• Kyle van Oosterum

Targeted Lockdown: In with the Old, Out with the Young?

More than half of the global population, approximately 3.9 billion people, have faced some form of “lockdown” as a result of the ongoing pandemic. The widespread imposition of lockdowns firmly established a governmental priority to curb the spread of COVID-19 and save lives. As the past few months have shown, the impact of the lockdown has also devastated the global economy. Estimates from the International Monetary Fund (IMF) suggest that the economic fallout will exceed that of the 2007-09 Great Recession. As governments begin to find their footing in the economic quicksand of the COVID-19 pandemic, one suggestion for how to move forward is to opt for “targeted lockdowns”. A targeted lockdown works by (1) identifying the group most susceptible to the severe health-effects of COVID-19 and (2) imposing a lockdown solely on those highly vulnerable groups. However, this raises several questions. Does a targeted lockdown provide the clearest policy-solution to strengthen the economy and protect public health? Or does it sacrifice the interests of the few for the interests of the many?

Although there is an abundance of scientific uncertainty around COVID-19 and its health effects, one well-documented piece of evidence demonstrates that the mortality rate for those over 65 years old is nearly 60 times that of people aged between 20 to 49. In the UK alone, some figures estimate that a quarter of Coronavirus-related deaths have occurred in care homes. The fact that mortality rates differ so significantly among certain age groups has led a team of researchers at MIT to conduct a study to determine whether there is strong reasoning to target a lockdown to more vulnerable age groups.

Whether a government operates with a “safety-focused” model – in which public health is the main priority – or an “economy-focused” model, targeted lockdowns strike a unique balance. According to their research, targeting keeps the mortality rate at 0.5 per cent while simultaneously reducing the economic fallout of total lockdown policies from 37 to 25 per cent. In combination with other measures such as contact tracing and social distancing, targeting may be a feasible political compromise in the notoriously difficult trade-off between prioritising the economy versus public health.

It is easy to see the appeal of a targeted lockdown especially as statistics lend strong support to such a policy. The consensus among these researchers, and most governments, is that simply “opening up” would be a poor policy choice as, if there were to be a second wave of the pandemic, the economic losses and mortality rates would be catastrophic. However tempting a return to normalcy might be, such a return is likely to be short-lived if it is not done properly.

This is why many governments have chosen to ease their lockdowns in phases, gradually escalating economic activity while ensuring not to undermine successful public health efforts. However, in practice, reopening society is often significantly delayed, causing mass frustration as evidenced in the case of Spain’s gradual return to normalcy. With mounting pressure to ease the lockdown without compromising public health, can targeted lockdowns perhaps serve as the silver bullet to help governments combat the pandemic?

It might just be too early to tell. As the authors of the MIT study above admit, information about the ongoing pandemic, whether the economic damages of the lockdown or the extent of health risks associated with COVID-19, is not yet conclusive. In addition, extensive data needs to be plugged into these models for them to generate meaningful results. With mass uncertainty undermining data and information, great caution needs to be exercised about any conclusions inferred by researchers. Despite this, governments are unlikely to delay action simply because they are not completely certain of the consequences of a given policy. Targeted lockdowns seem more and more likely to find their way into a government’s policy toolkit. Assuming then that these uncertainties can be accounted for, what is left to consider is what society would look like under a targeted lockdown.

As these measures aim to reduce the mortality rates of COVID-19, it is argued that it would be for the good of the elderly if they were isolated – perhaps against their will – for however long it takes to develop a vaccine and antiviral medication. In contrast, younger generations would be free to engage in certain economic and societal activities (assuming that social distancing requirements are still in place).

One thing worth pointing out is that four million elderly people in the United Kingdom live on their own. If targeted lockdowns were to be imposed, it would mean the majority of elderly people would be severely isolated from public life. A targeted lockdown policy would therefore drastically and unfairly impact the mental well-being of elderly populations. It would also perpetuate the prevailing attitude that it is morally permissible to leave the elderly behind when it comes to making difficult political decisions. More importantly, if a targeted lockdown were to be implemented in the UK it would violate the Equality Act 2010 which protects individuals against discrimination when an organisation’s policy puts people of a certain age group at a particular disadvantage.

It might be argued that the extraordinary circumstances arising from a public health crisis may permit governments to lawfully treat individuals differently due to their age. However, a government’s lawful action might not overlap with what the “morally right” action might be in this situation. In public health ethics (the field of study concerned with identifying moral justifications for actions that promote public health), philosophers and public health professionals often appeal to the fair innings argument. This argument suggests that since the elderly have had a “fair run” at life, the difficult ethical choices one needs to make should be skewed toward the young who have not yet lived a full life.

Concepts such as the fair innings argument would seem to provide a moral justification for imposing targeted lockdowns on the elderly. That still raises a question about whether it is a good moral justification. For one, it seems like this reasoning fits into a sort of utilitarian calculus that suggests the interests of the few can easily be outweighed by the interests of the many. A lot of people do not necessarily accept that moral logic, and it would be easy to imagine that the elderly would not either.

Another problem with the fair innings argument is that “fairness” seems to be defined solely in terms of the length of one’s life. However, the concept of fairness also refers to when people make choices and are held accountable for the consequences of their decisions. The elderly did not choose to be born when they did, and a targeted lockdown seems to punish them for a fact they cannot change. If fairness is understood in this way, it is hard to see how the fair innings argument is fair at all.

It is essential to pinpoint these problems. By doing so, the hidden arguments that inform policymaking can be revealed to the citizenry whom they will affect. Although appealing from the perspective of public health and economy, more needs to be said about a morally justified targeted lockdown. This is especially true for those individuals who are more vulnerable to COVID-19 through no fault of their own. Staying attuned to the moral complexities of policy choices is essential for governments in the coming months who must not only promote public health and the economy but properly shape the post-pandemic society.

If public health professionals are right when they claim that “what’s past is prologue”, it is likely that the COVID-19 pandemic will not be the last in this new era of global public health crises. Policymakers and economists must not only learn how to manage a pandemic but also teach future generations how to do it well. For now, a targeted lockdown presents just one of the many paths to recovery. However, only time will tell whether it is the right path for the world to take.