Scientists have just identified a virus. Fortunately, <2% people are at high risk. Even so, it is set to kill more than 30 million people worldwide , many thousands everyday. There is a simple way to prevent most of these deaths: have the <2% high risk population distance themselves. Would we, as a society, enforce that by law? Should we?
Who wouldn’t, you may say. Especially given what we are doing now. And yet, we didn’t.
The year is 1983, not 2020; the virus is HIV, and the <2% high risk population  are the people who engage in unprotected gay sex [3, 4]. The distancing required was also of a much milder form than being enforced now: sexual distancing rather than physical distancing. And yet, we didn’t enforce it by law.
Even today, >2000 people worldwide die everyday due to HIV, 800,000 a year [1, 3]. Tens of millions more suffer debilitating morbidities . Currently, >38 million are infected [1, 3], and about 5000 more get infected everyday .
And yet, our combat strategy was radically different from the current one. We decided to pour resources into arming the people with knowledge, information, and protective gear; and trusting them to make reasonably good decisions based on their unique circumstances. We decided that individual freedom is a worthy goal for the greater risk. We concurred, without saying out aloud, that every individual’s unique circumstances make them a better judge of their situation and actions, instead of centralized systems like the Government.
Indeed, legal and legislative restrictions on unprotected gay sex would be frowned upon, and even outraged at. And with good reason.
However, our response to SARS-CoV-2 has been quite the opposite. We have somehow concluded, somewhat absurdly, that an official in London is better suited to decide whether a lazy coffee shop in a remote Scottish village 800 km away should be allowed to open; that an administrator in Sacramento can order to close a public park in the suburbs of San Diego 900 km away; that a secretary in Delhi knows what is best for a cottage handicraft workshop in Jhargram 1500 km away.
Governments like to make laws. Whatever challenges they face, they try to regulate their way out of it. They think that the best way to deal with any problem is to throw laws at it. It is an existential belief. Unless they believed that what they are doing is important, they will not be able to do it.
Therefore, it becomes even more vital that the rest of us debate and demand supporting evidence for every increase in regulatory oversight.
The human body contains an estimated 30 trillion human cells [5, 6], 40 trillion bacteria [5, 6], and 400 trillion viruses . Trillions of replications take place every second inside our body, any of which could go rogue. The Earth itself is estimated to have 10 million trillion trillion (10³¹) viruses, 100 million times more than the stars in the observable Universe . Every year, 3–4 new species of viruses are found to infect humans . About 2 million viruses are thought to infect mammals and birds , making their transition to humans only a matter of time, especially with the enormous meat industry.
Therefore, novel viral and other infections will continue to sprout till human extinction. Thus, long term worldwide isolation as a way to combat infectious diseases is both impractical and unsustainable. When enforced through legal means, it is also unwise, overreaching, harsh, and even cruel on large sections of the population.
What we should do instead is what we have tried to do with every other disease so far:
- Go all out on education and sensitization, especially to the high-risk, elderly population.
- Create an abundance of protective gear: Masks and other PPE.
- Create systems and mechanisms to enable — not enforce — distancing. Measures could include complete migration to e-learning in public institutions, creating public low cost self-quarantine facilities, incentives to employers to migrate to work from home, etc.
- Protect the most vulnerable: Isolate non-COVID hospitals and nursing homes from pneumonia patients and visitors, ensure low cost doorstep delivery of essential services to senior citizens, guarantee widespread availability of paid testing and increase capacity of free testing, etc.
- Improve care for the sick: Increase availability of COVID hospitals, beds, ventilators, ambulances etc., increase the number of nursing and paramedical staff, increase availability of clinical consumables like blood and its components, medicines, equipment etc.
Needless to say, this proposed response would have cost much less than the global lockdown coupled with the decades-long-debt fueled mitigating economic package, while creating much needed public health infrastructure for the current as well as future infectious disease outbreaks.
Such an individual-centered response is founded on the strongest of human instincts — the will to live. By not leveraging our most powerful tool, and instead relying on the power of the state to enforce behavior has precipitated multiple crises.
State power has been analogized to carpet bombing, and there are quite a few similarities. State power isn’t accurate: its attention cannot be focused on all the individuals who need it the most. This was tragically reiterated in the severe death rate among elderly nursing homes throughout the US. State power is also not precise: due to lack of complete knowledge of unique individual conditions, a huge fraction of the population has suffered much more than their expected risk of COVID morbidities.
Lastly, this is no claim of a perfect solution — far from it. Instead, this article only intends to spark a debate on the current irrational practice of centralized enforcement of behavior that we have globally adopted, which completely ignores the unique needs and circumstances of each individual, while also severely limiting their freedom of thought and action.