A global health crisis? No, something far worse

Lun, 05/04/2020 - 13:53 -- anegrete

Every evening we scour those graphs looking for signs that the epidemic is in retreat. New cases of coronavirus disease 2019 (COVID-19). People in hospital with COVID-19. Critical care beds with COVID-19 patients. Daily COVID-19 deaths in hospital. And then the final and bluntly worded “global death comparison”. Those with responsibility for leading us through this emergency have called it “a once in a century global health crisis”. This statement is incorrect on two grounds. First, because we cannot know what the rest of the century will bring. It is highly probable that this current pandemic will be neither the last nor the worst global health crisis of the present century. But second, and more importantly, this global calamity is not a crisis concerning health. It is a crisis about life itself. We have been tempted in recent years to assume the omnipotence of our species. The idea of the Anthropocene places human activity as the dominant influence on the future of life on our planet. Although this newest of geological eras is supposed to underline the harm our species is doing to fragile planetary systems, paradoxically it also asserts our supremacy. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has revealed the hubris of this view. Our species has many reasons to be self-critical about the effects of our way of life on planetary sustainability. But we are only one species among many, and we are certainly not a dominant influence when faced with a virus that can destroy life with such ease and facility.

If this pandemic is a crisis about life itself, what tentative conclusions might we draw from its effects so far on human society? Some clues will be found in Didier Fassin’s Life: A Critical User’s Manual (2018). Fassin studied medicine in Paris before turning to public health and anthropology. His starting point is the awareness we must all have for the unequal lives around us. That observation invites us to reflect on the value we attach to human life. In trying to answer that question, we somehow have to reconcile “life as a fact of nature and as a fact of experience”. We can view COVID-19 as a biological challenge to understand, treat, and prevent. But we should also understand it as a biographical event in the lives of millions of people. Fassin divides his inquiry into inequality into three parts. First, he identifies forms of life, by which he means “ways of being in the world”. The daily insecurities faced by so many of our fellow citizens draw attention to “the predicament of contemporary democracies, incapable of living up to the principles that constitute the foundation of their very existence”. Second, he discusses an ethics of life. He contrasts the rising legitimacy of those who have a biologically defined disease with the declining legitimacy of lives lived in a particular social setting (such as one of poverty). The physical has prevailed over the political. Fassin calls this ethical trend one of “biolegitimacy”—a legitimacy of life defined in biological terms. Life is reduced purely to its physical expression. There is no room for understanding the political conditions within which life exists. There is no possibility to mobilise public sentiment to defend threats to political lives, lives marked by, for example, inequality. SARS-CoV-2 preferentially afflicts those who are more vulnerable, less well rewarded, and more invisible to those with power. Third, Fassin focuses on the politics of life, the government of populations, and the effects of politics on human lives. He is interested in how the actions of political regimes differentially influence human lives and reinforce the unequal worth of some of those lives in society. The “politics of life”, he writes, “are always politics of inequality”.

So what must we say? We must say that it is our task to uncover the biographies of those who have lived and died with COVID-19. It is our task to resist the biologicalisation of this disease and instead to insist on a social and political critique of COVID-19. It is our task to understand what this disease means to the lives of those it has afflicted and to use that understanding not only to change our perspective on the world but also to change the world itself. As Fassin concludes, our “critique does not have to choose between militancy and lucidity”

Tema de investigación: 
Crisis económica