Even though I knew what could happen, it was still a shock. I’d spent time in Sierra Leone during the Ebola epidemic and had seen how a disease can ravage a society. I was prepared for fixations on the daily case updates, changing guidance, grounded flights, ever-tightening movement restrictions. But the experience of living a pandemic rather than researching one has been surreal. As one friend put it, I’ve looked at countless graphs of exponential curves but I’ve never felt what it was like to be on one.
It is my job to study societies and disease. From a PhD on Lassa fever, then working as an anthropologist during the West African Ebola outbreak, I’ve spent the last decade studying the social dimensions of epidemics. Early this January I was in a meeting on pandemics as participants kept leaving to join urgent conference calls about a new outbreak in China. I went to Sierra Leone that month to do interviews for a project on pandemic preparedness. I’ve written what feels like endless papers about ‘lessons learned’ from past outbreaks.
With this new disease, Covid-19, I have been struck by moments of both surprise and déjà vu. What feels familiar and what feels different is revealing. I am trying to work out what it means for what might lie ahead.
Resisting instincts to be together
Ebola was a disease of love: it infected people who cared for the sick and looked after the dead. The control measures were anti-social in that they required people to refrain from the most human of urges to care for loved ones and bury them respectfully. Covid-19 does not transmit in as uniquely intimate a way as Ebola, infection occurs through care-giving but also from more casual contact. But still the control measures relate to how we show our love and care – to parents, grandparents, and wider society – and we must resist our instincts to be together.
Controversies over models and evidence
Familiar from Ebola are the controversies over models and evidence. For both Ebola and Covid-19 there have been major uncertainties about what the best course of action is. But Covid-19 also brings back the messiness of it all. The ‘epidemic of information’ is impossible to keep up with. People are endlessly re-deployed and over-worked. During the worst of Ebola I remember the chaos on the ground, in hospitals, in operation centres and seeing how mistakes were made, misunderstandings escalated, or circumstances confounded.
I also remember seeing how this messiness could later be interpreted and recast as stories of corruption, incompetence, and hidden ‘agendas’. Some people became heroes and some villains, some were labelled as ‘responsible’ or ‘irresponsible’, some places or actions were success stories and others failures. Of course some of these stories are true, but many are not, and most are over-simplifications. Underneath, people were often overworked, scared and confused. I wonder what narratives we will create out of Covid-19 and what human error, luck and messiness we will overlook. Our instinct to simplify complex events into stories makes it harder to learn lessons.
Politicisation and conspiracy theories
I expected politicisation and conspiracy. This happens with most outbreaks and is revealing of underlying anxieties and tensions. When Ebola was first reported in Sierra Leone it was in a region associated with the then government’s opposition. Rumours spread that Ebola was a government plot to de-populate this region. Some politicians and party-political newspapers stoked these tensions, and their claims were given credence by the government’s slow response to assist the region. In DRC the recent Ebola outbreak in North Kivu occurred in a conflict region and coincided with an election. The conditions for conspiracy were fertile and again rumours flew.
It has still been a surprise to see how the political rumour mill whirls around Covid-19; to see which dots are connected, and also where my personal politics are implicated. If the 5G conspiracy is at the wackier end of the spectrum, others strike at the heart of our everyday political views – and divides. For example the idea that Covid-19 is being used by the left to push through central planning at the expense of the economy, or the counter-logic that lives have been sacrificed for the economy. As ever, the line between reality, conspiracy and politicisation is blurry, as with the accusation that the government has put ‘Brexit before ventilators’. Making sense of these blurred lines is hard work in the midst of a pandemic.
What has been a curveball are the calls from (some of) the public for tougher government responses, more control, more lock-down. This is in stark contrast to most public health literature, and indeed to WHO advice historically. Of course what we are willing to be subject to is a reflection of how we view our government and their enforcers. Predictably, as the lockdown continues there are rising concerns about the harm it can do, and its unequal burdens. But by and large – and yes with some big caveats – despite austerity and Brexit, we in the UK seem to trust that they will look after us, or at least we did.
Echoes of Ebola in lockdown havoc
The same cannot be said everywhere. From India to Kenya lockdowns caused havoc and have been implemented with very little consideration of people’s needs. Violence is already being used to enforce impossible restrictions on people. There are echoes of Ebola here too, when the Liberian government tried to quarantine a whole ‘slum’ resulting in riots. What works in one place is not equally feasible in another. German social distancing cannot work in Somalia or Pakistan. It is not just a case of wealth and technical capacity but the nature of relationships between citizens and their states.
No longer ‘strange diseases escaping Africa’
A twist in the usual epidemic tale is that rather than ‘strange diseases escaping Africa’, they are now being imported into Africa from richer countries. As the pandemic ramps up in my home city London, my thoughts turn to Sierra Leone which confirmed its first case last week. I wish them the best. I fear we both have tough paths ahead. A grim part of this journey will be dealing with death, with bodies, with inadequate goodbyes. This caused heartache and violence in Sierra Leone during Ebola and I hope they’ve learned better ways of coping. Beyond that there will be celebrations when it is over, and then memories. Odd traces of the epidemic in everyday life. In Freetown it was motorbike riders wearing PPE as rain gear. Time will tell what the legacies of Covid-19 will be for us.
