In an article published Wednesday, the Brazil-based journalist Glenn Greenwald advocates COVID-19 policies that he acknowledges “will kill people,” claiming that the public is putting insufficient emphasis on the “costs” of saving lives.
The article appears against the backdrop of a surge in COVID-19 cases in the United States and Europe. Governments around the world have made clear that they will take no measures to stop the spread of the disease, and that schools and businesses will remain open. Greenwald’s article provides a political rationalization for this policy.
In his article, “The Bizarre Refusal to Apply Cost-Benefit Analysis to COVID Debates,” Greenwald states:
In virtually every realm of public policy, Americans embrace policies which they know will kill people, sometimes large numbers of people. They do so not because they are psychopaths but because they are rational: they assess that those deaths that will inevitably result from the policies they support are worth it in exchange for the benefits those policies provide. This rational cost-benefit analysis, even when not expressed in such explicit or crude terms, is foundational to public policy debates—except when it comes to COVID, where it has been bizarrely declared off-limits.
The approach advocated by Greenwald has indeed been “declared off-limits” by doctors and scientists, who see the preservation of human life as the bedrock of their moral obligation to society.
In a powerful editorial published in February 2021, the BMJ (formerly British Medical Journal) condemned calls for “balancing” the preservation of human life with economic interests.
When politicians and experts say that they are willing to allow tens of thousands of premature deaths for the sake of population immunity or in the hope of propping up the economy, is that not premeditated and reckless indifference to human life?
The scientists and doctors who wrote the editorial correctly called such a calculus on the value of human life “social murder.” Greenwald, by contrast, identifies precisely this central element of government policy, not to condemn it, but to demand that it be carried out more ruthlessly and aggressively.
What are the “costs” that Greenwald identifies that have to be balanced against the massive loss of life caused by the pandemic? He writes:
Thus, this mentality insists, we must keep schools closed to avoid the contracting by children of COVID regardless of the horrific costs which eighteen months or two years of school closures impose on all children.
No doubt, closing schools has an impact on the education and socialization of children. With the allocation of the necessary resources, this impact can be minimized by ensuring that all children have access to high-quality remote learning and their parents are given the resources necessary to stay at home while non-essential production is shut down. The impact on children—in terms of their illness and death, as well as the illness and death of their friends, parents, teachers and the population as a whole—makes the closure of schools a social and political imperative.
In warning of the “horrific costs” of closing schools, Greenwald never quotes those he argues against and thus feels free to put words in the mouth of his imaginary interlocuter. As a matter of fact, however, scientists have made clear that aggressive action, if implemented systematically, could stamp out the pandemic not in “two years,” but in two months.
In a presentation to the WSWS online event, “ For a global strategy to stop the pandemic and save lives! ” Dr. Malgorzata Gasperowicz presented a model showing that COVID-19 could be eliminated in just two months through the combination of mass vaccination, the shutdown of public schools and non-essential businesses and universal testing, contact tracing and isolation of infected individuals.
To support his demand for sacrificing human lives for “economic” reasons, Greenwald re-hashes an argument made over and over again by right-wing pundits. If we really wanted to save lives, he says, we should ban or severely restrict the use of automobiles.
Even with seat belts and airbags, a tragic number of life-years are lost given how many young people die or are left permanently and severely disabled by car accidents. Studies over the course of decades have demonstrated that even small reductions in speed limits save many lives, while radical reductions—supported by almost nobody—would eliminate most if not all deaths from car crashes.
Very few people call for a prohibition on the use of automobiles or “radical reductions” in speed limits, Greenwald argues, even though car crashes kill large numbers of people. In the same way, he implies, people should stop advocating for aggressive public health measures to stop the pandemic, even though it is killing large numbers of people.
First, in terms of numbers, the pandemic is actually killing far more people. More than 100 people die in automobile accidents every day in the US. By comparison, 1,290 people died from COVID-19 on Thursday, and over 1,000 people have died every day this week.
But it is not just a matter of scale. Every person who becomes sick with COVID-19 becomes a human Petri dish, giving the virus a new chance to mutate into an even more deadly variation. There have already been four major new strains, including the current “Delta” variant—with scientists warning that even more dangerous variants are likely if it keeps spreading. In other words, beyond the toll of death and injury, the “costs” of not containing the pandemic constantly grow like a snowball.
Greenwald himself noted the difference on Twitter in 2020, writing, 'Unlike car accidents or heart attacks, where the death rate is stable, the number of deaths increases virtually every day, sometimes exponentially, with no end in sight.' This is exactly right. Preventing infections from COVID-19 not only keeps those infected safe but also keeps the disease from spreading, infecting others and mutating.
As for Greenwald’s example, actions certainly are required and have been taken to reduce traffic fatalities.
In 1965, Ralph Nader published Unsafe at Any Speed, documenting efforts by US automakers, including General Motors, to fight critical safety features such as the introduction of seatbelts. The publication of the book led to the passage of the National Traffic and Motor Vehicle Safety Act, and a range of standard safety features for automobiles, including safety glass, emergency flashers and padded steering wheels.
Just one of these measures, the requirement to install and use seatbelts, has saved an estimated 374,196 lives from 1975 through 2017, and traffic fatalities per mile traveled have been reduced more than five-fold. Moreover, laws have been passed imposing severe fines and even criminal sanctions for driving under the influence of alcohol, a major contributor to traffic accidents. Other laws prohibit the use of phones while driving.
The type of “cost-benefit analysis” invoked by Greenwald has been used for decades to stonewall crucial safety regulations by major corporations. “Lawmakers who oppose regulations for ideological (or financial) reasons have long used cost-benefit analysis to obstruct vigorous public health and safety protections,” Public Citizen, the group founded by Nader, noted in 2013.
Earlier this month, Public Citizen responded to the right-wing arguments against public health measures to stop the pandemic by noting that the “biggest weakness of cost-benefit analysis is that it cannot meaningfully account for priceless values: human life, health, nature, freedom, justice, fairness, equality, or even peace of mind… In the eyes of cost-benefit analysis, if you can’t assign a dollar value to it, it doesn’t exist.”
“Cost-benefit analysis” may be appropriate in determining certain business decisions—how will resources be distributed most effectively in constructing a building, for example, or how will the construction of a factory in different locations impact transportation and resource costs.
It is entirely inappropriate in determining policy in response to the pandemic, because human life cannot be given a numerical value. The call for a “cost-benefit” analysis of public policy measures incorporates a whole series of assumptions: that nothing can be done to mitigate the impact of these measures, that the existing structure of class society will remain untouched, and, ultimately, that a price tag can be put on human life.
While covering themselves with references to the “costs” to children due to temporary school closures, the real concerns of those within the ruling class promoting a “cost-benefit” analysis is the cost to the profits of the corporations and the wealth of the ruling class.
A significant element about Greenwald’s article is the fact that just two days after it appeared, two UK government officials told i news that the government of Prime Minister Boris Johnson “will consider a cost-benefit analysis on both saving lives and effect of deaths on the UK economy.”
The newspaper wrote:
A cost-benefit analysis will have set the acceptable level of Covid-19 deaths before restrictions are reintroduced at around 1,000 deaths a week, two Government advisers have told i. … The Government’s cost-benefit analysis on Covid measures is believed to set not only the acceptable level of cost to save the life of a Covid patient at up to £30,000, but also how much each life lost costs the UK economy.
One of the officials even referred to “speed limits” as an example of measures that have to be weighed against the costs of implementing them.
This timing raises a question: Is Greenwald serving as a conduit for legitimizing the UK government’s policies? If not, it only goes to show how directly his political orientation tracks with the most ruthless sections of the political establishment. The implementation of a “cost-benefit” approach is entirely in keeping with UK Prime Minister Boris Johnson’s earlier proclamation: “no more fucking lockdowns—let the bodies pile high in their thousands.”
There are disturbing historical issues that are raised by the type of argument Greenwald is advancing. He claims that “rational cost-benefit analysis … is foundational to public policy debates.” As a matter of fact, it is not. The application of such an analysis to medicine and public health is informed by the legacy of eugenics and the German Nazi Party’s murder of tens of thousands of people with chronic illnesses whom the Nazis branded “unfit to live.”
In the bioethics textbook From Chance to Choice: Genetics and Justice, professors Allen Buchman, Dan Brock, Norman Daniels and Daniel Wikler note the legacy of “cost-benefit analysis” in the American eugenics movement.
It cites the “Eugenics Catechism of the American Eugenics Society” of 1926, which argues, “It has been estimated that the State of New York, up to 1916, spent over $2,000,000 on the descendants” of one family—the Jukes—claimed to be genetically deficient. “How much would it have cost to sterilize the original Jukes pair?” asked the society: “Less than $150.”
The book continues, “Similar examples abounded in the arithmetic books of German schoolchildren in the 1930s, extending to the cost of keeping institutionalized, handicapped people alive; not long afterward, tens of thousands lost their lives.”
“You carry the burden,” blared one Nazi propaganda poster showing a worker hauling two disabled people on his shoulders. “A person with a hereditary disease costs an average of 50,000 reichsmarks until they reach the age of 60.”
Under Nazi rule, tens of thousands of disabled people were murdered in secret, in a program whose horror and corrupting influence was depicted in the German television series Charité at War .
“How does the Hippocratic Oath square with an oath to the Führer?” asks one of the characters upon learning of his colleagues’ involvement in the murder of disabled children, referring to the oath taken by doctors and nurses to “abstain from all intentional wrong-doing and harm?”
Where do Greenwald’s arguments lead? Why stop with rejecting measures to save lives in the COVID-19 pandemic? Why not apply this “cost-benefit analysis” to medical care and social welfare in general? Why should working people receive medical care past the age of retirement? Would society not “benefit” if they were allowed to die a “natural” death?
Why spend so much money on cancer and heart disease research? After all, these are diseases that predominantly affect the elderly. Why even perform life-prolonging operations on people over 65? And what of children with developmental disorders? If the inherent value of human life is ignored, care for the disabled will “cost” society more than it will “benefit.”
In the midst of a deepening crisis produced by the pandemic, society has become deeply polarized. Greenwald speaks for a section of the affluent upper-middle class that is throwing in its lot with the financial oligarchy, embracing its homicidal policies and making lawyers’ briefs for the far right.
But there is another, more powerful pole in society. All over the world, the working class is entering into struggle in defense of its own social interests, crucial among which is the eradication of COVID-19. Broad sections of doctors, scientists and other professionals will be profoundly influenced and strengthened by this renewed movement of the working class.