It’s been a few weeks since I posted here and I could defend myself by saying that I’ve been working on grant proposals and talking with companies and non-governmental organizations to strategize future social marketing initiatives in local and global health.
I wouldn’t be lying.
But to be honest, there’s been another reason why I’ve been absent. And no, it’s not because I started playing Angry Birds…okay, I have but that’s not the reason.
I’ve been watching the economy.
For about a month (although more importantly over the last two weeks) there has been a focus on the economy unlike anything seen before. With the so-called ‘debt crisis’ and the ‘political brinkmanship’ being displayed far brighter than any peacock feather, it was almost impossible not to watch. The S&P downgrade and the global stock market plunges only made the situation apparently more dire and even in some estimations, apocalyptic.
For its part, the media has been doing its best to analyse the situation, keep the news and discussions objective and even trying to find some way to deal with or hide from the outcomes. Yet whenever a possible diagnosis and solution is identified, the trends change and everyone is left dumbfounded. At one point, even the greatest minds in economics were forced to admit when it comes to moving out of the crisis:
“We just don’t know.”
So, why is this so amazing to me? It’s not because this is groundbreaking, revolutionary and a start of a whole new way of life. Quite the opposite. It’s because, in my estimation, it’s pretty run of the mill stuff…
…for infectious disease.
I believe that anyone who has dealt with an microbiological outbreak, epidemic or pandemic understands what is going through these economics minds and can appreciate their suffering. After all, the stages of these crises have been similar and in many ways the outcomes have paralleled each other. And while they may seem worlds apart, as you’ll see from the following elaboration on each stage, they are more closely related than one might think.
1. A warning has been issued that there may be a problem or that one is coming
Germs: the identification of a novel or virulent strain in the environment with the potential to cause disease in humans.
Economics: A prospective outlook in February of debt problems across the globe
2. An trigger event occurs threatens the community
Germs: An index case of the strain has been identified
Economics: In this case, the Greek Default is inevitable
3. Unexpected impact of secondary transmission and virulence
Germs: More than one person is affected and the route is unknown – morbidity and mortality are suddenly being discussed
Economics: The fear of default spreads to the U.S. and other countries – downgrades are suddenly being mentioned
4. An attempt to inventory the issues
Germs: Is it transmissible from person to person? Is it hypervirulent? Is it resistant?
Economics: Is it debt? Is it greed? Is it government?
5. An attempt to rescue the situation is fruitless
Germs: Mass culling of animals may occur without stopping the spread; vaccines may be sped up for rapid delivery; stockpiles of antimicrobial drugs are purchased; masks and other barrier supplies are mass ordered for hospitals and other institutions. Yet the infections continue to spread.
Economics: Government plans to control the debt are raised; austerity measures are introduced; experts begin to advise clients to be cautious and avoid risk; markets start to increase in volatility. Yet nothing gets resolved.
* * *
At this point, a situation will change for the better or for the worse. In better times, the situation will lessen on its own and then allow for a process of remedy, recovery and rehabilitation. In many instances, such as short-lived outbreaks, like Ebola virus, or in economics, such as the “Flash Crash” of 2010, the best line of defense is passive and to allow the event to burn out on its own, much like a raging fire.
But, if the situation continues to be active, then there’s the likelihood it may worsen. And if it does, the only means for control may end up being highly unpopular and may even break the people’s confidence and their passivity.
6. The Tipping Point
Germs: A specific percentage of the population is infected and the realization that an outbreak/epidemic/pandemic must be declared.
Economics: The downgrade in the U.S. credit rating.
Germs: This different for each event. In the case of SARS, the fallout was the near-destruction of travel to any affected region, almost wiping out Toronto’s tourism industry for 2003. In the case of H1N1, there was mass confusion about the impact of the virus and that impacted both prevention and vaccination measures. In the Niagara region in the case of the recent C. difficile outbreak, people went as far as to protest outside the doors of the institutions. In the general public, there is a general sense that no one is safe, personal security is at risk and everyone has to blame someone else.
Economics: Ongoing. There was the global market crash on Monday, there are continuing tensions between the public and governments, and regardless of who steps to the microphone to ease tensions, nothing seems to resolve the issue. In the general public, there is a general sense that no one is safe, personal security is at risk and everyone has to blame someone else.
Germs: The agent has become fully characterized, its means of transmission known and control measures have been tested and implemented. In the case of SARS, this meant a near martial law in the healthcare environment. In the case of H1N1, it was the shutdown of schools and other areas where crowding may occur. And, in C. difficile, it was a matter of strict isolation procedures and extreme disinfection practices.
Economics: Not yet been achieved.
If one were to take from the germs experience, short term martial or draconian measures may be needed to stop this pandemic of economic collapse. Strict financial measures would have to be accepted and the public would be forced to live, at least for a while, knowing that their lives will be different and most probably worse.
And this brings up the one factor that is incredibly important for economics but given less importance in the germs world:
The people’s reaction.
It is almost ironic that in the germs world, where people’s health is the goal, the reaction of the people to the solution is not given much weight. It is assumed that any measure, no matter how strict, is better than having an entire population suffer. Think of how many people stood for hours and hours in line to get an H1N1 vaccine that may or may not have been necessary? When it comes to drastic measures, the term ‘life or death’ really does apply and it is believed that most would choose life, even if it is less comfortable than normal.
In the economic world, it’s a different story. Life and death is not the issue; it’s financial stability. And understandably, when one’s financial future is threatened or at least marginalized, it can lead to a different kind of outbreak…
…one that occurs in the streets.
We’ve already seen the riots in Greece and there is a worry that the financial sector may be the next target for the riots in England. There are still concerns about protests in other countries such as Spain, Portugal, Italy and even Germany. And while there have been protests of a peaceful nature in the United States, there is a sense of increased tension that may blow at any time. It’s a waiting game on a silent time bomb that everyone expects will explode but no one actually knows when.
Whatever resolution is finally achieved, I fear that it won’t be pretty and won’t happen without loss of property, freedoms and possibly, although I hope not, lives.
* * *
The last few weeks have been an adventure in learning for me. I’ve gained a new appreciation for the economy and how the world’s finances are not all that different from global health. I honestly believe that we in the microbiological and epidemiological worlds can learn from what we are seeing in order to better our own ability to address adverse events such as outbreaks and pandemics.
In turn, perhaps the economic world can turn to the germs world to learn more about how to stem the tide of these pending problems long before they happen. Health has been around far longer than money and the lessons learned over the ages can be translated to help identify means to attain rescue and remedy long before it hits the tipping point. After all, while outbreaks and epidemics occur on a regular basis, pandemics are still few and far between. And in at least one instance, SARS, a pandemic was actually stopped before it could reach that tipping point. I believe the economics world could use that experience to help in the future.
Perhaps I’ll put it more succinctly:
If the economic world looked at the current crisis as the germs world did SARS, many of us wouldn’t be in this situation today.
But if the germs world had acted the same way as the economics world has acted recently at the time of SARS, many of us wouldn’t be here period.
Would love to know your thoughts.