COVID-19: We Would Do It All Again

by Thomas Scarborough

'Compound Risks and Complex Emergencies.' PNAS.

Staying in a South African township in the autumn of 2021, once a week an old woman in worn out clothes slipped into the house unannounced, and sat down. She sat quietly for four hours, until lunch was served. She quietly ate her lunch, and left. I was curious to know the reason for her visits.

Her son, she said, had lost his work through the pandemic. He had been supporting her, and she could not now afford to feed herself. She couldn’t keep the lights burning after dark. She couldn’t even pay for candles—let alone the rest. Every day, she would slip quietly into a house like this, she said, and wait for a meal.

This was a direct result of a COVID-19 lockdown. Not that lockdowns are all the same, or have the same effects. The University of Oxford has developed a Stringency Index, which monitors a wide range of measures adopted by governments across the world, in response to the pandemic.

Without weighing up the rationale behind them, it is clear that these various measures have had grievous effects.

It is estimated that more than 200 million jobs were lost worldwide, in 2020 alone. The United Nations’ International Labour Organisation estimates that 8.8 percent of global working hours were lost, which is equivalent to 255 million full-time jobs. This is without considering the knock-on effects—apart from which, such losses are seldom made up in the years which follow.

According to the World Economic Forum, 38 percent of global cancer surgery was postponed or cancelled in the early months of the pandemic. The backlog, they said, would take nearly a year to clear. Of course, one can’t afford to postpone or cancel cancer surgery. Many surgeries were stopped besides—in fact, millions of surgeries per week.

Frustrations and the pressures of life under lockdown brought about huge increases in certain types of crime. Gender-based violence soared. The United Nations General Secretary reported a ‘horrifying global surge’. Scattered statistics confirm it. Many cities reported increases in gender violence of more than 30%. Some reported more than 200%. The effects of such violence never go away.

The lockdowns, in all their complexity and diversity, had negative effects on personal freedoms, supply chains, mental health, inequalities, and any number of things—and since everything is related to everything, almost anything one may think of was skewed.

Of course, not all of the effects of lockdowns were negative. Drug arrests plummeted in various places. Break-ins, not surprisingly, decreased as more people stayed home. In South Africa, a ban on liquor sales quickly emptied out hospital emergency rooms. Most importantly, it is thought that very many lives were saved from COVID-19.

How many lives were saved? This is hard to tell. Imperial College London judged that ‘the death toll would have been huge’—which is, there would have been millions more deaths. Surely this is true. At the same time, they noted that there are ‘the health consequences of lockdowns that may take years to fully uncover’—and paradoxically, the many attempts to stall the pandemic may have prolonged it.

How do we calculate the advantages and disadvantages of a pandemic response? It is, in fact, frightfully difficult. One needs to identify the real issues—or some would say, select them. One needs to weigh all relevant factors—however that might be done. There is a place, too, for the human trauma, whatever its logical status may be, and this is hard to quantify. 

At the end of the day, however, it all comes down to priorities.

An absolute priority during the pandemic was life. No matter how many or how few, lives should be saved. This emphasis is easy to see. Almost any graph which has traced the pandemic shows two lines: the number of cases, and the number of deaths. Other effects of the pandemic are by and large excluded from everyday graphs and charts—which is not to say that they are completely overlooked.

What does one mean, then, by loss of life? One means rapid loss of life, of the kind which overcomes one in the space of a few days from hospital admission to death. Such death, in most published instances, has been an almost complete abstraction—a number attached to COVID-19—signifying the priority of death pure and simple.

At the end of the day, the avoidance of rapid loss of life was the absolute priority in this pandemic. All other priorities were demoted, or put on hold, even repudiated as side-issues. Ought life to have been given absolute priority? Who can say? It has to do with human, cultural, and social values, as we find them, in the early 21st century.

The fact is that life—or the possibility of losing it quickly—was the immutable priority. Therefore, we would do it all again.