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Proc Natl Acad Sci U S A ; 119(4)2022 01 25.
Article in English | MEDLINE | ID: covidwho-1630982


Crisis motivates people to track news closely, and this increased engagement can expose individuals to politically sensitive information unrelated to the initial crisis. We use the case of the COVID-19 outbreak in China to examine how crisis affects information seeking in countries that normally exert significant control over access to media. The crisis spurred censorship circumvention and access to international news and political content on websites blocked in China. Once individuals circumvented censorship, they not only received more information about the crisis itself but also accessed unrelated information that the regime has long censored. Using comparisons to democratic and other authoritarian countries also affected by early outbreaks, the findings suggest that people blocked from accessing information most of the time might disproportionately and collectively access that long-hidden information during a crisis. Evaluations resulting from this access, negative or positive for a government, might draw on both current events and censored history.

Access to Information , COVID-19/psychology , Information Seeking Behavior/physiology , Access to Information/legislation & jurisprudence , Access to Information/psychology , COVID-19/epidemiology , China/epidemiology , Humans , Political Systems , Politics , SARS-CoV-2 , Social Media/legislation & jurisprudence , Social Media/statistics & numerical data , Social Media/trends
Health Aff (Millwood) ; 40(8): 1234-1242, 2021 08.
Article in English | MEDLINE | ID: covidwho-1337574


Despite widespread recognition that universal health coverage is a political choice, the roles that a country's political system plays in ensuring essential health services and minimizing financial risk remain poorly understood. Identifying the political determinants of universal health coverage is important for continued progress, and understanding the roles of political systems is particularly valuable in a global economic recession, which tests the continued commitment of nations to protecting their health of its citizens and to shielding them from financial risk. We measured the associations that democracy has with universal health coverage and government health spending in 170 countries during the period 1990-2019. We assessed how economic recessions affect those associations (using synthetic control methods) and the mechanisms connecting democracy with government health spending and universal health coverage (using machine learning methods). Our results show that democracy is positively associated with universal health coverage and government health spending and that this association is greatest for low-income countries. Free and fair elections were the mechanism primarily responsible for those positive associations. Democracies are more likely than autocracies to maintain universal health coverage, even amid economic recessions, when access to affordable, effective health services matters most.

Economic Recession , Universal Health Insurance , Democracy , Health Expenditures , Health Services , Humans , Political Systems
PLoS One ; 16(5): e0252062, 2021.
Article in English | MEDLINE | ID: covidwho-1241126


Transparency of Chinese media coverage became an international controversy when the COVID-19 outbreak initially emerged in Wuhan, the eventual crisis epicenter in China. Unlike studies characterizing mass media in authoritarian contexts as government mouthpieces during a crisis, this study aims to disaggregate Chinese media practices to uncover differences in when, where, and how the severity of COVID-19 was reported. We examine differences in how media institutions reported the severity of the COVID-19 epidemic in China during the pre-crisis period from 1 January 2020 to 20 January 2020 in terms of both the "vertical" or hierarchical positions of media institutions in the Chinese media ecosystem and the "horizontal" positions of media institutions' social proximity to Wuhan in terms of geographical human traffic flows. We find that the coverage of crisis severity is negatively associated with the media's social proximity to Wuhan, but the effect varies depending on the positional prominence of a news article and situation severity. Implications of the institutions' differentiated reporting strategies on future public health reporting in an authoritarian context are also discussed.

Access to Information , COVID-19/epidemiology , China , Disclosure/legislation & jurisprudence , Disclosure/statistics & numerical data , Humans , Mass Media/legislation & jurisprudence , Mass Media/statistics & numerical data , Models, Statistical , Political Systems
Ciênc. Saúde Colet ; 26(3): 1001-1012, mar. 2021. tab, graf
Article in English, Portuguese | WHO COVID, LILACS (Americas) | ID: covidwho-1138611


Resumo A resposta americana à pandemia envolve um proeminente volume de recursos federais, em especial destinados ao desenvolvimento e aquisição de produtos no uso interno, como diagnósticos ou vacinas. As justificativas para esse desembolso se baseiam em mecanismos de investimentos e aspectos históricos. Assim, a construção social do nacionalismo na formação na sociedade americana prejudica o acesso a tecnologias em saúde. A revisão desses aspectos demonstra como os Estados Unidos (EUA) garantiram compra de grande quantitativo de produtos em potencial, inclusive assegurando excessiva produção local. Essa política externa unilateral tem influenciado outros países ou blocos regionais e prejudicado a cooperação e a solidariedade global com impacto na saúde coletiva de diversas nações.

Abstract The American response to the pandemic involves a prominent volume of federal resources, especially for developing and acquiring products for internal use, such as diagnostics or vaccines. Investment mechanisms and historical aspects justify this expenditure. Thus, the social construction of nationalism in American society hinders access to health technologies. The review of such aspects shows how the United States (U.S.) secured a large number of potential products, ensuring excessive local production. This unilateral foreign policy has influenced other countries or regional blocs and undermined global cooperation and solidarity, affecting the collective health of several nations.

Humans , Global Health , Coronavirus Infections/epidemiology , Pandemics , International Cooperation , Political Systems , United States/epidemiology , United States Dept. of Health and Human Services/economics , Coronavirus Infections/diagnosis , Coronavirus Infections/therapy , Costs and Cost Analysis , Resource Allocation/economics , Resource Allocation/methods , Developing Countries , Diffusion of Innovation , Economics , Health Resources/economics , Health Resources/supply & distribution , Health Services Accessibility
PLoS One ; 16(3): e0248075, 2021.
Article in English | MEDLINE | ID: covidwho-1117473


The world is facing the coronavirus pandemic (COVID-19), which began in China. By August 18, 2020, the United States, Brazil, and India were the most affected countries. Health infrastructure and socioeconomic vulnerabilities may be affecting the response capacities of these countries. We compared official indicators to identify which vulnerabilities better determined the exposure risk to COVID-19 in both the most and least affected countries. To achieve this purpose, we collected indicators from the Infectious Disease Vulnerability Index (IDVI), the World Health Organization (WHO), the World Bank, and the Brazilian Geography and Statistics Institute (IBGE). All indicators were normalized to facilitate comparisons. Speed, incidence, and population were used to identify the groups of countries with the highest and lowest risks of infection. Countries' response capacities were determined based on socioeconomic, political, and health infrastructure conditions. Vulnerabilities were identified based on the indicator sensitivity. The highest-risk group included the U.S., Brazil, and India, whereas the lowest-risk group (with the largest population by continent) consisted of China, New Zealand, and Germany. The high-sensitivity cluster had 18 indicators (50% extra IDVI), such as merchandise trade, immunization, public services, maternal mortality, life expectancy at birth, hospital beds, GINI index, adolescent fertility, governance, political stability, transparency/corruption, industry, and water supply. The greatest vulnerability of the highest-risk group was related first to economic factors (merchandise trade), followed by public health (immunization), highlighting global dependence on Chinese trade, such as protective materials, equipment, and diagnostic tests. However, domestic political factors had more indicators, beginning with high sensitivity and followed by healthcare and economic conditions, which signified a lesser capacity to guide, coordinate, and supply the population with protective measures, such as social distancing.

COVID-19/epidemiology , Brazil/epidemiology , China/epidemiology , Delivery of Health Care , Germany/epidemiology , Humans , India/epidemiology , New Zealand/epidemiology , Pandemics , Political Systems , Risk Assessment , Socioeconomic Factors , United States/epidemiology , World Health Organization
Indian J Med Ethics ; V(3): 219-221, 2020.
Article in English | MEDLINE | ID: covidwho-1034316


Coronavirus disease (Covid-19), which originated in China, is now a full-blown pandemic which has thrown governments and societies off-track in an unprecedented manner. War metaphors have been used widely to describe the scenario, but many critics decry them as harmful narratives. In this piece, we discuss the utility of the war metaphor to build solidarity and fraternity, which will be essential to get through the crisis. We also explain how concerns regarding increased authoritarianism and state excesses due to the use of these narratives are misplaced. We then tease out the colonial era concept of war that guides the arguments against the use of war metaphors in pandemics. We argue that in the post-modern world and in South Asian and African philosophies, wars are seen through the prism of the larger cause of dharma or ubuntu and that individual losses or gains in these contexts are part of a larger cause. The use of war metaphors reflects the need to get together for a societal cause. These metaphors are largely understood across societies while other alternatives are exclusionary, poetic and tangential in nature.

Keywords : Covid-19, pandemics, war metaphors, communication, philosophy, SARS-CoV-2


COVID-19 , Communication , Metaphor , Morals , Pandemics , Social Behavior , Armed Conflicts , Asia , Comprehension , Government , Humans , Pandemics/ethics , Philosophy , Political Systems , SARS-CoV-2 , South Africa
J Bioeth Inq ; 17(4): 479-482, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-917162


The structure of this intervention is deliberately schizo-analytic: "and then-," and "then-." They are preparatory notes for a webinar by Transform! Europe on the COVID, arranged before the global explosion of Black Lives Matter. I question the top-down philanthropy of the bourgeois Left. I take the Rohingyas as bottom-line victims. I speak from two hometowns-Calcutta and New York. I ask the bourgeois Euro-U.S. Left not to monolithize the Global South. Many examples of how "India" is constructed are given. From New York, the United States is declared a failed state. Trump's delinquencies are mentioned. It is argued that the only remedy at present is human behaviour and the typical U.S. character is not ready to practice this. This empirical fact shows the failure of the Kantian Sublime and reminds us that Kant thinks that the human moral will comes in to protect us from a hugely frightening natural phenomenon only by "subreption," the same impulse that says that following steps provided by institutional religion will absolve us. Class and caste are taken into consideration throughout. I mention that as a coronavirus convalescent, I am donating plasma regularly.

COVID-19 , Morals , Pandemics , Political Systems , Politics , Developed Countries , Developing Countries , Global Health , Humans , India , Islam , Pandemics/ethics , Philosophy , Public Health , SARS-CoV-2 , Social Class , United States
Sci Rep ; 10(1): 18909, 2020 11 03.
Article in English | MEDLINE | ID: covidwho-910230


While the epidemic of SARS-CoV-2 has spread worldwide, there is much concern over the mortality rate that the infection induces. Available data suggest that COVID-19 case fatality rate had varied temporally (as the epidemic has progressed) and spatially (among countries). Here, we attempted to identify key factors possibly explaining the variability in case fatality rate across countries. We used data on the temporal trajectory of case fatality rate provided by the European Center for Disease Prevention and Control, and country-specific data on different metrics describing the incidence of known comorbidity factors associated with an increased risk of COVID-19 mortality at the individual level. We also compiled data on demography, economy and political regimes for each country. We found that temporal trajectories of case fatality rate greatly vary among countries. We found several factors associated with temporal changes in case fatality rate both among variables describing comorbidity risk and demographic, economic and political variables. In particular, countries with the highest values of DALYs lost to cardiovascular, cancer and chronic respiratory diseases had the highest values of COVID-19 CFR. CFR was also positively associated with the death rate due to smoking in people over 70 years. Interestingly, CFR was negatively associated with share of death due to lower respiratory infections. Among the demographic, economic and political variables, CFR was positively associated with share of the population over 70, GDP per capita, and level of democracy, while it was negatively associated with number of hospital beds ×1000. Overall, these results emphasize the role of comorbidity and socio-economic factors as possible drivers of COVID-19 case fatality rate at the population level.

Coronavirus Infections/mortality , Pneumonia, Viral/mortality , COVID-19 , Canada , Coronavirus Infections/epidemiology , Data Interpretation, Statistical , Demography/statistics & numerical data , Europe , Humans , Mortality/trends , Pandemics , Pneumonia, Viral/epidemiology , Political Systems/statistics & numerical data , Socioeconomic Factors , United States
J Bioeth Inq ; 17(4): 473-478, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-729919


The coronavirus epidemic is not just a biological phenomenon which affects humans: it is also a moment of a profound global and ecological crisis that includes many human and nonhuman actors. To confront the crisis, a radical philosophical change is needed, which penetrates to natural, economic, and cultural processes. The amassing of dictatorial powers of state apparatuses evoked by the pandemic highlights their basic impotence and the fact that the system as we know it cannot continue in its existing liberal-permissive form. While the final outcome is uncertain what is most probable is that a new barbarian capitalism will prevail: many old and weak will be sacrificed and let to die, workers will have to accept much lower standards of living, digital control of our lives will remain a permanent feature, and class distinctions will become much more than now a matter of life and death.

COVID-19 , Pandemics , Political Systems , Politics , COVID-19/economics , Capitalism , Disasters , Global Health , Humanism , Humans , Pandemics/ethics , Public Health , SARS-CoV-2 , Social Class , Social Conditions , Technology
J Bioeth Inq ; 17(4): 535-538, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-728251


The outbreak of COVID-19 comes at the time when a shrinking public sector healthcare is an acknowledged fact in post-colonial societies. The policies adopted by the apparatus of most nation states for the past thirty years or more reveal that providing healthcare to all sections of societies is not a priority. The gradual process of economic liberalization has established "market" as the only legitimate mechanism of the distribution of goods/services as per the efficiency principle. The financial markets are globalized in such a manner that nation states are constantly losing their capacity to perform redistributive functions. State withdrawal from the provision of welfare rights is undermining its moral authority to impose any normative imperative to the people who are being left alone at the mercy of market forces. But the spread of COVID-19 on a global scale has provided an opportunity to the nation state. With the help of healthcare systems, the State has reasserted itself as the ultimate archangel to define human beings and their respective status in the newly emerging nomenclature of the public sphere. In this paper, the rejuvenation of the nation state with respect to bio-power will be discussed in the postcolonial context.

COVID-19 , Government , Health Services Accessibility , Morals , Pandemics , Political Systems , Politics , COVID-19/economics , Colonialism , Commodification , Disease Outbreaks , Global Health , Health Policy , Health Services Accessibility/ethics , Humans , Internationality , Pandemics/ethics , Philosophy , Power, Psychological , Private Sector , Public Sector , SARS-CoV-2 , Social Justice
J Bioeth Inq ; 17(4): 543-547, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-728228


The ethical experience and lessons of China's and the world's response to COVID-19 will be debated for many years to come. But one feature of the Chinese authoritarian response that should not be overlooked is its practice of silencing and humiliating the whistle-blowers who told the truth about the epidemic. In this article, we document the humiliation of Dr Li Wenliang (1986-2020), the most prominent whistle-blower in the Chinese COVID-19 epidemic. Engaging with the thought of Israeli philosopher Avishai Margalit, who argues that humiliation constitutes an injury to a person's self-respect, we discuss his contention that a decent society is one that abolishes conditions which constitute a justification for its dependents to consider themselves humiliated. We explore the ways that institutions humiliate whistle-blowers in Western countries as well as in China.

COVID-19 , Pandemics , Public Health , Social Control, Informal/methods , Whistleblowing , China , Government , Humans , Morals , Philosophy , Physicians , Political Systems , Public Health/ethics , Respect , SARS-CoV-2 , Self Concept , Whistleblowing/ethics