Monday, June 24, 2024
HomeCOVID-19100,000 deaths and the questions we should be asking

100,000 deaths and the questions we should be asking


THE Covid chickens are coming home to roost. Vaccination continues apace, but this week Britain formally passed the 100,000 Covid-related death mark. Much has been written on the grimness of this milestone, but grimmer still is the narrowness of the narrative, the avenues of research and analysis unexplored. The government is now paying the price of two almost-criminal errors. Its first and greatest offence was to fail to debate what moral goals we should be pursuing. Secondly, whether by accident or design it failed to apply any meaningful cost/benefit analysis to its lockdown policies, concentrating solely on suppressing the virus at any cost.

Whatever the blustering blond may say, the logic of this narrative means that all paths now point to an even more ruinous zero-Covid strategy. Don’t imagine it will stop there, either: as Allister Heath argues forcefully in the Telegraph, in future governments will enforce lockdowns, quarantines and travel bans at the drop of a hat when faced with any future viral scare. If society is to find a way out of this authoritarian, dystopian morass, it needs a new narrative, and fast.

This blog is not going to reprise the wider cultural and philosophical issues about lockdown that the TCW editors and other writers have so ably championed – for now, that argument has sadly been lost, or rather simply ignored – sticking to what is reasonably quantifiable in judging the effectiveness or otherwise of lockdown policies in ways that may conceivably shift policy to a more rational direction in the short term.

The first question we have to ask is an ethical one, regarding death and its statistical usage. Death is very attractive from a statistical point of view: it is a Boolean condition – you are either dead or alive – and easily measured. However, leaving aside the well-known debate about those who died with Covid-19 rather than of it, death is unlike any other phenomenon that affects the human condition because it is certain: it cannot be stopped, merely delayed. In our secular age, society is deeply uncomfortable at acknowledging this painful truth and seeks to abolish death in the same way one may seek to abolish car crashes or obesity. The result is arguably huge distortions in policy.

A strong case can be made that a better goal for Covid-19 policy would be to minimise aggregate life shortening (i.e. the total number of years of life lost). We know that Covid-19 mortality is highly concentrated amongst the old and frail, with the average age of death being 82, but what of the mortality caused by lockdown policies? Judged by this measure, if the demographic cohort killed by lockdown is considerably younger, then lockdown would have to kill only a fraction of those killed by (or with) Covid-19 for it not to be worth the candle.

Some would argue that such an age-weighted policy would be cruel and callous, disrespectful to the elderly, perhaps even verging on euthanasia. Perhaps it was therefore previously politically impossible to make it, but now that the government has shown its commitment to the old and infirm by prioritising their mass vaccination it may be possible that aggregate life shortening rather than crude death rates can now play some part in policy formation.

It is only once this ethical dilemma has been resolved that it becomes possible to ask the questions that will allow us to acquire information – information being data plus value – as opposed to just data, and thus build a more balanced approach. Although some effects of lockdown may lead directly to death in the short term, such as the collapse in cancer screening, many of the effects of lockdown will be much longer-term contributory factors.

Among the questions to which we should now demand answers are the following:

·       What are the life-shortening effects of delays in screening for various diseases such as cancer, diabetes and heart disease? (Note that these are presumably already well known as they would underpin investments in various screening programmes.)

·       How much of missed screenings can be attributed directly to lockdown policies, and how much to diversion of resources to cope with Covid-19? Would a no-lockdown policy lead to an even greater diversion of health resources and therefore a further drop, or vice versa?

·       What are consequences in terms of life shortening caused by long-term poverty induced by the economic costs of lockdown – suicide, poor diet, etc? How much would a no-lockdown policy mitigate such effects?

·       What is the long-term effect on life shortening caused by a lower health funding due to lockdown-induced economic losses?

You may argue, and with some justice, that many of the predictions of such long-term effects may be so inexact that they would make those of Professor Neil Ferguson look precise by comparison, but it is only by widening the debate in this way that we will escape eternal lockdown zealotry.

Finally, although this blog has concentrated on approaches that may shift the dial on Covid policy in the short to medium term, in the long term a much deeper discussion on our society, its culture and values will be necessary, as TCW has always argued. Here, the Church will have a central role to play. Although individual clergy have often responded brilliantly to the challenge of Covid-19, some even finding new online congregations, its leadership has been to date utterly woeful and wimpish at every turn – as, of course, we have grown to expect. That said, there is still time for the Church to redeem itself: indeed, it may well be the final chance it has of staying relevant in modern society, because the ultra-risk-averse, attenuated society we now live in is ultimately caused not by Covid-19 but by our secular terror of death. Coming to terms with death is an area where leaders of faith can provide comfort and acceptance better than anyone else. Atheists may hate the idea, but we will get our freedoms back only once we, in some sense or other, get religion. Justin Welby, your time is now.

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Andrew Cadman
Andrew Cadman
IT Consultant who works and lives in the UK. He is @Andrewccadman on Parler.

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