Transforming our infrastructure systems to face pandemics
Correlation Between Quality of Infrastructure and Health Security, Source: AIIB, March 2020
By Reihana Mohideen
May 24, 2020 — Links International Journal of Socialist Renewal reposted from AngMasa Para Sa Sosyalismo — In our response strategies to the COVID-19 pandemic, we are effectively undertaking a massive experiment where we disrupt our entire economy and how we work and live within it. This has implications for our health and infrastructure linked systems and social inclusion linkages.
Better health is a measure of progress in diverse dimensions of sustainable energy, cities, transport and other infrastructure systems (see Figure 1. below). Our infrastructure — including everything from mass transit systems and roads, power grids, waterways, to buildings and utilities — is intended to connect people and enable the movement and accessibility of information, goods and services. We rely on it to recover after other types of disaster. Coalescing and connecting people are what these systems were designed for. These same qualities, however, also make our physical systems vehicles for viruses. In the case of pandemics like COVID-19 this connectivity works against us by making it easier for contagions to spread — crowded subways, busy airports, concentrated retail centers, centralized workplaces, penetrating roadways.
Cities everywhere have made infrastructure innovation a priority to ensure their physical systems can remain resilient in the face of natural disasters like hurricanes and fires, but are not equipped to face biological disasters. One critical element in the preparation for and response to natural and biological emergencies is the extent, strength and resilience of the health system and healthcare infrastructure. The first systems to fail in an emergency are often essential health services at both local (primary care) and national (tertiary hospital) levels.
Responding to the pandemic
A key strategy being deployed to respond to the COVID-19 pandemic is “social distancing”. This incorporates two seemingly contradictory activities — to be physically distant, but crucially to maintain, or even increase, social contact (such as prioritising electronic communication with others) during these unprecedented times (despite the subsequent change in terminology to refer to this as “physical” distancing, this contradiction persists). Unfortunately, the response to COVID-19 has demonstrated that in many cases these systems (health, power and infrastructure) have not been able to support population connectivity and access our society depends on in the face of biological disasters. The challenges of preventing transmission of the virus, and the poor resourcing and preparation of health systems, have left front-line health workers at great risk of contracting the disease, exactly at the time when effective health services are most needed.
The COVID-19 pandemic has also brought to the fore the critical role that governments need to play, not only during periods of crises, but more generally in providing adequate and resilient services to deal with economic, health, climate-related and other emerging challenges. After decades of reducing the role of government in economic and social affairs, governments around the world in the wake of the COVID-19 pandemic have had to respond by building and rebuilding essential health infrastructure along with providing a huge economic stimulus for failing economies.
Being better prepared and learning how to become more resilient, is a more viable long-term option than waiting for disasters to occur. Much can be learned from previous epidemics, such as the Ebola crisis in Africa, and the importance of infrastructure and health systems and systems engineering for integrated solutions. Mobile network platforms, for example, provide a vital set of tools to reach communities, especially infected individuals and affected households, with life-saving information, essential commodities and financial support, and monitoring of vital information. Senegal’s Ministry of Health sent four million SMSs to the general public warning of the dangers of Ebola and how to prevent it—encouraging individuals to alert health authorities of anyone showing signs of a fever and bleeding by calling a toll-free number.
The Ebola crisis showed that ICT infrastructure is also important for real-time monitoring of outbreaks as they spread. The Centers for Disease Control and Prevention (CDC) and Liberia’s Health Ministry tracked the approximate locations of mobile phone users in West Africa who dial emergency call centers in an effort to predict the onset and spread of Ebola outbreaks. By collecting tower data from telecommunications’ providers the beginnings of an outbreak can be visualised. A spike in the number of calls could suggest a crisis. (USAID, 2014)
Beginning in South Korea, Taiwan and Singapore, many different ICT initiatives have been deployed to curb the spread of COVID-19. Known or potential patients have been tracked through their cashless transactions, including credit and debit cards, and through the location of their mobile phones. The governments have developed smartphone apps, such as South Korea’s “Self-quarantine Safety Protection” that provides GPS tracking of citizens required to be on self-quarantine; this allows them to report their symptoms and status updates. South Korea has also optimized platforms such as television broadcasts, subway station announcements, and smartphones alerts to provide endless reminders about wearing face masks, pointers on social distancing, and daily transmission data. (Penang Institute, 2020)
Principles of integration, inclusion and resilience
Preparation for disaster response requires an integrated approach that combines infrastructure, service delivery and population response initiatives. Improving the access to needed services in an emergency – transport, infrastructure, ICT, water and power, health care – means ‘building back better’ in the wake of the current crisis, removing barriers to access and building resilience and inclusion.
Related to ICT initiatives and the use of mobile phone apps, there is concern that information does not necessarily reach those most in need – these technologies may be inaccessible for some high-risk groups, and messaging is not always well targeted (South Korea provides an example of these concerns).
There are now a number of frameworks recommending universal design principles to be applied in response and recovery, including ‘resilience building’, ‘leaving no one behind’, and others.
The impact of ‘social distancing‘
The experience with social distancing has been varied, with significant challenges posed for populations in low-and-middle-income countries. Without the economic infrastructure or social security needed to support a population prevented from carrying out normal income-earning activities, poorer populations in these countries can be left destitute by lockdown procedures needed to control the pandemic. In India, where the government suddenly announced a nationwide lockdown of some 1.3 billion people on 24 March, with just four-hours’ notice, the impact on the millions of those living in poverty has been devastating. The lack of transport infrastructure and systems has resulted in millions of migrant workers being stranded, forced to leave the cities, without work, unable to pay for food and rent, and with public transport locked down, forced to walk hundreds of miles to get back home, with some dying on the journey (UN, 2020). In the Philippines, where food aid has not arrived in many urban poor communities, vendors who have been forced to break home quarantine restrictions and sell their goods have been arrested.
Invariably, the social impacts of the lockdown strategies, have gender implications. The UN has warned governments that over the past few weeks they have seen “a horrifying surge in domestic violence”, with the “combination of economic and social stresses brought on by the pandemic, as well as restrictions on movement, have dramatically increased the numbers of women and girls facing abuse, in almost all countries”.
During the pandemic, the UN has reported, for example, that in Lebanon and Malaysia the number of calls to helplines double, compared with the same month last year; in China they have tripled; and in Australia, search engines such as Google are seeing the highest magnitude of searches for domestic violence help in the past five years. Meanwhile healthcare providers and police are overwhelmed and understaffed, local support groups are paralyzed or short of funds. Some domestic violence shelters are closed and others are full. (UN News, 2020)
While gender is a critical part, the social inclusion agenda is much wider, covering disability issues along with poverty and other concerns that marginalize sections of the population. The process of lockdowns in a pandemic, for example, can negatively affect those who most need care (people with disability, people with severe health problems, isolated populations). For this reason, the UK has just relaxed lockdown procedures for families of children with intellectual disabilities (as this was having an adverse impact). For biological or climate disasters, accessibility issues include challenges of egress/evacuation and access to service during lockdown. Not all barriers are physical: sex, age and disability provide barriers in themselves, as recognized in the 2030 universal health coverage agenda.
Impact on the environment
An unintended consequence of the lockdown is the beneficial impact on air pollution in several of Asia’s polluted cities. According to India’s Central Pollution Control Board, the lockdown since March 24 has led to a dramatic improvement in air quality across large parts of India, especially the Delhi-National Capital Region, with PM10 and PM2.5 levels reduced by about 35 to 40% in Delhi. A study of 31 provincial capital cities in China, including Wuhan, the epi-center of the COVID-19 outbreak, covering the period from December 1, 2019 to March 20, 2020, with data collected on a daily basis at the city level, found that reducing air pollution can mitigate COVID-19 infections and that effective lockdown policies such as measures that reduce inter- and intra-city movements are critical for COVID-19 infection control (Yang Han and others, 2020). A study conducted by the University of Stanford Department of Earth System Science in four cities in China — Beijing, Shanghai, Chengdu, and Guangzhou – found an average daily reduction of 15-17ug/m3 PM2.5 across January and February 2020 relative to the average in the previous four years and that this had important implications for mortality rates in these cities (G-FEED, 2020).
Impact on energy demand
According to the recent data compiled by the International Energy Agency (IEA, 2020) global energy demand declined by 3.8% in the first quarter of 2020. This happened mainly in March as confinement measures were introduced in Europe, North America and elsewhere. Global coal demand declined by almost 8% compared with the first quarter of 2019. The pandemic-created decline in industry in China, where coal remains prominent, is a major factor in this. Oil demand declined by nearly 5% in the first quarter, to great degree caused by a global decline of 50% in road transport below the 2019 average and 60% in aviation. Global demand for gas declined more moderately by approximately 2%, while demand for renewables increased. Electricity demand has been significantly reduced, by more than 20% or more during periods of full lockdown in several countries. Significantly, increased residential demand has been far outweighed by reductions in commercial and industrial operations. Demand reductions have lifted the share of renewables in the electricity supply, at the expense of other sources, including coal, gas and nuclear.
According to IEA modelling global CO2 emissions are expected to decline by 8%, or almost 2.6 gigatonnes (Gt), over the year —which would reduce them to the levels of 10 years ago. This is a massive reduction — six times larger than the reduction in 2009 caused by the global financial crisis. (IEA 2020)
However, there are a number of caveats to this apparent silver lining to the pandemic crisis. First, to reduce atmospheric CO2 to a safe level, emissions need to cease. The annual emissions of 10 years ago were already leading towards catastrophic climate change. Secondly, the reductions in energy use caused by the pandemic have come at the cost of increasing poverty and hardship. Thirdly, “as after previous crises, however, the rebound in emissions may be larger than the decline, unless the wave of investment to restart the economy is dedicated to cleaner and more resilient energy infrastructure” (IEA 2020).
Despite the IEA’s optimistic predictions, according to NOAA’s Mauna Loa Observatory, an atmospheric baseline station in Hawaii, a new record-breaking reading of the concentration of carbon dioxide in the atmosphere found that the daily average of CO2 levels on May 3 was 418.12 parts per million. According to the United Nations Framework Convention on Climate Change secretariat this was “the highest ever greenhouse gas concentration in history”. The UNFCC has called for “improved national climate action plans” as being “crucial to reverse the trend”. (Common Dreams, May 2020)
But the pandemic-created fall in emissions does point to ways a more permanent and less catastrophic reduction in energy use could be achieved. The decline in emissions from aviation is a case in point. It is worth noting the role played by a historically unprecedented degree of international travel in spreading the pandemic.
Resilience and livelihood
Resilience can be understood as ‘the ability of a system, community or society exposed to hazards to resist, absorb, accommodate to and recover from the effects of a hazard in a timely and efficient manner, including through the preservation and restoration of its essential basic structures and functions.’ (UNDRR 2009)
Under ‘basic structures’ we include energy, communications, transport, water and sanitation, and public health. Power system resilience(main grid and mini-grid or individual power systems) will consider the robustness of the system, structural redundancy within the system and the intrinsic adaptability and controllability of the system. In the health sector, resilience means ‘the capacity of health actors, institutions, and populations to prepare for and effectively respond to crises; maintain core functions when a crisis hits; and, informed by lessons learnt during the crisis, reorganize if conditions require it’ (Kruk et al, 2015; Nuzzo et al, 2019). Some of the activities and assessment criteria for resilience incorporating energy infrastructure and health systems would include:
- Energy-efficient urban planning (including access to renewable energy supply) to reduce outdoor and indoor air pollution (to prevent respiratory and cardiovascular disease).
- Uninterrupted energy supply (including off-grid, renewable and back-up generation) at all health facilities (24-hour, stable, quality supply).
- Access to renewable energy solutions in homes, transport (micro-mobility vehicles, e-bikes and e-scooters) and urban facilities to facilitate social distancing strategies.
- Communications, connectivity and access to information through mobile phone and electronic devices (supported by local and renewable energy sources) to reach those most in need and high-risk groups, with appropriate targeting.
- Removal of physical barriers to access to public infrastructures (healthcare, transport, retail) to take advantage of opportunities for ‘building back better’ in response to crisis.
- Distributed healthcare and energy solutions: energy-efficient, model health sub-centres, with on-site, distributed renewable energy and other locally available resources.
- Distributed and targeted care, including access to services for elderly, disabled and isolated people and home care where needed.
- Access to adequate WASH services to facilitate community hygiene and social distancing.
Physical accessibility to economic, social, employment, infrastructure services and health facilities as well as safety, easy egress and evacuation is a crucial part of resilience. Governments around the world have by and large failed to meet this ‘resilience test’.
The pandemic crisis has illuminated the precarious livelihood of much of the world’s population. As economies shut down, governments have responded to varying degrees to the loss of livelihood, including, particularly in richer countries, increasing social security payments and paying businesses to keep workers on the pay roll. In poorer countries, the place in global supply chains is a source of problems: for example in Bangladesh’s garment industry, where companies sub-contract for brands based in richer countries and therefore are dependent on demand in these countries.
A major factor in the big increases in economic hardship and poverty in many developing countries is the predominance of the informal sector. Livelihoods derived from small-scale entrepreneurship (vendors, etc) are immediately affected by shut downs and social distancing. As such livelihoods are precarious, the loss of income affects people who will not have any savings or accumulated resources for survival. Moreover, in most countries emergency welfare and economic assistance for those experiencing loss of livelihood has not covered the informal sector. Informal sector workers have been disproportionately affected by law enforcement-based measures at enforcing social distancing and quarantines.
The pandemic has underlined the need to for economic development to create permanent, regular employment.
Labour migration is another issue illuminated by the crisis. It has played a significant role in the global spread of the pandemic, although less so than business and leisure travel. Throughout the world, closing borders and suspension of air services and shipping has left millions of migrant workers stranded. The crisis has also illustrated some of the other issues facing economies dependent on remittances from workers overseas. One is vulnerability to crises in the countries where people are working. Another is that the benefit that migrant workers bring to the countries where they work is mirrored by the absence of such benefits in their homelands. For example, the pandemic has illustrated the high number of Filipinos working in health care worldwide (in Britain, Filipinos have been disproportionately represented among front lone health workers who have contracted Covid-19) while also illustrating the inadequacies of the health system in the Philippines.
Infrastructure systems must be transformed
The COVID-19 pandemic highlights the need for a fundamental transformation in all our infrastructure systems. These changes are underway, albeit to varying degrees, in the energy and power industries generally referred to as the ‘low-carbon energy transition’. The energy transition implies that the way we produce and consume energy has to change. While the power grid is undoubtedly an astonishing scientific and engineering achievement that transformed living standards in the last century—female and male life expectancy, maternal mortality, education and more—it now has to change. The world’s power grids are becoming old, too big, unreliable, harder to control, and expensive to maintain, experiencing peak-to-average problems. They are increasingly contributing to global warming and are not suited to incorporation of distributed energy, experiencing contingency restoration problems and increasing use of constant power loads and inverters. They are also socially inequitable—they are not available to everyone and have still been unable to solve the challenges of energy access in large parts of the population in the Global South where 840 million still have no access to electricity (IEA and others, 2019). The energy transition is a response to this and is already underway, and it is also driven by technology innovation. It is a transformation from the old grid to a new one, although the features of this new grid haven’t yet been clearly defined or understood. Einstein reflected that “We cannot solve our problems with the same thinking we used to create them”. Let’s go back to over 100 years ago, to the imperatives that gave rise to our essential infrastructure industries and systems. In the case of power and electricity infrastructure the question should be posed: How come the industry took the form that it did, driven by fossil fuels and a centralized grid? Weren’t there other options that were available?
Wind energy, for example, has been used for thousands of years, from propelling boats along the Nile River as early as 5,000 BC, to 200 BC, when simple wind-powered water pumps were used in China, and windmills with woven-reed blades were grinding grain in Persia and the Middle East. By the 11th century, wind pumps and windmills were being used extensively in the Middle East for food production. Merchants and the Crusaders brought wind technology to Europe. The Dutch developed large windpumps to drain lakes and marshes in the Rhine River Delta. American colonists used windmills to grind grain, to pump water, and to cut wood at sawmills. In the late 1800s and early 1900s, small wind-electric generators (wind turbines) were also widely used. The American philosopher Henry David Thoreau commented in 1862, with insight and foreboding, “First, there is the power of the Wind, constantly exerted over the globe… Here is an almost incalculable power at our disposal, yet how trifling the use we make of it.”.
Passive solar energy has been used as a form of light and heat since early civilisation. In the 5th century B.C., the ancient Greeks designed their homes to capture the sun’s heat during the winter. Later, the Romans improved on solar architecture by using clear materials such as mica or glass, preventing the escape of solar heat captured during the day. During 19th century, inventors and entrepreneurs in Europe and the U.S. developed solar energy technologies that would form the basis of modern designs. In 1839, nineteen-year-old Edmund Becquerel, a French experimental physicist, discovered the photovoltaic effect while experimenting with an electrolytic cell made up of two metal electrodes. Later, in 1878, a solar-powered steam engine was invented by a French mathematician, August Mouchet, after receiving funding from the French government to work on an alternative source of energy. He created the first solar steam-powered plant using parabolic dish collectors. This method of creating solar energy is still used today. The French government, shortsightedly, did not provide further funding as it was deemed to be too expensive. There was enormous interest in the potential of solar energy over the following decades. Between 1880 and 1914 one estimate is that there were almost fifty articles on solar energy published in Scientific American. (Jones, Geoffrey, and Loubna Bouamane, 2012) Thomas Edison, perceptively remarked in 1931 “I would put my money on the sun and solar energy. What a source of power! I hope we do not have to wait until oil and coal run out before we tackle that.”.
As in all technology innovation under capitalism ‘investment decisions’ are made, determined by the highest possible profit margins calculated at the lowest or optimal cost. Solar and wind energy resources are renewable and were, at that time, free. Owning these resources would have posed major challenges to individual capitalists and capital in general. Coal and oil on the other hand, are a different proposition. Capital is required to extract these resources and they can be privately owned, along with the ensuing profits. The social relations under capitalism, the ownership of the means of production, especially in such underpinning and strategic industries, would have been a key consideration underlying investment decisions at the time.
The transformation of our infrastructure systems therefore need to be driven and subject to the public good and not private profits. They should be ‘social products’. This necessitates that privatization of infrastructure and their services must be done away with. They need to come under public control. They also need to be decentralised – in this case smaller is better – closer to the point of consumption.
Marx indicated that thesocial product “is intended for the common satisfaction of needs, such as schools and health services, etc.” and it’s “just” distribution will be “determined by communal needs and purposes”. However, the social relations of “just” distribution will be driven by the social relations in production, in this instance the “communal character of production [which] would make the product into a communal, general product from the outset.” (Grundrisse)
The Covid-19 pandemic has placed a massive test on the World’s social infrastructure and has forced a sudden brake on the global economy. In doing so it has illuminated a number of features of the current global system, some of which were previously obscured or ignored. These include the high level of inequality both within and between nations, but also the high level of interdependence. Access to adequate healthcare for the whole of society is necessary to stop pandemics and measures such as “social distancing” are impossible if large sections of the population are unable to comply because of lack of livelihood or housing. The experience in the pandemic of the Philippines and India, for example, demonstrates that relying purely on authoritarian measures not only creates more hardship and suffering, but is ineffective. The pandemic has also illustrated the dependence of society on the labour of people who in normal times are often invisible.
Climate change is believed to have had some direct causality in the pandemic, mainly through causing wildlife to move to areas of concentrated human population. But more significantly, the causes of the pandemic overlap with many of the factors driving climate change: unnecessary global supply chains often determined by sourcing the cheapest labour; overuse of resources inherent in production being driven by capitalist profit; wilderness destruction; rapid urbanisation; and excessive air travel for business, leisure and labour migration, among others. Global warming is the most serious manifestation of a more general collapse of the ecosystem created by the current global economic system and pandemics are a manifestation of this.
The pandemic brings into relief the reality that while the global industrial capitalist system has created historically unprecedented wealth, this form of development has exceeded the limits of what is possible within the physical constraints of the ecosystem while leaving the basic needs of a majority of the world’s population still unmet. Transition to renewable energy is essential if humanity is to retain an ecosystem that can sustain us, but by itself is inadequate. There are also competing vested interests at stake in this low-carbon energy transition – fossil fuel corporate interests, capitalist state institutions and the bureaucracies that control the ‘old grid’ – they stand in entrenched opposition to the interests and welfare of working women and men and their communities. The superiority of renewable energy compared with fossil fuels for creating decentralised grids and distributed power generation makes it ideal for economic development based on satisfying human needs and focused at the level of a communal economy — with less dependence on global supply chains both in terms of resources used and wealth created (that is a move away from development models based on satisfying supply chains for the hyper-consumerist Western economies). But this will require a ‘New Norm’ based on radical change in the priorities driving production and the economy and a total reimagining of the global economy. The science and technology is there and even propels us in this direction. Our ability to bring about this radical change will be the outcome of political struggles against the system.
Reihana Mohideen is an electrical engineer, specialising in the socio-technical modelling of renewable energy systems. She is a National Council member of the Partido Lakas ng Masa (PLM), Philippines.