We Face a Social Crisis, Not a Medical Crisis

The term “expert” is often used carelessly in the news. This is problematic when many of us are clinging to our smartphones looking for guidance on what to do and not do during this second wave. Yet too often, in the face of the pandemic, we see experts commenting on topics that stretch their expertise. Nowhere is this more prevalent today than in the media and among political leaders who rely almost exclusively on medical experts despite the fact that their expertise is not what we need right now exclusively. While our understanding of the virus and its mutations is important, what is more important is our understanding of how broader society actually behaves in a crisis that demands collective action, selflessness and compassion.

Let’s look at an example of a recent CBC article entitled: 'Lockdown light' failed in Canada's hardest-hit regions. Here's what experts say should happen now”. This is one of many articles among reputable news outlets across Canada in the past 6 months that demonstrate a dangerous mismatch between the topic at hand and the expertise of the informants. The journalist reaches out to many experts including Ashleigh Tuite, a highly accomplished infectious disease epidemiologist and assistant professor at the University of Toronto's Dalla Lana School of Public Health. After commenting on the stress on the health system, she extends her expertise to policy decisions by suggesting that the problem is that Ontario and Quebec tried to be more strategic with their lockdowns in the second wave, stating that non-essential businesses were left open, travel wasn't restricted effectively, and the provinces only reacted when the situation turned dire.

Another expert cited is Dr. Irfan Dhalla, vice-president of physician quality at Unity Health, which includes St. Michael's and St. Joseph's hospitals in Toronto. He states:

"We need to be communicating clearly, and not sending mixed messages. We need to use restrictions and lockdowns to reduce transmission substantially, and only open up when we have the capacity to contain the virus with public health interventions like testing, contact tracing, and quarantine."

Notice how Dr. Dhalla has quite easily extended his expertise to communication and social messaging and apparently has expertise on how broader society responds to lock downs. Another is Dr. Raywat Deonandan, a global health epidemiologist and associate professor at the University of Ottawa. He states:

"The first lockdown was extreme. Everything was closed, everything, and people were really discouraged from even leaving their houses as well. People were terrified and so they were more likely to comply,"

Now look at the comment by this same professor that goes well beyond his expertise when he specifically discusses human behaviour at a societal level:

"Now, there isn't a lockdown — some businesses are closed but many are open still. So people are still going about their business, people are still socializing, because the fear is gone."

Another article published just recently by CBC about the 1500 flights since October filled with Canadians seeking sunny escapes really had nothing to do with the virus but was exclusively about human behaviour regarding how and why Canadians are not following guidelines. Yet who is the expert they ask for comment? Dr. Raywat Deonandan, professor of epidemiology at the University of Ottawa. Notice how his lack of expertise really come out in the following comment:

“I try not to judge people. Everyones got their reasons…maybe they need, you know, some kind of stress relief”

Yet rather than recognizing the need for alternative expertise, the reporter continues by including his advice that banning travel could cause “backlash and disobedience”, and would be a “hard sell politically and economically”.

Perhaps the most egregious example of this is a Globe and Mail article published just the other day that explains the results of a study that showed that Canadians engaged in riskier behaviour in the 2nd wave of the pandemic than in the 1st. To comment on this, who did the Globe turn to for advice? Yup, an epidemiologist at the University of Toronto. And did this person decline to comment on aggregate level social behaviour because it was outside her realm of expertise? No, she did not. Instead, she offers some pretty ill-informed advice like leaving windows open and greater government compassion in messaging.

According to the CDC, epidemiologists or “disease detectives” understand who is sick, what their symptoms are, when they got sick and where they could have been exposed”. A cursory look at a PhD in epidemiology raises significant doubt about their ability to comment on collective social behaviour. A scan of a typical Canadian PhD in epidemiology shows very little reference to courses in social psychology or sociology where they understand human behaviour at an aggregate level.

What’s happening here is that by using these medical experts almost exclusively we are conflating our knowledge of how viruses work with how society works. While our understanding of the virus, its mutations, and how it spreads are no doubt important, expertise of the medical community can only go so far. This, I think, is a fundamental explanation for why we’re in the predicament we are in today. The unfortunate thing is that political leaders will convince many voters that despite their failure in curbing these numbers, they simply could not have predicted the outcome because we’ve never faced something like this before.

But that’s plain wrong!

Fundamentally, the problem we’re facing today is a collective action problem. It’s important to understand that what this pandemic has done is tested our ability as individuals to make decisions and behave in ways that do not benefit ourselves directly but benefit others. Whenever we bear the full cost for which the full benefit of that cost does not get earned, we have a strong incentive to defect and avoid the cost. This is precisely what is happening. The odds of getting covid-19 as an individual remain remarkably low. But if all of us make a decision based on this prediction, like many people did on Christmas Eve when they met indoors with their extended family before the Dec. 26th lockdown, we’re all affected because at least 10 out of every 1000 people will spread the virus. We all bank, quite understandably, on the belief that we’re going to be the 990 who don’t.

This is called the tragedy of the commons.

We’re not sophisticated and mature enough as a society yet to sacrifice our individual interest for the broader collective, especially when we all know that if everyone else adheres to the guidelines, then I gain substantial benefit as the one who doesn’t.

Social scientists have been studying collective action problems for decades. Elinor Ostrom won the Nobel prize because she figured out how to avoid this very tragedy. Yet out of all the articles I’ve searched where we’ve leaned on experts in response to government action and policy to curb the spread, I’ve seen reference to this once or twice out of 4 or 5 dozen articles that instead rely on health experts. Consider an article that came out back in April that didn’t get much attention. The authors accurately described 4 types of behaviour in response to a situation like this. They go on to explain precisely how these categories interact which is a key point that ultimately explains our 2nd wave. Specifically, when “willing participants” (who represent 60% of the population) see enough “egoists” (who represent 20% of the population) breaking the rules, they start to be “willing to cheat”.

Recent work has shown how collectivity improves community resilience during a disaster while other work has shown that regional social capital – defined as norms and networks that bond communities together – facilitate coordination of local actors for the common good. In fact, some social scientists have stressed the importance of regional social capital on improving public health. My PhD student and I did some quick regressions and found that in US counties with high levels of cooperative social connectedness - social associations that promote general community spirit and common good - had lower covid cases.

My broader point here is that there is a flurry of research that has identified key success factors that promote community collectivism rather than individualism, which is precisely what we need during this pandemic. Yet despite the expertise that is clearly out there, we have blind worship of the medical community’s opinion. The media must cast a wider net to more accurately identify those who are truly experts on the topic they’re reporting while medical experts must decline to comment on those topics for which they lack expertise.

Many parts of the world, including Ontario, Canada, are in a race to vaccinate the population before cataclysmic virus spread. This is undoubtedly a sign that we have failed to overcome the greatest threat to humanity of modern times. While the vaccine is a fantastic achievement, this pandemic is unlikely isolated in its test of our collective resolve and will. And while I am optimistic that in future crises like these, we’ll rise up with an innovative response like the vaccine, the greater concern for me is that we will again see countless unnecessary deaths in the lead up to this discovery. These deaths were unnecessary because we’ve labeled this problem a medical one for too long. This is not just a medical problem. This is a social problem. It is about political will, it is about collective action, it is about community consciousness, it is about leadership.

Some have argued that the virus is pitting science against nature. Specifically, the virus is nature’s way of correcting the consequences of a relentless pursuit of growth on a finite planet. Many argue that science – specifically technology and innovation – represents our efforts to find a vaccine to stop nature’s path.

I don’t think this is it at all.

I think this is nature against human consciousness rather than science. For too long, we’ve based our growth and success as a civilization on the wrong measures. Wealth generation, prosperity, technology, efficiency, and convenience have been prioritized over cooperation, collaboration, and consciousness. Yet nature will always win against the species that competes against itself. The goal of nature is likely to reduce the human population and it is counting on human civilization to act selfishly to make this happen (i.e. the weaker part of the species dies). But what nature is not designed to attack is cooperation and collective action by a species. Nature is not wired to counter this level of intelligence. And this is why I think we need a greater focus on the social sciences to truly understand how to combat this virus. This expertise is out there. Let’s start using it!

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