In times of the coronavirus pandemic, a lot of people are talking about the need to ration. As a lecturer on the topic of bioethics, I talk about rationing all the time. The rationing of resources – organs, hospital beds, ventilators – is discussed in bioethics when there is a limit on available resources and the need for such resources is pressing. The need to ration entails the need to choose who will live and who is more likely to die. The coronavirus pandemic is causing us all to face fears about how rationing will affect us and our loved ones.
During the coronavirus pandemic lockdown, however, we are not only forced to ration resources. In the near future – weeks or months – we are going to have to ration movement and freedom. Isolation has been used according to policy-makers as a way to flatten the curve of contagion and therefore prevent overwhelmed hospitals and the need to make too many life and death rationing decisions. If this is accurate and not just spin, then when we begin to leave our homes, it will not happen all at once. A vaccine is too far off in the future for us to have trust in absolutes – that we can wait until no one will be sickened by this virus to loosen up rules of isolation.
Once the curve of contagion is under control, we can and must allow people to leave their homes, but in stages, slowly, so as not to trigger floods of cases befalling hospitals. And those who leave lockdown should be the less vulnerable, who suffer less from the virus – the elderly, the immune-compromised and those with serious underlying health conditions need to stay inside. The winding down of this lockdown will necessitate trust in the government, careful testing, self-isolation of the most vulnerable, attention to epidemiological parameters and a slow phasing into normal life. We will need to use trial and error and quicker testing and organized reporting, so as to ensure that any future spreading is minimized.
But this leaves us with the questions: who will be let out of lockdown first and for what purposes? How do we ration freedom? As we decide who should swallow the first gasps of increased freedom as the calls for isolation begin to lift, what should be prioritized?
First, a word about what should not be prioritized: ethicists reject the possibility that those with political clout should be given priority in medical care and, in this case, priority in exercising freedom. Thus, the public disgust at watching the president and prime minister of Israel enjoy the families during the Passover seder, while the rest of the country did without. Essential workers perhaps, but our political leasers’ families are no more essential than our own.
Most argue that the economy and the market should come first. Israel is facing the largest rate of unemployment in its history. The economy is slowing and the stock market crashing. Even today, with extremely tight lockdown provisions, some workers, even if not essential, are able to legally go to work for limited periods of time in a staggered manner. Thus, it may be expected that when the lockdown first lifts, it will be for the sake of allowing employees to return to work so they can maximize their efforts in the market.
Yet, in our consumer economy, it is not enough to allow hi-tech workers go back to their desks – they could work from home and with Zoom anyway. In order to really get the economy moving, people need to spend money. We need to open stores and provide services and jump-start spending and traveling, nationally and internationally. Thus, perhaps, we need to begin by allowing stores to open and consumers to shop.
Moreover, people need human connection and the economy needs us to recreate, so perhaps we should prioritize opening bars and restaurants. The mental health benefits of some recreation in parks beaches and cultural events can not be underestimated. Exercise and movement need to be allowed as soon as possible. Maybe we should even prioritize our pets? Not just for the animals themselves but for their owners, being restricted to 100 meters has been difficult for all involved.
However, despite these important priorities, as we consider how to gradually return to our busy lives and subsequently bear the consequences of potential further spread of the virus, I call for prioritization of children. Children need to get back to school. They need education — and online education is no replacement, especially not for young children. But, perhaps more importantly, they need socialization and they need exposure. It is not enough for children to remain confined to the four walls of their homes. They need to connect and interconnect to mature and grow.
Children, more than adults, need to socialize and experience and discover, together with their peers, as part of their maturation process. Confinement over long periods of time threatens that growth. As I watch my children adjusting to their current circumstances, I realize how important connection to others – live connection – is to them. Children are in transition, especially school-age children, and transitioning in their own homes can have deleterious effects – perhaps not visible immediately, but in the long run.
We always prioritize adult concerns and fears. Adults have more power, have louder voices, and greater status. Because children are our responsibility and because they are our future, we should prioritize their well-being above our own. Especially in Israel, where having children is so important, let’s demonstrate that it is not just having children, but prioritizing their well-being and care that is central to our value system.
Yes, the economy is suffering and the level of unemployment is unprecedented. And if children don’t have food, they can’t go to school. Ensuring sufficient necessities to even attend school must be considered first. And, our schools are crowded so we need to make creative provisions for alternating classroom time and online time, splitting classrooms, and perhaps going to school in shifts so as to facilitate social-distancing. And the youngest children who cannot distance themselves perhaps need to stay home longer. But I am afraid that children who do not leave their houses will wither. It is their need to function that should be given priority over adults in this time of crisis. Thus, as we transition from isolation to reconnection, assuming we can control other factors such as the need to social distance and isolate those who are infected, let the children go first. Send them back to school.