Monday, 6 April 2020

on the Judge's scrapheap

The former high court judge and general man of opinions, Lord Jonathan Sumption, wrote a challenging piece in The Times, sent to me by a friend. In attaching it I am probably breaching copyright but I could not find any contact address on the internet I've inserted some comments. He may well be right overall. But his prescription stands a good chance of chucking me on the scrapheap.
Maybe that is also right overall.

Coronavirus lockdown: we are so afraid of death, no one even asks whether this ‘cure’ is actually worse

“The only thing we have to fear is fear itself — nameless, unreasoning, unjustified terror which paralyses needed efforts to convert retreat into advance.” The words are Franklin D Roosevelt’s. His challenge was recession, not disease, but his words have a wider resonance.

Fear is dangerous. It is the enemy of reason. It suppresses balance and judgment. And it is infectious. Roosevelt thought government was doing too little. But today fear is more likely to push governments into doing too much, as democratic politicians run for cover in the face of public panic. Is the coronavirus the latest and most damaging example?

Epidemics are not new. Bubonic plague, smallpox, cholera, typhoid, meningitis, Spanish flu all took a heavy toll in their time. An earlier generation would not have understood the current hysteria over Covid-19, whose symptoms are milder and whose case mortality is lower than any of these.

What has changed? For one thing, we have become much more risk-averse. We no longer accept the wheel of fortune. We take security for granted. We do not tolerate avoidable tragedies. Fear stops us thinking about the more remote costs of the measures necessary to avoid them, measures that may pitch us into even greater misfortunes of a different kind.

As someone who (statistically at least) is nearer the bottom on the wheel or fortune than many, I am reluctant to acquiesce to dying conveniently. 

We have also acquired an irrational horror of death. Today death is the great obscenity, inevitable but somehow unnatural. In the midst of life, our ancestors lived with death, an ever-present fact that they understood and accommodated. They experienced the death of friends and family, young and old, generally at home. Today it is hidden away in hospitals and care homes: out of sight and out of mind, unmentionable until it strikes.

I think the idea that death was in effect domesticated in earlier eras is oddly romantic. The Boccaccio account of the bubonic plague that I posted here does not suggest that the ravages of disease were comfortably 'accommodated'. Death was what it always has been. Essentially nasty.

We know too little about Covid-19. We do not know its true case mortality because of the uncertainties about the total number infected. We do not know how many of those who have died would have died anyway — possibly a bit later — from other underlying conditions (“comorbidities”, in doctor-speak).

What is clear is that Covid-19 is not the Black Death. It is dangerous for those with serious existing medical conditions, especially if they are old. For others, the symptoms are mild in the overwhelming majority of cases.

The prime minister, the health secretary and the Prince of Wales — all of whom have caught it and are fine — represent the normal pattern. The much publicised but extremely rare deaths of fit young people are tragic but they are outliers.

Yet governments have adopted, with public support, the most extreme and indiscriminate measures.

We have subjected most of the population, young or old, vulnerable or fit, to house imprisonment for an indefinite period.

We have set about abolishing human sociability in ways that lead to unimaginable distress.

We have given the police powers that, even if they respect the limits, will create an authoritarian pattern of life utterly inconsistent with our traditions.

We have resorted to law, which requires exact definition, and banished common sense, which requires judgment.

These things represent an interference with our lives and our personal autonomy that is intolerable in a free society. To say that they are necessary for larger social ends, however valuable those ends may be, is to treat human beings as objects, mere instruments of policy.

And that is before we even get to the economic impact. We have put hundreds of thousands out of a job and into universal credit.

Recent research suggests that we are already pushing a fifth of small businesses into bankruptcy, many of which will have taken a lifetime of honest toil to build. The proportion is forecast to rise to a third after three months of lockdown.

Generations to come are being saddled with high levels of public and private debt. These things kill, too. If all this is the price of saving human life, we have to ask whether it is worth paying.

The truth is that in public policy there are no absolute values, not even the preservation of life. There are only pros and cons. Do we not allow cars, among the most lethal weapons ever devised, although we know for certain that every year thousands will be killed or maimed by them? We do this because we judge that it is a price worth paying to get about in speed and comfort. Every one of us who drives is a tacit party to that Faustian bargain.

The inability of people ('society') to understand  risk is one of the great anomalies in human behaviour. Does anyone ever educate children about what risk is and how it can be handled? I've been on boards where we have conducted risk assessments. Little was really understood, and the fact that the risks were all neatly tabulated on some sheets of paper seemed to neutralise them, courtesy of  a managerial exercise,

A similar calculation about the coronavirus might justify a very short period of lockdown and business closures, if it helped the critical care capacity of the NHS to catch up. It may even be that tough social distancing measures would be acceptable as applied only to vulnerable categories.

But as soon as the scientists start talking about a month or even three or six months, we are entering a realm of sinister fantasy in which the cure has taken over as the biggest threat to our society. Lockdowns are at best only a way of buying time anyway. Viruses don’t just go away. Ultimately, we will emerge from this crisis when we acquire some collective (or “herd”) immunity. That is how epidemics burn themselves out.

In the absence of a vaccine, it will happen, but only when a sufficient proportion of the population is exposed to the disease.

As someone who is 'vulnerable' by dint of age, I am reluctant gamble on my resistance to further the march of 'herd immunity'.  I feel I still have much to do. As always, I think my next book is to be the really good one. I am happy to accept personal restrictions, until such time as the 'absence of a vaccine' is rectified. 

I am not a scientist. Most of you are not scientists. But we can all read the scientific literature, which is immaculately clear but has obvious limitations. Scientists can help us assess the clinical consequences of different ways to contain the coronavirus. But they are no more qualified than the rest of us to say whether they are worth turning our world upside down and inflicting serious long-term damage. All of us have a responsibility to maintain a sense of proportion, especially when so many are losing theirs.



No comments:

Post a comment