COVID-19: comparisons and knowledge
Post by Tiago Moreira
One of the defining images of the COVID-19 crisis has been the graphs that trace the number of cases or fatalities in different countries across time. If you are in any way following this situation in the news or social media, you will most certainly have come across the Financial Times ‘Coronavirus tracked’ page or the Worldometer dedicated Coronavirus webpage. Confronted with this data, you will, as many others, have asked why one country is doing ‘better’ or ‘worse’ than another in this crisis.
These questions are of key political importance, citizens rightfully expecting governments to take decisions to protect their lives and well-being. In this, the UK has taken a different approach than most other European countries in managing the epidemic. A recent investigation from the Sunday Times has provided a series of political reasons why Britain took this path, concluding that:
“We could have been Germany but instead we were doomed by our incompetence, our hubris and our austerity."
Subsequently rebuked by Number 10, this account nonetheless gives an indication of how comparison with Germany or South Korea provides the basis for political accountability in this epidemic.
The fact is that, beyond the political aptitude of elected politicians, what the graphs provide us is a window into space of possibilities of managing the epidemic. As Professor Devi Sridhar, a specialist in Global Health from the University of Edinburgh, has described, the diversity of approaches that different governments have taken to the COVID-19 crisis tells of diverging takes on a variety of trade-offs. This has made clear how choices early on in the process might set countries on specific pathways which are difficult to shift. But it also highlighted how different forms of expertise and scientific advice have interacted with political cultures of decision-making, how science and values have co-produced diverse pathways of viral and social management.
Scholars in Science and Technology Studies often conceptualise those interactions through the concept of ‘civic epistemology’: these are “social and institutional practices by which political communities construct, review, validate, and deliberate politically relevant knowledge.” While the idea of ‘civic epistemology’ focuses on national level co-production processes, the COVID-19 crisis makes visible, I think, a ‘global civic epistemology’, where comparison is a key tool through which political communities negotiate what is valid and relevant knowledge.
This is because, as the historian of science Lorraine Daston has argued, “we are living in a moment of ground-zero empiricism, in which almost everything is up for grabs.” In this, there are uncertainties not only about the facts of the matter (‘can people be infected more than once?’), but also about what tools and methods should be used to know this novel virus. In a state of widespread uncertainty, comparisons seem like a (the only?) safe way to start to ask questions. Indeed, Daston herself uses comparison of case-fatality rates to demonstrate how little we know about this virus.
Comparison appears safe because it is a key technique in knowing and governing global health processes. As many have suggested, the transition from international to global health is marked by the increased reliance on summary, standardised measures of population health. Whereas in international health, countries could only be compared within categories of ‘development’, global health relies on comparable measurement across the globe. As the WHO researchers put it almost 2 decades ago, “comparison creates possibilities of investigating broad determinants at national and cross-national level. […] Health measurements, particularly for policy makers, generally only have meaning in context, and context means comparison (Murray et al., 2002, p.747)."
The safety of comparison is reliant on the existence of an infrastructure of classifications and measurement. In the COVID-19 situation, however, this is also being called into question: are different countries counting cases in the same way?, are deaths being classified as caused by coronavirus uniformly across contexts? As a BBC report put it, “Are you really comparing like with like?”
This might be the right moment then to start rethinking the knowledge making practices and institutions concerning global health processes. This would rely on another understanding of comparison that starts from close knowledge of the case, or the different ‘viral worlds’ people inhabit and are affected by. This approach would seek to compose comparability cautiously and iteratively with political communities across borders. Some would say that this is a naïve proposal, that does not understand the urgency of the moment. Perhaps, but it would help us build a common, more-than-human future.
Tiago Moreira is a Professor of Sociology in the Department of Sociology at Durham University.
Views and opinions expressed on this blog site are solely those of the authors and other contributors. They do not necessarily represent those of Durham University, its Department of Sociology, nor all members of the Health and Social Theory research group.