Armchair Epidemiologists

As Steven Johnson explains in The Ghost Map, one of the key factors that enabled John Snow to discover the true cause of the devastating 1854 cholera outbreak in London—a contaminated water pump—was familiarity with the local community. Snow was a resident of Soho, the neighbourhood at the centre of the epidemic. At the height of the outbreak, he walked the streets, observing the movements and behaviour of local residents, knocking on doors and, without a hint of prejudice, asking basic questions whose answers revealed what was actually happening. Snow’s approach stood in stark contrast to the attitude of the public health authorities led by Benjamin Hall. When emissaries were finally sent to collect data on the ground, their priority was to find evidence to support their failed miasma theory of infection.

I think of this story whenever I am confronted with the long-winded musings of the growing cadre of self-appointed COVID-19 experts. Armed with logical frameworks acquired at prestigious (or not so prestigious) universities and algorithmic models that predict the future like a crystal ball, they betray an irrepressible desire to dictate policies whose consequences they will not have to answer for.

At the height of the outbreak, he walked the streets, observing the movements and behaviour of local residents, knocking on doors

When was the last time they visited the cramped squares, the narrow streets, the jumble of homes, stores, warehouses and auto repair shops in the neighbourhoods they so vehemently wish to lock down? Have they bothered to speak with those of us who live here and try to learn—even superficially—about the complexity of our social and professional interactions, our economic anxieties, the fragility of our lives, our fear of sacrificing the future to save the present?

As far as I know, they haven’t set foot in my neighbourhood of L’Hospitalet de Llobregat, Collblanc–La Torrassa, also known as ground zero of the current outbreak. This would explain why the streets are plastered with information about the containment measures in Spanish and Catalan, but not in Cantonese, Mandarin, Urdu, Hindi, Darija, Arabic, Romanian, Ukrainian or Russian. It would also explain why we haven’t seen or heard young Bolivian, Honduran or Dominican citizen service officers reaching out to their peers to help them understand that this is not just another prohibition or exclusion, that we really do care about them, and that together we can find alternatives to the feelings of neglect and alienation that drive them towards risky activities. Why do political authorities, epidemiologists, public health experts and specialists of all stripes insist on making policies about (or against) communities rather than with them?

Professing to have the best of intentions, they study our social condition to identify our limitations and deny us our agency, instead of integrating us, in all our plurality, into the decision-making process

Guided by stereotypes and preconceptions, they operate from the comfort of their offices, confident that they possess unique and superior knowledge that can save us from our indolence. Professing to have the best of intentions, they study our social condition to identify our limitations and deny us our agency, instead of integrating us, in all our plurality, into the decision-making process. And what is the result? More pain and more despair.