Salus populi suprema lex esto.
That, we are told, is what Boris Johnson was telling his cabinet last week while recovering from his alarmingly close brush with death from Covid-19.
Salus populi: “The health of the people should be the supreme law”. It’s from Cicero’s On The Laws, as I am sure you all knew. The prime minister, back at work in Downing Street this week, is clearly restored to his old self, quoting the classics in fine style. In this case the famous statesman whose words he was drawing on was a Roman.
I guessed he would come out with something apt but it crossed my mind he might go for his great ancient Greek hero Pericles, leader of democratic Athens at the height of its glory, who, like Boris, had to grapple with inspiring the people in a time of plague. Not only that. Pericles found himself obliged to face down the anger of the demos, who held him responsible for their misfortunes. He told them bluntly:
…the apparent error of my policy lies in the infirmity of your resolution, since the suffering that it entails is being felt by every one among you, while its advantage is still remote and obscure to all, and a great and sudden reverse having befallen you, your mind is too much depressed to persevere in your resolves. For before what is sudden, unexpected, and least within calculation, the spirit quails; and putting all else aside, the plague has certainly been an emergency of this kind. Born, however, as you are, citizens of a great state, and brought up, as you have been, with habits equal to your birth, you should be ready to face the greatest disasters and still to keep unimpaired the lustre of your name… Cease then to grieve for your private afflictions, and address yourselves instead to the safety of the commonwealth.
At that time, securing the public safety of which Pericles spoke meant fighting a war he had led them into. Unlike any leader in a modern democracy, he had the balls – if we are to believe the historian Thucydides, who was himself a survivor of that same plague – to tell the people they were wrong: for honour’s sake they had to stay the course.
Is that, one wonders, what Boris was telling his cabinet? Was he, in a subtler way than Pericles, telling his government they must brace themselves to defy early signs of rebellion against the lockdown? Did he mean that all those people left out of work or furloughed at massive state expense, and all those businesses, large and small, that stood to be ruined by months more stuck in the doldrums would just have to suck it up?
That would be a massive call to make; but as is increasingly being acknowledged, big decisions cannot be put off much longer. Do we really have to put up with this lockdown indefinitely until a vaccine has not just been discovered and tested but also made widely available, which could take a couple of years? Or can a viable early exit strategy be found that does not sacrifice lives dishonourably? Those are the questions.
Yesterday morning, as I write, Boris gave us some clues as to his expectations with a statement from a lectern outside No.10. He made clear there will be no immediate end to the lockdown; but, in a touch reminiscent of his other great hero Winston Churchill, he marked this point in terms that echoed the wartime leader’s “end of the beginning” speech. Calling on us to be patient for the moment, he looked forward to a coming time when we could “fire up the engines of this vast UK economy” again, one by one.
As may be gathered from this emphasis of mine on speeches and rhetoric, Heretic TOC will not be grappling much with science and statistics today. In the last month, after all, it has become increasingly clear that although the experts have made a vital contribution – they have succeeded in “flattening the curve” in many countries, stopping the exponential rise in deaths that could reasonably have been expected without their advice, at least in densely occupied urban areas – they are also divided as to what to do next, and the coming phase will be about political leadership and decisions.
“We’ve managed to get to the life raft,” as epidemiologist Marc Lipsitch put it, “But I’m really unclear how we will get to the shore.”
When we do finally spot the right landing place we might well find it is in Sweden – a thought I’ll allow to drift at sea a little longer.
Any number of virologists, epidemiologists and clinicians are busy deploying their navigational skills as best they can but heretics like us, along with the politicians and the public, need to ponder the implications of the ideas they put forward: Will there be long-term consequences of keeping entire countries under sustained house arrest in this emergency? Do we face a dystopian future of permanent “contact tracing”, total surveillance and zero freedom? What does the lockdown mean already for kids stuck in a totalitarian nuclear family dwelling whose walls they can never breach? On the other hand, would lifting the lockdown too early imply a callous, Ayn Rand-style abandonment of the weak and vulnerable in hospitals and care homes? Would it fail those in the health services who are already putting their lives on the line to do their duty, by risking a second peak of the disease that could be higher than the first?
Not that these deeper concerns were lost sight of last time amidst the technical issues. Heretic TOC can actually claim to have been well ahead of the (now flattening) curve a month ago. I faced some criticism by commentators for speaking in terms of “brutal utilitarian calculations” as to the value of a life, and for doubting whether our civil liberties should be trashed just in order to prolong by a few months the lives of the old and infirm.
Yes, I was a bit blunt. It would be nice to think Pericles would have “Liked” my no bullshit approach. In the absence of a thumbs up from the great Greek, though, we might note that cost-benefit calculations and trade-offs along the lines I suggested are now being increasingly seen as necessary by big cheeses of our own times. Former civil service chief Gus O’Donnell, for instance, cited NICE as a model for rational medical decision making in a Covid context, just as Heretic TOC did, focusing on a tweaked version of the “life-years” concept I introduced.
O’Donnell, as it happens, also suggested a couple of days ago that a reasonable and fair way to get out of the lockdown would be to follow the pattern set by much-criticised Sweden. It is an idea I had liked the sound of for many weeks, ever since I first heard Sweden had decided against a compulsory lockdown. That country bravely followed its own course when – as libertarian pundits put it – so many other countries were being panicked into giving up their civil liberties. The Swedes decided instead on a voluntary approach to social distancing, even keeping bars and restaurants open.
Most European countries have opted for tight compulsory lockdowns – in France you even need a printed form every time you leave the house unless you want trouble with the police. Sweden, has been castigated for letting the disease let rip as a result of its laidback style, and it is true that mortality has been high compared to neighbouring countries. But the latest figures, as I write, show that the death rate per million of population is actually somewhat lower in Sweden (233) than in the UK (319). As for Belgium (633), wow! Such comparisons are admittedly somewhat specious as the figures are collected in different ways in different countries, but all in all it is far from obvious that Sweden’s policy can be written off as foolish and irresponsible.
In any case, even if we look no further than saving lives, the death rate from Covid-19 is not the only mortality factor to consider. For one thing, there is now evidence that focusing in a blinkered way on coronavirus is already leading to cancer patients and heart attack victims not being treated in a timely fashion, with an inevitable impact on their survival chances. And, as noted last time, what should also be taken into account is the years of life likely to be lost by shutting economies down. Last time, I cited a study showing that anything more than a 6.4% shrinkage in the size of the economy would in effect mean a lockdown doing more harm than good because it would add to the final net death rate. I was rightly taken to task by commentator Andrew Meier for failing to flesh out a more detailed picture. He added: “I don’t feel we can reasonably reduce the consequences of not taking adequate measures to control the spread of the virus to just a high mortality rate.”
His point was aimed at the need to consider the wider consequences of possibly letting the disease get out of control, beyond just the death rate, and he was right – the psychological consequences of panic setting in, for instance, could be terrible, as he said. And a point more widely emphasised, quite rightly, is the very strong imperative to make sure health services are not overwhelmed, as they were in Italy, with terrible consequences not just for the lives of doctors and nurses but also the morale and mental health of the survivors and of the whole country.
If we do look beyond the Grim Reaper’s likely harvest, though, we find in Sweden what seems to me an interesting contrast with the British situation. In the UK the health system was initially in danger of being swamped. In my now considered view, the government was probably right to go (reluctantly and belatedly, like the Netherlands) down the road of compulsion but should now change course quickly to a more libertarian stance.
Sweden never faced such extreme peril. Their health service going into the crisis was in better shape than the UK’s, which was already chronically “running hot”, with bed shortages every winter and many other shortcomings after a decade of austerity. Sweden also enjoyed the great advantages of a widely dispersed population with the highest proportion of people in any European country living alone; they topped the charts, too, in those already working from home. If voluntary “social distancing” was going to work anywhere, while keeping the economy open as much as possible, this was a very good country for the experiment. The capital, Stockholm, was an exception, with a high immigrant population in multi-occupation, multi-generation households, and this is precisely where the death rate has been highest.
Failure to protect the most vulnerable, in care homes and elsewhere, has been admitted as a shortcoming by the Swedish government; but they emphasise that their strategy is to see the problem as a marathon, not a sprint: their voluntary approach, with the greater freedoms it affords, is more sustainable in the long run than severe controls against which people are likely to rebel – indeed are already doing so, especially in some parts of the US.
What is prioritised comes down, in the last analysis, not just to the relative death rates resulting from different strategies, or even to a wide range of specific pros and cons. Rather, the approach we want to take will depend on our very broadest values, our view of the sort of society we want to live in. For the moment, the Swedish people are standing by the choice their country has made.
In Britain, though, we hear that government ministers have held a series of high-level meetings with trades unions and business leaders “amid fears that millions of people will be too fearful to return to work”. As amply documented by sociologist Frank Furedi and others, there are signs that we are becoming a very risk-averse culture. Even if the lockdown is lifted many will be afraid even to leave their houses – a poll found this was the case with around a fifth of all children.
Freddie Sayers, writing for UnHerd on the Swedish experiment, has wise words on this phenomenon:
The world becomes a place of indefinite anxiety, with the constant threat of curtailment hovering over all that is best and most human in life – family get-togethers, religious worship, children playing, plans for the future, creative projects – it risks becoming a conscribed, smaller, more fearful world. At its most extreme, a long-term “suppression state” really could start to feel like oppressive regimes of history, from the Puritans to the Communists, that misguidedly tried to remake the whole natural order in pursuit of a single definition of virtue. People who recoil from any move in this direction can hardly be dismissed, or called immoral.
Surely, in Britain, it is time to challenge the culture of cowardice that we have allowed to creep up on us in recent times. It is shameful that we are making even children scared of a disease that barely touches them. When Boris finally fires up those mighty engines he spoke of, we should at least be ready for the journey.
Salus populi suprema lex esto? Yes, but in its widest interpretation: the health of the people includes strength of the spirit as well as of the body. It depends on valuing not just our lives but our way of life.
Don’t know about you but the more I struggle to keep on top of all the corona news the more I feel I am drowning in a tsunami of information, even if at times it should be easy to discard – such as when we are repeatedly told that this or that vital fact about the disease is simply not known yet.
I make no apology, though, for adding my totally inexpert view to all the speculation and evaluation. Call it my contribution to democratic discourse. And at least I can genuinely claim to have consulted a pretty vast range of knowledge and opinion in forming my perspective and bringing it to you. Like the proverbial iceberg, nearly all of it remains underwater, unseen in the fairly small number of links I have given. A full reference list would run to well over a hundred articles and papers, to say nothing of broadcasts, podcasts, blogs etc., and many of these run to thousands of words, plus graphs, charts and hours of dialogue in sources such as The Economist, The Financial Times and Science, all of which have been among many serious sources giving free access to their Covid coverage, plus non-MSM alternatives such as Off-Guardian, Medium and Swiss Propaganda Research – thank you, “Explorer”, for alerting me to this last one. The MSM daily press in the UK and US have also been indispensible, plus quality periodicals such as The Spectator, and New Statesman on this side of the Atlantic and, well, The Atlantic on the other side.
With so much coverage to draw on, generally of high quality from both MSM and elsewhere, it is tempting to start an awards list here, my own personal Oscars for Best Statistical Presentation, Best Historical Parallels, etc. The ceremony could go on for hours, until you are all dropping like flies, killed not by Covid but boredom!
So I will refrain from that, or at least keep it short. I really absolutely must give a shout-out for UnHerd, especially the wonderful series of articles and podcasts on Sweden by executive editor Freddie Sayers. And I stick with Sweden for my two other nominations. The man I dubbed Heretic TOC’s “Europe Correspondent” after he told us about his encounter some time ago with Greta Thunberg, has been keeping up the good work with detailed, insightful on-the-spot reports for me from Sweden. Then, finally, I should mention the sterling contribution of Claire Fox’s Academy of Ideas, which recently hosted the first Zoom event in which I have participated, called “Economy Forum: How can we escape a coronavirus depression?” One of the speakers was Joan Hoey, director for Europe with the fabled Economist Intelligence Unit. I was able to ask her directly about the situation in Sweden. A full audio recording of this event is available for anyone interested.