Pandemic: A world-building exercise

First, there was light news of a vaccine against COVID-19 nearing the end of its phase 3 clinical trials with very promising results, accompanied with breezy speculations (often tied to the stock prices of a certain drug-maker) about how it’s going to end the pandemic in six months.

An Indian disease-transmission modeller – of the sort who often purport to be value-free ‘quants’ interested in solving mathematical puzzles that don’t impinge on the real world – reads about the vaccine and begins to tweak his models accordingly. Soon, he has a projection that shines bright in the dense gloom of bad news.

One day, as the world is surely hurtling towards a functional vaccine, it becomes known that some of the world’s richest countries – representing an eighth of the planet’s human population – have secreted more than half of the world’s supply of the vaccine.

Then, a poll finds that over half of all Americans wouldn’t trust a COVID-19 vaccine when it becomes available. The poll hasn’t been conducted in other countries.

A glut of companies around the world have invested heavily in various COVID-19 vaccine candidates, even as the latter are yet to complete phase 3 clinical trials. Should a candidate not clear its trial, a corresponding company could lose its investment without insurance or some form of underwriting by the corresponding government.

Taken together, these scenarios portend a significant delay between a vaccine successfully completing its clinical trials and becoming available to the population, and another delay between general availability and adoption.

The press glosses over these offsets, developing among its readers a distorted impression of the pandemic’s progression – an awkward blend of two images, really: one in which the richer countries are rapidly approaching herd immunity while, in the other, there is a shortage of vaccines.

Sooner or later, a right-wing commentator notices there is a commensurately increasing risk of these poorer countries ‘re-exporting’ the virus around the world. Politicians hear him and further stigmatise these countries, and build support for xenophobic and/or supremacist policies.

Meanwhile, the modeller notices the delays as well. When he revises his model, he finds that as governments relax lockdowns and reopen airports for international travel, differences in screening procedures in different countries could allow the case load to rise and fall around the world in waves – in effect ensuring the pandemic will take longer to end.

His new paper isn’t taken very seriously. It’s near the end of the pandemic, everyone has been told, and he’s being a buzzkill. (It’s also a preprint, and that, a senior scientist in government nearing his retirement remarks, “is all you need to know”.) Distrust of his results morphs slowly into a distrust towards scientists’ predictions, and becomes ground to dismiss most discomfiting findings.

The vaccine is finally available in middle- and low-income countries. But in India, this bigger picture plays out at smaller scales, like a fractal. Neither the modeller nor the head of state included the social realities of Indian society in their plans – but no one noticed because both had conducted science by press release.

As they scratch their heads, they also swat away at people at the outer limits of the country’s caste and class groups clutching at them in desperation. A migrant worker walks past unnoticed. One of them wonders if he needs to privatise healthcare more. The other is examining his paper for arithmetic mistakes.

Dehumanising language during an outbreak

It appears the SARS-CoV-2 coronavirus has begun local transmission in India, i.e. infecting more people within the country instead of each new patient having recently travelled to an already affected country. The advent of local transmission is an important event in the lexicon of epidemics and pandemics because, at least until 2009, that’s how the WHO differentiated between the two.

As of today, the virus has become locally transmissible in the world’s two most populous countries. At this juncture, pretty much everyone expects the number of cases within India to only increase, and as it does, the public healthcare system won’t be the only one under pressure. Reporters and editors will be too, and they’re likely to be more stressed on one front: their readers.

For example, over the course of March 4, the following sentences appeared in various news reports of the coronavirus:

The Italian man infected 16 Italians, his wife and an Indian driver.

The infected techie boarded a bus to Hyderabad from Bengaluru and jeopardised the safety of his co-passengers.

Two new suspected coronavirus cases have been reported in Hyderabad.

All 28 cases of infection are being monitored, the health ministry has said.

Quite a few people on Twitter, and likely in other fora, commented that these lines exemplify the sort of insensitivity towards patients that dehumanises them, elides their agency and casts them as perpetrators – of the transmission of a disease – and which, perhaps given enough time and reception, could engender apathy and even animosity towards the poorer sick.

The problem words seem to include ‘cases’, ‘burden’ and ‘infected’. But are they a problem, really? I ask because though I understand the complaints, I think they’re missing an important detail.

Referring to people as if they were objects only furthers their impotency in a medical care setup in which doctors can’t be questioned and the rationale for diagnoses is frequently secreted – both conditions ripe for exploitation. At the same time, the public part of this system has to deal with a case load it is barely equipped for and whose workers are underpaid relative to their counterparts in the private sector.

As a result, a doctor seeing 10- or 20-times as many patients as they’ve been trained and supported to will inevitably precipitate some amount of dehumanisation, and it could in fact help medical workers cope with circumstances in which they’re doing all they can to help but the patient suffers anyway. So dehumanisation is not always bad.

Second, and perhaps more importantly, the word ‘dehumanise’ and the attitude ‘dehumanise’ can and often do differ. For example, Union home minister Amit Shah calling Bangladeshi immigrants “termites” is not the same as a high-ranking doctor referring to his patient in terms of their disease, and this doctor is not the same as an overworked nurse referring to the people in her care as ‘cases’. The last two examples are progressively more forgivable because their use of the English language is more opportunistic, and the nurse in the last example may not intentionally dehumanise their patients if they knew what their words meant.

(The doctor didn’t: his example is based on a true story.)

Problematic attitudes often manifest most prominently as problematic words and labels but the use of a word alone wouldn’t imply a specific attitude in a country that has always had an uneasy relationship with the English language. Reporters and editors who carefully avoid potentially debilitating language as well as those who carefully use such language are both in the minority in India. Instead, my experiences as a journalist over eight years suggest the majority is composed of people who don’t know the language is a problem, who don’t have the time, energy and/or freedom to think about casual dehumanisation, and who don’t deserve to be blamed for something they don’t know they’re doing.

But by fixating on just words, and not the world of problems that gives rise to them, we risk interrogating and blaming the wrong causes. It would be fairer to expect journalists of, say, the The Guardian or the Washington Post to contemplate the relationship between language and thought if only because Western society harbours a deeper understanding of the healthcare system it originated, and exported to other parts of the world with its idiosyncrasies, and because native English speakers are likelier to properly understand the relationship between a word, its roots and its use in conversation.

On the other hand, non-native users of English – particularly non-fluent users – have no option but to use the words ‘case’, ‘burden’ and ‘infected’. The might actually prefer other words if:

  • They knew that (and/or had to accommodate their readers’ pickiness for whether) the word they used meant more than what they thought it did, or
  • They knew alternative words existed and were equally valid, or
  • They could confidently differentiate between a technical term and its most historically, socially, culturally and/or technically appropriate synonym.

But as it happens, these conditions are seldom met. In India, English is mostly reserved for communication; it’s not the language of thought for most people, especially most journalists, and certainly doesn’t hold anything more than a shard of mirror-glass to our societies and their social attitudes as they pertain to jargon. So as such, pointing to a reporter and asking them to say ‘persons infected with coronavirus’ instead of ‘case’ will magically reveal neither the difference between ‘case’ or ‘infected’ the scientific terms and ‘case’ or ‘infected’ the pejoratives nor the negotiated relationship between the use of ‘case’ and dehumanisation. And without elucidating the full breadth of these relationships, there is no way either doctors or reporters are going to modify their language simply because they were asked to – nor will their doing so, on the off chance, strike at the real threats.

On the other hand, there is bound to be an equally valid problem in terms of those who know how ‘case’ and ‘infected’ can be misused and who regularly read news reports whose use of English may or may not intend to dehumanise. Considering the strong possibility that the author may not know they’re using dehumanising language and are unlikely to be persuaded to write differently, those in the know have a corresponding responsibility to accommodate what is typically a case of the unknown unknowns and not ignorance or incompetence, and almost surely not malice.

This is also why I said reporters and editors might be stressed by their readers, rather their perspectives, and not on count of their language.


A final point: Harsh Vardhan, the Union health minister and utterer of the words “The Italian man infected 16 Italians”, and Amit Shah belong to the same party – a party that has habitually dehumanised Muslims, Dalits and immigrants as part of its nationalistic, xenophobic and communal narratives. More recently, the same party from its place at the Centre suspected a prominent research lab of weaponising the Nipah virus with help from foreign funds, and used this far-fetched possibility as an excuse to terminate the lab’s FCRA license.

So when Vardhan says ‘infected’, I reflexively, and nervously, double-check his statement for signs of ambiguity. I’m also anxious that if more Italian nationals touring India are infected by SARS-CoV-2 and the public healthcare system slips up on control measures, a wave of anti-Italian sentiment could follow.

Curious Bends – nuclear Himalayas, tiny Indians, renewables victory and more

1. 50 years ago a bomb’s worth of plutonium was lost on India’s second highest mountain. The mystery remains unanswered

“In October 1965, the US’ Central Intelligence Agency (CIA) and India’s Intelligence Bureau (IB) joined hands in a clandestine mission to install a nuclear-powered sensing device on the summit of India’s second highest peak, also one of its most revered: the 25,643ft (around 7815m) Nanda Devi in Uttarakhand’s Garhwal Himalayas.” Then they lost the plutonium-filled device. Fifty years later we still didn’t know where it is. (20 min read, livemint.com)

2. India’s preference for sons has created a nation of tiny people

“Indian children are among the shortest in the world, and the country’s preference for sons might be to blame. Globally, one in four children under the age of five is stunted—that is, they grew at a slower rate than a healthy child would. This stunting is manifest in shorter than average height. About half the stunted children live in Asia and another one-third live in Africa. India has the fifth-highest stunting rate in the world—nearly 40% of the children were stunted in 2005. This is a worrying proportion, even if you didn’t know that by 2020 India is projected to have the world’s youngest population.” (3 min read, qz.com)

3. The Ghanian puzzle: “Water, water, every where; not a clean drop to drink”

“Despite an abundance of water sources, most people in Ghana can’t simply turn a knob in the wall to get it. The water infrastructure in the country does not even come close to meeting demand; to call it patchwork would be an insult to quilts. Ghanaians have to balance their time, money and safety to determine where they will get a drink. Millions of them choose to get their water in 500-ml plastic sachets. And some of them get their sachets from Johnnie Water.” (25 min read, mosaicscience.com)

+ The author of this story, Shaun Raviv, is a freelance journalist. He’s “currently American, formerly Ghanaian and Swazi.”

4. The Indian government heavily subsidises private healthcare at the cost of public amenities

“Since medical insurance payments are tax-deductible, up to a quarter or more of the insurance premia that support the private corporate hospitals is probably claimed as a tax waiver. In other words, the government is paying Rs 6,000 crore for the sustenance of these corporate hospitals; those insured pay the rest. On top of this, state and local governments have provided land at subsidised rates to these hospitals, in return for free or subsidised treatment to poor patients, who were to account typically for a quarter of the total patients. There is no corporate hospital that has met its obligations on this score; in one infamous case, the hospital said it had promised free treatment but not a free bed or bed linen.” (3 min read, businessstandard.com)

5. Suicide will soon become India’s #1 killer

“On being asked whether he thought the government of India was doing enough for mental health problems in India, Patel told TOI “Nowhere near the need, witness the complete absence of public health approach to suicide for example”. An earlier research by professor Patel on suicides in India had thrown up shocking findings. Four of India’s southern states — Tamil Nadu, Andhra Pradesh, Karnakata and Kerala — that together constitute 22% of the country’s population were found to have recorded 42% of suicide deaths in men and 40% of self-inflicted fatalities in women in 2010.” (4 min read, timesofindia.com)

Chart of the Week

“The race for renewable energy has passed a turning point. The world is now adding more capacity for renewable power each year than coal, natural gas, and oil combined. And there’s no going back.” (bloomberg.com)

Capacity addition by energy sources, divided as fossil fuels and 'clean' energy.
Capacity addition by energy sources, divided as fossil fuels and ‘clean’ energy.