Cassandra Voices

Category: Science & Environment

  • Covid-19: The Perfect Storm

    Paying the piper?

    When a researcher publishes a research paper he or she is obliged to state clearly any funding source. The reasons for this are entirely obvious. Most ‘bad’, ‘faulty’, or ‘unreliable’ research is tainted by the interests of those who have provided financial support.

    There is nothing new in any of this, and scientific literature is replete with examples – from the use of Thalidimode for morning sickness to Andrew Wakefield linking the MMR vaccine to autism etc. – of bad or biased science. That is not to say necessarily that a scientist or expert offering scientific guidance has been influenced by the overt or covert desires of his sponsors; however, to preserve impartiality he must declare any sponsors before ‘expert’ or ‘scientific’ conclusions are tendered.

    Unfortunately, the same rigorous insistence on transparency in respect of funding does not extend to appearances on TV or Radio. Thus, if an ‘expert’ appears to promote a particular therapy, vaccination, or social behaviour, he is not obliged to declare a vested interests or private sponsorship.

    It falls to the media source itself – the newspaper or interviewer – to ascertain the affiliations or funding of a particular ‘expert,’ either prior to or during the delivery of scientific conclusions or guidance. This process is integral to maintaining ethical standards within journalism. It is particularly incumbent upon-state funded media, whose income is derived from mandatory licence fees that such standards are not compromised. Without this the general populace could find itself following faulty advice or guidelines to the advantage of ‘he who pays the piper.’

    This is precisely the dark territory we have entered in respect of public health guidelines on masks, lockdowns and vaccinations in response to Covid-19.

    Obligatory Mask-Wearing

    The Irish government has recently made it compulsory to wear surgical face masks on all public transport and inside shops.[i] If a person refuses to comply, without providing a ‘valid’ medical reason, he or she faces a fine of €2500, or a prison sentence of up to six months. The Gardai are to police the validity of such medical reasons. The ethics of a law requiring a Garda to question a member of the public on his or her medical condition in a public places has yet to be discussed in a meaningful manner, despite the clear infringement on an individual’s constitutional right to privacy.

    In respect of masks, there are indeed many strong counterarguments, drawn from respectable scientific literature,[ii] against the anti-viral efficacy of masks, the safety of prolonged mask use; besides the social division they create, pitting advocates on both sides against one another.

    Indeed, the near pointless nature of mask-wearing has been pointed out to the Oireachtas by its own commissioned expert witness: Professor Carl Heneghan director of University of Oxford’s Centre for Evidence-Based Medicine.

    Cloth masks are likely to do more harm than good, as it has been stated in many sources that viral particles are so small that the protection offered by most masks is analogous to ‘keeping flies off ones property with a chain-link fence.’ The plastic welder type face shield, in vogue among hotel staff, can reasonably be described as ridiculous in terms of its potential to protect against this virus, or anything at all for that matter. They are, like most masks, little more than a placebo.

    Masks afford wearers the delusion of protection. If one wishes to become aware of the appropriate attire to wear to effectively limit transmission of an aerosol or airborne virus from one person to another, there are plenty of images available online showing what ‘medical-grade’ protective attire and masks looks like.

    Hazmat suit.

    The serious question then arises; ‘when will the population be released from an obligation to wear masks?’

    There is no disputing that Covid-19 remains in circulation in Ireland: cases are detected daily and a small number of deaths continue to be reported. There are reasonable concerns that there will be an uptick in cases during the winter months. Historically, coronaviruses cause 30-40% of the common cold which peaks in winter and ‘dies off’ in the summer months. The natural history of coronaviruses is extensively described in the literature.

    I suspect the mandatory wearing of masks among the general public is motivated by two quasi-political aims. The first is to distract from what is best described as the ‘incompetent manslaughter’ of several hundred elderly care home residents at the height of the crisis.[iii] Secondly, to pave the way for mandatory vaccinations, the legal case for which has already been set out by Sarah Fulham-McQuillan, Assistant Professor in UCD’s Sutherland School of Law,[iv] despite such an intervention not even existing. Such an unprecedented law would obviously be to the direct financial benefit of select pharmaceutical companies.

    Therefore, the end game for public mask wearing, the ‘get out of jail card’, or release from the ’duty to mask’ has little to do with the mask itself, which in practical terms is little more than more symbolic; informing or even indoctrinating  an awareness of the ‘danger’ of the virus. The public can only stop wearing masks once the virus is no longer circulating in society. The only mechanism by which it can disappear is through the development of immunity within most of the population.

    Mandatory masks imply ‘mandatory’ protection for elderly vulnerable people and for young, healthy, non-vulnerable alike. Yet young healthy people have practically nothing to fear from Covid-19, again this is repeatedly cited in almost all available literature. Therefore, when the majority of healthy people within society are ‘protected’ from exposure by masks they are compelled to be protected from developing a natural-immunity through an otherwise natural exposure to the virus. This crucial point has been missing from the non-existent debate in the Irish media on the issue of mask wearing.

    When the state makes mask-wearing mandatory, the state has formally rejected natural-immunity among the non-vulnerable.

    When the State rejects ‘natural-immunity,’ indeed when it wilfully or legislatively deprives the non-vulnerable individual of opportunities to acquire natural immunity, the State is then compelled to adopt the only alternative to natural-immunity, and that ‘only alternative’ is a vaccine.

    We can assume that the lockdown and ongoing prohibitions on large social gatherings and social distancing have worked to an extent – albeit perversely not for the most vulnerable – and that those measures have ‘protected’ healthy young people. This means that only a low number of people have been exposed to the virus across society. This point is apparently confirmed by antibody surveys, showing that less than 5% of the population had antibodies,[v] although this survey was not extensive, and antibodies appear to fade rapidly in persons with mild Covid-19,[vi] which gives way to other forms of immunity.[vii]

    Thus, if the only means of eradicating the virus is reaching a herd immunity threshold – assuming we do not reach zero Covid and hermetically seal our borders indefinitely in a new Tír na nÓg – it follows then that the majority of society must eventually be vaccinated in order to achieve immunity. Given that masks have been mandated, it is entirely consistent with government policy that the ‘eagerly’ awaited vaccine must also be mandated.

    Warp Speed

    Perhaps the foremost expert who has been advocating compulsory mask-wearing in the general public has been Professor Luke O’Neill, a Trinity College biochemist, and head of its immunology department. Professor O’Neill is not a Medical Doctor, nor has he a qualification in public health or epidemiology. Most recently he has been to the fore in insisting mandatory masks should be extended to secondary school students.

    As an advocate of compulsory mask wearing, it follows that Professor O’Neill should be a proponent of a universally administered Covid-19 vaccine. Notably, Professor O’Neill’s Twitter feed has included enthusiastic countdowns for the vaccine being rushed through clinical trials at ‘warp speed.’[viii]

    There is nothing new here, and nothing is being uncovered or exposed. Professor O’Neill’s position is neither unusual nor indeed unreasonable. It is entirely expected. Any proponent of universal mask-wearing cannot avoid being a proponent of vaccination as the means of escaping the imposition of the mask – universal vaccination is the only escape from the universal mask.

    The relevant question may be whether Professor O’Neill is a proponent of compulsory masks because compulsory masks may only be escaped via compulsory vaccination?

    The subtle shift, lost on many, is that the current measures have transformed the positive anticipation of a vaccination for those at risk, into a formal obligation for universal vaccination.

    Mask wearers (in theory at least) remain ‘potential hosts’ for Covid-19; natural internal immunity having been officially avoided; immunity can only come from the pharmaceutical industry. Failing to make this connection is a failure of simple logic.

    If universal vaccination is the logical conclusion of mask-wearing, and if indeed members of the public are threatened with jail if they fail to comply; it would seem entirely reasonable to establish any potential conflicts of interest that might exist between any scientific proponents of masks, and the manufacturers of a vaccine, very likely to be compulsory for all; a proposal also mooted in other jurisdictions.

    One does not wish to focus upon Professor O’Neill unduly; however, as he has been perhaps the most publicly visible scientist to promote masks for all it is not unreasonable to examine his relationship with vaccine manufacturers, and operation ‘warp-speed’.

    Sitryx

    In 2018 Professor O’Neill, along with five others[ix], founded a private biotech firm called Sitryx. The company develops therapeutic agents that modulate the immune system. Agents that modulate the immune system or immune response, are essential ingredients to many if not most vaccines available on the market today.[x] It is therefore unsurprising to learn that the largest investors in Prof O’Neill’s firm are indeed vaccine manufacturers.

    GlaxoSmithKline[xi] and Lilly Pharmeceuticals[xii] Sitryx’s biggest sponsors, are currently developing potential vaccines for Covid-19. GSK has invested some $30 million into Sitryx[xiii], and also provided Professor O’Neill with a laboratory and assistants to facilitate his research. All of this information is in the public domain, and indeed is published on Sitryx’s own website:

    Sitryx was founded in 2018 with seed funding from SV Health Investors and raised $30 million Series A funding from an international syndicate of specialist investors including SV Health Investors, Sofinnova Partners, Longwood Fund and GSK. In 2020 Sitryx formed an exclusive global licensing and research collaboration with Eli Lilly and Company. Lilly also became an investor in the company.[xiv]

    What we can at least say is that a cautionary approach to vaccination would be antagonistic to Sitryx’s primary funders. Whilst mandatory vaccination could result in a transfer of enormous tax revenues into the coffers of those companies fortunate enough to win the ‘race’ for the vaccine.

    It is interesting to note that at the outset of the crisis, Professor O’Neill was interviewed on the Late Late Show. At that time he declared that masks were ‘pointless’, if not ‘dangerous’. He described the new coronavirus as an “evil virus” that could get into people’s bodies “through their eyes.” When asked why he thought people were wearing them he replied good humouredly they had watched “too many horror movies”.

    Strangely, however, within a matter of weeks the good professor had entirely changed his mind on the issue and continues to assert that masks are indeed entirely essential and should be mandated for almost everyone.

    Through no fault of his own, Professor O’Neill’s potential conflict of interest has been wilfully ignored in the national and mainstream media. To my knowledge, he has not once been asked about the relationship between his biotech company, and his sponsors at GSK or Lilly pharmaceuticals, having appeared on almost every talk show on radio and television in the land.

    An Alternative?

    Partiality towards the bio-tech agenda and public health guidance, might be in the public interest, if masks and subsequent vaccine were in fact the only option available. The general public have been led to believe that mask wearing regulations are ‘for the greater good’, and that those who object are reckless, anarchic, or simply ignorant.

    https://twitter.com/DonnellyStephen/status/1293973649683288070

    They are not. Mask-wearing policies differ across Europe, mandatory in some countries optional in others. Most Scandinavian countries have resisted the compulsion to the extent that is seen elsewhere. Norway only recommended their use on August 14th whilst using public transport in and around the capital Oslo.[xv]

    Throughout the pandemic the Swedish approach has been far less draconian than in most European countries, permitting (without encouraging) it’s healthy non-vulnerable citizens to be exposed to the virus within the community setting, and thereby developing natural immunity, a policy that is somewhat in keeping with the natural cycle of viral colds and flues. This takes advantage of natural processes to encourage its natural extinction or diminished severity.

    This reduces the potential hosts within society and the attendant risk of the virus spreading to vulnerable or elderly communities. In the face of widespread international criticism[xvi] the country has persisted with the closest model to the much maligned notion of ‘herd immunity.’ Recently the UK press, including the Financial Times[xvii] and Daily Telegraph[xviii], have awoken to the relative success of the Swedish approach, media sources are increasingly joining the ranks of the ‘converted’.

    The same model that the UK initially opted for, but later dismissed based on defective modelling from Imperial College, which suggested that a ‘herd immunity’ approach would lead to half a million deaths in the UK,[xix] a model that has since been shown to have been deeply flawed, and based on flawed epidemiology.[xx]

    The Swedish approach by avoiding compulsory mask-wearing is not entirely dependent upon universal vaccination as their only ‘end game’. That is not to say that the Swedes will avoid or decline a vaccine when or if it arrives on the market; it is merely that their approach is not locked-into a vaccine as the principal source of immunity for the population. The Swedes have maintained the right to ‘opt’ for a mask and, as such, and have preserved the right to ‘opt’ for a vaccine too.

    Regardless of what a country may choose in respect of vaccination, the Swedes will certainly have more of a ‘choice’ relative to those countries that continue to more actively avoid exposure among their healthy non-vulnerable citizens.

    Social Division

    The recent transformation of many aspects of the external environment, into something of a hospital ward, through the wearing of masks by many, and avoidance by many more, is certainly a new departure in the social habits for most people in Ireland and beyond.

    Many are under the impression that mask wearing either in public, in shops or on public transport, is not simply ‘a good idea’ but integral to saving lives. Battle lines have been drawn between the ‘sensible’, and the ‘reckless’.

    The state and national media are on the side of the ostensibly sensible, and mainstream media is presently flooded with a positive insistence upon masks. Regardless of the government’s insistence, and the concurrence of mainstream media, large numbers of people refuse to comply, and social division is apparent on the streets, among neighbours and even within families.

    This division is a consequence of government policy, and that policy is not based upon any agreed international standard. Interestingly, however, there is little evidence of debate on the subject. This lack of dialogue, and indeed the active suppression of views contradicting the official line, is a very worrying development within a supposedly democratic society, where a diverse range of opinions should be heard.

    The present social policy of mandating compliance is a difficult road to navigate without infringing human rights, as members of the public who choose not to wear a mask must disclose their most intimate and private medical details to members of An Garda Síochana in public places, if they are to avoid arrest, fines or imprisonment.

    In the recent past an individual’s personal medical details were entirely private and a doctor might be struck off the medical register or sued for sharing this information, without informed consent. Under the current emergency legislation a member of the Gardaí must elicit a quasi-medical history from a non-mask wearer and be satisfied as to its reliability if the non-mask wearer is to avoid arrest. Inalienable human rights to privacy, have been entirely brushed aside.

    Unfortunately the consequence of current policy is leading to what might be described as the most divisive situation in Ireland since the civil war. There are those who believe that they are ‘saving lives’; their own, their countrymen and the vulnerable. Opponents believe that wearing a mask is harmful to one’s health, will do nothing to save lives and that there are sinister, political and even corporate motives behind the directives.

    Each side of the divide is ostensibly concerned about public welfare. However, those conforming to the narrative are generally presumed correct, whilst nonconformists are readily dismissed as wearing ‘tinfoil-hats’, or being conspiracy theorists, or even ‘anti-vaxxers.’

    Presently, the division within society is only simmering. There have been occasional incidences of angry exchanges between both sides, yet these are mostly confined to the zones where mask wearing and other guidelines are compulsory; public transport, and social settings where other guidelines such as social distancing within pubs, restaurants or social venues also apply.

    https://twitter.com/IrishInquiry/status/1294238059949678592

    For most of us, wearing a mask on the bus, in the shops, or having the local publican issue a dodgy food receipt so that we can have a pint without fear of being arrested, may not be insurmountable limitations. If we are compliant we are unlikely to be questioning the guidelines, and will be looking forward to a return to normality. Fortunately, for the government it is difficult to look forwards and backwards at the same time. Sure enough, dialogue pertaining to mistakes, missed screenings, deaths in nursing homes etc. are all rather conveniently eclipsed by the current political mask wearing debate. It might be argued that there is indeed a malevolent purpose to this.

    If a division erupts into violence or aggression, the parties involved are generally on the extremist fringes of either side of the divide. This is unlikely to remain the case.

    I believe we have been led here by motives that are not in the interests of the greater public. The social division that is being fostered, may (for the present time) be manifest only at the level of ‘wearing the jersey’ and shouting up for one’s team. Yet this relatively benign manifestation is likely to evolve into a more sinister version of itself. This is perhaps inevitable as the associated stresses upon either side will undoubtedly increase in the coming months.

    Second Wave?

    At the time of writing deaths from Covid-19 have declined to almost nothing in Ireland and throughout most of Europe. The question that is in most people’s mind is whether or not this decline will continue throughout the autumn and winter months?

    Covid-19 is member of the coronavirus family, responsible for some 30-40% of the yearly or seasonal ‘colds’ that affect almost all nations.[xxi] With it still circulating, we can expect a seasonal increase in cases in the coming months. Our normal or historical experience with the cold and flu viruses each year sees their arrival some time in Autumn, peaking around March or April, and then waning before generally expiring in late Spring or early Summer.

    There are two significant factors influencing this process. The first being the natural immunity that develops within society as most people are exposed to and recover from the cold virus. The second factor being the increase in the length of daylight and the effects of daylight (UV-light) upon aerosols, droplets or viral particles on external surfaces. There is nothing new in any of these assertions, which are basic tenets of microbiological science.

    Therefore, we can conclude, that as the virus is still here, and as the measures to date have been moderately effective in preventing a build-up in natural-immunity within the population, as the days shorten, a resurgence seems inevitable.

    Stress and Disease

    In my twenty years of experience as a physician I have noted what many doctors have observed since the dawn of medicine itself. This is the simple empirical truth that psychological stress is a major factor in the subjective evolution or pathogenesis of ALL disease. This truism applies more for some diseases, less in others, but is indeed true for all disease. In many cases psychological stress is the sole factor that pushes the generally tolerable symptoms of minor illness, firmly and definitively into the realm of significant pathology. Indeed, the NHS advise that loneliness can make the symptoms of a cold virus feel worse.[xxii]

    Today, the language of psychological and emotional pain has been almost entirely medicalised. Now when one is talking about one’s ‘medical’ illness or one’s ‘diagnosis’, it takes the skill of a competent psychoanalyst to uncover the subjective psychological truths that invariably unite one’s medical ‘pain’ to a deeper insecurity – its emotional or psychological fountainhead. The process is an introspective one, and nowadays most of us are cut off from making these connections.

    For some it may be a simple lack of emotional-intelligence, for many more it is simply easier to run with the medical diagnosis, and just take the pill.

    I am not asserting that pain is ‘caused’ by emotion or psychology. It is not; it is caused by disease. However, emotion or psychology will determine the tolerability of pain and can push the sub-clinical pain into the realm of clinical manifestation. It will and does make almost all disease worse.

    An Honest Version of the Self

    Likewise too, when people become angry, on either side of the mask wearing-divide, there is a history to that anger, one that connects it to deeper and more profound frustrations. This is an important factor, rarely considered by a medical establishment that is in thrall to the idea of the human subject as a ‘biological machine’. One where symptoms are mechanical faults, requiring mechanical or physical remedies. Almost all of these remedies must then be purchased. Modern cures are rarely derived from nature, from introspection or the pursuit of an honest version of the self.

    This is entirely relevant to the subjective ‘deeper’ angers, insecurities and frustrations that are easily brought to the surface in many people, when the scapegoat of an inferior or non-compliant ‘other’ is provided or even offered up by the powers-that-be. History is our teacher here, and as usual she is wilfully ignored.

    I mention the influence of psychological stress to highlight the observation that it is a major determinant in one’s experience with Covid-19 as with any dis-ease. Psychological stress is (medically speaking) a self-fulling prophecy. People who are most anxious about becoming ill are most likely to become ill. If you ask yourself often enough whether or not you have a headache, you will eventually experience one.

    The same applies to Covid-19. Most people who are exposed to the virus do not even know they have been exposed. Many experience little more than a common cold or flu like illness, many more experience nothing at all. As is the case with the common cold, the crucial factor that determines where one is likely to fall upon the spectrum of suffering, is not simply the cold-virus itself, but rather the physical and importantly the mental health of the ‘victim’. There is no individual more acutely aware of his symptoms, than someone who is most anxious about his health.

    Back to School

    Psychological stress for some members of our society has an equally seasonal component. Each September when Irish children return to school, the stress levels within many Irish families, (particularly those with young children) begin to rise.

    There are immediate demands for uniforms, books, lists, shoes, sportswear, transport etc, all of which place a significant burden on parents, especially mothers. Returning to school this year for most families will be fraught with many additional anxieties.

    Children may have to wear masks, visors, social distance in the classroom and the playground, be prevented from bringing lunch boxes, and perhaps have their uniforms washed daily. Schools may not be able to accommodate required classroom sizes and schedules for attendance may have to be altered. The familiar routine is to be a ‘thing of the past’ – the implications for increased stress upon parents and children are incalculable. Let us organize all of this into a list of observations

    An elevated number of potential viral hosts, which is a consequence of suppression of natural-immunity.

    Increased life of the virus in the external environment due to decreased daylight

    Raised levels of social anxiety and subsequent susceptibility to illness/infection

    Continued persistence of the virus at low levels within Irish society

    These factors suggest a resurgence of the virus this winter, and taken in context with the existing level of social stress, and the inevitable increase in those stresses next month; it is not unreasonable to suggest a ‘perfect storm’ is gathering.

    It is highly likely that the present level of bitterness or anger between both sides of the mask wearing divide willl be where that stress and pain becomes publicly manifest. The deeper tragedy at play, is the fact that each side of the division will be seen as the aggresor. Yet those who have fostered the division remain immune to any degree of scrutiny for past mistakes, while dark clouds are on the horizon.

    [i] Orla Dwyer, ‘Explainer: Everything to know about new face covering regulations’, thejournal.ie, August 10th, 2020, https://www.thejournal.ie/when-and-how-to-wear-a-face-covering-ireland-5171841-Aug2020/

    [ii] David Isaacs et al, ‘Do facemasks protect against COVID‐19?’, Journal of Paediatric Child Health, June 16th, 2020, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7323223/?fbclid=IwAR15wQ0gOySIs8c7I4m9qsCiPJT6E66pM9Hiwr82AKeAPfcmfmKctK9qG1Y#__ffn_sectitle

    [iii] Catherine Fegan, ‘’Many in nursing homes died deaths that certainly could have been prevented’’, Irish Independent, June 13th, 2020, https://www.independent.ie/world-news/coronavirus/many-in-nursing-homes-died-deaths-that-certainly-could-have-been-prevented-39282569.html

    [iv] Sarah Fulham-McQuillan, ‘Strong legal basis for making Covid-19 vaccinations mandatory’, Irish Times, June 27th, 2020, https://www.irishtimes.com/opinion/strong-legal-basis-for-making-covid-19-vaccinations-mandatory-1.4313941?mode=sample&auth-failed=1&pw-origin=https%3A%2F%2Fwww.irishtimes.com%2Fopinion%2Fstrong-legal-basis-for-making-covid-19-vaccinations-mandatory-1.4313941

    [v] Simon Carswell, ‘Coronavirus: Ireland has ‘no significant’ herd immunity, study shows’, July 20th, 2020, https://www.irishtimes.com/news/health/coronavirus-ireland-has-no-significant-herd-immunity-study-shows-1.4308216

    [vi]F. Javier Ibarrondo, Ph.D. et al, ‘Rapid Decay of Anti–SARS-CoV-2 Antibodies in Persons with Mild Covid-19’, July 27th, 2020, The New England Journal of Medicine. https://www.nejm.org/doi/full/10.1056/nejmc2025179

    [vii] Katherine J. Wu, ‘Scientists See Signs of Lasting Immunity to Covid-19, Even After Mild Infections’, New York Times, August 16th, 2020, https://www.nytimes.com/2020/08/16/health/coronavirus-immunity-antibodies.html

    [viii] https://twitter.com/laoneill111/status/1276424356869046279

    [ix] Sitryx, ‘Founders’ http://www.sitryx.com/about-us/founders/

    [x] ‘Adjuvants help vaccines work better’ https://www.cdc.gov/vaccinesafety/concerns/adjuvants.html

    [xi] https://www.pmlive.com/pharma_news/gsk_signs_deal_with_medicargo_for_covid-19_vaccine_1344532

    [xii] ‘Lilly Initiates Phase 3 Trial of LY-CoV555 for Prevention of COVID-19 at Long-Term Care Facilities in Partnership with the National Institute of Allergy and Infectious Diseases (NIAID)’ https://investor.lilly.com/news-releases/news-release-details/lilly-initiates-phase-3-trial-ly-cov555-prevention-covid-19-long

    [xiii] ‘New biopharmaceutical company Sitryx launches with $30 million fundraising to develop disease modifying therapeutics in immunometabolism’, October 8th, 2018, https://www.globenewswire.com/news-release/2018/10/08/1617744/0/en/New-biopharmaceutical-company-Sitryx-launches-with-30-million-fundraising-to-develop-disease-modifying-therapeutics-in-immunometabolism.html

    [xiv] Sitryx ‘Founders’ http://www.sitryx.com/about-us/founders/

    [xv] VOA News, ‘Norway Makes First Face Mask Recommendation Since Pandemic Began’, VOA, August 14th, 2020, https://www.voanews.com/covid-19-pandemic/norway-makes-first-face-mask-recommendation-pandemic-began

    [xvi] Peter S. Gordon, ‘Sweden Has Become the World’s Cautionary Tale’, New York Times, July 7th, 2020, https://www.nytimes.com/2020/07/07/business/sweden-economy-coronavirus.html

    [xvii] Richard Milne ‘Sweden’s pandemic no longer stands out’, Financial Times, August 9th, 2020, https://www.ft.com/content/7acfc5b8-d96f-455b-9f36-b70dc850428f

    [xviii] Allister Herd, ‘Sweden’s success shows the true cost of our arrogant, failed establishment’, The Telegraph, August 10th, 2020   https://www.telegraph.co.uk/news/2020/08/12/swedens-success-shows-true-cost-arrogant-failed-establishment/

    [xix] Mark Landler and Stephen Castle, ‘Behind the Virus Report That Jarred the U.S. and the U.K. to Action’, New York Times, March 17th, 2020, https://www.nytimes.com/2020/03/17/world/europe/coronavirus-imperial-college-johnson.html

    [xx] See: David Richards and Konstantin Boudnik, ‘Neil Ferguson’s Imperial model could be the most devastating software mistake of all time’, The Telegraph, May 16th, 2020,
    And: Freddie Sayers, ‘Nobel prize-winning scientist: the Covid-19 epidemic was never exponential’, Unherd, May 2nd, 2020, https://unherd.com/thepost/nobel-prize-winning-scientist-the-covid-19-epidemic-was-never-exponential/

    [xxi] J. Black, Micriobiology Principles & Applications, (1993) p.580

    [xxii] ‘Loneliness may make cold symptoms feel worse’, NHS, March, 2017, https://www.nhs.uk/news/mental-health/loneliness-may-make-cold-symptoms-feel-worse/

  • ‘This is science which should go on trial’

    A zoom panel discussion organised by Lindau, which included two other Nobel-prize winning scientists, provided Stanford biophysicist and Nobel Laureate Michael Levitt with a platform to vent his fury over the global scientific community’s flawed response to the Covid-19 pandemic, as he saw it.

    In particular, he condemned Imperial College’s Neil Ferguson for failing to respond to his emails at the height of the crisis. He said that a flawed response had caused hundreds of billions of dollars’ worth of suffering and damage, that had disproportionately affected a younger generation, and which would not substantially alter the ultimate death toll.

    Levitt began by saying (at 11.41 in the video below):

    One thing that strikes me is that once the virus moved from the China-Korea phase is how totally inadequate science structure is for real time science. People are insisting on refereed reports. No one wants to share anything. The scientists are more panicked and scared by reality than anybody else. The august organisations like Lindau, The Royal Society, The National Academy of Science, have been totally silent … As a group, scientists have failed the younger generation.

    ‘There should have been a committee formed’, he said, ‘either by the Nobel Foundation, by Lindau, by the Royal Society, or the National Academy of Science in the middle of February.’

    He continued:

    The worst opposition I got was from very, very prominent scientists, who were so scared that the non-scientists would break quarantine and infect them. There was total panic, and the fact is that almost all the science we were hearing from organisations like the World Health Organisation, was wrong. We had Facebook censoring WHO-contrary views. This has been a disgraceful situation for science … We should have been talking to one another ..

    Over the course of the pandemic, he said he was releasing reports openly, but all he go back was abuse. Nonetheless, he argued, everything he said in the first six weeks was true, but that ‘for political reasons, we as scientists, let our views be corrupted.’

    He argued that ‘the data had very clear things to say. Nobody said to me: ‘let me check your numbers’. They all just said: ‘stop talking like that’.’

    Levitt reserved particularly harsh comments for epidemiologists who he said:

    see their job, not as getting things correct, but as preventing an epidemic. So therefore if they say it is 100-times worse than it’s going to be, then it’s ok. Their mistake was that we listened to them. They said the same thing for Ebola, they said the same thing for Bird Flu, no one shut down for them. We should never have listened to the epidemiologists. They have caused hundreds of billions of dollars’ worth of suffering and damage, mainly on the younger generation. This is going to be a tragedy. It’s going to make 9/11 look like a baby story. This is much, much worse. I am not against lockdown, I am against stupid lockdown, without considering the full picture, i.e. not just combating a virus, that is exactly as dangerous as flu, but also avoiding the economic damage, that every country has caused itself except Sweden. We have really, really failed as a group. There have been smart people in Sweden, and that’s about it. Germany is getting reinfected because they cut down too strongly. You know the level of stupidity that has been going on here has been amazing, and it just required a little bit of discussion of smart people. I am not saying I am right, but I would like people to contra me on the details.

    He says that ‘simple logical assumptions’ such as the infection fatality rate ‘got discussed so slowly and so late,’ while, ‘we circled the wagons against this, and it really, really hurt us.’

    Imperial College’s Neil Ferguson.

    Neil Ferguson, he said, ignored his emails, and that the problem did not simply lie with a lack of communication with the public, but that scientists refused to listen to people not in their fields.

    Now he said:

    Scientists are getting away scot-free for causing billions of dollars’ worth of damage and this is something that cannot be allowed to happen. It’s not just the World Health Organisation. Ferguson wanted Sweden to lockdown, got Britain to lockdown, and when the numbers become normal, exactly what you would expect without lockdown. He then says, ah it’s because of lockdown. This is terrible science. This is science which should go on trial. Scientists cannot cause damage like this and refuse to listen. I really, really tried hard to get them to at least discuss this with me. In the end I said something I never say: whatever. Just leave me alone, go ahead and die. And the fact is that epidemiology and modelling has been a disgrace. They have not looked at the data. They have been wrong at every turn. We are going to see that although coronavirus is a different disease, the net impact of death is going to be very similar to severe flu and it’s going to be that way without lockdown.

    Levitt reserved praise for Sweden:

    Sweden is the only country that has done the right thing by heading for what they consider to be herd immunity. It occurs at 15%, not at 80%, another error that the epidemiologists made. Sweden is going to end up with about 600 deaths per million.

    https://vimeo.com/433350887/33bbbe4090

  • The State of Irish Agriculture

    On April 30th, acting Minister for Agriculture Michael Creed defended Ireland’s agricultural sector,[i]  claiming we are the second most food secure country in the world. What Creed seems to have been referring to was an Irish independent article from October 2019, saying Ireland had moved from first place to second in a Global Food Security Index.[ii]

    In so doing, Ireland had been overtaken by Singapore, a micro state that imports over 90% of its food. You might ask, how is it possible that this island of concrete was adjudged to be the most food secure place on the planet?

    Singapore, ‘the world’s most food secure country’.

    On closer examination, it seems this “research” had been sponsored by Corteva Agriscience, one of the largest producers of pesticides in the world, and now a subsidiary of DowDupont after a merger with Dow Chemical, (the corporation responsible for the Bhopal Disaster in India 1984). Such vested interests cannot be trusted as a reliable source in assessing the food security of nation states.

    The fact that Singapore is ranked highest in a food security index sponsored by an agri-chemical multinational should come as no surprise, as these chemicals are much more likely to figure in industrially produced food systems, traded on a global market, rather than localized, subsistence food systems.

    It also comes as no mystery to find the Irish independent presenting this highly dubious study as fact. That newspaper has historically represented the interests of the comprador, or broker capitalist class in Ireland; that revolving door between agribusiness, finance and politics, servicing the multinationals that have located in Ireland.

    Moreover, Micheal Creed has a track record of presenting erroneous research to the Dáil regarding emissions from Ireland’s fast-expanding dairy sector.[iii]

    Food security in this scenario equates to commodities being traded on a global market with minimal restrictions. The evaluation is predicated on current availability, price and diversity of food consumed – regardless of productive factors or supply chain interference. It takes no account of the environmental or social consequences of this supply line, or any risks lying further down the line, whether a hard Brexit, a global pandemic, or that the global food system has eroded a quarter of all arable topsoil on the planet since the 1950s.[iv]

    Despite supposedly being number two in the world in terms of food security, Ireland now imports the majority of its potatoes and nearly all its wheat flour; the main staple carbohydrates of the people of Ireland.

    The Teagasc Consensus

    A large part of the belief in distortions like these can be attributed to the neoliberal religion of free trade, which is engrained as a belief system in a great number of Irish farmers.

    Over the course of the twentieth century, the adaptation of new and increasingly expensive inputs into agriculture have been sold as ‘progress’ to farmers. Numerous chemicals and pharmaceutical companies, including SmithKline, Pfizer, Merck, Schering Plough and Roche located their manufacturing facilities in Ireland during the 1960s and 70s, availing of lax or non-existent environmental regulation and lower labour costs. They stayed because of an attractive corporate tax regimes and unrestricted interference in Ireland’s educational system. By the turn of the twenty-first century they accounted for nearly seventy percent of global pharmaceutical output.[v]

    These multinationals have helped the Irish state to adopt an increasingly intensive, highly specialized monoculture agricultural system, geared towards the export market.

    Traditionally, farmers have gone along with this because of the developmental rhetoric and of course, generous EU subsidies.

    Also crucial to manufacturing consent has been the educational apparatus of Teagasc, the state research centre for agriculture. Teagasc uses science selectively to the end of export intensification.

    Connected to the revolving door between chemical and pharmaceutical multinationals located in Ireland, Teagasc and other state educational institutions have effectively locked farmers into an unsustainable, high-input agricultural model, based on the latest bio-technological ‘fixes’ formulated by the agri-chemical industry.

    The end result is scientistic rather than scientific, meaning science is adopted in a cosmetic manner, to provide technical short-term fixes within a strictly liberalised market paradigm.

    A truly scientific approach, which is essential in the face of irreversible climate change, requires rigorous philosophical as well as technical inquiry, taking into account all of the parts involved in a system and their effects. This is a thorny path to embark upon, especially when multinational interests are threatened.

    Irish state education, and Teagasc in particular, indoctrinates a free market ideology into young people. This includes the Law of Comparative Advantage, which involves specialization in one industry over others, for the purposes of international trade. This is the central tenet of the state’s agricultural policies, and the cornerstone of Teagasc’s educational institutions.

    The Law of Comparative Advantage has long been subjected to criticism from other schools of thought such as Development Economics: most notably the Singer-Prebisch thesis, which demonstrates that the terms of trade between countries producing primary products deteriorates over time, relative to countries producing manufactured goods.

    Notably, this economic ‘Law’, was formulated by British Economist David Ricardo in 1817, when the Spanish colonies in the Americas were in the process of becoming independent republics. Spain’s loss was Britain’s opportunity, as ‘free’ trade doctrines became the rationale for unequal exchange between the global North and the global South, then as now, keeping wealth flows disproportionately northwards.

    Now in the former British colony of Ireland the main farmers’ lobby, the IFA, maintains the consensus around globally traded commodities, successfully convincing many smaller farmers that their interests are joined to large scale beef and dairy producers.

    Just recently the IFA managed to compel acting Minister Creed to continue with live exports to Turkey, Algeria and Libya as a way of stabilizing prices.[vi]

    Yet many farmers are discovering that they have given away too much autonomy to the IFA and their political patrons in Fine Gael. Some small farmers broke away from the IFA to form the Beef Plan Movement, which challenged export monopolies from 2018, but the Movement seems to have dissipated.

    Now some disillusioned farmers are beginning to see the EU’s CAP as the source of their problems, and are calling for an ‘Eirexit’.[vii]  However, while free trade agreements in the EU and other consumer markets are a vehicle for the current model, the driver has long been the Irish State.

    Source of the Problem

    With many farmers now in grave financial difficulties, it has become apparent that the source of our agricultural difficulties lies in international free trade arrangements, European or otherwise, being used by the State and accepted without question by farmers’ lobbies in the name of ‘progress’.

    There was nothing inevitable about European integration pushing Ireland so far past its ecological carrying capacity in terms of agriculture: it came from the Irish state’s pursuit of European integration and other free trade arrangements.

    During the 1970s and 1980s, the Irish State pushed to clear wildlife from farms, even if the financial incentives came from EU grants. It is the Irish State which continues to push for export intensification through its Food Harvest 2020 and Foodwise 2025 schemes, seeking markets far beyond the EU. Ireland is now the second largest exporter of infant formula in the world, its largest market being China.[viii]

    A food system that is so integrated into global market chains has brought increased levels of monoculture specialisation in beef and dairy, severely diminishing the diversity of food produced [ix],  and depending not only on chemical inputs ,which pollute our environment and destroy biodiversity, but also on imported animal feedstuffs.

    The dairy industry has grown by 27% [x] in just five years and continues to expand, far exceeding the carrying capacity of the grassland it relies on. Due to homogenization, the supply chain of pretty much all Irish butter and non-organic dairy produce contains on palm kernels, and genetically modified, Roundup-Ready soya and corn.

    This amounts to an appropriation of land, labour and water resources from the global South, causing deforestation in tropical rainforests, erosion of topsoil which takes thousands of years to form; as well leading to the extinction of animal and plant species.

    The successive crises that these policies have led to in Ireland have been misrepresented as ‘fodder’ crises. They are in fact over-intensification crises, arising from destructive free trade policies which have pushed the island of Ireland past its agricultural carrying capacity.

    These are a reoccurring themes in Irish history. The difference between today’s and the crises of the eighteenth and nineteenth century is that Ireland is no longer bottom of the economic hierarchy in the global economic system. As a result, the environmental burden can be externalised to peripheral parts of the world, especially through feed imports.

    Inside Ireland’s largest milking machine. Henry Clarke (wikicommons).

    A New Way Forward

    The progress of the so-called ‘Green Revolution’ in agriculture from the 1940s is beginning to unravel. Short term bio-engineering fixes are spiralling out of control. A continuous stream of newly engineered GM crops – which can withstand higher concentrations of agri-chemicals – are being rolled out in response to new herbicide resistance in weeds which make the existing chemical concentration of previous GM varieties ineffective. The result is higher doses of chemicals in our food chain and mass extinction of pollinating insects and soil microorganisms.

    The limits and consequences of the industrial model of agriculture is now evident from a food security standpoint as well as in terms of the environment. The science behind our agriculture needs to involve a whole systems approach that takes into account all of the ecological consequences of globalized food production, and which places soil conservation and renewal at its core.

    At present, this is missing entirely from Teagasc’s educational apparatus as the current food production model is not circular, but extractive: heavily dependent on imported inputs which cause deforestation, topsoil degradation and extinction of species in other parts of the world, as well as wreaking havoc on biodiversity and water quality within Ireland.

    In the wake of Covid-19, a future roadmap is in the hands of whoever dares to seize the moment. The epidemic has occurred in the wake of years of environmental campaigning and the farm to fork strategy [xi],  which has been pushed through at European level. This  reflects a growing recognition of the limitations of the global industrial food model at the highest levels of political power.

    This crisis of international capitalism is a real opportunity for small producers to adopt more localized regenerative agricultural systems, which are embedded in community and work with natural ecosystems instead of attempting to dominate them. In these kinds of systems, farmers and communities of farmers produce foodstuffs suitable to their bio-regions, sequestering carbon in the soil.

    These kinds of systems generate their own inputs, freeing farmers from the clutches of the agri-chemical industry. In this kind of scenario, farmers produce a healthy diversity of food for their communities, instead of monoculture commodities for cargo ships.

    In order to achieve this, however, we require a complete overhaul of deep-seated beliefs about farming which have been perpetuated by state propaganda, the educational apparatus, and the media.

    The United Nations Food and Agriculture Organization now recognises agri-ecology as the way forward for developing food security in the face of climate change. We must fight State policies which prevent a regenerative agriculture. Not only is this achievable, it is essential.

    [i] VideoParliament Ireland,  Deputy Holly Cairns – speech from 30 Apr, YouTube, 2020 https://www.youtube.com/watch?v=8PrwuHgRxPM&feature=youtu.be&fbclid=IwAR16-ozAjJzFY_iF2fWI8jr0yu0ydOZCdse5vJxvXkavGEltsHoOMAZAM2g

    [ii] Margaret Donnelly, ‘Deputy Holly Cairns – speech from 30 Apr 2020’, Irish Independent, October 16th, 2018, https://www.independent.ie/business/farming/news/world-news/ireland-slips-to-second-in-the-world-for-food-security-37425858.html

    [iii] Press Release, ‘An Taisce has called on Minister Creed to retract misleading Dáil statements on rising dairy emissions’, 25th of June, 2018, https://www.antaisce.org/articles/an-taisce-has-called-on-minister-creed-to-retract-misleading-d%C3%A1il-statements-on-rising

    [iv] Chris Arsenault, ‘Only 60 Years of Farming Left If Soil Degradation Continues’, Scientific American, December 5th, 2014, https://www.scientificamerican.com/article/only-60-years-of-farming-left-if-soil-degradation-continues/.

    [v] Robert Allen, No Global: The people of Ireland versus the multinationals, Pluto Press, Dublin, 2004, p.4

    [vi] Untitled, ‘MINISTER CREED MUST ENSURE THAT LIVE EXPORTS TO ALGERIA CONTINUE’, IFA, May 10th, 2020, https://www.ifa.ie/minister-creed-must-ensure-that-live-exports-to-algeria-continue/#.XrgyI2hKg2w

    [vii] Irish Freedom Party, ‘Irish Farmers are Strangled by EU Regulations | Frank Shinnock at Irexit Cork’, March 4th, 2019, https://www.youtube.com/watch?v=rp41yqAWkzQ&t=1115s

    [viii] Stephen Cadogan, ‘ The origin is green — China is now Ireland’s second most important market for dairy exports’, Irish Examiner, November 15th, 2018, https://www.irishexaminer.com/breakingnews/farming/the-origin-is-green-china-is-now-irelands-second-most-important-market-for-dairy-exports-885402.html

    [ix] Conor Finnerty, ‘Only 1% of Irish farms grow vegetables, the lowest in the EU’, AgriLand, October 22nd, 2016, https://www.agriland.ie/farming-news/only-1-of-irish-farms-grow-vegetables-the-lowest-in-the-eu/

    [x] Ibid, Press Release, An Taisce.

    [xi] Untitled, ‘Farm 2 Fork and Biodiversity Strategies Hold Firm on Real Targets’, Arc2020, May 20th, 2020, https://www.arc2020.eu/farm-2-fork-and-biodiversity-strategies-hold-firm-on-real-targets/

  • Review: Notes from an Apocalypse

    ‘We are alive in a time of worst-case scenarios. The world we have inherited seems exhausted, destined for an absolute and final unravelling’. So begins Mark O’Connell’s journey into our ever-darkening future.

    There are, he notes darkly, fascists in the streets and in the palaces, while around us ‘the weather has gone uncanny, volatile, malevolent’. The last remaining truth, O’Connell proposes, ‘is the supreme fiction of money, and we are up to our necks in a rising sludge of decomposing facts. For those who wish to read them, and for those who do not, the cryptic but insistent signs of apocalypse are all around’.

    The faint splattering sound that reechoes throughout ‘Notes from an Apocalypse’ is that of the shit hitting the metaphorical fan.

    ‘Listen. Attune your ear to the general discord, and you will hear the cracking of the ice caps, the rising of the waters, the sinister whisper of the near future. Is it not a terrible time to be having children, and therefore, in the end, to be alive?’, O’Connell muses.

    Familiar Journey

    The journey is a familiar one, in every sense. My mind flows back to early 2003, my first-born still an infant then, her future an unknown country. Out of the fog of broken sleep and newfound joys and terrors, I began, for the first time in my adult life, to look into the future. Not days and weeks, but years and decades.

    What I found staring back was every bit as chilling as O’Connell’s more recent epiphany, and it has, to a lesser or greater degree, haunted my waking hours every day since then. As he points out, once you’ve become a parent, ‘whether it happens by choice or by chance, is that it is one of only very few events in life that are entirely irreversible. Once you’re in, existentially speaking, you’re in’.

    This being the case, the next question effectively writes itself: How are we supposed to live, ‘given the distinct possibility that our species, our civilization, might already be doomed?’ While he may have lost hope, O’Connell certainly hasn’t lost his dark sense of humour, describing the curious feeling of being sick to death of the end of days. ‘I’m sick, in particular, of climate change. Is it possible to be terrified and bored at the same time?’, he wonders aloud.

    Back in the good old days of the Cold War, the spectre of global annihilation was never far away. And while the risks were all-too-real, in reality it was always a binary proposition: either we would have a total nuclear war or nothing at all would happen. And, with luck, cooler heads would prevail and catastrophe would be avoided.

    O’Connell notes that we civilians were pleasantly blameless, either way, mere bystanders ‘whose role was limited to cowering in terror, maybe holding the occasional placard, partaking here and there in a chant if called upon to do so’. In classical eschatology, the apocalypse, whether religious or secular, would be delivered in a blinding thunderbolt, ‘a sudden intercession of divine or technological power’.

    The very real doom that encircles us is altogether more banal, more insidious and one in which we are both helpless bystanders and active, albeit unwitting, participants. To be alive today, to live in a prosperous modern society is to be an integral part of the very linear system of consumption, expansion and disposal that is fast destroying the natural world and the very basis for our current prosperity and all future prospects for every generation that succeeds us.

    Image: Daniele Idini

    Footprint

    O’Connell acknowledges the thin irony that his own gloomy travelogue entailed vast emissions of the very carbon that is burning down the world. ‘My footprint is as broad and deep and indelible as my guilt… I myself am the apocalypse of which I speak. That is the prophesy of this book’.

    That ‘Notes from an Apocalypse’ should be published in the midst of the first global pandemic of the Internet Age seems grimly apposite, life in imitation of art as the confident certainties of our world unravel in unpredictable, non-linear ways.

    O’Connell vividly describes his growing obsession with the imminent collapse of civilisation. He sees himself as being obsessed with the future, ‘an obsession that manifested as an inability to conceive of there being any kind of future at all…my journalistic objectivity, a fragile edifice to begin with, was under considerable strain’, he adds.

    Many people seek to escape their demons. In this trade, that’s not so easy. ‘It is both a privilege and a curse of being a writer that throwing yourself into your work so often involves immersing yourself deeper into the exact anxieties and obsessions other people throw themselves into their work to avoid’.

    The book, O’Connell accepts, probably was initially conceived as a form of therapy, though he admits to what he calls a more perverse motivation: ‘I was anxious about the apocalyptic tenor of our time, it is true, but I was also intrigued. These were dark days, no question, but they were also interesting ones: wildly and inexorably interesting. I was drawn toward the thing that frightened me, the thing that threatened to tear everything apart, myself included’.

    This gave him the impetus to embark on a series of what he describes as perverse pilgrimages ‘to those places where the shadows of the future fall most darkly across the present’. Nor is the overtly religious framing accidental. ‘If I could be said to have had a faith in those days, it was anxiety—the faith in the uncertainty and darkness of the future’.

    O’Connell’s research took him into many dark places; he describes being unable to click on links in his computer’s browser ‘for fear that what I gained in knowledge I would lose in sanity—my online existence was saturated in a sense of end-time urgency’.

    In other circumstances you could reasonably infer that the author was in reality experiencing what is for all intents clinical depression, the key difference being that the auguries of catastrophe which he was consulting are not the product of his fevered imagination, but are a painfully accurate reflection of the world as it stands.

    ‘Preppers’

    Avoiding the sensible options of pouring his energies into what might be seen as more constructive channels, O’Connell ‘set out towards the darkness itself’. And where better to start than with the weird US sub-culture called ‘preppers’. This group consists almost exclusively of middle aged and older white males with an unnatural interest in dried food, assault rifles and racism.

    O’Connell is merciless in his depiction: ‘as a group, preppers were involved in the ongoing maintenance of a shared escapist fantasy about the return to an imagined version of the American frontier—to an ideal of the rugged and self-reliant white man, providing for himself and his family, surviving against the odds in a hostile wilderness’.

    In seeking to rekindle some imaginary frontier spirit, what preppers are in fact doing, he adds, is ‘creating the necessary conditions for a return to the cleansing violence of the nation’s colonial past … In fact, you couldn’t even properly call it crypto-fascism: it was really just good old-fashioned original-style fascism’. The National Geographic’s TV channel ran a series for three years called Doomsday Preppers; O’Connell gorged on many hours of it on YouTube as part of his research. While ostensibly about gearing up for post-apocalyptic survival, he believes the show ‘is in fact a reality TV psychodrama about masculinity in crisis’.

    Preppers, he concludes, ‘are not preparing for their fears: they are preparing for their fantasies. The collapse of civilization means a return to modes of masculinity our culture no longer has much use for’.

    While disagreeing with them in almost every regard, O’Connell admits to relating to the ‘distributed matrix of unease from which the certainty of collapse grew. I, too, with my pessimism, my intimate imagination of the world’s unravelling, had driven my own wife, if not to despair itself, then to somewhere in its vast and crumbling exurbs’.

    I can certainly attest to the strain that burdening yourself with documenting the slow, agonising death of the world imposes both on you as an individual and on your long-suffering spouse and family.

    O’Connell’s perverse pilgrimage takes him to the wilds of South Dakota where, for a price, you can buy a bunker with all the mod cons. This bug-out fantasy is being marketed and sold with the characteristic exuberance of the U.S. real estate industry. ‘This was a new entry into the apocalyptic imaginary: bankers and hedge-fund managers, tanned and relaxed, taking the collapse of civilization as an opportunity to spend some time on the links, while a heavily armed private police force roamed the perimeters in search of intruders. All of this was a logical extension of the gated community. It was a logical extension of capitalism itself’.

    At its cold heart, this amounts to the haves battening down the hatches against the have-nots, unequal to the bitter end. Unlike the old anti-nuclear war slogan, it appears that all men will not in fact be cremated equal. And nowhere is this inequality more apparent than in New Zealand, now the world’s favourite end-of-the-world bolthole for the excessively rich.

    ‘Everyone was always saying these days that it was easier to imagine the end of the world than the end of capitalism. Everyone was always saying it, in my view, because it was obviously true’, O’Connell continues. ‘The perception, paranoid or otherwise, that billionaires were preparing for a coming collapse seemed a literal manifestation of this axiom. Those who were saved, in the end, would be those who could afford the premium of salvation’.

    Image: Daniele Idini

    Backup Planet

    Next, O’Connell tagged along with the space colonisation enthusiasts, most notably oddball billionaire Elon Musk, who described Mars as our ‘backup planet…just in case something goes wrong with Earth’. Similar to doomsday preppers with their bags of dried food, ‘Mars colonisation is apocalyptic scenario as escapist fantasy’.

    What he describes as a narrative of exit is, O’Connell argues, fundamentally male, a yearning for escape ‘as a means towards the nobility of self-determination’. The world, our world, urgently needs attention, care, rehabilitation, yet the ultra-rich techno-fantasists are instead writing it off, dreaming of new empty spaces to subjugate, to colonise, to shape in their image, without state or societal oversight, a darkly Utopian fantasy played out on the blank canvas of the cosmos.

    ‘The politics of exit are pursued, according to cultural critic Sarah Sharma at the expense of a politics of care. ‘Care, she writes, is that which responds to the uncompromisingly tethered nature of human dependency and the contingency of life, the mutual precariousness of the human condition’. To repudiate the Earth is to reject the imperative of care.

    It goes without saying that the escapist daydreams of the wealthy elites envisage salvation only for the tiny handful; the mass of humanity will, it seems, be consigned to burn, fight and starve amid the smouldering wreckage of a plundered biosphere that has been asset-stripped to the bone.

    The intuition that many of the global 0.001 percenters actually seriously believe this stuff makes sense of a circle I have long struggled to square: how can tycoons and titans so blithely ignore the ever-encroaching ecological consequences of the profitable destruction they are orchestrating? Surely they too have kids, they must ultimately breathe the same air and drink the same water as the rest of us? Well, apparently not.

    The colonial mindset that saw groups of determined Europeans and later, Americans, set out to conquer, subdue and enslave every country on Earth they encountered that was incapable of fighting them off is alive and well, and the age of gunboat colonialism has been replaced by the more subtle but equally effective economic colonialism.

    East India Company

    Today, as before, ultra-cheap goods, minerals and raw materials flood out of the global South through trade channels controlled by powerful transnational corporations whose monopolies are operated every bit as ruthlessly as the East India Company, which enjoyed a royal charter giving it permission to ‘wage war’ and, at its peak, had its own army numbering 260,000 troops, twice the size of the then British army.

    The rape, pillage and plunder of the Earth has as a project been underway in earnest for centuries, but it is those of us alive in the 21st century and without tickets to Mars, who are about to reap the whirlwind.

    As O’Connell notes, capitalism, ‘which exists and thrives through expansion of its own frontiers, through a relentless force of deterritorialization, is running out of frontiers; running out of boundaries to obliterate, nature to exploit’. The legacy of what he terms its monomaniacal pursuit of cheap resources is a ‘devastated planet that soon may be unliveable for vast numbers of its inhabitants’.

    Just quite how soon and for just how many was to become clearer even as I was reading ‘Notes from an Apocalypse’. It came in the publication of a new peer-reviewed study using data from UN population projections and a 3ºC global warming scenario in line with current scientific projections.

    While we think of ourselves as a highly adaptable species, filling niches from the high Arctic to the tropical jungles, in reality, most human populations are concentrated into narrow ‘climate bands’ in areas where the average surface temperature is in the range of 11–15ºC.

    An average global surface temperature rise of 3ºC in the coming decades would leave some three billion people in areas with average temperatures as hot as the Sahara desert is today. Wide tracts of India, Australia, Africa, South America and the Middle East will, in just a matter of decades, be essentially uninhabitable for humans and most animals.

    Consider the impact of 2-3 million refugees fleeing the aftermath of conflict in the Middle East and how the impact of these desperate migrants strained the EU almost to breaking point. Now, multiply that not by 100, but by 1,000 and suddenly the idea of escaping to establish a colony on a barren neighbouring planet no longer seems quite so insane.

    Back on planet Earth, the Arctic is burning. ‘That there were wildfires in the Arctic Circle felt like the most important fact in the world. This was a thing we should never not be thinking about, talking about… the subtext of every news headline now, of every push notification, was that we were completely and irrevocably fucked’.

    Image: Daniele Idini

    An Island Apart?

    O’Connell, who is Dublin-based, recalls sharing office space with an ecologist, who told him people often ask her how Ireland will fare with climate change. Overall, and relative to so many other countries, actually pretty well, is the short, but entirely incomplete answer.

    ‘What would it even mean, after all, to be fine in the context of a drowning world, a world on fire? We were a small island, with nine hundred miles of coastline and an army that would by itself be effectively useless against any kind of invasion. We would be relying, she said, on the goodwill of other countries whose people were starving, drowning, burning. We would not be fine’.

    O’Connell’s meditation returns time and again to his own son, from whom he feels he is keeping a secret. ‘Just as I want him to continue believing in Santa Claus for as long as possible, I want to defer the knowledge that he has been born into a dying world. I want to ward it off like a malediction’.

    He outlines the complex denialism both he and his wife engage in to shelter their son and his newly born sister from true knowledge of the world as it is. ‘There are times when it seems that we are protecting him, and protecting ourselves, from a much deeper and more troubling truth: that the world is no place for a child, no place to have taken an innocent person against their will’.

    O’Connell strikes a universal chord by observing that becoming a parent means having a radically increased stake in the future. Being responsible for a person who must live in the place and time normally inhabited only by your deepest fears means ‘I no longer feel the definitive force of pessimism as a philosophy…life no longer seems to afford me the luxury of submitting to the comfort of despair’.

    In what may be a rich irony, O’Connell professes to having lost his taste for cosmic nihilism: ‘Lately I have been glad to be alive in this time, if only because there is no other time in which it’s possible to be alive’.

    While it might seem glib in the extreme to be seeking out teachable moments from the imminent collapse of the biosphere and the extirpation of our species among countless others, what does perhaps emerge from his journey is a deeper, visceral understanding of what it truly means to have been alive in the first place.

    Notes from an Apocalypse: A Personal Journey to the End of the World and Back by Mark O’Connell, Granta, London, 2020.

    Featuring images by Daniele Idini from a series taken on Mount Etna, Crateri Silvestri, Sicily in 2019.
    https://www.instagram.com/idinidaniele/
    https://danieleidiniphoto.blogspot.com/

  • Diary of Pandemic Doctor: Nursing Home Chaos

    It’s Saturday morning and I stand exhausted in line for my weekly shop, having left home without breakfast to get ahead of the despondency that might otherwise keep me indoors all day, despite the incongruent sunshine. I know at heart I am mostly there in hopes of some semblance of normal human contact. The phone rings as I wait. I answer to the now familiar voice of the coroner detailing the latest coronavirus-related death at the nursing home where I work as a doctor. My mind races through the expanding catalogue of names residing in the hastily fashioned ‘COVID wing’ and fixes upon her sunken face and heaving chest.

    Last I saw her, rendered unrecognisable behind sheets of dehumanising plastic, she clutched at my hand with her failing limbs and begged me not to leave. But in every room, each now unadorned with the usual ersatz trappings of home and identity one finds in nursing homes – photographs, homespun blankets, love letters from grandchildren – fellow residents lie awaiting their rushed assessments. Oxygen saturations, pulse and respiratory rate, a survey of existing co-morbidities, and finally resuscitation and transfer status to be revisited and revised: who might possibly be saved by hospital transfer, and whose last comfort would be the inevitable cocktail of morphine and midazolam, slipped quietly under the skin at intervals until death arrives.

    I have some forty patients to see before resuming my main function back at the practice in the afternoon. There I will take calls from many of those caring for the residents and triage their symptoms, almost inevitably caused by the virus that has taken hold in this seemingly forgotten corner of society.

    Across the hall, the atmosphere is suddenly lifted by the wit and humour of a ninety-odd year-old who has somehow escaped the dementia and delirium that pervades here. Unlike his fellow residents, this is a man who never wears his breakfast and is more recognisable to me in crisp shirt and tie, top button fastened. When we first met some months ago I doubted his cognition on hearing him shouting instructions to ‘Alexa’ across the room, but it turns out that I was the one that was out of touch. I look at his records – not for resuscitation, not for transfer. Despite his joviality, the oxygen levels already look poor. Given that it is still early on in the course of his infection, it is only a matter of time before he will crash and be gone.

    As the nation scrambled to prepare itself for the deluge of demand on ventilators, this was the kind of man who was never to have been deemed eligible. Yet in spite of the full newspaper spread photos of busy intensive care units, I know there is room for him, and that he has the will to live. Despite his age, were he to defy the admittedly poor odds, he has a quality of life to return to. We embark on the conversation that echoes a distant role-play from medical training which treads gently but directly on taboo. How is it you wish to die, and what interventions might be acceptable or worthwhile to try to prevent that?

    I tell him I feel he should at least consider a hospital assessment, and he accuses me of looking for the remaining half of the president’s cheque that he had promised to his doctor following his last successful visit to hospital some months previously. The next time I am at the home he is no longer there and I hope to God I have made the right decision in encouraging him to leave.

    On and on it goes, as the moisture accumulates under my mask and the goggles steam over. The delicate exercise of balance between connection and scientific detachment as I pass from room to room. Gaping mouths and vacant faces paint a poor prognosis, but even the most frail have surprised us to somehow come out the other side of this infection. To what quality of life, one may well ask. Does dementia provide some sweet oblivion to the horror of all of this? It is an ugly and brutalising process, despite best efforts from nurses and carers.

    Almost entirely recruited en masse from India, these are the compassionate and cheerful bearers of what society now refuses, at poor return to themselves. Let’s not forget that it is a business after all. Living on site in groups of eight or ten, they are simultaneously the protectors of residents and also the vectors by which many will now die. Left to their own devices by a distracted state and a self-preserving management structure (inevitably homegrown), they continued over recent months to meet their duties without full awareness or being properly equipped, and so the virus spread its wings to envelope the entire campus.

    Care facilities always tell a story with their decor. I remember a private hospital from training where a self-playing grand piano sat in the lobby. It was possibly the last place in the country I would recommend anyone actually falling ill. This centre is steeped in a dubious faux-heritage atmosphere of fake mahogany and red carpets. At one point there was even a Leeson Street nightclub type velvet cordon rope placed outside the entrance. Perhaps more than anything else these finishes are there to assuage the guilt families inevitably feel as they break a certain human code by consigning a loved one to an institution. Such is the society we have organised for ourselves. But in this situation the contrast between decor and reality is one of the utmost dissonance; all is well, while everything is falling apart.

    The airwaves and print media are bursting with opinion, analysis and occasional outrage as the crisis unfolds and consumes the institutionalised elderly. The great and the good understand and discuss, sounding wise and all-knowing. But week after week we are alone. Where is the calvary? Where are the boots on the ground? Who is going to help?

    I cease to sleep. I withdraw from friends and family, unable to explain how this has all come to affect me. On the telephone, I struggle to contain the emotion of the distressed families who have been kept away from their loved ones for months at this stage. Meanwhile, the underclass of cleaners, carers, assistants and nurses struggle on, now considered heroes without capes, but shorter staffed and more at risk than ever. Simultaneously caring for and infecting those they seek to serve.

    I break the rules and cross the city from odd to even postcode to visit my widowed mother at a remove. The atmosphere is a languid scene of early summer as dogs are walked and the dividends of lockdown are embraced. Garden parties are heard over walls and milestones of self-development and Zoom yoga classes are considered. It’s a different world. But perhaps it always was. On leaving I check my phone and see another two missed calls from the coroner.

    This is the third in a series of diaries written by different doctors confronting aspects of the Covid-19 Pandemic. If you are interested in contributing an entry drop us a line to admin@cassandravoices.com. Anonymity is guaranteed.

  • To the Ends of the Earth: Earth Day 50 Years On

    Fifty years ago today, more than twenty million people took to the streets in towns and cities across the U.S. in what was and remains the largest environmental protest in history. On that evening’s news, CBS anchor, Walter Cronkite intoned: “a unique day in American history is ending, a day set aside for a nationwide outpouring of mankind seeking its own survival”.

    Cronkite went on to describe Earth Day as an effort at “saving lives from the deadly by-products of that bounty – the fouled skies, the filthy waters, the littered Earth”. One in 10 of the then entire population of America took some part in Earth Day, with bipartisan support across the political spectrum, as well as from both urban and rural areas.

    While it harnessed the momentum of the protest and social movements of the late 1960s, such as the anti-war, civil rights and women’s movements, the enduring effect of Earth Day was to be at a political and policy level: by the end of 1970, the (Republican) Nixon administration, bowing to the public mood and with the 1972 presidential election in mind, sanctioned the creation of the U.S. Environmental Protection Agency, as well as passing a raft of highly significant environmental laws and regulations.

    Notable among these were the National Environmental Education Act,  the Occupational Safety and Health Act, and, crucially, the Clean Air Act. In 1972, the U.S. Congress also passed the Clean Water Act, and in 1973, the Endangered Species Act became law. In the years that followed, a raft of other federal laws and regulations were enacted.

    Given the vast influence of the U.S., these regulations in turn were widely emulated around the world and have had profound and enduring impacts on water and air pollution in particular in many parts of the so-called developed world, including Ireland.

    William_Ruckelshaus being sworn in as the first EPA Administrator under President Richard Nixon.

    Hyper-partisan politics

    Viewed through the political prism of today’s deeply dysfunctional and hyper-partisan U.S. politics, it seems almost quaint to recall a time when people, irrespective of their politics, religion or skin colour, broadly agreed that eliminating deadly toxins from the air that they breathed and the water that their children drank was a good idea.

    Fifty years later, the ideologically toxic Trump regime is busily dismantling large chunks of the progressive regulatory framework that the actions of the U.S. environmental movement ushered into being in 1970. Most sane people think it’s probably a bad idea to allow high levels of mercury, a potent and irreversible neurotoxin, to be released into the air from coal-burning plants.

    Yet regulations limiting mercury emissions from coal-burning are currently being scrapped by Trump. So are rules blocking leaking and venting of hydrofluorocarbons from large air conditioning and refrigeration systems. These chemicals are highly potent greenhouse gases and, according to a 2015 NASA study, are also contributing to global ozone depletion.

    People’s Climate March, Washington DC, 2017.

    Criminal enterprise

    A devastating list of 95 of the major recent assaults by the Trump administration on environmental regulations was compiled by the New York Times late last year. Anyone still labouring under the impression that this is anything other than a family-run criminal enterprise, abetted by some of the most corrupt politicians/grifters in the long and often deeply corrupt history of U.S. politics, should take some time to review this list.

    But the key point remains: the original Earth Day was the foundation event for the modern environmental movement, and affected enduring changes in public and political attitudes towards pollution in particular, especially where the evidence of its deleterious effects were impossible to conceal.

    Air and water quality in the developed world improved markedly from the 1970s onwards, partially arising from Earth Day legacy, but also due to the offshoring of much of the West’s highly polluting heavy industries, which had triggered the crisis.

    So, wealthy countries began to de-industrialise, not by consuming less and living more modestly, but by shifting the axis of production – and pollution – over the horizon, to poorer countries where environmental standards were mostly non-existent and where politicians and public officials could far more easily be paid to look the other way, and desperate workers would accept a pittance to work in conditions dangerous to their own health and damaging to the communities where they lived.

    Global warming

    Ivan Pellacani (wikicommons)

    Another crucial element missing entirely from the original Earth Day was any consideration of global warming. While the concept was well understood within the scientific community by then, it had zero traction in the wider public, and much of the scientific establishment treated it more as an academic conundrum about what could possibly happen at some date several decades hence.

    In 1970, global carbon dioxide (CO2) levels stood at 325 parts per million (ppm), having risen from 316ppm when systematic scientific measurements began in 1958. The highest pre-industrial CO2 levels had stood at 280ppm, so the atmosphere in 1970 was already carrying 15% more CO2 than before the industrial revolution.

    This matters enormously, as the trace gas, CO2 is the atmosphere’s key chemical thermostat. Dial it up, and temperature rise, almost in lock-step. What about in the fifty years since then? Today, global CO2 levels stand at around 416ppm, which means it has risen by over a quarter in just five decades.

    This is likely the most rapid shift in atmospheric chemistry in Earth history. The last time there were CO2 levels this high was in the Pliocene, an era from 5.3 to 2.6 million years ago. Then, sea levels were 20 metres higher than today, and trees grew at the South Pole, and overall global temperatures were 3-4ºC higher than today.

    This unprecedented spike in atmospheric CO2 levels since 1970 will continue to impact temperatures on this planet for centuries into the future. Already, it has led to a rise in the average global surface temperature by just over 1ºC versus pre-industrial. This is the largest single temperature shift since the end of the last Ice Age.

    The Intergovernmental Panel on Climate Change (IPCC) estimates that the red line for dangerous and irreversible changes to the Earth’s climate system lies at around 1.5ºC, which is already perilously close to today’s levels. The IPCC advises that every effort must be made to decarbonise the global economy to avoid such a scenario.

    Based on today’s level of emissions, the global ‘carbon budget’ for +1.5ºC will have been exhausted by 2030. Even the economic downturn arising from the coronavirus pandemic (estimated to see a 5% cut in emissions this year) may only slow this process down by a matter of months.

    To avoid breaching the +1.5ºC danger line by 2030, global emissions will need to have fallen by a staggering 60% by then. Nothing short of a global political, economic, social and cultural revolution could effect such a profound transition in such a tight timeframe. In reality, our current economic model, coronavirus notwithstanding, sees emissions actually accelerating at the time we need to be hitting the brakes and bracing for impact.

    Anthropocene

    Under threat: Mountain Gorillas.

    However dramatic the rise in global emissions and temperatures have been in the last five decades, this almost pales into insignificance when measured against the toll humanity has taken on the natural world over this period. We have eradicated almost two thirds of all the wild mammals, birds, fish and reptiles in just 50 years.

    The last time a global mass die-off on this scale occurred was some 66 million years ago, in the wake of the asteroid impact that led to the extinction of all non-avian dinosaurs. Many scientists have already designated the current era as the Anthropocene, the era of human impacts, and state that the sixth great mass extinction event in Earth history is already well underway.

    Researchers used the term ‘biological annihilation’ to describe the nature and extent of what they termed the ‘frightening assault on the foundations of human civilisation’. It should be borne in mind that while this carnage ultimately threatens humanity, it has already laid waste to hundreds of millions of years of evolutionary progress and, in the process, brutally simplified countless once-complex ecosystems.

    “The situation has become so bad it would not be ethical not to use strong language”, said Prof Gerardo Ceballos of the National University in Mexico, commenting on the major study published in the peer-reviewed journal Proceedings of the National Academy of Sciences.

    Today, over three quarters of the entire world’s land surface has been ‘significantly altered’ by human actions, with tens of millions of hectares of forests razed and cleared for agriculture. The hunting of wildlife for food is another force accelerating extinctions, with at least 300 species of mammals facing near-term extinctions as a direct result of the bushmeat trade.

    At sea, the anarchy is even worse. Over 90% of the world’s large predatory fish, from sharks to tuna, marlin and swordfish, are already gone, with many species now on the brink of extinction. Studies project that as soon as 2048, the world’s oceans will essentially have been emptied of fish.

    The vast fishing fleets that scour the oceans have the capacity to catch-and-destroy fish far more quickly than species can breed. Further, ocean acidification as a result of global warming is accelerating, while surface water temperatures are rising quickly, further disrupting marine life.

    On top of this, tens of millions of tons of plastic waste is ending up in the world’s oceans every year, then slowly degrading from polymers into near-microscopic monomers, trillions of which are now contaminating the base of the entire marine food chain, as these pollutants are being inadvertently ingested by marine creatures from krill to sea birds. One estimate states that there will be more plastic in the world’s oceans by 2050 than fish.

    ‘We are stealing the future’

    It hasn’t all been one-way traffic. As nature has waned, the human footprint has expanded inexorably. Since 1970, the global population has more than doubled, from 3.7 billion to over 7.8 billion today. In 1970, the total gross domestic product (GDP) of the world economy was around $23.8 trillion (in 2011 values) but by 2019, this had quadrupled, to almost $90 trillion.

    Californian environmentalist and author Paul Hawken’s description of the predatory nature and mindset associated with the cult of endless economic expansion has never been bettered: “we are stealing the future, selling it in the present, and calling it GDP”.

    While the original Earth Day was inspired by people’s experience of ecological degradation they could see and even smell all around them, and while it achieved some notable successes as detailed earlier, its ultimate legacy is one of acute failure.

    We humans proved unable (or unwilling) to extend our empathy to other species, to nature itself, and to act unselfishly on behalf of people in other places, or indeed of all future generations. This did not of course happen by accident.

    Neo-liberal thought

    Generations of neo-liberal thought have helped inure humanity against the pain of the natural world and the suffering of others, both humans and fellow sentient animals, while shielding the billionaire predators, who have profiteered from this ruin, which is the consequences of their actions and inactions.

    Our species achieved spectacular evolutionary success not just by brute force and violence, but primarily by our ability to cooperate, and the strength and complexity of our social structures. These have been worn threadbare by decades of atomised consumerism.

    This too did not happen by accident. Fifteen years before the inaugural Earth Day, US economist, Victor Lebow laid out the template for the brave new world of expansion and consumption in 1955: “our enormously productive economy demands that we make consumption our way of life, that we convert the buying and use of goods into rituals, that we seek our spiritual satisfaction and our ego satisfaction in consumption. We need things consumed, burned up, worn out, replaced and discarded at an ever-increasing rate.”

    The Consumer Age is now at an end; replaced, I would posit, by the Age of Consequences. As the industrial revolution began in earnest in the early 19th century, poet William Wordsworth, perhaps sensing the fatal shift then underway in humanity’s relationship with nature, wrote presciently:

    The world is too much with us; late and soon,

    Getting and spending, we lay waste our powers;—

    Little we see in Nature that is ours;

    We have given our hearts away, a sordid boon!

    This Sea that bares her bosom to the moon;

    The winds that will be howling at all hours,

    And are up-gathered now like sleeping flowers;

    For this, for everything, we are out of tune

    Featuring image by Daniele Idini / Cassandra Voices

     

  • Underlying Conditions Exacerbate Covid-19 Pandemic

    Pressing Pause

    In the grip of serious illness anyone but an obtuse contrarian seeks medical assistance. As the coronavirus Covid-19 pandemic sweeps across the globe, doctors are performing heroics, often at grave risks to their own health. Enhanced screening, testing and emergency treatment facilities, along with developing a vaccine, are now paramount considerations; but we cannot ignore our underlying fragilities.

    Exclusive focus on the Holy Grail of an elusive cure disregards how the virus is exploiting poverty in wealthy countries, flawed public health policies and destructive environmental practices. At least we may still soften the blow of this outbreak, and reduce the harm and incidence of future episodes. With all changed – changed utterly – returning to business-as-usual is inconceivable.

    Despite what we hear from the Trump administration,[i] there are no specific medicines available to prevent or treat the new coronavirus Covid-19.[ii] The best estimate is that a year-and-a-half is the minimum time required to develop a reliable vaccine, which would actually set a record.[iii] Remarkably, a British-Italian partnership claims it will have one ready as soon as this September, but the challenge of manufacturing, distributing and mass-immunization – including the thorny issue of consent – on an unprecedented global scale, remain.[iv] The options are comprehensively laid out by medicinal chemist Derek Lowe.[v]

    The dangers posed by this outbreak, and future ones that nature will throw at us, require a thorough reappraisal of public health priorities. Medical systems in advanced Western countries – especially those dominated by the private sector – tend to prioritise treatment of the symptoms of the main non-contagious diseases. We ‘live’ with cancer and heart disease as opposed to addressing multifarious lifestyle causes, which the virus is now preying on.

    As Boris Johnson’s predicament underlines, anyone is susceptible to Covid-19, but chances of exposure – without recklessly ignoring medical advice – are often determined by social class, which intersects with lower life expectancy already.

    In responding to the pandemic any nation is likely to be only as strong as its weakest links. The co-existence of extremes of poverty and wealth in societies such as the United Kingdom and U.S. poses particular dangers.

    We must awaken to the environmental origins of viral diseases. What Julio Vincent Gambuto[vi] has described as this ‘Great Pause’ should bring a more harmonious relationship with nature, and other animals, as we negotiate with this and even greater environmental dangers.

    Finally, as Yuval Noah Harari cogently argued:

    When choosing between alternatives, we should ask ourselves not only how to overcome the immediate threat, but also what kind of world we will inhabit once the storm passes. Yes, the storm will pass, humankind will survive, most of us will still be alive — but we will inhabit a different world.[vii]

    In confronting this pandemic we face a choice between top-down, authoritarian control – seen vividly in China – where basic liberties have been all-but extinguished. The alternative is a state that trusts in the collective education and responsibility of citizens – civil society – a rather extreme experiment in which is unfolding in Sweden.

    There may indeed be periods when a state-imposed lockdown is justified to avert a calamity – as in Italy at the height of its surge – but we must remain vigilant to the seepage of emergency powers into ordinary usage when this crisis lifts and only countenance measures that are proportionate to risk.

    Already, authoritarian regimes, such as Viktor Orban’s in Hungary,[viii] are undermining democratic institutions. Alas, the ‘Fourth Estate’ of journalism has been greatly diminished by job losses in the age of the Internet and reliance on commercial advertising, which has opened the door to regressive but digitally-savvy far-right Populism.[ix]

    Social Gradient

    “Nickelsville” homeless encampment, Seattle, Joe Mabel (wikicommons).

    At this stage much of our knowledge of Covid-19 is provisional, but early research from the WHO in China found 78%-85% of contagions occurred in clusters within family groups.[x] Armed with knowledge of how the disease spreads and sufficient resources, affluent families around the world are taking care of elders and other vulnerable people.

    However, as Charles M. Blow put it: ‘Social Distancing is a Privilege’. He reported on how incidences are highly intersected with race (which aligns with poverty in the United States), citing surveys from Milwaukee and Chicago where victims were 81 and 70 per cent African-American respectively.[xi]

    Myriad factors link poverty to the contagion including: the number of residents per household; the space afforded to each occupant; the extent of inter-generational co-habitation; exposure to pollution; besides other health indicators, such as obesity. Particularly vulnerable categories include individuals squeezed into homeless shelters, or those living in crowded facilities accommodating refugees and asylum seekers; also older generations inadequately protected in residential care homes across Europe.[xii]

    Notably, countries that bore the brunt of austerity policies since the Financial Crash from 2007 such as Italy, Spain, and the U.K. are now experiencing higher mortalities tolls than others, such as Germany or Denmark, where living standards were maintained.

    Sweden

    Swedish Social Democratic Party in Vasaparken, Stockholm in 2013, Image: Frankie Fouganthin (wikicommons)

    Unlike almost every other European country the Swedish government did not mandate the closure of schools, pubs and restaurants. As the pandemic raged this seems to have been flawed, but it is worth exploring why a true catastrophe has not unfolded, as we’ve seen in Italy, Spain, France, the U.S. and the U.K.. Indeed the trajectory of new cases appears to be flattening as we enter mid-April.[xiii]

    Sweden’s mortality count per capita (which is equivalent to Ireland’s whose government has generally been lauded for its response[xiv]) is four times higher than that in neighbouring Norway’s and twice Denmark’s,[xv] both of which swiftly closed their borders, schools, pubs and other businesses, and imposed lockdowns. But the divergence may, in part, be explained by recent under-investment in healthcare. The country had the second lowest number of critical beds in Europe after Portugal prior to the crisis, with only 5 beds for every 100,000 inhabitants.[xvi] Moreover, we are yet to measure the health benefits of avoiding draconian measures.

    Cultural factors such as the absence of kissing and hugging as conventional greetings and sparse habitation are relevant, but it appears that Sweden’s mostly uninterrupted social democratic history throughout the twentieth century,[xvii] including free university education, insulates its population from the worst ravages.

    Notably, 40% of Swedish households are single-person residences,[xviii] and, although the largest cities of Stockholm and Gothenburg have experienced a recent housing crisis with scarce supply and high prices,[xix] recent concerted action by the Social Democrat-Green coalition government has alleviated this, providing subsidies to builders and tweaking capital gains tax for house sellers to encourage turnover.[xx]

    In contrast, English-speaking countries such as the United States and Britain (predicted to experience the worst outbreak in Europe[xxi]) have avoided intervention in the housing market, except at the very bottom of the social scale. But the ensuing ‘Financialization of Daily Life’[xxii] has been accompanied by the stripping away of welfare entitlements, bringing widespread homelessness and reliance on food banks. The current pandemic has been aggravated by political leaders so wedded to commercial priorities they seemed prepared to sacrifice the sick and the old.[xxiii]

    Obesity

    Image: Tibor Végh (wikicommons)

    The damage wrought by free market ideologies may run deeper in terms of human health if we accept a link with another global pandemic: obesity. This condition is strongly associated with many of the pre-existing health problems that place a person at greater risk of death from Covid-19 infections, including hypertension and diabetes.[xxiv]

    The onset of the obesity pandemic, now afflicting nearly two billion people around the globe,[xxv] has been linked to numerous developments, including the invention of high fructose corn syrup in 1967, as well as over-reliance on the motor car. But the arrival of Margaret Thatcher and Ronald Reagan into power in the 1980s is a generally overlooked factor.

    As Avner Offer asserted: ‘Among affluent societies, the highest prevalence of obesity is to be found in countries most strongly committed to market-liberal policy norms.’ He argues: ‘if stress generates obesity, then welfare states protect against stress, and are likely to have lower states of obesity.’

    He says: ‘it is appropriate to think of the rise of obesity as an eruption, and to look for another eruption to explain it’. He identifies this as the emergence of the New Right in the 1970s, and the market-liberal regimes that carried out economic and social programmes in the main English-speaking countries, and elsewhere.

    With regard to the U.K., where obesity rates have almost tripled since 1979 when Margaret Thatcher came to power, he claims obesogenic conditions were already in place by the 1970s: car-use and television-watching were well established, and food was already cheap and plentiful; but that Thatcherism acted as a catalyst.

    Heightened stress levels especially fuelled by employment uncertainties affect dietary choices: ‘Physiologically, stress leads individuals to prefer fatty and sweet foods, and frequently to consume more calories, exacerbating weight gain, especially in the form of risky abdominal fat.’[xxvi]

    The link between insecurity, stress and obesity is supported by the ‘social gradient’ of obesity’: it is most prevalent among those at the bottom of the social scale, stressed out and living in crowded accommodation in so-called ‘food desserts’, lacking access to nutritious foodstuffs.

    Public v Private Health

    It is a misconception that increasing health expenditure in any Western society, above a certain level, will lead to a rise in life expectancy. In fact, there are rapidly diminishing returns on investment. Moreover, many treatments arrive with significant health warnings, and leave many of us susceptible to Covid-19.

    Primary care, especially maternity services, paediatrics (including selective use of antibiotics and vaccination), and emergency treatment facilities, certainly minimises premature deaths. But countries in thrall to privatised healthcare tend to focus spending on medications, and other costly treatments, as opposed to preventive strategies. Thus the United States, which spends almost 18% of its GDP on healthcare (the highest level per capita in the world)[xxvii], has among the lowest life expectancies among advanced countries.[xxviii]

    Rather than addressing the environmental and lifestyle triggers of the diseases of cancer and heart disease that are the leading causes of mortality (and morbidity), the United States supports a vast pharmaceutical industry that thrives off ill-health, just as its Military Industrial Complex profits from perpetual warfare.

    Shockingly, in the United States a John Hopkins team calculated in 2016 that 250,000 deaths were caused by medical errors each year, making iatrogenic illness the third leading cause of death.[xxix]

    All of this coheres with the 1971 Tudor Hart Inverse Care Law,[xxx] stating:

    The availability of good medical care tends to vary inversely with the need for it in the population served. This inverse care law operates more completely where medical care is most exposed to market forces, and less so where such exposure is reduced. The market distribution of medical care is a primitive and historically outdated social form, and any return to it would further exaggerate the maldistribution of medical resources.

    In other words, efficiency declines as expenditure increases, and the more privatised the health market the worse the outcomes.

    Cancer and Heart Disease

    Disconcertingly, Siddhartha Mukherjee characterises the history of cancer research as, ‘intensely competitive’, and featuring, ‘a grim, nearly athletic, determination.’[xxxi] Patient welfare, as opposed to survival, is often not to the fore, as experts compete for the next breakthrough in extending life, or finding an ever-elusive cure.

    Apart from successfully discouraging smoking, we see insufficient focus and investment by national governments on preventive strategies, particularly in terms of nutrition, which often threaten vested interests. Confronting a virus that can often prove fatal for those on prolonged treatment courses should shift priorities.

    Notably warnings ought to be provided when we purchase red and processed meat, which according to the WHO are ‘possible’ and ‘probable’ carcinogens respectively.[xxxii]

    These foodstuffs, along with saturated animals fats and refined sugars, are also linked to heart disease, the other big killer in Western societies. The Harvard School of Public Health recommend a Mediterranean diet including: ‘high intake of olive oil, nuts, vegetables, fruits, and cereals; moderate intake of fish and poultry; low intake of dairy products, red meat, processed meats, and sweets; and wine in moderation, consumed with meals.’[xxxiii]

    Urban planning should also inculcate more daily exercise by encouraging cycling and walking as opposed to motor car dominance. At least Covid-19 gives us a vision of how tranquil cities can be if motor cars are restricted.

    Antibiotic Overuse

    Another longstanding issue related to this pandemic is persistent overuse of antibiotics in most Western countries, as Covid-19 patients in hospitals are now at great risk of succumbing to infection by bacterial opportunists.[xxxiv]

    Indirectly also, the welfare of a person’s microbiome, the collective term for the bacteria with which we enjoy a symbiotic relationship, is critical to overall health. Fundamental to the understanding of our complex relationship with the bacteria with which we coexist is the concept of amphibiosis: ‘the condition in which two life-forms create relationships that are either symbiotic or parasitic, depending on the context.’

    Over the last seventy years we have progressively weakening this crucial organ, upsetting our cohabitants. Martin Blaser links bacterial impoverishment to the onset of a host of modern plagues including obesity, diabetes, heart-burn and GORD, asthma, a host of allergies, IBS and even autism.

    According to Blaser the main source of the microbiome’s decline has been the invention in 1942 and subsequent over-use of antibiotics, which he likens to the development of the atom bomb. Apart from generally weakening our immune system, over-use in humans and in animal agriculture has given rise to superbugs such as MRSA that already kill thousands each year.

    Antibiotics have saved millions of lives, and many surgical procedures are too dangerous to consider without them. However, over-use by doctors and dentists has surged in most Western countries to the extent that often the average twenty year old has taken almost twenty courses. Indeed, a 2016 study found that over 30% of antibiotics prescribed in the U.S. are unnecessary.[xxxv]

    Generally, the fault does not lie with individual doctors. Besides patients demanding medication, they reflexively prescribe for sore throats to avoid occasionally fatal rheumatic fever, which typically occurs two or three weeks after an untreated strep infection and can be fatal. These infections are mainly viral and do not respond to antibiotics, but problematically a sore throat may already have been colonised by a strain of bacteria that is not causing the disease.

    Today most bacterial infections are treated with broad-spectrum antibiotics. Martin Blaser asserts that: ‘Until doctors can readily distinguish viral from bacterial throat infections, they will always follow the safer course.’ He continues: ‘It is not profitable for companies to go to the trouble and enormous expense of developing new antibiotics.’[xxxvi]

    Targeted antibiotics are only applicable in a small number of cases, and make little sense where companies are concerned with the bottom line, as opposed to the overall health of the patient, and society. A genuinely public healthcare system dictating research priorities would surely address this problem, and help confront Covid-19 and other respiratory diseases.

    Another problem lies with the use of antibiotics in animal agriculture. Just as in humans, untreatable bacterial infections are emerging in farm animals and these are passing the species barrier into human populations. Often farmers utilise antibiotics not to treat disease but in order for these animals to grow more quickly. The practice of using sub-therapeutic doses is now banned in the EU but the law is difficult to enforce.

    Blaser also connects over-use to the obesity pandemic as antibiotics also cause weight gain in humans. This is borne out by studies showing obese individuals to have far less of a range of bacterial strains compared to individuals of normal weight. An NHS study the Avon Longitudinal Study of Parents and Children showed that children who received antibiotics in the first six months of life were likely to have a higher body mass index.[xxxvii]

    Air Quality

    As in most crises, there is a silver lining to the Covid-19 pandemic as we witness huge improvements in air quality all across the world.

    In 2008, the European Environment Agency warned that air pollution causes almost 500,000 premature deaths in Europe every year, with most of the twenty-eight EU states failing to meet air quality targets.

    In 2015, about 422,000 people died prematurely in European countries from exposure to harmful levels of fine particle matter (PM2.5). These particles are too small to see or smell but cause or aggravate heart disease, asthma and lung cancer.

    The report also attributed 79,000 premature deaths to the toxic gas nitrogen dioxide (NO2) – related to vehicles and central boilers. Ground-level ozone (O3) is also killing an estimated 17,700 people, prematurely, across European nations.

    The main sources of air pollution are: fuel-consuming forms of transport; energy production and distribution; commercial and institutional buildings, and homes; industry agriculture, and waste management.[xxxviii]

    Air pollution has been linked to elevated mortalities in hot spots such as New York and Lombardy, where the Alps are visible from Milan as never before.[xxxix] This Great Pause allows us to reflect on the necessity of much of what we produce in our economies.

    Spillover

    Concentrated animal feeding operation (CAFO), Unionville, Missouri, United States, owned by Smithfield Foods.

    In 1994 Laurie Garrett warned the world:

    While the human race battles itself, fighting over ever more crowded turf and scarcer resources, the advantage moves to the microbes’ court. They are our predators and they will be victorious if we, homo sapiens, do not learn how to live in a rational global village that affords the microbes few opportunities.[xl]

    The origins of most of the contagious diseases we confront lie in our relationship with other animals. As David Quames puts it: ‘ecological disturbance causes disease to emerge. Shake a tree, and things fall out.’ He warned that human activities are causing the disintegration of ‘natural ecosystems at a cataclysmic rate.’[xli]

    Correctly, a huge amount of attention has been focused on China’s so-called wet markets of captured or dead wildlife, as the probable location of a zoonotic incident that engendered the novel virus (involving bats and the rare pangolin as a reservoir host).

    Previously, a southern Chinese appetite for wild animals was conflated with a period of sustained economic growth in the 1990s, and termed ’the Era of Wild Flavor.’ Businessmen would reportedly gather at one of the province’s many ‘Wild Flavor’ restaurants to feast on a great variety of animals, some of which were reputed to make consumers fan rong or ‘prosperous.’[xlii]

    David Quames describes the scene at the markets:

    The catfish the crabs, and eels churned slowly in aerated tanks. The bullfrogs huddled darkly in scrums. It was grim to be reminded how we doom animals with our appetite for flesh, but this place seemed no more odd or morbid than a meat market anywhere.[xliii]

    He goes on to warn that the risks are not limited to exotic meat markets, and that factory and livestock farms around the world present dangers: ‘It’s almost impossible to screen your pigs, cows, chicken, ducks, sheep, and goats for a virus of any sort until you have identified that virus (or at least a close relative), and we have only begun trying. He adds: ‘tomorrow’s virus pandemic may be no more than a “blip on the productivity output” of some livestock industry today.’[xliv]

    Cow fields are not a timeless and harmless rural idyll: ‘A trillion pounds of cows, fattening in feedlots and grazing on landscapes that formerly supported wild herbivores, are just another form of human impact. They are a proxy for our appetites and we are hungry.’[xlv]

    Perhaps it is no coincidence that carnivorous is an anagram of coronavirus.

    Little State, Big Government

    Fictitious map from George Orwell’s novel 1984.

    The finger must come off the pause button soon. Whether we develop a vaccine or not, we cannot indefinitely endure life as contestants on a dystopian game show. For many of us restraints on natural inclinations – including so-called ‘social distancing’ – have been traumatic. Extended lockdowns will be impossible to enforce without a descent into a barbarity of petty betrayals and transhumance; while the Chinese approach of tracking movements through smart phones – adopted in other countries too[xlvi] – is deeply sinister.

    As in Sweden, civil society can adjust behavioural norms to resist this virus and others to follow, and ensure governments respond meaningfully to even more pressing challenges, such as climate change and the Sixth Extinction. We may have to accept health passports at border checkpoints for a time, but within countries, we should expect freedom to roam, interact and trade.

    At this juncture we need a Little State, which does not impinge on basic liberties and privacy, but a Big Government – as in Sweden too – working to ensure conditions for human flourishing including: healthy nourishment, clean air and water, a roof over one’s head, as well as education and basic healthcare.

    Anyone resistant to government intervention might consider John Rawls’s justification of a redistribution of wealth by allusion to a hypothetical rational agent, ‘situated behind a veil of ignorance.’[xlvii] This fictional character cannot know the situation he will be born into, and must decide the kind of society he would favour. If the family you are born into is a lottery, any rational person surely favours an equitable distribution of wealth.

    At least we confront the prospect of another financial meltdown with an enhanced awareness of the financial clout of governments in a period of crisis. The public purse is deeper than has been acknowledged. Governments control the distribution and value ascribed to money, a measurement tool for the exchange of goods and services.

    In terms of public health we can reduce the use of antibiotics and other unnecessary drugs; promote exercise and combat sedentarism; curb pollution; and highlight the danger of over-consumption of unhealthy foodstuffs.

    It would be tragic if this pandemic led to the demonization and eradication of animals that could harbour suspect viruses, as opposed to leading to the permanent closure of the wet markets and hopefully factory farming too. Quite apart from the morality of this, we are dealing with highly complex ecosystems. Any measure could have unintended, dire consequences.

    As the U.N.’s Sustainability Goals[xlviii] reminds us, biodiversity is essential for human flourishing. The limits of natural capital must be taken into account if economic activity is to remain sustainable, which is especially important for feeding populations. The pandemic highlights crucial interdependencies, and the catastrophic consequences of another outbreak means that the burden to adapt is shared by us all.

    [i] David Smith, ‘Trump sows confusion with claim coronavirus drug will be ready soon’, The Guardian, March 19th, 2020, https://www.theguardian.com/us-news/2020/mar/19/coronavirus-drug-trump-confusion-malaria-treatment-readiness

    [ii] WHO, ‘Coronavirus disease (COVID-19) advice for the public: Myth busters’ https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/myth-busters

    [iii] Megan Molteni, ‘Everything You Need to Know About Coronavirus Vaccines’, Wired, April 3rd, 2020, https://www.wired.com/story/everything-you-need-to-know-about-coronavirus-vaccines/

    [iv] Untitled, ‘Coronavirus: Vaccine could be ready as early as September, according to scientist’ Sky News, April 12th, 2020,  https://news.sky.com/story/coronavirus-vaccine-could-be-ready-as-early-as-september-according-to-scientist-11971804

    [v] Derek Lowe, ‘Coronavirus Vaccine Prospects’ In the Pipeline, April 15th, 2020 https://blogs.sciencemag.org/pipeline/

    [vi] Julio Vincent Gambuto, ‘Prepare for the Ultimate Gaslighting*’, Medium April 10th, 2020, https://forge.medium.com/prepare-for-the-ultimate-gaslighting-6a8ce3f0a0e0

    [vii] ‘Yuval Noah Harari: the world after coronavirus’ March 20th, 2020 https://www.ft.com/content/19d90308-6858-11ea-a3c9-1fe6fedcca75?fbclid=IwAR2am6cP4xQoG17fnKTsCeJdteQJRNwE_D6YkUkkZL25gD7AQN4CW8AOFck

    [viii] Yasmen Serhan, ‘The EU Watches as Hungary Kills Democracy’, April 2nd, 2020, The Atlantic,  https://www.theatlantic.com/international/archive/2020/04/europe-hungary-viktor-orban-coronavirus-covid19-democracy/609313/

    [ix] Frank Armstrong, ‘Democracy in Decay: Steve Bannon & Jordan Peterson’, January 17th, 2020, Cassandra Voices,  https://cassandravoices.com/current-affairs/global/democracy-in-decay-steve-bannon-and-jordan-peterson/

    [x] WHO, ‘Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19)’, February, 2020, https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf

    [xi] Charles M. Blow, ‘Social Distancing Is a Privilege’, New York Times, April 4th, 2020 https://www.nytimes.com/2020/04/05/opinion/coronavirus-social-distancing.html

    [xii] Robert Booth, ‘Half of coronavirus deaths happen in care homes, data from EU suggests’, The Guardian, April 13th, 2020, https://www.theguardian.com/world/2020/apr/13/half-of-coronavirus-deaths-happen-in-care-homes-data-from-eu-suggests

    [xiii] Worldometer, ‘Sweden’, https://www.worldometers.info/coronavirus/country/sweden/

    [xiv] Frank Armstrong, ‘Ireland’s Response to the Coronavirus’, Cassandra Voices, March 28th, 2020, https://cassandravoices.com/current-affairs/irelands-response-to-the-coronavirus-pandemic/

    [xv] Niclas Rolander, ‘Swedish Virus Deaths top 1000 fueling criticism over strategy’ Bloomberg, April 14th, 2020 https://www.bloomberg.com/news/articles/2020-04-14/swedish-virus-deaths-top-1-000-fueling-criticism-over-strategy

    [xvi] A. Rhodes, P. Ferdinande, H. Flaatten, B. Guidet, P. G. Metnitz & R. P. Moreno, ‘The variability of critical care bed numbers in Europe’, Intensive Care Medicine volume 38, pages1647–1653(2012), https://link.springer.com/article/10.1007/s00134-012-2627-8

    [xvii] Untitled, ‘Before Sweden Was Social-Democratic, An interview with Erik Bengtsson’, Jacobin Magazine, September, 2019, https://www.jacobinmag.com/2019/09/sweden-social-democracy-erik-bengtsson

    [xviii] Melissa Godin, ‘Sweden’s Relaxed Approach to the Coronavirus Could Already Be Backfiring’, Time Magazine, April 9th, 2020,  https://time.com/5817412/sweden-coronavirus/

    [xix] Untitled, ‘Revealed: The state of Sweden’s housing shortage’, The Local, May 14th, 2019, https://www.thelocal.se/20190514/revealed-the-state-of-swedens-housing-shortage

    [xx] Simon Johnson, ‘Sweden grapples with housing market reform as risks mount’, Reuters, December 18th, 2019, https://www.reuters.com/article/sweden-economy-housing/sweden-grapples-with-housing-market-reform-as-risks-mount-idUSL8N28L43A

    [xxi] Rowena Mason, ‘UK could have Europe’s worst coronavirus death rate, says adviser’, April 12th, 2020, The Guardian,  https://www.theguardian.com/world/2020/apr/12/uk-could-have-europes-worst-coronavirus-death-rate-says-pandemic-expert

    [xxii] Randy Martin, Financialization of Daily Life, http://tupress.temple.edu/book/3182

    [xxiii] Chris Smyth, ‘No 10 denies Dominic Cummings would have let elderly die’, March 23rd, 2020, The Times, https://www.thetimes.co.uk/article/no-10-denies-dominic-cummings-would-have-let-elderly-die-qsl760jr9

    [xxiv] Jeffrey Kluger, ‘The True Impact of Underlying Health Conditions on Coronavirus Severity’, April 1st, 2020, Time Magazine, https://time.com/5813711/coronavirus-underlying-conditions/

    [xxv] WHO, ‘Obesity and overweight’ March 3rd, 2020, https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight

    [xxvi] Frank Armstrong, ‘The Unbearable Heaviness of Human Beings’, October 7th, 2020, The London Magazine, https://www.thelondonmagazine.org/article/the-unbearable-heaviness-of-human-beings-2/

    [xxvii] Irene Papanicolas, Liana R. Woskie, and Ashish Jha ‘Health Care Spending in the United States and Other High-Income Countries’, Commonwealth Fund, March 13th, 2018,

    https://www.commonwealthfund.org/publications/journal-article/2018/mar/health-care-spending-united-states-and-other-high-income

    [xxviii] OECD.stat https://stats.oecd.org/index.aspx?queryid=30114

    [xxix] Vanessa McMains, ‘Johns Hopkins study suggests medical errors are third-leading cause of death in U.S.’, John Hopkins University, May 3rd, 2016, https://hub.jhu.edu/2016/05/03/medical-errors-third-leading-cause-of-death/

    [xxx] Julian Tudor Hart, ‘The Inverse Care Law’, The Lancet, February 27th, 1971, https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(71)92410-X/fulltext

    [xxxi] Frank Armstrong, ‘Cancer – A Distorted Version of Our Normal Selves’ Cassandra Voices, September 7th, 2019, https://cassandravoices.com/uncategorized/cancer-a-distorted-version-of-our-normal-selves/

    [xxxii] Untitled, ‘Q&A on the carcinogenicity of the consumption of red meat and processed meat’, WHO October 26th, 2015 https://www.who.int/news-room/q-a-detail/q-a-on-the-carcinogenicity-of-the-consumption-of-red-meat-and-processed-meat

    [xxxiii] ‘Preventing Heart Disease’, The Nutrition Source, Harvard School of Public Health, https://www.hsph.harvard.edu/nutritionsource/disease-prevention/cardiovascular-disease/preventing-cvd/

    [xxxiv] Claas Kirchhelle, Adam Roberts, Andrew C. Singer, ‘Antibiotic Resistance Could Lead to More COVID-19 Deaths’, Scientific American, April 1st, 2020, 2020https://blogs.scientificamerican.com/observations/antibiotic-resistance-could-lead-to-more-covid-19-deaths/

    [xxxv] Center for Disease Control and Protection, ‘CDC: 1 in 3 antibiotic prescriptions unnecessary’  https://www.cdc.gov/media/releases/2016/p0503-unnecessary-prescriptions.html

    [xxxvi] Martin Blaser, Missing Microbe: How Killing Bacteria Creates Modern Plagues, One World, London 2014 pp.64-78.

    [xxxvii] L. Trasande, J Blustein, M Liu, E Corwin, LM Cox, and MJ Blaser, ‘Infant antibiotic exposures and early-life body mass’ August 21st, 2012,

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3798029/

    [xxxviii] Untitled, ‘Air pollution: Half a million early deaths in Europe despite progress’, BBC, October 29th, 2018, https://www.bbc.com/news/world-europe-46017339

    [xxxix] Damian Carrington, ‘Air pollution linked to far higher Covid-19 death rates, study finds’ April 7th, 2020, The Guardian, https://www.theguardian.com/environment/2020/apr/07/air-pollution-linked-to-far-higher-covid-19-death-rates-study-finds?fbclid=IwAR0HF2B0LT8aNLWigzRzEhui_w1_gfndwFPP2Xfe4nvu0r2ujY78Hy56RXM

    [xl] Richard Horton, ‘Coronavirus is the greatest global science policy failure in a generation’, April 7th, 2019 https://www.theguardian.com/commentisfree/2020/apr/09/deadly-virus-britain-failed-prepare-mers-sars-ebola-coronavirus

    [xli] David Quames, Spillover: Animal Infections and the Next Human Pandemic, Bodley Head, London, 2012, p.23

    [xlii] Cheryl Miller, ‘The Red Plague’, The New Atlantis, Winter, 2007, https://www.thenewatlantis.com/publications/the-red-plague

    [xliii] Quames, p.197

    [xliv] Quames, p.322

    [xlv] Quames, p.497

    [xlvi] Zac Doffman, ‘COVID-19 Phone Location Tracking: Yes, It’s Happening Now—Here’s What You Should Know’, Forbes, April 7th, 2020 https://www.forbes.com/sites/zakdoffman/2020/03/27/covid-19-phone-location-tracking-its-moving-fast-this-is-whats-happening-now/#1b7e565e11d3

    [xlvii] Stanford Encyclopaedia of Philosophy, https://plato.stanford.edu/entries/original-position/

    [xlviii] UN Sustainability Goals, https://www.un.org/sustainabledevelopment/biodiversity/

  • Diary of a Pandemic Doctor Part 2

    No one will want to read this, as this is about death.

    As we sit, quarantined in our homes, scrolling through the news of the pandemic, death seems to stand, ever present, in the corner of the sitting room. Our everyday behaviour is now invested with the knowledge of his presence. The actions we take, staying home, keeping two metres from one another, have a direct, logical relationship to the struggles of people gasping on ventilators in intensive care units.

    It is alien for us to have death at such close proximity. We have in the last decades managed to block it out, hide it away, to think that if we throw all our resources at it we might prevent it.

    But of course death is as natural to life as birth.

    Most of the time doctors battle against the humdrum vagaries of life: the sore throats, broken arms and anxieties; but now and then we are called upon to joust with death, and sometimes during this battle we have to lay down our arms and allow death take its prize.

    Some of my patients have begun dying from Covid-19. They have been unwell for a few days with fevers, chills, and muscle pain. Most get better after a week, but some suddenly develop hypoxemia, a low level of oxygen in their blood, and a few hours later are on a ventilator, mechanically deflating and inflating their lungs.

    If they develop the cytokine storm, a sudden rush of inflammatory cells entering the lungs, the immune system aberrantly attempting to combat the virus, they often die. Death walks the intensive care unit, taking every second patient.

    Just before the pandemic started I made several house calls to an elderly couple. They lived in an airy, high-stucco-ceilinged apartment, full of the accretions of a long life: family pictures hung on the walls, showing adult children, grandchildren; a straw parasol from a tropical holiday in the corner; coloured crystal glasses on the fireplace.

    In an overheated bedroom the elderly man lay on the bed, his limbs cachexic, his skin mottled with liver spots. His chest heaved unnaturally with the effort of breathing. The pump of his heart was failing, so his lungs filled with fluid.

    I had sent him to hospital twice, where they had tapped his lungs, but the respiratory physician called me on his final discharge to say that they would not take him again. I had tried, with diuretic tablets, to clear his lungs, so he could breathe more comfortably. But now even these were failing. It was time to lay down arms and give comfort, rather than fight.

    I took his wife and son aside in the darkened corridor and told them that I would be removing most of his medication, giving just the necessary to make him comfortable. His wife begged me to send him to hospital, saying that she had arranged things so the whole family would be home for Christmas to spend it with him.

    I tried, as best I could, to explain that now was the time to recognise that he would soon die, to gather the family quickly, to make him comfortable, and to spend that time with him. After a long discussion they became reconciled to the situation, took their places either side of the bed, holding the old man’s hands in theirs.

    The home nurse injected an infusion of morphine to relieve his distress, and I left to the sound of the quietening of his ragged breathing and his wife’s sobs.

    By recognising what death is we recognise what life is. That is maybe why this feels like such a moment of quickening. Death has come knocking at our doors and we are forced to open and acknowledge him. The door will close again, but the collective memory will remain, and when the pandemic is over this may help us to invest life with more meaning.

    Read the first installment of Dairy of a Pandemic Doctor here.

  • Diary of a Pandemic Doctor Part 1

    Tonight I walked to the sea in the dark. The city streets were empty except for a tomcat clawing at a wooden lamp post. It turned and padded off as it heard my steps, its shoulders rolling, leonine.

    When I came to the shore the air was still, the city’s lights amber diffusions in the ocean’s surface stretching out towards the islands marshalled in the bay. As I sat there I thought of personal crises I’d been through, small things now, that made it seem to me that the world for days or weeks creaked and turned askew. And then I thought of this moment, and this external threat, when the world really is altering before us.

    The sea’s surface had the sheen of glass – a dead calm. I imagined the water suddenly retreating, the shingle of the ocean’s floor hushing as it was revealed, fish flopping where they lay, the water gathering itself into a giant wave, a dark curtain throwing the skyscrapers of the city into shadow, its angry upper lip broiling with white foam.

    Over nine hundred dead in Italy today. Five of them doctors and nurses. 9% of those infected are medical personnel.

    What do we do in the face of this wave? Give in to hopelessness?

    Someone posted a photo of my graduating class from medical school in Ireland the other day. Young faces then, kids – Asian, Indian, American, Canadian, Australian, Irish, Norwegian. I think of them seeded through the world, now senior doctors, readying themselves for what is to come.

    Over 24,000 retired doctors and nurses in my own, small home country of Ireland took themselves out of retirement this week, and said they were ready to throw themselves into the fray; many are people who are of an age that they have a high risk of dying from the virus if they get infected.

    With that kind of bravery around we can’t give in to hopelessness. So we build a wall, use ourselves as bricks, and we repel the fucker as best we can.

    Before leaving I crouch at the sea’s edge and hold my fist under the water until it’s so cold it hurts. It’s time for all of us to get to work.

  • Coronavirus: a Silver Lining?

    My colleagues are working flat out these days. After seeing our list of patients, we are on the phone and email advising people to quarantine, to get tested, or take measures such as social distancing.

    What we are trying to do is help ‘flatten the curve’ of the outbreak: to avoid a peak of infections; to slow down the rate of transmission; and have it play out over as long a period as possible.

    The frightening reports from doctors in Italy describing an overwhelmed hospital service, dealing with a peak in admissions of potentially fatal bilateral interstitial pneumonia caused by the virus, makes the work ever more urgent.

    Many of our patients are elderly, multi-morbid, and therefore vulnerable to the worst effects of the virus.

    When I advise our healthy patients about measures they can take, many are blasé, given the symptoms they get will probably be mild. When I explain that these measures are not for their own sake, but rather for the most vulnerable among them – their relatives, friends or neighbours – I can see it sinking in, and a new seriousness emerging.

    If there is a silver lining to this crisis it is the revelation of how connected we are to each other, in ways we have almost forgotten. We are a species with special concerns. We cannot afford to operate alone as individuals; to do so is to threaten us all. This realisation is putting into stark relief the way we have organised our societies over the past few decades.

    Some private health care clinics in Dublin are now putting up signs saying they will not accept patients with respiratory symptoms, directing them towards their G.P’s. This is in one way understandable as a means of limiting transmission, but while the public service is taking extra measures to distribute information and organise the response, these private clinics are under no compulsion to do so.

    Successive Irish governments have developed a dual private\public system, where the state health service lacks resources and, not least, organisational capacity, meaning that this crisis could be a painful exposure of its limits.

    In the U.S, Trump’s apparatchiks like Mike Pompeo have sprinkled their public statements with references to the ‘Wuhan corona virus’, pointing the finger abroad to evade criticism of their response to the crisis.

    As of Sunday, a mere 1,707 Americans had been tested due to a lack of test kits. South Korea, by contrast, has tested more than 189,000 people. The U.S is hampered by a hollowing out of the U.S civil service and the privatization of health care.

    Turns out big government, when the shit hits the fan, is a very good idea.

    This crisis will abate. It is hard to gauge how many people we will lose to the infection, but when the wave has broken and dissipated, hopefully the realisation will have dawned that the defences we build are only strong enough if we build them together.

    Dr Samuel McManus is an Irish G.P. currently working in Norway.