It is
appropriate to be thinking seriously about the question posed above during the
COVID-19 pandemic.
The extent
to which it is appropriate for personal freedom to be sacrificed to protect the
vulnerable depends on context. The consequences of viewing either freedom or
protecting the vulnerable to have priority depend on the prevalence of the
virus in different communities and on the means available to protect vulnerable
people who are unable to self-isolate. Personal values are also involved; the
responses suggested by public health officials are not always in harmony with
the values of ordinary people.
Some people
see no trade-off between freedom and protecting the vulnerable. At one end of
the spectrum, one group in that category considers that personal freedom always
trumps all other considerations, irrespective of context. At the other end of
the spectrum, a different group argues that eliminating the virus trumps all
other considerations – they suggest that we cannot protect the vulnerable or
enjoy much freedom unless we eliminate the virus.
My response
to those who argue that personal freedom always trumps all other considerations
is that they should consider Friedrich Hayek’s observation that the norms of
just conduct that evolved to protect the private domains of individuals (life,
liberty and property) tend to change somewhat depending on context. There may
be good reasons for the private domains of individuals to be defined
differently during the extraordinary circumstances of a war or famine. Similarly,
behaviour that is appropriately held to be wholly in the private domain of
individuals can become problematic during a pandemic. For example, it is
appropriate for norms regarding physical distancing to have changed to reduce infection
risks for vulnerable people.
My response
to those who claim that elimination of the virus should trump all other
considerations is to point to the futility of attempting to achieve that
objective. Outbreaks have continued to occur even in isolated communities where
there have been no known active cases for months (e.g. New Zealand). It is unlikely
that the virus will ever be eliminated, even if an effective vaccine becomes
widely available. An ongoing suppression strategy inevitably requires ongoing
restrictions on personal freedom, so trade-offs are inevitable.
Different
strategies for protecting the vulnerable have different implications for
personal freedom, and hence different consequences for psychological health and
livelihoods. The broad choice is between focused measures aimed at protecting
members of vulnerable groups (e.g. people in nursing homes) and general
measures aimed at reducing community transmission. Focused measures involve
some restrictions on freedom (e.g. restricted conditions for visiting family
members in nursing homes) but attempting to achieve similar protection via
general measures to reduce community transmission involves much greater
restrictions of freedom.
There seems
to have been a general tendency to use a combination of focused and general
measures in most parts of the world. That may make sense in communities where
the number of active cases of infection is rising rapidly, but involves excessive
restriction of freedom where the number of cases in low and relatively stable.
Back in
March, I argued that a period of lock-down was
warranted in Australia to buy time to help cope with an expected influx of
hospital patients, and to put testing arrangements in place to enable
infectious people to be quarantined. That was a common view at the time, and similar
reasoning was used by federal and state governments to justify lock-downs. The
lock-downs were introduced following large scale voluntary self-isolation and shut-downs
of businesses whose customers were staying home.
However, the
strategy had unintended consequences. The combination of self-isolation,
shut-downs and lock-downs worked so well to suppress virus transmission that
some state governments shifted the goal posts. They closed state borders in an apparent
attempt to eliminate the virus within their states.
Subsequently,
the government of Victoria responded to a second-wave virus outbreak by adopting
an obsessive suppression strategy to reduce transmission rates. A severe
lock-down was introduced, placing the residents of Melbourne in virtual home
detention for several months.
There is
little doubt that the Victorian lock-down reduced transmission rates to a
greater extent than would otherwise have occurred, but the burden imposed on
Victorians seems to have been excessive. A more focused approach could have
protected the vulnerable with less loss of freedom to the rest of the Melbourne
community.
Perhaps the
severe approach adopted will enable Victorians to travel interstate sooner than
would otherwise be possible. However, like people in New South Wales, they still have little
chance of visiting Western Australia over the next few months, and would be
wise to exercise extreme care in making plans to travel to Queensland.
The federal
government’s provision of additional assistance to unemployed people and
businesses reduced the human misery that would otherwise have accompanied the
restrictions on personal freedom imposed by state governments. As noted
earlier, those restrictions include closure of state borders, which has been
detrimental to tourism. It seems unlikely that such stringent measures would
have been introduced if the state governments had to fund associated additional
welfare payments from their own coffers.
The
objective of governments in Australia – federal and state - now seems to be to
get to “COVID-Normal”. That involves ongoing restrictions on large gatherings,
distancing rules, sign-in rules for pubs and restaurants, and constant
hectoring by politicians and public health officials about the need for
vigilance. There are plans to reduce some restrictions on interstate travel,
and there is talk of allowing international travel to and from a few countries
with similarly low infection rates. However, a return to normal international
travel to and from Australia looks to be a long way away.
Getting to COVID-Normal,
means that Australians will be continuing to live in La La Land. For the next
few months, we will congratulate ourselves about the amount of personal freedom
that we enjoy relative to people in the United States and Europe, where
infection rates are much higher. However, I doubt that there will be as much
self-congratulation in 12 month time.
At some
stage Australians will need to think seriously about how we can make the
transition from COVID-Normal to living in the real world. What could be done to
enable that to happen within the next 12 months?
There are
grounds to hope that an effective vaccine will begin to become available within
a few months, but under current government policies that seems unlikely to
enable life to return to normal within a reasonable time frame. An effective
vaccine could enable those most vulnerable to the virus to be protected early
next year, and hence may offer potential for life to get back to normal without
much delay. However, effective protection of the most vulnerable seems unlikely
to be sufficient to persuade state government health departments to let go of
their single-minded suppression strategies. Given the climate of fear state
health officials have helped to generate, consideration of personal career
interests (ass protection) will continue to make them more concerned about
potential COVID-19 outbreaks than about other factors affecting the health and
wellbeing of citizens. For similar reasons, State premiers can be expected to
continue to hide behind the advice of public health officials, rather than to
make balanced decisions to protect livelihoods as well as lives.
It seems to
me that Australians should be giving serious consideration to the approach
advocated in the Great Barrington Declaration (GBD) of a group of infectious
disease epidemiologists and public health scientists. The GBD advocates focused
protection of those most vulnerable, whilst allowing the rest of the community
to live their lives normally and to build up immunity through natural infection.
The GBD
approach offers the best hope we have of life returning to normal in a
reasonable time frame. If we do not get an effective vaccine or treatment, natural
immunity offers the only hope that life can ever return to normal. If an
effective vaccine or treatment becomes available over the next few months, that
will remove most of the risks associated with the GBD approach. As I see it,
there is no good reason why life in Australia should not return to normal very
soon after vulnerable people have been offered the protection of a vaccine.