46. China locked down, the West followed suit – Johan von Schreeb

Disasters happen when hazard meets vulnerability. You can either reduce the hazard, which can be difficult, or reduce vulnerability.

”We have been good at doing that, actually”, says Johan von Schreeb, professor in global disaster medicine at Karolinska Institute in Solna, Sweden.

The way Bangladesh has handled its vulnerability to floods is an excellent example.

Johan was one of the founders of the Swedish section of Doctors without Borders. His engagement has taken him to places like Haiti, West Africa, Iraq, Ukraine and Yemen. Last fall he was deployed in Lebanon by WHO as a coordinator.

He soon learned that when disaster strikes, the help from the outside world is often irrational. International medical teams are deployed in disaster areas without really understanding the context. Countries send field hospitals more as a knee-jerk reaction than as a well-thought-out measure.

After the bomb blast in Lebanon in August last year it quickly became clear that there was no need for trauma care.

”But an Italian military field hospital arrived a whole month after the blast, ready to treat trauma patients. It was almost an insult”, says Johan.

Some disasters are more ”popular” than others in the eyes of outside helpers. After earthquakes aid organizations are lining up. After violence in the Central African Republic or outbreaks of disease in Sub-Saharan Africa, not so much.

The pandemic has been a complex mixed bag of rational and irrational measures, knee-jerk reactions and psychology. Sweden’s ”softer” strategy has been debated.

”I don’t think we understand the degree of liberty we have been able to maintain here in Sweden, not having to meet a policeman on the street corner issuing a fine of 1,000 euros because you’re out walking”, says von Schreeb.

”I guess it relates back to trust.”

We’ve had pandemics before but never this kind of harsh measures. Why now?

”Because China started”, concludes Johan von Schreeb.

”They contained it and they were quick, and to go against what the Chinese did would have been very difficult for a lot of countries. The politicians wanted to do something. And people were scared. Even in a country like France, where people often protest, people seemed to accept these measures.”

”There are opportunities to control populations by using this type of fear, and that is the scary part. You can justify these kinds of measures. Especially in countries where we have had riots for political reasons. I saw that in Lebanon.”

However, except for a few countries, we have managed to expand the health care system to cope, says Johan von Schreeb.

”Like in Sweden: we never needed to use the emergency field hospitals that were set up.”

The strict covid measures have arguably been more detrimental to public health than the coronavirus itself in parts of Africa. On that continent, only health workers and the vulnerable should be vaccinated, Johan says.

”But the rest … vaccinating children in Africa would not be the wisest thing to do. For the young this is not a major issue. If all are vaccinated there is no money left, and there is so much else to do in the health system.”