In his article ON POLICY CHOICES BY EUROPEAN COUNTRIES DURING THE 2020 COVID-19 OUTBREAK, Maurizio Bettiga proposes two opposing and contrasting (possible) policy justifications for the action taken to limit the spread of the Corona Virus across Europe:
1. fight the spread of the infection at all cost and prioritize every patient life over everything else, accepting substantial economic damage;
2. exert limited damage control, prioritizing maintenance of the “business as usual” to all possible extent, according to the principle of “acceptable loss”.
I would like to look at the Dutch approach and try to put it into context for anyone looking from outside, because I feel that the analysis presented of the ‘rational costs/benefit analysis’ that we might think could characterize the Dutch approach requires some more explanation.
I live and work in the Netherlands, my mother lives in the UK and my mother-in-law in Italy, so I have a triangular perspective on the problem. I also have the advantage of being able to read the local press in its own language, and so am not reliant on third hand descriptions in the international press.
This weekend a UK medical regulation expert informed me that no modern health system can support the strain that such an epidemic causes on a local (national or regional) level, but the Dutch government is challenging his belief. The Dutch approach is to try and slow the spread of the virus to such an extent that the hospitals do not become swamped with patients and can therefore offer adequate treatment to everyone that requires it.
The policy put into practice here has that goal, and politicians on TV talk shows state that the objective is to remain below the crisis line. The Dutch are not trying to stop the virus, but to manage it. If the policies are successful, spread may be extensive but would take longer, allowing the hospitals to stay in control of the intake and treatment.
The government and press are open about how many intensive-care places the country has, and also offer estimates of how many people might in reality be infected (confirmed cases are still under 1000, but the published estimate is that there may be 6000 infected persons within the territory).
As I write (from Monday 16 March) the schools have been closed, as have all cafes and restaurants, shops remain open however. The government is asking all those who can stay at home to do so. In the Netherlands, the population (as a whole) behaves as the government suggests they should. The gamble was taken to ask rather than require behavioural change in the belief that is no need to legislate in the way the Italian government have, because the government could rely on societal organizations and population to react proactively.
Although the regulation in place today states that gatherings of less than 100 people can take place, in effect they do not. The national news shows empty trains and busses, and the transport sector state that travel is down by 85% today in relation to a normal Monday, a drop that occurred more suddenly than expected, an adherence to the call for responsibility that is lauded and celebrated.
The Scouts, all sports clubs, petting farms, informal meetings, have all ceased activity. The large cinema groups are offering screenings in halls that only accept 100 ticket-holders, but that hold thousands of places. The halls are empty places today though as the population does not go anyway, it is a futile attempt on the part of the large cinema groups to limit financial damage.
The government relies on this sense of civiv responsibility, and uses it as a political tool. The closure announced on Sunday of all cafes was justified in terms of stopping what they call ‘cafe tourism’, as German tourists and those living in Brabant (where the rules were more restrictive) were found in cafes in areas that were under less restriction. We can discuss how much of this justification is real, but it does reflect the Italian approach of locking-down the entire country after thousands of people fled from Lombardy upon the announcement of the imminent exodus. People were blamed for not behaving responsibly, leading the entire country to suffer.
I should add that in the Netherlands, the press conference was scheduled for 5:30 in which they announced the closures from 6:00, so only 30 minutes of chaos ensued.
Dutch politicians stated that the strategy followed aims to limit economic damage as much as possible, while keeping the infection rate and associated hospital visits under saturation level. This position can’t really be placed on a continuum between Bettiga’s two points above, as the concept of acceptable loss does not relate to people, but the economy. And the argument is that if the plan works, damage to both the population and the economy will be minimized.
And the model relies heavily on personal and collective responsibility.
Last night (16 March) Dutch Prime Minister Mark Rutte made a televised address to the nation in which he called for solidarity and although he didn’t use the word responsibility, the call was clear for all to understand. He outlined three possible scenarios, including the one described above described in the newspapers today as ‘controlled spreading’, allowing the society to build up immunity but necessitating protection for the weakest (building a wall round those most at risk through societal action). Alongside a total closure scenario (that is described as bound to fail as the immunity would not be gained and sooner or later the virus would return) a third scenario was also described, that of leaving the virus to spread without putting any restrictions into place. This would lead to overburdening the hospitals however so should not be followed.
The personal and societal responsibility call is easy to see throughout this discourse, and it is notweworthy that 7 million people watched the speech on TV, that is almost half of the total population and numbers of this magnitude are usually reserved for football matches and international sporting events.
Boris Johnson is also relying on responsibility as a political tool, but not only individual responsibility. In not cancelling the football season, the government left the Premier League and the FA no choice but to cancel the tournaments once some of the playing or technical staff employed by the clubs were pushed into self- isolation. In effect these organizations took responsibility meaning that the government did not have to legislate.
The government maintained its business as usual message, while the spread forced non legislated closures. Johnson later said that the population must brace itself for the loss of family members ‘before their time’, but he states that the government has everything under control. The loss is framed as unavoidable rather than a sacrifice, although he is not short on wartime rhetoric.
Johnson also uses the (questionable) argument that immunity can be built up in the population and that those most at risk must be protected (the press and some government ministers suggest that over-seventies should be confined to their homes, at the moment voluntarily however following the logic described here). The British government’s line has changed over recent days however, and people are now requested to avoid social contact in order to slow the spread down.
Johnson does seem to accept a few losses along the way though.
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