It’s possible that I shall make an ass of myself. But in that case one can always get out of it with a little dialectic. I have, of course, so worded my proposition as to be right either way (K.Marx, Letter to F.Engels on the Indian Mutiny)
Monday, August 09, 2021
Using AI to predict suicidal behaviours in students
Algorithm shows self-esteem is one of four major predictors of suicidal behaviours
How can we predict suicide risk in students, especially at a time when the COVID-19 pandemic has negatively affected many people’s mental health? According to researchers from Montreal and France, self-esteem represents an important predictive marker of suicidal risk. The team from McGill University, University of Montreal, Inserm, and Université de Bordeaux is using artificial intelligence to identify factors that accurately predict suicidal behavior in students.
“Suicide is the second leading cause of death among 15- to 24-year-olds. Early detection of suicidal behaviours and thoughts is the key to providing appropriate treatment,” says lead author Mélissa Macalli, a PhD Candidate at University of Bordeaux.
Published in Scientific Reports, their analysis is based on data collected from over 5,000 university students in France who were followed for at least one year between 2013 and 2019. The study shows that out of 70 potential predictors, four detect around 80 percent of suicidal behaviours at follow-up. These are suicidal thoughts, anxiety, depressive symptoms, and self-esteem.
AI identifies main predictors of suicidal behaviours
Using machine learning, the researchers simultaneously analyzed the many factors associated with suicidal risk and ranked them according to their importance in predicting suicidal behaviours. These factors included sociodemographic data, lifestyle, substance use, childhood trauma, and personal and family history of suicidal behaviours.
“Many known factors can contribute to the increased risk in university students, such as the transition from high school to college, psychosocial stress, academic pressures, and adapting to a new environment. These are risks that have also been exacerbated by the health crisis triggered by the COVID-19 pandemic, although there is no clear evidence of an increase in suicide rates during the pandemic,” says co-author Massimiliano Orri, a Postdoctoral Fellow at McGill University with the McGill Group for Suicide Studies and at University of Bordeaux.
Opening the door to large scale screening
The students completed two surveys, one at the time of enrollment in the study and the other a year later, providing researchers with critical information about their health, drug and alcohol use, medical and psychiatric history, and their psychological state. This follow-up survey revealed that approximately 17 percent of the participating students, both women (17.4 percent) and men (16.8 percent), exhibited suicidal behaviours in the year elapsing between the two questionnaires.
“This research opens up the possibility of large-scale screening by identifying students at risk of suicide using short, simple questionnaires, in order to refer them to appropriate care,” explains senior author Christophe Tzourio, a Professor of epidemiology at Université de Bordeaux and Director of the Bordeaux Population Health research center. Such screening tools could provide an alternative to mental health assessments by a physician for students who are often reluctant to disclose sensitive personal information in face-to-face interactions.
Self-esteem: a previously unrecognized predictor
According to the researchers, self-esteem represents an important predictive marker of suicidal risk and should therefore be used in screening tools, even among students that do not show signs of suicidal behaviours.
In secondary analyses of 3,946 students that did not exhibit suicidal behaviours, the primary predictors that stood out for men was self-esteem. For women, they were self-esteem, depressive symptoms, and academic stress.
Low self-esteem is known to be a part of social anxiety, and to overlap with depression. Self-esteem, which is an important marker of psychological vulnerability in young adults has also been associated with suicidal thoughts. “Our study showed that self-esteem is an independent and prominent predictive marker,” say the researchers.
“The mental health specialists on our teams did not expect self-esteem to be one of the top four predictors of suicidal behaviours,” says Mélissa Macalli. “This finding would not have been discovered without the use of machine learning, which makes it possible to analyze a large amount of data simultaneously. This opens up new avenues for both research and prevention,” she concludes.
THE IRONY IS THAT SCHOOL REFORM FROM THE RIGHT
DECRIES SELF ESTEEM AS A LIBERAL CULTURAL
BUG A BOO
About this study
“A machine learning approach for predicting suicidal thoughts and behaviours among college students” by Mélissa Macalli, Marie Navarro, Massimiliano Orri, Marie Tournier, Rodolphe Thiébaut, Sylvana M. Côté and Christophe Tzourio was published in Scientific Reports.
New research published today in the Journal of Epidemiology and Community Health has found that education and employment experiences in early adulthood contribute to cardiovascular health inequalities in later life, independent of occupation and family income in mid-adulthood.
There are important differences in health between different sectors of our society, with those who are less educated and in lower status jobs shown to be less healthy and have shorter life expectancy on average than the more privileged. While early adulthood is an important time for both the development of adult socioeconomic position and for development of behaviours related to cardiovascular health, until now the degree to which early adulthood socioeconomic trajectories contribute directly to health differences observed in later life has not been clear.
Researchers from the University of Cambridge, University of Bristol and UCL Social Research Institute analysed health and socioeconomic data collected over several decades from over 12,000 members of the 1970 British Birth Cohort, to determine the contribution of early adulthood to differences in cardiovascular health in mid-adulthood. The scientists used a data-driven method to divide the population into different socioeconomic trajectory groups based on their participation in education, different job types, unemployment or economic inactivity across early adulthood (ages 16-24). They studied the association of these groups with cardiovascular risk factors at age 46, including blood pressure, cholesterol levels, waist circumference. To determine if the association of early adulthood socioeconomic trajectories with cardiovascular health was mediated by socioeconomic status later in life, they examined how correcting for occupation or family income at age 46 affected the link.
Professor Kate Tilling from the MRC Integrative Epidemiology Unit at the University of Bristol, and senior author on the paper, said: “Measuring socioeconomic position in early adulthood has always been difficult as this is a period of transition when most people’s occupations change over time. The method we’ve developed provides a flexible way to identify early adulthood socioeconomic position, and we hope that it will be used in future to answer other research questions related to this period of life.”
The researchers found that those who spent a longer time in education, going on to employment in professional or managerial roles during early adulthood, had better cardiovascular health more than 20 years later (at age 46) than other groups. Importantly this association wasn’t entirely because of a higher income or higher level job at age 46, suggesting an independent and long-term association of early adulthood influences with health.
The findings indicate that that material factors in mid-adulthood do not contribute to the pathway through which early adulthood socioeconomic trajectory affects mid-life health, and the authors suggest that the development of health behaviours or psychosocial factors such as stress, depression, and job control in early adulthood may play an important role.
Dr Eleanor Winpenny from the MRC Epidemiology Unit at the University of Cambridge, and first author on the paper, said:
“We found that an individual’s education and employment experiences in early adulthood had a far larger impact on measures of cardiovascular health more than twenty years later than their occupation or income at that time did.
These results suggest that we need to provide more support for young adults to allow healthy development into middle age and prevent disease in later life. Given the added disadvantage to young adults as a result the current coronavirus pandemic, there is an urgent need to understand and mitigate the effect these circumstances may be having on their future health”.
The research was funded by the Medical Research Council and the Centre for Diet and Activity Research (CEDAR), a UKCRC Public Health Research Centre of Excellence. Funding from the British Heart Foundation, Cancer Research UK, Economic and Social Research Council, Medical Research Council, the National Institute for Health Research, and Wellcome, under the auspices of the UK Clinical Research Collaboration.
Reference
Winpenny, E. et al. Early adulthood socioeconomic trajectories contribute to inequalities in adult cardiovascular health, independently of childhood and adulthood socioeconomic position. Journal of Epidemiology and Community Health 2021; 6 Aug 2021; DOI:10.1136/jech-2021-216611
The MRC Epidemiology Unit is a department at the University of Cambridge. It is working to improve the health of people in the UK and around the world. Obesity, type 2 diabetes and related metabolic disorders present a major and growing global public health challenge. These disorders result from a complex interplay between genetic, developmental, behavioural and environmental factors that operate throughout life. The mission of the Unit is to investigate the individual and combined effects of these factors and to develop and evaluate strategies to prevent these diseases and their consequences. www.mrc-epid.cam.ac.uk
About the University of Cambridge
The University of Cambridge is one of the world’s top ten leading universities, with a rich history of radical thinking dating back to 1209. Its mission is to contribute to society through the pursuit of education, learning and research at the highest international levels of excellence.
The University comprises 31 autonomous Colleges and 150 departments, faculties and institutions. Its 24,450 student body includes more than 9,000 international students from 147 countries. In 2020, 70.6% of its new undergraduate students were from state schools and 21.6% from economically disadvantaged areas.
Cambridge research spans almost every discipline, from science, technology, engineering and medicine through to the arts, humanities and social sciences, with multi-disciplinary teams working to address major global challenges. Its researchers provide academic leadership, develop strategic partnerships and collaborate with colleagues worldwide.
The University sits at the heart of the ‘Cambridge cluster’, in which more than 5,300 knowledge-intensive firms employ more than 67,000 people and generate £18 billion in turnover. Cambridge has the highest number of patent applications per 100,000 residents in the UK.
About the MRC IEU The MRC Integrative Epidemiology Unit (IEU) at the University of Bristol conducts some of the UK's most advanced population health science research. It uses genetics, population data and experimental interventions to look for the underlying causes of chronic disease. The unit exploits the latest advances in genetic and epigenetic technologies. We develop new analysis methods to improve understanding of how our family background, behaviours and genes work together. Using these to investigate how people develop and remain healthy or become ill. www.bristol.ac.uk/integrative-epidemiology/
About the Medical Research Council
The Medical Research Council is at the forefront of scientific discovery to improve human health. Founded in 1913 to tackle tuberculosis, the MRC now invests taxpayers’ money in some of the best medical research in the world across every area of health. Thirty-three MRC-funded researchers have won Nobel prizes in a wide range of disciplines, and MRC scientists have been behind such diverse discoveries as vitamins, the structure of DNA and the link between smoking and cancer, as well as achievements such as pioneering the use of randomised controlled trials, the invention of MRI scanning, and the development of a group of antibodies used in the making of some of the most successful drugs ever developed. Today, MRC-funded scientists tackle some of the greatest health problems facing humanity in the 21st century, from the rising tide of chronic diseases associated with ageing to the threats posed by rapidly mutating micro-organisms. The Medical Research Council is part of UK Research and Innovation. https://mrc.ukri.org/
DOI
10.1136/jech-2021-216611
METHOD OF RESEARCH
Observational study
SUBJECT OF RESEARCH
People
ARTICLE TITLE
Early adulthood socioeconomic trajectories contribute to inequalities in adult cardiovascular health, independently of childhood and adulthood socioeconomic position.
ARTICLE PUBLICATION DATE
5-Aug-2021
COI STATEMENT
None declared
Chasing the light from elusive ‘milky seas’: CSU researchers light a path toward unraveling mysteries of the ocean from space
IMAGE: A COMPARISON OF PHOTOS TAKEN BY OLDER SATELLITE INSTRUMENTS (LEFT) WITH IMAGERY FROM THE NEW DAY-NIGHT BAND (DNB) INSTRUMENT (RIGHT).view more
CREDIT: CSU/CIRA AND NOAA/NESDIS
Using nearly a decade of satellite data, researchers at Colorado State University have uncovered “milky seas” in a way they’ve never been seen before – a rare and fascinating oceanic bioluminescent phenomenon detected by a highly sensitive spaceborne low-light sensor.
Milky seas are an elusive and rare display of bioluminescence in the Earth’s ocean, and the largest known form on our planet. Distinct from turbulent froth created by wakes of ships, milky seas achieve a long-lived, widespread, and uniform glow in the ocean’s surface that can persist for several nights, and span more than 100,000 square kilometers (almost 39,000 square miles) – about the size of the state of Kentucky.
Mariners experience these extraordinary conditions only in certain remote areas of the world—mainly in the northwest Indian Ocean offshore of the Horn of Africa, and in the waters surrounding Indonesia. Predicting when, where, and why milky seas form remains a modern-day scientific mystery.
The mysterious glow
Surreal descriptions of the fabled “milky sea,” which eyewitnesses say glows as bright as a snow field or a bed of clouds, has been shared among mariners throughout history, said Steve Miller, CIRA’s incoming director and lead author on the Scientific Reports paper. These stories found their way into seafaring adventure novels like Moby-Dick and Twenty Thousand Leagues Under the Sea, taking their place in folklore, but not so much in scientific observation.
In more than 200 recorded sightings dating back to the 19th century, only once, in 1985, did a research vessel sail through a milky sea. The water sample collected at the time suggested a strain of luminous bacteria, colonizing a bloom of algae at the water’s surface, created the glow. Some of the features of milky seas, however, are not adequately explained by this hypothesis – especially in the face of eyewitness accounts.
Bolstered by new observations from space, researchers are now positioned to understand much more about the circumstances of this fascinating phenomenon. From far above the world’s oceans, the Suomi NPP and NOAA-20 satellites collect imagery using a sophisticated suite of sensors, including the “Day/Night Band” instrument. The Day/Night Band detects very faint amounts of visible light at night, and peers through the darkness to reveal the glow of city lights, the flames of forest fires, and much more – including, now, the ability to see milky seas.
“The Day/Night Band continues to amaze me with its ability to reveal light features of the night. Like Captain Ahab of Moby-Dick, the pursuit of these bioluminescent milky seas has been my personal ‘white whale’ of sorts for many years,” Miller said.
Catching the light
By carefully analyzing Day/Night Band observations from three locations where milky seas are often reported, Miller and his team located 12 occurrences of this elusive phenomenon between 2012 and 2021.
Catching the light created by milky seas requires patience – and the right conditions. Even faint moonlight reflecting off the ocean’s surface can mask the signal. Light emitted by the glowing upper atmosphere, both directly upward and as reflected by the clouds, can likewise contaminate observations. Researchers carefully analyzed signals in the satellite data to rule out other sources of light emission, and used sophisticated techniques to find the persistent bioluminescent structures emitting light beyond the background noise.
Appearing as a persistent glowing patch on the ocean at night, these glowing bodies of water move with ocean currents. Disappearing from view during the day – due to the overwhelming amount of light from the Sun compared to the faint glow from the ocean – these patches become visible again to the satellite.
Coupling the satellite observations with measures of sea surface temperature, marine biomass, and the analyzed sea surface currents have led the authors to pose new hypotheses for the unique conditions surrounding milky sea formation.
“Milky seas are simply marvelous expressions of our biosphere whose significance in nature we have not yet fathomed,” Miller said. “Their very being spins an unlikely and compelling tale that ties the surface to the skies, the microscopic to the global scales, and the human experience and technology across the ages; from merchant ships of the 18th century to spaceships of the modern day. The Day/Night Band has lit yet another pathway to scientific discovery.”
IMAGE: PURPLE SULFUR BACTERIA IN FRESHWATER LAKE CADAGNO (UPPER PANELS, IN GREEN AND PURPLE), AND THEIR SINGLE-CELL NITROGEN FIXATION ACTIVITY MEASURED WITH NANOSIMS (LOWER PANELS, WARM COLORS INDICATE HIGH ACTIVITY).view more
CREDIT: MAX PLANCK INSTITUTE FOR MARINE MICROBIOLOGY/M. PHILIPPI
Nitrogen is vital for all forms of life¬: It is part of proteins, nucleic acids and other cell structures. Thus, it was of great importance for the development of life on early Earth to be able to convert gaseous dinitrogen from the atmosphere into a bio-available form – ammonium. However, it has not yet been clarified who carried out this so-called nitrogen fixation on early Earth and with the help of which enzyme. Now, researchers at the Max Planck Institute for Marine Microbiology in Bremen have shown that under similarly barren conditions as in the Proterozoic ocean, a previously underappreciated group of bacteria can fix nitrogen very efficiently.
A “small Proterozoic ocean” in the Swiss Alps
Since the Proterozoic ocean can hardly be studied directly, the researchers Miriam Philippi and Katharina Kitzinger from the Max Planck Institute in Bremen and colleagues substituted it with a comparable modern-day habitat: The alpine Lake Cadagno in Switzerland. Unlike most other lakes, Lake Cadagno is permanently stratified, meaning that the upper and lower water layers do not mix. Purple sulfur bacteria inhabit the transition zone between the upper, oxygenated layer and the lower, oxygen-free and sulfidic layer. There, they carry out photosynthesis and oxidize sulfur. “The discovery of fossils of this group of microorganisms shows that they already lived on our planet at least 1.6 billion years ago, during the Proterozoic eon,” said Philippi, first author of the study. “Hence, this lake and these bacteria represent a system that resembles the Proterozoic ocean in many aspects.” Therefore, it is so well-suited for learning more about the processes on early Earth.
Purple sulfur bacteria fix nitrogen
Using a combination of biogeochemical and molecular analyses, Philippi and colleagues discovered that the purple sulfur bacteria in Lake Cadagno fix nitrogen very efficiently. Nitrogen fixation is the conversion of nitrogen gas, which is not very reactive, into nitrogen compounds that many organisms can use, for example algae. “To our knowledge, this is the first direct evidence of nitrogen fixation by purple sulfur bacteria in nature,” explained co-author Katharina Kitzinger. “We discovered that they use the most common enzyme in present-day, molybdenum nitrogenase, to do so. Although this enzyme is not rare, we were very surprised to find it in Lake Cadagno.” This is because there is only very little molybdenum in the water – just as in the Proterozoic ocean, which has led researchers to believe that non-molybdenum nitrogenases prevailed on early Earth. “Now we know that molybdenum nitrogenase works very efficiently, even at low molybdenum concentrations.”
“We thus provide the first indication that purple sulfur bacteria may have been partly responsible for nitrogen fixation in the Proterozoic ocean,” Philippi continued. “Until now, it was generally assumed that cyanobacteria carried out most of the nitrogen fixation then. We show that the role of purple sulfur bacteria in this process was likely underestimated.”
CAPTION
Salty springs at the lake bottom prevent mixing, resulting in a stable stratification. The upper meters contain oxygen but little nutrients. The lower layer is anoxic and rich in sulfide, creating a stable intermediate layer with steep concentration gradients of oxygen and sulfide. Here, the purple sulfur bacteria use solar energy to oxidize sulfide – and fix nitrogen.
CREDIT
Miriam Philippi
JOURNAL
Nature Communications
ARTICLE TITLE
Purple sulfur bacteria fix N2 via molybdenum-nitrogenase in a low molybdenum Proterozoic ocean analogue.
IMAGE: A MOUNTAIN LION ON A BLUFF OVERLOOKING LOS ANGELES. BY TRACKING THE WHEREABOUTS OF 12 MOUNTAIN LIONS BEFORE AND DURING THE COVID-19 PANDEMIC, ECOLOGISTS HAVE FOUND THAT THE RECLUSIVE SPECIES, BRIEFLY FREED OF THE NEED TO AVOID PEOPLE, ADOPTED AN ENERGY-EFFICIENT ECONOMY OF MOVEMENT DURING LA'S SHUTDOWN IN SPRING 2020.view more
CREDIT: NATIONAL PARK SERVICE
As people sheltered in place at the onset of the COVID-19 pandemic, sightings of wildlife in urban areas helped spawn a meme, “Nature is healing,” that reflected an intuitive belief: Carnivores were stretching their legs, and their ranges, by expanding into long-lost territory.
But new research from the University of Nebraska–Lincoln and National Park Service shows that mountain lions in Greater Los Angeles, when briefly spared the proximity of people, instead responded with an economy of movement that also reveals the costs of living near them.
“We saw a potential silver lining with COVID, which obviously has been generally a negative thing for everyone,” said John Benson, the study’s lead author and assistant professor of vertebrate ecology at Nebraska. “We saw an opportunity to get a better sense of how human disturbance and human activities influence animal behavior.”
Over a 43-day span that stretched from late March to early May of 2020, GPS-collared mountain lions in and around Los Angeles actually occupied smaller territories, and generally moved less, than they did before the pandemic. That span coincided with a statewide stay-at-home order and the closing of most parks around LA, including those favored by the famously reclusive species.
“There was this popular perception that animals were going to start running free, expanding their home ranges, moving greater distances, colonizing cities, coming into areas where they didn’t used to be,” Benson said. “But that goes against theory — the theory that animals should move as efficiently as possible.
“It actually makes sense that when you don’t have to dodge around as many humans, you could use the landscape more efficiently. Without humans, you don’t have to take a circuitous route to get from one place to another.”
The team tracked 12 mountain lions that had previously been collared with GPS locators by Jeff Sikich and Seth Riley of the National Park Service. Depending on the individual animal, those collars had already yielded between one and eight years of pre-pandemic data. That allowed the team to compile a distribution of past 43-day windows against which to compare the mountain lions’ space use and movement in the 43 days of spring 2020.
The researchers discovered that the home ranges of four resident mountain lions shrank considerably during the early days of the pandemic. After recording the locations of three mountain lions every two hours, the team also found that they were generally traveling shorter distances — in some cases, half or even a third as much as they did prior to the pandemic.
That matters, Benson said, because it helps quantify just how much energy mountain lions in Greater Los Angeles are expending to avoid people — energy they need to hunt for prey and search for mates. Though LA ranks as the largest metropolitan area in North America to house a wild felid of the mountain lion’s size, the 12 animals tagged by the research team probably represent a relatively sizable proportion of those still remaining there. A population that small is in danger of going locally extinct, he said, with any stressors taking ever-greater tolls as the population declines.
“Any additional stressor — like needing to modify your movement patterns, which could come with a cost of finding prey, getting enough to eat, mating, whatever it is — could be the stressor that tilts the balance toward the extinction process,” Benson said.
The beginning of the pandemic also presented a unique opportunity to tease apart whether wildlife is still motivated to avoid human infrastructure even when its builders have largely abandoned it, at least for a short while.
“People call it the ‘human footprint,’” Benson said. “We thought, ‘Here’s a chance to take the foot out of the footprint and see what animals are responding to.’”
CAPTION
With the ability to climb trees and an evolutionarily honed ability to hide, mountain lions are adept at avoiding humans. By tracking the whereabouts of 12 mountain lions before and during the COVID-19 pandemic, ecologists have found that the reclusive species, briefly freed of the need to avoid people, adopted an energy-efficient economy of movement during LA's shutdown in spring 2020.
CREDIT
National Park Service
So the team, which included Virginia Tech’s Heather Abernathy, decided to investigate how frequently mountain lions crossed park trails and major roads, including freeways, before versus early in the pandemic. As expected, a sample of seven mountain lions did crisscross the park trails more often in spring 2020, signaling that the presence of humans was, in fact, the main deterrent.
But a sample of 10 mountain lions continued avoiding primary and even intermediate-sized roads, despite a documented drop in traffic. Why the disparity? For starters, Benson said, the potential penalty for encountering foot traffic is much lower than it is for vehicle traffic. The team also suspects that the latter, though lower than usual, remained daunting enough to keep the mountain lions at bay. That was especially likely on Interstate 405, one of the busiest U.S. freeways and one that has historically acted as a hard border on the home ranges of neighboring mountain lions.
“The fact is that the roads in Southern California, especially big roads like freeways, are major barriers to movement for all kinds of wildlife, including mountain lions,” said Riley, also an adjunct faculty member at the University of California, Los Angeles. “The traffic was reduced, certainly, but there was still plenty of use occurring, and the barrier effect doesn’t just disappear.”
One of the tracked mountain lions, surrounded by busy freeways on three sides, occupies what may be the smallest home range ever recorded for an adult male: about 8 square miles, a fraction of the roughly 150 square miles enjoyed by a typical counterpart. Benson said the case study illustrates a paradox that makes sense in the light of theory: a carnivore, already confined to an artificially small range by human disturbance, choosing to occupy an even smaller range when that disturbance abates.
Human-created boundaries, and the effort that mountain lions exert to avoid the people dwelling within them, might be exacerbating human-wildlife conflicts in equally paradoxical ways. Avoiding people is necessary and good to some extent, Benson said, given that “bad things usually happen when we get annoyed by mountain lions.” Yet the energy they expend to do so might ironically increase human-wildlife conflict, he said, if high energy demands are leading them to seek additional food sources.
“This idea of coexistence — that if they stay out of our way, everyone’s happy — maybe it’s not that rosy,” he said, “if it causes them to burn more energy and then potentially makes them more likely to actually attack livestock or pets. This is not something we documented or investigated with our current study, but it would be an interesting hypothesis to test with future research.
“Does it have unintended consequences that we can’t control? I think that may be a good thing to look at and re-evaluate.”
The researchers reported their findings in the journal Ecological Solutions and Evidence.
JOURNAL
Ecological Solutions and Evidence
SUBJECT OF RESEARCH
Animals
ARTICLE TITLE
Mountain Lions Reduce Movement, Increase Efficiency During the Covid-19 Shutdown
ARTICLE PUBLICATION DATE
6-Aug-2021
Why lockdown in Africa does not work as a first COVID-19 pandemic response
IMAGE: DURING BETTER TIMES, AFRICAN COUNTRIES CAN IMPLEMENT SOCIAL MEASURES, FOLLOWED BY OTHER NON-MEDICAL INTERVENTIONS AT THE START OF A PANDEMIC, RATHER THAN LOCKDOWNS AS A FIRST RESPONSE, SAYS PROFESSOR NICHOLAS NGEPAH. HIS STUDY OF SOCIAL MEASURES THAT CAN CONTAIN THE SPREAD OF A PANDEMIC, INCLUDED ECONOMIC DATA FROM 53 AFRICAN COUNTRIES INCLUDING SOUTH AFRICA. THE FIRST RECORDED CASE IN EACH COUNTRY TO 4 JANUARY, 2021 WERE INCLUDED.view more
CREDIT: THERESE VAN WYK
In an African pandemic it is more productive to consider lockdowns, after using other non-medical measures first, Especially in countries with high levels of poverty and corruption, says Prof Nicholas Ngepah, a Professor of Economics at the University of Johannesburg in South Africa.
Looking at the socio-economic conditions of African countries, we can see reasons for this, he says.
“What has happened during COVID-19 is that people get locked down by strict regulations. But the majority don’t have the nutrition, basic economic opportunities and infrastructure to cope. It becomes almost impossible for a poor person to keep the rules of the lockdown.
“The rules are very strict, but people will contravene them. They will be willing to fight with public order policing to get their livelihoods going.”
This is the experience in South Africa and many other African countries, he says. The poorest are most conflicted with lockdown regulations.
Ngepah’s research titled “What lessons Africa can learn from the social determinants of COVID-19 spread, to better prepare for current and future pandemics on the continent” is published in a special issue of African Development Review.
The study is based on data from 53 African countries including South Africa. The first recorded case in each country to 4 January 2021 was included.
The latest pandemic
“The rich and the middle class would appear to comply well with lockdowns. But this is because they are able to rush to the shops and empty them. Poor people cannot empty shops because they don’t have money.
“Rich people have resources to keep going, so their desperate actions only show much later. With poor people, their desperation shows immediately, because they have no reserves to fall back on.”
“When a large part of your population is on the wrong end of inequality, it follows that many will not trust state machinery.
“If in good times, the state was not taking care of poor people, and now in bad times it comes along with very strict rules… it doesn’t work. The poor need good services, support and infrastructure before pandemics hit.”
The desperation during a pandemic lockdown has implications, he says. Governance and political stability are affected.
“It’s intuitive. If you are constrained without an alternative means of survival, you will end up revolting.”
Another reason the poor are unlikely to obey strict lockdowns, is corruption.
With high levels of corruption, impoverished workers feel they are asked to pay for the corruption of the rich in government, he says.
In South Africa, COVID-19 is the latest arrival in a long line of challenges. The country has pandemic levels of inequality, poverty, corruption, unemployment, and HIV/AIDS.
Poverty and spread
Quality policymaking is crucial in dealing with current and future pandemics, he says.
“In my view, the need to better take care of the poor has not been driven home in many policymakers’ minds yet, despite the COVID-19 pandemic,” says Ngepah.
“Economic deprivation by itself has a positive relationship with the spread of disease and mortality.
"In good times, poverty reduction policies should be taken seriously. Because poverty directly influences how successful stringency measures will be.
"Poverty also influences to what extent sanitation services will limit the spread of the disease.
“It also directly influences the rate of internal population dynamics, or internal migration. This is where the rural poor flee to the cities for economic opportunities – and create dense, very poor neighborhoods,” he says.
In South Africa, the ‘townships’ which receive these people, often do not have adequate water, power or sanitation services.
To slow the spread of the COVID-19 and future pandemics, African policymakers and governments need use social and economic measures available to them. These non-medical interventions can be very effective, he says.
Public capacity for testing
Firstly, enhance public health capacity for effective, swift testing for the pandemic disease so that cases are isolated early enough to deal with. This will limit spread and mortality.
Economic health of the most constrained
Secondly, before thinking about stringent lockdowns, first check the economic health of your population. Make sure that the basic capacities are in place, for them to be able to cope during the period of lockdown, he says.
“For a country with high levels of inequality like South Africa, you can’t just wake up in the morning, declare lockdown and send soldiers and police to try and enforce it, without checking first how the more deprived people are living. Especially in South Africa where we know that more than half the population is living below the poverty line.”
Thirdly, managing the international border swiftly is most important to limiting spread.
“Managing the border is about being able to foresee a problem and act before the pandemic spreads into communities. You need to close borders early, while quarantine measures will still work. This gives you breathing space to deal with internal issues before lockdown. It also creates time for the poor to prepare as best as they can with the very constrained resources they have.
“For example, before lockdown you would already put safety nets in place to say this is how we will cater for the poor during that time. As opposed to what’s happening here, where the poor are crying,” he says.
Quality services where most need is
Then in the medium and longer term, management of internal population dynamics is crucial. This can limit the growth of extremely poorneighborhoods which are ideal for the spread of any pandemic.
If poor people have services, jobs and good infrastructure where they are, the motivation to move into a disadvantaged area closer to a big city is lower.
“It is about pro-poor infrastructure and decentralization. It isn’t just about bringing key public services into poor neighborhoods. It is also about moving and redistributing government services so that they are closer to the majority of those who are most in need of them.”
As an example, currently a district police headquarters may be in a well-to-do suburb, with a badly resourced satellite station in a township. Ngepah suggests doing the opposite.
Put the well-resourced police headquarters in the township, where the majority who need it, are close by. The rich and middle class can go online or drive 30 minutes in their cars because physical proximity is often not a barrier for them, he says.
Sanitation infrastructure and services
Sanitation is probably the most important non-medical aspect of infrastructure before and during a pandemic, says Ngepah.
“On one hand, it is about habits. Most people learned about proper washing of hands during the pandemic. During good times, the government should prioritize this as something important. This pandemic came, but it is not the first communicable disease outbreak that we have had,” says Ngepah.
The second aspect of sanitation is the infrastructure.
“Don’t say wash hands and give all the lessons about handwashing - when the tap is not flowing, when there are no services relating to sanitation.”
The actual role of alcohol in the pandemic
In South Africa, debates have raged about the role of alcohol and social interaction in spreading COVID-19. But Ngepah says that managing internal population dynamics is more important than the issue of alcohol itself. This is because internal migration creates impoverished neighborhoods with bad or no services.
“If you ban alcohol, without checking the role of alcohol in the whole equation, you might not be getting the right result. Before you ban alcohol, check what the channel of transmission is. The channel of transmission of the corona virus pandemic is the socializing with alcohol, rather than alcohol by itself.
“When we are talking about spread, the real question is, how does alcohol spread the disease? My view, which is not proven in this study, but it is in line with other research, is that your social interaction route is important.
“Because we are trying to balance restraining COVID with the health of the economy and job losses. So we have to look at private alcohol consumption versus social alcohol consumption, before making decisions,” he says.
Support to small businesses, relaxation of labor laws
Most economies have seen job losses and rising unemployment during the pandemic. Small businesses, which have much lower reserves than large ones, have been hard hit in South Africa.
“Liquidity support to small business is paramount as a first measure to keep them afloat and prevent job losses,” says Ngepah.
“At the same time, in the context of high unemployment, we should be less stringent with small businesses when it comes to labor laws. Because small businesses usually have very thin margins. And if they have to employ more people, we have to have some trade-offs.
“Before COVID-19, the government had been trying to pilot a program to assist. They intervene by giving some resources to companies in exchange for skills development on the job. These are the things government should be thinking about to ease the burden of the wage bill in small enterprises in South Africa,” he says.
The most efficient way of managing pandemics is to get a handle on economic deprivation, he adds. Especially for a national or city government with the majority living in poverty,
Ngepah concludes: “Take care of the poor all the time, so they are well placed to obey you when you put rules in place. If this is done in normal times, then we will stress less during pandemics.
"In the military, they say that those who stress in times of peace to prepare themselves, will bleed less in times of war.”
JOURNAL
African Development Review
DOI
10.1111/1467-8268.12530
METHOD OF RESEARCH
Data/statistical analysis
SUBJECT OF RESEARCH
People
ARTICLE TITLE
What lessons Africa can learn from the social determinants of COVID-19 spread, to better prepare for current and future pandemics on the continent
