As Canadian expats in Austria, one of the things that has particularly struck my family and I is the orderliness with which the country is dealing with the pandemic. As quarantine policies were put into place, we saw panic toilet paper hoarding in other countries, but here in Austria people were (amazingly) compliant and seemed to obey instructions and timelines provided by the authorities. We never worried about our basic needs. Grocery stores were always well stocked, public transit was always there and on time – and masks were readily available when required as physical barrier to protect others.
Expert opinions, governments, and publics are making it clear that there is no one-size-fits-all solution to this pandemic. What works in Austria might not be what worked for South Korea; and likely not the same as what works in other parts of Europe. Consider the Canadian landscape. There is huge variation in sociopolitical and cultural dynamics between and within provinces and territories. What works for some parts of Canada (virtual home schooling, grocery shopping) is impossible for others (Canada’s North). Cultural norms (multigenerational living, child/elder care) vary across the vast landscape. The “At Home on the Land” initiative – aimed at the particular needs of Indigenous communities is an example of a culturally-grounded way to address the pandemic. Finding solutions isn’t always as intuitive as we might like.
Humans tend to look for the easiest way out – we want simple solutions to complex problems. We don’t seem to want to think about the problems, we want them magically disappear. And thinking “outside of the box” isn’t always appreciated. Hand washing, clean water and the advent of antibiotics have made enormous leaps in our ability to tackle public health outbreaks – significant results. Where the bubonic plague is estimated to have killed 30%-60% of Europe’s population in the Middle Ages, modern outbreaks are now quickly identified and contained (were you even aware of the 2017 outbreak in Madagascar?). Understanding transmission routes has significantly impacted public health outcomes. The identification of tainted water as a vector for cholera transmission by John Snow led to the advent of modern epidemiology. But, as we find solutions to larger challenges, those that remain are more complex with increasing numbers of variables making solutions harder to come by.
There is some global agreement: lots of testing, quick results/containment, use of masks/physical barriers for community protection, social distancing, data collection. However, certain measures work better in some jurisdictions than others. What policies and practices are working and why are they working in these contexts? What is applicable in different contexts?
Our current global situation, has reminded me of a presentation I saw on the 2014 Ebola outbreak (Professor Melissa Leach, IDS), and how important it is to remember the human factor in crises. She discussed how the key elements that made the Ebola pandemic so persistent – despite the best efforts of global public health engagement – was a/the failure to understand how historic context, trust, cultural dynamics played into the spread of the virus. Those providing interventions did not appreciate how historic context (i.e. post-colonialism, slavery, medical testing scandals) and mistrust in the intentions of Western interventions factored into the willingness of the local population to accept the solutions provided. Awareness of social structures, influencers and leaders, and co-creation were also important to developing solutions that would be adopted by affected communities.
Evidence is more than the numbers of tests, infections and deaths. It is understanding the social context of communities, society writ large, and how they interact within and between. It’s about understanding historical context and how it feeds into local culture, social interactions and trust relationships. It’s about community dynamics, power struggles and the struggle for some to meet basic survival needs. It’s about timing of decision-making, political landscapes and different ways of leading. As with many of our global challenges, it’s a complex and multifaceted systems problem – in which the human factor is a huge driver.
As we strive for solutions to this global crisis – bring on innovation, research and science funding. We will need these – but please, also bring along those who study the complexity that is humanity: epidemiologists, anthropologists, economists, ethicists, political scientists, sociologists, futurists, etc. In an era where evidence is being questioned, fake news is rampant and anti-science sentiments are strong, it is crucial that we remember that one piece to engaging with this and the world’s other wicked problems is our relationships with our communities – the ones we are trying to protect. Public trust, built on understanding of the importance of human dynamics is key to broad acceptance and uptake. Solutions need to be palatable to society, or they won’t be adopted.
As we focus on the virus, let’s not forget the humans.
Note: This article gives the views of the author, and not the position of the Nexus blog, nor of the International Institute for Applied Systems Analysis. Link to original post: https://sciencepolicy.ca/news/save-covid19-lets-not-forget-humans