The Case for Democracy in the COVID-19 Pandemic. David Seedhouse, Dr.
of Civil Emergencies’ (16), rated ‘most catastrophic', a ranking shared only with major ‘terrorist events'. When viral outbreaks occur, experts in epidemiology, medicine and related sciences use modelling tools to predict their likely course. The scientists present what they call the ‘reasonable worst-case scenario', which is often a calamitous prediction (17). This places governments in an extremely difficult position: their leading scientists explain the potential damage from the outbreak; other governments around the world initiate radical measures to suppress or mitigate it; deliberately or accidentally, news and social media outlets create alarm and anxiety in the public. In such heated circumstances, how can ministers fail to follow the ‘expert advice', and conform to crowd expectations?
But is this ‘safety first’ approach really in the public interest? Is the professional expertise that informs decision-making in these circumstances sufficiently broad to achieve the most sane and practical balance?
Many thousands of deaths are of great concern. It is important to remember that behind the charts and statistics human lives are being ended tragically and prematurely. But the coronavirus is by no means the only or most significant cause of human tragedy – there are a great many other human concerns too. If we are to react optimally to the next pandemic, these need to be systematically and honestly addressed in balance with ‘public health emergencies', and more robust and democratic response mechanisms need to be put in place.
3 Imbalanced Dualities
There are so many questions that need to be considered deeply. Yet the human reaction to the virus by governments and the public alike has been largely ad hoc, fearful and uncritical. Since February, governments around the world seem to have had just one focus: stop the virus and save lives, apparently whatever the cost.
Of course, policy-makers are aware of the economic, social and other health consequences of their policies, but these have not been factored in as equal considerations compared to ‘stopping the spread'.
There has been little reflection about whether lockdowns and ‘social distancing’ are effective (different countries have enacted different rules, and at the time of writing the UK appears to be moving towards a one-metre rule rather than the two-metre rule previously in place) (18). Common sense says they should be, but without proper studies and testable science, we do not know even this for sure. Yet these social restrictions have not only been implemented, they have been enforced and policed without public consultation.
According to Karl Popper, arguably the twentieth century's most eminent philosopher of science, this would be a simple scientific hypothesis:
Preventing people leaving their homes when there is a contagious outbreak will reduce the transmission of the virus
This is a potentially falsifiable hypothesis and might possibly pass the scrutiny of some ethics committees if there were informed consent. The hypothesis could be tested and potentially replicated, but it does not seem to have occurred to anyone. It is not difficult to imagine a meaningful procedure for this research. It would require finding two similar housing estates or perhaps villages, testing a sample of each population for the virus, and if the results showed similar levels, completely locking down one village while allowing the other to carry on as normal. That would be at least the start of a scientific investigation.
The most comprehensive science would consider more than one measure and examine the unintended consequences of the lockdown as well. But so long as there is one independent variable and one dependent variable this test would meet established criteria for science (the independent variable would be the lockdown measure and the dependent variable the level of morbidity).
But instead we have had experiments (all of this is an experiment) with no controls, little attempt at comparative analysis, and without any attempt to gain permission from us. We are all being researched without any real effort to do the research according to the normal standards.
The virus seems to have distorted humanity's perception of what matters. Nothing is in balance anymore. It is as if the world has been driven to distraction, mothlike, by a massive searchlight illuminating just one thing.
The list of dualities below should be in proportion, as is mostly the case in normal circumstances. Yet everything has become skewed. The items to the left of each pair (A) ought to be offset by the items to the right (B), yet in each case, when it comes to ‘official decision-making’ on others’ behalf, the balance is overwhelmingly tilted to the left:
Certainty (A) and Uncertainty (B)
Scientific directives (A) and Community values (B)
Medical priorities (A) and Economic stability (B)
Safety above all else (A) and Civil liberties (B)
Epidemiological modelling (A) and the Modelling of broader social consequences (B)
The scale of death from COVID-19 (A) compared to Other causes of death (B)
Disease prevention (A) and Well-functioning societies (B)
Expert specialists (A) and Collective wisdom (B)
Guesswork (A) and Evidence-based medicine (B)
Association (A) and Causation (B)
Psychological bias (A) and Self-awareness (B)
Policing (A) and Personal judgement (B)
Social control (A) and Ethics (B)
Enforcement (A) and Informed consent (B)
Risk perceptions (A) and Accurate comparisons (B)
Central commands (A) and Public consultation (B)
Propaganda (A) and Balanced information (B)
Paternalism (A) and Person-centred care (B)
Obedience (A) and Critical thinking (B)
Scaremongering journalism (A) and Investigative journalism (B)
Older adults (A) and Young people (B)
Protecting life (A) and Living a worthwhile life (B)
Firefighting a zoonotic virus (A) and Animal welfare (B)
This is a formidable array of oppositions, but they should not be set against one another. In a well-balanced society they should blend in some sort of harmony. There is no perfect equilibrium of course. Different cultures afford different weights to each pair in normal circumstances. But when the scales are slanted so far to the left, something is surely amiss and critical reflection is sorely needed.
Interestingly, these two dualities seem anomalous:
Guesswork (A) and Evidence-based medicine (B)
Association (A) and Causation (B)
Strictly speaking, a perfect set of patterns would have these reversed, since all the other As appeal to supposed certainties. However, the pattern represents what has been emphasised (A) and what needs to be rebalanced (B), and there is little doubt that these two As are dominant.
4 Certainty and Uncertainty
Certainty (A) and Uncertainty (B)
The most striking general feature of my research into the pandemic is that it is difficult, if not impossible, to gain a clear view of what is happening. Government and health organisation predictions and announcements change daily: the World Health Organisation (WHO), for example, said for months that there was no evidence that healthy people should wear facemasks, and then changed that advice on June 6th. New information emerges in a bewildering stream, much of it in fragments posted by news-media searching for the latest story. Drawing watertight conclusions from the cascade of words and data is impossible even for ‘the experts'.
It