Brian Davey jedan je od onih ljudi koje zaista brine nagli kolaps civilizacije poznatiji nam iz filmova ili prostorno ograničenih ratnih zona. Ono kad odjednom stvari više ne rade, ljudi nisu ljudi, a civilizacija je motto. Pripremajući svoju novu knjigu Credo, Brian ovdje prikazuje njezin predgovor koji u epidemiji ebole vidi opasno urušavanje temelja civlizirane zajednice.
Nije za osjetljive gledatelje, nije niti za one koji su sigurni da se tijek povijesti ne može stubokom izmijeniti u nekoliko mjeseci. Ali je zanimljivo za pročitati…
Ebola and “strong uncertainty” – understanding the world as it really is requires ‘emotional work’
As I was completing this book – or as I thought that I was completing it – the outbreak of Ebola in West Africa started to grown exponentially and now threatens to spread into the rest of the world including into the Europe, the UK, the USA and so on. It is already a major threat to the economies of West Africa and its implications will be far reaching if and when it spreads further.
What makes Ebola particularly vicious is not only the fact that it kills a very large percentage of those that it infects. It is also the fact that its method of transmission exploits human care relationships. It is the fact that the healthy look after the sick, clean up after them and then want to take their leave from them as people with whom they had emotional close relationships when they die. All this makes the carers and people in close relationships vulnerable to the virus in the body fluids of very sick people and of the dead. It is no accident then that women, as the chief care givers are particularly vulnerable to Ebola.
All this makes for a terrifying irony that must be addressed or the disease will not be controlled – that we are all dependent on some of the most exploited parts of our society doing their job well under conditions that will become very dangerous if this disease spreads – cleaners. In a globalised economy the cleaners in many of our major institutions – hospitals, universities, transport infrastructures, offices – are often sub-contracted migrant workers. They have to work for low pay under conditions which maximise profits for the companies that they work for and increase the chances that cleaners will be infected in an Ebola outbreak too.
How does it come about that an economic system has evolved that puts these cleaners at risk, and through them all of society, and yet does not give them the appropriate tools to work with? As we will see later in this book many economists would answer that this by describing it as a problem of “externalities” – companies employing
cleaners consider how to make profits for themselves and do not necessarily take into account all the costs and benefits of their decisions to the wider society. Later in this book I look more closely at this way of thinking. Suffice it to say here that, faced with the threat of Ebola spreading, what we
can immediately see is that the terminology of “externalities” is a way of describing ethical issues of great importance to society.
It does not occur to most people that economics is a way of framing and conceptualising what are, in effect, ethical issues. Yet many centuries ago economics was taught as a branch of moral philosophy and in this book I argue that there is an urgent need to return the subject to these roots. When we do then we find that
the world we live in is full of major ethical questions to be addressed that do not allow for simple answers – and least of all the naive and banal idea that a free market and free trade is able to solve any issue.
If you look at the roots of the term, “quarantine”, it originates from words that meant an isolation period of 40 days and this, or a “trentine” of 30 days, was a method used in earlier epochs to try to prevent the spread of infectious diseases. Travellers and traders from areas where a plague was rife would be required to wait on an island, or a ship would be required to rest at anchor offshore for the required period before being allowed to travel dock at a local port.
When the 19th century English economist David Ricardo argued the benefits of free trade he could not have foreseen that the global economy would eventually be bound together with air travel. He could not have foreseen that, to re-create long lasting quarantine arrangements between nations, would be impossible in an era of international production systems, using just in time global supply chains, without major disruption.
What, looking forward, he could not have foreseen is an example of what ecological economists call “strong uncertainty” seen in historical retrospect – the fact that the world evolves in ways that reveals unexpected and sometimes dangerous consequences for our good ideas, and that renders our predictions and certainties about the future irrelevant. No one foresaw that chemicals used in refrigeration would, when released, destroy the ozone layer.
This is important because economists like to portray themselves as the soothsayers and shamans of the modern world, consulting the runes in order to make predictions about future economic outcomes. They sometimes admit that they do not know what is going to happen but, since decisions have to be made anyway, they nevertheless resort to calculating probabilities for the things that they guess might go wrong. This is in order to facilitate insurance contracts and contingency arrangements for the decision makers who commit resources in anticipation of possible future events.
For some situations estimating probabilities of what might go wrong makes sense and is good enough but for other situations it is definitely not. In a world characterised by “strong uncertainty” there are surprises around the corner, and sometimes very unpleasant ones.
It is not very nice to admit some potential developments. Economic textbooks claim that, when they are theorising, economists are seeking to describe the world as it is, rather than making value judgements about how they think that the world should be. This seems easy enough and uncontroversial when describing how people make choices between tins of beans and tins of spaghetti hoops – but when we start theorising about rapidly rising death rates and the economic implications of quarantine and health care systems, then describing the world as it is can involve emotional effort because
it can be frightening.
What is particularly frightening is recognising and acknowledging those periods in history where, as individuals or as communities, we lose control and our very existence is at stake. There are very powerful psychological blocks and people may refuse to acknowledge that they are in such situations. For example, there are powerful reasons for denying climate change because economic interests would need to be sacrificed to tackle it. Yet if we are to describe the world as it is, and not as we think it should be, then we must acknowledge when we face dangers – and climate change is a huge danger. Economics describes how people react to circumstances and make “resource allocation” decisions – but the most important decisions that we make are in situations where the threats are very great and where we are tempted to deny our true situations and fudge our responses.
In his novel, the Plague, written in 1947, Albert Camus describes the early stages of an epidemic that befalls an Algerian town called Oran and he describes how a number of characters and the townsfolk in general react to it. It is full of deep psychological observation, including the description of the sense of unreality at the beginning of the plague process. There is anxiety but it is mixed with confidence. Yet there are situations in life where the confidence subsequently proves misplaced.
In this passage Camus writes about real people – not the fantasy of “rational decision makers” that economists typically describe:
“……the citizens of Oran were like the rest of the world, they thought about themselves; in other words they were humanists: they did not believe in pestilence. A pestilence does not have human dimensions, so people tell themselves that it is unreal, that it is bad dream which will end. But it does not always end and, from one bad dream to the next, it is people who end, humanist first of all because they have not prepared themselves. The people of our town were no more guilty than anyone else, they merely forgot to be modest and thought that everything was still possible for them, which implied that pestilence was impossible. They continued with business, with making arrangements for travel and holding opinions. Why should they have thought about the plague, which negates the future, negates journeys and debate? They considered themselves free and no one will ever be free as long as there is plague, pestilence and famine.” (Camus, 2013)
At the time of writing this book I have no idea whether Ebola will spread out of control globally and its effect on the world economy. I am still assuming a future and a place for journeys and debate. There have been other terrible diseases that seemed to be running out of control that humanity has partially tamed in some parts of the world – like HIV/Aids, like SARS. It does seem plausible though that Ebola could continue to spread and grow and not just in West Africa – but eventually across the entire world.
The current confidence about controlling Ebola transmission in developed countries like the UK is based on the assumption that it will be possible to keep the reproduction number of the virus below 1. The reproduction number is the number of people an infected person infects. At the moment the reproduction number in West Africa is about 1.5 to 2 or more further infections for each infected person which is why the number of cases is doubling every month. So – if you throw resources at a problem in a month’s time your resources are only achieving one half as much as a month earlier. Studies suggest that at this level even improved contact tracing, new medication, lower infection rates occurring in hospitals and lower infections through better burial practices is likely, at best, to slow the growth of the disease. (Rivers CM et al 2014) http://currents.plos.org/outbreaks/article/obk-14-0043-modeling-the-impact-of-interventions-on-an-epidemic-of-ebola-in-sierra-leone-and-liberia/
But growth of the disease in West Africa will also spread through cross border “exports” – both in Africa itself and trans-continentally – including into other large population centres – cities. Double the number of cases from the countries in which Ebola is originating and you would expect double the number of “exports”. In three months if you double the number of cases, double it again and double it again you have 8 times the number of “exports”, all other things being equal. In 6 months the epidemic would be 64 times the size.
At some point along this process the possibilities for standard public health measures for control of the disease by “importing countries” would break down – and not just because of the increasing numbers of “exports” – also because of the growing geographical spread of sources from which infectious “imports” would be coming. [...]
However, the more countries that Ebola spreads to the more difficult it would – or will – become to rule out an Ebola diagnosis for each of these people. So the number of cases that “might be” Ebola will increase and, after a certain point, the resource requirements of contact tracing and then the monitoring of all these people for up to 21 days would become quite impractical. The epidemic would overshoot resource availabilities and preparedness.
Now it will readily be seen that in this process, doubling every month, there will be powerful forces to close down international travel movements – but that is not, in fact, as easy as it seems for reasons already expressed here. We live in a global economy and global society. For example Liberia is a major source of rubber to go on the tyres of the world. The Firestone Natural Rubber Company has major plantations there. Everywhere across the world there are supply networks and just in time delivery schedules exporting and importing the components and raw materials of the products of the global economy. The epidemic in West Africa has already led to severe disruptions in the economies of those countries – and attempts to control its international spread could have a devastating effect on global trade and communications, including in food and food products – as well as on the international financial flows and financial institutions associated with them.
Many multinational production and financial arrangements, which are already vulnerable due to high energy costs and an unstable financial system as described in this book, could then start to unravel. The economic chaos would then feed back into and amplify the health crisis is a vicious self reinforcing cycle. Because that very idea is so frightening, many people will not want to even consider the possibility.
Sometimes things are as bad as they seem. When they are then one has a choice – start from ethical choices in the light of the nightmare reality and do what one can with others or live in a comforting fantasy.
20th October 2014