Sunday, October 11, 2020

Why COVID Risk Can't Be a Matter of Individual Choice

 


While Republicans/libertarians/economic royalists may not agree on how much of a danger COVID is, or even whether it exists at all, they all agree on what should be done about it.  Coercive government mandates shutting down economic activity are intolerable.  Instead, each individual should be allowed to freely choose how much risk they are willing to take. Certainly the elderly, people with medical conditions, and people with an elderly person or person with medical problems in their household should exercise maximum care, but everyone else should be free to decide how much risk they find individually acceptable. The usual challenge to libertarians -- what about children who are too young to understand -- can be dismissed by saying that the risk to children is minimal and there is at least some evidence children do not pass the disease on to adults.

So, why shouldn't each individual be free to decide how much risk to take?

The trouble with leaving risk tolerance to individual preference is that it works only if one person's risk does not endanger (unconsenting) others.  

An example might be evacuation before a hurricane.  Clearly society should evacuate people in hospital and nursing homes who are incapacitated from leaving by themselves, and incarcerated persons who have been forcibly prevented from leaving.  And it should furnish transportation to people too poor to afford their own.  But what about people perfectly capable of moving out, and capable of understanding the danger, who simply decide not to?  The main risk such people pose is to first responders, who are endangered by their stupidity.  What if we make clear that anyone refusing to heed a hurricane evacuation does so at their own risk and will not be rescued?  That is going to depend on whether you believe that society and government may -- and should -- protect people who don't want to be protected from their own actions.  Certainly a person who wants to stay and ride out the hurricane endangers no one else.  The hurricane will strike with equal force regardless of how many people are its path.  If anything, people who evacuate benefit if large numbers of people choose to stay because there is less traffic congestion.

Contagious disease is different. The risk that high risk-accepting people are willing to take can raise the danger for people who are less risk tolerant.  Some hurricane analogies are obvious.  We might allow a thrill-seeker to stay behind and ride out the hurricane, but we would not allow  him* to hide the car keys and prevent his wife and children to leave. Similarly, a single risk-taking member of a household may infect other household members who are more risk-averse.

And I will grant that a few isolated risk-taking individual pose little danger to the larger society outside their households.  But if a large enough minority of the population insists on going back to restaurants, bars, gyms, parties, etc. as if nothing had happened, the risk of out-of-control exponential spread that endangers everyone is absolutely real.  

Nor is it enough to say that anyone who is concerned can avoid exponential spread by staying home.  There are plenty of healthcare workers, first responders, and "essential" workers like grocery store clerks who don't have that choice, at least not without facing economic ruin.  (And, significantly, economic royalists want to ensure that anyone quitting such a job out of risk aversion will, indeed, face economic ruin).

And what about people with intermediate risk tolerance, people are risk-averse enough to stay out of restaurants, bars, and gyms, but still shop in person instead of having curbside delivery, or go mall-walking when the weather does not allow outdoors exercise?  In cases of out-of-control exponential spread, these activities become immensely more dangerous.  And in order to  maintain the same risk level, people may have to curtail these activities and become more and more isolated.  

In other words, people insisting on the freedom to engage in high-risk activities are curtailing the freedom of the more risk-averse.


A common Republican/libertarian/economic royalist objection to COVID restrictions is that it works great economic hardship, especially on small businesses.  This is true and while some stopgap measures -- ordering takeout and deliver from restaurants, curbside delivery for stores, temporary government assistance to get through -- may offer short term relief, continuing to shut down absolutely can cause severe, permanent economic damage.  

But so can out-of-control, exponential spread of the virus. Epidemiologists originally warned that if there was no social distancing, as many as 2.2 million Americans could die of COVID.  Realistically, this is not going to happen for two reasons. One reason is that we have gotten better at treating this disease and lowered the mortality rate.  But the other is that if spread become bad enough, people will take action to social distance, with resultant economic damage.  Business will shut down, not because government orders it, but because so many employees are falling sick. Word will get out about the dangers of high-risk venues like restaurants, bars, and gyms, and people will stay away of their own volition.  And businesses will fail.  And the economy will suffer.

I suppose Republicans/libertarians/economic royalists may regard that as acceptable, so long as it is the result of the free market, i.e., individual free choice, and not of coercive government mandates.  The rest of us -- and I think I speak for a much larger share of the population  here -- would conclude that if economic ruin is inevitable, we would prefer to have it accompanied by as little sickness and death as possible.

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*Let's face it.  Most people who behave like this are male.

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