COVID-19 Certainly Isn’t the Only Public Health Risk, But You’d Never Know That From the Ministry of Health’s Tunnel Vision Approach. That’s Because Our Policymakers Are Committing Three Simple Errors in Risk Regulation That Can Be Avoided For the Future
We have become wiser as a result of the COVID-19 pandemic, both as individuals and collectively. In many ways, the course of the Novel COVID-19 crisis in Israel has been a time of growth in our understanding of the world in which we live and even more so, a lesson in humility about what we do not understand and cannot control. We have had a front-row seat to the imponderable events that threw a wrench into the well-laid plans of humanity. (We call these “Acts of God” in the risk management clauses of legal contracts as if everything else that happens were somehow not also invariably always an “Act of God” as well.) As the Ancient Greek poet Aeschylus wrote, “pain which cannot forget. falls drop by drop upon the heart, until, in our own despair, against our will, comes wisdom through the… grace of God.”
On the positive side of the past pandemic year, some of us readjusted to a work world in which “working from home” became the norm rather than the exception. And those who could still work through it all gained a new appreciation of work and counted themselves fortunate. Within families, young siblings often had extra time to get to know one another and to bond with one another. Our global medical community and even Big Pharma, despite long suppressing needed treatments like the anti-cavity vaccine, stepped up and developed ground-breaking, game-changing new treatments and vaccines.
Thankfully, as far as we can tell one year on, the course of this pandemic has been far less devastating than the Spanish Flu pandemic of a century before. The new RNA vaccines are well over 90 percent effective at preventing infection and are almost totally effective at preventing death and serious illness by COVID-19 — and at least in the short-term seem to be relatively safe. While every death and chronic illness is a tragedy beyond description, this was not the Black Plague. We thus can count ourselves (comparatively and collectively, but not necessarily individually) fortunate, even in the face of the many tragedies that the COVID-19 has already caused. For those of us for whom gratitude is a concept, we may well breathe a heartfelt “thank God!”
Yet there is another side that is far less positive, a darker side to our experience during the COVID19 crisis. We have been victims, not only victims of the virus, but also victims of woeful shortsightedness on the part of policymakers as well as victims of bureaucratic overreaching and arrogance on the part of the Ministry of Health and those who heed its advice. One of the greatest casualties of the COVID-19 pandemic has been common sense in the area of risk management. Put simply: We have been acting as if COVID-19 is the only 800-pound gorilla in the room, the only serious risk to our health and welfare that we face as a country and have ignored all other countervailing grave public health and welfare risks. We have been recklessly subjected to “lockdowns” as our go-to policy solution when COVID-19 cases spike upwards. Israel effectively has been locked down to a greater or lesser extent for approximately eight months out of the past eleven months, more than any other country in the world. As will be seen, this lockdown strategy reflects tunnel vision, an obsessive and unhealthy focus on COVID-19 in addressing public health and welfare. This isn’t just hindsight being 20-20 or mere kvetching, it is a defective policy with dire consequences.
A few examples of the lack of common sense reflected in this COVID-19 “tunnel vision” approach by the Ministry of Health:
Lack of Common Sense in School Closures. As a parent, I’ve experienced this bit of Kafkaesque social engineering first-hand: school closures. More than virtually any other sector other than the hotel industry, schoolchildren have been subjected to lockdowns. To listen to policy-makers today, the only risk the public needs to worry about in connection with their children is the risk of spreading and catching COVID-19.
As a result of this obsessive tunnel vision, the policies promulgated utterly fail to take into account competing risks. Closing schools defies common sense for several reasons. First, the risk to school-age children is negligibly low, lower than the risk of death by car accident, or accidents like being locked in a car in summer or drowning in the bathtub. Second, shopping malls — catering to at-risk adults as well — are opened before schools: Is shopping at a mall more important than educating our children? Third, as of the writing of this article, the overwhelming majority of Israelis over the age of 60 have been vaccinated, and they are no longer in substantial danger of life-threatening infection via grandchildren. And exactly the over-60 population represents by far the greatest at-risk demographic for death by COVID-19. Forth, for the population between the ages of 30 and 59, the chances of death by cancer, heart disease, or car accident (in non-lockdowns) are all greater than death via COVID-19, so for them, too, infection by schoolchildren is a low-probability risk.
Yet policy-makers insist that opening schools is like “spilling blood”. By that standard, children should not be allowed to take baths, cross streets, or ride in motor vehicles either. Government risk choices are not logical, and they would not be our choices if we were free to make them. The result is devastating for our children: Today most schools in Israel remain closed.
Lack of Common Sense About the Grave Risks Caused by Lockdowns. Because of the obsessive focus on COVID-19 by the Ministry of Health and the politicians who heed its advice (often against the advice of the Finance and Education Ministries), the risks of lock-downs themselves have been largely ignored and unaddressed.
These substantial risks include no less than (to name only a few): depression and suicide due to bankruptcy and business closure and depression and loneliness due to isolation; domestic violence in dysfunctional families (who are even more dysfunctional when locked down together); delinquency and depression among children who are locked down and unable to attend school; increased alcohol and drug abuse as a result of lack of activity and depression; and increased failure to seek needed medical treatments that lead to more severe illness and death, to name a few.
Perhaps the biggest risk of them all is that of driving people into poverty and bankruptcy via forced lockdowns and the intellectual poverty and bankruptcy for children who are unable to learn and fall behind in their education. Studies show that joblessness causes a number of physical and mental health issues, not least of which is depressions and suicide, and so can the kind of isolation and idleness children experience when not attending school.
Yet the Ministry of Health and many policymakers pretend that there are no competing risks as a result of our tunnel vision lockdown policy on COVID-19. That tunnel vision causes grave damage to public health and welfare.
Lack of Common Sense in Failing to Weigh Costs Versus Benefits. Policy-makers have repeatedly announced that they are worried about the “Italian scenario” of the first pandemic wave, where medical resources in Italy, especially hospital beds and staff, were overwhelmed by serious cases of COVID-19. Israel’s official maximum capacity in COVID-19 wards has hovered around 850 beds, even as the serious cases requiring hospitalization exceeded 1000.
Yet at no time has the country significantly expanded its hospital capacity — including training new medical personnel and adding beds — to accommodate a scenario of increased serious cases. Nor have policymakers taken into account the increasing effectiveness of the antibody “cocktails” that have so dramatically curtailed the toll of the virus elsewhere, especially in the United States.
Instead, locking down the country has been the go-to policy solution. In light of the grave losses to our economy — estimated in the tens of billions of Shekels — and in light of all the public health and welfare consequences we have discussed, it would have been far, far cheaper to build new hospital capacity and invest in effective new treatments of serious cases than to lock down Israel. But that cost-benefit analysis was never implemented, and instead, we were simply “locked down.”
Lack of Common Sense in Speculation About “Future Strains”. The policymakers have sown worry and even panic about future mutated strains of the COVID-19 virus that may mutate around the protection afforded by the RNA vaccines. As of the date of this article, that worry is speculative and has not come to fruition. Both the Pfizer and Moderna vaccines have proven largely effective against the new strains. Yet policymakers reference that future potential risk in today’s lockdowns, ignoring the present risks that affect people’s present-day wellbeing. Future speculative risks should not trump current present and dangerous risks, including those from lockdowns.
Lack of Common Sense in Failing to Educate the Public About Competing Risks. Because the authorities are so focused on COVID-19, this tunnel vision causes a failure to engage in the kind of holistic risk analysis that we have been discussing. There is a myriad of risks that policymakers should be taking into account, but they are not. Many of these countervailing risks mandate the very opposite of lockdowns, we would need to actually open up to address them.
Unfortunately, the media, too, largely echoes what the policymakers are saying, creating an echo-chamber of COVID19 tunnel vision and panic, rather than pointing out the lack of common sense in many COVID-19 policies.
And so, we the citizens of Israel — those who unlike the policymakers have missed paychecks and watched life savings drained — are suffering the effects and often are ourselves not fully aware of the damage that this COVID-19 “tunnel vision” is causing. Our free press has traditionally kept the policymakers honest, an important role that has been all too often neglected in the present crisis.
So Why This Tunnel Vision?
So why has common sense been a casualty of COVID-19? The answer is rather straight-forward. Tunnel vision in COVID-19 policy is the result of an elitist, technocratic attitude among our policymakers. This is an unwelcome legacy of the socialist mentality that founded the State of Israel under the now negligible Mapai vision: From the socialist point of view, the enlightened “vanguard” of policymakers must lead (to borrow Lenin’s phrase). Private citizens outside of government, the socialist attitude goes, cannot be trusted to make rational decisions about their lives. Instead, the wise politicians and technocrats of the State should be trusted to make those choices for them.
But this is a dangerous error. When the Ministry of Health focuses on the narrow tunnel vision of COVID-19 risk, it misses the broader picture of risk that we as citizens face, collectively and individually. We each have lives that we are uniquely positioned to regulate. This is the essence of human freedom. Whether it is worth it for someone for business reasons or even (Gasp! Dare one mention it in the antireligious Israeli media?) genuine spiritual reasons to run a particular risk is best determined by the individual, because the individual is uniquely incentivized to seek his or her own welfare.
That does not mean our choices ever will be perfect. But the Ministry of Health’s choices is more imperfect. We weigh the costs and benefits carefully if we choose to send our children to school, to open our businesses, to pray in our synagogues, or to study in our study halls, aware of the risks but balancing the countervailing risks — and they are many — against the COVID 19 risk. This weighing of risks by individuals has always been the way free societies organized in the face of illnesses. I remember my parents describing the choices physicians made in the 1950s to expose themselves to the risk of contracting polio in order to treat their patients. Sometimes, it is noble to take one risk in the face of another because there are competing values at stake. The slander of the Ultra-Orthodox insistence on schooling children during the pandemic is an example of the tunnel vision of those who only consider COVID19 risks and no other risks and who do not respect personal liberty and autonomy. It is simply the latest scapegoating by bureaucrats and antireligious media and demagogues of a risk-management decision that weights countervailing values, not only COVID19.
By contrast to individual freedom of choice, bureaucratic top-down risk management — choices forced on us as individuals — is a form of arrogance in which technocrats usurp our own common sense and appropriate all individual risk-benefit analysis to the all-powerful State. The assumption of the Ministry of Health that “we know what is best for you” is pure overreaching: Policymakers are not Neo-Platonist philosopher kings better suited to make decisions than we are, nor are they Divine Prophets who see and deftly steer our proper course better than we can do for ourselves, nor are they somehow controllers of risk and thus a substitute for God Himself. Their job is to present facts not conclusions and allow us to make informed decisions, guided by our best judgment (and often informed by trusted advisors such as our physician or spiritual teachers). When government acts in that way, it enhances our lives. But when government binds our hands, it causes us to mistrust its authority and chafe under its yoke.
The wanton arrogance of the present “tunnel vision” lockdown approach is unique: Never before in history has the reaction to disease been to shut down basic activities in the world, even in the face of far deadlier pandemic threats to the public health — polio, tuberculosis, smallpox, and many more infectious diseases. Those pandemic threats did not lead to total obliviousness to the need to weigh other risks. And lockdowns were the very rare exception, never the rule (and in the case of the Spanish Flu of 1918-1919 did not work).
In the field of risk regulation, these mistakes are known as “the availability heuristic” — overestimating certain risks that are “high profile” at the expense of other risks that are greater but “lower profile” — and “system neglect” — ignoring the negative effects of one regulation on other areas of life. These are exactly the mistakes that our COVID19 policymakers have been committing here in Israel (though not only in Israel). As such, they are by no means wise “Philosopher Kings.”
Let us make no mistake: One of the reasons for the lack of trust in authority — whether government authority, scientific authority, or the authority of the news media itself — comes from these authorities’ insistence on managing the risks inherent in our daily lives, a lack of respect for citizens’ autonomy to make their own choices about those risks. Rather than assisting individuals struggling with many risks, these authorities have prescribed a ‘one-size-fits-all” that is effectively a “one-size-fits-none” strategy that fails us in our mission to manage our health and welfare risks.
The three simple errors that the policymakers have made on COVID-19 are thus: 1. Overemphasis of the COVID-19 risk to the exclusion of all others; 2. Failure to take into account risks caused by COVID-19 policies themselves; and 3. Failure to respect the liberty and freedom of citizens to make their own risk management decisions.
The takeaway from the mistakes made in this pandemic is that If common sense is not to be once again the casualty of the next public health crisis, policymakers should accord more freedom and autonomy to the citizens of Israel to weigh and decide about risks in their own lives. Policymakers’ attitude should be: “Because we know that we don’t know it all, we won’t try to play God. We will present the facts and leave the decision-making about risk management to you. And we’ll support you as best we can along the way.” The result is likely to be less tunnel vision and more holistic risk management as well as a greater respect by Israeli citizens for government authority as an agent of genuine liberty rather than its opposite. I predict that we in Israel will then be pleasantly surprised to see just how good our citizens’ common sense can be.