Lives Versus Lives
By Ramesh Thakur with Pearls and Irritations
When did the world’s media and politicians become collective versions of Lance Corporal Jones in the British comedy series Dad’s Army, screaming:
Don’t panic! Don’t panic!?
Colour me contrarian, but since the 2003 Iraq war, my working motto has been: when you come across excitable exclamation marks, substitute sceptical question marks and you’ll be right.
According to World Life Expectancy, Australia’s annual death toll is around 170,000. Heart diseases kill more than 23,000 people. The number of deaths from flu and pneumonia is over 4,000 and from road fatalities around 1,300.
It’s possible the worst fears of the coronavirus pandemic will prove wildly exaggerated.
In the panicky predictions of a runaway swine flu pandemic in 2009, instead of the feared 1.3% fatality rate, the actual rate was 0.02%. In the UK it was 0.026%. The total worldwide deaths was about 280,000 (range 151,700–575,400), and in the US about 12,500.
The World Health Organisation came under severe criticism for having served the interests of Big Pharma in selling unnecessary vaccines. Governments were left with costly surplus stocks for disposal.
Led by the media, panic set in to drive public policy before data was collected to show that, for most people, the Covid-19 virus will be no worse than seasonal flu.
The crisis escalated with an Imperial College study of 16 March which described Covid-19 as ‘a virus with comparable lethality to H1N1 influenza in 1918’ (the Spanish flu that killed upwards of 50mn people, one-sixth to one-third of them Indians).
Without an aggressive suppression strategy of prolonged lockdown, it could cause 0.5mn deaths in the UK and 2.2mn in the US. This caused PM Boris Johnson to switch dramatically from the initial herd immunity strategy — let the virus spread through the community because the mortality rate is well within the parameters of a seasonal flu — to a drastic nationwide lockdown.
Other governments were soon infected by the panic virus and the favoured strategy became to prioritise citizen’s health over the nation’s economy. As a total lockdown leads to economic shutdown, the pain is alleviated through industry bailout and social benefit packages.
A healthy economy requires a healthy workforce.
The injunction to first do no harm implies that governments should be wary of prolonged economic lockdowns: the cure might indeed be worse than the disease.
Public policy must be based on a balance of risks and benefits, often amidst uncertainty, incomplete information and unintended and perverse human, health and economic consequences. The health of citizens and the health of the national economy are closely connected and interdependent.
Modelling is assumption-driven and data-limited
Was the panic caused by flawed, inflated mortality statistics?
The original Imperial College paper used sketchy data and heroic assumptions. More sceptical voices have emerged since then.
One team finally got around to testing an entire village of 3,000 people near Florence for the SARS-CoV-2 virus which causes Covid-19. The results show that 50%-75% of those infected were asymptomatic and thus would not be tested in most jurisdictions.
On the basis of the existing albeit inadequate data, Eran Bendavid and Jay Bhattacharya, professors of medicine at Stanford University, conclude that the Covid-19 mortality rate could be as low as 0.01% of all those infected, one-tenth the average flu mortality of 0.1%: ‘Such a low death rate would be cause for optimism’.
Hence their conclusion:
A universal quarantine may not be worth the costs it imposes on the economy, community and individual mental and physical health. We should undertake immediate steps to evaluate the empirical basis of the current lockdowns.
On 25 March Neil Ferguson, lead author of the fateful Imperial College report, gave evidence to a parliamentary select committee inquiring into Britain’s response to Covid-19: ‘UK deaths from the disease are now unlikely to exceed 20,000… and could be much lower’. Moreover, between 50%-67% of them would likely have died within one year anyway owing to old age and co-morbidities.
Between them, these examples show firstly the perils and pitfalls of modelling, and secondly the problems and risks of basing public policy on models before sufficient data is available to test their assumptions and conclusions.
In the meantime we have imposed devastating social and economic costs. The sensible strategy would have been to isolate the elderly and vulnerable and let everyone else get on with their lives.
Influenza and pneumonia cause 3.2mn deaths worldwide annually. If each individual case around the world was tallied daily on the front page of all newspapers, a similar panic would arise.
Road accidents kill another 1.3mn annually that could be saved by banning all automobiles. Sensibly, we hold the resulting disruption to everyday life to be too high a price to pay. Similarly, life and death is part of an eternal cycle.
Take sensible precautions, carry on calmly and put in place emergency measures only after the facts are in.
Balancing risks, costs and benefits
The first balance a government must assess is the risk of creating mass hysteria and panic with premature reporting and the risk of losing control by delaying public announcements of the true scale, gravity and urgency of a nascent epidemiological emergency.
They can then settle on the optimal balance between sufficiently slowing the disease, preventing an economic meltdown and maintaining a functioning society while the threat and responses evolve and the virus spreads.
As someone who has seen poverty up close in many different countries, I believe the choice is not between ‘lives vs money’, but ‘lives vs lives’. We cannot have a first-world health care system and facilities if our economy tanks to third-world poverty. And in the third world, in a very real sense poverty is the biggest killer of all.
New York’s Gov. Andrew Cuomo has become the latest hero in the Democratic pantheon for insisting that his sweeping, expensive measures to stem the coronavirus would be worth it even if they saved one life: ‘We’re not going to put a dollar figure on human life’.
This is stirring but sheer idiocy: a soundbite, not sound policy.
Every single budget of every central and state government in every country of the world juggles with competing public policy priorities and, in that sense, puts a dollar figure on human life.
Health costs are incurred from increased loneliness and mental anxiety and social costs from emotional distress at job losses, financial stress and forced family separations. A 2014 study in Social Science and Medicine by Timothy J. Halliday showed that a 1% rise in the unemployment rate raises the risk of dying next year by 6%.
Of course Cuomo is not stupid, any more than other politicians who feel compelled to say silly things. It’s not that they cannot think clearly. Rather, they are trapped in a ‘gotcha’ political hothouse in which they cannot be seen to be thinking logically, based on facts, and speaking and acting accordingly.
In the risk-reward calculus, political leaders have less to lose from an excessive response based on preventing the worst imaginable outcome, and more to lose from a reasonable response based on the most likely trajectory.
On the same political calculation, they will be too risk-averse to stop and reverse course early in case something goes wrong, compared to keeping everyone at home because they can still point to fresh cases of infection.
Governments may not back off the sequester orders until citizens rebel against the de facto police state regulations and mentality as the new normal.
The lockdown has produced its own version of Thucydides’ dictum that the strong do what they can, the weak suffer as they must.
ABOUT THE AUTHOR
Emeritus Professor Ramesh Thakur at the Australian National University is the author or editor of some 50 books and 400 articles and book chapters.
He writes regularly for several newspapers around the world and serves on the international advisory boards of institutes in Africa, Asia, Europe and North America,
He says he writes as someone in the high risk category of over 70. He says he has no wish to live for an extra year or two at the cost of crushing his children’s careers, plans and dreams.
This piece merges two articles first published in Australia’s leading social policy journal Pearls and Irritations and is republished here with their kind permission. RAMESH THAKUR. Coronavirus pandemic: sceptical question marks make for better policy than excitable…
When did the world's media and politicians become collective versions of Lance Corporal Jones in the British comedy…johnmenadue.comRAMESH THAKUR. Lives vs lives: Corona without karuna - John Menadue - Pearls and Irritations
Coronavirus threatens to overwhelm the health and economies of many developing countries where a billion people subsist…johnmenadue.com
