Covid-19: An Inverted Approach

The Scientific Community advocate the use of lockdowns and other societally restrictive measures to combat the spread and mortality associated with Covid-19 in order to protect ordinary healthcare capacity. An argument commonly made in the United Kingdom is that we must keep hospital admissions for Covid-19 at a low level so as not to divert resources away from the treatment of other serious illnesses that reach the hospitalisation threshold, with particular consideration of cardiology, oncology and so on. These arguments are based on a logical fallacy that prioritise a priori patients arriving spontaneously at the emergency room with a Covid-19 clinical presentation that meets the hospitalisation threshold.

Governments utilise this rationale in imposing severe restrictions on individual liberty that ought to be considered intolerable by an educated populous. It is quite plausible that this logical fallacy is underpinned by the presupposition that political opinion is driven far more strongly by Covid-19 mortality data than by all-cause mortality, the latter of which being relatively unreported in the media.

A more reasonable approach to Covid-19 would constitute a total inversion of this logic. Given the relative stability of the proportion of people requiring care for all-cause severe illness, the capacity required to adequately care for them should be ringfenced in the event of a pandemic influenza or coronavirus. The free-floating capacity reserved for more randomised events, such as all-cause pneumonia, injury or other variable events should then not be inflated in response to a disease such as Covid-19, but instead it should operate on a selective basis in the event of surging cases.

In practise, this may involve admitting those with the highest chance of survival, while deprioritising those who, despite hospital treatment, are unlikely to survive. This is uncontroversial when one considers that cancer patients have been told their treatment must wait because of Covid-19 surge capacity throughout the entirety of the pandemic. It is worth mentioning here that all cancers require hospital treatment of some kind, and they almost all have a with-treatment mortality rate above 50%. Covid-19 has a mortality rate of less than 1% in the absence of clinical intervention.

It should not be the role of government to regulate the individual’s ability to contract or avoid infectious diseases, particularly those with a mortality rate only slightly higher than seasonal influenza. Instead, government may seek to inform the people that hospital treatment cannot be guaranteed in the event of a capacity-breaching surge event, while ensuring that they have the information necessary to assist them in avoiding the virus, or mitigating their chances of becoming seriously ill through personal health and other measures.

Moreover, the realities of hospital capacity being widely known will have strong behavioural effects on many people without the need for legislative enforcement.

This simple inversion of the logical fallacy of Covid-19 public health measures is more equitable, and furthermore, it is more ethically sound through reliance on individual responsibility instead of government dictate.

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