Arquivo da tag: Epidemia

Esse desconforto que você está sentindo é luto (HBR/Medium)

Por Scott Berinato, da Harvard Business Review. Traduzido por Ana Marcela Sarria (aqui); revisado por Renzo Taddei.

Texto original em inglês

HBR Staff/d3sign/Getty Images

Parte da equipe da HBR se reuniu virtualmente outro dia — uma tela cheia de rostos, numa cena que está se tornando cada vez mais comum por todos lados. Falamos sobre o conteúdo que estamos produzindo nestes tempos angustiantes e como podemos ajudar as pessoas. Mas também falamos sobre como estamos nos sentindo. Uma colega mencionou que o que ela sentia era luto. Cabeças acenaram em concordância na tela.

Se podemos nomeá-lo, talvez possamos lidar com ele. Conversamos com David Kessler sobre ideias de como fazer isso. Kessler é um grande especialista em luto. Ele co-escreveu, com Elisabeth Kübler-Ross, o livro On Grief and Grieving: Finding the Meaning of Grief through the Five Stages of Loss. Seu novo livro adiciona outro estágio no processo, Finding Meaning: The Sixth Stage of Grief. Kessler também trabalhou por uma década no sistema hospitalar de Los Angeles. Ele participou da equipe de risco biológico. Seu trabalho voluntário inclui ser membro da Reserva de Especialistas da polícia de Los Angeles para eventos traumáticos, assim como ter servido na equipe de serviços em situação de desastre da Cruz Vermelha. Ele é o fundador do www.grief.com, que tem mais de 5 milhões de visitas anuais advindas de 167 países.

Kessler compartilhou seus pensamentos sobre por que é importante reconhecer o luto que você pode estar sentindo, como controlá-lo, e por que ele acredita que vamos encontrar um sentido nele. A conversa está levemente editada para garantir maior clareza.

HBR: As pessoas estão sentindo muitas coisas agora. Écorreto chamar algumas das coisas que elas estão sentindo de luto?

Kessler: Sim, e estamos sentindo vários lutos diferentes. Estamos sentindo que o mundo mudou, e ele mudou mesmo. Sabemos que é temporário, mas não sentimos que seja, e compreendemos que as coisas vão ser diferentes. Assim como ir ao aeroporto mudou para sempre depois do 11 de setembro, as coisas vão mudar e este é o ponto no qual mudaram. A perda da normalidade; o medo do estrago econômico; a perda de conexão. Estamos sendo afetados por essas coisas, e estamos em luto. Não estamos acostumados a este tipo de luto coletivo no ar.

Você disse que estamos sentindo mais de um tipo de luto?

Sim, estamos sentindo, também, luto antecipado. Luto antecipado é esse sentimento que temos sobre o que o futuro nos reserva quando estamos incertos a respeito. Normalmente se centra na morte. Sentimos isso quando alguém tem um diagnóstico ruim, ou quando pensamos a respeito do fato de que vamos perder nosso pais em algum momento. Luto antecipado é também, mais maneira mais geral, sobre futuros imaginados. Tem uma tempestade chegando. Tem algo ruim lá fora. Com um vírus, este tipo de luto é muito confuso para as pessoas. Nossa cognição sabe que algo ruim está acontecendo, mas não podemos vê-lo. Isso rompe nosso sentido de segurança. Estamos sentindo a perda da segurança. Eu acho que jamais havíamos perdido coletivamente nosso senso geral de segurança desta forma. Indivíduos ou grupos específicos passaram por isso, mas isso é inédito em escala planetária. Estamos em luto nos níveis micro e macro.

O quê podemos fazer para lidar com o luto?

Entender os estágios do luto é um começo. Mas sempre que falo sobre os estágios do luto, eu lembro as pessoas de que os estágios não são lineares e podem não acontecer nessa ordem. Não é um mapa, mas nos fornece uma plataforma para acessar este mundo desconhecido. Existe a negação, que acontece bastante no início: “este vírus não vai nos afetar”. Existe a raiva: “vocês estão nos fazendo ficar em casa e tirando nossos trabalhos”. Existe a barganha: “ok, se estabelecemos o distanciamento social por duas semanas, tudo vai melhorar, certo?”. Existe a tristeza: “eu não sei quando isto vai terminar”. E, finalmente, a aceitação: “isto está acontecendo; eu tenho que descobrir como seguir adiante”.

A aceitação, como você pode imaginar, é onde está nosso poder. Encontramos o controle quando chegamos na fase da aceitação. “Eu posso lavar minhas mãos. Eu posso manter uma distância segura. Eu posso aprender a trabalhar virtualmente.”

Quando estamos sentindo luto, existe uma dor física. E a mente acelerada. Existem técnicas para lidar com isso e fazer com que seja menos intenso?

Vamos voltar para o luto antecipado. Luto antecipado não-saudável é, na verdade, ansiedade; esse é o sentimento sobre o qual você está falando. Nossa mente começa a nos mostrar imagens. Meus pais ficando doentes. Vemos os piores cenários. Essa é nossa mente sendo protetiva. Nosso objetivo é não ignorar essas imagens ou tentar fazê-las ir embora — sua mente não vai deixar você fazer isso e pode ser doloroso se você forçar. O objetivo é encontrar o equilíbrio nas coisas que você está pensando. Se você sente que imagens ruins estão tomando forma, mude o seu pensamento para imagens positivas. Todos nós ficamos doentes e o mundo segue adiante. Nem todo mundo que eu amo morre. Talvez não morram porque estamos todos fazendo as coisas certas. Nenhum cenário deve ser ignorado, mas nenhum deve dominar também.

Luto antecipado é a mente projetando-se para o futuro e imaginando o pior. Para se acalmar, você quer voltar para o presente. Este conselho vai soar familiar para qualquer pessoa que já meditou ou praticou mindfulness, mas as pessoas podem sempre se surpreender com o quão simples isto pode ser. Você pode nomear cinco coisas que estão na sala onde você está. Existe um computador, uma cadeira, uma foto de um cachorro, um tapete velho e uma xícara de café. É simples assim. Respire. Perceba que, no momento presente, nada do que você tinha antecipado aconteceu. Neste momento, você está bem. Você tem comida. Você não está doente. Use seus sentidos e pense sobre o que eles sentem. A mesa é dura. O cobertor é macio. Eu consigo sentir o ar entrando em minhas narinas. Isto efetivamente funciona para reduzir a dor.

Você também pode pensar sobre como abrir mão do que você não tem controle. O que seu vizinho está fazendo está fora do seu controle. O que está no seu controle é ficar a um metro de distância dele, e lavar suas mãos. Foque nisso.

Finalmente, é um bom momento para multiplicar a compaixão. As pessoas vão ter níveis diferentes de medo e luto e isso se manifesta de formas diferentes. Uma pessoa com quem trabalho ficou muito rude comigo outro dia e eu pensei: “não parece a mesma pessoa; essa é a forma como a pessoa está lidando com a situação. Estou vendo seu medo e ansiedade”. Então seja paciente. Pense sobre como as pessoas geralmente são e não quem elas parecem ser neste momento.

Um aspecto particularmente perturbador nesta pandemia é não saber quando ela acaba.

Isto é um estado temporário. Ajuda falar sobre isso. Eu trabalhei 10 anos no sistema hospitalar. Eu fui treinado para situações como esta. Eu também estudei a pandemia da gripe de 1918. As precauções que estamos tomando são corretas. A história nos conta isso. Isto se chama sobrevivência. Vamos sobreviver. Este é um tempo de se superproteger, mas não se reagir de forma desmedida.

E acredito que vamos encontrar sentido nisto. Eu fiquei honrado que a família de Elisabeth Kübler-Ross me deu permissão para acrescentar um sexto estado ao luto: significado. Eu tinha falado bastante com Elisabeth sobre o que viria depois da aceitação. Eu não quis parar na aceitação quando experimentei o luto pessoal. Eu quis significado naquelas horas mais difíceis. E efetivamente acredito que encontramos iluminação nestes momentos. Agora mesmo as pessoas estão percebendo que elas podem se conectar através da tecnologia. Elas não estão tão distantes quanto imaginavam. Elas estão percebendo que podem usar seus telefones para conversas longas. Estão apreciando caminhadas. Eu acredito que vamos continuar encontrando significado agora e quando isso tiver acabado.

O que você diria para alguém que lê tudo isto e ainda assim se sente sobrecarregado com o luto?

Continue tentando. Há algo poderoso em nomear o luto. Isso nos ajuda a sentir o que está dentro de nós. Tantas pessoas me disseram na última semana: “estou dizendo para meus colegas de trabalho que estou tendo dificuldades” ou “chorei na noite passada”. Quando você nomeia o luto, você é mais capaz de senti-lo e ele se move através de você. Emoções precisam de movimento. É importante que entendamos o que estamos passando. Um produto infeliz do movimento de autoajuda é que somos a primeira geração que tem emoções sobre suas emoções. Falamos para nós mesmos: “estou me sentindo triste, mas não deveria sentir isso; outras pessoas se sentem pior”. Nós podemos — devemos — parar no primeiro sentimento. “Eu me sinto triste. Vou me deixar sentir triste, por cinco minutos”. Seu objetivo nesse momento é sentir sua tristeza e medo e raiva, independente do que estejam sentindo as demais pessoas. Lutar contra isso não ajuda porque seu corpo está produzindo o sentimento. Se permitimos que os sentimentos aconteçam, eles vão acontecer de uma maneira ordenada, e nos empoderar. Então não seremos vítimas.

Numa maneira ordenada?

Sim. às vezes tentamos não sentir o que estamos sentindo porque temos essa imagem de um “bando de emoções”. Se eu me sentir triste e acolher a tristeza, ela não irá embora. O bando de emoções ruins vai me dominar. A verdade é que uma emoção se move através de nós. Não existe um bando de emoções que vai nos pegar. É absurdo pensar que não deveríamos sentir luto agora. Permita-se sentir o luto e siga adiante.

That Discomfort You’re Feeling Is Grief (HBR)

Scott Berinato

March 23, 2020

HBR Staff/d3sign/Getty Images

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Some of the HBR edit staff met virtually the other day — a screen full of faces in a scene becoming more common everywhere. We talked about the content we’re commissioning in this harrowing time of a pandemic and how we can help people. But we also talked about how we were feeling. One colleague mentioned that what she felt was grief. Heads nodded in all the panes.

If we can name it, perhaps we can manage it. We turned to David Kessler for ideas on how to do that. Kessler is the world’s foremost expert on grief. He co-wrote with Elisabeth Kübler-Ross On Grief and Grieving: Finding the Meaning of Grief through the Five Stages of Loss. His new book adds another stage to the process, Finding Meaning: The Sixth Stage of Grief. Kessler also has worked for a decade in a three-hospital system in Los Angeles. He served on their biohazards team. His volunteer work includes being an LAPD Specialist Reserve for traumatic events as well as having served on the Red Cross’s disaster services team. He is the founder of www.grief.com, which has over 5 million visits yearly from 167 countries.

Kessler shared his thoughts on why it’s important to acknowledge the grief you may be feeling, how to manage it, and how he believes we will find meaning in it. The conversation is lightly edited for clarity.

HBR: People are feeling any number of things right now. Is it right to call some of what they’re feeling grief?

Kessler: Yes, and we’re feeling a number of different griefs. We feel the world has changed, and it has. We know this is temporary, but it doesn’t feel that way, and we realize things will be different. Just as going to the airport is forever different from how it was before 9/11, things will change and this is the point at which they changed. The loss of normalcy; the fear of economic toll; the loss of connection. This is hitting us and we’re grieving. Collectively. We are not used to this kind of collective grief in the air.

You said we’re feeling more than one kind of grief?

Yes, we’re also feeling anticipatory grief. Anticipatory grief is that feeling we get about what the future holds when we’re uncertain. Usually it centers on death. We feel it when someone gets a dire diagnosis or when we have the normal thought that we’ll lose a parent someday. Anticipatory grief is also more broadly imagined futures. There is a storm coming. There’s something bad out there. With a virus, this kind of grief is so confusing for people. Our primitive mind knows something bad is happening, but you can’t see it. This breaks our sense of safety. We’re feeling that loss of safety. I don’t think we’ve collectively lost our sense of general safety like this. Individually or as smaller groups, people have felt this. But all together, this is new. We are grieving on a micro and a macro level.

What can individuals do to manage all this grief?

Understanding the stages of grief is a start. But whenever I talk about the stages of grief, I have to remind people that the stages aren’t linear and may not happen in this order. It’s not a map but it provides some scaffolding for this unknown world. There’s denial, which we say a lot of early on: This virus won’t affect us. There’s anger: You’re making me stay home and taking away my activities. There’s bargaining: Okay, if I social distance for two weeks everything will be better, right? There’s sadness: I don’t know when this will end. And finally there’s acceptance. This is happening; I have to figure out how to proceed.

Acceptance, as you might imagine, is where the power lies. We find control in acceptance. I can wash my hands. I can keep a safe distance. I can learn how to work virtually.

When we’re feeling grief there’s that physical pain. And the racing mind. Are there techniques to deal with that to make it less intense?

Let’s go back to anticipatory grief. Unhealthy anticipatory grief is really anxiety, and that’s the feeling you’re talking about. Our mind begins to show us images. My parents getting sick. We see the worst scenarios. That’s our minds being protective. Our goal is not to ignore those images or to try to make them go away — your mind won’t let you do that and it can be painful to try and force it. The goal is to find balance in the things you’re thinking. If you feel the worst image taking shape, make yourself think of the best image. We all get a little sick and the world continues. Not everyone I love dies. Maybe no one does because we’re all taking the right steps. Neither scenario should be ignored but neither should dominate either.

Anticipatory grief is the mind going to the future and imagining the worst. To calm yourself, you want to come into the present. This will be familiar advice to anyone who has meditated or practiced mindfulness but people are always surprised at how prosaic this can be. You can name five things in the room. There’s a computer, a chair, a picture of the dog, an old rug, and a coffee mug. It’s that simple. Breathe. Realize that in the present moment, nothing you’ve anticipated has happened. In this moment, you’re okay. You have food. You are not sick. Use your senses and think about what they feel. The desk is hard. The blanket is soft. I can feel the breath coming into my nose. This really will work to dampen some of that pain.

You can also think about how to let go of what you can’t control. What your neighbor is doing is out of your control. What is in your control is staying six feet away from them and washing your hands. Focus on that.

Finally, it’s a good time to stock up on compassion. Everyone will have different levels of fear and grief and it manifests in different ways. A coworker got very snippy with me the other day and I thought, That’s not like this person; that’s how they’re dealing with this. I’m seeing their fear and anxiety. So be patient. Think about who someone usually is and not who they seem to be in this moment.

One particularly troubling aspect of this pandemic is the open-endedness of it.

This is a temporary state. It helps to say it. I worked for 10 years in the hospital system. I’ve been trained for situations like this. I’ve also studied the 1918 flu pandemic. The precautions we’re taking are the right ones. History tells us that. This is survivable. We will survive. This is a time to overprotect but not overreact.

And, I believe we will find meaning in it. I’ve been honored that Elisabeth Kübler-Ross’s family has given me permission to add a sixth stage to grief: Meaning. I had talked to Elisabeth quite a bit about what came after acceptance. I did not want to stop at acceptance when I experienced some personal grief. I wanted meaning in those darkest hours. And I do believe we find light in those times. Even now people are realizing they can connect through technology. They are not as remote as they thought. They are realizing they can use their phones for long conversations. They’re appreciating walks. I believe we will continue to find meaning now and when this is over.

What do you say to someone who’s read all this and is still feeling overwhelmed with grief?

Keep trying. There is something powerful about naming this as grief. It helps us feel what’s inside of us. So many have told me in the past week, “I’m telling my coworkers I’m having a hard time,” or “I cried last night.” When you name it, you feel it and it moves through you. Emotions need motion. It’s important we acknowledge what we go through. One unfortunate byproduct of the self-help movement is we’re the first generation to have feelings about our feelings. We tell ourselves things like, I feel sad, but I shouldn’t feel that; other people have it worse. We can — we should — stop at the first feeling. I feel sad. Let me go for five minutes to feel sad. Your work is to feel your sadness and fear and anger whether or not someone else is feeling something. Fighting it doesn’t help because your body is producing the feeling. If we allow the feelings to happen, they’ll happen in an orderly way, and it empowers us. Then we’re not victims.

In an orderly way?

Yes. Sometimes we try not to feel what we’re feeling because we have this image of a “gang of feelings.” If I feel sad and let that in, it’ll never go away. The gang of bad feelings will overrun me. The truth is a feeling that moves through us. We feel it and it goes and then we go to the next feeling. There’s no gang out to get us. It’s absurd to think we shouldn’t feel grief right now. Let yourself feel the grief and keep going.

Original post

How Does Pandemic Change the Big Picture? (Resilience.org)

By Richard Heinberg, originally published by Resilience.org

March 25, 2020

As of 2019, the Big Picture for humanity was approximately as follows. Homo sapiens (that’s us), a big-brained bipedal mammal, had spent the Pleistocene epoch (from 2.5 million years ago until 12,000 years ago) developing its ability to control fire, talk, paint pictures, play bone flutes, and make tools and clothes. Language dramatically enhanced our sociality and helped enable us to invade and inhabit every continent except Antarctica. During the Holocene epoch (the last 12,000 years), we started living in permanent settlements, developed agriculture, and built state societies with kings, slavery, economic inequality, full-time division of labor, money, religions, and armies. The Anthropocene epoch (more of a brief interlude, really) dawned only a couple of centuries ago as we humans started using fossil fuels, which empowered us dramatically to grow our population and per capita consumption rates, mechanize production and transport, and basically dominate the entire planet. The mechanization of agriculture, by making the landed peasantry redundant, led to mass urbanization and quickly pumped up the size of the middle class. However, the use of fossil fuels destabilized the global climate, while also vastly increasing existing problems like pollution, resource depletion, and the destruction of habitat for most wild creatures. In addition, over the past few decades we learned how to use debt to transfer consumption from the future to the present, based on the risky assumption that the economy will continue to grow forever, thereby enabling future generations to pay for the lifestyle we enjoy now.

In short, the Big Picture was one of ever-increasing power and peril. Suddenly it has changed. A pattern of furious economic growth, consistent over many decades since the dawn of the Anthropocene (with only occasional interruptions, primarily consisting of the Great Depression and two World Wars), has slammed precipitously into the wall of pandemic (un)preparedness. In an effort to limit mortality from the novel coronavirus, governments around the world have put their economies into a state of suspended animation, telling most workers to stay home and to avoid direct contact with others.

How is this development impacting trends that were already underway? Will future generations look back on the coronavirus pandemic as a blip or a game changer? Let’s review a few of the major trends that developed during the Anthropocene and engage in a little informed speculation about how they might be affected by the COVID-19 outbreak.

Climate change: In China, lockdowns of workers and closures of companies have led to a dramatic reduction in greenhouse gas emissions. Over the coming weeks, emissions for the world as a whole could fall by ten percent or more. Note to climate warriors: don’t cheer too loudly; folks who are out of work won’t appreciate gloating greenies.

The world’s response to the coronavirus undermines the argument that governments cannot reduce carbon emissions because doing so would hurt their economies. Clearly, national leaders felt that the more immediate (though, in the larger scheme of things, much less significant) threat of pandemic justified shutting down commerce. Climate activists should now feel emboldened to make the following case: If economic degrowth is what it takes to preserve a habitable biosphere, then world leaders can and must find fair and humane ways to reduce society’s scale of energy usage, resource extraction, manufacturing, and waste dumping—all of which contribute to climate change.

However, the pandemic is not good news for the transition to renewable energy. Supply chains for solar and wind companies have been disrupted, and demand for new installations is down. And with super-cheap oil and gas in the offing (see “Resource Depletion,” below), market forces are likely to hinder rather than help both the renewables industry and the shift to electric cars.

Economic inequality: For the gig economy, and for people living paycheck to paycheck (which includes up to 74 percent of Americans earning hourly wages), the coronavirus lockdown is a catastrophe. Over the short term, existing economic inequalities will result in highly unequal levels of sacrifice and suffering. It may be relatively easy for low-wage workers to rationalize a mandated week or two at home as a forced vacation, but if tens of millions of Americans with no savings experience several months without income, regional social stresses could build to the breaking point. That’s one reason government officials are talking about cash handouts.

Over the longer term, recent absurd levels of inequality could get seriously snipped. In his book The Great Leveler, historian Walter Scheidel argues that, in the past, economic inequality has been reversed most dramatically by what he calls the “Four Horsemen”—mass mobilization for warfare, transformative revolution, state collapse, and plague. Currently many governments are undertaking economic re-allocation efforts equivalent in scale to those seen in the World Wars. For example, Denmark is paying 75 percent of wages (for salaries up to ~$50k/year) for companies that would otherwise have to lay off workers, for a period of three months. This not only enables quarantined workers to survive, but allows them to stay on the payroll and not have to go through a rehiring process later.

Thus, the current pandemic might arguably qualify as two of Scheidel’s Horsemen (mass mobilization and plague). The investor class is witnessing capital destruction at a prodigious rate and scale, while government efforts at maintaining civility and social well-being may entail providing a safety net for those with the least. Of course, this isn’t the way social justice advocates envisioned reining in inequality, but the result may end up being equivalent to another New Deal, and possibly even a Green New Deal.

Biodiversity loss: The novel coronavirus pandemic almost certainly began in wild animal markets in Wuhan, China. As Carl Safina put it in a recent article, “Humans caused the pandemic by putting the world’s animals into a cruel blender and drinking that smoothie.” While there have been other zoonotic epidemics in recent years, including HIV, the Marburg virus, SARS, and the 2009 H1N1 “swine flu” pandemic, the global coronavirus outbreak could provide a teachable moment, when wildlife conservation organizations can call successfully for an international moratorium on the trade or sale of any non-domesticated animal species (with zoos providing a highly regulated exception).

Otherwise, don’t expect much of a change in the overall declining trend in the numbers of insects, reptiles, amphibians, and wild birds and mammals with which we share this little planet.

Overpopulation: A few cynical millennials have called the novel coronavirus the “Boomer Remover” due to its tendency to attack the elderly with greatest virulence. Because humanity has recently been adding 80 million new members per year (births minus deaths), an erasure of one year’s net growth in population is possible in a worst-case scenario. However, the potential for a short-term moderation of our overall pattern of demographic expansion could be at least partly offset by the results, starting nine months from now, of hundreds of millions of people of reproductive age worldwide staying home for weeks with little to keep them busy. For wealthy nations with falling fertility levels, a much bigger threat to human population stability will likely continue to be posed by the buildup of endocrine-disrupting chemicals in the environment. For poor nations with high population growth trends, equal education opportunities for everyone regardless of gender will substantially help reduce growth rates.

Resource depletion: With manufacturing on the skids, demand and hence prices for most commodities are plummeting. The world’s most economically crucial commodity, oil, has seen its price fall from $50 a barrel to close to $20 (as of this writing); some analysts are forecasting prices in the single digits. With oil usage crashing, petroleum storage capacity will run out, at which point producers will have no choice but to mothball some oil wells. Oil companies will likely be bailed out, but cannot be profitable under current conditions. The prospect of ever ramping world oil extraction rates back up to recent levels seems dim. It is likely, then, that the long-anticipated moment of the world oil production peak has already occurred, with little fanfare, in November, 2018.

Of course, the blowout in oil markets is a result of economic disaster rather than sound policies of resource conservation. Therefore, adaptation on the part of industry and society as a whole will be chaotic. The international implications are fraught and hard to predict: several key Middle Eastern nations will see their economies shredded by low oil prices, and Great Powers (specifically, China and Russia) may seek to take advantage of the moment by seeking to realign alliances in the region.

Pollution: Marshall Burke of Stanford University has recently written that “the reductions in air pollution in China caused by this economic disruption likely saved 20 times more lives in China than have currently been lost due to infection with the virus in that country.” Reduced rates of manufacturing and consumption should help to reduce overall pollution, but of course this is the side effect of crisis, not the result of sound policy. Therefore, without environmental policy interventions, there’s no reason to expect pollution reduction benefits to be sustained. Just one example of how some temporary benefits could be balanced by new harms: The use of single-use plastics is likely to increase during the pandemic response.

Global debt bomb: The world economy is again in a deflationary moment, as it was in 1932 and 2008. For central banks and governments, all fiscal efforts will be geared toward re-inflating an economy that is otherwise hissing and flattening. There is a heightened risk that investors will realize that, in a no-growth world, their financial instruments are inherently worthless, forcing not just a collapse of the market value of stocks, but a repudiation of the very rules of the game. However, since the coronavirus epidemic itself will eventually subside, the more likely outcome is a period of defaults and bankruptcies mitigated by heroic levels of Fed bond purchases, and government bailouts (of the oil and airline industries, just for starters) and deficit spending. Eventually, if money printing goes exponential, hyperinflation is a possibility, but not soon. Big takeaway: the financial system has been destabilized and, like the oil industry, may never return to “normal.”

*          *          *

Let’s return to the question posed above: Will humanity look back on the coronavirus pandemic as a blip or a game changer? The likely answer depends partly on how long the pandemic lasts, and that, in turn, will depend largely on how soon tests become widely available, and when treatments and vaccines are found. US Government documents marked “not for public release” suggest significant shortages not just of medical equipment, but also of general goods over the next 18 months for government, industry, and private citizens, if solutions are not quickly forthcoming.

The level at which the game is changed also depends on the degree of downturn in employment and GDP. Fred Bullard, President of the St. Louis Fed, has gone on record saying that the US unemployment rate may hit 30 percent in the second quarter because of shutdowns to fight the coronavirus, and that GDP could drop 50 percent. This would be economic carnage far beyond the scale of the Great Depression (the United States unemployment rate in 1933 was 25 percent; its GDP fell an estimated 15 percent). If the global economy falls that far, and remains locked down even for a few weeks, label the coronavirus “game changer, big time.”

But a change to what? Dystopian possibilities come only too readily to mind. However, in conversation, some of my think-tank colleagues have suggested the pandemic could turn out to be a “Goldilocks” crisis that would disrupt the global order just enough, and in such a way, as to foster a response that sets at least some societies on a trajectory toward cooperation, redistribution, and degrowth.

First, governments often deal with shortages (foreseen in the report cited above) through the tried-and-true strategy of quota rationing. As Stan Cox details in his indispensable book Any Way You Slice It: The Past, Present, and Future of Rationing, quota rationing doesn’t always work well; but when it does, the results can be fairly admirable. During both World Wars, Americans participated enthusiastically in rationing programs for food, tires, clothing, and more. Britain continued its rationing programs well after the end of WWII, and surveys showed that, during the period of rationing, Britons were generally better fed and healthier than either before or after. In most imaginary scenarios for deliberate economic degrowth, quota rationing programs for energy and materials figure prominently.

Cox concludes that rationing programs tend to be more successful when people are united against a common enemy, and when shortages are believed to be temporary. Despite President Trump’s efforts to dub it the “Chinese virus,” SARS-Cov-2 has no inherent nationality, nor is it Democrat or Republican. It is indeed a common enemy, and people tend to become more cooperative when faced with a collective threat. Further, epidemiologists agree that the threat will have an end point, even if we don’t know exactly when that will be. Therefore, conditions for success in rationing exist, and rationing could help foster more communitarian and cooperative attitudes overall.

Also, as discussed above, the pandemic has the potential for significant economic leveling. Historically, not all leveling moments featured increased cooperation: when initiated by state collapse or transformative revolution, leveling has been accompanied by widespread suffering and bloody conflict. However, during the great leveling moments of the twentieth century—the Depression and the two World Wars—Americans managed to pull together with a sense of shared sacrifice.

Over the longer term, we are still faced with the challenges of climate change, resource depletion, overpopulation, pollution, and biodiversity loss. While the pandemic might have minor or temporary spinoff effects that ameliorate these problems, it won’t solve them. Significant, sustained collective effort will still be required to transform energy systems, economies, and lifestyles (though the pandemic could transform economies and lifestyles in unpredictable ways). If the coronavirus response puts us on a cooperative footing, all the better. Of course, that would be at the expense of currently unknown ultimate numbers of fatalities and sicknesses, as well as widespread fear and privation. The potential bits of silver I’ve mentioned are the linings of a cloud; but, as Monty Python can still remind us via YouTube, it’s always good to look on the bright side of life.

Coronavírus anuncia revolução no modo de vida que conhecemos (Folha de S.Paulo)

www1.folha.uol.com.br

Domenico De Masi – 22.3.2020


[RESUMO] Sociólogo italiano narra situação dramática em seu país e argumenta que as imposições em decorrência da pandemia, como o trabalho em casa, a solidariedade e o papel da esfera pública, demonstram que é possível e desejável mudar a lógica mercadista da economia e criar modos de viver mais racionais e proveitosos para o mundo contemporâneo.

A Itália de onde escrevo, um dos países mais vivazes e alegres do mundo, é hoje apenas um deserto. Cada um dos seus 60 milhões de habitantes acha que é imortal, que o vírus não o tocará, que irá matar não ele mas alguma outra pessoa. Porém, no silêncio do seu coração, cada um sabe que essa ilusão é pueril e que essa pandemia misteriosa, abstrata e tangível ao mesmo tempo, escolhe suas vítimas ao acaso, como numa roleta russa.

Em algum tempo vamos saber se o vírus pode ser debelado ou se nos matará em massa, assim como fez no século passado a famosa gripe espanhola, que matou 1 milhão de pessoas por semana durante 25 semanas seguidas.

Moro há 50 anos no centro de Roma, na rua mais movimentada da cidade, que leva da praça Veneza à Basílica de São Pedro.

Normalmente, essa rua está 24 horas por dia entupida de trânsito, de turistas e peregrinos. Há duas semanas, está muda e deserta. Só de vez em quando ouve-se o grito de uma sirene de ambulância e algum sem-teto passa. A cidade inteira está fantasmagórica como a Los Angeles de “Blade Runner”. Aqui, porém, desapareceram até os replicantes extraterrestres.

Fechados os lugares públicos, as escolas, as fábricas, as lojas, as estações, os portos e os aeroportos, a Itália é agora um país separado do resto da Europa e do mundo. Cada cidade está parada, cada família trancafiada em casa. Quem sai à revelia dos pouquíssimos motivos permitidos é interceptado imediatamente pelas rondas policiais que aplicam penas bastante severas.

Os gregos antigos consideravam que, quando algo é indispensável e todavia impossível, a situação é trágica. Foram necessários 50 dias, milhares de doentes e mortos para que os italianos entendessem que a situação é, enfim, irremediavelmente trágica.

O que significa uma pandemia como essa para Roma, para a Itália, para a humanidade como um todo? Como ela age nas mentes e nos corações de todos nós que, armados com tecnologias poderosas e inteligência artificial, até poucas semanas atrás nos sentíamos os senhores do céu e da terra?

Subitamente nos descobrimos frágeis pigmeus diante da onipotência imaterial de um vírus que, por vias misteriosas, escapou de um morcego chinês para vir matar homens e mulheres em nossas cidades.

A sujeição a um vírus desconhecido, para o qual não há nem cura nem vacina, transformou a Itália numa enorme caserna blindada e os 60 milhões de italianos noutros tantos dóceis soldadinhos empenhados num gigantesco exercício militar no qual estão obrigados a aprender a verdade que antes ignoravam obstinadamente. O que não quer dizer que irão apreendê-la.

Numa Europa onde, até ontem, era permitida a livre circulação de pessoas, mercadorias e dinheiro, agora cada país, em vez de abraçar uma colaboração ainda mais solidária com os demais, tranca suas próprias fronteiras, iludindo-se de forma cínica e infantil que seja possível deter o vírus com barreiras aduaneiras.

Contudo, hoje, mais do que nunca, os soberanismos parecem tentativas fantasiosas contra a globalização. Hoje, mais do que nunca, a difusão da pandemia e sua rápida volta ao mundo demonstraram que deter a globalização é como se opor à força de gravidade. Nosso planeta já é aquela “aldeia global” da qual falava McLuhan, unida por infortúnios e pela vontade de viver, precisando de uma direção unitária, capaz de coordenar a ação sinérgica de todos os povos que desejam se salvar. Nessa aldeia global, nenhum homem, nenhum país é uma ilha.

Talvez tenhamos aprendido que o caso agora é de vida ou morte e que ninguém pode enfrentar sozinho um vírus tão ardiloso e potente. Por isso, são necessários recursos, inteligências, competências, ações e instituições coletivas. Coordenação e coesão geral. É necessária uma cabine de comando, um governo competente que tenha autoridade, uma equipe formada por um vértice político de grande inteligência e apoiada pelos máximos representantes das ciências médicas, da economia, da sociologia, da psicologia social e da comunicação.

Talvez tenhamos aprendido que os fatos e os dados devem prevalecer sobre as opiniões, a competência reconhecida deva prevalecer sobre o simples bom senso, a prudência e a gradualidade das intervenções devem prevalecer às tomadas de decisões arrogantes e à improvisação imprudente. Por outro lado, é necessário tolerar os erros de quem possui a responsabilidade terrível de tomar decisões, líder que deve ser generosamente amparado para que sejam melhoradas.

Talvez tenhamos aprendido que, perante um vírus desconhecido, assim como diante de um problema complexo, as decisões sobre a pandemia não apenas devem ser tomadas pelas pessoas competentes mas também ser comunicadas de forma unívoca, com autoridade, prontamente, de forma abrangente e clara. Todo o alarmismo, todo o exagero, toda a subestimação é terrível porque confunde as ideias e nos faz perder um tempo precioso. Carência e excesso de informações são parâmetros nocivos. Talk shows superficiais e fake news delirantes levam ao cinismo e à desumanização.

Talvez tenhamos aprendido que, nos países civilizados, o bem-estar é uma conquista irrenunciável. Por sorte e pela sabedoria dos nossos pais, a Constituição italiana de 1948 considera a saúde como um direito fundamental de cada ser humano. Já a reforma sanitária de 1978 instituiu um serviço nacional universal que considera a saúde não como meramente a ausência de doença, mas como o bem-estar físico, psíquico e social completo.

Graças a esse regime de saúde, todos os residentes (e também os turistas) fruem dos cuidados médicos sem qualquer custo. Isso nos possibilitou descobrir e curar prontamente os contágios e reduzir o número de mortes.

No país mais rico e mais poderoso do mundo, os EUA, onde o bem-estar é estupidamente mortificado, os suspeitos de Covid-19 precisam desembolsar o equivalente a 1.200 euros pelo teste. O vírus corona, ao se difundir, causaria uma verdadeira hecatombe entre 90 milhões de estadunidenses que, desprovidos de seguro-saúde, seriam cinicamente rejeitados pelos hospitais.

A propaganda neoliberal, que se alastrou sob a bandeira insana de Reagan e Thatcher, desacreditou tudo o que é público em favor do setor privado. Porém, pelo contrário, nessas semanas trágicas, a reação eficiente dos hospitais e dos funcionários públicos diante do surgimento da pandemia nos ensinou que a nossa saúde pública, da mesma forma que outras funções públicas, dispõe, muito mais do que o setor privado, de pessoas preparadas profissionalmente, motivadas e generosas até o heroísmo.

Toda noite, às 18h, todas as janelas da Itália se escancaram e cada um canta ou toca o hino nacional para agradecer aos médicos e a todos os profissionais da saúde.

A pandemia está nos ensinando que o pensamento de Keynes permanece precioso. Em 1980, o prêmio Nobel Robert Lucas Jr. observou: “Não é possível encontrar nenhum bom economista com menos de 40 anos que se diga ‘keynesiano’. Nas universidades, as teorias keynesianas não são levadas a sério e provocam sorrisinhos de superioridade”.

Hoje, essa crise histórica, com seus mortos e com suas tragédias, se porum lado nos leva à recessão, por outro nos lembra que, para evitar uma crise irreparável, em vez de políticas de austeridade, é preferível dar lugar aos investimentos públicos maciços e “open-ended”, ainda que isso leve ao déficit público.

Talvez tenhamos aprendido tudo isso e várias outras coisas com aquilo que ocorreu fora do recinto doméstico, isto é, entre o governo e todo o povo do país. Entretanto, hoje, a nossa vida está segregada entre as paredes domésticas. Todos estão restritos entre as quatro paredes da própria casa: não só as famílias que vivem em harmonia e acordo, mas também os solitários, os casais em crise e os núcleos familiares em que o diálogo entre pais e filhos há muito tempo andava claudicante.

A sociedade industrial nos habituara a separar o local de trabalho do local de vida, nos fazendo passar a maior parte do nosso tempo com chefes e colegas nas empresas: os que a sociologia chama de grupos “secundários”, frios, formais, nos quais as relações são quase exclusivamente profissionais. Uma parte mínima do nosso tempo nos via reunidos em família ou com os amigos, ou seja, com grupos “primários”, calorosos, informais, envolventes.

De repente, o descanso compulsório em casa nos obrigou de forma inédita ao isolamento total, a uma convivência forçada que para alguns parece agradável e tranquilizadora, mas que para outros é invasiva e até opressora. Os mais sortudos conseguem transformar o ócio depressivo em ócio criativo, conjugando a leitura, o estudo, o lúdico com a parcela de trabalho que é possível desempenhar em regime de “smart working”.

Sabíamos teoricamente que essa modalidade de trabalho à distância permite aos trabalhadores uma preciosa economia de tempo, dinheiro, stress e alienação; e às empresas, evita os microconflitos, despesas na manutenção do local de trabalho e promove incremento da eficiência, recuperando de 15 a 20% da produtividade; à coletividade, evita a poluição, o entupimento de trânsito e despesas de manutenção das estradas.

Agora que 10 milhões de italianos, forçados pelo vírus, rapidamente adotaram o teletrabalho, minimizando seu sentimento de inutilidade e os danos à economia nacional, nos perguntamos por que as empresas não haviam adotado antes uma forma de organização tão eficaz e enxuta. A resposta está naquilo que os antropólogos definem como “cultural gap” —lacuna cultural— das empresas, dos sindicatos, dos chefes.

O tempo livre que, até um mês atrás, nos parecia um luxo raro, hoje abunda. O espaço, que nas cidades vazias se dilatou, por sua vez falta nas casas. Por isso, estamos apreciando a ajuda que nos chega da internet, graças à qual, mesmo permanecendo forçosamente distantes, é possível nos reunirmos virtualmente, nos informarmos, nos confrontarmos, nos encorajarmos.

Nessa reclusão, os jovens têm a maior vantagem, graças à sua facilidade com os computadores, enquanto os velhos têm mais vantagem por serem mais independentes, mais acostumados a estar em casa, fazendo pequenos trabalhos e jogos sedentários, contentando-se com a televisão.

Em todos se insinua o medo de que, mais cedo ou mais tarde, possa terminar o abastecimento dos mantimentos. O colapso da economia torna-se cada vez mais inevitável, já que tanto a produção como o consumo encontram-se bloqueados.

Há alguns anos, Kennet Building, um dos pais da teoria geral dos sistemas, comentando a sociedade opulenta, afirmou: “Quem acredita na possibilidade do crescimento infinito num mundo finito ou é louco ou é economista”. E Serge Latouche acrescentou: “O drama é que agora somos todos mais ou menos economistas. Aonde estamos nos encaminhando? Diretamente contra um muro. Estamos a bordo de um bólido sem piloto, sem marcha a ré e sem freios que irá se chocar contra os limites do planeta”. Latouche propõe abandonar a sociedade de consumo com um decrescimento planificado, progressivo e sereno.

A marcha a ré e os freios que a cultura neoliberal se recusou obstinadamente a usar agora foram desencadeados: não graças a uma revolução violenta, mas sim a um vírus invisível que um morcego soprou sobre a sociedade opulenta, obrigando-a a se repensar.

“A Peste” (1947), obra-prima profética de Albert Camus, talvez possa nos ajudar nesse repensar. Naquele romance, a ciência era protagonista, ou seja, o médico Bernardo Rieux, ocupado até o fim, como médico e como homem, de socorrer os contagiados, enquanto “o cheiro de morte emburrecia todos os que não matava”.

Hoje, nós também, como o nosso tão humano irmão Rieux, estamos presos num limbo entre o pesar e a esperança, no qual temos que aprender que “a peste pode vir e ir embora sem que o coração do homem seja modificado”; que “o bacilo da peste não morre nem desaparece nunca, que pode permanecer adormecido por décadas nos móveis e nas roupas, que espera pacientemente nos quartos, nas adegas, nas malas, nos lenços e nos papéis, que talvez chegue o dia em que, infortúnio ou lição aos homens, a peste acordará seus ratos para mandá-los morrer numa cidade feliz”.


Domenico De Masi, sociólogo italiano, é autor dos livros “Ócio Criativo” e “O Futuro do Trabalho”.

Tradução de Francesca Cricelli.

Texto original

‘It’s OK to feel anxious.’ How a professor in China faced coronavirus disruptions and fears (Science)

Robert Neubecker

By Kai Liu – Mar. 17, 2020 , 9:00 AM

In early February, I was working from home when I received a message informing me—and all the other professors at my university in China—that courses would be taught online because of the novel coronavirus. I was already feeling anxious about the mounting epidemic, and my university had locked its doors a few days earlier. Then, when I realized I’d have to teach students online, my anxiety level grew. I didn’t have any experience with online teaching platforms. I was also skeptical about how effective they’d be. “How will I gauge the students’ reactions to my lectures through a computer screen?” I wondered. “Will they learn anything?”

people sitting at a dinner table

I live in Xuzhou, China—roughly 500 kilometers from Wuhan, the epicenter of the COVID-19 pandemic. Unlike Wuhan, my city isn’t on lockdown, but residents have been discouraged from going outside and many businesses and institutions are closed. I’ve spent most of the past 2 months at home, along with my wife and daughter, fearful of the future and wondering when life will get back to normal.  

Thankfully, none of my family members, friends, or colleagues have tested positive for the novel coronavirus. Working from home is also possible for me because my research doesn’t involve lab work. But the spread of the virus and the rapidly rising death toll have weighed heavily on my mind. I’ve found it difficult to sleep. I’ve also had trouble focusing on work. One day early in the outbreak, I sat down at my computer intending to write a grant proposal. But all I could do was stare at the screen.

Years ago, I’d heard that Taoism philosophies were helpful for finding internal peace. So, I decided to listen to a few recordings. One instructed listeners to “govern [yourself] by doing nothing that goes against nature.” That resonated with me because I realized that I’d been trying to push my anxieties aside and force myself to concentrate on work—an approach that wasn’t working because it didn’t feel natural. From then on, I told myself that it was OK to feel anxious, even if it impeded my work. That helped to lessen my internal struggles.

Over the past 2 months, I’ve also learned how to teach courses online, and I have found unexpected joy in that process—even though I struggled at first. There were multiple online teaching platforms to choose from, and I didn’t know which one was best or how to use it. I opted for a platform that had a large server, thinking that it would cope better with heavy usage. My university provided some helpful guidance, and I also learned through trial and error.

I’ve spent most of the past 2 months at home … wondering when life will get back to normal.

My first lecture was especially difficult because I couldn’t see the students’ faces. I was accustomed to lecturing in front of an audience. Online, I felt like I was speaking at my students but not getting anything in return. I communicated with a few of them afterward to get their feedback and they agreed with me, saying that I needed to find a way to make my lectures more interactive. So, I started to encourage my students to leave questions for me in the platform’s comment section during my lectures.

Almost immediately, my students started peppering me with questions. I was surprised by the level of engagement. In a normal classroom setting, they are afraid to raise their hands; most wait until after the lecture is over to approach me and ask a question. But online, students were more comfortable sharing their questions in front of the entire class. That was a great outcome because if one student has a question, it’s likely that another student has the same question and would benefit from hearing the answer. I’ve also been pleased to see from the homework assignments that they are following my teaching well.

China was the first country to close its universities, but over the past month, universities in Italy, the United States, and elsewhere have made similar moves. I hope that my story can provide inspiration for academics who are fearful of what’s to come. It’s OK to feel anxious. But I’d also recommend staying open to change. You never know what you’ll learn.

Original publication

A Professor of Disasters and Health on Covid-19 (Nautilus)

Posted By Ilan Kelman on Mar 16, 2020

It is no mystery why pandemics happen. Those with the knowledge, wisdom, and resources must choose to decide to avoid these disasters that afflict everyone.Photograph by Pavel L Photo and Video / Shutterstock

A new virus sweeps the world, closing borders, shutting down arts and sports, and killing thousands of people. Is this coronavirus pandemic, with the disease named Covid-19, simply a natural disaster, a culling of overpopulation as suggested by callous commentators who seem to revel in human misery? Is it nature’s rebuttal to human-caused climate change, forcing us to reduce fossil fuel-based transportation and overconsumption (apart from toilet paper)? The answer is neither. As with almost all disasters, the Covid-19 disaster is the outcome of human choices.

The Earth, with its microorganisms, tectonic activity, powerful weather, and other phenomena, has long posed dangers to humans. We know this, so it is up to us to deal with it. Sometimes we manage and sometimes we do not. Sometimes we are forced into situations with few choices, such as impoverished people living on the slopes of Mexico City’s volcano or in the subsiding floodplains of Jakarta. Not everyone can or should be a planner or engineer, to avoid houses built on soils prone to liquefying in an earthquake or offices lacking basic seismic reinforcement. Sometimes, we need to trust the zoning regulations and building codes—and their monitoring and enforcement—to keep us safe. Too often, gaps are revealed only after people have died, from the collapse of the CTV Building in Christchurch, New Zealand, during the 2011 earthquake, to New Orleans flooding during Hurricane Katrina in 2005. Those who suffer most, from Australia’s 2020 bushfires to Haiti’s 2010 earthquake, tend to have the fewest options for countering their vulnerabilities which were created by others.

We know that, by disturbing ecosystems, we make pandemics beyond Covid-19 more likely to occur.

When we are vulnerable to nature, it is because societal actions set people up to be harmed by nature. As we cannot blame nature for disasters, we should avoid the phrase “natural disaster.” They are just “disasters.” It could be shoddily built infrastructure, breaking or not having planning regulations, not being able to afford or not having insurance, poor communication of warnings, or fearing assault in an evacuation shelter. It is the same with disease. 

The World Health Organization of the United Nations was lambasted for being far too slow to observe and respond to what became the largest Ebola epidemic yet known, in West Africa between 2014 and 2016. In the years before, donor countries to the WHO had slashed the funds available, particularly hitting the division responsible for surveilling, monitoring, preparing for, and responding to possible epidemics. Experienced staff departed, communication lines to health systems around the world slackened, and institutional memory faded. Not that the UN’s organizations are perfect otherwise, displaying their own operational failings alongside geographic and cultural biases. Plus, many of the Ebola-struck countries—for instance, Guinea, Liberia, and Sierra Leone—have long lacked adequate health systems, with the governments mired in corruption, conflict, external exploitation, and incompetence. Deficient local, national, and international governance for epidemics meant that Ebola spread far faster and farther afield than it would have if health systems had been supported. A further illustration comes from infected people ending up in the United Kingdom and the United States, yet neither country experienced an Ebola outbreak nor was there ever a pandemic. When it was decided that the spread of Ebola should be stopped, knowledge, resources, and actions were harnessed to stop the spread of Ebola. Earlier choices in West Africa, especially long-term backing for health systems, would have curtailed the disease far sooner.

And so we come to Covid-19. When a strange form of pneumonia appeared in patients in Wuhan, China in December 2019, medical staff reported it and soon identified the origin in one market. They isolated the new virus and publicly announced its genetic sequence. Authorities gave assurances that transmission between humans was not possible and that the virus was under control, despite evidence that neither was the case. Medical staff in Wuhan noticing the sickness explained that they were not permitted to broadcast their knowledge about it. Ai Fen, an emergency department doctor, was reprimanded and told to keep quiet. An ophthalmologist, Li Wenliang, was intimidated and silenced. He eventually died of coronavirus, with the media adorning him with the poignant label of “whistle blower.”

It is a choice to institute what is now referred to as a “cover up” when a potential public health threat emerges. It is a choice not to listen to health professionals hired in key positions when they are trying to save lives through public health measures. It is a choice to have opaque dissemination procedures and to try to shut down information flow. Now that the pandemic has been created by choices early on, it is a choice that many others are making to panic-buy soap while others are not bothering to wash their hands properly or to stop touching their food or face with unwashed hands. So much of disease is about human behavior. This in no way diminishes the importance of the essential medical responses. Without vaccines, smallpox, polio, rinderpest, measles, mumps, and a whole host of other lethal diseases would continue to run rampant. Along with antibiotics and other pharmaceuticals, vaccines not only save lives daily, but also reduce the costs of running health systems by stopping illness.

Health systems must have technologies and tools—dialysis machines, isolation wards, defibrillators, and stents within the dizzying array—but must not stop at technical means and buildings. Any health system must be underpinned by people, training, and experience—exactly what many of the authorities disdained when people in Wuhan suddenly fell ill. Earlier choices in China might have curtailed the spread of Covid-19 before it morphed into a pandemic. Even basic hygiene when dealing with animals might have prevented the virus from jumping species to humans.

Today, diseases targeted for eradication include rubella, measles, dracunculiasis (Guinea worm disease), and polio. The latter two remain endemic in conflict zones, often reappearing due to war, like polio did in 2013, in Syria, where it had disappeared a decade previously. Similarly, dracunculiasis is close to being eradicated, stubbornly remaining in areas wracked by violence including Chad and South Sudan. Choices to target these diseases are nonetheless preventing epidemics of them, with eradication in sight. London and Paris famously eliminated cholera in the 19th century by building sewage systems, among other actions. Malaria used to be prevalent in southern England and across the US. Dedicated efforts eradicated it and continue to prevent its re-introduction, despite cases from travelers and near international airports. We can continue these efforts by choice or we can let malaria return.

We know that, by disturbing ecosystems, we make pandemics beyond Covid-19 more likely to occur. “In Africa, we see a lot of incursion driven by oil or mineral extraction in areas that typically had few human populations,” Dennis Carroll, an infectious disease researcher, told Nautilus editor Kevin Berger. “The problem is not only moving workers and establishing camps in these domains, but building roads that allow for even more movement of populations. Roads also allow for the movement of wildlife animals, which may be part of a food trade, to make their way into urban settlements. All these dramatic changes increase the potential spread of infection.” It is no mystery why pandemics happen. Those with the knowledge, wisdom, and resources must choose to decide to avoid these disasters that afflict everyone.

Ilan Kelman is Professor of Disasters and Health at University College London and the author of Disaster By Choice: How Our Actions Turn Natural Hazards into Catastrophes. Follow him on Twitter/Instagram @IlanKelman.

Argentine and Brazilian doctors suspect mosquito insecticide as cause of microcephaly (The Ecologist)

Claire Robinson / GMWatch

10th February 2016

With the proposed connection between the Zika virus and Brazil’s outbreak of microcephaly in new born babies looking increasingly tenuous, Latin American doctors are proposing another possible cause: Pyriproxyfen, a pesticide used in Brazil since 2014 to arrest the development of mosquito larvae in drinking water tanks. Might the ‘cure’ in fact be the poison?

Malformations detected in thousands of children from pregnant women living in areas where the Brazilian state added Pyriproxyfen to drinking water are not a coincidence, even though the Ministry of Health places direct blame on the Zika virus.

The World Health Organization view that the microcephaly outbreak in Brazil’s impoverished northeast is caused by the Zika virus has, so far, received few challenges.

Brazil’s Health Minister, Marcelo Castro, has gone so far as to say that he has “100% certainty”that there is a link between Zika and microcephaly, a birth defect in which babies are born with small heads.

The view is widely supported in the medical community worldwide, including by the US’s influential Center for Disease Control. But there is no hard evidence of the link, rather a mixture of epidemiological indications and circumstantial evidence.

One of the key scientific papers, by A S Oliveira Melo et al in the journal Ultrasound in Obstetrics & Gynecology, found Zika virus in the amniotic fluids and other tissues of the affected babies and their mothers. But only two women were examined, far too small a number to establish a statistically significant link.

The New York Times also reported on 3rd February on the outcome of analyses by Brazil’s Health Ministry: “Of the cases examined so far, 404 have been confirmed as having microcephaly. Only 17 of them tested positive for the Zika virus. But the government and many researchers say that number may be largely irrelevant, because their tests would find the presence of the virus in only a tiny percentage of cases.”

And last weekend, the most powerful indicator yet that the microcephaly may have another cause altogether was announced by Colombia’s president, Juan Manuel Santos, as reported by the Washington Post. Colombian public health officials, stated Santos, have so far diagnosed 3,177 pregnant women with the Zika virus- but in no case had microcephaly been observed in the foetus.

Argentine doctors: it’s the insecticide

Now a new report has been published by the Argentine doctors’ organisation, Physicians in the Crop-Sprayed Towns (PCST), [1] which not only challenges the theory that the Zika virus epidemic in Brazil is the cause of the increase in microcephaly among newborns, but proposes an alternative explanation.

According to PCST, the Ministry failed to recognise that in the area where most sick people live, a chemical larvicide that produces malformations in mosquitoes was introduced into the drinking water supply in 2014.

This pesticide, Pyriproxyfen, is used in a state-controlled programme aimed at eradicating disease-carrying mosquitos. The Physicians added that the Pyriproxyfen is manufactured by Sumitomo Chemical, a Japanese ‘strategic partner‘ of Monsanto. – a company they have learned to distrust due to the vast volume of the company’s pesticides sprayed onto Argentina’s cropland.

Pyriproxyfen is a growth inhibitor of mosquito larvae, which alters the development process from larva to pupa to adult, thus generating malformations in developing mosquitoes and killing or disabling them. It acts as an insect juvenile hormone or juvenoid, and has the effect of inhibiting the development of adult insect characteristics (for example, wings and mature external genitalia) and reproductive development.

The chemical has a relatively low risk profile as shown by its WHO listing, with low acute toxicity. Tests carried out in a variety of animals by Sumitomo found that it was not a teratogen (did not cause birth defects) in the mammals it was tested on. However this cannot be taken as a completely reliable indicator of its effects in humans – especially in the face of opposing evidence.

The PCST commented: “Malformations detected in thousands of children from pregnant women living in areas where the Brazilian state added Pyriproxyfen to drinking water are not a coincidence, even though the Ministry of Health places a direct blame on the Zika virus for this damage.”

They also noted that Zika has traditionally been held to be a relatively benign disease that has never before been associated with birth defects, even in areas where it infects 75% of the population.

Brazilian doctors also suspect pyriproxyfen

Pyriproxyfen is a relatively new introduction to the Brazilian environment; the microcephaly increase is a relatively new phenomenon. So the larvicide seems a plausible causative factor in microcephaly – far more so than GM mosquitos, which some have blamed for the Zika epidemic and thus for the birth defects.

The PCST report, which also addresses the Dengue fever epidemic in Brazil, concurs with the findings of a separate report on the Zika outbreak by the Brazilian doctors’ and public health researchers’ organisation, Abrasco. [2]

Abrasco also names Pyriproxyfen as a possible cause of the microcephaly. It condemns the strategy of chemical control of Zika-carrying mosquitoes, which it says is contaminating the environment as well as people and is not decreasing the numbers of mosquitoes.

Instead Abrasco suggests that this strategy is in fact driven by the commercial interests of the chemical industry, which it says is deeply integrated into the Latin American ministries of health, as well as the World Health Organization and the Pan American Health Organisation.

Abrasco names the British GM insect company Oxitec as part of the corporate lobby that is distorting the facts about Zika to suit its own profit-making agenda. Oxitec sells GM mosquitoes engineered for sterility and markets them as a disease-combatting product – a strategy condemned by the Argentine Physicians as “a total failure, except for the company supplying mosquitoes.”

Both the Brazilian and Argentine doctors’ and researchers’ associations agree that poverty is a key neglected factor in the Zika epidemic. Abrasco condemned the Brazilian government for its “deliberate concealment” of economic and social causes: “In Argentina and across America the poorest populations with the least access to sanitation and safe water suffer most from the outbreak.” PCST agrees, stating, “The basis of the progress of the disease lies in inequality and poverty.”

Abrasco adds that the disease is closely linked to environmental degradation: floods caused by logging and the massive use of herbicides on (GM) herbicide-tolerant soy crops – in short, “the impacts of extractive industries.”

The notion that environmental degradation may a factor in the spread of Zika finds backing in the view of Dino Martins, PhD, a Kenyan entomologist. Martins said that “the explosion of mosquitoes in urban areas, which is driving the Zika crisis” is caused by “a lack of natural diversity that would otherwise keep mosquito populations under control, and the proliferation of waste and lack of disposal in some areas which provide artificial habitat for breeding mosquitoes.”

Community-based actions

The Argentine Physicians believe that the best defence against Zika is “community-based actions”. An example of such actions is featured in a BBC News report on the Dengue virus in El Salvador.

A favourite breeding place for disease-carrying mosquitoes is storage containers of standing water. El Salvadorians have started keeping fish in the water containers, and the fish eat the mosquito larvae. Dengue has vanished along with the mosquitoes that transmit the disease. And so far, the locals don’t have any Zika cases either.

Simple yet effective programmes like this are in danger of being neglected in Brazil in favour of the corporate-backed programmes of pesticide spraying and releasing GM mosquitoes. The latter is completely unproven and the former may be causing far more serious harm than the mosquitoes that are being targeted.

 


 

Claire Robinson is an editor at GMWatch.

This article was originally published by GMWatch. This version includes additional reporting by The Ecologist.

Notes

1. ‘Report from Physicians in the Crop-Sprayed Towns regarding Dengue-Zika, microcephaly, and mass-spraying with chemical poisons‘. 2016. Physicians in the Crop-Sprayed Towns.

2. ‘Nota técnica e carta aberta à população: Microcefalia e doenças vetoriais relacionadas ao Aedes aegypti: os perigos das abordagens com larvicidas e nebulização química – fumacê‘. January 2016. GT Salud y Ambiente. Asociación Brasileña de Salud Colectiva. ABRASCO.

 

OMS declara vírus zica e microcefalia ‘emergência pública internacional’ (JC)

Comitê de Emergência se reuniu pela primeira vez nesta segunda-feira (1) para reagir ao aumento do número de casos de desordens neurológicas e malformações congênitas, sobretudo nas Américas. País mais atingido é o Brasil

A Organização Mundial da Saúde (OMS) realizou nesta segunda-feira (1) a primeira reunião do Comité de Emergência que trata dos recentes casos de microcefalia e outros distúrbios neurológicos em áreas afetadas pelo vírus zika, sobretudo nas Américas. O país mais atingido é o Brasil.

O Secretariado da OMS informou ao Comitê sobre a situação dos casos de microcefalia e Síndrome de Guillain-Barré, circunstancialmente associados à transmissão do vírus zika. O Comitê foi recebeu informações sobre a história do vírus zika, sua extensão, apresentação clínica e epidemiologia.

As representações do Brasil, França, Estados Unidos e El Salvador apresentaram as primeiras informações sobre uma potencial associação entre a microcefalia – bem como outros distúrbios neurológicos – e a doença provocada pelo vírus zika.

Segundo o comunicado da OMS, os especialistas reunidos em Genebra concordam que uma relação causal entre a infecção do zika durante a gravidez e microcefalia é “fortemente suspeita”, embora ainda não comprovada cientificamente.

A falta de vacinas e testes de um diagnóstico rápido e confiável, bem como a ausência de imunidade da população em países recém-afetados, foram citadas como novos motivos de preocupação.

Para a Comissão da OMS, o recente conjunto de casos microcefalia e outros distúrbios neurológicos relatados no Brasil, logo após ocorrências semelhantes na Polinésia Francesa, em 2014, constituem uma “emergência de saúde pública de importância internacional”, condição conhecida também pela sua sigla em inglês (PHEIC).

Em uma decisão aceita pela diretora-geral da OMS, Margaret Chan, o Comitê da agência da ONU busca assim coordenar uma resposta global de modo a minimizar a ameaça nos países afetados e reduzir o risco de propagação internacional.

Recomendações à diretora-geral da OMS

O Comitê, em resposta às informações fornecidas, fez recomendações à OMS sobre medidas a serem tomadas.

Em relação aos distúrbios neurológicos e microcefalia, o Comitê sugere que a vigilância de microcefalia e da Síndrome de Guillain-Barré deve ser padronizada e melhorada, particularmente em áreas conhecidas de transmissão do vírus zika, bem como em áreas de risco de transmissão.

O Comitê também recomendou que seja intensificada a investigação acerca da etiologia – a causa das doenças – nos novos focos onde ocorrem os casos de distúrbios neurológicos e de microcefalia, para determinar se existe uma relação causal entre o vírus zika e outros fatores desconhecidos.

Como estes grupos se situam em áreas recém-infectadas com o vírus zika, de acordo com as boas práticas de saúde pública e na ausência de outra explicação para esses agrupamentos, o Comitê destaca a importância de “medidas agressivas” para reduzir a infecção com o vírus zika, especialmente entre as mulheres grávidas e mulheres em idade fértil.

Como medida de precaução, o Comitê fez as seguintes recomendações adicionais:

Transmissão do vírus zika

A vigilância para infecção pelo vírus zika deve ser reforçada, com a divulgação de definições de casos padrão e diagnósticos para áreas de risco.

O desenvolvimento de novos diagnósticos de infecção pelo vírus zika devem ser priorizados para facilitar as medidas de vigilância e de controle.

A comunicação de risco deve ser reforçada em países com transmissão do vírus zika para responder às preocupações da população, reforçar o envolvimento da comunidade, melhorar a comunicação e assegurar a aplicação de controle de vetores e medidas de proteção individual.

Medidas de controle de vetores e medidas de proteção individual adequada devem ser agressivamente promovidas e implementadas para reduzir o risco de exposição ao vírus zika.

Atenção deve ser dada para assegurar que as mulheres em idade fértil e mulheres grávidas em especial tenham as informações e materiais necessários para reduzir o risco de exposição.

As mulheres grávidas que tenham sido expostas ao vírus zika devem ser aconselhadas e acompanhadas por resultados do nascimento com base na melhor informação disponível e práticas e políticas nacionais.

Medidas de longo prazo

Esforços de pesquisa e desenvolvimento apropriados devem ser intensificados para vacinas, terapias e diagnósticos do vírus zika.

Em áreas conhecidas de transmissão do vírus zika, os serviços de saúde devem estar preparados para o aumento potencial de síndromes neurológicas e/ou malformações congênitas.

Medidas de viagem

Não deve haver restrições a viagens ou ao comércio com países, regiões e/ou territórios onde esteja ocorrendo a transmissão do vírus zika.

Viajantes para áreas com transmissão do vírus zika devem receber informações atualizadas sobre os potenciais riscos e medidas adequadas para reduzir a possibilidade de exposição a picadas do mosquito.

Recomendações da OMS sobre padrões em matéria de desinfestação de aeronaves e aeroportos devem ser implementadas.

Compartilhamento de dados

As autoridades nacionais devem garantir a comunicação e o compartilhamento ágeis e em tempo de informações relevantes de importância para a saúde pública, para esta Emergência.

Dados clínicos, virológicos e epidemiológicos, relacionados com o aumento das taxas de microcefalia e/ou Síndrome de Guillain-Barré, ou com a transmissão do vírus zika, devem ser rapidamente compartilhados com a OMS para facilitar a compreensão internacional destes eventos, para orientar o apoio internacional para os esforços de controle, priorizando a pesquisa e desenvolvimento de produtos.

Acompanhe:

http://who.int/emergencies/zika-virus

http://new.paho.org/bra

http://combateaedes.saude.gov.br

http://bit.ly/zikaoms

ONU

 

Leia também:

Agência Brasil – Notificação de casos de Zika passa a ser obrigatória no Brasil

Ebola Is Wiping Out the World’s Gorillas (The Daily Beast)

Finbarr O’Reilly/Reuters

01.22.15

In just four decades, Ebola has wiped out one third of the world’s chimp and gorilla populations. If it continues, the results will be devastating.

While coverage of the current Ebola epidemic in West Africa remains centered on the human populations in Guinea, Sierra Leone, and Liberia, wildlife experts’ concern is mounting over the virus’ favorite victims: great apes.

Guinea, where the epidemic originated, has the largest population of chimpanzees in all of West Africa. Liberia is close behind. Central Africa is home to western lowland gorillas, the largest and most widespread of all four species. Due to forest density, the number of those infected is unknown. But with hundreds of thousands of ape casualties from Ebola, it’s doubtful they’ve escaped unscathed.

Animal activists are ramping up efforts to find an Ebola vaccine for great apes, but with inadequate international support for human research, their mission could be seen as competing with one to save humans. Experts from the Jane Goodall Institute of Canada insist such apprehension would be misplaced. Two streams of funding—one for humans, one for apes—can coexist in this epidemic, they assert, and must.

“The media was really focusing on human beings,” Sophie Muset, project manager for JGI, says. “But it has been traumatic to [the great ape] population for many years.”

Over the course of just four decades, Ebola has wiped out one third of the world’s population of chimpanzees and gorillas, which now stand at less than 300,000 and 95,000 respectively.

The first large-scale “die-offs” due to Ebola began in the late 1990s, and haven’t stopped. Over the course of just four decades, Ebola has wiped out one third of the world’s population of chimpanzees and gorillas, which now stand at less than 300,000 and 95,000 respectively. Both species are now classified as endangered by the International Union for Conservation of Nature; western gorillas are “critically” so.

One of earliest Ebola “die-offs” of great apes came in 1994, when an Ebola outbreak in Minkébé decimated the region’s entire population—once the second largest in the world. In 2002, an outbreak in the Democratic Republic of Congo wiped out 95 percent of the region’s gorilla population. And an equally brutal attack broke out in 2006, when Ebola Zaire in Gabon (the same strain as the current outbreak) left an estimated 5,000 gorillas dead.

The dwindling population of both species, combined with outside poaching threats, means Ebola poses a very real threat to their existence. To evaluate the damage thus far, the Wild Chimpanzee Foundation is conducting population assessments in West Africa, with the goal of getting a rough estimate of how many have died. Given the combined damage that Ebola has inflicted on this population, the results are likely to be troubling.

In a way, great apes are Ebola’s perfect victims. Acutely tactile mammals, their dynamic social environments revolve around intimacy with each other. Touching hands, scratching backs, hugging, kissing, and tickling, they are near constantly intertwined—giving Ebola a free ride.

In a May 2007 study from The American Naturalist, researchers studying the interactions between chimpanzees and gorillas found evidence the Ebola can even spread between the social groups. At three different sites in northern Republic of Congo, they found bacteria from gorillas and chimps on the same fruit trees. For a virus that spreads through bodily fluids, this is an ideal scenario.

“They live in groups [and] they are very close,” says Muset, who has worked with chimps on the ground in Uganda and the DRC. “Since Ebola transmission happens through body fluids, it spreads very fast.”

For gorillas in particular, this culture proves deadly, making their mortality rate for this virus closer to  95 percent. But like humans, the corpses of chimpanzees and gorillas remain contagious with Ebola for days. While the chimps and gorillas infected with Ebola will likely die in a matter of days, the virus can live on in their corpse for days—in turn, spreading to humans who eat or touch their meat.

It is one such interaction that could result in the spread from apes to humans. But in this particular outbreak, experts have zeroed in on the fruit bat (believed to be the original carrier) as the source. The index patient, a 2-year-old in Guinea, was reportedly playing on a tree with a fruit bat colony.

Whether or not a great ape was involved in the transmission of the virus to humans during this outbreak is unknown. Such an interaction is possible. Interestingly, however, it’s not the risk that great apes with Ebola pose to humans that wildlife experts find most concerning. It’s the risk that their absence poses to the wild.

Owing to a diet consisting mostly of fruit, honey, and leaves, gorillas and chimpanzees are crucial to forest life. Inadvertently distributing seeds and pollen throughout the forest, they stimulate biodiversity within it. Without them, the biodiversity of the vegetation may plummet, endangering all of the species that relied on it—and, in turn, the people that relied on them.

“They are not the only ones who act as seed dispersers,” says Muset. “But they are the big players in that field. So when [a die-off] happens, it can decimate an entire forest.”

Wildlife experts worldwide are working to raise both awareness and funds for a vaccination process. It’s a battle that she says was gaining speed last January, when a researcher announced that he had found a vaccine that could work in chimps But as the epidemic in West Africa grew, the focus shifted.

But Muset says its time to return to the project. “There is a vaccine, but it has never been tested on chimpanzees,” she says.  “Progress has been made, and preliminary testing done, but testing in the field need to happen to make it real.”

As to the question of whether it’s ethical to be searching for a vaccine for wild animals when humans are still suffering as well, Muset is honest. “For sure there is a direct competition here. But wildlife and humans have a lot of diseases in common that they can transmit from one to the other,” she says. “And I think you can think of it as two streams of funding, one to wildlife and the other to human beings.”

While it’s great apes that wildlife experts are seeking to save, human nature as a whole, Muset argues, is at stake. “If you want a healthy ecosystem, the more you have to invest in health for wildlife and humans,” she says. “Then, the better place it will be.  Because really, it all works together.”

Without swift influx of substantial aid, Ebola epidemic in Africa poised to explode (Science Daily)

Date: October 23, 2014

Source: Yale University

Summary: The Ebola virus disease epidemic already devastating swaths of West Africa will likely get far worse in the coming weeks and months unless international commitments are significantly and immediately increased, new research predicts.

Artist’s conception (stock illustration). Credit: © Jim Vallee / Fotolia

The Ebola virus disease epidemic already devastating swaths of West Africa will likely get far worse in the coming weeks and months unless international commitments are significantly and immediately increased, new research led by Yale researchers predicts.

The findings are published in the Oct. 24 issue of The Lancet Infectious Diseases.

A team of seven scientists from Yale’s Schools of Public Health and Medicine and the Ministry of Health and Social Welfare in Liberia developed a mathematical transmission model of the viral disease and applied it to Liberia’s most populous county, Montserrado, an area already hard hit. The researchers determined that tens of thousands of new Ebola cases — and deaths — are likely by Dec. 15 if the epidemic continues on its present course.

“Our predictions highlight the rapidly closing window of opportunity for controlling the outbreak and averting a catastrophic toll of new Ebola cases and deaths in the coming months,” said Alison Galvani, professor of epidemiology at the School of Public Health and the paper’s senior author. “Although we might still be within the midst of what will ultimately be viewed as the early phase of the current outbreak, the possibility of averting calamitous repercussions from an initially delayed and insufficient response is quickly eroding.”

The model developed by Galvani and colleagues projects as many as 170,996 total reported and unreported cases of the disease, representing 12% of the overall population of some 1.38 million people, and 90,122 deaths in Montserrado alone by Dec. 15. Of these, the authors estimate 42,669 cases and 27,175 deaths will have been reported by that time.

Much of this suffering — some 97,940 cases of the disease — could be averted if the international community steps up control measures immediately, starting Oct. 31, the model predicts. This would require additional Ebola treatment center beds, a fivefold increase in the speed with which cases are detected, and allocation of protective kits to households of patients awaiting treatment center admission. The study predicts that, at best, just over half as many cases (53,957) can be averted if the interventions are delayed to Nov. 15. Had all of these measures been in place by Oct. 15, the model calculates that 137,432 cases in Montserrado could have been avoided.

There have been approximately 9,000 reported cases and 4,500 deaths from the disease in Liberia, Sierra Leone, and Guinea since the latest outbreak began with a case in a toddler in rural Guinea in December 2013. For the first time cases have been confirmed among health-care workers treating patients in the United States and parts of Europe.

“The current global health strategy is woefully inadequate to stop the current volatile Ebola epidemic,” co-author Dr. Frederick Altice, professor of internal medicine and public health added. “At a minimum, capable logisticians are needed to construct a sufficient number of Ebola treatment units in order to avoid the unnecessary deaths of tens, if not hundreds, of thousands of people.”

Other authors include lead author Joseph Lewnard, Martial L. Ndeffo Mbah, Jorge A. Alfaro-Murillo, Luke Bawo, and Tolbert G. Nyenswah.

The National Institutes of Health funded the study.


Journal Reference:

  1. Joseph A Lewnard, Martial L Ndeffo Mbah, Jorge A Alfaro-Murillo, Frederick L Altice, Luke Bawo, Tolbert G Nyenswah, Alison P Galvani. Dynamics and control of Ebola virus transmission in Montserrado, Liberia: a mathematical modelling analysis. Lancet Infectious Diseases, October 24, 2014 DOI:10.1016/S1473-3099(14)70995-8

Cruz Vermelha prevê ao menos quatro meses para controlar ebola (Agência Brasil)

A epidemia já causou mais de 4,5 mil mortes na África Ocidental

A epidemia de ebola vai demorar pelo menos quatro meses para ser contida se todas as medidas necessárias forem tomadas, disse hoje (22) o responsável geral da Cruz Vermelha, Elhadj As Sy, alertando para “o preço da inação”. A epidemia já causou mais de 4,5 mil mortes na África Ocidental e os especialistas alertam que a taxa de infecção poderá chegar a 10 mil por semana no início de dezembro.

Ainda não há vacina aprovada para o ebola, que também atingiu profissionais da saúde na Espanha e nos Estados Unidos.

Elhadj As Sy listou uma série de medidas que poderiam ajudar a colocar o ebola sob controle, incluindo “um bom isolamento, bom tratamento dos casos confirmados, e bom, seguro e digno enterro às pessoas falecidas”. “Será possível, como era possível no passado, conter esta epidemia dentro de quatro a seis meses” se a resposta for adequada, acrescentou.

“Eu acho que esta é a nossa melhor perspectiva e nós estamos fazendo todo o possível para mobilizar nossos recursos e nossas capacidades para travar o surto”, destacou. As Sy, que falava em uma conferência da Cruz Vermelha da Ásia-Pacífico, acrescentou que “há sempre um preço pela inação”.

Novas medidas serão adotadas hoje nos Estados Unidos, entre as quais os voos dos países mais afetados – Libéria, Serra Leoa e Guiné-Conacri – serão encaminhados para cinco aeroportos e os passageiros passarão por exames mais completos de saúde.

Entretanto, especialistas que escrevem para a revista The Lancet, disseram, na terça-feira (21), que a triagem dos passageiros nos aeroportos de saída seria uma opção melhor do que monitorá-los no destino da viagem.

(Agência Lusa / Agência Brasil)

http://agenciabrasil.ebc.com.br/internacional/noticia/2014-10/cruz-vermelha-serao-necessarios-pelo-menos-quatro-meses-para-controlar

The Most Terrifying Thing About Ebola (Slate)

The disease threatens humanity by preying on humanity.

Photo by John Moore/Getty ImagesSuspected Ebola patient Finda “Zanabo” prays over her sick family members before being admitted to the Doctors Without Borders Ebola treatment center on Aug. 21, 2014, near Monrovia, Liberia. Photo by John Moore/Getty Images

As the Ebola epidemic in West Africa has spiraled out of control, affecting thousands of Liberians, Sierra Leonians, and Guineans, and threatening thousands more, the world’s reaction has been glacially, lethally slow. Only in the past few weeks have heads of state begun to take serious notice. To date, the virus has killed more than 2,600 people. This is a comparatively small number when measured against much more established diseases such as malaria,HIV/AIDS, influenza, and so on, but several factors about this outbreak have some of the world’s top health professionals gravely concerned:

  • Its kill rate: In this particular outbreak, a running tabulation suggests that 54 percent of the infected die, though adjusted numbers suggest that the rate is much higher.
  • Its exponential growth: At this point, the number of people infected is doubling approximately every three weeks, leading some epidemiologists to projectbetween 77,000 and 277,000 cases by the end of 2014.
  • The gruesomeness with which it kills: by hijacking cells and migrating throughout the body to affect all organs, causing victims to bleed profusely.
  • The ease with which it is transmitted: through contact with bodily fluids, including sweat, tears, saliva, blood, urine, semen, etc., including objects that have come in contact with bodily fluids (such as bed sheets, clothing, and needles) and corpses.
  • The threat of mutation: Prominent figures have expressed serious concerns that this disease will go airborne, and there are many other mechanisms through which mutation might make it much more transmissible.

Terrifying as these factors are, it is not clear to me that any of them capture what is truly, horribly tragic about this disease.

The most striking thing about the virus is the way in which it propagates. True, through bodily fluids, but to suggest as much is to ignore the conditions under which bodily contact occurs. Instead, the mechanism Ebola exploits is far more insidious. This virus preys on care and love, piggybacking on the deepest, most distinctively human virtues. Affected parties are almost all medical professionals and family members, snared by Ebola while in the business of caring for their fellow humans. More strikingly, 75 percent of Ebola victims are women, people who do much of the care work throughout Africa and the rest of the world. In short, Ebola parasitizes our humanity.

More than most other pandemic diseases (malaria, cholera, plague, etc.) and more than airborne diseases (influenza, swine flu, H5N1, etc.) that are transmitted indiscriminately through the air, this disease is passed through very minute amounts of bodily fluid. Just a slip of contact with the infected party and the caregiver herself can be stricken.

The images coming from Africa are chilling. Little boys, left alone in the street without parents, shivering and sick, untouchable by the throngs of people around them. Grown men, writhing at the door to a hospital, hoping for care as their parents stand helplessly, wondering how to help. Mothers and fathers, fighting weakness and exhaustion to move to the edge of a tent in order to catch a distant, final glimpse of a get-well video that their children have made for them.

If Ebola is not stopped, this disease can destroy whole families within a month, relatives of those families shortly thereafter, friends of those relatives after that, and on and on. As it takes hold (and it is taking hold fast), it cuts out the heart of family and civilization. More than the profuse bleeding and high kill rate, this is why the disease is terrifying. Ebola sunders the bonds that make us human.

Aid providers are now working fastidiously to sever these ties themselves, fighting hopelessly against the natural inclinations that people have to love and care for the ill. They have launched aggressive public information campaigns, distributedupdates widely, called for more equipment and gear, summoned the military, tried to rein in the hysteria, and so on. Yet no sheet of plastic or latex can disrupt these human inclinations.

Such heroic efforts are the appropriate medical response to a virulent public health catastrophe. The public health community is doing an incredible job, facing unbelievable risks, relying on extremely limited resources. Yet these efforts can only do half of the work. Infected parties—not all, to be sure, but some (enough)—cannot abide by the rules of disease isolation. Some will act without donning protective clothing. Some will assist without taking proper measures. And still others will refuse to enter isolation units because doing so means leaving their families and their loved ones behind, abandoning their humanity, and subjecting themselves to the terror of dying a sterile, lonely death.

It is tempting, at these times, to focus on the absurd and senseless actions of a few. One of the primary vectors in Sierra Leone is believed to have been a traditional healer who had been telling people that she could cure Ebola. In Monrovia a few weeks back, angry citizens stormed a clinic and removed patients from their care. “There is no Ebola!” they are reported to have been shouting. More recently, the largest newspaper in Liberia published an article suggesting that Ebola is a conspiracy of the United States, aimed to undermine Africa. And, perhaps even more sadly, a team of health workers and journalists was just brutally murdered in Guinea. It is easy, in other words, to blame the spread on stupidity, or illiteracy, or ritualism, or conspiracy theories, or any number of other irrational factors.

Photo by John Moore/Getty ImagesA man checks on a very sick Saah Exco, 10, in a back alley of the West Point slum on Aug. 19, 2014, in Monrovia, Liberia. Photo by John Moore/Getty Images

But imagine: You are a parent whose child has suddenly come ill with a fever. Do you cast your child away and refuse to touch him? Do you cover your face and your arms? Stay back! Unclean! Or do you comfort your child when he asks for you, arms outstretched, to make the pain go away?

Imagine: You live in a home with five other family members. Your sister falls ill, ostensibly from Ebola, but possibly from malaria, typhoid, yellow fever, or the flu. You are aware of the danger to yourself and your other family members, but you have no simple means to move her, and she is too weak to move herself. What do you do?

Imagine: You are a child of 5 years old. Your mother is sick. She implores you to back away. But you are scared. What you need, more than anything, is a hug and a cry.

Who can blame a person for this? It is a terrible, awful predicament. A moral predicament. To stay, comfort, and give love and care to those who are in desperate need, or to shuttle them off into an isolation ward, perhaps never to see them again? What an inhumane decision this is.

What makes the Ebola virus so terrifying is not its kill rate, its exponential growth, the gruesome way in which it kills, the ease of transmission, or the threat of mutation, but rather that people who care can do almost nothing but sit on the sidelines and watch.

* * *

Many have asked whether Ebola could come here, come West. (The implication, in its way, is crass—as if to suggest that we need not be concerned about a tragedy unless it poses a threat to us.) We have been reassured that it will never spread widely here, because our public health networks are too strong, our hospitals too well-stocked. The naysayers may be right about this. But they are not right that it does not pose a threat to us.

For starters, despite the pretense, the West is not immune from absurd, unscientific thinking. We have our fair share of scientific illiteracy, skepticism, ritualism, and foolishness. But beyond this, it is our similarities, not our differences, that make us vulnerable to this plague. We are human. Every mechanism we have for caring—touching, holding, feeding, playing, warming, comforting, caressing—every mechanism that we use to bind us to our families and our neighbors, is preyed upon by Ebola. We cannot seal each other into hyperbaric chambers and expect that once we emerge, the carnage will be over. We are humans, and we will care about our children and our families even if it means that we may die in doing so.

The lesson here is a vital one: People do not give up on humanity so very easily. Even if we persuade all of the population to forgo rituals like washing the dead, we will not easily persuade parents to keep from holding their sick children, children from clinging to their ailing parents, or children from playing and wrestling and slobbering all over one another. We tried to alter such behaviors with HIV/AIDS. A seemingly simple edict—“just lay off the sex with infected parties”—would seem all that is required to halt that disease. But we have learned over the decades that people do not give up sex so readily.

If you think curtailing sex is hard, love and compassion will be that much harder. Humans will never give this up—we cannot give this up, for it is fundamental to who we are. The more that medical personnel require this of people without also giving them methods to manifest care, the more care and compassion will manifest in pockets outside of quarantine. And the more humanity that manifests unchecked, the more space this virus has to grow. Unchecked humanity will seep through the cracks and barriers that we build to keep our families safe, and if left to find its own way, will carry a lethal payload.

The problem is double-edged. Ebola threatens humanity by preying on humanity. The seemingly simple solution is to destroy humanity ourselves—to seal everything off and let the disease burn out on its own. But doing so means destroying ourselves in order to save ourselves, which is no solution at all.

Photo by John Moore/Getty ImagesA medical worker in a protective suit works near Ebola patients in a Doctors Without Borders hospital on Sept. 7, 2014, in Monrovia, Liberia. Photo by Dominique Faget/AFP/Getty Images

We must find a method of caring without touching, of contacting without making contact. The physiological barriers are, for the time being, necessary. But we cannot stop people from caring about one another, so we must create, for the time being, mechanisms for caring. Since we will never be able to beat back humanity, we must coordinate humanity, at the family level, the local level, and the global level.

The only one way to battle a disease that affixes itself parasitically to our humanity is to overwhelm it with greater, stronger humanity. To immunize Africa and the rest of the world with a blast of humanity so powerful that the disease can no longer take root. What it will take to beat this virus is to turn its most powerful vehicle, our most powerful weapon, against it.

Here are some things we can do:

Donate to the great organizations that are working tirelessly to bring this disease under control. They need volunteers, medical supplies, facilities, transportation, food, etc. Share information about Ebola, so people will learn about it, know about it, and know how to address it when it comes. And inform and help others. It is natural at a time of crisis to call for sealing the borders, to build fences and walls that separate us further from outside threats. But a disease that infects humanity cannot easily be walled off in this way. Walling off just creates unprotected pockets of humanity, divisions between us and them: my family, your family; that village, this village; inside, outside.

* * *

One final thing.

When Prince Prospero, ill-fated protagonist of Edgar Allan Poe’s story “The Masque of the Red Death,” locked himself in his castle to avoid a contagion that was sweeping his country—a disease that caused “profuse bleeding at the pores”—he assumed mistakenly that the only reasonable solution to his problem was to remove himself from the scene. For months he lived lavishly, surrounded by courtiers, improvisatori, buffoons, musicians, and wine, removed from danger while the pestilence wrought havoc outside.

As with much of Poe’s writing, Prospero’s tale does not end well. For six months, all was calm. He and his courtiers enjoyed their lives, secure and isolated from the plague laying waste to the countryside. Then, one night during a masquerade ball, the Red Death snuck into the castle, hidden behind a mask and a cloak, to afflict Prospero and his revelers, dropping them one by one in the “blood-bedewed halls.” Prospero’s security was a façade, leaving darkness and decay to hold “illimitable dominion over all.” The eventual intrusion that would be his undoing foretells of a danger in believing that we can keep the world’s ills at bay by keeping our distance.

If we seek safety by shutting out the rest of the world, we are in for a brutally ugly awakening. Nature is a cruel mistress, but Ebola is her cruelest, most devious trick yet.

Benjamin Hale is associate professor of philosophy and environmental studies at the University of Colorado–Boulder. He is vice president of the International Society of Environmental Ethics and co-editor of the journal Ethics, Policy & Environment.