The other costs

Every day at 1pm Director General of Health Ashley Bloomfield updates us on the number of confirmed and probable cases of Covid-19, the number who have recovered and those who have died.

It is impossible to count the other costs:

A leading heart failure specialist is among those concerned that lives could be lost through people failing to seek treatment during the pandemic.

And another fears that a drop in pathology testing could mean cancers and coronary disease go undetected for longer, while cancelling or postponing elective surgery could mean some patients end up in hospital in a much more serious condition. . . 

Delays in diagnosis and treatment can mean much worse outcomes for many diseases and ocnditions.

There are other unseen costs:

University of Auckland Economist Dr Ananish Chaudhuri says the immediate emotional power of people dying with the disease could lead New Zealand into an extension of the Covid-19 lockdown with dire consequences, including more deaths.

Chaudhuri, who is currently Visiting Professor of Public Policy, at Harvard Kennedy School, says people over-estimate the costs of immediate and visible dangers, which clouds judgement and calculations of the unseen costs arising from their reaction.

“Extension of the lockdown would aim to save a more certain number of lives now, for an unknown number of lives we will lose over time due to health and economic impacts.

“Unemployment is not just a number; there are human health and fatality costs. When unemployment goes up the life expectancy of those people goes down. Furthermore, there are devastating consequences for communities from high unemployment – depression, poverty, violence, falling education.

“People have tried to claim that extending the current lockdown is a choice between saving lives and losing money, but it’s not. It’s a choice between losing lives now but losing lives later – and possibly a greater number and a greater variety of otherwise healthy people later.”

Chaudhuri points to research showing that the immediate aftermath of the 911 attacks was an estimated 1500 additional deaths on the road, from people driving rather than flying. It arose because in an environment surrounded by concerns over terrorism, people judged they were more likely to die of terrorism than a traffic accident, or even of the more likely event of respiratory illness or heart attack.

“The problem is that we pay more attention to, and value higher, things happening right in front of us – but we don’t pay attention to, or value, even larger things that happen less visibly or more slowly.”

Chaudhuri says an error is being made by those who differentiate between objectives of suppression, eradication, or mitigation.

“It’s a continuum between doing nothing and doing everything – and there’s different costs along that continuum. The challenge is to correctly perceive and calculate those costs.” Chaudhuri says.

It is not a simple case of the lockdown saving lives and freeing us up endangering them.

Lives will be saved by fewer people contracting Covid-19 because of the lockdown and some will be saved by being able to get treatment that would have been denied them had hospitals been overwhelmed with Covid-19 cases. But other lives will be lost and blighted through delayed diagnosis and treatment, increases in suicide, and the emotional and financial toll of business failures and job losses.

I think it was right to go into lockdown and that, if it wasn’t done sooner, large gatherings should have been stopped earlier.

Friends who were invited to a wedding on March 21st received a message a few days earlier from the couple saying their guests health was more important than their wedding and they were postponing it.

On the advice of friends who are doctors we cancelled a 90th birthday we were to host on the 21st too.

That day the government order went out that no gatherings of more than five people should take place but that was too late for those already taking place, at least one of which has resulted in a cluster of Covid-19.

In supporting the lockdown, I acknowledge that it incurs other substantial costs including lives that will be lost. That is why I support the idea of what’s safe rather than what’s essential as the guide for which businesses can operate.

If an electrician can visit a safely house when all the fuses blow, why can’t s/he work on a new build or renovation?

If supermarkets and dairies can sell their goods safely why not bakeries, butchers and greengrocers?

If greenkeepers can work on golf courses, why can’t a lone operator mow private lawns?

The rules around a change in levels will be announced today.

To reduce the other costs of the lockdown, they must include a change from allowing only essential businesses to operate to allowing any business that can operate safely to do so.




4 Responses to The other costs

  1. adamsmith1922 says:

    Reblogged this on The Inquiring Mind and commented:
    Some good points made in this post from Homepaddock


  2. Andrei says:

    I don’t know Ele – the only real epidemic in my view has been one of irrational fear which has led to politicians panicked into making very poor decisions.

    Our ridiculous Prime Minister was originally claiming 80,000 deaths would result if they didn’t “do something”, revised to a more generic 10s of thousands a day later and then 25,000 as a worst case scenario.

    My Dad died of pneumonia – he had silicosis but it was pneumonia that adminstered the coup de grace which is par for the course for silicosis. If it happened today they probably would count him as a COVID-19 death. When he died it was entirely expected

    Everybody dies eventually and the people who are dying in most cases have already exceeded the life expectancy of New Zealanders circa 2020 and would have been considered unusally old circa 1920.

    And they are people whse life expectancy realistically is very short regardeless of COVID-19

    Right now this epidemic is dying away in Europe because the weather is warming – it has alll but gone from the Faroes where nobody has died and presumably the entire population has been exposed

    In Iceland too – where the authorities have the biggest handle on its
    prevelance in the community it is dying away

    The dumbest thing about our reposnse is that here the winter is coming and as is well known the death rates go up in winter mostly due to respiratory viruses. which flourish in winter causing pneumonia.

    And we locked down well before the peak season for these things and will either have to remain hunkered down until late spring or emerge into the world when the spread of colds and flu are at their peak.

    It isn’t quantiy of life that matters it is quality of life and our quality of life has been significantly degraded and will be for years to come to protect dementia patients in rest homes whose quality of life is zero.

    And I can almost guarantee you more people have already died in New Zealand as a result of this foolishness than have allegedly died from this virus


  3. pb says:

    It’s an extension of the zero-risk fallacy pushed by the safety zealots. Anything can be justified in the name of safety. Even a complete destruction of the economy.

    But what if life is risk? What if the meaning of life is found in risk? We are ruled, for now, by frightened bureaucratic people wielding inordinate power.

    “It’s a dangerous business, Frodo, going out your door.”


  4. Teletext says:

    One of the major problems the health system is going to have after the lockdown is the re-starting of the elective surgery and out patients system.

    I was due an appointment with a specialist early this month but both he and I have no idea when it will now happen.

    My wife was due her second hip replacement 4 years ago but fell off the list. Went back on it earlier this year with the op due this month. She is in constant pain all the time, causing her to have to leave her job (she would have been a much needed essential worker) and is now a drain on the welfare system.

    So much for our “dear leader” and her panic stricken decisions and zero planning on what to do when her precious lockdown ends.

    If the health system thinks it has a problem now, wait till we return to some sort of normality.

    I would hate to guess the number of people who have died as a result of their inability to access necessary health resources over the last month.


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