Last year, now-Past President Amy Lobben titled her first newsletter column, “The Spatial Scale of ‘We,’” to reflect on the rapid shrinking of who counts as ‘we’ “to a remarkably small spatial and social scale” in the context of the COVID-19 pandemic. Her phrase has resonated with me over the past few weeks as I consider the global pandemic that is soon to enter its third year.
As I write, the Omicron variant dominates the news. Many countries have imposed bans on travel from southern Africa – measures that the World Health Organization (WHO) and African leaders alike describe as counterproductive because such measures penalize transparency and swift scientific work, while failing to stop Omicron’s spread. Instead, public health experts have argued that the world will not cease to reel from new variants until mass vaccination is accomplished globally. However, because of vaccine nationalism — the hoarding of vaccines by wealthy nations, the blocking of patent waivers on COVID-19 vaccines and other technologies, and the underfunding of COVAX – as of November 2021, only 7% of the population of Africa is fully vaccinated. Roughly 54% of the global population had received at least one COVID-19 vaccine dose, an order of magnitude greater than in low-income countries, where the rate is 5.8%. Wealthier countries have ignored WHO pleas to hold off on booster shots until people in lower income countries can receive their initial vaccinations. By the end of this month, 10 high income countries are projected to have 870 million excess doses even after boosters are given.
This short-sighted view of the “we” that must be protected from severe illness and death not only exacerbates long-standing patterns of global inequity, but is ultimately foolish, both in terms of human health and economically. The more the virus spreads, the more likely new variants will appear that evade current vaccines, further prolonging the pandemic.
This short-sighted view of the “we” that must be protected from severe illness and death not only exacerbates long-standing patterns of global inequity, but is ultimately foolish, both in terms of human health and economically.
One study estimates that the cost of global vaccination is about $23 billion (much less with patent waivers), compared to many trillion dollars in costs of the disease to date. Yet, as with global climate change, another problem that can only be solved with a recognition of the responsibility to address long-standing inequalities along with true global cooperation, the inability to stretch understandings of who is a “deserving-other” beyond the borders of the nation-state and beyond the imperatives of the corporate boardroom will result in a great deal of preventable suffering.
The same failure to imagine a more robust “we” to whom one has responsibility, reproduces itself at smaller scales. For the last two months my home state of Colorado has been in the grips of a COVID surge that has overwhelmed hospitals. Though 63% of the state’s population is fully vaccinated, this average hides significant spatial variation, with some county rates as low as 40%. Combine this with a governor unwilling to impose another mask mandate and the highly transmissible delta variant, and by early November, the state was forced to activate an emergency protocol, “crisis standards of care,” which further increases nurse to patient ratios and allows workers to care for sicker patients than they normally would. Even with these measures in place, 94% of ICU beds across the state are currently full; in some counties, it is greater than 100%, meaning doubling up on space or sending patients to distant locations.
My husband is a registered nurse who works on a hospital medical/surgical floor, so I’ve gotten a sense of what this feels like for health care workers. For the past several months, his hospital’s ICU has been so full that many patients who require intensive care – where the patient: nurse ratio is 2:1 – have been put instead in the general medical floor, where the ratio is more than twice that. The profit-driven hospital company in the meantime has prioritized earnings by continuing truly elective surgeries, ignoring pleas from nurses that their workloads are simply unbearable and, increasingly, unsafe. Highly experienced and skilled nurses are quitting in droves out of exhaustion and frustration, and hospital turnover is high. Indeed, across the US, nearly one in five health care workers have quit since the start of the pandemic. After one particularly harrowing day with too many patients needing intensive care, and only one nurse assistant available for an entire floor, my husband too considered leaving the profession he loves.
The neoliberal restructuring of health care as a profit-making industry beholden to shareholders led to a “just in time” business model that entailed an almost 40% decline in hospital beds between 1981 and 1999; even before the pandemic, hospitals were maxed out.
As with all crises, there are many contributing factors. The neoliberal restructuring of health care as a profit-making industry beholden to shareholders led to a “just in time” business model that entailed an almost 40% decline in hospital beds between 1981 and 1999; even before the pandemic, hospitals were maxed out. Vaccine reluctance stems from a host of understandable social factors including distrust of government and skepticism of medical expertise that has indeed often been flawed and arrogant. But in the face of overwhelming evidence at this point in the pandemic, continuing vaccine refusal translates into the suffering of others – including those who cannot get vaccinated (mostly children under 5), those who cannot receive adequate treatment for other medical conditions, whether heart failure or cancer, because hospitals are full of COVID patients, and health care workers struggling with the “crushing downward spiral” of exhaustion.
Vaccine refusals beg the question not only of who counts as “we,” but also of the extent to which some people still believe in a society at all. Margaret Thatcher famously proclaimed that there is no such thing as society, only individual men, women, and their families. Increasingly, acknowledging any kind of responsibility to the well-being of strangers in society has become unthinkable in the constitution of a certain brand of individualism in which the individual self is conceptualized as a fortress. This fortress-individual does not believe that the virus can breach its defenses, and cares not for the argument that vaccination can help protect others.
The apotheosis of the fortress-individual is…also found in the strange idea, unique to the US, that there is simply nothing that can be done to stop gun violence… that the dead and maimed must pay for the sacrosanct freedom of fortress individuals to carry lethal weapons far beyond the imagination of the crafters of the US Constitution.
The apotheosis of the fortress-individual is perhaps the “stand your ground” self-defense statute that exists in 30 US states and the ways in which it has been used to justify racialized vigilantism, from George Zimmerman’s acquittal in the murder of Trayvon Martin to the acquittal of Kyle Rittenhouse for the murders of Joseph Rosenbaum and Anthony Huber, and the wounding of Gaige Grosskreutz — the latter even in a state without a full-fledged stand-your-ground law. But it’s also found in the strange idea, unique to the US, that there is simply nothing that can be done to stop gun violence, that the 651 mass shootings, including 222 school shootings to date in the US in 2021, are inevitable, the price that the dead and maimed must pay for the sacrosanct freedom of fortress individuals to carry lethal weapons far beyond the imagination of the crafters of the US Constitution. This strikes particularly close to home for me because a mass shooting took place this March in a grocery store a few short blocks from my house, a place where my family and many colleagues and their children frequented, and where high school students regularly hung out. Ten people were killed, including several of my sister-in-law’s former co-workers at the store.
Geography is “earth writing” – its purview is the globe, and geographers are uniquely equipped to examine not only spatial patterns (whether of gun violence or pandemic-related hospitalizations and responses) but also to think beyond methodological nationalism. Celebrated human geographer Doreen Massey conceptualized space as the product of interrelations, a discrete multiplicity that is dynamic rather than static, open rather than closed. Spatiality is about relationality; thus Massey argued that people of particular places have a responsibility towards the wider relations on which they invariably both depend and have an effect. Former AAG president Victoria Lawson stated in her presidential address that Geography is a caring discipline, and advocated for “research and practice that begins from a critical ethic of care and responsibility.” I suggest that this responsibility can only be fulfilled by geographers who are not lone fortresses, and who have the capacity to care for a capacious “we.”
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On December 3, you should have received an email inviting you to take the “AAG Annual Meetings and Climate Action” survey. I’m sure you are as tired of surveys as I am, but I’d like to ask that you please take a few minutes if you have not already; it is also available at this link. Extensive member participation is crucial to shaping how AAG moves forward to meet low/net-zero carbon goals related to travel to annual meetings. AAG seeks to reduce these emissions in line with IPCC recommendations, while continuing to provide benefits to all members, increasing access to meetings for those who have faced past barriers to participation, and keeping AAG fiscally sound. These are a lot of considerations to juggle, and AAG can only successfully navigate into our collective climate change-shaped future with your input.
Thank you for filling it out!
Editor’s Note: AAG will collect results to the survey through December 31.
Please note: The ideas expressed in the AAG President’s column are not necessarily the views of the AAG as a whole. This column is traditionally a space in which the president may talk about their views or focus during their tenure as president of AAG, or spotlight their areas of professional work. Please feel free to email the president directly at emily [dot] yeh [at] colorado [dot] edu to enable a constructive discussion.
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