Covid-19: odds of winning

Social distancing as a strategy can only succeed if no significant minority is allowed to deviate

Rashid Mahmood Langrial March 31, 2020
The writer obtained his training at Harvard and is based in Lahore. He is a practitioner of design thinking and implementation in the public sector

After a lot of dithering and despite some lingering scepticism, Pakistan has finally proclaimed to fight an enemy whose virulence has no parallel in our national memory: the Covid-19. Let’s make no mistake: it is no easy battle to fight; it shall not only overwhelm the capacity of our healthcare system but shall also test the limits of our ability to stay coherent as a collective entity. Since Partition, no challenge has taxed our body politic so devilishly as the upcoming fight against this pandemic is likely to do. So, what are the odds of winning this critical battle for the flesh and soul of Pakistan? Unfortunately, there is yet no magic bullet in this battle against a virus that has mutated so recently that we know so little of its behaviour; and till our scientists give us the magic bullet, the fight against the pandemic rests purely on the total transformation of our collective behaviour towards personal hygiene and social distancing.

First the fundamentals of social distancing as a strategy for flattening the viral spread curve: in game-theoretic terms, it is a cooperation game whose positive network effects only materialise if there is no significant deviation in its early phase. Imagine a two-period cooperation game where the cost of deviation in Period I (a time period when most of the populace is without immunity) is so high that even a minor deviation defeats the purpose of coordinated strategy. Fortunately, in Period II (when majority of the population has achieved immunity), deviation by a minority does not cancel out the positive network externalities. For purposes of flattening the disease spread curve, Period II is not relevant but Period I is critical. During Period I, even if a couple of dozen people from the neighbourhood continue to meet for Friday prayers or for a weekend cricket match, the purpose of social distancing is defeated and spread of the virus continues unabated.

With Covid-19’s oblivion to distinction of class or piety in best tradition of microbial communism and with stakes so high (literally, life at stake), in theory, there must be little incentive for any agent to deviate from the obligation of social distancing. In practice, however, we have observed that the obligation of social distancing has been violated at will by the clerics who have been holding their congregations as late as the second week of March in Lahore and are attended by most of their flock living in poorer neighbourhoods and villages who have, at best, sporadically embraced the idea of social distancing. The state itself, through either lack of conviction or fear of failure, has hesitated to enforce social distancing even at public places. High priests of the state, despite the announcement of a lockdown across the country, at public events and official engagements, are being televised live while not observing the minimum distance protocols as late as the last week of March.

What can potentially explain this cognitively dissonant behaviour of various actors of the society i.e. clerics, officials of the state, and elected and not-so-elected high priests? Aren’t they normal people with rational expectations, engaged in preservation of their self-interest? Despite being avid users of various remedies that the modern science of medicine and surgery offers, in the heart of their hearts, they view disease and particularly a contagion as divine-ordained. In fact, they believe in the divine theory of disease as opposed to its natural/secular interpretation. For them, a pandemic is an act of an angry God, unleashed to punish and chastise humankind for its collective disobedience to His commands. The divine theory of disease brings in its wake divine remedies as well: collective prayers at religious gatherings assume the character of a cure rather than a source of a viral vector. Only a divine theory of disease can explain the gathering of some 200 devout Hindus in Delhi, to drink cow urine in order to ward off the coronavirus or the Burmese monks’ insistence for the placement of seven ground peppercorns on the tongue to escape the scourge of corona.

Despite Hippocrates’ clear declaration in 5 BC that disease is a natural event, explainable by secular causes and curable by rational methods, the powerful influence of Galen’s miasma theory of epidemics held back human understanding of plagues till the germ theory of disease established a clear mechanism of causality during the investigation of Bombay’s bubonic plague at the end of the 19th century. Meanwhile for two millennia, due to the deductive influence of Galen over Hippocratic medicine, human understanding of epidemics hinged either on the divine or demonic theory of disease. In most Muslim societies where Galen ruled the roost via the Yunnani system of medicine, epidemics are hard-wired into the human conscience and sub-conscience with supernatural interpretations. One is surprised to meet people in the high and mighty offices of the state who sincerely believe disease and epidemic to be wages of sin.

Social distancing as a strategy can only succeed if no significant minority is allowed to deviate; the conviction required to marshal this level of compliance cannot be available to a society whose dominant sections do not intellectually subscribe to a secular explanation of the epidemic and, by extension, a secular explanation of the universe. We cannot simultaneously adhere to the supernatural explanation of the idea of cosmos and do the required hard work for behavioural transformations on the basis of scientific principles. Having loaded the dice against ourselves, our odds of winning are pretty low; after all, we cannot practice magic and medicine at the same time.

Published in The Express Tribune, March 31st, 2020.

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