Was lockdown racist? Lecture in Princeton Center for Human Values, Boston SPH

Delighted to be giving a talk called “Was lockdown racist?” at the Princeton Centre for Human Values (2 Nov) and the Boston School of Public Health’s Department of Global Health (7 Nov).

Princeton: 2 Nov @ 4.30pm, Center for Human Values

Boston SPH: 7 Nov @ 1pm, Dept of Global Health

Abstract

In 2016, South African learner Zulaikha Patel argued that a school rule requiring hair to be neat was racist, despite applying equally to pupils of all races. This paper argues that suppression strategies deployed against Covid-19, especially in the early stages of the pandemic, were racist in the same way. The suppression strategy was motivated by science done in traditional seats of colonial power. Local factors shaped (as they normally do) both the methods used and the recommendations arrived at. These did not adequately consider the situation of many people globally living in various contexts of poverty: including on those in Africa. Notwithstanding, the recommendations were promulgated by the World Health Organisation and others, with no regard for local context. Feasibility of implementing “lockdowns” in breadline conditions, effectiveness in overcrowded conditions, local priorities, and the age of the population (in Africa, median 19.7) were not contemplated. Local political and financial interests were aligned with this neglect, and local scientific capacity was in any case lacking. When a regulatory package is implemented in an African country with high costs and low benefits, and originates in a strategy conceived in Europe and promulgated by European-based international organisations, it is impossible to ignore racial dynamics. I show that the trope of “lockdown” as enacted for Covid is a central difference between the responses to Covid and other epidemics in Africa, and I show that one cannot adequately explain this contrast without reference to race. Therefore lockdown was racist.

‘Can you lock down in a slum?’ published in Global Epidemiology

Delighted that this paper co-authored with Pieter Streicher has now been published in Global Epidemiology.

Broadbent A, Streicher P. Can you lock down in a slum? And who would benefit if you tried? Difficult questions about epidemiology’s commitment to global health inequalities during Covid-19. Global Epidemiology. 2022;4:100074. doi:10.1016/J.GLOEPI.2022.100074 (https://www.sciencedirect.com/science/article/pii/S2590113322000049)

Is lockdown right? Bioethics, global health and COVID-19. Talk I’m giving for PhilHEAD workshop https://philhead.org/events/ 17 Oct, 3pm SA/EU

Excited to be giving these thoughts their first outing, in what I hope will be my considered philosophical paper on the thoughts I’ve been having during 2020. The event is open and you can join here: https://bit.ly/3lnxPci

Interview – why lockdowns didn’t work in South Africa – Radio 702 https://omny.fm/shows/early-breakfast-with-abongile-nzelenzele/why-lockdown-didnt-work

https://omny.fm/shows/early-breakfast-with-abongile-nzelenzele/why-lockdown-didnt-work

Commenting on a recent piece in The Conversation, related to a paper published in Global Epidemiology recently, indicating no obvious effect of lockdown over and above mitigation in South Africa.

Paper just out in Global Epidemiology: COVID-19 in South Africa https://doi.org/10.1016/j.gloepi.2020.100034 #epitwitter @CGDev @besmart

https://www.sciencedirect.com/science/article/pii/S2590113320300183

With Herkulaas Combrink and Benjamin Smart.

Part of a project at the Institute for the Future of Knowledge funded by the Center for Global Development. The project looks at the indirect health effects of lockdown in multiple countries.

Lots of people in Africa have already been infected with SARS-Cov-2. Good news, if frustrating for those of us predicting this since March https://www.sciencemag.org/news/2020/08/pandemic-appears-have-spared-africa-so-far-scientists-are-struggling-explain-why

https://www.sciencemag.org/news/2020/08/pandemic-appears-have-spared-africa-so-far-scientists-are-struggling-explain-why

Lockdown was never right for Africa. Half the population is 19 or under, highlighted in this report; and known prior to COVID, of course. On the cost side of the balance sheet, other risks are massively dominant over that posed by COVID-19. Living conditions mean that suppression was never achievable in any case. Costs of lockdown were obviously going to be horrific, because recession means starvation in contexts of poverty. What a mess for those countries that did lock down. And those that didn’t seem to be doing fine, COVID-wise: e.g. Malawi, whose supreme court prevented the government from locking down.

Aside from all that, it’s clear that there’s a great deal of uncertainty about why some places get hit so much harder than others by COVID-19. Sweden is held up as being hit hard, and blamed; but that ignores the fact that many other European countries that did lock down were hit a lot harder. Why? I favour the following theory: we don’t know.

Epistemic humility in all matters relating to medicine is always appropriate.

I think Sweden handled this pandemic better than any other country. Here’s Anders Tegnell explaining the Swedish stance, again: https://unherd.com/2020/07/swedens-anders-tegnell-judge-me-in-a-year/

If I guess the time, and get it right, do I know the time? No, says common sense, and nearly all theoretical and formal epistemology. If I guess that it will rain tomorrow, am I any better off? Presumably not. Yet we assess predictions almost entirely by whether they are right.

I do think Swedish predictive work was broadly accurate, compared to, for example, the models produced by Imperial College London. But more importantly, I think their stance was rational. They did what was right given the evidence. That isn’t the same as being right in the sense of landing on the truth. But there’s nothing either epistemically or morally significant about the latter. The former, however, is both. Sweden behaved more reasonably than any other country, or perhaps at least as reasonably as the most reasonable, given that there was room for reasonable disagreement.

The stance on Sweden is another version of the intellectual intolerance of the age. And it ignores the evidence. Sweden has done well: not perfectly, but no country has, that I can think of. Whether it comes out tops long-term is up in the air. But there is good reason to think it will – at least as good as the reasons to think it won’t.

eNCA TV interview – COVID-19 in South Africa, readiness (lack of), lockdown making zero difference, and the need to ask people what will work for them https://www.youtube.com/watch?v=No67yxuNrzU @mediauj #epitwitter @enca

ENCA interview – COVID progress in SA, comments on readiness and regulations

Soon I’ll have an opinion piece out arguing several of these points. In particular, regulation is just the wrong idea in the first place: people need to be consulted. And that’s not a watery option, it’s the way to get effective solutions that are context-specific.

Lancet letter: ‘Lockdown is not egalitarian: the costs fall on the global poor.’ #epitwitter

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31422-7/fulltext

We wrote this letter a couple of months ago in response to an editorial in the Lancet suggesting that opposing lockdowns was neoliberal. I continue to be surprised by how the world hasn’t noticed that, in fact, extreme measures to combat COVID-19 shift the burden from the wealthy to the poor, who suffer more from the measures than from the disease. It’s a disease that primarily affects the old, and thus primarily the wealthy. This is true even if people who are of the same age fare worse if they are lower down the socioeconomic scale. That is unsurprising, extremely so; what is surprising, and what outweighs that effect massively, is that this disease is so much more dangerous for demographics that are dominated by the wealthy of the world. I still feel that has not been grasped in the global north. So, I’m very pleased to have this letter out. Maybe it will change the perspective just a little towards a more global one.