Lessons for a Post COVID-19 World: You Make the Call

This is Part 1 of a three-part series on how our response to the COVID-19 experience did, is and will transform each, and all, of us. Before we can act differently (Part 3), we must decide differently (Part 2); to decide differently, we must first see differently (Part 1).

Part 1: Worldview; Part 2 World Health; Part 3 Global Action.

Part 1 – Worldview: What Did We learn?

“We must look at the lens through we see the world, as well as the world we see, and that the lens itself shapes how we interpret the world.”

• Stephen R. Covey, 7 Habits of Highly Effective People: Powerful Lessons in Personal Change

April 2020 marked the 50^th anniversary of Earth Day and the month that COVID-19 became the number one killer in the U.S., exceeding average daily deaths for heart disease (NYTimes, 4/19/2020). To capitalize on our time sheltering in place, it is helpful to assess and assimilate what we have learned from our WW-Corona experience. Specifically, how has it informed our worldview?

With a thorough post-mortem underway on the public health “clinical” decision making by U.S. and global leadership, we will learn from the virus battle. But the focus of this article is on what you, I and we collectively have learned during the quarantine war.

In our physical distancing, did you and I retrench? Or did we renew?

‘Retrench’ Worldview

Our survival, flight-or-fight instinct is individualistic and self-centered–and reflexively human. Operating in modern society while retaining our fundamental survival instincts can yield certain (anti-)social behaviors that we are not proud of, including hoarding and self-interest over community interest. In addition to shaping our individual perspectives, these behaviors determine how we relate to the world around us, informing our worldview and influencing the behaviors of others. 

Nationalism or protectionism is a country-level version of this individualistic behavior. Much like urgent survival behavior, the time horizon of nationalist behavior is short. Its orientation is vertical, focusing only on the interests of those in one silo—the “every man for himself” mentality becomes one of “every country for itself” – and its perspective is compartmental. And, like any individual- or department-maximizing approach, its narrow focus sub-optimizes the performance of the whole system, organization or community. 

This parochial perspective is a heads-down “duck and cover” view. This win-lose mantra is “I’m OK, You’re Not.”

‘Renew’ Worldview

An alternative to this reflexive “thinking fast,” as behavioral economist and Nobel Prize winner Daniel Kahneman terms it, is a more reflective, “thinking slow.” If quarantine was, instead of a time of retrenchment, a time of reflection and re-connection, then our worldview might look more wholistic than individualistic. 

• What if, instead of being solo during the first pandemic in our lifetime, we renewed social SOLOdarity for a common cause? This involves recogntion that our fellow earthlings, undergoing the same challenges that we are, are not so geographically far or so fundamentally different from us.
• What if we realized that we have only one planet? And that we must treat it as if there is no ‘second planet’ back-up plan. Would we better see the innate interconnection between the world and its various challenges?
• What if you, I, and the collective we understood that none of us are safe until all of us are safe? That the world really is, as Thomas Friedman notes, flat (rhetorically, digitally, and virally).

Culture shapes our worldview. The strong individualistic culture of the U.S. works well for certain situations, such as our “free market” system. This system delivers a lot of benefits, but equity and universal health coverage – a World Health Organization (WHO) goal – are not among them.

Did we learn how well this aspect of our U.S. culture works in a pandemic? The behaviors shaped by the more communal Eastern and African cultures appear better suited to strengthen ‘community immunity,’ particularly when community transmission is the battleground of COVID-19 and the only vaccine available to all is not a medical vaccine, but an old-fashion social one.

This broader perspective is a more wholistic, global citizen view. This connective mantra is “I’m OK, if You’re OK.”

So What?

The “me first,” individualist view, is not available, or literally not affordable, to most people on the planet. One-in-ten people on our planet live in extreme poverty, defined by the World Bank as less than $1.90/day; more than one-in-four are estimated to live on less than $3.50/day. Sheltering in place is not an option when you are already in a daily battle to put food on the table. In most low-resource countries, soap and clean water are not available – only 15% of sub-Saharan Africans had access to basic handwashing facilities (UN, 2015); In Liberia, 97% of households do not have clean water and soap (WHO, 2017). Ventilator access? One out of five African countries have no ventilators. Per capita, the U.S. has over 300 times the number of ventilators as in Africa. 

What is (human) Right?

If we believe health – or even healthcare – is a human right, then we must remember that equity does not just happen, especially in a pandemic that is fueled by infodemic inequities. Experts recognize that inequities are not only exacerbated in times of pandemic, they actually cause them. As Nancy Birdsall, Director of the Center for Global Development, describes, “Globalization, as we know it today, is fundamentally asymmetric. In its benefits and its risks, it works less well for the currently poor countries and for poor households within developing countries.” The historic specter of the “4 horsemen of the apocalypse” (war, famine, pestilence, death – civil unrest and disaster) are long recognized as the perfect way to drive an epidemic because epidemics have always followed. Although many fail (or choose not) to see the signs in the short term, inequities inevitably result in “development in reverse.”

As we shelter in place, let us remind ourselves that the conditions that support effective health promotion are the same conditions that support principles of social justice globally: equity, access, participation and rights. They are as interrelated as we are.

Coming out of our collective quarantine, we deceive ourselves if we think we can “go back to normal.” However, we will have the opportunity to create a new normal. We will have a second chance to implement the culture and perspective conducive to a better and healthier world – together. While fundamentally necessary, this is possible only if we collectively first chose to review and renew our ONE Worldview. 

If we have learned from our COVID-19 lesson.

“If you change yourself you will change your world.”

• Mahatma Gandhi

Rob Thames serves as director of Global Health Administration Partners (GHAP), the consulting arm of Global Health Ministries (GHM).  GHAP partners in 14 low-resource countries to improve health by strengthening leadership, governance and financing. He writes about global health and healthcare leadership at robthames.com.