Now that vaccinations are not having the initially hoped-for effect and the Netherlands is in a third lockdown, the question arises of how we should proceed as a society in the long term.
As the pandemic hit the world from January 2020, it was clear that the risks were skewed. The elderly and people with an extra health risk were especially at risk. One way or the other, society has demanded a great sacrifice from young people. Young people naturally have more contacts than older people. Lockdowns therefore have much more impact on their social lives and their future prospects (the closure of education) than on the elderly, while young people were actually less at risk.
Policymakers were forced to make far-reaching decisions under great uncertainty. At the end of 2020, they could argue that vaccination was imminent. The development of vaccines within a year is a pinnacle of medical science. From August, however, the duration of protection turned out to be shorter than previously hoped, especially for the elderly, who actually needed this protection the most.
After Beta and Delta came the Omikron variant in December. This led to a lot of concern in the Netherlands, more than elsewhere in the world. Yet the trend in the Netherlands is no different than worldwide: many infections, but relatively few fatalities. No country has followed the Netherlands in the lockdown of December.
Lost years of life
At the same time, it became clear how great the collateral damage was from lockdowns. Many entrepreneurs saw their life’s work destroyed, especially in the hospitality industry, the cultural sector, and in parts of the retail trade. The scientific evidence for long-term adverse effects of closing schools, daycare centers and higher education is piling up. A conservative estimate shows that the number of life years lost among cancer patients in the next five years due to postponing care is a multiple of the number of life years lost due to corona.
Any estimate of the costs and benefits of lockdown measures is uncertain. However, everything indicates that in the event of school closures and postponement of non-corona care, the social costs of the corona policy were much higher than what we normally find acceptable in healthcare. This is due to what is known in healthcare as the rule of rescue: an acute threat always has priority over interventions whose effect only becomes visible in the long run. Faced with a patient in agony, the tendency of every physician is to save that patient. That is wonderful professional ethics, but it leads to unwanted side effects.
Cost-benefit analyzes in healthcare show time and again that a euro has a much greater effect in terms of health benefits in prevention than in acute care.
It is a big taboo: the impact of corona is increasingly comparable to the flu
It is important to know whether someone has antibodies against the coronavirus. This can be determined with serological testing. However, these are insufficiently done in the Netherlands. It would be good to invest in it. These tests can increase the willingness to have a booster shot if it appears that there is insufficient resistance.
The impact of corona is increasingly comparable to the flu, which causes many victims among the elderly every year. This comparison is a great social taboo, but indispensable for our sense of proportion. We seem to be moving towards a situation in which the annual number of fatal corona victims will be in the same order of magnitude as an average flu epidemic.
As with the flu, the main line of defense against corona is an annual booster shot. But in the event of a flu epidemic, no one is considering lockdown measures or postponing treatment of cancer patients because flu patients are given priority in the ICU.
Better education, less smoking, a sugar tax and a campaign for healthier eating will help our life expectancy more than with lockdown measures to combat the corona pandemic. Our life expectancy is not helped by closing gyms. Prevention could have limited the consequences of the corona pandemic, but the pandemic actually delayed that prevention.
Also read this opinion piece: Prevent another pandemic, boycott the animal industry
Solidarity with young people
The precautionary principle requires that the government takes measures in advance to limit foreseeable risks as much as possible. This fundamental right will always have to be weighed up against conflicting freedom rights. This requires a transparent and integrated approach that has been lacking in the corona crisis to date.
The necessary preventive measures, such as vaccination and testing obligations, require a clear legal basis. The decision-making process in which all interests and rights are discussed transparently must be clearly regulated.
Eighteen months ago, there was still doubt whether the profits from fewer fatal corona victims outweighed the costs of school closures and delayed non-corona care. Not anymore. We can think about permanent measures, such as a different distribution of school holidays over the year. But there is no longer any justification for large-scale lockdowns. The threat of new lockdowns alone is disrupting social life. Society has long appealed to the solidarity of the young with the elderly. Now it is important to make room again for the development of young people.
A version of this article also appeared in NRC Handelsblad on 14 January 2022
A version of this article also appeared in NRC on the morning of January 14, 2022
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