ADELAIDE - I spent 32 years working in various capacities within the health, hospital and aged care sector.
It was a continuous learning experience for me and one which, despite the anxiety and distress it sometimes generated, was richly rewarding in providing insights into the nature of humanity.
A fascinating part of my long term learning experience was working in the public and environmental health division of South Australia’s department of health.
Over a period of about four years I was exposed to information relating to all manner of public health issues ranging from the basics of disease, dunnies and drains through to the more esoteric but no less important worlds of radiation physics, pharmacology, food technology, epidemiology and communicable disease.
Public health as a speciality is often regarded by doctors as a slightly quaint branch of medicine, a place where failed clinicians tend to congregate.
This is a very unfair characterisation of the discipline which is undoubtedly the most important and effective in protecting overall public health.
Imagine what sort of world we would live in if the sewage system ceased to function properly or the water supply became tainted or, as we are now discovering, a new and lethal communicable disease got loose.
The great fear that has haunted public health specialists for many decades is the possible emergence of an organism which was so virulent and so fast moving that it would leave our health systems playing a desperate game of catch up while it wrought havoc across the world.
Let me tell you, there are some very, very scary organisms out there that fully justify this fear.
The COVID 19 virus (coronavirus), horrible as it is, does not rank amongst the most virulently lethal communicable diseases that might one day confront us.
History has provided many horrible examples of diseases that have killed huge numbers of us in very short order.
The best known is, of course, the black plague (Yersinia pestis), which wiped out at least one- third of Europe’s population when it first appeared there in the 14th century.
It carried on killing humans across the world in great numbers well into the 19th century before effective preventive and treatment methods finally brought it under control.
The last known case in South Australia was a sailor who contracted the disease at Port Adelaide in 1919.
Still, there is no room for complacency, as the black death is still with us, notably in parts of Africa. Rather startlingly, cases continue to be reported in the USA from time to time.
Other hardly less virulent communicable diseases such as smallpox, tuberculosis, typhoid, diphtheria, poliomyelitis, cholera and yellow fever cut a swathe through humanity for centuries before large scale immunisation finally brought them under control.
Less virulent but still serious so-called “childhood diseases” like measles, mumps, chicken pox, rubella and scarlet fever are also well controlled.
Influenza, a disease that most people erroneously regard as innocuous, still kills around 3,500 Australians every year. This is despite a large scale and very effective vaccination program.
So successful have public health services been in suppressing communicable diseases, that many people in the so-called developed world have become very complacent about the risks attached to such illnesses.
Indeed, we now have the anti-vaccination movement which is based upon the utterly wrongheaded belief that vaccines are in fact more dangerous than the diseases they are designed to suppress.
This belief is only possible because the incidence of these diseases is now so low that people have completely forgotten how much harm they once did and, in fact, can still do.
This has led to a resurgence of cases of diseases like measles and whooping cough. Although the associated death rates are still low, the distress and residual disabilities that are caused by a disease like measles, notably partial or total deafness, can be life changing events.
It is important to understand that, almost without exception, communicable disease arises from human interactions with something in the environment.
So, the black plague was transmitted by the bite a flea carried by the common rat, while yellow fever probably first passed from primates to humans in Africa during the 18th century. Cholera has existed for many millennia and humans contract it by drinking from a contaminated water supply.
The essential lesson from the origins of all these diseases is that we ignore the environment we live in at our considerable peril.
This brings me to COVID 19 (the virus) which is now raging rampant across the globe. This is one of a large family of Corona viruses which exist in our environment, mostly without causing humans any harm.
This disease made the jump from an animal species to humans only a matter of a few months ago. Where and when this occurred is not yet clear but it seems to have originated in the so called ‘wet’ animal markets in the Hubei Province of China. These markets specialise in the sale of exotic animal species for human consumption.
It is a peculiarity of Chinese culture to eat such animals. Usually, humans stick to a diet of animal protein derived largely from domestic animals or wild animals that have been hunted for food for many centuries.
Whatever the causal mechanism, it turns out that this virus is very easily spread by human to human contact and is unusually virulent compared to most other viruses of its type such as the common cold.
The overall death rate appears to be not less than one percent which is 10 times higher than that of influenza, but could turn out to be as high as 3.5%.
Italy is currently reporting a death rate of around 7% but there may be particular factors in Italy, such as its higher proportion of the population over age 65 years that is skewing the death rate upwards.
The speed with which this virus has spread has been simply incredible.
In a globalised world, crossed daily by tens of thousands of air journeys, the virus has arrived almost simultaneously on every continent and seems destined to invade literally every corner of the planet within a very short time.
The health impacts have been profound enough, with many people dying very rapidly and our health systems being overwhelmed by the need to admit and treat the 20% or so of victims who need hospitalisation.
The race is on to develop a vaccine for the virus and no doubt the winner of this race will make a vast fortune.
But even if everything goes well, a vaccine will not be available for another year or so. By that time, the virus will have wrought huge harm across the globe.
In the meantime, international air travel has ground to a halt, tourism as an industry collapsed more or less overnight, the supply chains for many goods and services have been serious disrupted and the world’s finance markets have once again frozen as lenders try to figure out which individuals or companies seeking their funds actually have the capacity to survive the current downturn and pay them back.
Financial experts are trembling at the prospect that the world’s gigantic debt mountain (K1,090 trillion and counting) will finally collapse as many debtors are either unable or unwilling to repay creditors.
Once again, it will be the taxpayers who foot the bill of trying to save the worthy as well as the profligate from disaster and, in so doing, spare us all the catastrophe of a full blown economic depression.
Currently, there is no expert or analyst who believes that the world will escape a serious recession and many believe that the impact will linger for years, not months.
We are witnessing the much feared but long expected ‘black swan’ event, which by its nature is unforeseen and unforeseeable. Black swan events are characterised by their extreme rarity, their severe impact, and the widespread insistence they were obvious in hindsight.
History says that when the dust finally settles after the virus is tamed and some semblance of economic order is restored, we will very probably draw the wrong conclusions about what caused this debacle and either take no remedial action or the wrong action.
This is certainly what happened after the global financial crisis and there is no reason to have confidence that it will not be repeated by the world’s current political leadership, who are committed to the dangerously unsustainable neo-liberal economic model which I believe lies at the very heart of this debacle.
For me, the lesson is that we have to put a stop to the rapacious exploitation of the natural environment that is a necessary corollary of the neo-liberal mania for economic growth at any cost.
The virus is an example of what happens when our apparently in-built human desire to exploit anything and everything around us leads us to indulge in behaviours that are far riskier and potentially more damaging than we seem able to realise.
It is extraordinary that someone’s desire to profit from someone else’s desire to chow down on a bat or pangolin can lead to a pandemic that will very probably kill millions of people and disrupt the entire world economic system.
We need to urgently rethink the whole idea that never ending growth and consumption of resources is a sustainable economic philosophy. It plainly is not.
Surely it is long overdue to contemplate the idea that economic activity is meant to be a means to an end, being a sustainable and reasonably comfortable life for humanity generally, not an end in itself.
Also, surely it is wrong at every level, moral, ethical and even from an economic standpoint, to have a system whereby the winners accumulate wealth beyond even that of entire nations, while the majority remain in sometimes abject poverty?
The virus should be a wake up call for those of us living in the so-called developed world that we are not going to be immune from the consequences of ill advised exploitative behaviour in even the most remote corners of the globe.
We will not be able to sit here, fat, dumb and happy, while bad things happen to other people.
While I am quite sure that the world will be a different place when the virus has run its course, I am pessimistic that it will be a better place unless our children and grand children can show that they are much smarter than us and develop a much more sustainable, environmentally sensible way of running an economic system that is manifestly fairer and more equitable in the way it distributes the benefits of human work and ingenuity.
I believe that the path to such a system will be found in a major revision and restructuring of the current system, not the invention of an entirely new approach.
The total upending of the system has been tried in the past, notably the communist experiment, with disastrous results. Progressive reform seems to offer a more sensible way forward.
If we or our successors fail to do the hard work of reforming the current socio-economic system to achieve a better balance with the environment and in the distribution of resources, then further events like COVID 19 will be inevitable.
As I said previously, there are many very much scarier things out there than this virus. For example, the class of organisms called hantaviruses include things like ebola fever, which kills 70% of its victims.
If something like this gets loose, then discussions about economic theory will very rapidly be rendered utterly irrelevant.
For this reason, I believe that we would be wise to see COVID 19 as not just the terrible disease that it undoubtedly is, but also a warning from history that we must change our ways permanently or suffer from further ‘black swan’ events that are likely to be even more hideous and life changing for us all.