How Long Can People Sustain Appropriate COVID-19 Response and Behaviour?

Driving through the road below the Munirka flyover on Delhi’s Outer Ring Road has a surreal feel to it. It is true of most roads across a world in lockdown. Bottlenecks until a few months ago, these stretches now resemble football pitches—you can take a U-turn towards the same flank and keep driving without looking in the rearview mirror, almost. But —unlike other parts of the world and even the fancier neighbourhoods of Delhi—life seems to be back to normal as you turn into one of the narrow roads to the middle-class residential areas. Except for the six-feet mandatory gap between those queued up to buy milk from the local Mother Dairy, there are scores of residents walking along the main colony road, throwing social distancing norms to the wind. As the sun goes down, children can be seen racing on cycles, adolescent girls giggling over their mobiles together, and groups of young men talking animatedly to kill the boredom of being inside their cramped dwellings the whole day. Policemen seem bone-tired from Delhi’s scorching May sun and ignore the residents milling about, many of whom are not wearing mandatory masks. India may be in lockdown but Indians are irrepressibly social, even at the risk of infection.

Silicon Valley techie Byju Sukumaran speaks of something similar in his tony US neighbourhood: “I can see people really letting their guard down. I just came back from a walk and saw teenagers being teenagers: hanging out in small clusters. There were also teenaged couples strolling, rubbing shoulders with each other…Road construction crew was taking a break, all huddled together.”

Almost 50 days into the lockdown, Delhi is far from flattening the Covid-19 curve. On the other side of the globe, California risks people becoming complacent at a time when the curve was just beginning to flatten, proving that the human tendency to break free of the monotony of the lockdown is only growing stronger, in defiance of rules and orders that restrict movement. From US cities to towns in interior India, people are hoping for an ease in the shutdown. A section of economists, sociologists and epidemiologists themselves are arguing that saving livelihoods should also be a key priority of governments now largely focused on saving lives.

Learning to live with the virus and pursue livelihoods is fraught with danger and requires drastic behavioural changes. Some societies have done it with near perfection, but can their experiences be replicated worldwide, especially in countries as populous as India, a democracy?

“Some are disciplined [enough to maintain social distancing for a long period] but most aren’t. I think there is a role for strict government rules to get everyone comfortable with these policies,” points out Joshua Gans, professor at the Rotman School of Management, University of Toronto, who wrote the book Economics in the Age of COVID-19 within a month of the lockdown. Psychologist Barry Schwartz, Professor of Social Theory and Social Action at Swarthmore College, Pennsylvania, has studied and written extensively on this subject. He contends that if the pandemic and then the economic recovery take a long time, there would be “lasting changes in how we behave”. He feels our views of what is important in life will change. “Our views of the importance of security will change. Our attitudes toward the largely invisible workers who are now making life possible will change. And no doubt our social customs regarding group gathering and physical intimacy will change,” he tells Open. But then adds a caveat: “My fear is that the lessons we learn from this disaster will be too short-lived and we will return to our selfish, short-sighted foolishness before too long.”

Hong Kong, Vietnam, Taiwan, Singapore and Vietnam, which have close links or land borders with mainland China, offer us models of a successful fight to save lives and do minimal damage to livelihoods. Thanks to its exposure to earlier pandemics such as SARS and others, Hong Kong did early and elaborate social distancing, and is raved about in public health circles as a model for the world even in battling the likely next wave of infection and attack of the mutated virus. Vietnam, a poor country, experimented with border controls, low-cost hi-tech, and so on. It campaigned tirelessly using a hand-washing song in what is widely seen as a frugal and highly effective Covid-19 response. Taiwan went to the extent of probing pneumonia cases in Wuhan to prepare itself against community spread. South Korea went for a 24X7 emergency response by screening and testing passengers and citizens. Singapore also did targeted activities, including contact tracing and even paid for screening and hospitalisation.

Hareendranath Moolayil, a shipping executive who has been a Hong Kong city resident for three years, is surprised at the level of preparedness and adaptability of people there to the new life. “Wearing masks even when someone has a cold comes naturally to train commuters and others. Even on trains, they manage to maintain social distancing by being extremely disciplined,” says this Indian-origin executive who had travelled to 17 airports and three seaports between early February and mid-March on work. “I was shocked at the lack of readiness elsewhere in Europe and the US although they were talking a lot about a Chinese virus. They didn’t detain me or check my temperature at any of these airports, from New Orleans to those in Estonia and the Gulf countries. Hong Kong achieved the unthinkable through social distancing and more than enforcement, everything was about self-discipline,” he avers. Rajasekharan Pillai, a former McKinsey executive and serial entrepreneur, says the same about Berlin which also showed remarkable diligence in addressing the threat of Covid-19 spread through what he calls an “immaculate social distancing policy”. People’s participation in the governmental task of keeping community spread of coronavirus at bay was commendable in these countries. In Germany, most measures were voluntary and liquor shops remained open, trains ran, albeit at a lower frequency, and people went to parks in groups of only two.

Apart from these countries, some with sizeable city populations, government-individual collaboration worked in Sweden as well. At over 10 million, its population is much higher than those countries in its neighbourhood like Denmark and Finland. Sweden’s policy of ‘no border control’ was controversial. The epidemiologist and bureaucrat behind the policy, Anders Tegnell, who said “closing borders is ridiculous”, spoke to Open about his priorities and the success of his country’s strategy. He says that it is very likely that people of Hong Kong and Vietnam, who have experienced SARS outbreaks, were habitually inclined to adapt far more quickly than others to live with a new virus. “We used existing trust [between people and the government] and experience in other fields [medicine, economics, etcetera] to make it happen,” he says. He is confident that “parts of the Swedish model” can be replicated across the world. Sweden launched voluntary measures by telling older people to maintain social distancing, advising people to work mostly from home although borders and schools for under-16s and most businesses, including restaurants and bars, remained open, according to various reports.

But measures that elicit people’s voluntary participation do not work everywhere. Steps that invest a lot in ‘trust’ may not work in India, says an ICMR official worried about the general tendency of Indians to crowd, break queues and show scant respect for social distancing rules. I had the misfortune of watching people break all such rules and cause a stampede (videos of which went viral) outside the liquor retail outlet at the C-Block market in Delhi’s Vasant Vihar. The neighbourhood, which houses several embassies and diplomatic missions, was recently in the news for its powerful resident-welfare group that had used creative means of collaboration, cooperation and some peer pressure to make sure residents followed lockdown rules while all their medical, essential and emergency needs were taken care of by volunteers. But on May 4th, the day the liquor vend opened after over 40 days of lockdown, serpentine queues spilled over into all the neighbourhood roads, leaving residents in fear and dismay. “This is the only liquor outlet for miles around, so people came here from all nearby localities,” noted a school principal who lives in C Block facing the market.

Schwartz says this is where states can help by trying to institutionalise some of the good lessons from the pandemic. Those in the Indian Government can even call for the strict enforcement of such norms to ensure people are “ready to live with the virus by taking maximum precautions to save their lives and livelihood,” avers an official. He rues: “Unfortunately, we cannot do what the Chinese did: rule with an iron fist. After all, we are a democracy.” The disaster management act bestows the Government with great powers, but using the same in a democracy is certain to invite criticism.

The hazards of creating systems designed for resilience will be the biggest headache in both the current and post-Covid scenarios. Schwartz is hopeful that economists, mathematicians and policymakers will try to do that and may be successful in having such mechanisms in place. “Will it be sustained? I am less certain of that.”

The New Codes of Conduct
Tables and chairs taped up to maintain social distancing at a Starbucks coffee shop in Hong Kong, April 2 (Photo: Reuters)

As the rat race has moved from real life to social media and online, more people are forming new habits of learning and unlearning. This includes reviving old hobbies in music, painting, dancing and discovering new passions like learning calculus on Coursera and art history through specialised courses. Or, for that matter, watching informative documentaries on Netflix and other streaming sites besides binge-watching web series. Although such ingenuity—or even the act of luxuriating—in coping with the lockdown is laudable, getting back to work and revving up the economy need a bigger impetus than it appears. It is noteworthy that although people are active offline too in the solitude of their homes, trying to get into shape, write, or engage in serious reading, dragging oneself back to normalcy requires a coordinated action at individual, social and governmental levels.

Speaking to Open, Israeli-American behavioural economist and best-selling author Dan Ariely says that people will return to the old ways and shed social distancing shortly after the Covid-19 outbreak is brought to an end. This, he argues, is because we, as a society, choose efficiency over resilience and, therefore, are not naturally inclined to think long-term. Ariely, professor of psychology and behavioural economics at Duke University, adds: “I think initially people will stick to social distancing out of fear but, maybe six months or so later, we will get closer to each other again.”

Fear will help even Indians, as erratic as many other people, behave appropriately while getting back to work. Behavioural economists and policymakers agree that new habits do develop in dire situations—as in the case of the war-ready people of Vietnam and Hong Kong—but as a species, humans are trained to be short-sighted, warns Schwartz.

In that context, art often reflects life. In the new Amazon Prime web series Upload, human beings on their deathbed in the year 2033 have the option to either die and go to an uncertain heaven or hell, or—if they have the money—have their memories scanned and ‘uploaded’ to a parallel cyber-heaven where they can continue to ‘live’ with their human families for eternity or till their money runs out, whichever comes first. Now, even after leaving their corporeal bodies, most of these ‘uploaded’ humans continue to act in the same ways they did while alive. They display the same habits, compulsions, cruelty or compassion, and acts of privileged behaviour. Apparently, even death does not cure us of what life cannot.

Living with the virus is easier said than done for most people. Rajeev MA works at the Artificial Intelligence (AI) division at Tata Consultancy Services. As part of work and out of sheer interest, he creates mathematical models and thinks independently of human behaviour. He offers a convincing answer to why either learning to live with the virus or being prepared for a similar or worse public-health emergency is a tough proposition. “Segmenting the entire population to one or hyper segmentation to treat every individual as independent is not going to work,” he says. “Regional variations will be evident in human behavioural changes and some segments of the economy will have higher behaviour changes than others. Behavioural changes based on density of population cannot be ignored. Religious beliefs and practices which involve mass congregation or gatherings might have a temporary impact.”

Rajeev is more concerned about knowing how much the change in personal lives can alter our economies. He comes to the practical aspect of it: beyond human behaviour, government and societal policies will have to enforce social distancing to help people cope with living with the virus and after humans defeat the virus with a vaccine.

Rajeev sees some advantages, too. He avers that investment to ward off existential threats arising out of biological warfare or by agents of nature will see an increasing trend. “It might involve technologies that compromise individual privacy to protect humanity at large [individual safety to collective safety]. History has shown that it takes time for humanity to overcome social stigma attached to diseases.” The AI expert also expects cross-border trade and human travel to “re-correct” post Covid-19 besides a shift from centralised manufacturing and supply chains to decentralised manufacturing. Rajeev notes that human beings normally want to bounce back to their previous status as if possessed by nostalgia, but policies can work against such natural urges. “Security controls after 9/11 are a classic example. All of us want to move freely during travel, but it was not possible after 9/11. Post Covid-19, we might get scanned for temperature and might get banned from travel if flu or other similar symptoms are noticed.” Rajeev, too, feels that innovation in medical science and larger investment in public health are likely to follow this crisis. In the process, such efforts will bring down the costs of high-end medical equipment. Innovation, as seen in the activities of tech start-ups now, will lead to premium pricing and faster clinical trials, he forecasts.

Most people now work from home globally and it has been acknowledged that offices will disappear or become spacious enough to meet health challenges. The trend, meanwhile, would extend to city planning as well, with architects and town-planners going for a rethink. Rajeev sees freelancers striking gold thanks to this prospective trend triggered by productivity and security priorities. In highly regulated industries, such trends may not be viable soon enough. More people are expected to use online and card payment as currency notes are seen as carriers of infectious disease.

Philosopher and University of Chicago professor Martha Nussbaum says she is not a great admirer of policies that favour the young over the old. She also notes that poor people everywhere are at greater risk, as it is in India. “I am opposed to lifting lockdowns before 14 days of declining numbers, because in the long run it will be worse. And there is no justification for sacrificing a whole elderly generation to the preferences of the young.”

Ariely’s tempting proposition that human beings are typically seekers of efficiency more than resilience proves that such concerns are not without reason. After all, sustaining disease-ready behaviour is a tough call and its stringent enforcement is replete with risks of living under the long shadow of populist politics. Lessons from the political churnings triggered by the two World Wars, the Cold War and other geopolitical skirmishes prove just that: caution is often short-lived.

First published in Open

 

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