An ‘exit strategy’ means trading off public health, social cohesion
and economic disaster. We need to decide with our hearts as well as our
heads
We’re
starting to find a strange new rhythm. For those of us still working,
it might be a day at the desk, a walk and a family meal. There are
children to supervise or entertain, calls to check on loved ones, some
virtual socialising, streaming, reading and an occasional trip to the
supermarket with a carefully drawn list, after calculating how best to
avoid crowds.
The one thing we can’t do is plan. Work diaries, usually blocked out with colour-coded meetings and commitments, are bare. There’s no need to consult the family calendars pinned to the fridge either, because no one is going to those birthday parties or school dates or weekends away.
Having spent years downloading mindfulness apps as an antidote to our busyness, we’re all trying to live in the present because the future feels even scarier than this strange closed-in life. The possibility that it could last six months or more doesn’t bear too much consideration.
There’s plenty to worry about, of course, but without detailed, personal calculations about tomorrow, next week or next school holidays running through our heads, it really is easier to pay full attention to sunlit leaves or birdsong or cooking smells. It’s unsettling, to be drifting like this, untethered from the future, but for many of us it’s bearable, for now.
But as “the curve” flattens and fears of replicating the horror
scenarios that are playing out internationally subside, we are realising
that our future plans are contingent on the Big Plan, a national “exit
strategy” that will require diabolical decisions trading off public
health, social cohesion and economic disaster. And we all do need to
think about that.The one thing we can’t do is plan. Work diaries, usually blocked out with colour-coded meetings and commitments, are bare. There’s no need to consult the family calendars pinned to the fridge either, because no one is going to those birthday parties or school dates or weekends away.
Having spent years downloading mindfulness apps as an antidote to our busyness, we’re all trying to live in the present because the future feels even scarier than this strange closed-in life. The possibility that it could last six months or more doesn’t bear too much consideration.
There’s plenty to worry about, of course, but without detailed, personal calculations about tomorrow, next week or next school holidays running through our heads, it really is easier to pay full attention to sunlit leaves or birdsong or cooking smells. It’s unsettling, to be drifting like this, untethered from the future, but for many of us it’s bearable, for now.
Considering this option is not accepting the stupidly brutal advocacy of an immediate end to lockdowns in the service of free market ideology, nor the horrifying social Darwinist argument that a rapid lifting of restrictions would still see the fittest survive. It’s based on an assessment that we might not be able to live like this, or be able to afford to live like this, for the year to 18 months, or even longer, that it might take for a vaccine to be developed.
Governments have started to talk about the trade-offs involved in various exit plan options. Understandably, they are approaching the topic tentatively, because most of us will stay housebound for months, and because of the serious potential consequences of even a small relaxation of the rules. The national cabinet has asked health experts for advice, and Australia-specific modelling. But these are not judgments that can be made solely on the basis of economic calculations or epidemiological forecasting. They are moral and ethical questions that require not just our heads but also our hearts.
As Ben Doherty wrote for Guardian Australia this week there’s no room for complacency in these calculations, as overseas experience shows, lifting restrictions carries a real risk of another infection wave.
“Singapore, for weeks the darling of international comparison … has since seen a dramatic spike in the number of infections – a 60% jump in new daily infections – and has announced a further tightening of restrictions … Japan, similarly, having kept infections low for two months, has now declared a month-long state of emergency in response to a jump in new cases,” he wrote.
The Australian prime minister, Scott Morrison, has started flagging the idea of trials: some states cautiously easing restrictions earlier than others, standing vigilant to reapply them if the virus spread gets out of hand.
“You will have some jurisdictions, some states and territories, that might be in a position to move when others are not, then we will learn from the experience of those states that may have trialled things,” he said this week
The New South Wales premier, Gladys Berejiklian, promised her state’s restrictions would be reviewed regularly, but she was clearer about the trade-off; “every time you relax a restriction, more people will get sick, more people will die”.
All around the world attention is turning to these exit plan options, and the fraught questions they raise.
Exactly how do we calibrate the inevitable increase in infection rate with health system capacity and how do we avoid a devastating second and third wave of disease? What preparations need to be made so we have the capacity to identify, test and isolate most confirmed Covid-19 contacts and their close contacts? How many test kits and ICU beds do we need?
What levels of surveillance, and what sacrifices of privacy could be involved in test-and-trace?
These are high-stakes decisions for us all, and as epidemiologist Tony Blakely argued this week they need to be made with public understanding and consent.
“I am strongly advocating that Australia uses the next few weeks to deliberate on what we do next. That means pulling back from the (necessary till now) unchecked executive authority of government, and re-instituting parliamentary oversight … We need to also hear from a wide range of experts to help us deliberate. Philosophers, ethicists, economists, public health experts and epidemiologists – to name just a few,” he wrote in the Nine newspapers.
“At the end of this deliberation process, it will necessarily return to the politicians to ‘make the call’. But they need some sense of societal consent.”
It’s too late for parliamentary oversight. Parliament stands adjourned until August, apart from the committee scrutinising the new coronavirus laws. But it is not too late for the national conversation, with all the relevant modelling and information made publicly available.
Getting this plan right is a path to one day resuming our individual plans, to reclaiming a future. But it has consequences that demand compassion and deep consideration.
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