Imagine a tribe at the dawn of civilization, under a dark starry night, huddled beside the fire sitting down for their supper. The lurking wolf reveals itself and soon a few of his friends show themselves and then the pack surrounds the humans. The headman jumps up with his spear.
In real life, there are no superheroes to save the day without collateral damage. The headman and a few of his warriors have to kill the wolves before his tribe is taken. Who does he save first? Children and women? Should he maximize total lives saved or protect the vulnerable? While his unscientific mind may subconsciously be thinking about the sharpness of his spear and the need to use other tools to ward off the wolves, his immediate reflex is to save his family.
Dial forward several thousand years. The tribe is now 7 billion people. The wolf is a virus.
A pack of wolves is a visible enemy. Their attack patterns are well understood. The virus is invisible and unpredictable. We don’t know its attack patterns. Have we evolved as a civilization to handle this conundrum of choice? Who lives and who dies?
The consequences of human choice in the face of death and destruction have been in consideration since time immemorial. Krishna advises and admonishes Arjuna to take action that befits his status as a warrior in the epic Mahabharata.
"Let the motive be in the deed,” says Krishna, implying that the consequences of your action are not yours.
This notion of "Duty" was later codified under "Deontology". The essence of it is to carry out the deeds through a moral code without regard to the consequences of actions.
Is our moral code and duty during this time to save every life or to save as many lives as we can? Duty-bound by our moral code should we cast aside economic consequences and deal with the urgent challenge of saving the lives of Covid victims?
What about individual freedom?
"Free the country", says Elon Musk.
If a priori morality of some philosophies is human freedom, how can that freedom be curtailed by a cruel state?
Should I have the freedom to bathe in the sun below the blue sky on the beaches of Florida while the masked warriors wage their battle against the virus at labs and hospitals? Is that the freedom we are entitled to as citizens of a civil democracy? More importantly, should our elected government make these choices on our behalf?
Duty based on a set of morals and individual freedom at all costs are two ends of a spectrum. Is there anything in the middle?
Consequentialists would argue the cost-benefit of actions rather than inherent duty or fundamental freedoms. Should we not consider the ROI of drastic actions like the shutdown?
Should we consider economic costs alone? What about the human cost, and even within human costs how do we evaluate the sufferings of a heart patient or stage 4 cancer patient over the immediacy of handling the virus surge? How do we calculate the cost of imprisoning the youth of the country for an indeterminate amount of time within the confines of their own homes? Is there a cost to suspending education even with the benefits of video?
In many countries, there is a human cost of children staying at home where familial rape and abuse is common. Schools are sanctuaries not only for dignity but also for hunger. Many get their daily meals in schools. What is the cost of going hungry?
A global supply chain connecting the east and west has drastically altered the pace of a pandemic. The spread is too fast to think and prepare. What worked in China may not work in India or Italy. Further the virus does not seem to work the same way even within a country. The near uniformity of responses across nations, to prioritize lives that could potentially be lost due to the virus over everything else has serious consequences for some countries. While the death toll is high in Italy, over 140 million people in India, more than twice the entire population of Italy, are stranded without the dignity of labor, delegated to depend on doles from the public or the police. Some may die of hunger. How many deaths do we weigh against the hardships of 140 million people?
Was India’s choice to follow the rest of the world and shut down the right thing to do? Did it even have a choice in the face of a public outcry to act? Did it have the option to ignore what worked in China and South Korea and think about the problem with its unique constraints? With over a billion people and a fragile economic situation and over 65% of its population below the age of 65, it is not the same as South Korea. What should India maximize for?
The often referenced trolley problem, popularized by the "Good Place", is about the greater good. Imagine a train or a trolley that is about to crush a hundred people, hurtling down a track. You have the power to divert the rails so it goes off the track but it would hit an engine yard with 10 people and kill them. Would you divert the trolley to save 100 and sacrifice 10?
If you maximize the number of lives you will kill 10. Would you act to willingly kill 10 in cold blood to save 100? Our choices are not that different from what our ancestors faced 10000 years ago in a scienceless age as their brains quickly tried to figure out the damage they could live with. As the Good place points out theory can be different than real life or as Mike Tyson more eloquently put it “everyone has a plan until they get punched in the mouth”. The Virus is a punch to our very existence.
Can the virus wipe out the entire human race if left unchecked? Is there even a way to model this scenario? Could we do an ROI on how we fight the virus? If there is a way to determine an ROI to survive as a society, “Utilitarians” would argue for maximum utility or ROI. That is to maximize what is good for society.
Who decides what is good though? What if 9 out of 10 people in the engine yard were young engineers who could go on to change the world? Valuing quantity ( 100) over quality(10) may not be what society wants to maximize.
Some would posit that maximizing the overall happiness of the population is good. So what is happiness? Is it economic prosperity? If so, then shutdown is not maximizing that happiness. We should maximize the happiness of the 100 people to go on and earn a living and if 10 people die so be it. That would be the "Utilitarian" view.
In a way, large nation-states with standing armies in history have mostly operated in this way. Think of conscription to fight wars. Why do we send innocent young men to death even if voluntary? So the rest of us can have the freedom and /or happiness? If we can send innocent young men to death should we send well-lived old people to their death and free up the rest of the world to go about doing whatever they were doing?
A vast majority of front line workers today fighting against the virus are the conscripted army, keeping alive our freedom to breathe, in the comfort of our own homes.
Jeremy Bentham, an English philosopher whose writings influenced most capitalist societies argues for optimizing pleasure over pain. Of course, this reduces us humans as just two-toned musical instruments that cry out in pleasure or pain and the goal of governance is to hit the pleasure note for the society.
The people who want to rush to the beaches in California or Florida are Benthamites, urging decisions that maximize societal pleasure over the immediate pain of death and despair for a few.
Michael Sandel in his brilliant book “Justice, What is the right thing to do?” talks about this with the example of Romans throwing Christians to the lions.
“In ancient Rome, they threw Christians to the lions in the Coliseum for the amusement of the crowd. Yes, the Christian suffers excruciating pain as the lion mails and devours him. But think of the collective ecstasy of the cheering spectators packing the Coliseum. If enough Romans derive enough pleasure from the violent spectacle, are there any grounds on which a utilitarian can condemn it”
The problem with this approach, apart from its arguable immorality, is a violation of the human rights of individuals and their families that are susceptible to the virus( and those who are thrown to the Lions). Is societal pleasure higher than the rights of a minority to live( even assuming that the virus affects only a minority)? Are there gradations in pleasure? Relax the rules so people can run in parks and go to Disneyland but let the schools and offices be closed? Who decides which pleasure is rated higher?
Decisions amidst the certainty of impending disasters like a tornado or a cyclone are hard enough to model and optimize for. When dealing with an invisible enemy it becomes near impossible. Social scientists and public officials in governments the world over grapple with these all the time. Contrary to what we see on WhatsApp or Twitter, public servants are not stupid. Decisions are hard and require hard choices. We only see the root node of the decision tree while the branches that led to those decisions are hidden underground.
The danger in a globalized social media world is the pressure that public officials face to do things that don’t match their analysis simply because of the ignorant public cries for uniformity of action irrespective of what the local circumstances may be. “It worked in South Korea so why the hell is Sweden not doing it”, the crowd screams on Twitter. The implication is that just copy and don’t analyze.
If philosophy and social science are uncertain arts what does the certainty of science tell us about our situation?
The only thing certain is the name SARS-CoV-2. There are many many unanswered questions. Why so few got sick in many parts of the world while it raged in NYC, Italy, and the UK. Why did Seattle settle down even though it was one of the first to get infected. Is it the shelter in place? Social distancing efforts? Was it a different strain of the mutated virus in NYC? Between Italy and its neighbors, there is a vast difference in deaths.
While the problem is not only uncertain and intractable, it is highly localized. Zip Codes a few distances apart have varying degrees of impact. Scientists track something called the CFR( Case Fatality Rate). The denominator for CFR is Total cases. Total cases is a number that depends on testing. We all know the fiasco surrounding testing. So CFR is not something that can be used to derive a good model because the denominator is suspect until we get tests at scale.
Deaths as we know also vary between regions and localities. Elderly in China and it is a mix in the US. So causality is not clear.
The pattern of attack was originally thought to be lungs and now with more data, even this is not certain. In this situation, everyone becomes an epidemiologist on social media.
Aaron Ginn, a Silicon Valley technologist, self-published an article pointing out the government response to Covid was overblown and expensive on Medium called “Evidence Over Hysteria—COVID-19 - Debunked. It was later taken down by Medium. We are all information addicts, in this day and age, designed to consume and commiserate with the "fact" that arrives at the right moment of our thoughts and moods. We don't know if it is right or wrong, we don't know Aaron Ginn but if we "feel" that the government overreacted then the article strikes a chord and we retweet and resend adding artificial authenticity to the content.
Expertise comes from depth in a field and most experts I know toil for decades outside of the shine of social media. Further science is a team sport in the modern age, especially when dealing with an invisible enemy. While individuals may be right occasionally it pays to patiently weigh the pros and cons of an argument, peer-reviewed and analyzed.
Carl Bergstrom a professor of biology at University of Washington says “We go seeking fresher and fresher information, and end up consuming unvetted misinformation that’s spreading rapidly”
Scientists have to go searching for answers in uneven terrain, unsure of the beast they are dealing with, groping in the darkness by the candlelight of very little data. The tunnel is long and we are hoping to see sunlight before the candle gives out.
Science is a weapon to defeat the virus but it is not a tool of choice to make ethical decisions on what is best for society. R0 is a number and one input into making this decision for sure and scientists should be key advisors to the elected representatives.
To pause human activity cannot just be a scientific decision even if that may be the right one in a given locality. It needs to be driven by a framework to make choices under siege based on specific circumstances. What is good for New York may not be right for New Delhi.
Sweden has been an outlier going against prevailing scientific and social media opinion. They have treated this war against the virus as a long drawn out war and not a short term event that can be solved with shutdowns. The death toll has been significantly higher measured on a 2-month scale but Sweden is calculating for 2+ years and not 2 months. It is keeping its schools open. It seems to be preparing for a seven-game series rather than a pickup game with the virus.
Every society has a framework for making life decisions and much of that derives from culture and approach at a given point in time. Science is the only tool we have to fight our battles against unseen enemies. When we are a 7 billion large tribe, there are many unseen enemies. We need a lot of science to defeat these little monsters but they are pesky. Measles, for example, has been around for decades and 2019 saw the highest uptick in the number of cases in several years.
Fighting viruses is generations long. It is a marathon even when vaccines are available as measles has shown us. Not everyone can get vaccinated because of choice or circumstances or in many cases in Africa and India because of cost. Our fight against Covid is not by any means short even when a vaccine is available.
Worldwide, tens of millions of people are dependent on daily work. As humans, we tend to put a lot more weight on emotions and sympathize with those that were living and suddenly died. Our heart cries for the loved ones who were lost to the virus. It is wrenching that many were unable to say proper goodbyes, stranded in the sterility of makeshift hospitals, surrounded by machines when they should have been given a sendoff befitting the life they lived by those that cared.
For every such death, there are also the unintended consequences of the shutdown that are far from our field of emotions. An extreme case was the group that was run over by a train on the tracks of Mumbai. Workers returning to their home hundreds of miles of away chose the train tracks as their guiding path. They assumed trains were not running and settled down to rest after a tiring trek on the tracks. They never got to see another day.
It is complicated. Governance and decision making when lives are at stake is never easy. It can be just as easy to slip into a state of apathy over the deaths and assume that this the new normal. We as a society have consistently done that with other diseases until it directly lands on our own door step. A crisis of this magnitude is very hard for normal people to comprehend. So you get overreactions.
There are two kinds of over reactions. One from freedom flaggers who tend to view the government and control as immoral and don’t want to be told what to do. At the other end is the elitist whose life is not upended much by shutdown, and lobbies to keep the finger on the pause button.
The virus itself may be teaching us a lesson here. By all indications, with Covid-19 the immune overreaction of the human body seems to be the danger leading to death. We have to guard against our own overreaction to the dangers of the virus from destroying us.
A thoughtful oped by Ted Sarandos, Chief Content Officer at Netflix, highlights approaches that business can take to gently ease out while keeping watch on safety.
As we come out of this period it is not so much as getting back on track. In the Netflix documentary “Becoming”, a youngster asks Michelle Obama how she managed to get her life back on track. The implication here is that she went from being a free citizen to a fettered first lady and fell back into civilization.
“It’s a whole new track. It’s not going back, it’s just all different, and it’s different forever. So it’s not getting back on track, but it’s creating my next track.”, says Michelle Obama.
The world needs a new track as well. A track that can address the inequality in health and wealth, a genuine attempt at investing and building things that matter and may be a slow down in a pure shareholder approach to capitalism. It will not be business as usual as we unchain ourselves to step out into the post shutdown world.