by Dr Alberto Giubilini
The idea that “we are all in it together” has polluted ethical reflection about lockdown. Slogans often do that. At best, the idea is misleading. At worst, it is simply false. In either case, it has turned ethical analysis of lockdown into ideological moralism.
COVID-19 did not put us in it together. That slogan is a legacy of the initial uncertainty around the virus. In February-March 2020, we knew very little about it and we thought it was way more dangerous and lethal across all population groups. We now know COVID-19 is a serious threat to the elderly and certain vulnerable groups. But to young people, it is not (that is, if we look at the data, not at individual stories). The mortality rate is estimated to be below 0.1% in the under 40s, to double approximately every eight years, and to rise above 5% in the over 80s. The mortality rate of COVID-19 in children is comparable to that of chickenpox, that is, almost non-existent. “Long-covid” is often invoked to justify restrictions also for the young, but it has a similar pattern to mortality rates: the risk is low for the young and increases with age. This does not mean that COVID-19 is a made up problem or that we should not take it seriously. But it does mean that it is a very serious threat for a limited portion of the population.
So we are not in it together because of the virus. Blaming the virus for the costs imposed by restrictions is wrong, although it is not uncommon. For example, when the BBC asks “How has coronavirus affected mental health?”, it should really be asking how restrictions have affected mental health.
We are only in it together because we have decided to put ourselves in it together by having indiscriminate and very tight restrictions. We could have decided otherwise, as for example Sweden did by avoiding lockdowns and better protecting basic liberties and the economy while having a much lower COVID-19 mortality than many European and Western countries.
Because age is the main risk factor, lockdown raises a question around inter-generational justice. The young are in lockdown; that is, their basic rights and liberties have been suspended, their mental and physical health has being jeopardised, and their education and job prospects are being compromised. The benefit of this goes mostly to the elderly and the vulnerable. Most of the aforementioned costs of lockdown accrue to the young, including reduced life expectancy and deterioration in physical and mental health that economic recessions typically involve.
It can be considered ethically acceptable to burden certain groups for the sake of others, within certain limits. The ethical question is where this limit is, but that such a limit must exist, i.e. that we cannot go on with lockdowns for too long, is hard to deny.
It seems we are now accepting lockdown as the default solution and are not even asking the ethical question of where that limit is.
Consider two extreme scenarios.
Scenario 1: a lockdown that goes on for, say, 10 years. Even the three to four public health experts and epidemiologists routinely interviewed by the BBC who push for prolonged lockdowns with little to no mention of its costs (including public health costs) would say this is not acceptable. Plausibly, the reason why it is not acceptable is that the burden on the young would be disproportionate to any benefit we could get in terms of protecting the vulnerable through lockdown. That means that there is a threshold at some point.
Scenario 2: we have no restrictions whatsoever: everything is as it was before March 2020. Even those who favour a ‘herd immunity’ strategy would probably not see this favourably. Surely, if there is something that we could do to protect the vulnerable and that does not cause us much harm – such as wearing a mask when entering an indoor public space – we should do it. These kinds of limited restrictions seem proportionate.
With the current lockdown, we are somewhere between these two extremes. So we constantly need to ask ourselves whether we are beyond that threshold and whether the kind of cost we are imposing on younger people is worth its benefits.
And yet, we are simply not asking that question. If we did, the slideshows during the press conferences from Downing Street would contain data about the current and future costs of restrictions, not only about COVID-19 infection and mortality rates. Public health experts are not asking that question. Most academic ethicists refuse to ask that question.
I have argued elsewhere that we are now well beyond that threshold and that therefore the current lockdown is a form of unfair discrimination against the young. We might disagree on that, sure. But we need to address that question with a rational, evidence-based discussion, especially by those who are paid precisely to evaluate these measures.
Unfortunately, the perverse tendency of academics to divide scholars into two closed groups – the good people and the bad people – has affected the debates around lockdown. The narrative in this case is that the good people are those in favour of lockdown – and therefore they care about the vulnerable and the common good – and the bad people are those against lockdown – the selfish ones who don’t care about the important things.
This might partly explain why, for example, the trendy thing to do within academic circles is to criticise the Swedish approach to the pandemic because Sweden never locked down, in spite of the data mentioned above. Or to disregard the evidence suggesting that the actual benefits of lockdown compared to milder measures is not as large as is commonly thought. This is very relevant because when we ask whether the costs are proportionate to the benefits we need to know what the actual benefits are.
What makes the situation particularly unfair is that there are alternative ways of distributing the costs and benefits. If we disregard the alternatives, the costs imposed on the young are much harder to justify. The obvious alternative, especially now that we have vaccines, is selective lockdown of the elderly and the vulnerable while they wait for their jabs. This is fair because, after a certain threshold, it is fair that those who benefit the most from a policy (in terms of protection from a serious threat) are also the ones who should bear a greater share of its cost. But discussion of selective shielding, which some have defended (see here and here), suffers from the same problem within academic circles. It is one of those points that very few are prepared to discuss seriously.
So here we are, all in it together, in the name of some perverse form of levelling down equality. That’s what you can expect when ethics gives way to moralism.
Dr Alberto Giubilini is a Senior Research Fellow in Bioethics at Oxford University.
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