I know I risk adding to a bitter debate, filled with intolerant vitriol aimed at anyone who dares raise questions of proportionality regarding our response to Covid-19. But hey I’m locked down at home and have a website, so I’m going to throw my two cents in.
I also know like all those who have dared to post as little as a Facebook comment questioning a certain set of Covid-19 response tactics, I’m going to be tagged as a cruel, stupid, ALT right, racist, anti-vax, pro Trump, anti-science, climate change denier who wants to kill old people. It’s OK I have thick skin and can assure you only a small smattering of that description is true.
Firstly, I want to have a dig at those of you who have dragged this debate into the gutter. Disasters often bring out the best in humanity, but they also bring out the worst and these two contrasts have been on equally vivid display over the past month.
I find it interesting those, that self-proclaim tolerance and caring, can engage in the most demonstrable behaviour towards others online and on air.
Whether it be on TV, radio or online people have been, for lack of a better word, terrible humans.
Something to keep in mind, just because someone disagrees with you doesn’t mean they hate you.
Whatever happened to reasoned debate that doesn’t end in people de-friending each other?
Make points, not personal insults, respect people’s right to think differently to, or have different views on how to get there and agree to disagree if you must.
Anyway, back to my point small point about cars and Covid-19 and how we take a balanced approach to life and death in decision making.
I don’t know whose response to Covid-19 has been the right one, it’s too early to tell. I’ve seen a lot of very good arguments made for every approach from Sweden’s liberal efforts to Vietnam's militant no nonsense.
I’m open to taking the facts once they are all in and weighing up the total cost and total benefit in the long run from each approach and picking a winner but it’s too soon for that now.
What I do know is we risk making poor long-term decisions if we do not question, probe and rigorously debate our approach and the proportionality of it at all stages, just like we do with other important issues in our society.
As I’ve noted above this interrogatory approach has been hard due to extreme pressure applied to agree with set narratives or risk being cast out of reasoned society.
One core argument of the lockdown at all cost group, is that comparisons with other causes of death are not valid when dealing with Covid-19. Apparently its immoral or at the very least inappropriate to discuss and compare the efforts and associated cost incurred saving people from Covid-19 to those associated with saving people from drowning, cancer or car crashes.
I don't agree.
The argument goes something like this. Lock down antagonists will point out that, we don’t stop people driving because 353 people died on the roads in 2019, so why would we lock the country down to save an unknown number of people from Covid-19? Probably a bit of a simplistic argument, but still valid for consideration.
Lockdown protagonists oppose this using a multiplicity of arguments, but one focuses on impact to others from a contagious virus along with the unknown nature of a new virus. It’s therefore better to be extremely cautious to avoid unknown downside risk. They are both valid points but don’t detract from a sensible cost benefit approach especially since we now have a lot more data to add into the mix.
If we lockdown for Covid-19 and take a similar approach to lowering the road toll by banning driving it plays out almost identically.
With Covid-19, the risk of death is significantly reduced for the individual themselves as well for society in general. Health wise in the short term we are all better off.
With vehicle accidents, if we ban driving, the risk of death on the roads is eliminated for the individual and significantly reduced for pedestrians, horse riders, cyclist and any other road non-vehicular road users and health wise in the short term we are all alive and therefore better off.
On the face of it this seems like a fair comparison of results.
Yes, there could be endless debate about the validity of the comparison and we could get lost in the rabbit warren of semantics, arguing about how essential driving is compared to say visiting a sick relative but at that point it’s all very subjective.
So, while enjoyable and extremely useful especially to those in far flung areas driving isn’t compulsory and we survived 99% of humanity without cars, so there is almost more precedent to a life without driving than our current situation of effectively quarantining healthy people.
So, if we wanted to save the approximately 350 lives lost in road accidents each year in NZ, we could in theory ban driving completely, just like we have locked down society to save lives from Covid-19, yet we don’t…?
The reason why we don’t is simple. Yes, it would work but it would also create a plethora of broader issues, including extreme financial destruction to the NZ economy. The cure is worse than disease in this instance.
Covid-19 is very similar, we can shut down the economy and severely restrict social interactions (lockdown), we know it’s possible and it’s saving lives but just like banning cars it creates a mountain of other issues.
Quite simply we don’t ban cars because the cost of not driving is too high for society to entertain as an option, even for the sake of those lives. The deaths while tragic, are collateral damage for the benefit to society of vehicular transport.
In NZ we value those lives lost at around 4.7 million a pop, which gives us nearly 1.7 billion dollars of lost life per year on the roads. To mitigate deaths where we can (trying to spend around or less than 4.7 million per life) we invest money based on a cost v benefit basis in road safety.
We have laws to restrict speed limits, enforce safe vehicles and seat belts, ban substances that impair driving as well as preventing certain people (too young, too old, too blind) from driving, we have road safety adverts on TV and billboards around our highways.
We have had an active debate about death on our roads for decades and worked hard to reduce them while continuing to drive as we realise the alternative is catastrophic.
Reluctantly but in a fully cognisant manner we accept some death, as its necessary for what we have decided is the greater good of society.
It may sound harsh but it’s an accepted reality, so why is Covid-19 any different?
Andrew Cuomo the Governor of New York said if we save one life the lockdown is justified. Just one life…? He was forceful in this argument and berated the reporter who was simply trying to make the point I'm making here. This is hardly balanced is it? We don’t take this approach with Cancer, on the roads or at our beaches, lakes and rivers to save lives.
There are so many things we could ban, change and do away with to save just one life if we deemed the cost was worth the benefit but as a society we haven’t. What we have done is take a balanced approach to risk mitigation and looked at the costs of reducing death further to see if they are reasonable. We then decide how much to fund the likes of road safety, Pharmac and the health system and what laws to pass to save people from harm without impinging too deeply on their freedoms.
It may sound harsh but with limited resources it’s the only way to sensibly allocate funding. If you disagree about the allocation you get to have your say every three years at the election.
Taking the ‘whatever it takes’ approach for Covid-19 and applying it more generally, how can we then in the future
Tell cancer patients we can’t afford to fund their drugs?
Hip replacement patients they need to wait years to get their operation due to health funding issues yet?
Communities they can’t get that roundabout or underpass because not enough people have died to make it worthwhile?
Id argue, morally now we can't going forward. We have removed that bar with this approach and it’s a dangerous precedent to set in a country of limited resources.
Putting it into a practical example. Patients, waiting for treatment drug treatments to be funded by Pharmac, would be royally pissed off after having often received little government compassion for their cause, that now billions of dollars have been pulled, essentially from thin air to fight Covid-19. This is the same government who said no to them, the government that has made tough choices to allocate our limited resources in the best way to save the most lives, the government now seemingly willing to spend whatever it takes to save any one life from Covid-19.
We have never taken a win at all costs approach like this. We have always considered the costs and benefits both in the short and long term of our options, made those public and had a debate about them.
Now I'm not taking a side here on which approach is right. But I am asking, just how you go back to, cold hard cost benefit analysis, to decide who the government saves after this? How can we ever again justify billion-dollar slush funds for the likes for Shane Jones to splash around? Given the Covid-19 approach shouldn't it all be going to health and saving lives directly, little else matters or does it?
Being fair to the government, this has been a train wreak globally and something all countries are struggling with, they have had to make lots of fast and hard choices and there was no real playbook. I’m sure there has also been a lot of debates behind closed doors around the issues raised in this piece and many models and predictions being made to weigh up various policies.
However little of this has filtered out to the general public, aside from some very questionable initial models on deaths and some treasury forecasts on how many of us will be unemployed. What has come out hasn’t been up for debate. As I’ve noted any dissenting view has been jumped on quickly. We haven’t been able to maturely and broadly debate our if measures are proportionate and appropriate without fear and fracture.
We have been told there is no plan B, plan A is the only plan, that to me seems ignorant at best and arrogant as worst.
For what it’s worth, I’ve been a pretty good lockdown subject, I’ve kept the bubble small, washed my hands, worked from home and played my part.
While I’ve complied, my personal opinion is we have gone a little hard for a little too long and need a more balanced approach that considers costs and benefits more broadly in the long run, just like we do for every other cause of mortality.
However, as I’ve said it’s too early to tell and I’m happy to be debate it, learn more and be proven right or wrong in time. What would be nice is if governments and their army of partisan online warriors bashing people on their behalf were open to this as well.
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