Handling COVID-19 pandemic: Perspectives from context, social justice & equity, indigeneity & traditions and philosophy

Photo by CDC

The ongoing pandemic of SARS-CoV-2 has affected 77.3 million lives and claimed more than 1.7 million lives, at the time of writing this report. (JHU CSSE) Declared as a Public Health Emergency of International Concern in January 2020 and a Pandemic in March 2020, by WHO, it has ravaged the socioeconomic fabric of usual life. Resulting in one of the deepest recessions since the Great Depression, it is set to leave long lasting scars with major global challenges. (World Bank) Risk of debt crises looms in countries with weaker financial metrics. (The Guardian) The poor and vulnerable sections of society are disproportionately affected by disruptions which have wreaked havoc on livelihoods and social safety nets. (UN News) Abrupt shift to online mode of education has affected learning outcomes for learners exposed to digital divide. (Wired) Supply chain shocks resulted in inconvenient or impossible access of essentials for households. (World Bank) Widespread misinformation created chaos for efficient management of the pandemic. (Johns Hopkins Medicine) Xenophobia reignited fault lines of the society which demagogues exploited for political advantage. (NYT) For the good, emissions levels of greenhouse gases and pollutants plummeted consequent to ‘anthropause.’ (Rutz et al. 2020) The pandemic has ushered in ‘a new normal’ in which life catapults to a reality of posthumanism. (TechCrunch)

As a response to the pandemic, combat measures of various shades have been initiated for adaptation and mitigation across the swathes of the globe. WHO has played a phenomenal role in coordinating efforts by issuing public advisory, scientific briefs and situation reports. In this essay, perspectives from combat measures with the themes of context, social justice & equity, and indigeneity & traditions, are discussed. A closer look at the Indian scenario is taken to understand what is going on closer home. Towards the end, a seminal text of philosophy is highlighted which can be a guiding light to understand the depth of the matter.

The suspected origin of coronavirus is from the wetmarkets of Wuhan - through zoonotic transmission from bats and/or pangolins to humans. Infamous for selling wild animals, the wet markets are considered as an “everyday destination for many Chinese people.” (WEF) They play an important role in the production of Traditional Chinese Medicine. Closure of wet markets have deeply embedded socioeconomic and political dimensions - as it affects the lives and livelihoods of hundreds who depend on it. Despite infection risks and violation of animal rights, the wet markets flourish in Wuhan as business as usual. (Reuters) International pressures of banning wet markets and their practices has been questioned on grounds of racial prejudice - of targeting Asian cuisine. It is noteworthy to add that wet markets are not unique to China, they thrive in many other countries. (Huffington Post)

The nature of the spread of coronavirus is such that it raises many eyebrows. Rich nations are disproportionately affected by the pandemic in terms of deaths per million. (The Economist) However, when it comes to resilience of the economy, the poorer nations suffered more. (BBC) The pandemic exacerbated the vulnerabilities of pre existing inequalities of gender, generation, race etc. through its unequal impact. Has the response to the spread of coronavirus taken into account such widespread inequities? An article in The Lancet by Cash & Patel, takes an insightful take on it by questioning the one size fits all approach of the lockdowns and social distancing norms in India. It argues that excessive focus on sophisticated tertiary care and technological measures might have done more harm than good. Every nation has distinct population structure, public health needs, healthcare resources, forms of governance, inequities, fiscal resilience etc. As such, adoption of a blanket approach by the nations to combat coronavirus only reflects the colonial mentality of the dispensation. A stronger response to the pandemic could have been more cognizant of the context and circumstances of the nation, and harnessed “home-grown expertise, grassroots experience and community resources.”

However, it would be wrong to assume that India did not orient its approach in accordance with its own realities. The Ministry of AYUSH released guidelines for preventive healthcare measures and boosting immunity supported by Ayurvedic, Homeopathy and Unani research in the wake of the pandemic. (PIB) Products like chyawanprash and Patanjali’s Coronil saw high demand. (The Hindu) Gomutra pills and panchgavya (a mixture of five cow products curd, ghee, milk, dung, and urine) obtained clinical trials approval under the Clinical Trials Registry-India (CTRI), a registry maintained by the Indian Council of Medical Research (ICMR). (The Print) ‘Cowpathy’ has been extensively promoted with the landmark research proposal SUTRA-PIC (Scientific Utilization through Research Augmentation-Prime Products from Indigenous Cows) floated by DBT. (Somatosphere) It is noteworthy to highlight that ‘mainstreaming’ of AYUSH is an important mandate of National Rural Health Mission to help solve the human resource shortage in Indian healthcare, as doctor-patient ratio in India is less than the WHO-prescribed limit of 1:1000, particularly in rural areas. (NHSRC, MoHFW) Despite significant strides in making a difference to millions of lives, AYUSH has drawn flak for being “pseudosciences being pushed by BJP politicians.” (Foreign Policy) A comment by Gopichandran et al. suggests the following ethical issues to be considered while mainstreaming AYUSH: doing good, doing no harm, truth telling, informed choice, mutual respect and trust, public accountability, and social justice. (IJME)

Contradictions become problematic in the absence of a coherent philosophy of medicine. Claims to universality need to be seen in the light of the conflicting tensions of medicine divining the body and philosophy the intellect. The normative approach be defined through medicine prescribing the right conduct of the body and philosophy the conduct of the social and political life. A conscious balancing calls for both - technicism of medicine and detachment of philosophy. Has modern medicine become distrustful of philosophical intrusion? Traditional metaphysics of purpose, value, meaning and mode of human existence commands critical reflection. Complexities and absurdities of being human cannot be understood with logic, epistemology and causality alone. A true dialogue must consider the nexus of values, choice and priorities. Medical praxis exist in a social milieu. Critical reflection, dialectical reasoning, uncovering of value and purpose, asking first-order questions to problems - these allow better grasp of ethics of medicine. (Pellegrino 1976)

References:

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Global Economic Prospects, June 2020. (2020, June 8). World Bank. https://www.worldbank.org/en/news/press-release/2020/06/08/covid-19-to-plunge-global-economy-into-worst-recession-since-world-war-ii

Stiglitz, J. (2020, August 3). A global debt crisis is looming – how can we prevent it? The Guardian. https://www.theguardian.com/business/2020/aug/03/global-debt-crisis-relief-coronavirus-pandemic

Impacts of COVID-19 disproportionately affect poor and vulnerable: UN. (2020, July 2). UN News. https://news.un.org/en/story/2020/06/1067502

Ceres, P. (2020, August 8). A ‘Covid Slide’ Could Widen the Digital Divide for Students. Wired. https://www.wired.com/story/schools-digital-divide-remote-learning/

Food Security and COVID-19. (2020). World Bank. https://www.worldbank.org/en/topic/agriculture/brief/food-security-and-covid-19

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