What is the right thing to do? And how is it best to encourage us all to do it?
An emotive appeal may well have greater impact than a weight of statistics and numbers. I was inspired by something Amy Remeikis, journalist with the Guardian Australia, said on ABC TV’s The Drum last week:
“I just hope that when people are walking around and they’re seeing what they’re calling apocalyptic scenes and everyone’s seeing how negative it is; I look at an empty space and I see that as an act of love or of giving, because it’s people trying to save the lives of people they may never meet and that includes my father. – – I know there are people all over the country who are terrified for their relatives and that’s why l really do hope so many people are taking this as seriously as it needs to be taken.”
The Prime Minister and others have consistently attributed decisions they have made about the virus to the health advice from the Federal and State/Territory Chief Medical Officers. “Don’t blame or credit us governments; we are simply following independent, world’s best scientific advice.”
In turn, the Chief Medical Officers have referred to (or deferred to?) the modelling of COVID-19 transmission and infection done both here and in other countries.
We have been promised an open-book approach to the modelling being relied upon, but have yet to get it. This is perhaps because complete openness would lead to more distraction from the central task. Those who are already frantic providing health advice to the National Cabinet can do without debate about their preferred judgements, including because they differ from those of some other experts.
These ‘others’ include a team from Australia’s leading research universities, asked for advice by Professor Brendan Murphy, Commonwealth CMO. Their view was not unanimous but the majority of them called two weeks ago for “a rapid, sweeping and costly lockdown to pave the way for a national recovery once the crisis abates”.
Even with open access to the health modelling still more would be needed in order to understand – and evaluate – the decisions made in response to the pandemic. Presumably the economic impacts of various potential decisions have also been modelled, with the inputs being potential decisions about restrictions on businesses and movement, and the outputs such things as business turnover, the number of jobs lost and investor confidence.
The third part of the equation, and the most outrageously difficult, has been to make judgements about the relative value of different outcomes from the health and economy models. Put simply, it has in effect been a question of how much economic cost is justified to save a life.
When we have a chance to scrutinise the health and economic modelling that has been relied upon there will still be disagreement about whether or not the decisions made have been optimal. One thing we can be sure will be agreed is that all such modelling consistently displays great sensitivity – meaning that small changes in the assumptions and inputs at the front end have resulted in huge variations in outputs. Sensitivity must be even greater where the phenomenon being modelled is subject to exponential growth.
The Prime Minister has spoken often of the importance of preserving “life as we know it” – a euphemism for protecting the economy. For some people it has been impossible to shake the belief that his and his government’s embarrassment about their premature ‘back in black’ celebrations made them attribute, for some time, more weight to the economic crisis than to the virus.
In the earliest discussions with my eldest son – rational and risk-averse – I had taken the (disgraceful?) line that if there is a new virus in the world we might as well get used to it and develop immunity as well as we can. On the last weekend before the 500 threshold was declared I was in Bathurst with about a thousand others at the NSW over-65s hockey championships. Just in the nick of time.
Soon after that I was a convert to what I think of as The Norman Swan Line: the government should go hard and early, to maximise the probability of halting the spread. As Dr Swan has been saying for several weeks, the only potential down-side of this approach is that if spread is prevented and nothing happens, the nay-sayers would be able to say that the government had over-reached. That would be a great outcome!
I have been doing my bit for the Swan line. A sort of epiphany was at the Parkinson’s singing group on the Monday of the week after the hockey tournament. As soon as I sat down with the small group of us in the church hall I realised what we were doing. Given our small number and our recent history of travel, the probability of our meeting increasing the rate of transmission of the virus was close to zero. But my decision to attend had contributed to a meeting – and gatherings of 10 or 500 are occasioned by the individual decisions of 10 or 500 individuals. The desired outcome cannot be achieved without my compliance.
We each need to commit to that act of love or giving in order to save the lives of people we will never meet.
Thus disposed, the staged or gradualist approach adopted by the National Cabinet “as a result of the medical advice”, never seemed to me to make sense. If we know that a total lockdown will work, and that we will probably need that eventually, why wait?
Which brings us back to the modelling of health and economic impacts. In the case of school closures, the modelling would require assumptions about different transmission rates with various proportions of school children at school, based on even more basic assumptions about the behaviour of school children, parents and the virus itself. The decision to keep schools open while encouraging parents to keep their kids at home seemed to indicate a lack of confidence in the modelling and the Federal Government’s unwillingness to be held accountable for a decision on the matter. The hard decision rested with the States and Territories.
The Federation seems to have come to the view that the States and Territories are responsible for action consequent on the belief that overcoming the health crisis is a pre-requisite to beating the economic crisis, while the national government acts through its taxing and spending powers to engage in preparations for economic bounce-back.
The generosity of the national government on economic matters has been astonishing, although it is people not governments who will inherit the debt. And it is fervently to be hoped that the cart and the horse are lined up in the right order.