An empty street in Karachi during the lockdown. Photo Credit: Wasim Gazdar
Is there a trade-off between saving lives and saving livelihoods?
Individuals make decisions about this more often than they might notice.
There are too many hazardous occupations to list: mining, security services,
bomb disposal, firefighting, sanitation work, waste disposal, high rise
construction jobs, and so many more. But also there are multiple health hazards
in occupations otherwise deemed not to be hazardous – street workers’ exposure
to traffic fumes, agricultural workers’ exposure to chemicals etc.
These are hard choices for the most part. We try to reduce hazard (health
and safety regulations for example) but also, ultimately, leave it as a matter
of individual choice. A person, supposedly, decides for herself or
himself if a risk is worth taking. There are many flaws in this construction of
choice, but also enough in it for most of us to sleep easy, while people put
themselves at risk doing jobs that need to be done for our safety or comfort.
What happens when some new source of risk emerges? Such as COVID-19? Our
collective choice will determine whether this becomes one additional source of
ill-health and death that individuals will have to face, or not. Do we accept
it, as we accepted rising levels of air pollution, or traffic accidents – as a
fact of life? Or do we say, as we did with respect to terrorism, that this new
source of threat is not acceptable, that we will make all efforts to stop it
becoming a norm? As a society we have the capacity for both fatalism and
activism in good measure. Which do we choose to deploy now?
There are around 1.5 million deaths in Pakistan every year. Not all of
them are what are defined as ‘premature’ deaths. COVID19 is a highly contagious
disease. It has, to date, affected over 14,000 people in Pakistan, of whom 292
have died. The rate of fatality has risen from 1.4% to over 2% in just
the last two weeks. Even if just a tenth of our population gets infected, at
the current rate of fatality we can expect around half a million deaths. An
infection rate of a third would lead to a doubling of the total number of
deaths compared to a normal year. If actual fatality rates are much lower, as
some have suggested, the number of deaths might be as ‘low’ as 40,000. For
context – road accidents claim around 40,000 lives while air pollution causes
135,000 deaths in a year. The total death toll in the ‘war on terror’ was
estimated to be around 30,000.
For communities and countries, the analysis of a trade-off between saving
lives and saving livelihoods is even more complex than it is for individuals.
For individuals, we can and do take shelter behind the manufactured assumption
of people being free to make their own choices. But for a community or a
country, the choice involves saving Person A’s life over Person B’s livelihood
or vice versa. Because there is no simple technical way of resolving this
problem, it makes sense to pay attention to collective choices already made.
Why did we choose to draw a line under terrorism even though it was a
smaller source of death than air pollution or road accidents? Was it because it
arrived suddenly rather than slowly and incrementally? Was it because it
threatened, if not stopped, to escalate exponentially? Was it because there was
a global consensus that supported our effort? Was it because it threatened to
overturn our existing order, and make us a global pariah? We made our collective
choices on the basis of who we thought we were, on the basis, yes, of political
considerations, but anchored in values. And once we had decided to combat
terrorism, how did we frame the issue of its economic impact? Did we debate the
‘economic cost’ of eradicating terrorism, or did we belt up and create a
narrative about the cost that terrorism was imposing on our economy?
Understanding the epidemiology of COVID-19 is science in the
making. That in itself would be reason enough to follow validated global
practices to slow the disease down, so that our mental and organisational
capacities gain time to catch up. We know more now than we did two weeks
ago, and will undoubtedly have learned more in the coming two weeks. The same
goes for any analysis of the economic impact of the disease as well as measures
for its containment. What happens to our economy depends not only on the
morbidity and mortality faced by our people, but also on the measures that we
as well as our trading, aiding and ‘remittance’ partners take. In uncertainty
of this magnitude – with possible estimates of deaths ranging from 40,000 to
over a million – it is not surprising that there are diverse perspectives on
the trade-off between saving lives and saving livelihoods.
The question we have to ask ourselves is the following: how low would the
probability of a million additional deaths have to be for us NOT to put almost
everything we had into containing that number? This cannot be answered only
through analytics. It is about who we believe we are, as individuals and as a
collectivity. How we respond will then shape what we become.
This article first appeared in the Jinnah
Institute’s ‘Lockdown Paradox’ series on 25th April 2020 and is republished here with the author’s
consent.
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Saturday, 2 May 2020
Coronavirus Lockdown: Should We Prioritize Lives or Livelihoods?
By: Haris Gazdar