[ Question ]

How bad is coronavirus really?

by Holly_Elmore1 min read8th May 20208 comments


How bad is coronavirus compared to the traditional top causes of EA? Is it something we as a community should be focused on even though it is not at all neglected? At what point is it too economically devastating (—> other kinds of suffering and death) to continue lockdown even without a vaccine?

I read the news, too, but there’s something about the level of response to coronavirus given the very moderate deadliness— especially within EA— that just does not add up to me. Please make the case for me!

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Malaria kills about half a million people each year, mostly toddlers. That number could double if normal prevention work isn't done.

Coronavirus kills around 1% of the people it infects in developed countries, mostly older people. However, it could potentially cause an order of magnitude higher deaths in certain settings (eg refugee camps without adequate sanitation or modern medicine).

If everyone alive were infected this year, I'd expect tens or hundreds of millions of deaths, compared to one million deaths from malaria.

However, I don't expect everyone to be infected. Governments, NGOs and healthcare workers are all working very hard on this. So although the scale is much larger than malaria, I'm skeptical that the average EA can make a bigger difference donating to coronavirus relief than malaria prevention.

Just a quick comment: I'd be wary of any answers to this that focus narrowly on the health impact (eg expected death toll) without trying to factor in other major impacts on well-being: economic (increased poverty and especially unemployment, reduced GDP, lost savings due to market drop), geopolitical (eg increased nationalism/protectionism, and even increased potential for war), and maybe more - even basic things like global anxiety! (Also some benefits, eg reduced carbon emissions, though I'd argue these are overrated.) These aren't easy to assess but I'd be very surprised if they didn't add up to more net impact than the deaths/illnesses themselves.

It depends if you define "coronavirus" as the virus, or the whole cascading scenario we are in, and whether you take account of fear, coms and incompetence*.

If you consider India, where the scenario includes a national lockdown and secondary deaths from involuntary migration, loss of health services, malnutrition, impoverishment, a huge hit to the economy etc, this is really bad, and comparable to the 1930s, even in the context of malaria etc.

(Apology for not adding links/refs - I'm v busy on ALLFED pandemic work.)

If we had had preparedness in the form of a ready-to-go food voucher system in every large city, or tracing and "smart lockdowns" much of this secondary / cascading impact could have been avoided. Any good working group, if they included lockdowns as part of a pandemic preparedness strategy, would within an hour of interrogating that strategy have seen the need for such a voucher system, and that preparing and installing one would have been ridiculously cheap, compared to the downside risks and consequences, and that maybe a test-trace-isolate as done successfully in Korea and Kerala would be a far better approach.

So that would have taken preparedness work, and imitating best practice in Korea etc, and one way to do this would be through Foresight Institutes not dissimilar from FHI, Gates Foundation, Oxford Martin School etc, which ALLFED.info proposes for South Asia, as do others.

We also, need to understand why the SARS-1 lessons learned were implemented in some Asian countries but not in UK, USA, Italy etc and whether our governments simply lack the needed capacities-incentives-culture, and therefore it must be done by Central Bank continuity teams, private sector or new institutions with their own constitutional/federal mandates, which can't be undone or unfunded by political whim or due to short-sighted errors.

*By fear, coms and incompetence I mean whether your theory of change is along the lines:

< academics do research and propose solutions -> wise politicians listen and implement and never get confused between science and economic thinking and their own agendas >

or whether you take account that

(a) governments don't always successfully limit fear in the population and that fear may drive mass behaviour as much as reality

(b) that how communication happens culturally may be a huge factor (compare NZ, India, China, USA, UK, Kenya)

(c) governments take decisions for a range of reasons, and simply presenting logical solutions to governments, even campaigning for them, isn't effective as many people imagine, especially in high pressure or fast-moving scenarios

So your preparedness may require equal attention to coms/media/internal coms/Nudge work as it does to classic DRR, implementation science/scaling etc.

This is perhaps somewhat unintuitive to the EA movement, which tends to have very few people involved in behavioural and psychological science, with a few honourable exceptions such as Fiona Conlon and the Charity Science (Health) team in India which I believe includes Varsha Venugopal, Krutika Ravishankar, and Nithya Nagarathinam - they are working on SMS messaging to support safer behaviour during covid19.

There are two different angles on this question. One is whether the level of response in EA has been appropriate, the second is whether the level of response outside of EA (i.e., by society at large) has been appropriate.

I really don't know about the first one. People outside of EA radically underestimate the scale of ongoing moral catastrophes, but once you take those into account, it's not clear to me how to compare -- as one example -- the suffering produced by factory farming to the suffering produced by a bad response to coronavirus in developed countries (replace "suffering" with "negative effects" or something else if "suffering" isn't the locus of your moral concern). My guess is many of the best EA causes should still be the primary focus of EAs, as non-EAs are counterfactually unlikely to be motivated by them. I do think, however, that at the very beginning of the coronavirus timeline (January to early March), the massive EA focus on coronavirus was by-and-large appropriate, given how nonchalant most of society seemed to be about the coronavirus.

Now for the second one -- has the response of society been appropriate? I'm also under-informed here, but my very unoriginal answer is that the response to the coronavirus has been appropriate if you consider it proportional, not to the deadliness of the disease, but to (1) the infectivity of the disease (2) the corresponding inability of the healthcare system to handle a lot of infections. You wrote:

I read the news, too, but there’s something about the level of response to coronavirus given the very moderate deadliness— especially within EA— that just does not add up to me.

And it seems like you're probably not accounting for (1) and (2). It does not seem like a particularly deadly disease (when compared to other, more dangerous pathogens), but it is very easily spread, which is where the worry comes from.