Brazilian nurses mourn 137 colleagues on May 12; 15,000 are infected. The new coronavirus is killing nurses faster in Brazil than anywhere else in the world. (By Euronews)
There are two voids in the pandemic: the first is global communication and the second is
advice from quarters other than scientists and economists.
I am more than my body and my money. And, clearly, the new coronavirus travels across
geographic boundaries.
I suggest incorporating both these aspects in an international advisory panel of philosophers,
writers, and artists, sociologists, theologians and other thinkers. Otherwise, politicians will continue to ping-pong between the green light from their financial wizards and red or yellow from medical experts. National leaders are desperate for guidance that could be found in a panel of specialists outside of their political sphere. After all, we are in a worldwide crisis. If we cannot talk across national and regional lines now, then when?
We need each other.
Some politicians and health officials reiterate that the pursuits of physical health and a thriving economy are inextricably linked, not diametrically opposed. But that is as far as they take it.
Much of the world is entering a “gray space” as Los Angeles Mayor Eric Garcetti described American states.
“That space lies between flinging open the doors and cautionary measures to prevent a virus resurgence,” wrote The Christian Science Monitor on May 21. “It includes ethical dimensions as governors and local officials make life-altering choices, while those unhappy with the decisions push back in the courts and on the street.”
These decisions are not easy ones. Sometimes, we get suspicious of and angry at our leaders because they lack certainty. If politicians are honest, they are all at a loss. Most are acting in the best interests of their populace. I would feel more confident about political decisions if the input was broadened to include ethics. Perhaps, then, there would be more listening and less shouting when we feel that our individual toes are being stepped on.
What price is life?
“One thing that the American public has to get used to is a tough conversation, not just about risk, but about loss and vulnerability,” said Anita Chandra, vice president and director of Rand Corporation’s research on social and economic well-being. “Those are tough conversations for policymakers and public officials and leaders to have – especially when they also want to calm fears and allay anxieties. But there is no perfect and there is no precise when you have an overwhelming crisis like a pandemic.
“We have to be able to talk about choices and the ethics of our decisions. We have to get more comfortable with those discussions – whether it’s around a vaccine or reopening businesses – than we have been in the last few months.”
It is not only Americans. It is all of us.
There is no standard concept for the value of a human life in economics. However, economists often consider the value of a statistical life (VSL) when examining risk/reward trade-offs, which people make with regard to their health. VSL is very different from the value of an actual life. It is based on how much individuals are willing to pay to reduce the risk of death, according to The Christian Science Monitor. Governments use VSLs to determine the cost of environmental regulations and road improvements. Right now, VSLs range between $9 million and $11 million per life.
Also, there is a formula for the use of medical treatments:
“Outside the U.S., it is not unusual to judge some treatments as worth it and others not,” according to The New York Times on May 11. "The World Health Organization has a formula for governments in making these decisions, starting with dividing the annual GDP of a nation per person. The WHO suggests paying for treatments that cost less than three times this figure for each year of good health they provide. (A treatment that costs less than one time the national annual GDP per capita is considered highly cost-effective.)”
Many studies have attempted to deduce how much Americans are willing to pay for a year of life in good health.
“All ways of deciding how to use collective resources are discriminatory to someone,” said Christopher McCabe, executive director and CEO of the Institute of Health Economics in Alberta, Canada. “The best we can hope for is to make those decisions in a transparent process. A fundamental problem in the U.S. is that there is no agreement on that process.”
What price is life?
It sounds cold. Yet, whether or not we admit it, we are placing a value on human life when we close down or reopen countries. We, simply, hope that we are making a decision that spares the most lives.
As Andrew Cuomo, governor of the hard-hit state of New York, said recently: “How much is a human life worth? That is the real discussion that no one is admitting, openly or freely.”
Why is that? It feels wrong to have this discussion. Ethically wrong. And it feels frightening. It is much easier, and it is comforting to hide behind Cuomo’s words:
“My mother is not expendable.”
But what if we do not have the resources to try to save everyone?
Let’s say a vaccine is developed and approved by the United States Food and Drug Administration, European Medicines Agency and other medical groups. The demand would be worldwide. Let’s say that there are enough injections for 75 percent to 95 percent of the population, which is enough to create herd immunity, but not enough to meet the high demand. What do we do then?
In the movie, Contagion, virologists and their families received the vaccine first. The U.S. Centers for Disease Control and Prevention held a lottery by birthdates for the rest of the population. Is that what we want?
In a way, we are already playing a lottery when we reopen societies with so many unknowns about the new coronavirus.
Long before a potential vaccine, there already have been spikes in cases of COVID-19. How do we react to spikes? Do we believe that closing down the society would revert the spikes? Do we believe that the spikes are worth rejuvenation of the economy?
What price is life?
We need guidance. Truly.