Western rewriting of human rights leading to racism and pandemic disaster

Otto Kölbl, June 29 2021

Since 2008, I have been a direct observer of how Western academia, media, certain NGOs and politics have attempted to rewrite human rights. The horrendous consequences could be seen when the COVID-19 pandemic struck. This virus could have been contained by decisive action early on, as several countries have shown. As soon as the danger emanating from this virus was known in the second half of January, the WHO immediately and repeatedly called on all countries to take the necessary measures for efficient containment. However, these calls were initially ignored by the huge majority of experts and governments.

At the same time, Western academic experts and media started to prepare the population for a strategy based on herd immunity through infection. In a first phase beginning at the end of January 2020, several articles claimed that the “panic” caused by the virus could be much worse than the virus itself (1–4). From mid-February on, influential experts claimed that this virus could not be contained, that its spreading would only stop once herd immunity had been reached and that we could only slow it down in order to prevent hospital capacity overwhelming. SARS-CoV-2 was often compared to a bad seasonal flu. Within two weeks, all other experts who had a voice in the media fell in line. The academic consensus was nearly perfect.

By mid-March, it became increasingly obvious that this virus could actually be contained; China and South Korea had shown how to do it. Furthermore, the terrible situation in Italy showed that even high-income countries could not deal with a massive wave of COVID-19 without seeing their hospital capacity overwhelmed. However, the “lost month” between mid-February and mid-March has had dramatic consequences. In Europe, the death toll due to this misjudgment reached hundreds of thousands. Furthermore, the faster spreading variant from northern Italy wreaked havoc way beyond Europe, especially in the Americas, before haunting Africa and Asia in the form of further mutations.

We will see below that this is probably the most spectacular, but by far not the only case where the whole academic consensus was wrong and had to be corrected weeks or months later, after having made the fight against COVID-19 unnecessarily difficult. How could it happen that the Western academic consensus, worked out by eminent experts in the most influential universities in the world, got so many questions relating to this pandemic so wrong?

The dogma of the 21st century: limiting the power of the state

Experience has shown that those countries which took decisive, well-coordinated measures against COVID-19 have been able to keep the number of cases and of deaths low and to limit the socioeconomic impact of the pandemic. Many of these measures, in order to be efficient, must target the whole population and be made mandatory. All this goes against a consensus within Western academia and media and certain NGOs that the only way of achieving good governance is to engage in an all-out effort to limit the power of the state. This consensus has become so strong that it turned into a dogma which even led to the rewriting of human rights. Here are the main pillars of this consensus:

• Limiting the power of the state through a regulatory framework is indispensable to achieving good governance in the interest of the people.
• The UN human rights framework is a crucial aspect of this regulatory framework. It allows individual people and non-state actors to hold governments accountable and to make sure that every person can enjoy their fundamental rights.
• Each restriction to fundamental freedoms must be shown to be necessary in a verifiable way, e.g. through academic research.
• The state must only provide services on demand, under strict supervision.
• The independence of the academic community, the media and the legal system must be protected against any interference by authorities.

All this sounds very convincing. However, the COVID-19 pandemic has shown that these principles had a destructive impact on the ability of the state to take efficient measures against a massive threat to lives and public health. More importantly, it led to the academic community rejecting any effort to organize their research activity, which in turn led to important research not being done and to other misjudgments.

The UN human rights framework

The Universal Declaration of Human Rights UDHR (5) from 1948 is certainly the best known UN human rights text. However, being a declaration voted by the UN General Assembly, it only has the status of a recommendation. The two Covenants from 1966, on the other hand, are international treaties which become an integral part of international law for those countries having ratified them. They are also much more detailed than the Declaration. The Declaration, the two Covenants and two Optional Protocols form the International Bill of Human Rights (6). The two Covenants will be most extensively quoted here to explain the UN human rights concept.

The International Covenant on Economic, Social and Cultural Rights (ICESCR) (7) deals mainly with the right to a decent standard of living, to certain social services and to participation in cultural life. The International Covenant on Civil and Political Rights (ICCPR) (8) deals mainly with the protection of certain rights against interference by the state, e.g. of the right to free speech, of religion, to a fair trial etc. and with the right to participation in political life (freedom of assembly, to democratic elections. etc.).

It should be obvious that the efficient use of a human rights framework to limit the power of the state (as explained above) will offer adequate protection against certain forms of abuse like for example arbitrary detention by state authorities (ICCPR Art. 9). Protection against arbitrary detention by non-state actors (e.g. organized crime or warlords) is of course another matter. The same is true for the “right to security of person” in general. According to the UN human rights texts, whether the security of individual people is threatened by authorities or by non-state actors is irrelevant. Human rights are basically about everybody being able to enjoy their rights (ICESCR and ICCPR Preamble). The state must do what it takes to achieve this. Sometimes, this requires limits to the arbitrary power of the state. In other cases, it requires having a functional and efficient state to prevent abuses by other actors. A third aspect involves the obligation by authorities to see to it that the whole population can enjoy fundamental services. Unfortunately, Western academia and media increasingly tend to focus exclusively on the first of these three aspects of human rights.

The human rights concept used by the Western media

A detailed quantitative analysis of hundreds of newspaper articles conducted in 2011 has revealed that certain human rights are hardly ever mentioned as such by the Western media (9). This is true especially for the economic, social and cultural (ESC) rights. For example, the “right to health” is mentioned occasionally, but generally without specifying that it belong to human rights. Actually, the ESC rights are more often mentioned in a way which implies that they are not part of human rights than in a way which includes them. This is all the more true when it is an issue which can be solved only by the state providing a certain service to the whole population, as opposed for example to a question of discrimination.

After doing the above mentioned research, I was highly alarmed by the results: Our media systematically try to silence certain major aspects of human rights. I presented the results at academic conferences, forums and workshops in Lausanne, Barcelona, Paris, Innsbruck and Beijing. Except in Beijing, where the reaction was mixed, in all other places, it was simply appalling: “If it’s mainly the communist countries which pushed for the inclusion of ESC rights into human rights, now that the Soviet Union is gone, why should we keep them in?” Except for the preliminary results included in the Beijing forum proceedings, I gave up on the idea of making a paper out of it.

Thinking that the concept might be too abstract and that a concrete application would illustrate the problem better, I focused on the evaluation of the achievements of governments regarding their obligation to decrease infant mortality. The method is directly based on the relevant human rights texts, in particular on the ICESCR. This text requires each state to reduce infant mortality (ICESCR art. 12) “to the maximum of its available resources” (ICESCR art. 2). The UN Vienna Declaration from 1993 also explicitly mentions the importance of reducing infant mortality (10). Infant mortality is highly dependent on per capita GDP purchasing power parity, especially if other factors relating to the macroeconomic structure are taken into account (11, 12). One possible way of evaluating the efforts made by each country is therefore to take the residual value after performing a regression model: how does the actual infant mortality rate compare with the rate we would expect based on the GDP level? If the actual value is lower than the expected value, the country did a good job. If it is higher, it could probably have done better. This method of course only provides a snapshot at a precise moment in time. An analysis of the evolution over time provides a more complete picture.

All this is not complicated. There are many different ways of doing it, but they will yield similar results. If we consider that compliance with human rights standards should be monitored in every country, it is a must: The obligation to make consistent efforts to decrease infant mortality is explicitly mentioned in some of the most fundamental UN human rights texts. In the past, some academic researchers made attempts to provide the necessary data and analysis (13, 14). And yet, I cannot remember any media or NGO report intended for a broader audience featuring an assessment of this particular human right. Like many others, it is systematically excluded from the human rights concept conveyed to the public in Western countries. Why?

One of the reasons might be that such an analysis does not provide the results desired by Western academia, media and NGOs. As explained above, these three actors deploy considerable efforts to limit the power of state institutions. They claim that each additional mechanism contributing to this objective will make governance more efficient and closer to the needs and aspirations of the population. The “problem” with infant mortality as evaluated the method explained above is that the countries which have achieved the best results in reducing infant mortality rate tend to be communist, former communist or otherwise not entirely liberal countries. For example, the infant mortality rate in Cuba is significantly lower than in the US, despite the US having a much higher GDP level. Even the CIA has to concede this embarrassing fact in their World Factbook (15). Obviously, the US Central Intelligence Agency cares more about the lives of babies born in this world than the Western academia, media and NGOs, which consistently refuse to address this issue.

After the sobering experience with my research about the distortions to the UN human rights concept in Western media, I did not even try anymore to present the new research results about infant mortality all over Europe. Since I had to pay for all the travel expenses and congress fees myself, I never had the resources to take part in events in the US. Even travelling across Europe is quite expensive. When I tried to present these results at the University of Lausanne, where I am a doctoral student, my application was rejected, even though the event in question was a rather informal workshop for doctoral students and my proposed presentation fit perfectly into the topic. I presented the results in Beijing, at an official human rights forum, where the reception was lukewarm. This might come as a surprise, since my results were very positive with regards to the performance of China. It took me quite some time to understand the reasons behind it and the disastrous consequences.

Distortion of China’s socioeconomic development and build-up of anti-Chinese racism

A few years later, I became aware of a worrying trend. All recent documentaries about China under Mao Zedong conveyed the same message: Mao was allegedly responsible for tens of millions of deaths, he stayed in power only through ruthless repression, but many Chinese still celebrate him as a successful leader. It was immediately obvious to me that this message is both incorrect and dangerous. It depicts a major part of the Chinese as being unable to think freely, as people who let their government dictate what they must think, even if it goes against their own interests. This is the most brutal way of dehumanizing people: Claiming that they are not able to think by themselves.

When living and working in China and during my trips to collect data, I have talked with many elderly people about life under Mao Zedong. I have also spent a long time digging into all the available data from reliable sources about socioeconomic development during this era in the various regions of the globe. Both with regards to infant mortality and life expectancy, the Communist Party of China (CPC) under Mao Zedong did an outstanding job. If we assume reasonable estimates for these indicators before 1949, when the CPC took power from the Guomindang (GMD), probably no country in human history achieved a faster increase in life expectancy and decrease in infant mortality than China under Mao. Even GDP growth, while moderate compared to other Asian countries, was actually one of the fastest ever reached by a country starting from a level corresponding to a poor agrarian state with a high population density.

The Great Leap forward (1958–1962) was a horrendous disaster which cost 25–30 million people their lives (excess mortality), according to a World Bank expert who should be considered a solid reference (16). However, in order to understand the reaction of the Chinese people to this disaster, we must keep in mind that excess mortality is always calculated with regards to a certain base of comparison. Between 1949 and 1957, life expectancy rose from probably a little over 30 years to 46.7 years. The 25–30 million excess deaths are calculated by comparing mortality during the Great Leap forward to the situation just before (i.e. the 46.7 years in 1957) and just after (i.e. in the years after 1962). Many Chinese people certainly compared the situation during the Great Leap forward to the situation before Mao Zedong, i.e. during GMD rule under Chiang Kaishek. In 1960, during the worst years of the Great Leap forward, life expectancy decreased to 31.5 years, probably similar to the value under Chiang Kaishek in “normal” years. After 1960, life expectancy increased very fast to reach values consistently close to or above 50 years from 1962 on; by 1976, the last year of the Mao era, it had reached 66 years.

During the last decades of the Qing dynasty and during the whole of the Republic of China (1912–1949), China was called the “Sick Man of Asia”. The main reason was the fact that most countries in Asia started a sustained socioeconomic development process during this period, but not China. On the contrary, two times in the 1850s and 1860s (Taiping Revolution) and in the 1910s and 1920s (warlord era), Chinese state structures collapsed in major parts of the country, leading to widespread chaos and destruction. Even during periods of relative stability, e.g. during the “Nanjing decade” 1928–1937, there was some development in major cities, but the situation in rural regions, where 90% of the population resided, stagnated or even deteriorated. After World War 2, virtually nobody, neither in China nor among Western observers, had any hope that the GMD government was able to bring any good to China.

In 1949, China went from having one of the most corrupt and incompetent governments in the world to becoming one of the highest achievers in human history in terms of socioeconomic development, i.e. in terms of saving human lives. The Great Leap forward illustrates it perfectly. If a 4-year-long crisis with a sharp dip which brought life expectancy back to what was “normal” before 1949 cost the lives of 25–30 million people (as compared to the good years just before and just after), imagine how many lives the good years under Mao Zedong saved, as compared to what the Chinese had to expect from a continuation of GMD rule. I did not do the exact calculation, but it’s definitely hundreds of millions. This makes a massive difference in the concrete lives of the population. It is not difficult to understand why so many Chinese who know the change between GMD and CPC rule still have got huge respect for Mao Zedong.

How was this change brought about concretely? Answering this question will help us to understand why the Western discourse goes unchallenged, despite the fact that the most reliable Western and international sources as well as the testimony of hundreds of millions of Chinese prove it wrong. Events not only in China, but also in numerous other countries in the world show that in order to decrease mortality or to start a sustained development process, the only way is for the government to take measures benefiting the whole population. Implementing the most basic hygiene measures for the whole population will do much more to improve public health than providing state-of-the-art healthcare for the lucky few who can pay for it. The same is true for other aspects of socioeconomic development: providing very basic education, infrastructure and industrialization for the whole population will result in faster subsequent development than if you focus on more elaborate services for wealthy city-dwellers.

By using all the resources of the country to provide the most basic services to the whole population, Mao Zedong achieved not only one of the fastest decrease in mortality in human history and more generally impressive socioeconomic development, he also laid the foundation for subsequent fast economic growth during the reform era. However, Mao’s focus on the poor and on rural areas also came at a price. The former ruling elite was used to see the state use all the available means only for them. Many of them realized that the late Qing dynasty and GMD rule had been a terrible disaster for China. However, they were not willing to accept that bringing China on the path of socioeconomic development and reducing the horrendous levels of misery and mortality required taking care of the whole population. They advocated what we could call now a “trickle-down” approach. First develop the cities and focus on educating the elite by investing in universities; the poor will benefit later from development. What they refused to realize is: In all successful examples of fast development, this is not how it worked. In the early industrializing countries (Western countries and Japan), providing basic education and healthcare for the whole population played a crucial role and was a priority. The same is true in the countries in Asia which had started to develop at the beginning of the 20th century. Actually, Sun Yatsen, the founder of the GMD party, was very well aware of this. However, due to fierce resistance from the whole ruling elite, nothing was ever implemented. This is certainly one of the reasons why China is one of the few countries in Asia where the population ended up overthrowing the whole ruling elite in a revolution. It is also one of the reasons why Mao Zedong, in order to realize his social policies, had to crush opposition through fierce repression on a regular basis.

Another characteristics of China under Mao Zedong is the regular use of mass mobilization campaigns to achieve various goals. Land redistribution in the first years of CPC rule and various literacy campaigns are typical examples. Some of these campaigns were highly efficient and productive, whereas others resulted in massive violence and destruction. We must keep in mind that in 1949, China was an extremely poor country, poorer than the surrounding countries which had initiated their socioeconomic development decades earlier. For many urgently necessary measures, the state did not have enough resources. The only way of getting them done was through ideologically motivated mobilization.

The last and probably most controversial mass mobilization campaign was the Cultural Revolution (1966–1976). In a first phase (1966–1969), Mao Zedong, who had been sidelined after the disaster of the Great Leap forward, mobilized young people in the form of the Red Guards against both the traditional elite and the new communist elite. Even the traditional Chinese culture and its artifacts became the target of systematic destruction. This mobilization took the form of “struggle sessions” where young people submitted all people in positions of power and responsibility to humiliations and torture, sometimes leading to executions. In some places, this lead to armed conflict between the Red Guards and authorities. After the situation threatened to get totally out of control, Mao asked the army to intervene to restore stability. The second phase (1969–1976) saw the most radical version of institutionalized communism which China has ever experienced. Access to higher education and career depended almost exclusively on the right social background and known devotion to the party (or party officials). Every suspicion of “rightist” or “counter-revolutionary” attitude could have harsh consequences. Many young people from the cities were sent to the countryside. Present-day historians claim that all this was exclusively a question of power: Mao Zedong wanting to become again the most influential person in China. Contemporary observers point out that by the mid-1960s, two problems became increasingly serious: The traditional elite sought to restore its former privileges, while communist party members and government officials had become a new privileged elite. This resulted not only in widespread corruption, but also in a lack of opportunity for all those who did not have the necessary connections with either the old or the new ruling elite. When Mao Zedong mobilized the Red Guards for an onslaught against these two elites, this was not an ideologically motivated act of madness; he fought against forces which were becoming a threat to the stability of government and society through their quest for privileges.

He also used this movement for further building up basic infrastructure and services. Still now, when you go to the countryside and talk with farmers about the irrigation and flood control infrastructure they use, quite often, they will tell you that it dates back to the 1970s. The increase in yield achieved in the 1980s through the household responsibility system would not have been possible without this massive infrastructure buildup. More generally, over the whole Mao era 1949–1976, roughly the same area was put under irrigation as in the previous 2–3 millennia. If we take into account that most of this work was done by hand with the same tools as in ancient times, we can appreciate the resilience of the people who made it possible. It was the only way of feeding a population which increased steadily thanks to better healthcare and improved standard of living.

Another aspect of the Cultural Revolution is directly related to the fight against illness and pandemics, namely the barefoot doctor program or (as it is called in other countries) community health worker (CHW) program. The basic idea is to provide a few people from each village community with basic training in preventive and curative medicine, so that new ideas and basic care come from within the community itself. This principle was invented well before the Cultural Revolution; it had been used for many decades in various countries all over the world in isolated attempts to improve hygiene and medical care mainly in rural communities. However, it had never been implemented in a systematic way in a whole country. The impact on infant mortality, which unlike life expectancy depends much more on healthcare than on standard of living, was impressive. The Chinese barefoot doctor program was praised all over the world and became an inspiration for many similar programs.

Bringing healthcare to the people, worldwide

Many other countries started to implement similar programs, especially in South Asia, for example in Bangladesh, which after independence in 1971 was one of the poorest countries in the world. In other countries, similar programs emerged, but on a smaller scale. In the 1990s, the AIDS epidemic ravaged Sub-Saharan Africa. When at the beginning of the millennium, retroviral drugs became available at an affordable price, there were not enough doctors to take care of the number of cases. Those countries which had implemented CHW programs were able not only to inform their population better about necessary precautions, but also to provide the newly available drugs to those in need. As a result, they achieved a much faster decrease in the number of cases and of deaths than other countries like South Africa which had much more resources, but refused to implement such a program on a large scale.

CHW programs had a positive impact not only on AIDS, but also on tuberculosis (TB) which all too often takes advantage of the weakened immune system of people with AIDS. The spreading of TB is much more difficult to contain, since it is a respiratory illness. Due to the high incidence in some countries and to inadequate treatment which is all too often not carried out completely, we see more and more multi-resistant strains emerge. They inflict massive damage not only to local societies, but also to international exchanges as we know them. Just think about what happens when everybody realizes that by travelling to certain regions of the globe, you can get and pass on a bacteria which will either kill you or require months or years of debilitating therapy with horrific side effects. And yet, our media don’t care. Those governments which grossly neglect the right of their population to healthcare and to efficient measures against endemic and epidemic illnesses are hardly ever criticized.

Maybe we should have a look at how countries in Western Europe fought against TB and infant mortality. When I was a child, twice a bus stopped in front of the kindergarten and all children had to line up to get an x-ray of their lungs. This kind of systematic screening has certainly contributed to virtually eradicating TB in Western countries, where it was widespread until several decades ago. Measures taken to decrease infant mortality are similar. In the week which follows hospital discharge after birth, in many countries, a nurse will ring at the door to see the child. According to some testimonies, the nurse will not even ask for an appointment but simply show up at the door in a surprise visit. This is the most efficient way of spotting signs of neglect or inadequate care. These are two examples of “bringing healthcare to the people” in Western countries and they work. They help to prevent deaths and illness within the whole population.

Unfortunately, what was a common and efficient strategy in healthcare policy during the 20th century is being increasingly abandoned in the 21st century. The new paradigm is that the people should search for information by themselves and seek adequate healthcare out of their own initiative. It should be obvious that only a small part of the population will dedicate the necessary time to this task. The results show it very clearly. In 1950, India was better off than China in virtually every aspect. Since then, India has increasingly adopted a hands-off approach to public health, whereas China, with the exception of the more liberal Deng Xiaoping era, maintained a rather interventionist approach. By now, according to World Bank data (17), 679'000 infants in their first year of life died in India in 2019; in China, 113'000, with a roughly equivalent population, but a somewhat lower birth rate; in the US, 22'000, with one quarter of the population. In the US, infant mortality rate is more than twice the rate in comparable countries with a similar GDP level. This gap emerged first in the early 1980s, under Ronald Reagan. Since then, it increased under each single president, including Barak Obama (18). Within one or two years, at the present pace, China will have a lower infant mortality rate than the US, despite still having a much lower per capita GDP. Do our academic experts, media and civil society care? No. The fact that decreasing infant mortality is part of the human rights obligations according to UN human rights treaties is not relevant to them. They have settled for a hands-off approach and will ignore all information about the consequences. In particular, in a pandemic, where applying measures to the whole population is crucial, this approach will necessarily lead to a disastrous failure. That is precisely what happened when COVID-19 struck.

Dealing with COVID-19: Some of what went wrong

On December 24 2019, a doctor in a hospital in Wuhan had the first suspicion that a series of recent pneumonias was not due to known pathogens and that a new virus could have emerged. A first partial genome sequence confirmed the hypothesis. By January 23 2020, the Chinese government had taken the decision to contain this virus through distancing and hygiene measures, lockdowns and massive testing-tracing-isolating. It was obvious to everybody in China that these measures had to be applied to the whole population for them to work. Within two weeks, the peak in new cases was reached.

Why did it take the Chinese government almost one month to take the decision that COVID-19 can and must be contained, i.e. that the government must take the necessary measures in order to prevent this virus from spreading through the whole society? We might also ask why it took European and North American experts much longer to reach the same conclusion.

Three weeks after China decided that this virus can and must be contained, on February 13, German virologist Christian Drosten was the first to claim that there was a consensus among leading experts that COVID-19 would become a pandemic (19). One day later, Harvard professor Marc Lipsitch provided more details about the expected consequences (20):

“I think it is likely we’ll see a global pandemic,” said Marc Lipsitch, a professor of epidemiology at Harvard T.H. Chan School of Public Health. “If a pandemic happens, 40% to 70% of people world-wide are likely to be infected in the coming year.

These first claims that COVID-19 could not be contained were still cautious. However, since they followed the articles warning that the panic about the virus could be worse that the virus itself, they alarmed me sufficiently to push me to write a paper with a co-author, advocating that Western countries follow the Chinese example and make an all-out effort to contain the virus (21). This paper drew enough attention within governments and in the media (22) to get us both into the COVID-19 taskforce of the German Interior Ministry (23). This taskforce was not the main official taskforce of the German federal government, which was following the advice of Drosten and other national and international experts and considered herd immunity through infection to be unavoidable. The interior minister Horst Seehofer had set up some kind of “alternative” taskforce to explore the possibility of containing the virus instead of going for mitigation and let the virus spread through the whole society. Our first report from March 22 2020 was probably instrumental in switching the strategy of the federal government to containment instead of herd immunity (24). It described the danger emanating from this virus in very clear words and advocated working in close collaboration with the whole society to achieve fast containment of the pandemic. It was supposed to remain confidential and to be circulated only within the government and among selected experts, but on March 27, it was leaked to the press and got a largely positive reaction in the media nationally (25–27) and internationally (28, 29). Drosten was among the voices that day which still claimed that containment was not feasible, probably in direct reaction to our report (30):

We have to assume by now that the virus will spread through the whole society. This means that 60–70% of the population will get infected before the pandemic spreading will stop.

A few days later, it became clear that the German chancellor Angela Merkel also still considered herd immunity through infection the only possible outcome (31). Only by mid-April did the federal government realize that “flattening the curve” could not work and went for containment. By then, fortunately, the measures intended to “flatten the curve” had been implemented in such an efficient way by the German administration and the population that the number of cases was decreasing fast, long before herd immunity was reached. Many people had realized that going for herd immunity was madness long before the most influential experts and the federal government.

Being a member of this taskforce allowed me to understand the mechanisms from within. Efficient containment is a question of taking efficient measures for the whole population after having informed properly about the danger emanating from this virus. This is what was called above “taking healthcare to the people”. Some people in high-ranking leadership positions understood the need for acting in this way and had the competence and experience of doing so. However, their intended actions were blocked by others invoking the constitution or fundamental freedoms, when actually similar measures were taken a few decades ago in the same countries with the same constitution and the same concept of fundamental freedoms. Much of what eminent experts and highly influential people considered to be “impossible in a democracy” ended up being implemented a few months later, when the number of deaths became too high to be acceptable.

However, this does not mean that after some initial hesitations, Germany switched to efficient containment. “Efficient” would mean that among all the available measures, those with the highest impact on the epidemic and lowest cost would be chosen over those with a higher socioeconomic impact. This did not happen.

Face masks, for example, were used on a large scale during the Spanish Flu in 1918/1919. Still in 2003, when I bought a box of face masks in Switzerland before traveling to China during the SARS epidemic, the box came with the information: “Face masks for the population in case of a pandemic, in line with recommendations by the Swiss Office of Public Health.” At the beginning of 2020, when it was most needed, the consensus that the widespread wearing of face masks within the population contributes to slowing down or containing the spreading of a respiratory virus was suddenly gone. It took a massive outcry among some experts and even more “non-experts” to restore this consensus by April 2020, after the first wave had been contained by often very harsh lockdowns. Unfortunately, the damage had been done. With widespread mask wearing right from the start, before the first wave started, the number of infected people and of fatalities as well as the socioeconomic impact could have been strongly reduced. One of the main reasons for this initial misevaluation is certainly that virtually all research projects about the efficiency of face masks before the 2020 pandemic focused exclusively on the protection for the wearer, which is moderate at best. The protection for other people if the wearer is unknowingly infected with a virus, e.g. asymptomatic, had been the object of little research.

The same is true for the epidemiological dimension of widespread wearing of face masks: To what extent can the various types of face masks, when used systematically in certain settings, decrease the reproduction number Re? Despite the importance of this question being obvious to everybody with some basic knowledge in epidemiology, virtually no research was available on this question at the beginning of the pandemic. After the start of the pandemic, once face masks were widely used in a desperate attempt to reduce the number of cases, it would have been relatively easy to evaluate their impact on the spreading of the virus. Unfortunately, this chance was missed too. In order to measure the precise impact of actually wearing a face mask (as opposed to a recommendation to wear one or mandatory use in certain settings), it would have been necessary to collect data on how many people actually wear a face mask in the various settings for a wide array of regions or countries. With the number of deaths reaching hundreds of thousands in certain countries, despite the fact that face masks became the object of bitter conflicts in many societies, there has never been any attempt to organize a systematic collection of all relevant data to the spreading of the virus across the world. Attempts to evaluate the efficiency (or absence thereof) of the various measures implemented to contain the virus had to rely on information about the measures decided by authorities, instead of having much more reliable information about how these measures were actually implemented on the ground. The almost exclusive focus on individual prevention (“How can I protect myself against the virus” as opposed to “How can we protect the whole population against a pandemic”) and the reluctance of researchers to collect their own data are two determining factors for the failure of the academic community to provide adequate research to prevent the spreading of COVID-19.

The various mouth wash, gargling and nasal rinse/spray methods are another example of inadequate pre-pandemic preparation and of absence of coordinated efforts to fill the gaps once the pandemic started. Millennia of experience in traditional health techniques and decades of mostly small scale medical research indicate that these methods can have a beneficial impact on the spreading of a virus, at an extremely moderate socioeconomic impact. Here again, most research tried to evaluate to what extent people using these methods can protect themselves against catching a respiratory illness or reduce the severity of their symptoms. Very few projects tried to evaluate to what extent the reduction of the viral load might decrease the risk of transmission to other persons. Here too, after the pandemic started, a coordinated effort could have allowed us to fill the gaps in terms of urgently needed research very fast. No such effort was ever made. On the contrary, a systematic analysis of available academic research and media reporting on this topic reveals that media reporting is consistently less positive with regards to the potential of these methods than the research available at that time. Since this analysis was done, two more academic papers confirmed the importance of these methods, but they got hardly any attention, neither by experts nor by the media.

These are just two examples. There are many more. All point to a similar approach to the COVID-19 pandemic: only high-tech measures which can allow individuals to protect themselves will get attention and funding. All the measures which are not very efficient to protect the individuals who apply them, but can play a major role in reducing transmission if they are applied on a large scale within society, will be virtually ignored.

There is one exception, namely the various forms of lockdowns. They were the standard anti-pandemic measure in 1918 and have been for centuries before. However, they come at a huge socioeconomic cost, in particular for people who are self-employed or who don’t have a stable position and for small businesses. It is obvious that the socioeconomic impact of a lockdown or of school closure is greater by orders of magnitude than the cost of making sure that everybody wears a face masks or gargles three times a day with salt water or with an antiseptic solution. An adequate combination of protective screens and HEPA air filters for all schools, restaurants and workplaces is certainly more expensive, but still much lower than the cost of lockdowns. Even if we consider only the purely economic cost, lockdowns have caused a decrease in GPD amounting to trillions of dollars worldwide. Funding the required research to evaluate the potential of the measures mentioned above and to find the optimal combination costs less than one billion. Still, there was no coordinated effort to get this research done, not even a call by influential experts or any major media outlet to undertake such an effort. My own calls within the taskforce mentioned above, in preprints and in blog articles were unanimously rejected.

In the field of treatment of patients with COVID-19, the situation was slightly different, but equally problematic. The medical community certainly did a great job with saving the lives of those who experienced a severe course of illness. In particular during the first months of the pandemic, they did so all too often at considerable personal risk due to insufficient availability of PPE. We need an investigation into the impact of the herd immunity approach claimed by virtually all experts to be unavoidable on the efforts by governments to provide PPE to the medical community. It should be obvious that if all advisors consider that the virus will spread through the whole community anyway, making an all-out effort to protect the medical community does not make sense. It will hardly save any lives since doctors and nurses are among the most exposed to the virus. On the other hand, if the objective is to contain the virus long before herd immunity is reached, protecting doctors and nurses is crucial to avoid nosocomial infections.

On the other hand, many doctors and experts fiercely criticized the lack of research into possible treatments for cases which still have only light symptoms (32). The idea is that an adequate treatment in the early phase of the illness will prevent a degradation of the condition. During the first months of the pandemic, chloroquine and hydroxychloroquine were considered to have a potential for early treatment. A later large-scale randomized trial showed that these drugs did not have a significant impact. However, this trial was criticized for not testing the combination with azithromycin and for not recruiting patients in the very early stages of the illness or even before the first symptoms appeared. Another large-scale randomized trial conducted in May to July 2020, but published only in March 2021, showed a significant prophylactic impact of hydroxychloroquine. In a second time, high hopes were pinned on Ivermectin. The fact that the producer of this drug refused to fund a large-scale trial was certainly not a plus for trust into the pharmaceutical industry. Universities in high-income countries did not set up the kind of trial which could provide a reliable answer either. A large number of small scale trials, most of them conducted in developing countries, reached various results, with a majority showing a favorable impact. Many doctors did not understand why providing the necessary funding for a large-scale trial was such a problem, especially if we consider the number of lives which are at stake and the fact that Ivermectin has got hardly any side effects.

Meantime, the vaccines which were developed and produced with unprecedented speed have largely taken the teeth out of the virus in most high-income countries. However, many low and middle income countries still battle widespread and deadly outbreaks. Even high income countries could see the emergence of new variants against which the vaccines protect insufficiently. Researchers have also found new viruses with the potential to cause another pandemic at any moment. We can now draw the lessons from COVID-19, in particular from what went wrong. Repeating the slogan “Listen to science!” over and over again will not necessarily help us to get the necessary research done and to restore trust in our media, in our academic community and in the institutions in general after all that went wrong.

The COVID-19 disaster in the light of human rights

We have seen above that the Western academic community, even before the present pandemic, was increasingly reluctance to accept that providing efficient healthcare to the whole population and taking efficient measures against endemic and pandemic illnesses is part of human rights obligations for each state. The fact that these obligations are listed explicitly in the most fundamental UN human rights texts is simply ignored. Instead, the focus is on providing information to those who make the necessary effort to seek information by themselves. It should be obvious that this attitude towards healthcare policy is largely favorable to people with a high level of formal education. What is more, in case of a pandemic, these people can also much more easily work from home office or take other precautions to avoid being exposed to a virus. Add to this the fact that in the present pandemic, urgently needed research to contain COVID-19 at the lowest possible socioeconomic cost was simply not done. With regards to many crucial issues, the academic consensus was incorrect and had to be corrected weeks or months later. No attempts were made to remedy to this situation.

What we get is a general picture of a disconnection between the academic community and the rest of society. The whole academic community seems to consider that they have got no responsibility or obligation towards society at all, that even in a pandemic, it is normal that each single member of the academic society can continue to work on what they consider to move their career forward. Any suggestion that in order to provide the research necessary to prevent hundreds of thousands of deaths, those researchers with the necessary competences should be organized into efficient teams to get this research done as fast as possible is systematically rejected. Academic freedom is among the rights guaranteed by the most fundamental human rights texts. However, all the texts also mention that rights can be restricted by the state if required. Until recently, most people assumed that in case of a pandemic, the academic community would move fast to provide the necessary research and that this research would be helpful in containing the pandemic. Probably nobody expected that the most influential experts in Europe and North America would reach conclusions and advocate a fundamental approach to the pandemic for weeks which would turn out later to be disastrous errors, and that urgently needed data collection and research would simply not be done. Most people did not expect that after a long series of misjudgments and failures, the academic community, with massive support from the media, would try to silence early warners.

We need rigorous research into the precise mechanisms and the deeper reasons behind these failures. The concept of information transmission chain can provide some valuable insights. It comes with a research methodology which was first used in 2011 to describe the distortion of the human rights concept by some European and American media (9). It was again used more recently to analyze the transmission of information within academic research about gargling and nasal rinse methods to reduce the spreading of COVID-19 and the related media coverage (33). Experience with this concept has shown that information from reliable sources which is available, but gets neglected by research and media, is often an indication for problematic dealing with information. A detailed analysis of the various topics mentioned here would be a good starting point for a discussion of what worked well and of what went wrong in the present pandemic and in other fields where the performance of academic community has led to criticism from various sectors of society.

References

1. Dingwall R. We Should Deescalate the War on the Coronavirus. Wired. 29.01.2020. https://www.wired.com/story/opinion-we-should-deescalate-the-war-on-the-coronavirus/
2. Fisher M. Coronavirus ‘Hits All the Hot Buttons’ for How We Misjudge Risk. New York Times. 13.02.2020. https://www.nytimes.com/2020/02/13/world/asia/coronavirus-risk-interpreter.html
3. Latza Nadeau B. Italy Shows Just How Crazy Coronavirus Panic Can Get. Daily Beast. 29.02.2020. https://www.thedailybeast.com/italy-shows-just-how-crazy-coronavirus-panic-can-get
4. Broder D. When Coronavirus Made Italy Go Insane. Jacobine Magazine. 29.02.2020. https://jacobinmag.com/2020/02/coronavirus-outbreak-italy-face-masks-panic-milan-fashion-week-lega
5. United Nations. The Universal Declaration of Human Rights New York1948. https://www.un.org/en/universal-declaration-human-rights/index.html
6. United Nations. Fact Sheet №2 (Rev.1), The International Bill of Human Rights 1996. https://www.ohchr.org/documents/publications/factsheet2rev.1en.pdf
7. United Nations. International Covenant on Economic, Social and Cultural Rights 1966. https://www.ohchr.org/EN/ProfessionalInterest/Pages/CESCR.aspx
8. United Nations. International Covenant on Civil and Political Rights New York1966. https://www.ohchr.org/EN/ProfessionalInterest/Pages/CCPR.aspx
9. Kölbl O, Human rights, values and the media. Fourth Beijing Forum on Human Rights; 2011; Beijing.
10. United Nations. Vienna Declaration and Programme of Action. 1993. https://www.ohchr.org/en/professionalinterest/pages/vienna.aspx
11. Randolph S, Fukuda-Parr S, Lawson-Remer T. Economic and Social Rights Fulfillment Index: Country Scores and Rankings. Journal of Human Rights. 2010;9(3):230–61. http://www.tandfonline.com/doi/abs/10.1080/14754835.2010.501257
12. Moore S, Teixeira AC, Shiell A. The health of nations in a global context: Trade, global stratification, and infant mortality rates. Social Science & Medicine. 2006;63(1):165–78. http://www.sciencedirect.com/science/article/pii/S0277953605007008
13. Backman G, al. e. Health systems and the right to health: an assessment of 194 countries. The Lancet. 2008;372:2047–85. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(08)61781-X/supplemental
14. Griffey B. The ‘Reasonableness’ Test: Assessing Violations of State Obligations under the Optional Protocol to the International Covenant on Economic, Social and Cultural Rights. Human Rights Law Review. 2011;11(2):275–327. http://hrlr.oxfordjournals.org/content/11/2/275.abstract
15. CIA. World Factbook. https://www.cia.gov/the-world-factbook/
16. Hill K. Demographic Trends in China from 1950 to 1982: World Bank; 1988. http://documents.worldbank.org/curated/en/492811468771874832/Demographic-trends-in-China-1953-1982
17. The World Bank Data Indicators. https://data.worldbank.org/indicator?tab=all
18. Kolbl O. Never leave a cowboy in charge of the nursery, or 12,000 babies will die each year 2015. https://www.rainbowbuilders.org/health/infant-mortality-usa-america
19. Schumann F. Eine Pandemie wird jeden Tag wahrscheinlicher. Die Zeit. 2020/02/13. https://www.zeit.de/wissen/gesundheit/2020-02/coronavirus-wissenschaftler-pandemie/komplettansicht
20. Craven McGinty J. How Many People Might One Person With Coronavirus Infect? Wall Street Journal. 14.02.2020. https://www.wsj.com/articles/how-many-people-might-one-person-with-coronavirus-infect-11581676200
21. Kölbl O, Mayer M. Learning from Wuhan — there is no Alternative to the Containment of COVID-19 2020 updated 04.03.2020. https://www.researchgate.net/publication/339721905_Learning_from_Wuhan_-_there_is_no_Alternative_to_the_Containment_of_COVID-19
22. lik/jala. China-Experten zu Sars-CoV-19Wer noch über Fußballspielabsagen debattiert, hat Dimension des Problems nicht begriffen. Focus. 2020/03/12. https://www.focus.de/gesundheit/news/china-experte-zu-sars-cov-19-wer-noch-ueber-fussballspielabsagen-debattiert-hat-dimension-des-problems-nicht-begriffen_id_11760541.html
23. Brost M. Horst Seehofer: Nah am Herzen. Die Zeit. 01.04.2020. https://www.zeit.de/2020/15/horst-seehofer-corona-krise-innenministerium/komplettansicht
24. Augurzky B, Bardt H, Bude H, Döhrn R, Hüther M, Kölbl O, et al. Wie wir COVID-19 unter Kontrolle bekommen 2020 updated 22.03.2020. https://www.bmi.bund.de/SharedDocs/downloads/DE/veroeffentlichungen/2020/corona/szenarienpapier-covid19.pdf?__blob=publicationFile&v=6
25. Grill M, Mascolo G. Mit effizientem Testen zum “Best Case”. ARD. 27.03.2020. https://www.tagesschau.de/investigativ/ndr-wdr/corona-strategiepapier-szenarien-101.html
26. Knobbe M. Vertrauliche Regierungsstudie beschreibt Corona-Szenarien für Deutschland. Der Spiegel. 27.03.2020. https://www.spiegel.de/politik/deutschland/corona-in-deutschland-vertrauliche-regierungsstudie-beschreibt-verschiedene-szenarien-a-1cafaac1-3932-434d-b4de-2f63bce0315d
27. Charisius H, Mascolo G, Richter N. Innenministerium dringt auf massive Ausweitung von Corona-Tests. Süddeutsche Zeitung. 27.03.2020. https://www.sueddeutsche.de/politik/coronavirus-tests-strategie-1.4858950
28. Prantner C. «2019=1919+1929»: Das deutsche Innenministerium denkt in einem Strategiepapier über Szenarien zwischen einem geordneten Krisen-Ausstieg und Corona-Aufständen nach. Neue Zürcher Zeitung. 05.04.2020. https://www.nzz.ch/international/das-deutsche-innenministerium-denkt-in-einem-strategiepapier-ueber-szenarien-zwischen-einem-geordneten-ausstieg-aus-der-krise-und-corona-aufstaenden-nach-ld.1550352
29. Connolly K. Germany told it needs to massively increase coronavirus testing. The Guardian. 02.04.2020. https://www.theguardian.com/world/2020/apr/02/germany-told-it-needs-to-massively-increase-coronavirus-testing
30. (23) Coronavirus-Update: Die Forschung braucht jetzt ein Netzwerk. NDR Info. 27.03.2020. https://www.ndr.de/nachrichten/info/23-Coronavirus-Update-Die-Forschung-braucht-jetzt-ein-Netzwerk,podcastcoronavirus164.html
31. Erst dann soll es Corona-Lockerungen geben: Das steckt hinter Merkels 10-Tages-Regel. Focus. 2020/04/01. https://www.focus.de/gesundheit/news/verdopplung-der-fallzahlen-verlangsamen-erst-dann-soll-es-corona-lockerungen-geben-das-steckt-hinter-merkels-10-tages-regel_id_11830886.html
32. https://c19early.com/. https://c19early.com/
33. Kolbl O. Can mouthwash, gargling or nasal spray/rinse (MGN) measures reduce transmission of COVID-19? An information transmission chain analysis of relevant research and media reports 2021 updated 2021/04/12. https://www.researchgate.net/publication/350819952_Can_mouthwash_gargling_or_nasal_sprayrinse_MGN_measures_reduce_transmission_of_COVID-19_An_information_transmission_chain_analysis_of_relevant_research_and_media_reports