Ethics, Politics, and the Tragedy of Containment

The human cost will continue to accrue until the lockdowns are lifted, or even until the beginning of next year, hence the difficulty in collecting reliable statistics. But there is no question that it will be high, Valdai Club expert Jacques Sapir writes.

The experience of generalised confinement or lock-down will have deeply affected the populations who have suffered it. Faced with the Covid-19 epidemic, it was indeed a strategy widely used in Europe (with the exception of Sweden and Belarus) and less in Asia, even if in China it was used on a regional basis; it was also used in Africa and in the Americas.

Have we, as some claim, chosen to sacrifice our freedoms and our economy to save the most vulnerable among us? François Lenglet, an economic columnist for TF-1 and LCI, television channels with a strong audience in France, has even argued that confinement resulted in preserving the rich elderly at the expense of the working poor, who will be much more exposed to the dire projected economic consequences of the containment strategy. So, have the governments that made the decision to mandate the self-confinement of their populations made a form of ethical choice, favouring the inactive over the active, or the rich over the poor?

This idea of an ethical choice is interesting, but is it justified? The decision to use general containment appears more like a strategy born out of despair, employed by political powers that were overwhelmed by the course of events. This is what we have seen in France, Italy and Spain in particular. The case of France is interesting in that in the first ten days of March, the government and President alike were still making reassuring remarks. Thus, on the evening of March 6, when there were already 613 coronavirus cases declared in France and their number was doubling every three days, President Macron encouraged the French to go out, on the grounds that there was "no reason to change our outing habits”. On March 12, Mr. Macron affirmed that "the scientists" had concluded that there was nothing to prevent the French, "even the most vulnerable", from going to the polls for the first round of the municipal elections. Then, on March 16, in his televised address, he spoke of a "war" against the virus and announced a general confinement. Of course, there had been in the meantime a glaring lack of masks, hydro-alcoholic gel, respirators, and beds in the hospitals’ intensive care units…

In Italy and Spain, governments panicked over a devastating regional development of the epidemic in Lombardy and Catalonia, respectively. From these various cases, one can think that it was a form of fear which stood behind the decision to mandate self-confinement. In the case of France, it was the fear of being accused of negligence, and this fear materialised in the fear of criminal prosecution following numerous legal complaints; fear, too, because the government was facing a disease whose real lethality had been poorly measured as of the beginning of March; fear, finally, of also giving foreign observers the image of a country plunging into chaos. This leaves us far from an ethical choice, but indeed in the presence of a political choice, even if it remains still quite difficult for policymakers to really explain such a choice.

This political choice was not necessarily unjustified. Professor Didier Raoult, in his interview with LCI on May 26, offered an interesting indication. After having expressed his scientific doubts as to the effectiveness of the containment strategy, and explained that there is a big difference between the “quarantine”, i.e. confinement, and a “lazaret” policy (where only the sick are subject to a lock-down), he gives a political interpretation of confinement. He explains it is the result of a panic arising within the population and the government. He sees in it a measure which, while being ineffective medically speaking, makes it possible to combat this panic, and thus to limit the death toll that this panic would certainly have provoked. The argument is worth considering. It demonstrates a strategic, albeit not a technical or tactical perspective of the epidemic. It is not yet known whether this approach or the aforementioned ones have been decisive. But, it can be considered a given that the decision was political and not ethical.

This decision, however, came at a cost. We first think, of course, of the economic cost. It will be considerable. The containment and its aftermath have caused a major economic crisis. In France, the drop in GDP in 2020 is expected to range between -10% and -12%. It will certainly be -10% in Italy and Spain, and possibly -6% in Russia. However, this economic crisis is just one aspect of the cost of containment.

There is also a human cost, which will be difficult to measure. Containment was intended to protect, but it also killed. It killed the elderly, who have been cut off from their families and social ties, and who are dying of despair. It also killed many young working people, who could not bear to be cut off from their social environment and who fell prey to alcohol or drugs. It killed fragile, depressed and autistic people. Victims were also claimed by the explosion of violence in families who were brutally forced to live in confinement. The few data available show a 90% increase in violence against children and an almost 100% rise in violence against women.

This human cost will continue to accrue until the lockdowns are lifted, or even until the beginning of next year, hence the difficulty in collecting reliable statistics. But there is no question that it will be high.

Were the authorities aware of this before they made the decision on containment? Here we must answer in the negative, because no large-scale experiment had been made which could have shed some light on all the effects of the relatively long-term lock-down.

On the other hand, the human cost of the crisis generated by mandatory self-confinement could be predicted. We know that any sharp rise in unemployment causes a sharp rise in direct mortality (suicide), but also indirect (increase in morbidity due to the impoverishment of part of the population). All of this was known from the earlier work of doctors and sociologists. It seems inconceivable (but alas not completely impossible) that governments were not aware of the economic catastrophe that mass confinement would cause.

Therefore, another choice emerges for policymakers: that between, on one hand, allowing the disease to cause certain deaths and facing lawsuits and accusations of negligence for failing to adequately respond to the pandemic, or on the other hand, taking measures that would inevitably cause other deaths, albeit ones to which societies are (relatively) accustomed. It’s a cynical choice, but it’s a highly political choice.

The fact remains that this choice highlights both the predisposition of a so-called democratic government to encroach on public freedoms, and the blatant unpreparedness of France and other European countries for the risks associated with epidemics.

This general lack of preparation is curious, to say the least. Since the SARS epidemic (2002-2004), numerous studies have been carried out in France. Scientists, including the aforementioned Professor Didier Raoult, winner of the INSERM grand prize in 2010 and one of the most quoted French researchers, had alerted the authorities to the risk posed by such an epidemic. Preparations for such crises had been in place until 2010-2012. Then it seemed to have ceased to interest the administration, and funding dried up. The real question to ask is: why?

Why was the body tasked with monitoring the risks posed by epidemics dissolved? Why were the supplies of materials, sufficient in 2010, gradually reduced to the point that the Director-General of the Ministry Health, Professor Jérôme Salomon, made special note of it in 2017? Why didn’t he resign when confronted by the government’s ineptitude in addressing this question?

It seems that financial considerations were allowed to prevail over a strategic national security decision, to a point where the state found itself helpless and had no other option than to mandate self-confinement, with all the consequences that this has caused. And that, beyond presenting a political problem, quite certainly raises an ethical problem

Views expressed are of individual Members and Contributors, rather than the Club's, unless explicitly stated otherwise.