{"id":365,"date":"2023-04-10T12:49:02","date_gmt":"2023-04-10T11:49:02","guid":{"rendered":"https:\/\/blogs.ncl.ac.uk\/theodoreschrecker\/?p=365"},"modified":"2023-04-10T14:03:47","modified_gmt":"2023-04-10T13:03:47","slug":"the-covid-19-pandemic-as-tipping-point-part-1","status":"publish","type":"post","link":"https:\/\/blogs.ncl.ac.uk\/theodoreschrecker\/2023\/04\/10\/the-covid-19-pandemic-as-tipping-point-part-1\/","title":{"rendered":"The Covid-19 pandemic as tipping point (Part 1)"},"content":{"rendered":"\n

Acknowledgement:<\/strong> This commentary was originally written for Policies for Equitable Action on Health<\/a>.  It is reposted here with the kind permission of Daniele Dionisio, who runs PEAH.  Further republication consistent with the Creative Commons licence that applies to my entire blog is encouraged.<\/p>\n\n\n\n

I began a (pessimistic) 2022 book chapter<\/a> on the prospects for \u2018building back better\u2019 after the Covid-19 pandemic by quoting the first sentences of J.G. Ballard\u2019s magnificent dystopian novel High-Rise<\/em>:<\/p>\n\n\n\n

Later, as he sat on his balcony eating the dog, Dr Robert Laing reflected on the unusual events that had taken place within this huge apartment building during the previous three months.  Now that everything had returned to normal, he was surprised that there had been no obvious beginning, no point beyond which their lives had moved into a clearly more sinister dimension.<\/p><\/blockquote>\n\n\n\n

The giveaway word here is \u201cnormal,\u201d and the new normal to which Laing\u2019s world has returned is one in which a deadly class war between the affluent and even more affluent residents of a 40-story tower block has completely destroyed the interior of the building and most of its vital systems, and survivors are reduced to killing and eating the pets of their less fortunate neighbours.  In a scene near the end of the novel, surviving children play with human bones in the tower block\u2019s rooftop sculpture garden.<\/p>\n\n\n\n

This rather dramatic introduction was designed not to suggest that post-pandemic societies will literally regress to that extent, although that could happen in some contexts, but rather that conditions of life that come to be regarded as normal in the post-pandemic world will probably look very, very different from those of late 2019, and for most of us more insecure and threatening.  I am more convinced of this now than I was when I wrote the chapter. <\/p>\n\n\n\n

In a recent conference paper, I argued that the pandemic should be understood as a tipping point, initiating processes that magnify and accelerate existing trends, in particular those involving rising inequality and its direct and indirect effects on health. The concept of a tipping point is used in several, slightly different ways depending on context, but it is now most familiar from research on climate change.\u00a0 Leading climate researcher Timothy Lenton<\/a> explains<\/a>: tipping points \u201coccur when there is strongly self-amplifying (mathematically positive) feedback within a system such that a small perturbation can trigger a large response from the system, sending it into a qualitatively different future state.\u201d \u00a0Stated more colloquially<\/a>, \u201csometimes little things can make a big difference,\u201d or at least a disproportionate difference, \u201cto the state and\/or fate of a system.\u201d \u00a0<\/p>\n\n\n\n

Figure 1.  Schematic representation of cascading effects in the vegetation\u2013rainfall system<\/strong><\/p>\n\n\n\n

\"\"

(a) Vegetation\u2013atmosphere system in equilibrium. (b) Initial forest loss triggered by decreasing oceanic moisture inflow. This reduces local evapotranspiration and the resulting downwind moisture transport. (c) As a result, the rainfall regime is altered in another location, leading to further forest loss and reduced moisture transport.  Reproduced without change from Zemp, D. C., Schleussner, C. F., Barbosa, H. M. J., Hirota, M., Montade, V., Sampaio, G. et al. (2017). Self-amplified Amazon forest loss due to vegetation-atmosphere feedbacks. Nature Communications, 8,<\/em> 14681 under a Creative Commons Attribution 4.0 International Licence<\/a>.<\/figcaption><\/figure>\n\n\n\n

An especially striking example is provided by deforestation in large tropical rain forests (Figure 1).  As much as half of the precipitation that falls on such forests originates from evapotranspiration within the forest itself.   The concern is that deforestation resulting from human activity (forest clearance) will combine with reduced oceanic moisture inflows to lead to a tipping point in which reduced rainfall accelerates forest dieback, and the rain forest transitions to savannah or steppe.  This will itself accelerate climate change, as the forest no longer provides a carbon sink.  Researchers write<\/a> that findings about multiple processes of this kind \u201cimply that shifts in Earth ecosystems occur over \u2018human\u2019 timescales of years and decades, meaning the collapse of large vulnerable ecosystems, such as the Amazon rainforest and Caribbean coral reefs, may take only a few decades once triggered.\u201d  This is a long time in the context of such phenomena as election cycles, but an eyeblink in geological time.  Whatever the time scale, once a tipping point has been reached, the pace of changes that were already under way accelerates rapidly, and entirely new changes may begin.<\/p>\n\n\n\n

My pre-retirement colleague Clare Bambra and colleagues have provided an especially compelling account<\/a> of how distribution of health outcomes during the pandemic reflected and magnified economic inequalities (open access, and essential reading). Looking ahead, here are a few of the patterns (far from an exhaustive list) that suggest the value of considering the pandemic as tipping point:<\/p>\n\n\n\n