujhav diya hai? Prime Time with Ravish Kumar, 1 May 2020 (in Hindi). Link: https://www.youtube.com/watch?v=FNzlq1whlq4
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(64) China coronavirus: Wuhan medical staff being infected at much faster pace than reported as national death toll hits 26, South China Morning Post, 24 January 2020. Link: https://www.scmp.com/news/china/society/article/3047441/wuhan-medical-staff-being-infected-virus-much-faster-pace
(65) Coronavirus: shocking footage shows Chinese family being forced into quarantine by police, Evening Standard, 8 February 2020. Link to video: https://www.youtube.com/watch?v=nNeTWX7WgwA
(66) Ebola community health workers trained for the future, 10 March 2020. Link: https://www.afro.who.int/news/ebola-community-health-workers-trained-future?fbclid=IwAR2zmg7cus3tbD8LCJZCzCsjFXM_BuQ9o9dhYxNx7z6u7X_cUR0DPwMNkVQ
(67) Sweden’s relaxed approach to the coronavirus could already be backfiring, Time, 9 April 2020. Link: https://time.com/5817412/sweden-coronavirus/
(68) Spanish soldiers find elderly patients ‘abandoned’ in retirement home, France 24, 24 March 2020. Link: https://www.france24.com/en/20200324-spanish-soldiers-find-elderly-patients-abandoned-in-retirement-homes ; ‘Just sedate old people, pray they live’: with nearly 12k deaths in Spain, Covid-19 suffocates hospitals, News19=8.com, 5 April 2020. Link: https://www.news18.com/news/world/they-just-sedate-old-people-pray-they-live-with-nearly-12k-deaths-in-spain-covid-19-suffocates-hospitals-2564945.html; Pensioner, 84, on lockdown due to coronavirus….Daily Mail, 8 April 2020. Link: https://www.dailymail.co.uk/news/article-8201815/Pensioner-84-lockdown-coronavirus-forced-eat-old-food-BIN.html; Burials on New York island are not new but are increasing during pandemic, npr.org, 10 April 2020. Link: https://www.npr.org/sections/coronavirus-live-updates/2020/04/10/831875297/burials-on-new-york-island-are-not-new-but-are-increasing-during-pandemic ; Mass graves for coronavirus victims shouldn’t come as a shock, The Conversation https://theconversation.com/mass-graves-for-coronavirus-victims-shouldnt-come-as-a-shock-its-how-the-poor-have-been-buried-for-centuries-136655; ‘This whole corridor is dead’: Europe’s coronavirus care home disaster, The Irish Times, 19 May 2020. Link: https://www.irishtimes.com/news/world/europe/this-whole-corridor-is-dead-europe-s-coronavirus-care-home-disaster-1.4256568 ; Coronavirus: Europe’s care homes struggle as deaths rise, BBC, 3 April 2020. Link: https://www.bbc.com/news/world-europe-52147861 ; A deluged system leaves some elderly to die, rocking Spain’s self-image, New York Times, 25 March 2020. Link: https://www.nytimes.com/2020/03/25/world/europe/Spain-coronavirus-nursing-homes.html
(69) New York Governor Andrew Cuomo criticised over highest nursing home death toll, The New Indian Express, 10 May 2020. Link: https://www.newindianexpress.com/world/2020/may/10/new-york-governor-andrew-cuomo-criticised-over-highest-nursing-home-death-toll-2141550.html
(70) Nation-wise data from the International Long Term Care Policy Network, “Mortality associated with COVID among people who use long term care”, updates of 21 May 2020 and 26 June 2020. Link to 26 June 20202 update here: https://ltccovid.org/wp-content/uploads/2020/06/Mortality-associated-with-COVID-among-people-who-use-long-term-care-26-June-1.pdf; State-wise data for the USA from Covid-19 brutal on NY long-term care facilities, The Buffalo Post quoting Kaiser Family Foundation data, 26 May 2020. Link: https://buffalonews.com/business/local/covid-19-brutal-on-ny-long-term-care-facilities-nationwide-its-worse/article_739b408b-5d34-5b8d-be83-124047368d2b.html
(71) A deluge of death in Northern Italy, 25 March 2020. Link: https://graphics.reuters.com/HEALTH-CORONAVIRUS-LOMBARDY/0100B5LT46P/index.html; ‘We take the dead from morning till night’, The New York Times, 27 March 2020. Link: https://www.nytimes.com/interactive/2020/03/27/world/europe/coronavirus-italy-bergamo.html?auth=login-email&login=email
(72) Mumbai: 25-year-old with no conditions dies after 3 days in hospital, Time of India, 21 April 2020. Link: https://timesofindia.indiatimes.com/city/mumbai/mumbai-25-year-old-with-no-conditions-dies-after-3-days-in-hospital/articleshow/75262442.cms
(73) Coronavirus: with SP and RJ from this Tuesday, all capitals stop trade to reduce the risk of contagion, globo.com, 24 March 2020 (in Brazilian Portuguese). Link: https://g1.globo.com/economia/noticia/2020/03/24/cidades-fecham-comercio.ghtml; Bolsonaro says he ‘wouldn’t feel anything if infected with Covid-19 and attacks state lockdowns, The Guardian, 25 March 2020. Link: https://www.theguardian.com/world/2020/mar/25/bolsonaro-brazil-wouldnt-feel-anything-covid-19-attack-state-lockdowns; Bolsonaro and governors on a collision course, The Brazilian Repot, 26 March 2020. Link: https://brazilian.report/newsletters/brazil-daily/2020/03/26/governors-in-brazil-on-a-collision-course-with-president-bolsonaro/; Rio and 5 other municipalities in the state declare an emergency to contain the coronavirus, g1.globo.com, 18 March 2020 (in Brazilian Portuguese). Link: https://g1.globo.com/rj/rio-de-janeiro/noticia/2020/03/18/prefeitura-do-rio-declara-situacao-de-emergencia.ghtml; https://g1.globo.com/rj/rio-de-janeiro/noticia/2020/03/17/governo-do-rj-determina-reducao-de-50percent-da-capacidade-de-lotacao-dos-transportes-publicos.ghtml
(74) Data from catcomm.org/favela-facts.
(75) Brazil’s super-rich and the exclusive club at the heart of a coronavirus hotspot, The Guardian, 4 April 2020. Link: https://www.theguardian.com/world/2020/apr/04/brazils-super-rich-and-the-exclusive-club-at-the-heart-of-a-coronavirus-hotspot
(76) Rio’s favela’s count the cost as deadly spread of Covid-19 hits the city’s poor, The Guardian, 25 April 2020. Link: https://www.theguardian.com/world/2020/apr/25/rio-favelas-coronavirus-brazil
(77) Brazil Covid-19 data from https://disasterresponse.maps.arcgis.com/apps/dashboards/b16474584d1b43948955ca1462b9e998
(78) Data from https://painel.vozdascomunidades.com.br/
(79) How one of Brazil’s largest favelas confronts coronavirus, Bloomberg, 3 May 2020. Link: https://www.bloomberg.com/news/features/2020-05-03/how-one-of-brazil-s-largest-favelas-confronts-coronavirus?fbclid=IwAR2L1GWPMDyUgtXBdQGbcEYPbcOQ9jTccTaZiCJHH4GsmHgvshvVUAXS3fg
(80) Brazil’s favelas forced to fight coronavirus alone, DW, 2 July 2020. Link: https://www.dw.com/en/brazils-favelas-forced-to-fight-coronavirus-alone/a-54031886; Data on favelas from https://painel.vozdascomunidades.com.br/ and state-wise Brazil data from https://www.statista.com/statistics/1103791/brazil-coronavirus-cases-state/
(81) Malabar Hill resident among 5 new cases, Mumbai Mirror, 21 March 2020. Link: https://mumbaimirror.indiatimes.com/coronavirus/news/malabar-hill-resident-among-5-new-cases/articleshow/74740898.cms
(82) Asia’s largest slum Dharavi reports first Covid-19 case, Economic Times 2 April 2020. Link: https://economictimes.indiatimes.com/news/politics-and-nation/asias-largest-slum-dharavi-reports-first-case-of-coronavirus/articleshow/74937159.cms ; Number of coronavirus cases in Maharashtra rises to 335, LiveMint, 1 April 2020. Link: https://www.livemint.com/news/india/number-of-coronavirus-cases-in-maharashtra-rises-to-335-11585749948541.html
(83) Mumbai becomes epicentre of Covid-19 positive cases and death reports, The New Indian Express, 5 April 2020. Link: https://www.newindianexpress.com/cities/mumbai/2020/apr/05/mumbai-becomes-epicentre-of-covid-19-positive-cases-and-death-reports-2126173.html
(84) Maharashtra nears 10,000 mark.., NDTV, 29 April 2020. Link: https://www.ndtv.com/india-news/maharashtra-nears-10-000-mark-mumbai-has-6-644-coronavirus-cases-2220609
(85) Mumbai Covid19 Tracker: 12 BMC wards report over 1500 positive cases, Mumbai Mirror, 31 May 2020. Link: https://mumbaimirror.indiatimes.com/coronavirus/news/mumbai-covid-19-tracker-12-bmc-wards-report-over-1500-positive-cases-dharavi-dadar-and-mahim-among-citys-worst-hit/articleshow/76120988.cms
(86) Mumbai: In Dharavi 75% infected are frontline workers, Indian Express, 23 May 2020. Link: https://indianexpress.com/article/cities/mumbai/in-dharavi-75-infected-are-frontline-workers-6423111/
(87) In the week funk dances returned to communities, favelas recorded more than 100 deaths from Covid-19, OGlobo, 8 June 2020 (in Brazilian Portuguese). Link: https://oglobo.globo.com/rio/na-semana-em-que-bailes-funks-voltaram-comunidades-favelas-registram-mais-de-cem-mortes-por-covid-19-1-24468827
(88) In Delhi slums people queue for drinking water ignoring social distancing norms, Business Insider, 18 April 2020. Link: https://www.businessinsider.in/india/news/in-delhi-slums-people-queue-for-drinking-water-ignoring-social-distancing-norms/articleshow/75218038.cms
(89) Ramaphosa announces 21day coronavirus lockdown for South Africa, BusinessTech, 23 March 2020. Link: https://businesstech.co.za/news/government/383927/ramaphosa-announces-21-day-coronavirus-lockdown-for-south-africa/
(90) Mzansi reacts to police & army ‘brutality’ during lockdown, TimesLive, South Africa, 31 March 2020. Link: https://www.timeslive.co.za/news/south-africa/2020-03-31-mzansi-reacts-to-police-army-brutality-during-lockdown-they-must-respect-the-law/
(91) UN Raises alarm about police brutality in Covid-19 lockdowns, Al Jazeera, 28 April 2020. Link: https://www.aljazeera.com/news/2020/04/raises-alarm-police-brutality-covid-19-lockdowns-200428070216771.html?fbclid=IwAR0luxsHfBtWv1GuDp46YitHRZi5ER3xjfplukqDrK7Hjb5KY5bxSOiUWAE
(92) Maharashtra government seals all hotspots including Dharavi, LiveMint, 9 April 2020. Link: https://www.livemint.com/news/india/mumbai-seals-parts-of-dharavi-11586437129347.html
(93) Coronavirus fallout: From Maharashtra an exodus of migrant workers with no work, The Wire: Science, 22 March 2020. Link: https://science.thewire.in/health/coronavirus-maharashtra-migrant-workers/
(94) Quarantine puts at risk the income of Brazilian slum dwellers, says research, globo.com, 24 March 2020 (in Brazilian Portuguese). Link: https://g1.globo.com/bemestar/coronavirus/noticia/2020/03/24/quarentena-poe-em-risco-a-renda-de-moradores-de-favelas-brasileiras-diz-pesquisa.ghtml
(95) Coronavirus fallout: From Maharashtra an exodus of migrant workers with no work, The Wire: Science, 22 March 2020. Link: https://science.thewire.in/health/coronavirus-maharashtra-migrant-workers/
(96) Ground Report: Chaos at Anand Vihar as buses prepare to take migrant workers home, The Wire, 28 March 2020. Link: https://www.youtube.com/watch?v=gW61drhb8FE; India lockdown: Migrant workers in very large numbers at Delhi’s Anand Vihar bus terminal, The Economic Times, 28 March 2020. Link: https://economictimes.indiatimes.com/news/politics-and-nation/india-lockdown-migrant-workers-in-very-large-numbers-at-delhis-anand-vihar-bus-terminal/videoshow/74865929.cms?from=mdr; Watch: Thousands of migrant workers crowd Anand Vihar Bus Terminal amid lockdown, Times of India, 28 March 2020. Link: https://timesofindia.indiatimes.com/videos/city/delhi/watch-thousands-of-migrant-workers-crowd-anand-vihar-bus-terminal-amid-lockdown/videoshow/74865108.cms; Covid 19 Lockdown: Hungry Helpless Migrant Workers Flee Cities, 29 March 2020, India Today (Video). Link: https://www.youtube.com/watch?v=lUVGVBNWDZ0; Stranded Migrant workers walk for days to reach home amidst lockdown, CNN News18, 27 March 2020. Link: https://www.youtube.com/watch?v=PgIbqEzdPyg
(97) My kids are hungry, you think Covid-19 is what I fear? News18.com, 29 March 2020. Link: https://www.news18.com/news/india/my-kids-are-hungry-you-think-covid-19-is-what-i-fear-thousands-of-migrant-workers-flee-amid-lockdown-2555453.html
(98) Covid 19 lockdown triggers massive exodus of migrant workers Noida-Agra Highway, CNN News18, 28 March 2020. Video link: https://www.youtube.com/watch?v=tt8e8owMTGY; Migrant Workers Walking their ways back home say hunger will get them before the virus, CNN News18, 27 March 2020. Video link: https://www.youtube.com/watch?v=-PBD4yBJlJQ; Stranded Migrant workers walk for days to reach home, CNN-New18, 26 Mach 2020. Video link: https://www.youtube.com/watch?v=PgIbqEzdPyg
(99) Des ki baat Ravish Kumar ke saath: Mazdooron ki Majboori, NDTV India, 6 May 2020 (in Hindi), https://www.youtube.com/watch?v=lfdmcaOeWmY; Des ki baat Ravish Kumar ke saath: Mazdooron ki Ghar Waapsi ki Jaddojehad, NDTV India, 11 May 2020 (in Hindi). Link: https://www.youtube.com/watch?v=ovbpvCLaYL8
(100) Des ki baat Ravish Kumar ke saath: Mazdooron ki Ghar Waapsi ki Jaddojehad, NDTV India, 11 May 2020 (in Hindi). Link: https://www.youtube.com/watch?v=ovbpvCLaYL8
(101) Des ki baat Ravish Kumar ke saath: Mazdooron ki Majboori, NDTV India, 6 May 2020, (in Hindi) https://www.youtube.com/watch?v=lfdmcaOeWmY
(102) Uddhav Thackrey appeals to migrant workers to stay put, The Hindu Business Line, 28 March 2020. Link: https://www.thehindubusinessline.com/news/uddhav-thackeray-appeals-to-migrant-workers-in-maharashtra-to-stay-put/article31189724.ece
(103) How the coronavirus is impacting favelas in Rio de Janeiro, Forbes, 29 April 2020. Link: https://www.forbes.com/sites/joshualaw/2020/04/29/how-the-coronavirus-is-impacting-favelas-in-rio-de-janeiro/#3023c783ee39
(104) Daulatdia brothel: as clients disappear hunger sets in, The Business Standard, Bangladesh, 8 April 2020. Link: https://tbsnews.net/panorama/daulatdia-brothel-clients-disappear-hunger-sets-66586
(105) ‘This is what happens to us’, The Washington Post, 3 June 2020. Link: https://www.washingtonpost.com/graphics/2020/politics/coronavirus-race-african-americans/
(106) The social inequalities that the Covid-19 pandemic shows us, Brasil de Fato, 4 April 2020 (in Brazilian Portuguese). Link: https://www.brasildefato.com.br/2020/04/04/artigo-as-desigualdades-sociais-que-a-pandemia-da-covid-19-nos-mostra
(107) To contain coronavirus, residents negotiate end of funk balls in Rocinha, midiamax, 9 June 2020 (in Brazilian Portuguese). Link: https://www.midiamax.com.br/brasil/2020/para-conter-coronavirus-associacao-de-moradores-negociou-fim-dos-bailes-funk-na-rocinha
(108) 1 million Bangladeshi garments workers lose jobs amid Covid-19 economic fallout, mpr.org, 3 April 2020. Link: https://www.npr.org/sections/coronavirus-live-updates/2020/04/03/826617334/1-million-bangladeshi-garment-workers-lose-jobs-amid-covid-19-economic-fallout
(109) Fury in Kenya over police brutality amid coronavirus curfew, Al Jazeera, 2 April 2020. Link: https://www.aljazeera.com/news/2020/04/fury-kenya-police-brutality-coronavirus-curfew-200402125719150.html?utm_source=website&utm_medium=article_page&utm_campaign=read_more_links
(110) Lockdown: cops, metro cop face 3 counts of murder and other serious charges, news24.com, 31 March 2020. Link: https://www.news24.com/news24/southafrica/news/cops-face-3-counts-of-murder-and-other-serious-charges-amid-lockdown-20200331; Police brutality on the rise during lockdown, IOL, South Africa, 5 April 2020. Link: https://www.iol.co.za/news/south-africa/police-brutality-on-the-rise-during-lockdown-46250431; SANDF issues stern warning after soldiers accused of beating Alexandra man to death, IOL, 12 April 2020. Link: https://www.iol.co.za/news/south-africa/gauteng/sandf-issues-stern-warning-after-soldiers-accused-of-beating-alexandra-man-to-death-46625061?fbclid=IwAR3j00XAzYI5j6rOLwEe5k_VoWiRQYeh4reKfCNLINELcc4JHVRSVt5S8tQ. Also see (28).
(111) Covid-19: Security forces in Africa brutalizing civilians under lockdown, DW, 20 April 2020. Link: https://www.dw.com/en/covid-19-security-forces-in-africa-brutalizing-civilians-under-lockdown/a-53192163?fbclid=IwAR1zWI6PygaOesr1Ntw32ShrUyRS2pgbYD7G_E1OCe44d1dnlK0
(112) Court orders suspension of South African soldiers over death of man in lockdown, Reuters, 15 May 2020. Link: https://www.reuters.com/article/us-health-coronavirus-safrica-military/court-orders-suspension-of-south-african-soldiers-over-death-of-man-in-lockdown-idUSKBN22R24O
(113) We’ll keep enforcing lockdown, says French Minister amid unrest, Reuters, 22 April 2020. Link: https://www.reuters.com/article/us-health-coronavirus-france-security/french-motorcyclist-whose-crash-fuelled-riots-urges-calm-amid-more-unrest-idUSKCN2240DC
(114) Containment Measures: Police checks must not be abusive, violent or discriminatory, Human Rights League and Others, France, 27 March 2020 (in French). Link: https://www.ldh-france.org/mesures-de-confinement-les-controles-de-police-ne-doivent-etre-ni-abusifs-ni-violents-ni-discriminatoires/
(115) The Religious Retreat that sparked India’s Major Coronavirus Manhunt, Reuters, 2 April 2020. Link: https://www.reuters.com/article/us-health-coronavirus-india-islam-insigh/the-religious-retreat-that-sparked-indias-major-coronavirus-manhunt-idUSKBN21K3KF
(116) Tabligh members undergoing treatment…The Economic Times, 3 April 2020. Link: https://economictimes.indiatimes.com/news/politics-and-nation/tabligh-members-undergoing-treatment-not-cooperating-doctors-to-delhi-govt/articleshow/74969727.cms?from=mdr
(117) Tablighi Jamaat par bole CM Arvind Kejriwal, Navbharat Times, 31 March 2020 (in Hindi). Link: https://www.youtube.com/watch?v=yNA_OKk4IKE
(118) Coronavirus conspiracy theories targeting Muslims spread in India, The Guardian, 13 April 2020. Link: https://www.theguardian.com/world/2020/apr/13/coronavirus-conspiracy-theories-targeting-muslims-spread-in-india ; ‘Muslim traders not allowed’, reads poster in Indore village, Scroll.in, 3 May 2020. Link: https://scroll.in/latest/960924/muslims-not-allowed-reads-poster-in-indore-village-police-file-case; Gurugram: Youths assault neighbour, 6 of them arrested, Times of India, 7 April 2020. Link: https://timesofindia.indiatimes.com/city/gurgaon/youths-assault-neighbour-6-of-them-arrested/articleshow/75018533.cms
(119) Press Release: International Institute for Religious Freedom and Human Rights Without Frontiers. Link: https://www.iirf.eu/news/other-news/cesnur-and-human-rights-without-frontiers-release-white-paper-on-shincheonji-and-coronavirus/ ; Shincheonji & Coronavirus in South Korea: Sorting Fact from Fiction, Human Rights Without Frontiers et al.. Link: https://drive.google.com/file/d/1DRcWhbQ1xoJRs-tkAFp38IWi-3QB8qJX/view
(120) Coronavirus is spreading at religious gatherings, ricocheting across nations, The Wall Street Journal, 18 March 2020. Link: https://www.wsj.com/articles/coronavirus-is-spreading-at-religious-gatherings-ricocheting-across-nations-11584548174
(121) 202 confirmed coronavirus cases in South Africa, BusinessTech, South Africa, 20 March 2020. Link: https://businesstech.co.za/news/lifestyle/383455/202-confirmed-coronavirus-cases-in-south-africa/
(122) Coronavirus: SA’s patient zero and one other are home and all clear, IOL, South Africa, 20 March 2020. Link: https://www.iol.co.za/news/south-africa/kwazulu-natal/coronavirus-sas-patient-zero-and-one-other-are-home-and-all-clear-45296869
(123) Rights in the time of Covid-19, UNAIDS, 20 March 2020. Link: https://www.unaids.org/en/resources/documents/2020/human-rights-and-covid-19
(124) African countries respond to Guangzhou’s ‘Anti Epidemic Measures’, The Diplomat, 27 April 2020. Link: https://thediplomat.com/2020/04/african-countries-respond-to-guangzhous-anti-epidemic-measures/
(125) List of incidents of xenophobia and racism related to the Covid-19 pandemic, Wikipedia. https://en.wikipedia.org/wiki/List_of_incidents_of_xenophobia_and_racism_related_to_the_COVID-19_pandemic
(126) Covid-19: Bangladesh Army says troops will be on streets until govt recalls, PTI, The Hindu, 29 March 2020. Link: https://www.thehindu.com/news/international/covid-19-bangladesh-army-says-troops-will-be-on-streets-until-govt-recalls/article31197469.ece
(127) Bangladesh: End wave of Covid-19 ‘rumour’ arrests, Human Rights Watch, 31 March 2020. Link: https://www.hrw.org/news/2020/03/31/bangladesh-end-wave-covid-19-rumor-arrests?fbclid=IwAR0ZW3igg-DHw24SfVWvAdgC-bckCRRaANzt7YQf4fpcSSkdIhFW5G7IOnU
(128) Nigerian security forces kill 18 during curfew enforcement, AL Jazeera, 16 April 2020. Link: https://www.aljazeera.com/news/2020/04/nigerian-security-forces-kill-18-curfew-enforcement-200416142503603.html?utm_source=website&utm_medium=article_page&utm_campaign=read_more_links
(129) South Africa’s ruthlessly efficient fight against coronavirus, BBC, 3 April 2020. Link: https://www.bbc.com/news/world-africa-52125713?fbclid=IwAR3z4vjmq_PPI2_GB3divYSX3_UKODdSMa6DARgbsLFhHkRm0B8LtjJIyFs
(130) Statement by President Cyril Ramaphosa, 23 April 2020. Link: https://sacoronavirus.co.za/2020/04/23/statement-by-president-cyril-ramaphosa-on-south-africas-response-to-the-coronavirus-pandemic-union-buildings-tshwane/
(131) Des Ki Baat Ravish Kumar ke Saath, Patri par zindagi lautti hai, yahan majdooron ko mili maut, NDTV India, May 8, 2020, ; Des ki Baat Ravish Kumar ke Saath: Rail ki patriyon par chalta desh, NDTV India, 8 May 2020. Link: https://www.youtube.com/watch?v=K2W2Fq2-BTs&list=PLpSN4vP31-KuS06SnZK5As7hprxvALTQ8&index=59&t=0s; Des ki Baat Ravish Kumar ke Saath Media ko majdooron ki bebassi dikhane se prashasan ki taraf se roka gaya, NDTV India, 8 May 2020. Link: https://www.youtube.com/watch?v=og-wP1VqRQY&list=PLpSN4vP31-KuS06SnZK5As7hprxvALTQ8&index=57; Migrant workers: Maharashtra accident victims were battling hunger; The Hindu, 8 May 2020. Link: https://www.thehindu.com/news/national/other-states/maharashtra-train-accident-victims-were-battling-hunger/article31538217.ece
(132) Mapping accidents that killed over 100 migrant workers on the way home during lockdown, New18.com, 20 May 2020. Link: https://www.news18.com/news/india/mapping-accidents-that-killed-over-100-migrant-workers-on-their-way-to-home-during-nationwide-lockdown-2627947.html; UP migrant walking home dies allegedly of hunger, The Hindu, 17 May 2020. Link: https://www.thehindu.com/news/national/other-states/up-migrant-walking-home-dies-allegedly-of-hunger/article31609993.ece; Coronavirus lockdown: The Indian migrants dying to get home, BBC, 20 May 2020. Link: https://www.bbc.com/news/world-asia-india-52672764; 22 migrant workers, kin have died trying to return home since the lockdown started, The Wire, 30 March 2020. Link: https://thewire.in/rights/coronavirus-national-lockdown-migrant-workers-dead; 198 migrant workers killed in road accidents during lockdown: Report, Hindustan Times, 2 June 2020. Link: https://www.hindustantimes.com/india-news/198-migrant-workers-killed-in-road-accidents-during-lockdown-report/story-hTWzAWMYn0kyycKw1dyKqL.html; Walking home, migrant worker dies of sunstroke in Andhra Pradesh, The New Indian Express, 22 May 2020. Link: https://www.newindianexpress.com/cities/vijayawada/2020/may/22/walking-home-migrant-worker-dies-of-sunstroke-in-andhra-pradesh-2146527.html; 378 die on the way home according to this report11 May Des ki Baat Mazdooron ki ghar wapsi ki jaddojehad. Coronavirus lockdown: Deaths in Shramik trains not due to lack of food, water, says government, The Hindu, 5 June 2020. Link: https://www.thehindu.com/news/national/coronavirus-lockdown-deaths-in-shramik-trains-not-due-to-lack-of-food-water-says-government/article31759464.ece
(133) India should aim for 10-week total lockdown…India Today, 22 April 2020. Link: https://www.indiatoday.in/india/story/india-should-aim-for-10-week-total-lockdown-not-rush-exit-top-health-journal-editor-1669917-2020-04-22
(134) Congo’s Ebola fight has lessons for Covid-19, Human Rights Watch, 26 March 2020. Link: https://www.hrw.org/news/2020/03/26/congos-ebola-fight-has-lessons-covid-19; Was DR Congo’s Ebola virus outbreak used as a political tool? The Lancet, Editorial, Vol. 393, 12 January 2019. Link: https://www.thelancet.com/action/showPdf?pii=S0140-6736%2819%2930002-9 ;191 Biosocial approaches to the 2013-2016 Ebola Pandemic, Richardson et al., Health and Human Rights Journal, June 2016, 18(1): 115-128. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5070685/.
(135) Ebola and the narrative of mistrust, Richardson et al., BMJ Glob Health 2019 4(6) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6936462/
(136) Bulletin of the World Health Organisation, Jane Parry, 12 December 2005. Link: https://www.who.int/bulletin/volumes/83/12/news21205/en/; Risky Zoographies: The limits of place in Avian Flu management, Natalie Porter, Environmental Humanities (2012) 1 (1): 103-121. Link https://read.dukeupress.edu/environmental-humanities/article/1/1/103/8073/Risky-Zoographies-The-Limits-of-Place-in-Avian-Flu
(137) China sends medical aid to Pakistan via PoK…HT, 28 March 2020. Link: https://www.hindustantimes.com/world-news/china-sends-medical-aid-to-pakistan-via-pok-dispatches-team-of-experts-to-help/story-K5tpx8meEnXNQ8Q9ITNxGL.html; Doxycycline and Ivermectin combo may be new effective Covid-19 treatment, Medical Dialogues, 18 May 2020. Link: https://medicaldialogues.in/medicine/news/doxycycline-and-ivermectin-combo-may-be-new-effective-covid-19-treatment-65868; 215 Pakistan to start manufacturing Covid-19 treatment drug, Gulf Today, 15 May 2020. Link: https://www.gulftoday.ae/en/news/2020/05/15/pakistan-to-start-manufacturing-covid19-treatment-drug; Bangladesh Medical College Hospital physician see ‘astounding results’ with drug combination targeting Covid-19, TrialSite News, 18 May 2020. Link: https://www.trialsitenews.com/bangladesh-medical-college-hospital-physician-see-astounding-results-with-drug-combination-targeting-covid-19/
(138) Physicians to population ratios reference: https://data.worldbank.org/indicator/SH.MED.PHYS.ZS
(139) For 2019 World Bank thresholds for income classification see https://blogs.worldbank.org/opendata/new-country-classifications-income-level-2019-2020); Data for beds-per-1000-of-population and percentage of ICU beds taken from the Covid Expert Group’s Report No. 12, dated 26 March 2020 (at (7)). According this report, Lower Income Countries have 1.24 beds per 1000 population on average and High Income Countries have 4.82 beds per 1000 population on average.
(139A) Source: https://www.who.int/healthinfo/global_burden_disease/estimates_country_2004_2008/en/ . In general, I have preferred using WHO data from this year, which was updated in 2011, as this appears to be the last year for which the WHO has received and incorporated comments from other countries.
(140) These calculations are based on WHO mortality estimates for 2008 at https://www.who.int/healthinfo/global_burden_disease/estimates_country_2004_2008/en/ .
(140A) These percentages are NOT from the WHO, they are my calculations are based on WHO estimates for 2008 of tuberculosis incidence here: https://apps.who.int/gho/data/view.main.57040ALL?lang=en and number of tuberculosis deaths) here (see under “by sex”): https://www.who.int/healthinfo/global_burden_disease/estimates_country_2004_2008/en/. The underlying data used by me is in the table below:
Country | Tuberculosis Incidence | Tuberculosis Deaths |
India | 31,40,000 | 2.7 lakh (approx.) |
Italy | 4700 | 400 |
Germany | 4800 | 400 |
France | 6600 | 700 |
USA | 15,000 | 700 |
UK | 9300 | 400 |
Kenya | 2.25 lakh (approx.) | 9700 |
South Africa | 4.86 lakh (approx..) | 19,500 |
Mexico | 24,000 | 2700 |
Sweden | 590 | 100 |
(140B) For tuberculosis incidence in Norway see https://apps.who.int/gho/data/view.main.57040ALL?lang=en . 2002 was a terrible year for tuberculosis in Norway with 100 deaths estimated in that year to this disease against an incidence estimate of 280 cases, giving a crude fatality rate of over 35%. Again this percentage is NOT from the WHO, it is my calculation based on WHO estimates for tuberculosis incidence here: https://apps.who.int/gho/data/view.main.57040ALL?lang=en and for mortality here: https://www.who.int/healthinfo/global_burden_disease/estimates_2000_2002/en/.
(140C) Source: WHO malaria figures for 2016 from here: https://apps.who.int/gho/data/node.main.A1364?lang=en (incidence) and here: https://www.who.int/healthinfo/global_burden_disease/estimates/en/ (mortality) click under ‘By Country WHO Member States, 2016.
(140D) Source: https://apps.who.int/gho/data/node.main.620?lang=en. HIV positive and AIDS cases for US for the year 2010 (later year case incidence is not available) and for other countries for the years 2018.
(140E) Ebola figures from https://www.who.int/news-room/fact-sheets/detail/ebola-virus-disease
(140F) “Mortality and Burden of Disease Estimates for WHO Member States” issued by WHO’s Department of Measurement and Health Information and “WHO Methods and data Sources for Country-Level Causes of Death 2000-2016” dated 2018.
(140G) Testing data from Worldometer.
(141) AIIMS data from https://www.aiims.edu/images/pdf/annual_reports/annual%20report19-e-20-1-20.pdf
(142) Becker’s Hospital Review data https://www.aiims.edu/images/pdf/annual_reports/annual%20report19-e-20-1-20.pdf
(143) ‘Doctor diplomacy’: Cuba seeks to make its mark in Europe amid Covid-19 crisis, The Guardian, 6 May 2020. Link: https://www.theguardian.com/world/2020/may/06/doctor-diplomacy-cuba-seeks-to-make-its-mark-in-europe-amid-covid-19-crisis
(144) WHO says Madagascar’s herbal tonic against Covid-19 is not a cure, AL Jazeera, 4 May 2020. Link: https://www.aljazeera.com/news/2020/05/madagascars-herbal-tonic-covid-19-cure-200504081212753.html?xif= ; Coronavirus: What is Madagascar’s ‘herbal remedy’ Covid-Organics? Al Jazeera, 6 May 2020. Link: https://www.aljazeera.com/news/2020/05/coronavirus-madagascar-herbal-remedy-covid-organics-200505131055598.html
(145) The use of non-pharmaceutical forms of Artemisia, WHO, 10 October 2019. Link: https://www.who.int/publications/i/item/the-use-of-non-pharmaceutical-forms-of-artemisia
(146) ‘WHO commends Madagascar’s fight against Covid-19’, AA.com, Africa, 21 May 2020. Link: https://www.aa.com.tr/en/africa/who-commends-madagascars-fight-against-covid-19/1848550
(147) Covid-19: Tests for miracle cure’ herb Artemisia begin, DW, 15 May 2020. Link: https://www.dw.com/en/covid-19-tests-for-miracle-cure-herb-artemisia-begin/a-53442366
(148) Madagascar slams WHO for not endorsing its herbal cure, AA.com, Africa, 11 May 2020. Link: https://www.aa.com.tr/en/africa/madagascar-slams-who-for-not-endorsing-its-herbal-cure/1836905
(149) Overview of malaria treatment, WHO, 18 January 2018. Link: www.who.int/malaria/areas/treatment/overview/en/
(150) Africans, three Ebola experts call for access to trial drug, Los Angeles Times, 6 August 2014. Link: https://www.latimes.com/world/africa/la-fg-three-ebola-experts-release-drugs-20140806-story.html
(151) Discovery and description Zaire Virus in 1976…, Breman et al., The Journal of Infectious Disease, October 2016, 15; 214 (Suppl 3): S93-S101. Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5050466/#JIW207C1; Ebola haemorrhagic fever in Zaire, 1976, Report of an International Commission. Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2395567/pdf/bullwho00439-0113.pdf
(152) Ethical considerations of experimental interventions in the Ebola outbreak, Annette Rid and Ezekiel J Emanuel, The Lancet, Vol. 384, 22 November 2014. Link: https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(14)61315-5.pdf
(153) Ebola: What it tells us about medical ethics, Angus J. Dawson, The Journal of Medical Ethics 2015; 41: 107-110; Link: https://jme.bmj.com/content/41/1/107; Ebola and ethics: autopsy of a failure, Christian A Gericke, BMJ 2015; 350. Link: https://www.bmj.com/content/350/bmj.h2105
(154) Trial of Ebola drug ZMapp launches in Liberia, US, Centre for Disease Research & Policy, 27 February 2015. Link: https://www.cidrap.umn.edu/news-perspective/2015/02/trial-ebola-drug-zmapp-launches-liberia-us
(155) Ebola is now curable…wired.com, 8 December 2019. Link: https://www.wired.com/story/ebola-is-now-curable-heres-how-the-new-treatments-work/
(156) Politics around Hydroxychloroquine hamper science, npr.org, 21 May 2020. Link: https://www.npr.org/sections/health-shots/2020/05/21/859851682/politics-around-hydroxychloroquine-hamper-science?fbclid=IwAR3f9iSiYsnpSkaN7T-wauT0I0D3kWlyB-7_s5QkQhWIFdqhs0EW9xwqxDY)
(157) CSIR chief flays Hydroxychloroquine trial suspension, The Hindu, 30 May 2020. Link: https://www.thehindu.com/sci-tech/health/coronavirus-csir-chief-flays-hcq-trial-suspension/article31712065.ece
(158) Global experts go head-to-head over claims the coronavirus ‘no longer exists clinically’, CNBC, 2 June 2020. Link: https://www.cnbc.com/2020/06/02/claim-coronavirus-no-longer-exists-provokes-controversy.html?__source=iosappshare%7Ccom.apple.UIKit.activity.CopyToPasteboard&fbclid=IwAR2vY80wwIBIiCGbFawFU-75UoYf_junth2xy4ogfbQ8ZKaJqmfX1-YM0Lc
(159) Coronavirus could ‘burn out’ on its own before we have a working vaccine: Former WHO chief, Firstpost, 20 May 2020. Link: https://www.firstpost.com/health/coronavirus-could-burn-out-on-its-own-before-we-have-a-working-vaccine-former-who-chief-8387911.html
(160) Indians in Wuhan say strict lockdown….The Economic Times, 9 April 2020. Link: https://economictimes.indiatimes.com/news/politics-and-nation/indians-in-wuhan-say-strict-lockdown-social-distancing-only-ways-to-contain-covid-19/articleshow/75064547.cms?from; China ends Wuhan lockdown…The New York Times, 7 April 2020. Link: https://www.nytimes.com/2020/04/07/world/asia/wuhan-coronavirus.html
(161) Early missteps and state secrecy in China likely allowed coronavirus to spread farther and faster, The Washington Post, 1 February 2020. Link: https://www.washingtonpost.com/world/2020/02/01/early-missteps-state-secrecy-china-likely-allowed-coronavirus-spread-farther-faster/
(162) People in China will make 3 billion trips in the next 40 days….Business Insider, 14 January 2020. Link: https://www.businessinsider.in/business/news/people-in-china-will-make-3-billion-trips-in-the-next-40-days-to-celebrate-lunar-new-year-the-worlds-largest-annual-human-migration/articleshow/73236413.cms#aoh=15910888889118&referrer=https%3A%2F%2Fwww.google.com&_tf=From%20%251%24s
(163) SARS-CoV-2 Viral Load in Upper Respiratory Specimens of Infected Patients, Zou et al., The New England Journal of Medicine 382: 12, 19 March 2020, first published on February 19, 2020. Link: https://www.nejm.org/doi/full/10.1056/NEJMc2001737
(164) Transmission of 2019-nCoV Infection from an Asymptomatic Contact in Germany, Rothe et al., The New England Journal of Medicine 382; 10 March 5, 2020, first published on January 30, 2020). Link: https://www.nejm.org/doi/full/10.1056/NEJMc2001468
(165) The Novel Coronavirus Pneumonia Emergency Response Epidemiology Team, The Epidemiological Characteristics of an Outbreak of 2019 Novel Coronavirus Disease (COVID-19) – China 2002, China CDC Weekly Vol. 2 No. x, pg 1. Link: http://weekly.chinacdc.cn/en/article/id/e53946e2-c6c4-41e9-9a9b-fea8db1a8f51
(166) Bangladesh virus prayer gathering sparks outcry, Taipei Times, 20 March 2020. Link: https://www.taipeitimes.com/News/world/archives/2020/03/20/2003733062; Brahmanbaria funeral crowd: Probe body starts investigation, Dhaka Tribune, 20 April 2020. Link: https://www.dhakatribune.com/bangladesh/nation/2020/04/20/probe-body-starts-working-over-brahmanbaria-funeral-crowd
(167) FranceInfo Survey: “The majority of people were infected”: from Corsica to overseas….franceinfo.com, 30 March 2020. Link: https://www.francetvinfo.fr/sante/maladie/coronavirus/video-coronavirus-le-nombre-de-contaminations-lors-du-rassemblement-evangelique-de-mulhouse-a-ete-largement-sous-evalue_3889133.html
(168) Back to the Future for Influenza Preimmunity – Looking Back at Influenza Virus History to Infer the Outcome of Future Infections, Francis et al., Viruses, 30 January 2019. Link: https://www.mdpi.com/1999-4915/11/2/122
(169) ‘A terrible price’: The deadly racial disparities of Covid-19 in America, The New York Times, 29 April 2020. Link: https://www.nytimes.com/2020/04/29/magazine/racial-disparities-covid-19.html
(170) Racial disparities in Louisiana’s Covid-19 death rate reflect systemic problems, 4WWL, 7 April 2020. Link: https://www.wwltv.com/article/news/health/coronavirus/racial-disparities-in-louisianas-covid-19-death-rate-reflect-systemic-problems/289-bd36c4b1-1bdf-4d07-baad-6c3d207172f2
(171) We have an appointment with death, Slavoj Zizek, Kultur, 1 April 2020. https://www.welt.de/kultur/article207219549/Slavoj-Zizek-The-epidemic-as-a-date-with-death.html
(172) Debate Noam Chomsky & Michel Foucault, On Human Nature https://www.youtube.com/watch?v=3wfNl2L0Gf8
(174) Coronavirus: What’s going wrong in Sweden’s care homes, BBC, 19 May 2020. Link: https://www.bbc.com/news/world-europe-52704836
(175) Mumbai high rises report spike in Covid-19…..Firstpost, 22 June 2020. Link: https://www.firstpost.com/health/mumbai-high-rises-report-spike-in-covid-19-cases-but-implementation-of-sealing-norms-patchy-bmc-puts-onus-on-housing-societies-8509391.html and High rise in number of positive cases in Mulund, Mumbai Mirror, 13 June 2020. Link: https://mumbaimirror.indiatimes.com/mumbai/cover-story/high-rise-in-number-of-of-ve-cases-in-mulund/articleshow/76349782.cms
(176) More than 28,000 stranded Indians have landed in Mumbai since May, MumbaiLive.com, 4 July 2020. Link: https://www.mumbailive.com/en/transport/more-than-28000-stranded-indians-have-landed-in-mumbai-since-may-52292
(177) Updated list of containment zones or red zones in Mumbai as of July 2, Mumbai Live, 3 July 2020. Link: https://www.mumbailive.com/en/civic/containment-zones-list-mumbai-list-coronavirus-lockdown-52242
(178) Source: Mumbai Live Covid Updates
(179) Mumbai: Dharavi sees a drop in new Covid-19 cases and deaths, Mumbai Mirror, 30 June 2020. Link: https://mumbaimirror.indiatimes.com/coronavirus/news/mumbai-dharavi-sees-a-drop-in-new-covid-19-cases-and-deaths/articleshow/76713018.cms
(180) BMC begins to withdraw after 90-day Covid-19 war in Dharavi, Mumbai Mirror, 3 July 2020. Link: https://mumbaimirror.indiatimes.com/coronavirus/news/bmc-begins-to-withdraw-after-90-day-covid-19-war-in-dharavi/articleshow/76769595.cms
(181) Cases as on July 2 https://www.freepressjournal.in/mumbai/coronavirus-in-mumbai-ward-wise-breakdown-of-covid-19-cases-issued-by-bmc-as-of-july-2
(182) Coronavirus: 21 cases found, building on Nepean Sea road sealed, Mumbai Live, 23 June 2020. Link: https://www.mumbailive.com/en/civic/the-bmc-sealed-an-entire-building-nestled-on-the-nepean-sea-road-after-21-cases-of-coronavirus-were-reported-from-the-society.-51737
(183) How Covid hotspot Dharavi, Asia’s largest slum, fought against all odds to flatten the curve, The Print, 14 June 2020 Link: https://theprint.in/india/how-covid-hotspot-dharavi-asias-largest-slum-fought-against-all-odds-to-flatten-the-curve/441036/
(184) BMC has sealed 1,000 buildings in a week, Mumbai Live, 25 June 2020. Link: https://www.mumbailive.com/en/civic/the-surge-in-the-number-of-coronavirus-cases-in-the-suburbs-of-mumbai-has-led-to-the-sealing-of-1000-buildings-in-the-past-eight-days-51856
(185) Coronavirus UK map….BBC, 6 July 2020. Link: https://www.bbc.com/news/uk-51768274
(186) Tegnell: Italian travellers are not the main source of infection, Sweden, SVT Nyheter, 2 May 2020 (in Swedish). https://www.svt.se/nyheter/inrikes/tegnell-italienresenarerna-inte-storsta-kallan-till-smitta ; ‘Coronavirus came to Sweden from countries that were under our radar’: Public Health Agency chief, The Local, 11 June 2020. Link: https://www.thelocal.se/20200611/public-health-agency-head-coronavirus-came-to-sweden-from-countries-that-were-under-our-radar
(187) Critics question Swedish approach as coronavirus death toll reaches 1,000, The Guardian, 15 April 2020. Link https://www.theguardian.com/world/2020/apr/15/sweden-coronavirus-death-toll-reaches-1000
(188) Large reduction in travel by public transport in the county, Sweden, KalmarPosten, 15 April 2020 (in Swedish). Link: https://www.kalmarposten.se/article/stor-minskning-av-resande-med-kollektivtrafik-i-lanet/ ; Travel halved at Skanetrafiken, Sweden, Aftonbladet, 25 March 2020 (in Swedish). Link: https://www.aftonbladet.se/nyheter/a/Op7rjq/resandet-halverat-hos-skanetrafiken ; West traffic takes the corona crisis very seriously, GT, expressen.se, Sweden, 8 April 2020 (in Swedish). Link: https://www.expressen.se/gt/debatt-gt/vasttrafik-tar-coronakrisen-pa-allra-storsta-allvar/
(189) Close to every third car away from Stockholm’s streets, Omni, Sweden (in Swedish). Link: https://omni.se/nara-var-tredje-bil-borta-fran-stockholms-gator/a/awQ7jL
(190) Stockholmers stay home at Easter,, SVT Nyheter, Sweden, 9 April 2020 (in Swedish). Link: https://www.svt.se/nyheter/snabbkollen/stockholmare-stannar-hemma-i-pask ; Travel from Stockholm during Passover, Telia.se, 9 April 2020 (in Swedish). Link: http://press.telia.se/pressreleases/svenskarna-stannar-hemma-under-paasklovet-2990179
(191) I call Foucault a “post-modernist” here with apologies to him. He famously disliked being called this. Certainly, his message was more profound and more delicate than the term allowed. In fact, Foucault was at his most Foucauldian when rejecting this label. Categorisation subtracts from the whole of what is being said. This is precisely the attitude we, especially scientists and doctors, need to adopt in the present crisis.
(192) Appendix-A & B; Appendix-C; Appendix-D; Appendix-E.
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