More on the lockdown debate

It’s been a bumpy ride on the COVID-19 train over the last couple of months.  First it was possibly nothing, then it was the end of the world. Then as the lockdowns bit hard and more reliable data came out of our own experience with NYC and other US locales, doubts began to surface again.  And the acrimony is still flying fast and furious over who is more evil – the callous monsters  who are putting money above lives trying to open things back up, or the heartless elites who are so certain of their own righteousness that the rights and struggles of the working class mean nothing.

I’ve spent a lot of time thinking about how this has unfolded, and I want to talk not about what would have been the exact correct answer, but about what we’ve learned about our society and it’s decision-making process.  

I think there are basically two types of arguments here – whether or not the damage of the measures against COVID is turning out to be worse than the disease itself in terms of suffering, and whether or not those measures are violations of human rights.  These are distinct arguments.  There is also a third argument happening over the threat level of the virus as the data evolves, but that is a technical argument that I am not equipped to fully evaluate.  However I don’t think a perfect answer is needed for our discussion here.

Debate 1 – The cost of lockdowns vs the cost of Covid.

This is the utilitarian conversation.I think that this debate shows the bias our society has towards what sounds like science and things that can be measured and quantified.  To be clear before we get started – I am not claiming the coronavirus science is junk or a hoax.  I am just talking about the pull it has on our imagination.

We were – are still – faced with a virus that, according to the best numbers we have, may kill hundreds of thousands of Americans if everyone in the country were infected.  While people from every age group have died, virtually all of them on a percentage basis were already sick and elderly, often in nursing homes or receiving some other form of care.  And we, along with most Western countries, have reacted with almost complete lockdowns shutting down all business and all social interaction.  The measures taken were serious and unprecedented, and have not been seen in free societies outside of foreign occupation during a war.

This leaves us with a serious apples to oranges comparison problem.  How do we know that what we are doing is better than facing the virus with some less restrictive precautions and weathering the storm?  How can you measure the one against the other?  

Here are some examples of the kind of utilitarian questions raised by these actions.

  • How are we counting lives lost?  Some countries only count people directly killed by coronavirus complications.  Others, like the US, have very broad statistics that count anyone that had COVID while dying of complications tied to another morbidity, or even who died without confirmed COVID but was known to have been exposed to someone who had it.
  • How does quality of life measure against risk of death?  We are seeing increased rates of poverty, domestic abuse, alcohol use, depression, and anything else you can think of that is correlated with inactivity and lack of purpose.  What risk is worth 1 month of this?  5 months?  A year? Is it better to live helplessly at home or die as a free person? Or is that question just hyperbole?
  • How many people do the lockdowns indirectly kill?  In the movie “The Big Short” the main character comments that every 1% jump in the unemployment rate is 50,000 dead.  I have no idea if that’s literally true and I’m sure statisticians could fight over it for a lifetime.  But the idea is perfectly valid.  Suicide rates spike when jobs are lost.  Drug and alcohol use and attendant accidental deaths do the same.  People just generally get unhealthier and older faster when sitting at home.  People may lose careers and never get them back – meaning they will over time have an unhealthier, poorer life than they otherwise would have.  And in this unique case there is the shutdown of preventative and elective care and the loss of health insurance. 
  • How do you weigh extra time for the old and sick, against the futures of the next generation?  The overwhelming majority of those dying are old with pre-existing conditions, and an unknown but large number are terminally or already in nursing homes.  The life expectancy of someone going into a nursing home is very short – most are dead within 6 months, and the overwhelming majority within 1-2 years.  What is the weight of 3 extra months or extra years for an elderly person, versus a young family unable to have children or pushed into years or a lifetime of poverty?
  • What is the risk of additional shocks to the economy while we are down?  We don’t know what else will happen besides the layoffs and reduced consumer spending.  Will a hurricane hit New York again?  An earthquake in LA? Some big fraud be revealed in a key industry?  These normal types of disasters happen all the time, and we have weakened ourselves in the face of them.
  • What happens if all-or-nothing measures can’t be sustained long enough? Trying to get rid of the virus completely in a country may take months or even a couple of years.  If the economic impact is so bad that the effort cannot be sustained, then the virus comes back in the end when effort fall apart.  In the end no lives are saved and the loss is added to the self-inflicted collapse.  Would it be better to accept a less ambitious, slow containment plan, which might bring more deaths (at least at first) but which society has the stamina to carry through?
  • What is the risk of political collapse or wars, here or elsewhere, as a result of this downturn?  It’s important not to forget that the Great Depression was a time of great turmoil politically.  It gave us not only bread lines and the New Deal, but also Hitler and wars.  As the world economy collapses, what comes down with it?  Middle Eastern peace?  Latin American governments?  The EU?  How does that impact spread?
  • What happens with this precedent?  We have governments taking away large amounts of freedom from their population through fear.  Even if that is justified in this instance, will it be next time?

The difficulty of comparison

The point to take away here that we don’t know.  The risks above cannot be quantified.  The dangers of the lockdown are too long-term and too hard to put a number to.  That’s been exactly the problem for this discussion.  On one side is one problem, the coronavirus, and it has a big scary number attached to it that is being delivered by respected experts like doctors.  On the other side, we have a big list of serious dangers that are made more likely by the measures, but which may or may not come to pass.  

It’s like playing minesweeper.  We could hit almost nothing and be fine.  Or we could hit some catastrophic mines on this path and end up so much worse off that in five or ten years we will wish we’d taken a more measured response and absorbed more COVID deaths.  Since there are both no certainties to the harms of the lockdown, and no certainties to the effectiveness of any economic interventions to alleviate those harms, people find it hard to debate the costs of lockdown effectively.  And so we ended up fixating on the big scary COVID numbers and running full tilt toward a lockdown that is now being eroded piecemeal as individuals suffered harm and frustration and started complaining.

This is an abandonment of responsibility.  It’s a hard, unclear, emotional conversation to have, but our leaders had a duty to do more than just latch onto the medical plan.  The doctors’ job was to give the best data they could and they have done it.  The leaders’ job was to weigh the predicted medical outcomes for the virus against the other social, political, and economic costs of the strategy.  Some societies have had relatively balanced approaches, but others have been extreme.

Debate 2 – Freedom

Then there is a second debate, which is the moral and political debate about whether there are redlines that cannot be crossed no matter the need of the moment.  The lockdowns have been criticized for taking away people’s freedom of movement, assembly, and religion.  There is also a lot of criticism about the disingenuous way positions supporting lockdown have been expressed.  I think we should consider this debate separate from the utilitarian one.  

One important consideration is that rights are not supposed to be a debate of the moment.  Rights are the plan you set down in stone ahead of time so that you won’t be tempted to violate them no matter how bad the situation is.  The thought here is that a human right is something you are willing to kill or face death for because the principle of the right is more important than just living. We understand that if we aren’t willing to take those risks, then rights can become just pretty words in extreme situations.

Of course we also typically set down some exceptions about what we can compromise on in the interests of safety.  For example, we have freedom of speech, except to call for immediate harm to an innocent person or to shout fire in a crowded theater.  We have freedom of assembly, but we have occupancy limits on buildings and we have processes of approval to gather in key public spaces in the middle of cities.  The important thing about these caveats is that they are built in before the problem occurs, because we don’t trust ourselves to properly weigh the value of human rights in the moment.  Most relevantly to the COVID situation, we allow the government to declare states of emergency with certain powers for a given time and place.

There has been a lot of debate about whether the lockdowns have crossed this line in some states and countries.  For example, several states made exceptions for religious gatherings and some have banned them.  Some states are arresting people for being outside their home, others restricting travel, others being less strict and are just asking people not to gather in large groups.  And there have been more specific kerfluffles, like the Wisconsin elections where the governor attempted to unilaterally postpone the elections after the legislature could not agree on a measure to make them safer.

Now one certainty is that  a lot of debate will come out of this  (and Supreme Court cases) arguing after the fact which measures were actually a violation and what we should do next time.  It is healthy to do the debrief.  Personally, I don’t know which measures will be determined to have violated human rights in the legal sense.  But I will be surprised if none have in any state.

Picking sides and partisan warfare

What’s equally disturbing for me is the partisan and dishonest nature of the discussion.  The administration blames it on the previous administration or China, the Democrats on Trump, and none of it seems to be based on evidence.  But what bothers me the most is the way data is presented by those supporting lockdown, because they are the ones trying to restrict my freedom and so I am least tolerant of dishonesty there.  Now I don’t think they are directly lying.  But they are presenting things in a certain light.  

This mostly seems to be taking the form of giving numbers out of context to increase fear.  For example, you will hear that ‘even young people aren’t safe’ without acknowledging that while technically young healthy people have died without any preexisting conditions, this is extraordinarily rare. It is one in thousands of developed cases and one in tens or hundreds of thousands of people exposed to the virus.  It’s saying things like ‘opening will hurt the most vulnerable in our society because more minorities are more likely to die from the virus’ without acknowledging that the exact same group of people is also the most vulnerable to suffering and death in an economic depression.  It is proclaiming the need for a 2-4 week lockdown to ‘flatten the curve’, and then extending it for months toward a different goal entirely – complete eradication of the virus.

I have been uncomfortably reminded of the old question as to how a Democracy slides into dictatorship.  To paraphrase Hermann Goering (a Nazi leader), “It is the same in any country.  Tell the people they are in danger and being attacked.  Shout that anyone who disagrees is a traitor who endangers the lives of the others.”  I’m also reminded of the 9/11 attacks, after which we changed things in a panic that never changed back.

Whether or not the measures were the right thing to do – and we probably won’t know for a couple of years at least – and whether or not we get all of our old freedoms back, this has been a big political awakening for me.  I have seen the truth of those words in how quickly the majority of the population accepted the word of authority figures that such drastic measures were necessary and how savagely they turned on anyone who disagreed.  This lockdown isn’t just people responsibly sanitizing their hands and wearing face masks.  It is also governments providing online forms to turn in neighbors for letting friends visit, and people calling the police to report people on their street for having visitors.  Whether you believe that is justified in the current crisis or not, that should scare you as a social development long-term.

A Bias Toward Action

Now I know that many people are well aware that there are costs on both sides of the lock down/open up strategy debate.  How much you weigh one side or the other will have a lot to do with your own experiences and vulnerabilities.  People who can easily work from home might be more likely to support a three-month lockdown than people who will lose everything economically.  It is no coincidence that the poorest states are among those most reluctant to lock down and quickest to open up.  

On a personal note, I think that in the phase of uncertainty we should have the moral courage to take some basic precautions and keep going about our lives.  I am not a stranger to tragedy.  I have cared for dying family members and lived with the chronically ill.  But as a society we seem to have forgotten that everyone will die once themselves and before that we will see people close to us die many times.  It’s a terrible thing.  But fear of it should not keep us from living, and COVID is not Ebola or Smallpox.  My own feeling is that fear should not be enough to restrict the whole population for months or years.  I can’t shake the feeling that we are doing the social equivalent of freezing in the headlights, too overwhelmed to rationally take care of ourselves.  In the end, it may be that having stopped moving will hurt us more than anything else.

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