After listening to medical doctors in Kenya during this pandemic period, I am convinced that they only understand the craft of treating the public health emergency but when it comes public policy, these posh and serious folks are just hedgehogs.
Unlike foxes who know many things, hedgehogs focus on a single outcome and and cannot imagine other outcomes.
In Kenya, medical doctors are grounded in narrative fallacies, another pandemic I will call "the tyranny of narrative fallacy." The first narrative fallacy is that we are balancing between lives and livelihoods. It is time to burry that fallacy because there is no such balance.
The pandemic is basically a double-edged sword — a public health emergency and also an economic disruptor at the same time. So, to say that we are balancing between lives and livelihoods is analogous to saying that a double-edged sword can only kill from one side of the blade or that one can swallow only one side of a coin.
Globally, millions of people are at more risk of dying from hunger in this pandemic period because of severe income shocks than from Covid-19. This memo doesn't seem to have reached medical doctors in Kenya.
It is clinically documented that unequal economies are suffering a deeper recession due to the public health problem. For Kenya, 1.4 million people are at risk of dying from acute hunger today.
This stands to aggravate their health risks and make them significantly more vulnerable to the coronavirus. So, the toxic narrative fallacy that we are balancing lives against livelihoods, and we can rebuild the economy but not lives is lazy hedgehog thinking that the economy is brick and mortar oblivious to the heavy human cost.
The second narrative fallacy is about the modelling being done, informing decisions being made by the Executive. In his last presser, the President mentioned that his decision to order the cessation of movement in and out of five counties, zoned as one, was informed by data brought to him showing that 60 percent of new infections were happening within Nairobi and its environs.
Now, what is not being said is that most of the testing is happening in Nairobi. If Nairobi is the major data source, it is obvious it would lead in infections numbers and drawing national inference for decision making is misleading. Simply put, this is using incomplete data to represent reality in the wrong direction.
The third narrative fallacy is government banning private companies from importing vaccines, which doctors have welcomed saying that vaccines are a public good. Health economics should be taught as a compulsory unit in medical schools because this is epistemic arrogance and ignorance.
To start with, a vaccine is not a public good, it’s private. What is a public good is the herd immunity out of mass vaccination because its benefit can be shared simultaneously. If we vaccinate 70 percent of our population, the 30 percent unvaccinated are able to free ride on the benefit of the mass vaccination, which is reduced infections.
Government banning importation of vaccines by the private sector is bad public health emergency response. The government delivery system should reach the poor and vulnerable people. But the effect of the ban is that it will create a market for those free vaccines it is offering.
Because of the limited vaccines available, those who would have bought the vaccines from private players will now pay to jump the queue of free government vaccines elbowing out the poor. For example, one who urgently wants to travel out of the country and is not eligible for vaccination will pay to jump the queue.
I know doctors will take a high moral ground that this will not happen. But government drugs always end up in their private clinics and administered by them.
So, can we do science not philosophy — more so social science?