The difference of opinions between experts regarding the severity of the response that is warranted to mitigate the coronavirus outbreak is reflected in disagreements between various government policies, as well as among the general population. Some argue that the extremely heavy-handed responses are unjustified, and that the deleterious impact of the imposed restrictions will cause greater harm than the virus itself. Others argue, as the Israeli government has, that the top priority—whether for ethical or economic reasons—must be to do whatever is possible to slow down and eliminate the outbreak, even if that means imposing severe restrictions on the whole population. Although most people I know preferred the latter approach, at least initially, as the duration and societal impact of social distancing increases, greater numbers of people will likely side with the former argument: these measures are just too much of a sacrifice.
In the following, I am offering what may be called a “values-based” argument in defense of greater restrictions. This type of approach is one that I use in psychological practice when clients are thinking about how they want to make decisions and conduct their lives. I believe it is also a useful framework through which to think about the current crisis and the sacrifices we are being asked to make by our government and infectious disease experts.
First, a few assumptions:
- As no one has any natural immunity, a large percentage of the global population will become infected with the virus if left unchecked. A recent estimate for the USA population indicated that 40-70% of USA citizens would get the virus, which would result in somewhere between 140-245 million individuals becoming infected. It stands to reason that a similar percentage around the world would contract the illness.
- The mortality rate for those affected is between 1-3%. This point is highly debatable and as yet unknown, as it is unclear how many people have actually contracted the disease, as well as why different countries have seen such vast differences in their mortality rates. Nevertheless, even if the lowest estimates are correct, without a vaccine or drug to prevent infection or treat the virus, this would point to hundreds of thousands or millions of deaths in the USA, tens of thousands of deaths in Israel, and tens of millions of deaths around the world.
- Evidence exists that extreme measures can help. In addition to the advice of infectious disease experts, who until now have fairly accurately predicted how this outbreak would unfold based on their models, we have seen empirical evidence in China and other countries affected early on that very restrictive measures of various types have substantially reduced or eliminated new cases. On the other hand, countries that have delayed implementing strong measures have seen the outbreak grow exponentially.
- The number of deaths caused by COVID-19 will be substantially higher than the number of deaths caused by a decimated economy. This point is also debatable, although experts seem to assume this to be true, at least at the moment.
- These restrictions cause tremendous psychological strain. It does not require professional training to observe the real mental distress the consequences of both the virus outbreak and the social restrictions have caused. As a clinical psychologist, I can attest to this reality among those who I know in both personal and professional capacities.
Generally speaking, our values as they relate to people’s physical health, mental health, and economic well-being complement each other, and fulfilling one is harmonious with fulfilling the others. At the root of the current challenge is that the value of supporting our own and others’ physical health is at odds with these other very important values in our lives of supporting our mental and economic stability, at least in the short term. An additional issue arises for those in a free society, in which a fundamental principle is that we are able to choose how we balance the application of opposing values—I should be able to decide to what extent I distance from others, to what extent I am able to pursue my economic opportunities, and how much my own mental distress plays a role in my actions. The heavy-handed approach makes these decisions for us: the value of societal physical health trumps all other concerns, and I do not have agency to balance my values differently. However, if we consider how, given the choice, we would voluntarily balance our values, considering the assumptions listed above, I believe the restrictive approach gets it right.
As an exercise, consider possible options for how to complete this sentence.
In my community of 1,000 people, I’m okay with 20 of them dying within the next 5 months so that…
…I can watch live sporting events
…I can go out to restaurants
…I can hang out with my friends regularly
…I can pray with a minyan
…I can still afford to go on vacation.
…My kids don’t miss 3 months of school
…I’m not stressed to my wit’s end every day
…I don’t have to sell my home and downsize
…I still have a job
…I will not be homeless
…I can afford to feed myself or my children
I do not know where on this list people would draw their line. For myself, I would probably not be willing to accept the last two. But as a society, I believe this balance of values requires us to prioritize physical safety, even at the cost of almost everything else on this list. And it is then the job of national and local governments, as well as private charities, to ensure that the final two do not come to fruition.
As free societies have done in the past, we will rebound economically from these potentially catastrophic circumstances. Surely, assuming a sufficiently effective treatment or vaccine is not found soon, many people’s lives will change dramatically and negatively, as they are able to afford far fewer of the luxuries we have become accustomed to in our society, which is by far the most prosperous in human history. Many will also struggle paying for basic needs. But when weighed against the potential to save literally millions of human lives, a values assessment makes the choice very clear. And a mistake on this question—valuing our short/medium term economic stability and mental relief over physical life—may be a fatal mistake from which we cannot recover.