#FromMyReadings, Issue 4, 2021
A Different Type of Long COVID, The Importance of Research That Doesn’t Make Sense, What a Cricket Crisis Says About Our Behaviour in Good Times
[Before you read on, I urge you to take a look at the beginning of my earlier post and donate to those causes if you can. India can do with more COVID-19 relief efforts. Thank you.]
1. A Different Type of Long COVID (Zeynep Tufecki’s Insight)
I’m becoming a fan of Zeynep Tufecki’s newsletter Insight. Her recent posts have focused on COVID-19, and how our framings of the disease affect the way we think and react to the pandemic.
Her May 28th post, We Need To Get Real About How the Pandemic Will End, was sober, albeit unsurprising. She argues that COVID-19 may follow a similar trajectory to the AIDS epidemic — the majority of deaths may occur after a cure for the disease was found. In our case (she argues), that means the worst of the pandemic may lie ahead of us.
Tufecki has several reasons for her claim and you can read them here. Essentially, she argues that the majority of the world is likely to get COVID-19 before vaccinations. Less-advantaged regions don’t yet have access to vaccines; the virus is mutating quickly; and regions which have escaped the bulk of the pandemic will find it increasingly hard to remain that way.
I take two things away from Tufecki’s piece:
- First, we have to stop equating the availability of a solution with the end of a problem. We seem to be prone to this as a species (or perhaps this is just how we are in our times). We think that discovering a medicine means that the disease is on its way out, or that inventing smartphones will automatically lead to more people on the internet. The bulk of a challenge lies in deciding what to do with a solution rather than the solution itself. In the case of vaccines, we still don’t have a system to provide access to the majority of the world.
- This in turn implies the pandemic is unlikely to come to a sudden end any time soon. Dramatic ends may happen in isolated places (Eg: Wuhan in China seems to have recovered fully — see Section 2 of an earlier post about this), but much of the world may have to deal with recurring waves of COVID-19, as the virus mutates and vaccinations don’t keep pace.
There is a condition called ‘Long COVID’ which has been noted in COVID-19 patients who have seemingly recovered from the disease. COVID-19 recoveries have reported symptoms of fatigue, illness, and more long-term changes to their body that long outlasts discharge from hospital.
We may see a different kind of Long COVID at a much larger scale, where different variants of SARS-Cov-2 continue to mutate in unvaccinated regions and repeatedly return to haunt the planet. This may continue until all parts of the globe build enough capacity to permanently restrict the disease. This is not a prediction, but a possibility. I really hope this sort of Global-Scale Long COVID won’t happen, and that we’ll be able to get much of the world vaccinated soon. But, a Global-Scale Long COVID may not be impossible.
PS — I found this after I had finished writing this post, but a similar opinion on COVID-19 becoming ‘a seasonal’ event in India was expressed by CMC-Vellore virologist and microbiology professor, Dr. Gagandeep Kang.
2. The Importance of Research That Doesn’t Make Sense (At Present)
An Atlantic article contains a fascinating story of how three preserved bodies from the Spanish Flu Pandemic of 1918 helped us better understand the Second Wave of said pandemic.
The Second Wave hit Europe in late 1918 and (in a pattern now familiar to us) was deadlier and more widespread than the first. During this time, three bodies were preserved in Germany, two boys and a girl. Decades later, tissue samples from their lungs were used to sequence the flu viruses from the Second Wave to help understand how the flu evolved between the two waves to spread more effectively.
What’s really interesting is how these samples were obtained in the first place. The article says:
Sébastien Calvignac-Spencer, a virologist at the Robert Koch Institute, in Berlin, came across the samples in this newest study in a stroke of luck. A couple of years ago, he decided to investigate the collections of the Berlin Museum of Medical History of the Charité.
He wasn’t looking for anything in particular, but he soon stumbled upon several lung specimens from 1918, a year he of course recognized as a notable one for respiratory disease.
The article also points out why samples from the 1918 flu are so hard to find:
Doctors then hadn’t even figured out that influenza was caused by a virus. “There’s no way the individual who saved these samples in 1918 had any idea of what could be done to them…”
[…]
Without the pathologist who painstakingly preserved these samples and the museums that kept them for decades before science caught up, our understanding of the 1918 flu would be all the poorer.
Time and again, we come across random, unpredictable patterns of how research takes place.
Governments and funding agencies tacitly assume that research is linear. Prioritise an area of research first, and then channel funds to that area. This will yield results in that particular field of research within a particular time-frame. Now, this isn’t completely false. Space exploration boomed in the 1960s because the Cold War drove US/USSR funding towards space research. New climate technologies are being developed now because we’ve chosen to prioritise fighting climate change.
However, it would be a fallacy to assume the opposite — that one should shut down or discontinue funding research that is not an area of priority. Research is hard, much of it is non-linear, and there’s no telling when an obscure field that made no sense (“Why are we funding this?”) will suddenly become an area of importance (or vice versa).
Another example to illustrate this. In 1985, a Hungarian scientist, Dr. Katherine Karicko, was invited to work in Philadelphia, United States. Her focus area was on the Messenger Ribonucleiac Acid, a single stranded polymeric molecule, that she felt had potential to be developed to treat disease.
However, funding interest in her area died down and her idea of using this molecule to battle disease was treated with skepticism. According to her story, she lost grant application after application, lost colleagues to funding crunches and was eventually demoted at her university.
Nevertheless, she kept working on her idea until she and a former colleague figured out how to use a synthetic version of Messenger Ribonucleiac Acid (more commonly known as mRNA) to change the human body’s immune response to viruses. Her work paved the way for mRNA vaccines that are now being developed by Pfizer and Moderna to fight the COVID-19 pandemic.
As a society, we are doomed to make tough choices on what to fund. Somewhere, a research project will always be defunded because the money is required elsewhere. Nevertheless, researchers live in times where cost-cutting philosophies from certain sectors have bled into areas where they are irrelevant. I’ve heard anecdotes where libraries are asked to present returns on investment projections and laboratories were asked to charge PhD students for facility use.
We need new approaches to research funding, approaches which acknowledge in their decisions, how research that’s seemingly irrelevant today, may have value later on. These approaches will look and feel less efficient than the ones we currently use, but it’s important to see that economic efficiency is a matter of context and framing. For example, it’s much more efficient to repurpose decades-old research into a quick vaccine, rather than start from scratch. However, such efficiency will not be visible when you start that decades-long project.
3. What a Cricket Crisis Tells Us About Our Behaviour in Good Times
The New Indian Express has an article on how the COVID-19 pandemic is affecting scorers, umpires, and analysts in domestic cricket in India. As with most sports during the pandemic, domestic cricket has been suspended and non-playing staff have been left in the lurch.
The article mentions how some of this mess was created in the first place:
“When the number of [domestic] teams increased to 38, the number of matches across age-groups for both genders was more than 2,000.The BCCI [Board of Control for Cricket in India] needed us. And though we were not given contracts, we gave up our jobs for umpiring.
Last season, the BCCI couldn’t hold matches. We were not wanted anymore. Since we are not part of payrolls, we don’t get any money from BCCI,” says another umpire from the west zone.”
Officials who are formally employed feel uncomfortable about their colleagues’ situation:
“When BCCI needed them, they left their jobs and came because private companies didn’t sanction leaves. We are talking about 40–50 days. Last year, the BCCI didn’t need them so it left them in the lurch.”
From the text above, this situation doesn’t seem to be “caused by the pandemic”. Not really. Instead, the pandemic seems to highlight the structural problems of BCCI’s employment practices. The situation itself seemed to have been built long before COVID-19, with the BCCI not using more prosperous times to secure better working conditions for its domestic cricket staff.
The BCCI is hardly alone in this. No one really knows how large the informal economy is in India, but estimates of informal or unorganised work ranges between 85 to 95% of the total workforce, with the Periodic Labour Force Survey 2017–18 estimating that over 70% of the non-agricultural workforce have no written/enforceable contracts with their employers.
The lack of enforceable contracts, guaranteeing protections from layoffs or ensuring financial safety during a crisis, leads to much of the workforce being thrown haphazardly into situations like the one above. Popular narratives in Indian media like to focus on the other extreme, of factory strikes by unionised workers who cannot be laid off and the retaliatory lockouts (people still remember the year-long 1982 Bombay Mills strike). However, this does not apply to the vast majority of workers out there, most of whom have little bargaining power to begin with.
Indeed, this is only one more episode of the pandemic revealing underlying problems in the Indian economy. There have been others. For example, Indian policy long treated rural and urban areas as deeply distinct categories, ignoring the annual migration cycles where workers moved from village to insecure city housing (and back) in search of work. The pandemic threw this open jarringly last year, when workers stranded in poor urban housing during the lockdown were forced to walk back thousands of kilometres to safer housing in their villages.
Such problems are highlighted during crises, but are not caused during them. Instead, they are the outcomes of policy, political, and social forces building up for decades before the crisis, very often during periods of prosperity. It’s important to remember that not long ago, India was going through a real estate boom in her cities. Many of the construction workers back then had to put up with temporary housing and lack of access to basic necessities, just as they did during the pandemic.
The seeds of crisis are planted during prosperity. If we don’t use prosperous times to secure ourselves for a rainy day, we will be left drenched. If only some of the money from the real estate boom had been spent on more secure housing or health coverage for construction workers, we may have been able to reduce the immensity of the Great Migrant Walk last year. The same goes for domestic cricket. If only contracts had been more present, more secure and more enforceable, the present crisis could have been averted.
