Iatrogenic: The Dilemma of Ingenuity
COVID-19 has changed our lives and we have adjusted to this challenging time. Please enjoy the conversation below. It’s a dialogue between two scholars who met at Schiphol on their way to Nairobi.
Makau: Hello Chedeye. Where are you going with your designer face mask? It’s good to see you after three years.
Chedeye: See how time flies! The last time I saw you was before I defended my thesis – Three Essays on the Desirability of Public Health. You asked tough questions during my defense.
Makau: You are lucky your thesis was before the pandemic. Otherwise, I would have asked you about the impact of face-masks and the desirability of inoculation.
Chedeye: Daktari, I have spent the last eight months exploring those concepts at Adekunle-Hikma foundation as a visiting fellow.
Makau: Expatiate …
Chedeye: The use of face-masks has increased without significant economic growth. As a result of this, there is an increase in the demand for complements and a decrease in demand for substitutes.
Makau: Great analysis of the commodity market. What will happen in the factor market?
Chedeye: Simple! Resources will move to the production of face-masks and possibly its complements too.
Makau: Analysis of the economy has a lot of nuances which makes your analysis too simplistic. Personally, I think the use of face-masks is beneficial to both the user and non-user, hence it contributes to public health. In other words, government should make face-masks available because it is a public good.
Chedeye: Sawa. I also believe that vaccines are even more beneficial and availability of vaccines and its inoculation should be a public good. Furthermore, vaccines and face-masks create positive externalities.
Makau: How is the litter of face-masks all over the place a positive externality?
Chedeye: Environmental sustainability can be ensured through the use of reusable masks.
Makau: Let’s join the queue. It’s good my flight was changed by KLM to Kenya Airways (KQ). That made it possible for me to meet you.
Chedeye: Why was your flight changed?
Makau: There was a delay in Toronto which makes it impossible to meet our departure from Schiphol to Nairobi. So the KLM ladies at Pearson International Airport changed my route to KQ instead of an alternative that will make me fly to Nairobi via Dubai.
Chedeye: It’s easy because they belong to the SkyTeam Alliance in the oligopolistic airline industry.
Makau: You should explore Sweezy model – explains rigidity, and Chamberlin model – explains interdependency and tacit collusion, to understand the airline industry.
Chedeye: Reason why North American airlines don`t give food on flights - even those that are more than six hours, charge $25 for baggage check-in with no repercussion, and if you want in-flight entertainment you better have the appropriate application on your personal device.
Makau: That is why people have respect for the Middle East and Asian airlines. They have better services.
Chedeye: I hope the market for vaccines will not have cons as seen in some oligopolistic industries.
Makau: The biggest problem now is iatrogenic and the impact of echo-chamber.
Chedeye: Iatrogenic? Echo-chamber? I don’t understand.
Makau: I will educate you after I wake up. Its eight hours to Nairobi. And I need to sleep. I have a meeting tonight with the management of the African Economic Research Consortium (AERC).
Chedeye: AERC! They sponsored my masters and PhD studies.
Makau: Yes, it is an organization for economic research and training…
After few hours…
Chedeye: While you were asleep, I watched Kunle Afolayan`s Citation, Kemi Adetiba`s King of Boys (KOB), And Mo Abudu`s Oloture.
Makau: I have seen them on Netflix now waiting for KOB2 and the biopic on the life of Ayinla Omowura, an Apala musician who died in 1980.
Chedeye: I hope you had a nice sleep. We need to conclude our discussion. We have two hours before we disembark.
Makau: Yes, I enjoyed my sleep. Business class is really convenient.
Now let’s continue our discussion. A family friend was mistakenly amputated because of misdiagnosis few years ago, people are advised to push fluids when they consume antibiotics because they kill red blood cells, a cousin`s cervix was removed but was later discovered not to be cancerous, and a classmate had to sell properties, eventually became bankrupt, in order to pay for an expensive medical procedure.
Chedeye, the examples presented are some of the unintended consequences of medical processes required to create a healthy population.
Chedeye: But is it ethical to leave people to continue to suffer because the solution is not necessarily desirable?
Makau: That is the dilemma.
Chedeye: I think it can be resolved by information symmetry and proper follow up after the administration of a medical procedure.
Makau: It’s a possibility if the populace are not in an echo-chamber and disillusioned by the effects.
Echo-chamber effect will make people to believe in their opinions reinforced by their environment or social group.
Chedeye: I see and watch a lot of opinions on social media nowadays especially WhatsApp!
Makau: Truth is relative and very fluid.
Chedeye: Even though there are side effects, a little bit of iatrogenic, as a result of inoculation for some people, I still believe in the creation of positive externality for the entire population.
Makau: True. In 2017 when I was planning my sabbatical to a West African country I had to get the vaccines for cholera, typhoid, hepatitis A and B, and yellow fever (now indeterminate, used to be valid for 10 years). I was given a set of tablets for malaria – no vaccine.
Chedeye: And is that a guarantee that you won`t get sick?
Makau: Nothing is perfect but for sure it increases immunity.
Chedeye: Lest I forget, what is it about echo-chamber? I don`t understand the relevance …
Makau: People are affected by an explanation they keep hearing and form an opinion which they think is superior. Though not necessarily based on facts.
Chedeye: And what is the fact?
Makau: The fact is that there will be side effects for some people and this can be managed with appropriate information and actions of the stakeholders.
Chedeye: Furthermore, it is far better to make a little bit of progress than none at all.
Makau: Hopefully, we will only need to show our proof of vaccination (valid for a given period) the next time we travel instead of multiple COVID-19 tests.
Chedeye: I hear it can cost up to $200 per test.
For sure, air travel will be better with inoculation until the coast is clear.
Makau: I have taken the test 10 times in the last three months because I need to travel within the East African Community.
Chedeye: A lady did the test, a nostril gave positive result while the other gave a negative result. The explanation eludes me. May be that’s inconclusive…
Makau: The captain is already announcing preparation for landing.
Chedeye: Yes, it`s been a pleasant flight with good food. By the way, how is your uncle?
Makau: He is fine only that nowadays he is unhappy with the situation in most African countries. He thinks they will be the last to get the vaccines. I hope he is wrong …
Chedeye: Meticulous man
Makau: He will pick me at the airport.
Captain: Welcome to Nairobi…
After passing through immigration and customs…
Makau: Chedeye, that’s my uncle over there …
Uncle: Karibu Kenya. Habari za jioni?
Chedeye: Mzuri sana. And sorry about the demise of your friend – Ndarua’s dad.
Uncle: Asante. Dunia tuna pita.
Chedeye: True!
Makau: Hope to see you at the next Adekunle-Hikma foundation policy conference in beautiful Zanzibar.
Chedeye: Kwaheri Daktari. Extend my greetings to Ndarua, Magomere, Shimba, Ciliaka, and Ole Saringe.
By
Bamidele Adekunle @badekunl
December 23, 2020
The issue of how our echo chambers are affected by our interactions, especially during the pandemic, is very important. They are also impacted by our access to social media and reinforced by artificial intelligence which gives us more of the same types of opinions. I also think because people were forced to stay home they depended even more heavily on social media, of which substack is one type.
Once again, I find this dialogic way of bringing out issues, very interesting.