On 8 September, the World Health Organisation (WHO) warned of a deadly condition that is likely to kill around 11 million people worldwide every year.
This includes 2.9 million deaths among children, most of which are preventable. Given these awful projections, it is surely clear that urgent action is needed: social distancing; facemasks; lockdowns; unprecedented investment in vaccine development.
But that wouldn’t address the problem, because we’re talking about sepsis, something that affects 49 million people annually and also leaves many survivors with long-term health problems.
While its press release about sepsis received little media attention, the WHO’s subsequent warning that Covid-19’s global death toll could reach 2 million, even if a vaccine is found, was awarded a prominent position on the BBC News website and elsewhere.
So which should we be more worried about and where should our efforts be invested so as to minimise suffering, long-term illness and deaths?
The emphasis has been placed firmly on prevention of Covid-19 deaths, most of which involve elderly people with significant comorbidities. Forget about sepsis. Forget about numerous other serious and preventable diseases.
And while we’re at it, let’s also set aside the enormous and wide-ranging collateral damage caused by lockdowns and other measures: deaths due to other diseases that were left undiagnosed or untreated; widespread mental health problems; the health and well-being costs of unemployment and poverty; massive disruption of education; countless precious life-moments lost that can never be recovered; traumatic birth experiences; increased domestic abuse; and many people living out the last few months of their lives in isolation and misery, after which friends and relatives feel unable to grieve properly due to social distancing measures. And that’s without even looking beyond the UK.
Perhaps, when the costs of responding to Covid-19 by doing nothing or doing less are considered carefully, it will become clear that the emphasis is appropriate and the costs justified. Nevertheless, there is surely room for public disagreement and debate. How great a risk does the disease pose, compared to other risks that are routinely accepted? Is locking down entire populations a proportionate or morally justifiable response? These are some of the questions important to a robust public debate.
Academic philosophers, such as us, like to question assumptions, consider alternative perspectives and find holes in arguments. However, in questioning the orthodox Covid-19 narrative (according to which there is an unprecedented threat, best dealt with via extreme social restrictions), we are rarely met with careful consideration and counterarguments. More often, we get awkward looks, expressions of discomfort or disapproval, and a steadfast refusal to even contemplate the possibility of certain claims being mistaken or certain actions misguided.
Sometimes, there is the feeling of being estranged from it all, watching — with detached curiosity — the dedicated social-distancing and confident virtue-signalling of those evidently immune from doubt. They know what is happening; they know what is right; they know what to do. How easy it would be to set aside any remaining doubts, immerse oneself fully in these performances, and — with time — recover a sense of solidarity and certainty.
That said, there must be a place for honest, high-quality, critical debate, especially at a time like this, involving considerable uncertainty and extremely high stakes. So, rather than falling in line, we instead want to offer a diagnosis of others’ confidence. Why do so many people appear reluctant to even consider the possibility that lockdowns might be ineffective or inappropriate responses to the situation, that the widespread imposition of non-medical facemasks is based on inadequate evidence, and that the costs of certain measures, in terms of lives lost or blighted, may turn out to be higher than the gains?
We could point to an assortment of reasoning biases at work here, some of which play an especially prominent role in situations of uncertainty and threat. Think of the availability bias, for instance: the prospect of being attacked by a shark while swimming may be considerably more worrying than that of being run over while crossing the road to the beach, although the latter is more likely.
However, there is also an overarching shortcoming that unites various biases, one that we see time and time again: a failure to consider things in their wider context. Granted, the virus is a serious problem, but how does it compare to other threats we face? Perhaps we do need to lock down our societies to slow the rate of transmission, but are such radical steps consistent with how various other kinds of risks are appraised? It is clear that non-medical facemasks reduce the spread of large droplets, but simple interventions can have complex effects in the context of actual social environments. Is it really so obvious that the various behavioural changes they elicit will collectively serve to reduce transmission?
it is difficult to address such questions when Covid deaths are reported without any reference to all-cause mortality, when mask-wearing is presented as obviously right, and when calls for cost-benefit analyses are met with quiet disapproval or blunt charges of callousness, as though this were a straightforward matter of deciding to save lives or instead to protect the economy.
Sometimes, it can feel as though one’s interlocutors live in another world, a place where different rules and standards apply, where different things seem obvious, and where certain facts are not up for debate at all. They operate with different sets of certainties, in ways that lock out the possibility of critical discussion. We think this may actually be what is happening: there really is a way in which many people have come to inhabit a different world. Let’s explore the idea further.
Back in 1889, the philosopher and psychologist William James suggested that, during the course of our lives, we slide between different “worlds” or “sub-universes”, including the worlds of “sense”, “science”, “the supernatural”, “individual opinion”, and “sheer madness”. These worlds are connected to varying degrees, although immersion in one can lead one to lose sight of others. According to James, all of us place the flag of truth in one or another of these worlds, taking it to be our “world of ultimate realities”. It is not something we seek evidence for or subject to critical scrutiny. Rather, it is a context we take as given when thinking through matters and weighing up evidence.
Consider how, during the course of daily life, some things appear more salient than others — they light up for us, stand out, grab our attention. These things also matter to us in different ways: maybe they excite us, threaten us, comfort us, draw us in, or repel us. Whether and how we find various things salient or significant depends on our projects, commitments, and values, which become engrained over many years and operate as a lens through which we see and think about everything. But there is more to having a world than having such a lens, and recognising this takes us closer to understanding certain reactions to the pandemic.
For James, what is most fundamental is an underlying, inarticulate feeling of how things are. This includes a deeply-felt sense of the essential character of the world, whether it is fundamentally good or bad, what is up for debate and what is to be accepted without question. Also included is a sense of the kinds of people we should take seriously in our personal efforts to understand things. For instance, writing a few years earlier, James describes his philosophical opponent, the rationalist, as inhabiting a world that is too crisp, clean, simplified, and abstract — “too buttoned-up … and clean-shaven” to capture “the vast slow-breathing unconscious Kosmos”.
We suspect that many people have slipped into a sort of “Covidworld” and moved the flag of truth to that world, via a process that resembles religious conversion more than it does the adoption of new beliefs that remain open to critical scrutiny. As the philosopher Ludwig Wittgenstein once put it, some people get converted to a very different “picture of the world”, complete with its own certainties, practices and ways of speaking.
To understand how this could have happened, consider the swift and profound effects that the March lockdown had on our practically meaningful worlds. Intricate webs of well-established projects and pastimes were suddenly suspended or lost. Work stopped or changed radically. Over the ensuing months, our everyday habits of life were replaced with something new and unfamiliar.
More usually, our efforts to cope with profound life-disruptions and negotiate instability involve turning to other people for advice, guidance, and support. When this works, our interrupted sense of what is compelling or reasonable is renewed and our sense of stability returns. Lockdown reduced this kind of support, as we were all affected by it and cut off from many of our usual social interactions. Constantly subjected to the mantra, “stay at home; protect the NHS; save lives”, the variety and spontaneity of our collective social life was replaced by the clapping, the rainbows, the daily government briefings, the charts of new cases and deaths, the burgeoning signage telling us all to keep our distance, the arrows on the pavements, and the social media bombardment. Then came facemasks, the threat of Long Covid, socially distanced classrooms, ominous predictions of a “second wave”, an increasingly elaborate set of new restrictions, a tier system, and calls for circuit-breakers.
Along with all of this, there has been a subtler and more pervasive alteration in many people’s sense of how things are with the world. It is no longer homely in the way it once was. Everything is shrouded in danger and distrust. A world that was once a theatre of possibilities is now suffused with an air of dread. People we might once have passed on the street with a smile or a nod are now experienced as potential disease carriers, to be met with suspicion or avoided.
In the context of this altered way of finding ourselves in the world, a new system of rules, projects, practices and pastimes has taken hold. Fear of the virus is the single fulcrum around which everything now turns, shaping our attention, concerns, conversations, and activities. For many, the world feels altogether different, like the inevitable onset of a winter that must be endured with grim resignation.
Over time, Covidworld tightens its grip, eclipsing all other concerns. It reminds us of Wittgenstein’s example of a culture dominated by belief in a Last Judgment, a conviction expressed “not by reasoning or by appeal to ordinary grounds for belief”, but through its role in “regulating” all aspects of life. Similarly, Covidworld offers a simple, internally coherent substitute for the messier and more complicated reality we once inhabited.
A reluctance on the part of many people to engage in serious debate can be understood in terms of the transition into this different world, a place complete with its own foundational beliefs and performances. Lockdowns work; masks lessen transmission; the second wave is an unacceptable threat and must be suppressed.
Since all of this is beyond doubt, questions about the adequacy of evidence are often reinterpreted in moral terms and dismissed as irresponsible acts of “covidiocy”. Many of those who would more usually insist on examining alternative possibilities or challenge the party line now fall strangely silent. Lack of critical reflection is further fuelled by a distrust of those who do not belong to Covidworld.
Granted, there are conspiracy-mongers who fail to grasp that 5G masts cannot spread viruses, but there are also those who ask questions that really ought to be seen as sensible, like whether a range of social restrictions are proportionate, in view of their human, social, and economic costs. For those firmly embedded in Covidworld, however, such questions may seem no less far-fetched than that of someone who seriously wonders whether the world is just a dream. The flag of truth now flies in Covidworld; it is not a place to be questioned, but the place within which questioning takes place.
Could something like this really be happening? We think so. It would certainly explain a curious detachment of the standards applied to Covid-19 from standards normally applied elsewhere, especially concerning attitudes towards risk. The world has always been a tough place to live in. Our sense of safety and security could be shattered at any time by accident, serious illness, loss of abilities, bereavement, mistreatment at the hands of others, unemployment, failure, or humiliation. And, whatever else happens, death will catch up with us eventually.
Ordinarily, most of us don’t pay much attention to the risks we face, instead sleepwalking past them until they strike. Yet we still know, in a sort of detached way, that more than 10,000 people die most weeks in the UK, that many of those deaths are preventable, that influenza kills thousands of people every winter, and that many human lives are constantly marred by disease, poverty, neglect and cruelty. The Covid-19 pandemic has shone a light on the death and suffering caused by the virus, but at the same time eclipsed other concerns. Yes, this is really horrible, but things have always been horrible. Shine the light more widely and you will find much more of the same.
Even allowing that Covid-19 is a significantly greater risk to many people than, say, influenza, there remains a curious disconnection between attitudes towards risk in the two cases. Winter flu deaths have been an accepted part of life for many years, while Covid-19 takes centre-stage. What seems different now is that the rules, standards, practices, values, and attitudes internal to Covidworld have become cut off, to varying degrees, from the wider context of human life.
One might respond that we should have been more concerned about influenza all along and that we should have taken more care with easily implementable hygiene measures long ago. That is right and there are lessons to be learned. Similarly, there are good grounds for suggesting that more should be done to tackle sepsis.
But what would happen if we eliminated all of the inconsistency by taking the standards applied to Covid-19 and applying them to every other form of risk?
The social world would come to present itself as an all-enveloping threat, a harsh realm within which life would be intolerable.
Human life is replete with risks, but we manage them by making judgments shaped by a sense of salience and proportionality, rooted in the wider context of our social world. That is why it is important to understand and challenge the widespread decontextualisation that attends Covid-19. However, the extent of this challenge should not be underestimated. When the gulf seems somehow too vast for critical debate to get off the ground, when you are struck by the uncanny feeling of encountering a perspective that is quite alien, maybe that’s because they really are from another world.