Learning from Covid-19: Transforming Risk Perceptions to Rebuild the Public Sector
By: Craig Thompson
Tags: The Culture Wars, Covid 19, Neoliberalism, Reopen Economy, Risk

Learning from Covid-19: Transforming Risk Perceptions to Rebuild the Public Sector

Craig J. Thompson, University of Wisconsin-Madison

As governments and societies grapple with the Covid-19 pandemic, the logic of risk management has become integral to people’s everyday lives. Many daily activities that, not too long ago, had seldom raised any significant concern about safety have become a source of anxiety; how much risk am I taking by shaking hands, talking to someone in close proximity, spending time in a public park, shopping, or going to work?

I study the ways in which risk perceptions are shaped by a broad spectrum of sociocultural influences — such as a scientific study whose findings are selectively reported (and often distorted) on social media. For example, activities like biking and running, which had once been culturally associated with ideals of fitness, well-being and vitality, have now been reframed as a potential public health menace owing to the social media propagation of a study research suggesting that “respiratory particle slipstreams” could be a potential source of viral contamination (Blocken et al. 2020, http://www.urbanphysics.net/Social%20Distancing%20v20_White_Paper.pdf.

As defined by the sociologist Ulrich Beck (2009), risks are “the anticipation of a catastrophe.” Accordingly, proactive efforts to manage risk invariably raise questions about how far a given society (or individual) should go in preparing for an anticipated catastrophe and how much burden and cost should be borne in pursuing the goal of risk reduction. Since risk is an abstract concept, existing in the realm of probabilities (and often unpredictable contingencies), there is no definitive criteria that can distinguish between preparation and paranoia or between rational precaution and hysterical overreaction. Not too long ago, doomsday preppers were a cultural icon of irrational fear and anxiety; in our pandemic environment, they are increasingly seen as prescient individuals who harbor a wealth of practical, and perhaps life-saving, information (https://www.forbes.com/sites/petersuciu/2020/03/23/preppers-are-sharing-tips-on-surviving-covid-19-via-social-media/#7265b75914cf).

The increasingly polemical debates over how societies should respond to the public health and economic challenges of Covid-19 mirror these uncertainties and ambiguities. They also highlight the ways in which risk perceptions can be shaped by a gamut of competing and, often contradictory, discourses narratives, images, and metaphors. We must not let the cure be worse than the disease! Tyrannical government overreach!! Herd Immunity! We should just isolate the at-risk populations!; We must not put the economy over lives! Re-opening too soon will extend the crisis!

In making sense of these competing risk constructions, to re-open or socially isolate is not the question. Rather, it is whose risk perceptions are deemed trustworthy and believable (and by whom)?

The scientific and health-care communities share a general consensus that social distancing practices and stay-at-home policies (aka “economic lockdowns”) have been effective at slowing the rate of infection and reducing the concomitant demands on the medical system. Furthermore, tracking data shows that those states which have recently lifted such “flattening the curve” protocols are witnessing a worrisome increase in reported Covid-19 cases (https://www.cnbc.com/2020/05/12/coronavirus-cases-are-on-the-rise-in-texas-and-other-states-that-reopened-early-former-fda-chief-says.html.

While we might have expected this crisis would be an impetus for national unity, the Covid-19 pandemic has become yet another divisive “culture war” issue where beliefs about the severity of the public health threat and the need for proactive social distancing measures (and limits on marketplace interactions) clearly split along partisan lines (https://www.pewresearch.org/fact-tank/2020/04/02/5-facts-about-partisan-reactions-to-covid-19-in-the-u-s/). As each day passes, more and more states are making plans to re-open their economies; a trend strongly endorsed by many high profile Republican politicians and their MAGA political base; the latter group now gaining global attention through organized protests in swing-state capitals, such as Lansing, Michigan and Madison, Wisconsin, where Democratic governors have imposed strong stay-at-home orders.

[On May 13, 2020, Wisconsin’s conservative leaning supreme overturned Governor Tony Evers’ stay-home-order, ruling it “unlawful and unenforceable,” in response to an unprecedented case filed by Wisconsin’s Republican-led legislature (https://www.jsonline.com/story/news/politics/2020/05/13/wisconsin-supreme-court-strikes-down-tony-evers-coronavirus-orders/5179205002/.

Explanations of this political divide typically posit a distinction between those who base their decisions on scientific evidence (and expertise) and those who disavow science in favor of their ideological commitments, whether it be an antipathy toward any government infringement upon personal freedom or the market economy, unconditional support for the Trump administration or some combination thereof.

When considered from a risk perception frame, however, this science versus anti-science problematically obscures the cultural conditions underlying “the re-open the economy” movement and the alternative constructions of risk that are enabling it to gain an increasing degree of social as well as political traction.

Rather than science versus anti-science, the more relevant distinction is between orthodox science — sanctioned by institutional authorities like the WHO and leading medical institutions — and dissident science which casts doubt on the legitimacy of establishment institutional authorities. In this regard, the “reopen the economy” protesters draw from many of the same skeptical, anti-institutional discourses that have previously mobilized climate change deniers and anti-vaxxers. These latter groups do not self-identify as being “anti-science.” Rather, they embrace the identity position of being a select group of enlightened, free-thinkers who have discovered a “truth” that has been repressed or falsely discredited by institutional gate keepers. Accordingly, they embrace and propagate these dissident constructions of risks.

Talk to an anti-vaxxer or a climate change denier and odds are he/she will quickly inundate you with studies, graphs, and charts “proving” a vaccine-autism link or that the climate has not appreciably warmed since 1998 or that the appreciable warming is due to solar flares, etc., etc. etc. And sometimes these anti-establishments findings and implications can be traced to flawed studies conducted under the institutional auspices of orthodox science, such as the now officially discredited (and retracted) study that posited a direct link between vaccines and autism but remains a canonical text among anti-vax advocates (see Goodlee, Smith and Marcovitch 2011 for a fuller discussion)

In the context of Covid-19, the “reopen the economy” faction has canonized a pair of studies (whose pre-review results have been widely publicized) indicating that this virus’s fatality rate is much lower than official estimates. The methodological flaws in this study are so glaring that the highly respected statistician Andrew Gelman (Columbia University) concluded that the studies’ authors owed the world an apology for their shoddy data collection and analysis (see https://arstechnica.com/science/2020/04/experts-demolish-studies-suggesting-covid-19-is-no-worse-than-flu/.). Nonetheless, two of those authors have become conservative media darlings (https://www.foxnews.com/media/coronavirus-death-rate-flu-jay-bhattacharya). If you interact with someone on social media advocating that “we” need to take a common-sense approach and “open the economy up,” references to these statistically suspect studies and conclusions are likely to not be far behind. These dissident findings as well as far-fetched conspiracy theories about the origins of Covid-19 and the nefarious motives of public health authorities— e.g., https://techcrunch.com/2020/05/07/plandemic-video-judy-mikovits/ — have gained an alarming degree of legitimacy among conservative political factions through their reiterations by ideologically aligned politicians, media pundits, economists, and other social influencers.

The “reopen the economy” movement also valorizes the psychological, social, and, economic value of work and thereby portrays stay-at-home policies as a dire threat to the material and moral fabric of society. While this rationale may seem like one steeped exclusively in ideological and economic considerations, it also harbors an implicit risk assessment arguing that the income losses generated by a prolonged economic shutdown also lowers life expectancy; could disrupt supplies of necessary medications for those suffering from chronic illness; exacerbate the existing problems of hunger and food insecurity; and increase rates of suicide and domestic violence (https://qz.com/1850947/the-deadly-consequences-of-the-covid-19-economic-shutdown/).

These dissident risk assessments underlie the “we must not let the cure be worse than the disease” narrative that began circulating just as the United States began its “flatten the curve” mobilization. In March 2020, for example, Stanford professor of epidemiology John Ioannidis opined that such actions might well be premature and could engender a needless socio-economic disaster akin to “an elephant being attacked by a house cat. Frustrated and trying to avoid the cat, the elephant accidentally jumps off a cliff and dies.” (Ioannidis 2020, https://www.statnews.com/2020/03/17/a-fiasco-in-the-making-as-the-coronavirus-pandemic-takes-hold-we-are-making-decisions-without-reliable-data/.) A month later, New York Times columnist Bret Stephens used his media bully pulpit to forcefully argue that economically restrictive, social distancing measures pose a greater threat to societal well-being than the disease itself. While conceding that densely populated areas, like NYC, may require an extension of more draconian measures, Stephens proclaims that “The rest of America needs to get back to life.” https://www.nytimes.com/2020/04/24/opinion/coronavirus-lockdown.html. [As a relevant side note, the NYT’s own tracking of the corona virus an escalating rate of confirmed cases in lower population density areas — https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html].

Such arguments are bound to be ideologically compelling for many who are grappling with the inconveniences and stresses of social distancing and its many complexities and demands (children unexpectedly being at home on a full-time basis; mounting financial pressures over making ends meet; depression and on and on). Even those who are better able to weather the economic retraction may still be deeply troubled by the deleterious effects these “flatten the curve” governmental mandates are having on local businesses, educational systems, and overall quality of life. For those who live in areas that have not (yet) been heavily impacted by the pandemic, it is easy to believe that the risks of a continued economic lockdown outweigh those posed by the pandemic itself.

Returning to Stephens’ NYT column, he approvingly quotes this statement from Tomislav Mihaljevic, CEO of the Cleveland clinic — “We’re using the methodology from the 14th century to combat the biggest pandemic of the 21st century” — and then added his own accentuating coda — “It can’t go on.” Until a vaccine or a very effective and widely available, anti-viral treatment is discovered, however, our current medical tools for combating this virus are not all that different from medieval times, except we have means for testing (though in the US, accurate test kits remain in woefully short supply) and we have a much better understanding of how to reduce the rate of transmission — the very protective mechanism that “re-open the economy” advocates casts as harboring too many other socio-economic risks to be sustainable.

As also discussed by Ulrich Beck (2009), the conventional responses to systemic risks are apathy, denial, or transformation. As we have seen in the context of climate change — perhaps the foremost example of a systemic risk — apathy has been a very prominent cultural reaction for several decades, most particularly in US socio-political circles. However, the consequences of the Covid-19 pandemic have been far too disruptive for apathy to gain a cultural foothold. Rather, we are witnessing a stark social division between those who support a presumably short-term transformation in societal practices (the majority position) and a minority (but expanding) segment demanding arapid return to economic “normalcy: a form of denial supported by varied dispatches from the outposts of dissident science.

These conflicting risk perceptions are, understandably, taking center stage in our political discussions, news media coverage and social media interactions. However, I suggest that this crisis moment should be regarded as an opportunity to take necessary steps to better prepare the United States and the world-at-large for the next pandemic. And mobilizing political actors and the general public to support such future oriented policies requires a reconfiguration of the risk perceptions that are now prevailing.

Preparing for future risks when preparation runs against the ideological tide

Gazing into our imaginary crystal ball, we can envision that, at some point on the chronological horizon, the threat posed by the SARS-CoV-2 virus will be dissipated by a medical breakthrough or a sufficient degree of herd immunity. But, we can be equally assured that another crisis-inducing pandemic also awaits in the future. In fact, we have known about this “likely future,” which now has colonized our current reality, since 2005 when a number of leading epidemiologists, global health experts, and microbiologists began to warn that governments needed to take much greater precautions against the ever increasing risk of economy shuddering, life threatening, politically destabilizing pandemics (https://www.vanityfair.com/news/2020/03/why-didnt-the-world-listen-to-the-coronavirus-cassandras); these Casandra-like predictions have since been amplified, year after year, by, among others, the Bill and Melinda Gates Foundation, global institutions like the World Bank and the WHO, and, not to be overlooked for their cultural impact, Hollywood disaster films such as Contagion (2011).

Perhaps “mistakes were made” in regard to these past unheeded warnings but surely Covid-19 is the irrefutable wake-up call that guarantees pandemic preparation will become an enduring a global priority? History suggests that such a presumption could be quite mistaken. Many expected that the 2008 financial crisis would precipitate radical changes in the relationship between government and big finance but, steadily, institutional pressures and incentives to expand the economy through debt-driven bubbles have taken priority over safeguarding measures (see Colombo 2018, https://www.forbes.com/sites/jessecolombo/2018/08/29/the-u-s-is-experiencing-a-dangerous-corporate-debt-bubble/#554c7e81600e).

As we can gain more chronological distance from the events of 2020, we can envision that many influential actors will strongly re-assert the neoliberal ideological belief that the health of the financialized market economy (i.e., stock market values; corporate profits) should be the ultimate benchmark for assessing the well-being of the nation. And, it seems likely that potential preventive measures — most significantly, major investments in rebuilding the public health infrastructure and greatly expanding access to affordable health-care — will again be dismissed as too constraining, too intrusive, and too much of a (bloated) bureaucratic drain on the free market economy.

Ironically, one key structural factor that has most significantly impeded the capacity of the United States to manage this pandemic has been 40 years of neoliberal reforms. Over the last 5 to 10 years, there has also been a growing pushback against neoliberal economic and political policies, with Bernie Sanders’ 2016 Presidential campaign bringing these critical arguments squarely into the political and cultural spotlight. But, the implication that neoliberalism could be a consequential source of risk — that renders societies less prepared to manage future pandemics and, more vulnerable to catastrophic outcomes — has not yet become a significant political talking point. And the Covid-19 pandemic provides considerable evidence to motivate such a shift in collectively shared risk perceptions.

By re-assessing neoliberalism as a form of systemic risk, we can also expand on the implications of a pronounced ideological contradiction manifest in re-open advocates’ veneration of Sweden’s less restrictive approach to managing the Covid-19 outbreak https://www.mercurynews.com/2020/04/30/friedman-is-sweden-getting-it-right-with-its-covid-19-approach/). To be clear, the Swedish approach, which at its core is premised on the goal of building herd immunity — has generated controversy. Through a reliance on voluntary social distancing guidelines and only banning gatherings of 50 people are more, the Swedish model allowed Swedes’ to maintain most of their normal routines — from sending their children to school, to shopping at their favorite store or socializing at a restaurant or cafe — and by implication to allow the Swedish economy to more or less function as normal. However, this unorthodox approach has also generated the highest infection and death rates among their Scandinavian counterparts, such as Norway and Finland, who have enacted emergency shutdowns of many public and private institutions and restricted social gatherings (https://www.vox.com/2020/4/9/21213472/coronavirus-sweden-herd-immunity-cases-death.) And as more longitudinal economic data has become available, it appears that this Swedish policy may not have provided comparative economic benefits (https://www.worldpoliticsreview.com/articles/28759/the-swedish-model-is-a-failure-not-a-panacea). On the other hand, the Swedish health-care system has not been overwhelmed by the increased demand for medical care and its infection and rates remain well below initial projections https://www.euronews.com/2020/04/21/analysis-is-sweden-right-in-its-handling-of-covid-19.

History will eventually judge whether Sweden’s strategy was a responsible or reckless approach. However, we can infer right now that it could have quickly become an unmitigated disaster, without a strong and extensive social safety net (or what neoliberal critics would condemn as an inefficient, market-distorting, moral hazard prone, welfare state). At this precise juncture, we can highlight the ideological disconnect between conservative politicians and pundits who praise Sweden’s Covid-19 response for not encroaching on personal freedom or impeding economic activity while remaining steadfastly silent about Sweden’s broader system of governance. While the Nordic model has been modified (and in many ways curtailed) by neoliberal reforms, it still supports a robust public sector, providing free to (highly subsidized) low cost health-care, education (including college), and day-care services to its citizens; a largely unionized work-force where a living wage is a right (rather than a contested ideal); and paid parental leave among, many other benefits. Not surprisingly, Swedes’ trust in their government institutions is far higher than their American counterparts (https://foreignpolicy.com/2020/04/15/secret-success-coronavirus-trust-public-policy/).

In contrast, neoliberal policies are premised on an ideological belief that the public sector is an inherently less efficient means for distributing resources (such as health-care) than free-market competition. In the neoliberal world, the guiding principle for all policy actions should be to maximize economic growth and shareholder wealth. Accordingly, the legitimate role of government is not to construct a more equitable society (such as through the provision of health-care, education, and living wages); rather, governments should safeguard the market from the risks posed by anti-competitive restrictions (ranging from tariffs to environmental regulations) or misguided efforts at social engineering. Seen in this neoliberal risk frame, the tax revenues needed to support the public sector are a counterproductive transfer of wealth that directs capital away from more efficient and productive free-market enterprises; union negotiated wages, protections, and benefits create numerous inefficiencies and artificially distort the value of workers’ human capital. In the ideal neoliberal world, workers should be treated as entrepreneurial free agents, as in the so-called gig economy, whose value is determined by the rational play of free market forces.

From massive tax cuts for corporations and high income earners, shareholder wealth maximizing practices such as stock buy backs, deregulation, and the privatization of public services, neoliberal policies have reshaped societies across the globe all in the name of economic prosperity (and engendering a real politik effect of concentrating wealth among the top 1%) (Piketty 2020). To date, leading criticisms and proposed alternatives to neoliberal hegemony have turned on a classic Marxian tension between the rights of labor and the exploitative power of capital, rather than a question of risk and risk (ill) preparedness. One notable exception to this norm has been environmental activists and progressive economists who have also drawn linkages between neoliberal policies and the structural forces driving anthropogenic climate change (see for example Schor 2019, http://triplecrisis.com/neoliberalism-and-climate-change/).

The transformative power of this risk linkage has been constrained by a political status quo where climate change apathy and denial still hold powerful sway. Pivoting to a different risk formulation which highlights how neoliberal policies render societies less resistant to threats of a global pandemic and, beginning that conversation in the present moment, might be a more efficacious strategy to build support for revitalizing the public sector and redressing the myriad structural flaws that have been exposed by Covid-19.

When re-framed through the lens of Covid-19, neoliberal policies suddenly appear as a source of structural risk that leave societies less prepared to effectively manage the multi-faceted societal demands of a global pandemic. For example, let us consider the iconic cultural heroes that have emerged from this current crisis: doctors, nurses, medical researchers, and “essential” workers. Many of these essential workers — medical assistants, assisted living staff, truck drivers, and blue and pink collar laborers in grocery stores, restaurants, and farms, warehouses, loading dock — have long been cast as low-skilled workers whose demands for higher wages, health-care benefits, and paid leave were often disparaged as being incompatible with their “market value” and a hindrance to firms’ market competitiveness. The Covid-19 pandemic has, for now at least, shifted cultural perceptions of such workers’ societal value. If these perceptions are only fleeting ones before we return to the neoliberal status quo, then an important opportunity to enhance workers’ security (and their capacity to withstand the economic shocks of a future pandemic) and to reinvest in our resource-challenged public sector (and thereby revitalize our societal immunity against future catastrophes) will have been lost.

Addendum:

One addendum on political barriers to investments in risk prevention: President Trump is correctly claiming that Obama administration did not sufficiently replenish the federal stockpile of N95 masks, which had historically been underfunded and depleted by the 2009 Swine flu outbreak (https://www.independent.co.uk/news/world/americas/us-politics/coronavirus-trump-obama-stockpile-medical-equipment-a9515431.html)

This blame-deflecting charge still does not explain why the Trump administration did not request funds to redress this shortfall. Perhaps, more importantly from a risk management standpoint, Trump and his allies fail to mention that then President Obama’s budget requests to rebuild these emergency stockpiles — in concern with a recommendation on emergency preparedness from the CDC — were continually rebuked by the Tea Party dominated congress. At the time of the so-called Tea party revolt, the nation was only a year removed from the Swine flu outbreak but it had been sufficiently contained to create a lingering memory of crisis or threat. In coming to Congressional power, the Tea party ran on a platform that opposed the Affordable Health Care act and demanded tax cuts and immediate debt reduction (though the nation was still recovering from the 2008 financial crash). During this pivotal political period, very little political dialogue concerned the potential risks that such shortages posed to the public health in the event of a pandemic, though these risk had been formerly recognized by the CDC. The Tea party revolt ideologically de-legitimated the goal of building the public sector in the name of pandemic preparedness and this issue ceased to be a major political concern for the ensuing 2012, 2014, 2016, or even 2018 elections (where Democrats regained controlled of the house through an anti-Trump blue wave). In contrast, we can expect that the 2020 election will prioritize the question of how the United States could have been better prepared for this pandemic but, we need to maintain this cultural memory and altered risk perceptions to ensure that this question maintains its salience for future elections and budgetary and policy debates.

fear of an expanding government which was pursuing the Grover Norquist-inspired goal of shrinking the federal government until it could be drown in a bathtub. https://www.propublica.org/article/us-emergency-medical-stockpile-funding-unprepared-coronavirus

References:

Beck, Ulrich (2009), World at Risk, Malden, MA: Polity Press.

Goodlee, Fiona, Jane Smith, Harvey Marcovitch (2011), “Editorial: Wakefield’s article linking MMR vaccine and autism was fraudulent,” https://www.bmj.com/content/342/bmj.c7452.

Piketty, Thomas (2020), Capital and Ideology, trans. Arthur Goldhammer, Harvard University Press, Cambridge, MA.