“…one of the more uplifting facts of online life is that it has shown us time and again that modern connected societies can unite for rapid and positive change. And humans throughout history, when united against a common threat, have achieved amazing things.”
This proposal for limiting harm caused by COVID-19 focuses on the following main points:
- how we can leave lockdown safely
- how we can protect the vulnerable without sacrificing the freedom, affluence and wellbeing of the rest of the population, and
- the potential negative consequences of staying in lockdown.
Why should you read this?
- because you care about the vulnerable
- because you care about your own health
- because you don’t want the economy to collapse
- because you’re concerned about the potential harm caused by lockdown
- because you want to think about and discuss the best possible way to approach and resolve the current crisis
What follows is a simple plan to limit the harm caused by COVID-19, taking into account potential loss of life and harm to people’s health, the psychological impact of lockdowns, and the economic impact of immobilised work forces.
Currently around the world nations are shutting down their economies to differing but universally concerning degrees in an attempt to limit the spread of COVID-19. Most of these efforts are an attempt to reduce the loss of life the virus causes, and thus they are being made with noble intentions. However, they are going to inevitably lead to economic paralysis for large parts of the world, and cause ongoing harm and even devastation to economies, which in turn will cause a lot of suffering and even loss of life. As well as this the psychological effect of lockdowns on modern populations is uncharted terrain, but when speculating about it we should be aware that humans are naturally active and gregarious creatures, and that in modern society a lot of people suffer from loneliness and isolation anyway, and that compounding these factors is going to have a detrimental effect on many people’s wellbeing. Imagine you were a person who already had very few or no friends, and gained your sense of community and identity from the few interactions you had, along with the time you spent in public spaces simply being in proximity to other people. Imagine the effect that a lockdown could have on these people: no phone calls, no interaction at all; something not far off solitary confinement. Also, we should consider the effect of the lockdown on those members of the population who already suffer from depression, paranoia or other forms of poor mental health, and see that there are many aspects to a lockdown that could trigger these people and cause them to deteriorate further.
Another important factor to consider here is that the current lockdowns have no foreseeable end, barring a vaccine, which seems many months or potentially even over a year off. Thus countries who enter lockdowns have no way out of them; if they reduce the spread of the disease then any lapse in their citizens’ isolation could lead to a new flare up, and even if a country was to eradicate the disease entirely within their borders (probably impossible) then their borders would need to remain closed, and just one individual coming from overseas or one contagious item sent from overseas could reignite the problem. So countries that enter lockdowns are voluntarily going into economic freefall.
Thus it is logical that such ongoing lockdowns should be avoided as much as is possible.
A way out of lockdown (or a way to avoid it entirely): If a lockdown is in place already then this could be continued until the transmission rates of the disease have slowed down somewhat. But the answer is the same for countries who either who want to reverse out of a lockdown without reversing its life-preserving effects, or avoid having a lockdown at all: to only isolate those who are most vulnerable i.e. those over 50 or 60 and those with pre-existing medical conditions that make them vulnerable. If countries channel their resources into identifying and protecting only vulnerable members of society (and making sure they do a fantastic job of it) then the rest of the population will be able to keep the economy afloat. Plus workplace tasks that are able to be done at home can be allocated to those of working age who are in isolation, keeping them active and productive, and thus benefiting both the economy and the mental health / quality of life of this demographic.
Because as is well known the severity of the disease is far lower for those under the age of 50. According to the BBC:
Fewer than 5% of under-50s needed to be hospitalised because of their symptoms, but this rose to 24% for 70 to 79-year-olds.
Similarly, only 5% of under-40s who ended up in hospital required critical care, compared with 27% of people in their 60s and 43% of people in their 70s.
What this entails is that if you are under 40 your chance of needing critical care if you catch the virus is less than 1/400, and this is not even taking into consideration that these figures include those with pre-existing illnesses, which means that if you are under 40 your chance of needing critical care will be much lower than 1/400.
The data and statistics on COVID-19 have yet to be refined, streamlined and elaborated on, but whatever data you look at one thing is clear: COVID-19 is generally not a particularly deadly disease for those in good health under the age of 50. In fact, it could only be described as a very deadly virus in those over 70 or with specific pre-existing medical conditions.
Thus the plan would be to identify those clearly at risk, and to put them into isolation in their own houses or state-provided accommodation, where they would be provided with practical and emotional support and sanitary delivery of food and supplies (those who delivered to them would need to be regularly tested for COVID-19 and be in isolation themselves, apart from their necessary work interactions). This group would remain in isolation until a vaccine had been found, and contribute to society remotely. It would be compulsory for them to stay in isolation firstly for their own protection but also because of the detrimental effects on their families and society at large were they to become gravely ill or die. And in the outside world, among the general low-risk population, the virus would be allowed to spread, causing minimal harm and potentially allowing herd immunity to build up. Nations who were carrying out this plan simultaneously would be able to open up their borders to each other and resume the free flow of people and trade. Countries that did not would continue to be at an economic disadvantage.
Another component of this plan: Because there is some risk that those under 50 could have undiagnosed medical conditions that could make (albeit a very small proportion) of them predisposed to becoming severely harmed by COVID-19, certain systems would be put in place to optimise the reduction of harm caused to those members of the population living outside of isolation.
Firstly members of the general non-isolated population would receive funding and be ensured access to medical testing for any underlying / undiagnosed illnesses that could predispose them to severe / debilitating effects should they catch the virus. Anyone found to be at high risk would go into isolation. Those on the borderline could choose whether to go into isolation.
Next, the healthy low-risk population would be encouraged to follow health advice that would lower their chances of being severely harmed or killed by the virus should they catch it. This would include healthy eating, exercise and avoidance of behaviours known to compromise immunity, such as drug-taking and smoking.
Next, hygiene procedures would remain in place in the general population to limit / slow the spread of the virus. We don’t actively try to spread the flu, do we? Because though it’s generally relatively harmless it’s unpleasant and makes us unable to function for a while.
Next, anyone of any age and health status would be able to choose isolation. Thus the decision to remain in society pre-vaccine would be voluntary, and people would be informed about their choice. Reasons could include wanting to live with those for whom isolation was mandatory, such as family members, or simply out of caution. People who entered isolation voluntarily would not be unfairly disadvantaged (e.g. their employers would not be able to dismiss them) but they would not have their living costs provided for beyond a small basic wage.
After the implementation of these measures, the population outside of isolation would be living in the safest way that would be possible without sacrificing meaningful community life or economic solvency. But though all precautions had been taken and the risk would be very small, there would still be a very minor risk to non-isolated individuals of suffering serious effects from COVID-19. Thus every member of society who chose to live outside of isolation would be agreeing in an enlightened capacity to take this risk. And this is normal. It is a deluded fallacy to pretend we don’t already live in a society where people are legally allowed to take risks. Every time someone gets in a car or on a plane they risk dying, as they do when they have protected sex (the condom could break, and their partner could have a deadly STI). People who eat meat all the time and no vegetables are taking a risk of developing colon cancer. When people go for a walk in the mountains in a cold country there is a chance of them dying in a landslide or snowstorm, no matter how prepared they are. Let’s not mention people who go hang-gliding. Meaningful, unshackled existence always involves some risk; the aim is to minimise the risk without taking away the meaning of being alive. Besides, we must remember that if we let our economies and social lives totally erode due to our response to COVID-19, we enter into a realm that contains totally different risks, some known and some not.
In some ways certain governments during the COVID-19 epidemic, though mostly well-intentioned, might be confusing their responsibility to protect their citizens’ health with the role of nursemaid, and in the process might be unnecessarily compromising people’s civil freedoms (and, as was mentioned earlier, people’s quality of life and mental health). And certain other governments may not be doing enough to protect their citizens’ health.
It is even possible that some governments have realised they can use their failure to protect their citizens to their economic advantage. These governments could be misreporting rates of COVID-19 infection and deaths, and letting their most vulnerable citizens die while using the remaining population to get their economies going again. They would then gain economic dominance over countries immobilised by lockdown and trying to protect their citizens. But, these rogue states will not be dominant if we follow this plan.
We know we can protect those vulnerable to COVID-19 through stringent and supported isolation. So then what would be the risk to the remaining population, those going about their daily lives in society? We know that people under 50 who are in good health are at a really low risk of being caused serious harm by COVID-19, and that this low level of risk does not take into account the effects of our proposed measures to protect the non-isolated population, such as social distancing and hygiene, testing so that those with the virus can be identified and temporarily isolated, and supporting people to strengthen their immunity through healthy lifestyle practices—and also of course, remember it will be an option for anyone who chooses to isolate to do so. So effectively if the vulnerable were isolated we would be dealing with the equivalent of a disease with a very low level of harm, and we need to consider, in such a scenario, if confronted by such a disease, would we really be prepared to enter into lockdown, with all its extreme known and unknown negative consequences, societal, economic and to people’s health? And if we stay in lockdown, can we really pretend we are simply avoiding a risk, without acknowledging we are taking a huge one in its own right?
Thus this plan outlines a simple and balanced approach to minimising the number of people killed and severely harmed by COVID-19, without sacrificing our economies, our fragile and precious social structures, and our way of life.
Note: many of those who would be made to isolate during the undertaking of this plan may cry foul, saying, “It’s unfair we have to isolate when others don’t have to”. Most people would however see the sense of vulnerable groups being isolated, and if called upon would be responsible enough to make this sacrifice in order, ultimately, to protect themselves and their country.
But another possible variation on the plan would make isolation voluntary for everyone (although it would be strongly advised for the vulnerable). In this variation anyone in isolation would be given just as much support as in the original plan. There could even be incentives for vulnerable people choosing isolation. But it would still be their choice. Or it could be somewhere in between: the vulnerable could be made to isolate for a certain period, after which it would become optional.
The particulars of the plan would vary between countries, based on those countries’ traditions, the priorities of citizens, and the degree to which the virus had spread there already. (There is no reason why citizens of democratic nations would not be allowed to vote on which path their country should follow.)
Many governments might be disinclined to give individuals in their country the freedom to choose whether to enter isolation or not, believing people would behave irresponsibly. But there is no reason to believe that a significant proportion would do so; in fact one of the more uplifting facts of online life is that it has shown us time and again that modern connected societies can unite for rapid and positive change. And humans throughout history, when united against a common threat, have achieved amazing things.