In early April an article co-authored by Zachary Barnett-Howell and Ahmed Mushfiq Mobarak, emerged on ‘The benefits and costs of social distancing in rich and poor countries.’ The study was readily taken up by many in the industry, evidently including Pakistan’s planning minister, to argue against the COVID-19 lockdown in Pakistan. The study deploys some standard economic measuring and modelling methodologies to argue that strict lockdowns in poorer countries cost more than the benefit of saved lives, because people ‘face mortality risks, whether from disease or as a result of their occupation, and individuals may accept these risks willingly when appropriately compensated’. They use the standard methodology of value of statistical life (VSL) to put a dollar value to lives saved and argue that the benefits of lives saved in poorer countries are far outweighed by the economic costs of social distancing etc. They helpfully explain the VSL as follows:
A recent example is the strike by Instacart workers in the United States during this pandemic, who are demanding an additional $5 in hazard pay per order as compensation for their increased exposure to the disease (Olson and Anderson, 2020). The VSL adds up these probabilistic risks to estimate the monetary value that people in a given country assign to saving one of these statistical lives (p. 5).
In academia, we are used to such reasoning by economists and have learned to ignore them. We are also mindful that the rest of the world listens to them, and no-one listens to us geographers, which is fine by us. For us geographers, it is obviously ludicrous to base our argument on the grocery workers’ ‘willingness’ to value their lives and health at $5. Messers Barnett-Howell and Mobarak too, thoughtfully concede that the working poor’s willingness to accept $5 for greater risk, for example ‘may be due to necessity rather than choice’ (p6). You think?
That their argument is fatally unsound is not something that I have to rehearse here. Khurram Husain and many others have done a better of job of it than I can. The important point is that Barnett-Howell and Mobarak are not doing anything weird. They are sharing with us one of the finest examples of economistic thinking, and quantitative method, in which they are trained. The ones’ lapping up their wisdom are not stupid either. Their thoughts and actions are also consistent with the way they were produced. As neo-liberal, consumerist subjects, who can imagine the end of the world, but not of capitalism. I have also talked about the capitalist underpinnings of the debate for and against lockdowns in this publication, and those too don’t bear repeating here. What I do want to bring about is what different perspectives, especially geography can bring to the debate in the face of COVID-19 pandemic.
It is a truism to state that economics is not the only social science. Just as high medicine of hospitals and ventilators is not the only type of medical knowledge and practice. COVID-19 in the absence of a treatment is fundamentally a public health issue. And public health and community medicine practitioners often have vastly different skills and thinking from their standard MBBS and classified specialists. While the later are well, really technicians of the body, public health people are the social scientists and thinkers. As a hazards geographer I find myself often in agreement with them, and Dr Vikram Patel is one such public health practitioner. He rightly argues, as we geographers have for the past 3 decades that, the cardinal principles of any public health, or hazards intervention are: that context matters and equity and justice are paramount.
As a geographer, I have always been impressed by the Kerala and Cuba models of hazards response. Those models are based upon community level penetration of public health workers and community activists. These activists can be a source of educating, insuring compliance, buy in, services, relief, recovery and legitimation of hazard response or public health interventions. Sadly, left with a centralised and militarised legacy of colonialism, in most of the global South, especially Pakistan, the premium is upon centralised decision making by politician and then military and civilian bureaucrats. The imposing name of our key ‘National Command and Operations Centre’, should be revelatory enough of the militarist thinking and masculinity at play there.
Geographical approach to COVID-19 hazard would be spatially and socially differentiated. In case of Pakistan lockdown protocols would be differentiated between low density rural and high density urban areas. Restrictions would be differentiated between more solitary or outdoor activities, e.g., agriculture, landscaping, mobile vending and more group indoor activities, e.g., proselytising, trading, office work, manufacturing etc.
Equally, maximum autonomy would be given to federating units and local government (after resurrecting them) to take decisions most appropriate for the contexts in which they operate, with the provincial and federal governments providing technical and financial assistance. This, what I call the problem solving approach would not be worried about corruption, but more about legitimacy, public consent and delivery.
Lest one should think that I am biased against economists, I shall end with a quote from an economist friend, Fawad Khan, to show that they too can talk sense, from time to time:
Most of the mortalities [from COVID-19] are because of the additional effect of corona on pre-existing conditions such as malnutrition, obesity, sugar, hypertension, coronary heart disease etc. [To have the world’s healthiest population in Sweden are] good reasons to celebrate a policy of putting human life and health as a top priority in public policy and economic factors such as stock market valuation. But those of us [e.g., in Pakistan] who have not done that, do not share that luxury both in the developed and underdeveloped world, so we must pay for those mistakes, no matter which difficult policy we adopt now. Health over wealth, or death over livelihood which is disguised as death = bhook (hunger) over employment. It’s too late to choose now because we made those choices a long time back. But corona has been a reset button where we have a choice to stick with the priorities that got us to the point we are at. Or be like Sweden and put life before wealth.