As the initial shock from the coronavirus pandemic starts to fade away, countries are increasingly faced with the realization that in some regards, saving business might come at odds with saving human lives.

This decision will be paramount for deciding the course of action over what increasingly looks like a marathon fight and not a sprint.

“Governments will not be able to minimize both deaths from coronavirus disease 2019 (COVID-19) and the economic impact of viral spread” — this is the sobering introduction to a report published in The Lancet, one of the world’s leading medical journals.

The report was published in what now seems like forever ago: March 9, when western countries were just starting to experience the outbreaks.

But as we start to realize that severe measures may be in place for months, it’s becoming increasingly clear that this is also an economic crisis — not just a health one.

Head in the sand?

As the WHO was just declaring COVID-19 a global pandemic and countries were taking increasingly severe measures to contain the disease, Donald Trump’s “We must protect our cruise ship industry” quip rings particularly important.

Many political leaders attempted to downplay the severity of the situation, but Trump’s reaction to the situation is particularly telling.

“We’re going substantially down, not up,” he said, as the number of cases was just beginning to explode.

“I think we’re doing a really good job in this country at keeping it down”, he stated just a few days later, as the country was floundering its initial testing response.

Then, after he declared a national emergency and it became clear that the US would not be spared by the crisis, he took a U-turn and said “I’ve always known this is a real pandemic.”

Trump may be more clumsy in his statements and more brazen with lying, but he is clearly not the only high-ranking politician to take this attitude.

Part of that reason is that the realization that this is a real pandemic comes with another reality: that the only thing that really works in tackling the disease is shutting things down.

Of course, no one really wants to shut down schools, transportation, and companies. This poses massive challenges, both social and economic. But taking these measures can be very effective in preventing viral transmission. This would buy valuable time for research, as well as giving medical workers the best chance of treating severe cases without being overwhelmed. Simply put, the measures that seem to work best require isolation — and isolation is challenging for the people, and devastating for the economy.

“So what is left at present for mitigation is voluntary plus mandated quarantine, stopping mass gatherings, closure of educational institutes or places of work where infection has been identified, and isolation of households, towns, or cities,” the Lancet report explains.

Trade-offs

Faced with the decision of taking precautions that might later turn unnecessary, most epidemiologists wouldn’t even hesitate. But most epidemiologists don’t become high-ranking politicians.

With some notable exceptions, the political response to the outbreak has been slow at first. There have also been controversies. Notably, the UK’s initial announcement to allow the virus to pass through the population and build herd immunity was widely criticized by experts, including Richard Horton, chief editor of The Lancet. Just a few days later, the UK a major change of direction, realizing that without suppression and isolation, the medical system will be overrun many times over.

Horton placed this initial mistake on ignoring data coming from other countries, and critics pointed out that Boris Johnson, the country’s Prime Minister, might be prioritizing economic rebound over people’s wellbeing. Johnson was quick to point out that he is taking the measures that he expects will save the most lives. But much of his briefings on COVID-19 have emphasized economic measures as much as on health and social measures — if not more.

But it is very plausible that deep down, leading politicians are making a very cold calculation: at what point does it become acceptable to trade-off saving human lives to ensure economic rebound?

It sounds extremely cynical, but it’s a calculation done all the time. In economics, the value of life is a parameter used to quantify the economic benefit of avoiding a fatality. While the justice system considers human life “priceless” (human life cannot be bought at any price), the economy and political systems operate under different assumptions. With limited resources and skill (ambulances, doctors, hospitals), it is not always possible to save every life, and trade-offs are made.

This will very likely be the case in this pandemic.

It’s important to point out that health and economy are interlinked in many ways, and when one suffers, so, too, does the other — at least, most of the time. At some point, the two become decoupled. It is possible to focus on economic growth at the expense of human health and vice versa. No one will want to admit this, but at some point, a calculation of this manner will be made about COVID-19.

In an ideal world, we would save lives while helping the economy. In practice, countries might have to choose whether to prioritize health or economic rebound.

Health, economy, and privacy: a trilemma

There is another aspect which is becoming increasingly apparent — it’s not just about economy and health, but also privacy.

Many of the measures that have been successful in Asian countries — ignoring China’s draconic measures and focusing on democratic countries — have involved significant concessions of privacy.

In Taiwan and Korea, two of the countries rightfully praised for their containment efforts, quarantine was monitored (and sometimes enforced) through a phone app that confirmed geolocation.

Imposing something like this would be hard to imagine in GDPR Europe, as well as in the US or other major democracies.

So the trilemma would translate into something like this: you can only prioritize two of the following three.

• health;
• economy;
• privacy.

Some Asian countries have chosen the first two, and many other countries are sobering up to the fact that they can’t choose everything. Their choice will be of paramount importance as we advance through this crisis.

No vaccine or effective antiviral drug is likely to be available soon. Vaccine development is underway, but even in the optimistic scenario, it’s hard to see mass production happening in less than 12 months. Treatments are also being heavily researched, but new treatments face a similar timeline. Repurposing existing drugs to fight COVID-19 is a promising avenue, but there is no guarantee that such a drug will be found, and this will be also time-consuming and challenging.

Before that happens, it’s up to all of us to make a difference. Now, more than ever, social power matters. Let’s do our best and act responsibly — we’re in this together.

“There are difficult decisions ahead for governments. How individuals respond to advice on how best to prevent transmission will be as important as government actions, if not more important. Government communication strategies to keep the public informed of how best to avoid infection are vital, as is extra support to manage the economic downturn,” the Lancet study concludes.