mt. solitary a weblog

XXVII.

This is a photograph of the street I live on in central Tel Aviv early on a weeknight, usually bustling with people, entirely empty during the coronavirus lockdown.


1. COVID-19

I’m not sure if there’s anything else I really could write about at this particular time. Like everyone else my age, I’ve never in my life experienced an event which so completely eclipses all other events in its importance and influence over life (September 11, 2001 was similar in its significance but its real-time impact globally was smaller than this). In the last week I have become convinced that, even though this is probably just the beginning of what may well be a hugely tragic global disaster, this is already the biggest global event to happen since the Second World War. This is true I think just considering the fact that billions of people are being confined to their homes, and the drastic snowball effect that is having on all parts of the global economny and societies, without even getting to the public health crisis and the potential cost in human life.

Last time, in XXVI, I talked about the pressure of trying to say something new and interesting about a well-trodden subject like fatherhood. The same is true but on a weirder scale here, since everything that has been written about the pandemic, the disease, its social and economic effects, has all been written in the past few months. Everything is new and uncertain and the volume and acceleration of things happening and being understood every day are unprecedented. This is the nature of exponential growth: just when you think you are coming to terms with something, the order of magnitude changes, and suddenly there are new challenges you didn’t even think of before.

What I do think is particularly fascinating, and what few think pieces I’ve read so far (so many think pieces) have really seemed to get to the heart of, or even really to discuss openly, is the moral tradeoff which is behind all the discussions between governments around the world: the tradeoff between human life and economic damage. This tradeoff is tangibly present throughout the entire crisis, influencing decisions, forcing people to take sides. Even if it is never mentioned by politicians (though by some, notably Donald Trump and Jair Bolsonaro, it is), it’s obviously there, as otherwise there would be no limit to the size of stimulus packages, or the severity of lockdowns, or people’s willingness to comply with them and stay in their homes.

Here’s the truth: there is a direct and intuitively clear link between social distancing and reducing fatalities during a viral pandemic the scale and level of contagiousness of the novel coronavirus. You can convince yourself fairly easily if you’re still skeptical by playing around with a model like this one, which shows you how all the different parameters influence the most important indicator of success or failure in the outcome of this crisis: total fatalities, which is directly dependent on the ability of national health systems to care for all the people who will become sick at the same time. By making that “same time” window wider, we “flatten the curve” of the epidemic, smearing its effects over a longer time but making it do the limbo under the disastrous horizontal asymptote representing total hospital capacity.

Here’s the other truth: the extreme social distancing required to make this happen will have a tremendous effect on the economy. Confining people to their homes means all businesses which rely on people to be outside of their homes: gyms, cafes, restaurants, hairdressers, almost all retail and tourism, will see their revenue fall to zero overnight. Unemployment skyrockets. People start to lose their jobs, and everyone else starts to worry about theirs. Job losses from the sectors that were hit first will start to ripple through other parts of the economy. A depression-scale loss of wealth and productivity is possible. It’s the societal equivalent of shooting yourself in the foot, the deliberate and rapid hibernation of the global economy caused by dramatic government intervention on a scale I’ve never seen in my lifetime.

So this looks like it gives us some parameters to play with in a simple model: on the left-hand side, the total number of COVID-19 fatalities once the pandemic is over (no one quite knows how it’s going to end of course), with a knob you can control that “flattens” or “tightens” the epidemiological curve. You’ll be able to see the fatalities drop as you flatten the curve, since hospital resources will be more available and more people who need life-saving treatment will receive it and recover. But when you turn that knob, a number on the right-hand side moves too, and that number represents the economic damage: say, the total damage to GDP in a given country, in the local currency. The more you flatten the curve, the more draconian and severe the social distancing rules must be, and this has a direct impact on a country’s output.

Here’s the interesting moral question: where is the moral place to set the knob? It can’t be “keep the curve as tight as possible”, which represents the most COVID-19 fatalities and zero economic effect (even though this is of course a simplification of the real situation: the economic effect of doing nothing and simply letting the virus wipe out millions of people and overwhelm global health systems would also be significant), since all but the most pig-headed “libertarians” (where are all the libertarians by the way?) must accept that governments have some responsibility to save lives of their citizens at some cost. And it also can’t be “make the curve as flat as possible”, since eventually unchecked and unending economic slowdown will dramatically change the shape and nature of the planet as we know it.

Of course, the obvious conclusion from all this is that to set the knob involves implicitly placing a monetary value on human life, since this will allow us to directly weigh numbers on the left-hand side against numbers on the right. Particularly morally troubling in this crisis is that this value directly depends on age and health, since the economic weight on the left-hand side must include some measure of remaining productive years.

This of course feels like a step too far, and it’s as far down the rabbit hole as I’m personally willing to go, though I am certain governments and researchers around the world have spent collectively many hours already during this crisis trying to determine these monetary values. On a purely utilitarian level it makes sense, particularly once you begin to quantify the potential loss of life resulting from a depression-scale economic downturn (suicides, homelessness, people losing health insurance and so on). But I think it’s an important thing to keep in mind while we all hunker down and try to see this pandemic out.

And of course, being data literate and aware of the tradeoffs and basic epidemiological models should be something anyone with a passing interest in humanity and its future prosperity strives towards. Lockdowns on the scale and severity seen in Israel or New Zealand, let alone Italy or Hubei, would never be accepted in the United States, for example, due to ignorance of these sorts of hard moral and statistical questions. People would refuse to comply, citing the importance of their individual freedom and the health of the economy as being more important than a bunch of old people who were probably going to die anyway, essentially planting roots down on one extremum of the thought experiment above and keeping their head in the sand throughout the entire pandemic. But this is the equation, whether we like it or not, and it’s worth being intellectually and morally honest about it.

In fact, I think honesty of all kinds is what is going to get humanity through this crisis, and I dearly hope that once it’s all over we will start to realise the importance of truth and honesty again, something that we have seemed dangerously close to discarding over the past decade. You can’t begin to withstand a threat like a pandemic without truth and data and people making rational decisions based on facts. It’s one of the few silver linings of this crisis that we may yet regain our faith and dependence on truth.

2. Reading, watching and listening

Reading

Watching

Listening