COVID-19 raises some very tough questions

elocal Magazine, ed. 234. 5 September 2020

As I write this month, Auckland is again in a Level 3 lockdown, with all the frustrations and irritations of that situation. I myself got caught up in a huge traffic jam, which had four lanes of traffic (including the bus lane) at a total stand-still for more than an hour, because of a mad rush of people wanting to get tested for the virus – and I doubt if anybody in that traffic jam was in fact wanting to get tested. I certainly didn’t.

And all around the perimeter of “Auckland”, a vast area extending from beyond Wellsford in the north to Pukekohe in the south, there were reports of hour long delays as cars and trucks waited in line to prove their eligibility to cross the border. For farmers and vegetable growers in the Pukekohe region, the restrictions were a nightmare.

Four questions demand answers. I’m not pretending that everybody will give the same answers to these questions, but explicitly or implicitly all need answers.

First, how much control should the state have over its citizens? Should the state be able to force people to wear masks for example? Should the state be able to force people to stay in their “bubbles”? Should the state be able to force people to be tested for the virus? When (or if) an effective vaccine becomes available, should the state be able to force people to be vaccinated?

I regard myself as being on the libertarian end of the political spectrum, but I think the state should have the power to oblige people to wear masks because it now seems fairly clear that wearing a mask reduces the likelihood that the wearer will pass COVID-19 to others before the wearer is even aware that he is carrying the virus.

Similarly, given that the actions of a small minority can jeopardise the efforts of the majority to combat the spread of the virus, I think the state can be justified in requiring people to stay in their “bubbles”. And certainly where some people are at high risk of contracting the virus because of the nature of their job, and therefore passing it on to the wider public, the state must surely have the ability to require testing.

Compulsory vaccination? This is probably the trickiest question of all because of the number of people who have strongly and sincerely held views against vaccination, often fuelled by perfectly nutty conspiracy theories involving the founder of Microsoft. My own mother was opposed to vaccination and as a result when all the other kids my age were vaccinated against polio, I was not vaccinated. But in retrospect that was a totally selfish thing to do: I gained the protection of herd immunity because almost all the other kids were vaccinated. So when a vaccine becomes available, I think the state should have the right to make vaccination compulsory unless there is some medically approved reason for not vaccinating.

The second question relates to why on earth the Government has been so sloppy on testing those who, on the face of it, are most likely to contract the disease, namely those working where people arrive from overseas – our ports and airports – and those working in managed-isolation and quarantine hotels. Recent revelations of just how few people have been tested, in many cases apparently because they objected to being tested when they were asymptomatic, have been utterly appalling. How can the Government expect the public, and in particular the Auckland public, to submit to a Level 3 lockdown, with all the loss of income, loss of jobs, inconvenience, and all the rest, when there is no effective testing of the people most likely to transmit the disease to the wider community?

I suspect that the public will forgive the Government for lots of other mistakes, but they will find it very hard to forgive this complete failure to implement an adequate testing regime for people who are the most likely to transmit the disease to the wider community.

The third question relates to how we safely re-open our borders. Like it or not, we cannot remain indefinitely sealed off from the outside world, and of course already we are not fully sealed off.

We have New Zealanders and New Zealand residents returning from overseas as of right. We have air crew entering and leaving the country frequently, often on the planes needed to carry time-sensitive freight to overseas markets. We have people allowed in to make major movies, or to repair racing tracks in Christchurch, or to compete in important yacht races.

But closing off the border to the vast number of those who would like to come to New Zealand has an enormous cost. Perhaps we can’t open the door without limit to overseas tourists and students seeking education in New Zealand, but there are clearly some countries where COVID infection rates are even lower than in New Zealand – China and Taiwan come immediately to mind, and Fiji and Samoa have apparently got no COVID cases. In a world where infection rates are vastly higher in countries which have traditionally been highly sought after by students in countries like China, such as the US and the UK, we have the opportunity to attract high-paying students for tertiary education, as Australia has begun to do. And for people coming to study in New Zealand for several years, the inconvenience of a two week quarantine period is trivial.

And my fourth and final question relates to the apparent absence of any careful analysis of the costs and benefits of our current strategy. I wrote a column entitled “Have we been conned?” a few months ago, and in that I criticised the Government for projecting many tens of thousands of deaths – 80,000 was mentioned – if drastic action to lock down the economy was not taken. The Prime Minister suggested that no cost was too high to avoid that awful situation.

But as I argued at that time, it was quickly apparent that even a modestly competent system of tracking and tracing would avert the huge number of deaths which the Prime Minister projected if no action was taken; and the implication of her action was that the severe restrictions which she was imposing on the economy had only economic costs. In other words, she totally ignored the increased suicides, increased domestic violence, increased mental health issues, and so on. She implied that there was no limit to the economic cost we should bear as a country to save lives.

But there is always a trade-off between economic cost and lives saved. Few would argue that taxpayers should pay $10 billion to save the life of an ailing 95-year-old. And if that is the case, we must as a society, explicitly or implicitly, decide how much cost to incur to prevent COVID-19 deaths.

I don’t have the knowledge or the skill to calculate how much we have paid as a community to date in order to limit COVID-19 deaths and related serious illnesses (and it becomes increasingly clear that, quite apart from the deaths, COVID-19 can inflict serious and long-lasting damage to human bodies). We know we have incurred a very large cost in lost jobs, businesses destroyed, delays in elective surgery, and so on in trying to eliminate COVID-19. We know that we have suffered a tiny number of COVID-19 deaths, almost all of those of people who were quite elderly and often with other health conditions.

The cost-benefit calculation for what has already happened is of course of interest. But what is really important is what the costs and benefits of alternative policies going forward are. What are the costs – human and economic – compared with the benefits in terms of deaths and serious illnesses avoided of alternative policies from here forward? Should we emulate Taiwan, or Switzerland, or Sweden? I suspect no Government wants to make that trade-off public, but make no mistake: every policy has substantial costs as well as benefits, and the Government is making those trade-offs whether they admit it or not.

https://www.elocal.co.nz/Articles/3731

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Copyright © 2020 Don Brash.