Beginning of the endemic? Omicron’s spread

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Hello and welcome to the Intelligence from the Economist. I'm your host, Jason Palmer. Every weekday we provide a fresh perspective on the events shaping your world. The suggestion that video games are addictive is as old as video games themselves. Now the World Health Organization recognizes the addiction as a mental disorder. We look into how the business models of modern gaming may be feeding that need. And 50 years ago, the new nation of Bangladesh was born from East Pakistan after a grueling nine month war. Little has been known about the earliest stages of that conflict, but revealing images by one daring photographer have just come to light. First up though, For the second year now, the coronavirus pandemic has made its mark on the holiday season. The Omicron variant is pushing out all others all over the world, from America to Western Europe to Southern Africa. Case numbers just keep hitting new records. Yesterday, more than 2,400 flights were cancelled. As with so many industries, there are just too many staff unable to work. But a smaller fraction of all those millions of global cases are resulting in hospitalizations or deaths. And that may mean it hopefully means that the world is entering a new, more manageable phase of the pandemic.

What we know so far about Omicron is that it spreads incredibly rapidly. That's very clear from all countries where the variant has already been found. You see this almost vertical increase in the number of new cases very quickly.

Slovea Chankova is our healthcare correspondent.

However, the good news is that it appears to be much milder. It causes severe disease less frequently than Delta or any previous variants. That's partly because the layers of immunity which have been built up through the population, either through natural infection or vaccines, are breaking the link between infections and severe disease and hospitalizations.

So that's a little bit in conflict with what we were hearing earlier on, which was that the concern with Omicron was these breakthrough infections that the Vaccinations, the immunity that you mention aren't really holding off Omicron.

Yeah, that's right. Unfortunately, even a full course of vaccination, two doses of the AstraZeneca or Pfizer vaccine, appear to matter very little for how likely we are to catch Omicron. They're protective, probably about 20% at most. And that's also the case if you've had Covid before. You don't get a whole lot of protection against catching Omicron. In places like the uk, each infection has been producing at least three more, which is what you were seeing when the virus first emerged in Europe. Before we had any vaccines or any population immunity, it was just spreading like wildfire. But not that many people are going to get severely ill because they're protected from vaccines and from having had Covid in the past. So you have these various layers of immunity on top of each other. And Omicron is quite good at evading them when it comes to infections, but it's not very good at all at evading them when it comes to causing severe disease.

And it does seem to match a bit of received wisdom that we've been hearing about for some time now, that over the course of lots of pandemics, they tend to this condition, right, being much more transmissible, but not being as deadly. Is that a pattern we're seeing playing out here, or am I seeing a pattern where there isn't one?

That's the hope. I mean, the common cold coronaviruses, that's how they started. They caused the first waves. Lots of people got really ill and then over time, they became milder, but they're still highly infectious. Each winter, we all get colds multiple times, but very few of us get very, very ill. What we are seeing with Omicron now definitely points in that direction, and the hope is that this is indeed breaking point and that's how things are going to be in the future. Even if new variants emerge, this layer of immunity we have will hold up against severe disease, and then boosters given to the most vulnerable people will soften the blow of new variants further. You know, we also have not just vaccines, we also have very effective drugs now, including some antiviral medications, which, if they're given early on to the people who are at the highest risk, they can prevent hospitalizations by anywhere between 30 and 80%, which is massive. So the bottom line is that the way things are now, we are probably finally getting at the tipping point between a pandemic disease, which this has been for the last two years into an endemic disease, much like the seasonal flu.

But that suggests, if we are indeed opening a new chapter here, that the way of dealing with things should change along with it. I mean, what does this mean for how the world, how governments, how people deal with the way this is progressing?

So the way it will be dealt with, if we think about these non pharmaceutical measures, such as lockdowns and closing schools and masks and so on, we are probably done away away with them within a year or two. You may have some measures, but things like lockdowns, I don't think we are ever going to see those again once the Omicron wave passes through.

So what you're describing here makes a lot of sense, is in a sense comforting in that Omicron looks like the kind of variant that we might have hoped for if we had to have another one. But at the same time, the world does still seem to be in a great deal of chaos in dealing with it. How do we get past this part?

We should remember that Omicron is brand new. We heard about it just a month ago, and we've been learning a great deal as it spread around the world. But governments, in the meantime, they have to act when they have imperfect information about it. So all these studies that I mentioned, they came out just in the past week. Many of them are based on incomplete information, although they're all pointing in the same direction. But the crucial bit that's missing still is that Omicron is just about to spread into older age groups. It remains to be seen how the numbers are going to play out there, because these are the groups more likely to end up in hospital.

So for the moment anyway, there's reason for cautious optimism, obviously still watching the numbers. And I guess that there is still the concern that more variants await us. There are more Greek letters.

Yes, I think that's almost certain to happen. There will be more variants, and what we hope is that there will be more like Omicron. But what will be important for sure is that these layers of immunity which we have built through vaccination and the various waves, including this big Omicron wave, are surely going to protect us against future variants, no matter how different they are from Omicron.

Slava, thank you very much for joining us.

Thank you, Jason.

For more analysis like this from our international network of correspondence, take out a subscription to the Economist. Get a great introductory deal@Equality.com IntelligenceOffer the link is in the show notes. There's some chance that you have a new video game console that you didn't have a few days ago. If so, congratulations and beware. For almost half a century, there have been concerns that gamers can become hooked. Pit yourself against the computer. Millions, mostly teenagers, have. So many, in fact, that psychologists are beginning to worry that some youths are becoming spaced out on the space games. Some countries are acting on that concern. Earlier this year, China, the world's biggest market for video games, tightened its already strict laws limiting online game use to a single hour a day. Even medical bodies are weighing in. For the first time, the World Health Organization will classify gaming disorder in its international classification of diseases. The addiction is real. So now the question is how much it's being exploited.

So this question of whether video games are addictive has been around almost as long as games themselves.

Tim Cross is the Economist's technology editor.

There's definitely some evidence that they can be compulsive. So lots of people who've played games will experience the sensation thinking, okay, just five more minutes and then suddenly you turn around and it's three in the morning. Or people will play to the extent that it starts to affect other things like their relationships or even work.

But as you say, these concerns have been around as long as video games themselves.

Yeah, I mean, you can go all the way back to arcade cabinets or even the early days as big online games. So two decades ago, there was a game called EverQuest, which was a very early, massively multiplayer online game. Norrath quickly developed from infancy as brave explorers journeyed forth in search of fertile.

Lands on which to build.

And some of the people who got really into it ended up giving it this nickname of Evercrack to talk about how the games seem to have this ability to take over their lives. And then from the other direction, you see, psychologists have been setting up clinics that claim to be able to treat gaming addiction. So there's a very well known clinic in Britain called the Priory, which traditionally helps celebrities kick their supposed addictions to cocaine or sex or shopping or whatever. You can now go to the Priory and ask to be cured of your gaming addiction as well.

But there's a real difference though, between being a cocaine addict and being a sex addict or perhaps a gambling addict. There are physical substances or they are not. There's the book you can't see put down, that's a sort of addiction, I suppose. I mean, what does it mean that the WHO has ruled on this?

So for a long time, for something to be classified as addictive, there needed to be an actual chemical, a physical substance that you could point to, like nicotine or morphine, on which a user could become physically dependent to some extent. So if you're like me and you drink three or four cups of tea a day and you try and stop cold turkey, it will be, you know, a little bit unpleasant and you'll be grouchy and so on. Something like alcohol. If you get physically addicted to alcohol, stopping cold turkey can even kill you. There's a biochemical link between ingesting this substance and then getting to a point where you're relying on it to function at all. But in the 1990s to 2000s, that started to broaden out and so people said, well, some of the neurological mechanisms that underlie this apply to behaviours as well. Because behaviors cause chemical changes in the brain in some areas. This is now fairly uncontroversial. I think most people now would agree that it's possible to get addicted to gambling. Gaming disorder falls into this category of what's called behavioural addictions. And the WHO guidance, I guess, is sort of reflecting that change in psychology. Though it is noticeable that apart from gambling, gaming is the only behavioural addiction that's on the who's list.

But a lot of the behaviors that you're describing around gaming are the sorts of behaviours you might describe around any sort of hobby or what you might casually call an obsession.

Yes. And I think this is the sort of issue that this whole behavioural addiction framework has to grapple with, which is, where do you draw the line? There was one paper published in 2013, I think tongue in cheek, that surveyed about 1,000 keen tango dancers, looked at the diagnostic rules for behavioural addictions which say things like, you pursue this to the exclusion of other hobbies, you pursue it even though it harms you in certain ways, and so on, and found that about 40% of them might qualify as tango addicts under this new paradigm. This is one of the issues. Where do you draw the line? And why would we say that the games cross that line, whereas being keen on rugby or hang gliding or painting or something doesn't.

On the flip side, though, it is very much in games makers interests to make their games really compelling. I suppose.

Yes. And I think this is the strongest argument that the pro camp have, as it were, which is that the way games work has changed pretty fundamentally in the last 20 years. So in the old days, when you bought a game, it used to be like buying a fridge or a bag of carrots or something, you know, you would buy it and then that was it. That the Transaction was over, it was a one off. That's now changed because of mobile gaming and because of the Internet. And the dominant business model these days is that you give the game itself away free or very cheaply, and then you rely on in game purchases to make all your money. So you buy cosmetic upgrades or power ups or whatever. And we're talking about games like Candy Crush Saga, all those endless run games that you get on smartphones. And the reason that changes things is twofold. One, it gives the developers a direct incentive to try and encourage people to play their games as much as possible, because the more you play, the more money you're likely to spend inside the game. And two, because you're always connected, the developers can get these very valuable analytics back, loads of data about how people are playing their games. And that gives them the ability to tweak the design in such a way that you're likely to spend as much time and therefore as much money as possible on these products.

Not just the shape of the market though. I mean, like each games maker wants its offering to be really just unput downable. Just like a good book.

That's right. And if you look at the way games are designed now, it's another place where psychology meets this industry. So the most famous one, I guess is psychology of how rewards work. If a reward is completely predictable, it's not all that compelling. If it's completely random, it's not all that compelling because you've got no way to influence it. What people really like is semi compelling rewards where you can influence how likely you are to get the reward, but it's not perfectly predictable. And you'll see a lot of games use that kind of reward structure. For instance, one of the FIFA games, you can play this thing called FIFA Ultimate Team where you build up like a fantasy football team of players. But to get the players, you have to buy packs that contain virtual cards. You never know what you're going to get with each pack. And you'll see other games do things like punishing players who don't log in every day. Or you'll see things like in game currencies, these things basically function like casino chips. And one reason that casinos like chips is that we know that when people are playing with unfamiliar currencies, you're likely to spend more.

But at what point do those kinds of incentives become exploitation? And how much does the fact that gaming addiction is now, now formalized changed the equation on that?

Well, so this is what regulators are starting to wrestle with. I spoke to several game developers for this piece. And off the record, some of them will say this kind of thing feels a bit sleazy and exploitative to me. And I sometimes have these sort of ethical worries about what exactly are we doing here. So there's loads of analytics data out there, but only the games companies have it. It would ultimately be bad for the games industry if they ended up in the same sort of category as alcohol and cigarettes. And so one idea is that maybe it would make sense to start unlocking some of this data and giving it to researchers so that they can get a sense of just how many people are there out there who are spending thousands of dollars that they don't have on these things. And if it's a tiny number, then maybe not much needs to change. If it's not, then I think maybe regulation at some point might be coming.

Thanks very much for joining us, Tim.

Thanks, J.

50 years ago this month, Bangladesh's war of independence came to an end. No one knows how many people died in the brutal nine month conflict. Estimates range from a few hundred thousand to three million. That uncertainty speaks to the difficulties that journalists and photographers found in getting the story out to the rest of the world, particularly at the outset of the war. But some recently discovered photographs shed new light on that dark time.

If I take you back to March 1971, 50 years ago, east Pakistan, today known as Bangladesh, declared itself independent from West Pakistan, prompting West Pakistan to send in forces to stop this separatist attempt.

Susanna Savage writes about Bangladesh for the.

Economist Anne de Henning at the time was a 26 year old French photographer traveling in Asia. She was in Kathmandu. She heard about this and she heard about the massacre being unleashed on the civilian population in Bangladesh, in East Pakistan, and she headed to the border.

I had read that the foreign press corps had whoever was in Dhaka in.

March, they were expelled.

So she headed to Calcutta, which is an Indian city on the border with Bangladesh, and she tried to get into Bangladesh. It took her three attempts and eventually she snuck across and joined the Liberation army and traveled with them through small towns of Bangladesh as they prepared to fight.

I was very bent on getting in. Of course, that's always, you know, what.

You want to do to get the news out.

Because there was no news.

One knew there were massacres, that fighting.

Had started, that the situation was really horrible.

But there were no pictures and no articles.

Nothing was coming out.

And what is it that makes her pictures from that period stand out?

So there were quite a lot of photographers who photographed the conflict, but not very Many foreign photographers were there at the beginning, as Anda Henning was. So she really captured the early days of the war as Bangladeshis prepared to fight. That meant that she caught in her photos this stillness and the tension between this and this stillness and the threat of violence, and also the stark contrast between Bangladeshi's enthusiasm for freedom and their complete lack of preparedness for fighting. So one photo I particularly like shows the town of Kushtia and there's an open truck full of freedom fighters intruding on a street scene. So it's men on bicycles glancing across as one of the freedom fighters runs ahead. And then there's a dead cow lying in a pool of blood in the foreground. And Bangladeshis were really keen to use the photographers and to use this opportunity to get their message out to the rest of the world, especially to ask for arms. So there's one photograph where the freedom fighter's chanting and they're chanting for America to send weapons. And Anna Henning really captured these types of moments.

And why is it that her images from 50 years ago are just getting attention now?

So it actually was a bit of a chance discovery. There is a couple in Dhaka who are very well known in the art world called Rajeeb and Nadia Samdani. They run Dhaka Art Summit, which is a hub for contemporary art in South Asia. In 2020, it was the birth centennial of Bangabondu, or Sheikh Mujibir Rahman. He's known as the Father of Bangladesh. He was the first prime minister and he was the politician who led Bangladesh to independence. So they were looking on the Internet, trying to find photographs of him, and they came across Anda Henning's website and there they found never seen before, portraits of Sheikh najeeb taken in 1972, as well as photos of the war itself from the previous year. So they found these photos and thought they were really special and have created an exhibition around them at the National Art Gallery in Dhaka.

And as for that kind of rare view of the early days of Bangladeshi independence, what do we see in the pictures? What do we get from them?

Eventually, in December 1971, Pakistan's forces were defeated. It was after that that Anne de Henning returned in the April of 1972 to photograph Sheikh Majeeb as he delivered a speech just after America formally recognized Bangladesh as a country. And these photographs are quite interesting because normally Ander Henning's photos are shot in black and white, but with the photos of Sheikh Majeeb, she shifts to color and it really shows the vibrancy of Bangu Bandu, of the country's new leader and of the hope he represented for everyone in Bangladesh and especially for the freedom fighters. And there's some sort of sadness there as well because this optimism didn't last long. Within a decade of independence, by 1981, a military dictatorship was installed in Bangladesh and Sheikh Najeeb had been killed in a coup. And even before that, democracy started to unravel. But Bangladeshis have remained really transfixed on this moment in history. I would say actually over time rather than becoming more distant or less important, Bangladeshis have become more focused on this and it's gained political significance. And so this new exhibition plays to that and it offers fresh glimpses into a moment in their history which is seen as absolutely defining.

Susanna, thanks very much for joining us.

Thank you very much, Jason.

That's all for this episode of THE Intelligence. If you like us leave a US A rating and a review and see you back here tomorrow.