Jeyakumar Devaraj looks at why so many people in the US are turning their backs on scientific advice and what it means for the rest of the world.
The highly dysfunctional manner in which the US is handling Covid-19 can be perplexing, especially when it is increasingly clear that it is not just limited to the actions of the US president and his immediate team.
Images from Michigan and other states where ordinary citizens are clamouring for their rights to gather in groups, to celebrate mass services and to not wear face masks in public show that anti-science sentiment is fairly widespread among sections of the American public.
Rates of transmission
The facts about the epidemiology of Covid-19 are easy to understand.
If the virus is allowed to spread without any attempt to practise physical distancing and isolate those who are infected, each infected person will pass the infection to another three persons on average, ie the rate of transmission is three.
Given that the average incubation period is six days, this would mean that 100 cases on day zero will lead to 300 cases on day six, 900 cases on day 12, 2,700 cases on day 18, 8,100 on day 24 and 24,300 cases on day 30. If measures to disrupt the transmission are not implemented, we would get 218,700 cases by day 42.
However long before reaching this number, hospitals will be swamped by 15% of the cases who go into respiratory failure and require oxygen therapy. Hospitals will run short of acute care beds and personal protective equipment, and many staff will get infected. Clinical services will collapse, and bodies will pile up in morgues.
This is not unfounded speculation. We all saw it happening in Wuhan, Spain, Italy, London and in New York. That’s the nature of this beast!
The US is nowhere near “herd immunity”.
Studies in New York have revealed that about 24% of the people of New York City have the antibodies for Covid-19. New York City achieved that level of immunity after going through six harrowing weeks that saw more than 700 fatalities a day at its peak.
But that level of immunity will still not protect them from another wave of infection if they relax their lockdown too quickly. The rate of transmission for New York City will be 2.28 if they do not take active steps to reduce transmission (3 x 0.76 = 2.28).
A rate of transmission of below 1.0 would mean that the number of new cases will decrease. A rate of more than 1.0 will witness a rising number of new cases at a compounded rate. It would take an antibody prevalence level of 70% to confer herd immunity to a community (ie when the rate of transmission is 3 x 0.3 = 0.9).
Some upstate districts of New York have an antibody prevalence rates of about 5%. This lower rate is probably similar to the situation in most other states in the US.
The rash decisions being taken in many US states to open up the economy before the epidemic is brought under proper control will cause a huge spike in cases and a tremendous amount of human suffering.
The US already has 1,691,229 diagnosed cases (30.5% of the world total) and 99,398 deaths (28.6% of the world total) despite comprising only 4.3% of the world population. It will find out painfully that you cannot control an infectious epidemic through bluster, fake news, blaming others and exhorting the population to return to normal activities.
All the US states now opening up in a gung-ho fashion will have to declare lockdowns eventually as that is the only proven way of disrupting transmission and bringing down the rate of transmission to below one.
All the other solutions being touted – summer sunshine and hydroxychloroquine – are highly speculative, and there is no evidence that they can bring down the rate of transmission.
Why the rejection of scientific advice?
The wilful rejection of scientific advice on such a large scale among the American public cannot be attributed solely to rugged American individualism. It is a sociological phenomenon that has a societal cause.
My take is that the American middle and working classes have become very mistrustful of their political elite. This elite class has, over the past 30 years, put the US on a path that has seen many well-paying secure jobs moving to overseas destinations and factories closing all over the country.
Labour has become casualised, and with that, incomes for the bottom 70% of the population have stagnated despite vast increases in wealth for the top 15%. Debt levels for households and students have risen; so too financial insecurity.
These trends have continued under both Republican and Democratic governments. Policies responsible for these trends include free trade agreements such as the North American Free Trade Agreement (Nafta), the progressive lowering of corporate taxes and the liberalisation of financial markets. Academics and experts who appear in various TV talk shows have supported such policies as the best way to preserve the American way of life.
As the saying goes, “You can’t fool all the people all the time.” Significant sections of the American public have concluded that the elite – political, economic and the Ivy League school-educated intelligentsia – are lying to them and ripping them off. Their quality of life has deteriorated and their daily life has grown increasingly precarious, but the elites are living in luxury.
This is the emotive force behind the anti-science, post-truth stance shown by so many. It is a rebellion against the status quo – somewhat like the “Malu apa, bossku” (What’s there to be ashamed of, boss) phenomenon we see in Malaysia.
Trump is not the engineer of this sentiment, but he is riding it. The stinging criticism of Trump by mainstream media and academicians actually enhances the support he receives from this section of the public. These people feel deeply that the system has failed them and that the political and academic elites are a bunch of self-serving crooks.
Interestingly enough, this anti-science sentiment is not as pronounced in certain states. People in New York, for example, seem willing to go along with the lockdown there. That might be partly because of the high rate of Covid-19 infections there: people can see their lives are at risk and something had to be done.
Moreover, New York Governor Andrew Cuomo is taking efforts to explain painstakingly various aspects of the responses by the state authorities and the reasons these are being taken. This approach has played a big role in winning over sceptics and ensuring broad-based support for a scientific approach to handling the Covid-19 crisis in the state. New York has inflected the curve downwards, and leaders are now talking about a phased re-opening of the economy.
Should we be concerned?
Should the rest of the world be concerned that America is lurching towards a monumental health disaster? Yes, for three reasons.
First, the world is so interconnected today that no part of the world can be safe if the epidemic is not brought under control everywhere. The second wave that is incubating in the US can re-seed the infection back to countries that have “flattened the curve”, if these countries are silly enough to lift travel restrictions too rapidly.
Second, the US accounts for about 24% of global gross domestic product (GDP). The huge negative impact of a poorly controlled epidemic on the US economy will depress global aggregate demand for the rest of 2020 and prolong and deepen the recession that is unfolding.
Third, a wounded tiger is most dangerous, especially when it has the largest military force on the planet. The US president and his team are trying to deflect blame onto China, and large sections of the American public seem to be falling for this ploy. The US is also taking a more belligerent stance towards Iran, Venezuela and nuclear arms control. So, there is a danger of military interventions by the US in the next one year.
The US descent into “post-truth” should serve as a warning for those of us who believe rationality and science should be the basis for plans to develop our country.
If we, the intelligentsia in Malaysia, fail to connect with the ordinary people; if we fail to use science and rationality to tackle the real problems they are facing; if we instead sell our intellectual and professional services to the corporate elite; if we promote economic activities that widen the income gap, reduce social support networks, and make the lives of ordinary Malaysians more precarious; then our post-truth moment cannot be too far away.