It is strange that what many people decry in our societies – loneliness – will probably save us from flirting with partial extinction. In confining the whole population of France to two weeks of house arrest, Emmanuel Macron has used one of the ills of present-day society so that we can all continue living together. But at the same time, he has taken away the responsibility towards fighting the pandemic, that each and every one of us should carry.
There are three visions concerning the best way to tackle the coronavirus pandemic. The first, is that of a complete lockdown, where the whole country closes its doors to the outside world, and each citizen cuts himself off from his environment. Only time will tell whether France, Italy and Spain, will be successful in combating COVID-19. China has shown us the way, but does not yet know what will happen when the restrictions are lifted, if they are lifted.
The second approach is one of quiet resignation based on the acceptance that people will get sick and people will have to die. It is all in the call for a brighter future, a future where so many people will be immune to the virus, that its presence amongst us won’t matter one ounce. Assuming that the coronavirus does us the favour of not mutating, maybe Boris Johnson will be proved right, whilst the rest of us will end up with egg on our face for having panicked.
Thirdly, there are those in the middle. In true Dutch style, where compromise rules, Mark Rutte explained to the Dutch nation that a “controlled” outbreak was necessary to obtain the immunity of the many, in order to protect the few. We have to accept that the virus is here to stay and that we have to accommodate it as good we can. Only when enough people are immune and/or when a vaccine is found, will the virus no longer feel welcome.
Whatever the rights and wrongs of government policies, whatever the evidence-based scientific theories and practical solutions, the final outcome of the coronavirus pandemic will depend on how seriously you and I take our responsibilities, and on how far we are prepared to go in giving up a way of life we took for granted.
Voluntary confinement is less about you and I, and more about others. It reflects our capacity to take into account the general interest. I phone a patient of mine, to cancel an appointment in accordance with current advice, only to find out that she is entertaining friends. Has she really no idea of what is going on? Is she having fun whilst she still can? While others are locked-up, or not working, she epitomizes a refusal of all that goes beyond the individual. It is a “me first,” attitude combined with short-sightedness that will, one day, get us all into real trouble, if we aren’t in real trouble already.
Human short-sightedness, especially when the problem doesn’t concern you yet, is another aspect of human nature that will get us into trouble. In the same way that there are those who consider global warming as a dream – and an unrealistic dream, at that – there are those who think that COVID-19 is just another flu. For them, it’s a case of “catch it” and “get over it.” Maybe it is, but we cannot be sure. The problem we face, is that in medical science, there’s nothing worse than uncertainty.
I frowned, when I passed a dental practice that had remained open. Two information posters can be clearly read at the entrance. The first is a poster that all dentists have access to. It relates general advice on how to limit the spread of infection by washing your hands and sneezing in your elbow. The second warns anyone who is suffering from a sore throat or has respiratory symptoms, not to enter the premises, and cancel the appointment by phone. All dentists in the Netherlands have received strong advice from the Dutch Dental Association to remain open for emergencies only, until April 6th. The advice, of course, is not mandatory, and it is up to each practitioner to decide whether he should continue working normally.
It is difficult enough to follow advice that infringes on individual liberties. But when the advice is vague and unconvincing, and differs between experts, it becomes almost impossible to follow. In the UK, pub and restaurant owners are furious over the government’s advice to avoid pubs and restaurants whilst, at the same time, not issuing the order for immediate closure, and coming up with financial plans to help the affected industries.
In all medical situations, a favourable outcome is best obtained when both patient and doctor trust each other. Such a degree of trust is necessary to obtain patient compliance that leads to curing the disease.
Citizens have a responsibility of thinking about others and acting in a way that protects both themselves and their community. Authorities too, have responsibilities. First and foremost, they must be clear about their objectives, and transparent in their actions. As in all of medicine, the patient has to consent to the proposed treatment, and the consent must be informed. In this respect, the television appearances of Mark Rutte and Emmanuel Macron could not have been more different. Rutte gave the impression of being a loving father trying to convince his sick but reticent child to take a bitter medicine. He explained that the Dutch government had three choices, and that the path chosen was the lesser of three evils. For the French president, it was all out war, with no rational explanation. The country was at war – a sanitary war. And if the French people did not obey their general, they would be punished.
President Macron’s address was as full of panache as it was empty of meaning and honesty. In comparing the situation to war, Macron forgets that 20,000 men lost their lives on the very first day of the 1914-1918 war. More importantly, though, Macron did not explain to the French people what the government’s thinking was, and what choices it had.
– It’s an idea that can make you laugh, but the only way to fight against the plague is honesty.
– What is honesty? said Rambert, suddenly serious.
– I don’t know what it is in general. But in my case, I know that it consists in doing my job. – Albert Camus (The Plague)
We should all be prepared to make sacrifices for the greater good, but as with climate change, we will only act when disaster affects us personally. Governments must be honest, and show that, without taking brave and informed decisions, society as we know it ceases to exist. If anything good is to come out of the coronavirus pandemic, it’s the opportunity given to those who govern to demonstrate that politics is the only way to run a society.