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ОглавлениеRisk as a way of managing uncertainty
All societies need ways of managing the uncertainties of the future and accounting for the misfortunes of the past. In pre-modern societies, such as small-scale intimate societies or historic societies in Europe, religion and supernatural beliefs, such as those in witchcraft (Alaszewski, 2015), provided the basis for prediction of the future and allocation of blame for misfortune. In the modern high-income countries with developed health care, these systems have been (partially) replaced by rational ones, especially risk, in which human actions are based on reason and evidence. Indeed, for sociologists such as Anthony Giddens (1991), this drive towards rationality is the hallmark of modernity.
The use of risk to manage uncertainty
The emergence of risk as a framework for rational decision making can be traced back to the emergence of mercantile capitalism in the 17th century. Merchants managed the risk of shipping accidents and loss by sharing the risks through insurance. Lloyd’s of London was founded by Edward Lloyd in a coffee shop in London in 1686 and still functions as market place in which insurers pool and spread risk. The mathematical underpinning of risk, statistics and probability developed in the 17th century out of studies of games of chance and gambling (Bernstein, 1996). In the 18th century, the study and use of risk was stimulated by the Enlightenment, a social movement committed to the development of secular knowledge aiming to replace ignorance, superstition and religion with rationality based on science. In the case of risk, by observing past events it is possible to estimate the probability of such events occurring in the future and therefore make better, more rational decisions in the present (Bernstein, 1996, p. 48).
Predicting the future
One role of risk in contemporary society is as a way of reducing uncertainty by predicting and managing the future. There is a focus on the technical problems of measuring probability. In the COVID-19 pandemic a lot of attention has been given to measuring or modelling the probability of infection by the virus. Less attention tends to be paid to the other key element of risk: the different possible outcomes. This is partly because when focusing on one specific outcome, such as contracting COVID-19, the values are clear: contracting COVID-19 is a bad outcome and it is self-evident that reducing infection and ‘saving lives’ is a positive outcome. However, things become complex when choices have to be made that involve a good outcome for some individuals but a bad outcome for others.
As I will argue in Chapters 3 and 5, policy makers are more comfortable dealing with the technical aspects of risk, the numbers, but are less comfortable when value judgements have to be made.
Allocating blame
Risk can also play a role in making sense of past misfortunes. As Bernstein observed, risk and probability have ‘a double meaning, one looking into the future and the other interpreting the past’ (Bernstein, 1996, p. 48). The past and future seem different—in the past things have happened and cannot be changed while in the future nothing has happened and therefore anything can happen. However, like the concept of sin in religious societies, in modern societies risk can be used both to predict the future and to account for the failure to predict and take action to prevent danger in the past. The difference between the concept of sin and that of risk is that sin has an explicitly moral aspect while risk appears to be a more neutral; however, such neutrality disappears when blame is allocated for past failures.
Mary Douglas, a social anthropologist, reflected on the ways in which risk is used to allocate blame. She argued that before a bad event, the risk taker about to take the risk is warned but if this warning is ignored and the predicted bad event happens then the risk taker is open to blame (Douglas, 1990, p. 5). This process of blame allocation with its implications of moral failing can be seen various modern disasters. In the case of BSE/vCJD (mad cow disease and its human version) Professor Richard Lacey, a microbiologist, was a dissenting scientist whose warnings were ridiculed (BMJ, 2019). In the Bristol Royal Infirmary, where the incompetence of paediatric surgeons led to preventable child deaths, Dr Stephen Bolsin was the ostracised whistleblower (BMJ, 2016). The whistleblowers’ warnings were disregarded but they were vindicated in subsequent inquiries that used hindsight to identify and allocate blame for those who disregarded the warnings and the risk. I will examine in Chapter 7 the role which hindsight and inquiries are already playing in societal responses to COVID-19.
Other approaches to managing uncertainty
Trust and hope
Risk and rational decision making are aspirations. Individuals in modern societies, especially those in positions of power who make decisions on behalf of others, seek to legitimise their authority by claiming that their decisions are rational, based on the best possible evidence and risk assessments and will result in the best possible outcomes (see Alaszewski and Brown, 2012 for a discussion of these aspirations). However, there are a number of factors that undermine rationality and risk. Perhaps the most obvious factor is a lack of knowledge. As I will show in Chapter 2, at the start of the pandemic policy makers had to deal with the uncertainty of a new disease. Doing nothing and hoping for the best was not a justifiable option so policy makers looked for alternative sources of knowledge.
In modern societies, knowledge about complex events such as pandemics tends to be controlled by technical experts, doctors and epidemiologists. Most policy makers and most citizens are not experts and therefore depend on and have to trust experts (Alaszewski, 2003). Trust involves an element of rationality. Individuals can use different sources of information to judge trustworthiness such as their past experience, the recommendation of friends and family, evidence of qualifications or personal judgement. But trust also has an irrational element: it is essentially an act of faith. As Brown and Calnan (2012) have observed, amongst the vulnerable there is often a ‘will to trust’.
As I will show in Chapter 4, trust has played an important role in the pandemic both between politicians and experts and between policy makers and the public. In most policy systems, politicians who take on responsibility for policy making in health do not have specific expertise in health (in the UK it is unusual to have a health minister with experience of health and social care). Therefore, these politicians have to rely on scientists and medical specialists who do have this expertise. As I will show in Chapter 3, such relationships may be difficult, and indeed have an element of distrust, especially where there is a conflict of ideologies.
Trust is also an important element in the relationship between policy makers and the public, especially during a pandemic when policy makers have access to risk assessments and want to communicate them to the public so that members of the public can change their behaviours in ways that reduces individual and collective risk. I will consider in Chapter 3 how risk communication can foster or undermine trust and in Chapter 6 examine the conspiracy theories that reflect the growth of distrust in science and governments.
Trust and hope are essentially default strategies, used when there is a knowledge deficit. There are other strategies that exist alongside and can undermine or come into conflict with risk-based strategies, including faith, ideology and emotion. Faith, particularly in a system of religious belief, can conflict with risk and result in resistance to risk-based systems. Gross and Shuval (2008) have documented the ways in which ultra-Orthodox communities in Israel used medical knowledge. Given belief in divine power, members of the community were only willing to use medical knowledge if it provided certainty. ‘Knowledge had to be actual and factual, based on the existing situation, and not on the future, however predictable it may be.’ Thus, for members of this religious sect, ‘risk science which aims to imagine future situations and their probabilities is nothing but futile’ (Gross and Shuval, 2008, p. 555). During the COVID-19 lockdown in New York, the Hasidic Ultra Jewish community in Williamsburg were reported to have repeatedly broken lockdown regulations culminating in police action on 28 April 2020 to break up a large crowd that had gathered at the funeral of Rabbi Chaim Mertz. This attracted widespread media coverage (Layne and Caspani, 2020).
Limits of rationality: religion, ideology and emotion
Ideology, like religious faith, provides a way of viewing and making sense of the world and can form the basis of social movements, especially if espoused by a charismatic leader. Ideologies can be compatible and draw on risk. For example, vegans highlight the risks of eating animal products both to the individual and to the planet. Ideologies can, however, draw on the rhetoric of risk to challenge the consensus of expert opinion on risk. As I will show in Chapter 6, conspiracy theorists claimed that that there was evidence that COVID-19 was either not real or a product of specific technologies but that this evidence was suppressed.
Risk is based on calculations, the systematic use of reason based on evidence. This can be both time consuming and demanding. In everyday life, such systematic approaches are often bypassed by the use of shortcuts such as emotions, intuition and heuristics or rule of thumb. Unlike arguments based on reason and rationality, emotional appeals do not require a lot of thought or effort to understand; they can easily be converted into and communicated as slogans. Public health campaigners have used emotional appeals to foreground particular health risks to alter individuals’ behaviour by making them more aware of and anxious about these specific threats to their health. In the UK such campaigns using emotions, for example anxiety, fear and guilt, have highlighted specific dangers from new diseases such as HIV/AIDS with the 1980s’ ‘don’t die of ignorance’ campaign (Burgess, 2017) as well as the annual ‘don’t drink and drive’ campaigns that started in 1964 (The Telegraph, 2020).
The directness and simplicity of emotional appeals means that they are often used by social movements to recruit and communicate with participants. Such emotional appeals can be used in political campaigns. In the US, President Donald Trump used campaign rallies and Twitter to create and communicate with his followers. His messaging was ideological and emotional and symbols such as borders featured prominently. It created a sense of authenticity; a sense that the reader has a direct relationship with the real Donald Trump and his emotional state. Shane (2018) observed: ‘the typographical texture [of Trump’s Tweets] tells us about Trump’s personality and emotional state. It implies a speed of composition, impulsivity, and the lack of PR intervention’.
Such messaging gave Trump supporters a sense of belonging and purpose, important feelings that helped counteract the isolation and loneliness that many experience in modern societies. It also identified the dangers as phenomena outside the boundary of the social movement whether these are black rioters in US cities, Mexican drug barons or Chinese manufacturers of goods or viruses. The way to control these risks was to shut the borders to maintain the purity of those inside (Douglas, 2002). Such ideologies provided the basis for ‘alternative’ truth which, as I show in Chapter 6, played an important role in the response to the pandemic.
Comment
In this book, I will explore the ways in which countries responded to the threats of COVID-19 in 2020 and examine the ways in which different aspects of risk have shaped these responses.
