We have been living with the pandemic for almost two years now. As everywhere in the world, its management in Quebec highlights more than ever the challenge of public decisions to be taken urgently in the face of an uncertain situation and requiring complexity. Indeed, ethics, human behavior, economy, culture, symbols, biology and microbiology are intrinsically linked in this unusual period.
However, in the media as well as in the discourse of our decision-makers, the current situation seems to challenge almost only “Science”. This is strongly mobilized in this case, which, for a good majority of the population, touches the untouchable (and the indisputable), our human life: medical science in this context takes on an almost sacred character.
The fact is dangled that this Science, which has become simple and unequivocal in public discourse and personified by a highly publicized doctor, should solve everything by a key means: the vaccine, assisted by a set of simple, even simplistic measures: “a problem + data = solutions and actions”. In this type of reasoning, the tendency is to circumscribe the problem relatively quickly and to apply immediate solutions. And if that doesn’t work, it’s because the scientist wasn’t the right one… Next!
However, as we know, this pandemic cannot be identified so simply. The global and complex issues that are specific to our advanced societies can hardly be resolved quickly with the wave of a magic wand. Admittedly, a virus has been identified, but once the first months of this unprecedented period have passed, it is clear that, regardless of its field, science is not the only one watching over the solutions to counter the epidemic. and reduce harm. The problems experienced in Quebec as elsewhere and the current management clearly show that we must go beyond SARS-CoV-2 to resolve the crisis. However, the horizon which then opens summons several gray areas of our society as well as previous “crises” which have been poorly resolved or poorly healed.
We need only mention the labor challenge, for which the lack of workers was already felt before the pandemic. Therefore, the concern to keep the economy running “as before” cannot overlook this pre-pandemic reality to which no lasting solution had been found. On another subject, quite recently, the fragility of our health care system seems to have hit us hard. Until then, we did not want to see the unspeakable! The disturbing consequence is that today, the most recent decisions reflect that it is the capacity of our health system which is now almost the only element that counts and puts us in danger… we even go so far as to allow contact with infected personnel to preserve this ability!
However, we inherit a health system in poor condition, which has come under the heavy weight of yet another reform in 2016 and which is struggling to recover from “Barrette medicine”. This system was already fragile; the pandemic has pushed it to its limits, and is holding it down: we cannot produce competent personnel, necessary equipment, local and territorial services, etc., etc. in the blink of an eye. With more than 80% of the population correctly vaccinated, the current problem of the pandemic in Quebec is not that of propagation or contagion, but rather an organizational issue, and of public governance as Emilie Nicolas rightly raises in his column “Public Dismantling 101” (The duty, January 13, 2022).
Why, then, is the only response to these structural flaws vaccination (certainly one of the pieces of the solution) and multiple individual constraints?
This approach is classic and comes from a time when the complexity of the world seemed less to us, where we cured rather than prevented and where we could still think about risk management in a vacuum, without seeing the interdependence issues.
Hide other problems
If, in the first months, the urgency was to isolate the virus, it is now to protect the hospital system! But by imperceptibly shifting the heart of the SARS-CoV-2 issue towards the health system and by placing the weight of the consequences of the crisis (of the health system rather than of the virus) on individuals, we continue to hide, in the same spirit, other structural problems and causes, which are the responsibility of politics and public administration. Without clearing individuals, is it fair to place them as solely responsible for a possible way out of the crisis?
And isn’t it simplistic to believe that vaccination — and science — will end this whole pandemic?
Placing an over-responsibility on individuals, which in the same breath makes it possible to question public policies and organizations less, is a well-known model of a neoliberal system like ours; the example of climate change, which we know well, corroborates this.
A healthy fear can therefore exist that the discourse on saving science (the vaccine) or fallible (the Dr Arruda, for example) is a rhetoric (of solution) aimed at masking causes that have nothing to do with the virus. The mad cow crisis or the tainted blood crisis are cases where science served as a screen for other imperatives and complex societal histories.
A background in social sciences is not necessary to understand that we face multiple temporalities and inextricable interrelationships. However, even if we juggle daily with a plurality of factors, the current management of the pandemic seems to ignore them, as well as uncertainty (a notion that rhymes badly with political politics). Instead, we are offered piecemeal “solutions”. But could we do a better job of naming the current crisis, of attributing it not only to a virus, but also to past errors of governance, while at the same time recognizing the complexity and the multiple causes of a phenomenon which is at the same time medical, natural and social? This learning could be useful to us collectively in anticipation of the next crises that are sure to occur, because we live in a fascinating and complex world!