Alfred Dawes | Striking the balance between lives and livelihood

In the ancient Hindu epic, Mahabharata, Yudhisthira at his coronation ceremony, received the gift of a bow. The significance – to remember to always stay balanced, not too tight nor too loose. The use of the bow to illustrate balance and the so named median way is a key teaching in Buddhism.

The Ying and Yang forces of nature and the Christian teaching of all things in moderation all echo these earlier teachings on how to maintain harmony in one’s life. Unfortunately, no matter how often we hear this advice, we always veer from one extreme to the other in our personal lives and in societal priorities. Whether it is being consumed by work at the expense of family time or justifying sloth with prioritising ‘me time’. The direction of the world is often punctuated by sharp swings between conservative and liberal thought with a general trend towards liberalism. Whenever there is too far a swing towards the liberal agenda there is a conservative pushback that rolls back and delays liberal progress. These swings account for the slow progress in the acceptance many times of what we could consider morally correct thought.

History is replete with examples of this concept on a geopolitical level. It partially explains why slavery and apartheid persisted for so long. After the collapse of Yugoslavia, nationalists of its constituent ethnicities quoted the maximum extent of their historic empires in their claim for a homeland, a paradigm that led to bloodshed. Sometimes compromise is the only way to avoid catastrophic consequences for resolute parties with diametrically opposing positions. At times the objective is to make both parties leave the table equally upset. In some instances, there will never be a compromise, just wild pendulum swings. A classic example of the latter is US politics’ Red state versus Blue state garrisons.

Our present reality is shaped by a war between the COVID-19 hawks and doves. There are those who believe we ought to have more stringent measures to limit movement and gatherings. Then there are those who believe that this treatment is worse than the disease itself, with the effects on education, mental health and the economy reverberating for years after COVID-19 is gone. Stuck in the middle are the policymakers who will be crucified if they get it wrong. After all, it’s balancing lives and livelihoods. Comparisons are drawn from various countries as to the ‘right’ way to do it. Sweden, Taiwan and New Zealand have been held up to support both sides of the arguments. The US is held up by both sides as exactly what not to do. The irony is that they are now classifying Jamaica as a high-risk country for travel. This has serious implications for our tourism industry.

LONG DARK WINTER

The reality is that COVID-19 struck during the tail end of the last winter tourist season. Hotels had already enjoyed healthy bookings and the high seasonal inflow of foreign exchange had a good run before the lockdowns in March. That was enough to keep many small businesses in the hospitality sector hobbling along during the downturn. This will be our first true tourist season in the midst of the pandemic. If we cannot earn enough in tourism and entertainment, the next couple of months will be a long, dark winter. Heeding the calls for tighter controls will result in the final shutters drawn on many businesses. Relaxing controls will lead to a spike in the number of cases. The balance must be what level of a spike will we be comfortable with and which spike exactly should we be observing.

If we ever tested for influenza with PCR (Polymerase chain reaction) the way we tested for COVID-19 , there would have been widespread panic every winter. We continuously ignore the fact prostrate before us, that COVID-19 now is not as deadly as COVID-19 in March-April.

Even in the most vulnerable of populations, a government-run nursing home, where 65 residents contracted COVID-19 with an expected number of deaths between 15 and 20, ‘only’ 1 person died from this ‘deadly’ virus. Instead of focusing on the number of hospitalisations and deaths we continue to harp on the number of positives even when they show little or no symptoms. In fact, there is panic being generated over how many asymptomatic persons may be carrying the disease. The goal cannot be to stop the number of infections from rising, otherwise we will never get through this. Instead, we must look at the number of deaths and hospitalisations as a marker of how well we are doing. If there are no excess deaths, then the pendulum should be allowed to swing more to the relaxation of restrictions. If hospitalisations begin to rise, short periods of enhanced restrictions will restore equilibrium.

One simple measure that would go a long way in saving the hospitality sector is the removal of the mandatory quarantine period. Test and retest travellers to make sure they do not have the virus rather than sentencing them to quarantine needlessly. That will allow resources to be focused on other measures rather than policing them. This would allow more people to be comfortable travelling and increase much-needed earnings in the hospitality sector. As we are now maintaining mandatory quarantines without any spike in deaths or hospitalisations is not an equilibrium point. We are following the hawks and injuring ourselves battling a hypothetical scenario that has time and time again failed to materialise. It is time to move towards the middle ground in the fight against COVID-19. After all, thousands of years of human history is telling us so.

n Dr Alfred Dawes is a general, laparoscopic, and weight-loss surgeon; Fellow of the American College of Surgeons; former senior medical officer of the Savanna-la-Mar Public General Hospital; former president of the Jamaica Medical Doctors Association. @dr_aldawes. Email feedback to columns@gleanerjm.com and adawes@ilapmedical.com