Coronavirus contemplations: Part II

Coronavirus contemplations: Part II
Comment: In this three-part series, Dr Azmi Bishara takes a deep dive look at how citizens and states have responded to an unprecedented coronavirus pandemic that is reshaping our world.
30 min read
18 May, 2020
There are over 4.7 million confirmed cases of coronavirus, and at least 316,060 deaths [Getty]
This is Part II of a three-part series. Read Part I here, and Part III here

V: Coronavirus - the Great Leveller?

The words 'stay at home' have replaced all the other repeated pleasantries conventional in traditional Arab greetings – 'how are you?', 'how's your health?' These pleasantries, although crucial, were never meant as real questions: usually there was no expectation of an answer. But 'stay at home' is something else. It encourages your interlocutor to worry, to suffer real psychological worry – to engage in a piecemeal yet obsessive effort to disinfect himself and his possessions that he'd be sure to laugh at if he saw it on film, a pantomime of anxiety and involuntary behaviour of a kind verging on cliché.

You think constantly about disinfectant. What have you disinfected? What did you forget? Before what? After what? And what's the use of all this disinfectant anyway if you haven't disinfected your glasses in a whole two weeks? Only one thing distracts you: your failure to make touching your face into a voluntary rather than involuntary action, your failure to notice that you are about to do it before you do it. Whenever you think about it, some spot on your face – a different one each time – starts to itch insistently. The more obstinately you refuse to touch your face, the more insistent it becomes, until nothing can possibly save you except getting up, disinfecting your hands and taking bitter revenge on the itch. That's assuming you don't touch your face involuntarily ten or more times on your way to the soap.

For the first time in human history, staying at home has become a communal responsibility – its own stand-alone contribution to the public good. Before it was a sign of a failing – laziness or introversion – or that you were unemployed. Now it's become a virtue, the height of human effort and innovation. And this is only one of the strange realities of this new age.

The world has seen plagues and catastrophes before. But we have never seen people staying at home in this way – the streets and squares of cities all over the world simultaneously empty. This is a new and entirely modern phenomenon.

Note that most of the guides, recommendations and advice offered in TV shows or on social media about how to use your time and make staying home a "constructive" and easy endeavour are designed for upper middle class small families in nice apartments or terraced houses.

The call to stay at home recalls the millions of people who would love to comply but who have no homes to go to. And it should also remind you that there are many different types of 'home' – from palaces to cottages to apartments with and without balconies – and many different sizes of family. There is a difference between a large family stuck in a cramped two-room apartment and a small family in a spacious villa that allows each individual privacy despite them living together. It's been said that coronavirus renders everyone equal. This may be true biologically. But even here there are very different levels of treatment available in intensive care that may affect the virus's impact except in extreme cases. The death rate isn't just a matter of age and underlying conditions. It also depends on how attentive the care is, how many doctors and beds there are available, how many hospitals and ICUs – and how well equipped they are.

The epidemic treats workers or small business owners who have listened to instructions and stayed at home – despite their existential fear that they won't be able to feed their family next month – very differently from those who have job security yet not sure until when it will last, and those who are carefully following stock market fluctuations from home.

Neither is distance learning – now set to become a key part of education as a whole – the same for all learners or classes: it depends on an internet that is unavailable or expensive for many and whose speed and reliability differs from country to country. At least as things stand distance learning is far from egalitarian. It reproduces disparities within and between societies. It does not solve gaps in education investment, staff shortages, or varying quality of teachers, curricula and pedagogical methods.

Unlike wars and other violent catastrophes, where (at least as a general rule) men remain superior to women, epidemics – like other familial and domestic problems – typically reveal how weak men really are and their inability to cope. Women, meanwhile, show their powers of perseverance. People are currently stuck at home – a woman's domain in most societies. Moreover, there are women still working outside, providing for their families even as they carry on doing domestic labour. Shopping for daily necessities is also typically the lot of women (at least anecdotally – I don't have any data to support this). Will the crisis push women up the social ladder? There is no definitive answer. In some cases financial pressures and overcrowded homes have led to an increase in domestic violence. But many men may come out of this crisis with a much greater appreciation for women, and many women with greater self-confidence. In any case, women were already moving forward and closing the gap with men – a process that has accelerated more than ever before in the last few decades.

The elderly are not dependent on or a burden on anyone. They have worked throughout their lives to build countries, societies and generations young and old – including that same small minority that complain about their elders and treat them as a burden. Those for whom human affection is not enough of an incentive to care for elderly family members might be reminded that even in their own callous terms looking after the old is not charity but a matter of  debt – giving them their fair dues after all they have done throughout their lives. This is a debt that younger generations cannot possibly hope to repay whatever they do. Treating the elderly as a burden is an unforgivable behaviour that can only be made up for by the work of thousands of the thousands of young people worldwide who volunteer to help them. There is a younger, more moral generation who promise a better world to come.

The experiences of the elderly in care homes during this epidemic will return this issue to the spotlight. Is it really reasonable for old age to be subject to the whims of the market? Most US care homes, for example, are profit-making enterprises. It is clear that they lack the moral responsibility and ability to care for the elderly required by an epidemic so fatal to this generation in particular.

Some feminist thinkers of the late 20th century dissatisfied with the 'abstract principles' of justice ethics proposed instead the idea of care ethics. I have always felt that the latter does not replace the former but rather complements it. In times like these it is easy to see the importance of a care ethics based not on general principles derived from the values of equality and freedom but on sympathy and the desire to find solutions to problems rooted in concern for another's suffering. The principles of justice are not enough in a time of unexpected crisis. And they have little to say when individuals find themselves powerless in the face of hardship.

Given all this talk of pandemics, it might be worth remembering some facts about HIV/AIDS:

In the 1990s people in East and West were deeply concerned with the HIV/AIDS epidemic – concerning a virus transmissible through blood and sexual fluids but which has nonetheless taken the lives of millions. HIV became the subject of literature, art and cinema, as well as myths and rumours dwarfing those surrounding coronavirus. For a while having it was branded morally suspicious, to the point that some were scared to admit their diagnosis and those that did were considered brave because of its association with the taboo of homosexuality. In the West this period has been put to rest, but in the East it is still very much with us, despite the fact that it is now well-established that the virus can be transmitted through hospital blood transfusions or other means. It is now also clear that it is possible to be a carrier, and thereby infect others, without becoming ill, and there is a long list of other complicating factors. Many of those infected have suffered and continue to suffer with immune deficiencies. But it is getting hold of a treatment that allows their bodies to coexist with the virus that is their greatest challenge today. And the media doesn't have much time for them, because more than 80 per cent of the cases are in Africa and the Asia Pacific(two thirds of them in Africa alone)

From the beginning of the epidemic through to 2018, 74.9 million people have been infected with HIV. Around 32 million people have died from the virus or from everyday illnesses made fatal by the autoimmune deficiency that it causes. The number of deaths has fallen by some 55% since the epidemic's peak: in 2018 some 770,000 people around the world died from AIDS-related illnesses compared to 1.7 million in 2004. According to the WHO, Africa is still the worst-affected region: one in every 25 adults (3.9% of the African population) is infected with the virus, account for around two thirds of cases worldwide. And global interest in the pandemic has clearly diminished – not only because of the discovery of a treatment, but also because the virus has retreated in North America, where in the 80s and 90s it was the subject of much public anxiety. Nowadays it is limited to the global south, particularly Africa. AIDS drugs produced in the global north are consumed in the south. Figure 1 shows the number of people living with AIDS, the number of new infections and the number of deaths by region as provided in the latest published statistics.

Figure 1: Regional AIDS data, 2018

People living with HIV

(as of end of 2018)

% of total cases in the world

New HIV infections 2018

% of total cases in the world

AIDS-related deaths

2018

% of total cases in the world

Eastern and Southern Africa

20.6 million

[18.2 million – 23.2 million]

54.4

800 000

[620 000 – 1.0 million]

47.1

310 000

[230 000 – 400 000]

40.3

Asia and the Pacific

5.9 million

[5.1 million – 7.1 million]

15.6

310 000

[270 000 – 380 000]

18.2

200 000

[160 000 – 290 000]

26.0

Western and Central Africa

5.0 million

[4.0 million– 6.3 million]

13.2

280 000

[180 000 – 420 000]

16.5

160 000

[110 000 – 230 000]

20.8

The Caribbean

340 000

[290 000 – 390 000]

0.9

16 000

[11 000 – 24 000]

0.9

6 700

[5100 – 9100]

8.7

Eastern Europe and Central Asia

1.7 million

[1.5 million – 1.9 million]

4.5

150 000

[140 000– 160 000]

8.8

38 000

[28 000 – 48 000]

4.9

Latin America

1.9 million

[1.6 million – 2.4 million]

5.0

100 000

[79 000 – 130 000]

5.9

35 000

[25 000 – 46 000]

4.5

Western and Central Europe and North America

2.2 million

[1.9 million – 2.4 million]

5.8

68 000

[58 000 – 77 000]

4.0

13 000

[9400 – 16 000]

1.7

Middle East and North Africa

240 000

[160 000 – 390 000]

0.6

20 000

[8500 – 40 000]

1.2

8 400

[4800 – 14 000]

1.1

Global Totals

37.9 million

[32.7 million – 44.0 million]

1.7 million

[1.4 million – 2.3 million]

770 000

[570 000 – 1.1 million]

 

For the first time in human history, staying at home has become a communal responsibility – its own stand-alone contribution to the public good.

 

VI: On the 'front line'

Hospitals are in a state of emergency. Medical professionals are risking their lives to fight the epidemic. To describe this state of affairs, it has become common to refer to hospitals as 'the front line' of the epidemic – that is, the most dangerous place to be. This is a central part of the popular rituals by which medical staff are honoured and celebrated; medical professionals themselves hope that this newfound respect will be reflected by public health policy. The crisis has made the difference between public and private sector hospitals very clear: it is the former that have served as the front line and have accomplished great things, especially in countries in which medicine is not simply another means of getting rich.

The soldiers fighting on this 'front line' use all sorts of  techniques and are experimenting with various drugs originally intended for a range of illnesses. There are nonetheless differences in results: care and attention make a difference, in some cases between life and death – even during an epidemic in which there is as yet no established treatment. Medical professionals are facing the same risks, complaining of the same shortage of ventilators and PPE, and have been seeing their families only rarely over the long weeks since the crisis began; this is transforming them into something of a new global subculture. If this subculture organises itself then it is sure to have an effect on public policy.

I usually think of hospitals as a place where even the most ardently dignified are forced to give up their much-valued autonomy and personal space in order to be free first of pain and then of illness. From the moment you decide to go into hospital, which is after all your decision, this trade-off becomes inevitable. Once you have 'voluntarily' handed over your body to the doctors there is no use in resisting. Hospitals are not a space for the exercise of personal autonomy. Despite the great developments made with regard to respect for patients' desires, the general rule is still that if someone decides to check himself into a hospital, he has implicitly recognised the authority of the medical profession. In a hospital 'emergency' (and note the similarity to the 'state of emergency' imposed by states) saving the patient is more important than respecting his desires. Much legislation has been put in place to deal with these situations and delineate possible exceptions.

Much has been written about hospitals as an institution, including procedures – which often become an end in themselves – policies and polemics. There is politics even in hospitals. I'm not interested here in reviewing all that has been written on the hospital as a space for the categorisation of the sick and the healthy, the role this process has played as a technology of control, the way patients' bodies have been treated as objects and not selves, or any of the other enlightening works on the history of medical science and professional practice. These points no longer apply to medicine in general. There have been great advances, not only in medical science itself but in its humanity and its ethics, its ability to recognise its mistakes and its willingness to be held accountable. The same applies to medical legislation, particularly in democratic countries. The number of hospital beds or doctors per capita is now a measure of countries' advancement and human development.

Why do we trust doctors? Because treating a patient in order to cure, or, if a cure is not possible, to reduce their suffering is not a matter of individual doctors' ethics; they are part of the job description. The physician himself, his domestic problems, his personal morals and political stances – these are irrelevant, and even if he cannot entirely escape them, he is expected to leave them at the hospital door. The patient in this case is a human body and not an individual with a personality (religion, nationality, colour, family, class). And the patient himself does not see the doctor through the normal social or political lenses: it is not his ethnicity, religion or ideology that are important but his years of experience, his education and his scientific knowledge. A physician who fails to do everything in his power to treat a patient is no longer a physician. And some doctors have taken this route before by becoming mere experts in the human body as an object of control, agreeing to work in detention centres or prisons to further unjust political agendas, or carrying out experiments on detainees.

You might find it disturbing how "casually" some doctors deal with suffering and illness after their long years of experience and exposure. But you know in your innermost thoughts that, as disturbing as it is, this may also be what puts you at your ease – that their professionalism and skill are not measured by their apparent indifference but by their ability to diagnose and treat illness. A very personable doctor may well be fairly useless medically, while his less sensitive colleague may be very skilled indeed – focusing on curing you and not on keeping you happy. Bodily suffering forces you to accept this, even if you might in your heart of hearts prefer a doctor who is both skilled and polite (good manners cost nothing). Sometimes, too, the opposite can be true: doctors may wish for a more polite and personable patient.

Subjecting medicine to profit by making hospitals into businesses and clinics into medical services emporia has a negative effect on the profession itself if doctors do not hold fast to its principles – if the law cannot effectively regulate this process and the society-organised-as-state fails to provide quality care (i.e. correct treatment aiming for recovery under appropriate conditions) to those patients who cannot afford to compete for treatment in a marketplace of supply and demand.

Modern hospitals bring together doctors and nurses of all colours and creeds. They are among the largest employers of professional immigrants. The ethnic and religious mixture present in hospitals, the diversity within the profession, is a shining beacon of modern human civilisation. In the West we often find the immigrant identity of doctors being positively emphasised, particularly in cases where they have lost their lives while working to save Covid-19 patients. This emphasis may be useful as far as public opinion is concerned, particularly inasmuch as it embarrasses anti-immigrant and racist voices of all kinds, but it does raise the question – does an immigrant have to be a doctor for their contribution to the economy and society to be valued? Why do they have to be outstanding to be accepted as a human being of equal value?

There are countries (even advanced countries) that would be unable to provide healthcare to their inhabitants without immigrants (nurses, doctors, cleaning staff). There are also rentier states without enough medical staff, whose citizens may be willing to see their children working as doctors but will not accept them becoming nurses – never mind cleaners, without whom no public facilities, least of all hospitals, would be able to operate. You can't help but find it bewildering that in some of these countries, which rely so heavily on immigrant labour, there is a vocal minority complaining about providing foreign workers with healthcare.

In Portugal the government has decided that as regards coronavirus, immigrants (even illegal immigrants) are to be treated the same as citizens – something that should never have been in question. This was a sensible decision. In any case, it is a doctor's job to treat people wherever they can regardless of government decisions.

On 6 April 2020, the British Prime Minister Boris Johnson was taken to hospital after being diagnosed with coronavirus 10 days earlier. He did not fall ill because of the British government's relaxed attitude to the epidemic in its early days – viruses do not seek revenge on those that underestimate them. But his insouciance as PM, as the ultimate voice in public policy, is passively responsible for many others falling ill – others who might have avoided infection if the UK had introduced stricter measures as soon as coronavirus was declared a global pandemic.

Since the Thatcher era, the NHS has suffered from neglect. Many subsequent governments have been inclined towards total or partial privatisation. Neglect of the public sector (health and education) typically involves depriving it of money, good governance and close oversight of corruption. Complaints regarding the sums of 'taxpayers' money' that it receives are intended to undermine its legitimacy and justify privatising it. Now everyone is lining up to praise the NHS, including Johnson himself when he was discharged from hospital (despite having been accused as recently as November 2019 of trying to sell it to the US). This should serve as a lesson to other countries, including Arab countries.

The free competition permitted by free societies and the market economy underpins a great deal of intellectual, scientific and industrial innovation. But one of its negative aspects (if it is not subordinated to other values) is its commodification of human health. This applies to investment in new medicines and vaccines: the desire to profit from this kind of investment is one of the major impediments to the development of a SARS vaccine (and if work on a SARS-1 vaccine had continued it would have been much easier to develop one for SARS-2, i.e. coronavirus) – just as it has been a major impediment to the development of cancer treatments. Capitalist investment focuses on the most widely used medicines and vaccines – those that guarantee a rapid return. There is a race to develop a coronavirus vaccine because it attracts investment from concerned countries for social health reasons unrelated to profit, but also because everyone will need to be vaccinated, possibly on an annual basis, and there is thus no doubt that it will be profitable.

The natural sciences have developed ever more quickly and innovatively, and the best healthcare has appeared in developed capitalist countries. This doesn't mean providing the best health services to the public at large. That would require several conditions to be met – the presence of a public health sector, free treatment, and public policy that does not subordinate people's health to the laws of the marketplace. Only a few developed countries that insist on free treatment and invest in an expansive public health service meet these conditions. Some developing countries have health services of this kind, but although anything is better than nothing, they suffer from medical shortcomings, provide limited services, and are often badly administrated and unaccountable. The great challenge is to achieve the best of both worlds.

Pandemic preparedness is usually limited, like preparedness for natural disasters. But it could be better if state institutions were less short-sighted and if they listened to scientists and experts. Alongside private sector initiative and innovation, confronting a pandemic requires the sort of major investment in research and organisational capacity that no private sector can ever provide no matter how developed it is.

Subjecting medicine to profit by making hospitals into businesses and clinics into medical services emporia has a negative effect on the profession itself if doctors do not hold fast to its principles.



VII: The international system

On 8 April 2020 – as humanity as a whole were following minute by minute the facts and figures tracing the spread of coronavirus – the Organisation for the Prohibition of Chemical Weapons released a report finding the Syrian regime directly responsible for the use of sarin and chlorine gas in an attack on the town of Latamneh. This was the first time that such a report had alluded directly to the perpetrator. The Security Council did convene, but no resolutions were passed and despite the report originating with a neutral international organisation it received very little attention. The timing of its publication does not make the crimes committed any less horrific. Nor can it in fact be blamed for the disinterest of the so-called 'international community', which had already turned its back on the sufferings of the Syrian people long before the pandemic. Coronavirus cannot, at least, be accused of covering up crimes against humanity!

Throughout history outbreaks of disease have brought wars to a halt. The first reports of the Peloponnesian War describe Athens on the brink of victory before their fortunes were suddenly reversed by a plague (some have suggested the plague, although there is no way of knowing). The 'Spanish flu' (which may well have originated in overcrowded British encampments in France or even in the United States) helped bring the First World War to an end. But Khalifa Haftar (does anyone have the energy, at this moment in time, to think about such a person?) has little time for coronavirus and certainly doesn't consider it a good enough reason to stop shelling Tripoli. Nor do the various parties to the conflict in Yemen seem very concerned by the disease. ISIS continues to attack targets here and there, and Egyptian planes are still bombing Sinai. And there has been no end to the Syrian regime's war against its people. It plans to defeat the virus as it has 'defeated' the 'terrorist infestation' – or perhaps it will 'reserve the right to respond', or choose to respond 'in the right place and at the right time' as it famously does in the case of the constant Israeli incursions into its territory. Anything can happen in a region sick in both body and soul.

In one sense then life as we know it has carried on, keeping to normal its rules and rhythm. Nothing has changed. All that is different is that it is now operating in the shadows, placed at the end of the news bulletin because nobody can stand to hear about anything but the pandemic. The US elections set to take place in November 2020 still drive everything Donald Trump says and does; the topics of his statements may have changed but their motivations and aims have not. The same applies to China's aspirations to global economic hegemony and its new silk road. Coronavirus is no more than a new theatre in which battles of propaganda and export can be fought.

People do not sit down and work out new global systems in the aftermath of crises because the experience of catastrophe makes them wiser. That's just not how things happen. Nonetheless, a great deal has been written about how the international system will change after coronavirus. When such pieces talk about the global system, they usually mean not the truly global but the international system: their vision does not extend, for example, to environmental balance between man and nature. Let's think about this for a moment. Will coronavirus really change the logic according to which international relations operate – that is, the balance of interests and of power? Will states really become more rational, moral, or both, because of the pandemic? I doubt it. Such a thing has never happened before, and there is no reason that it would start to happen now.

Major historical crises produce new measures and systems that may last for a while, but which are eventually lost to the hurly-burly of interest, priority and 'thinking outside the box'. What did humanity gain from the First World War? It was followed only twenty years later by another even more ferocious war, a war in which nuclear weapons (towards the end of the conflict) replaced the chemical weapons banned during its predecessor. World War II produced the welfare state – and the economic depression that contributed to the rise of Fascism and Nazism, the crisis of capitalism in the 1930s and the emergence of the post-war 'Communist threat' certainly influenced this development. But the economic neoliberalism hegemonic since the end of the 1970s has imposed an economic principle wrongly attributed to liberalism (to which it is quite alien, since it places freedom and equality in direct opposition), – to wit, that for the state to intervene in order to redress social grievances is an attack on freedom. It is as if the Great Depression never happened at all, as if the state's interventions were a luxury and not a necessity crucial to check the market's irrationality and avoid its consequences.

The international system is thus willing to be tolerant of crimes against humanity where – under different circumstances – they were once a reason to make war. Everything depends on interest and the balance of power. Ethnic cleansing has returned in Myanmar as if it never happened in the Balkans; random strikes, crimes against humanity and chemical weapons in Syria as though we had never seen similar atrocities in Grozny and Rwanda. Colonialism continues in Palestine despite decolonisation – including the dismantling of the Apartheid, as if we have learnt nothing from South Africa.

I hope that people in general will become more rational and more moral, and that this will influence politics and perhaps the nature of political regimes (but not necessarily their relations with one another). But this is a hope, not a prediction, and one which coincides with Trump freezing funding to the WHO.

Many people have been entertaining themselves with thought experiments surrounding the leadership of post-coronavirus international system. Their impressionistic ideas draw heavily on the way that different countries are dealing with the pandemic. It thus occurred to me that I might be able to put forward some ideas that could help to play this game less impressionistically and in a way that more closely reflects reality.

Even if we put aside the nature of its political system and the attractiveness of different lifestyles, a major state is not measured simply by its economy in the sense of GDP but also by its military capabilities; its willingness to bankroll its leadership position through subsidies to other states, funding international organisations etc; its capacity for innovative development of productive forces; the role of science in production; human development indices; and its education, knowledge base and innovativeness. All this is to say that it is not a matter simply of the size of a country's economy but also of its constituent parts. There is a difference between countries that rely on manufacturing for export, exploiting the ready availability of cheap labour and using imported technologies, and the countries that are driving the development of productive forces in technology and science.

Figure 2: Comparative data on the US, China and EU countries

Country

GNI per capita adjusted for PPP (in dollars)

GNI PPP (in trillions of dollars)

Military expenditure (billions of dollars)

Military expenditure as a percentage of GDP

High-technology exports as a percentage of manufactured exports

Health sector spending as a percentage of GDP

Ranking in Global Health Security Index

Ranking in Global Education Index

Ranking in Global Human Development Index

Year (most recent data)

2018

2018

2018

2018

2018

2016

2019

2018

2018

USA

63,690

20.84

649.0

3.2

18.90

17.1

1

12

15

China

18,170

25.30

250.0

1.9

30.89 (2017)

5

30

110

85

EU

43,714

22.43

249.3

1.4

16.27

--

--

--

--

UK

45,350

3.02

50.0

1.8

22.30

9.8

11

8

15

France

46,360

3.11

63.8

2.3

25.92

11.5

8

41

26

Germany

54,560

4.52

49.5

1.2

15.74

11.1

22

1

4

Italy

42,290

2.56

27.8

1.3

7.79

8.9

45

49

29

Spain

39,800

1.86

18.2

1.3

7.19

9

12

36

25

It seems that the world is about to see structural changes both social and economic. Some of our daily rituals are set to change. Hand sanitiser is likely to be a part of our lives for the foreseeable future. The countries of the world will be more aware of the danger of pandemics. This may well produce international legislation setting forth rules delineating how countries should deal with threats to public health on a global scale and how they should make sure they are well-supplied with the strategic equipment required by times of crisis. But the logic of interstate relations will not change. Nor will the current trend towards a multipolar world.

Will coronavirus really change the logic according to which international relations operate – that is, the balance of interests and of power?



VIII: Comparing countries' responses to the virus

Politicising pandemics and using them to support one political position or another is a mixture of ignorance and a lack of conscience. One example of this particular mixture is the stark divisions around coronavirus along particular political axes – the praise for the 'Socialist' China (in reality a capitalist authoritarian dictatorship – the best of both worlds) and the attacks on capitalist democracies like Italy, Spain or the United Kingdom.

The Chinese government is credited with acting quickly to take control of the situation and check the spread of the virus within China. We should not forget that China has vast resources unavailable to other countries, or how easy it is for the Chinese government to issue orders and control its population. The almost military discipline and unquestioning obedience characteristic of authoritarian systems, in this case, become a 'virtue' – despite the fact that China took a long time indeed to announce the spread of the virus or warn others of the danger. One popular theory, unproven but defended by a Nobel prize-winning French scientist, says that the virus may have originated in a virological research laboratory in the city of Wuhan itself. And it is not just the  presence of such a laboratory that has invited these suspicions.

Since the 1990s China's great leap forward and its accelerating economic development – including raising millions out of an endless cycle of poverty and starvation at the mercy of seasonal famines – have won the admiration of many, especially in developing countries. China, having once been a third world country, has now joined the ranks of the great powers; it has the largest economy in the world in terms of GNI based on purchasing power parity (PPP) and the second in terms of GNI as of 2018. But it is nonetheless very strange how insistently some go on about a new world order led by China, particularly when they impute a 'humanist' quality to this imagined new order. Where have these people got the idea that China is more 'humanist' in its foreign relations? We're talking about a country governed by a brutal capitalism with no concern for human rights or for the environment – a capitalism closer to that which prevailed in the nineteenth century. China itself does not pretend to represent humanist values, even ideologically. And it is interested above all else in economic hegemony; it has no desire to pay the costs of global political leadership.

China is an authoritarian regime with vague ethnonationalist inclinations. In cooperation with Putin's Russia, it has manufactured and exported the idea that democracy, like human rights, is an (imported) Western idea that does not suit other civilisations. Moreover, any future international system is certain to be multipolar – and as is the case now, the extent to which it is 'humanist' will be the subject of much debate, struggle and sacrifice.

In current discussions two trends overlap: criticising (and admiring) China for its initial cover-up of the epidemic and its suppression of any attempt to make it public (which nonetheless made it no better at fighting the epidemic than Taiwan, South Korea or Singapore), and a critique of neoliberalism made implicitly by people everywhere because it concerns their health. The risks of pandemics can only be confronted using public health policies and investments that place human health above the laws of the market or supply and demand (the same should apply to education and elderly care). This requires a high degree of economic growth and a GNP allowing extensive spending on human development. Growth can exist without social justice – indeed, under neoliberal policies growth can simply widen the wealth gap. But distributive social justice accompanied by a capacity for investment in education and health cannot take place without growth producing a high per capita income – that is, GNP divided by the population.

In developed countries the pandemic has thrown into stark relief the failings of neoliberal policies hostile to the welfare state – the same policies that produced right wing populism. By obeying the order to stay at home and protect their health, millions have lost their jobs and incomes.

Democratic countries did not take the pandemic seriously enough at first. This is a point against them and not in their favour. But their unwillingness to impose lockdowns and controls on the lives of their citizens, and their initial reliance on appeals and advice rather than orders or other obstacles, are among the distinguishing features of the better 'quality of life' enjoyed in such societies under normal circumstances. A democratic regime's value is not measured by how good it is in a crisis – unlike people, including leaders, whose true colours are often revealed by disasters or emergencies. In any case, this will teach democracies the importance of being prepared for situations like this. Neoliberal policies opposed to state involvement in welfare have undoubtedly impacted spending on health and medical research.

The countries of northern Europe have provided different models of dealing with the crisis. In these countries the public health sector is still strong. Many of those making comparisons forget that the high death rate in North Italy is attributed not only to delays in taking action or insufficient preparedness but also to the higher average age and the large number of elderly people particularly vulnerable to complications from the virus. An older population is a sign of an economically and medically developed area.

Capitalism exists in Russia and China just as it exists in the USA and Europe, but the political and intellectual liberties allowing for free expression and innovation exist only in democracies. The same applies to the transparent release of pandemic statistics, being held accountable for their credibility, and the right to examine this credibility. Taxpayers in democratic states will not tolerate governments whose data lacks credibility. The ability to express all this is a feature of democracies and not of countries like China, Russia, Iran or Syria.

Measures taken by any country to confront coronavirus encourage similar measures by other countries; nobody is going to reinvent the preventative wheel in the absence of a vaccine or a treatment, and as such global schools of thought have emerged on how to deal with the virus. The media, curiously, is given to contrasting two extreme cases – China and Italy (lately overtaken by the UK) – just as it does in politics or sport. Some express their admiration for China, whose long cover-up contributed to the spread of the virus, while paying very little attention to the more successful South Korean model (which only the WHO seems to be interested in). And everyone pretends to have forgotten that the economic price paid by China to lock down a single province of 60 million people while the rest of the country went on working and producing (a model followed initially by Italy when it imposed a lockdown in northern regions of the country) cannot be compared with the price of shutting down everything elsewhere.

Those countries that do not possess the same resources as the USA or Europe – or, for that matter, China, South Korea or Singapore – have limited options: they must do whatever they can to prevent infection via lockdowns or other means, relying on citizens' awareness and sense of solidarity until such time as some other country discovers a vaccine. But will they really do everything they can?

Dr Azmi Bishara is a Palestinian intellectual, academic and writer.

Follow him on Twitter: @AzmiBishara

This article was translated by Chris Hitchcock. Chris is an Arabic-English translator working at the Arab Center for Research and Policy Studies.

Opinions expressed in this article remain those of the author and do not necessarily represent those of The New Arab, its editorial board or staff.