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How Many Deaths Are We Willing To Accept?

The recent outbreak of COVID-19 disease caused by the SARS-CoV-2 virus has created chaos throughout most ‘First World’ countries and has impacted on virtually every population worldwide.

Western Countries in particular have taken drastic action to prevent deaths from this virus, readily accepting astronomical economic and societal cost.

Different approaches from different countries are resulting in different outcomes and it will be many years before we can fully analyse these strategies to determine the best approach next time around.

Each strategy has been primarily designed to limit the number of deaths in each community. Although we cannot prevent every death, limiting personal freedoms and making significant financial investments can have an impact on the number of deaths. The rule of diminished returns however, means that at some point saving another life will simply be too expensive both in monetary terms and in societal damage.

We will only accept so much disruption in our lives and will only tolerate so much financial stress. At some stage we have to decide just how many deaths we are willing to accept.

As COVID is a new disease we haven’t yet decided how many deaths we are willing to permit or how much money and effort we are willing to invest but we have made those decisions about many other infectious diseases.

Australia has done remarkably well to limit the impact of COVID-19 and at the time of writing there are 90 confirmed deaths from COVID in our country. It is impossible to calculate the number of lives that have been saved but we can estimate some of the financial costs. The Government’s total support package to date has been $320 Billion (AUD) and there are further heavy costs to come with predictions of a deep recession and huge reductions in Gross Domestic Product.

There is little doubt that Australia is not willing to accept many deaths and is willing to invest big-time to prevent those deaths.

So let’s take a little look at the statistics for some other infectious diseases currently impacting the planet and see how many deaths we are willing to accept and how much we are willing to invest to prevent them.

Tuberculosis

1.5 million people on our planet died from Tuberculosis (TB) in 2018. It is a particular problem in India where 449,000 died from the disease in 2018. Most cases of TB are pretty easy to treat so we could quite easily save a large number of lives each year with some decent financial investment. In India it costs approximately $215 (USD) to treat a straightforward case of TB.

HIV

Disease caused by the Human Immunodeficiency Virus (HIV) is now fairly well controlled in western countries, although treatment is expensive. Prevention is however very cheap and very easy. It is estimated that 50% of cases could be simply prevented with the use of condoms. Since it reared its ugly head in the 1980’s HIV has killed 32 million people including 770,000 in 2018. It costs between 2 and 3 cents (USD) to manufacture a condom.

Hepatitis

Hepatitis is widespread but easily prevented and treated. Immunisation in many countries including Australia is a routine part of the childhood vaccination program so Hepatitis is very rare in these participating countries. Hepatitis though is still causing major issues worldwide. 15 million people in Pakistan for example are affected by hepatitis and many can be easily treated. It costs about $20 (USD) to treat and cure Hepatitis C in Pakistan.

Malaria

Malaria is caused by a little parasite transmitted through the bite of an infected female mosquito. It is very common and widespread in Africa. In 2018 there were 405,000 deaths from Malaria. It costs just $5.84 (USD) to treat an uncomplicated case.

Many would suggest that saving children’s lives is especially important not least because they have many years to contribute to society. It is worth considering that COVID only very rarely causes illness in children and death in healthy children is almost unheard of. COVID is an illness that kills the old and the frail. In an Italian study for example 99% of patients who died from COVID had a pre-existing illness and the average age of death was 79.5 years.

Some infectious diseases take a particularly heavy toll in children. Of those 405,000 malaria deaths in 2018 for example, 272,000 where children under the age of 5.

Measles

Measles has been virtually eradicated in western countries although objections to vaccinations have led to a recent resurgence. World-wide though it is a massive killer. The vast majority of the 140,000 measles deaths in 2018 were in children under the age of 5. The vaccine for measles is cheap, safe and effective. It costs $1 (USD) to immunise a child. That’s not a misprint: one dollar.

Diarrhoeal Diseases

To finish, let’s take a brief look at diseases that cause diarrhoea. Diarrhoea is technically a symptom rather than a disease and can be caused by a variety of viruses, bacteria and parasites almost always transmitted by faeces contaminated water. Diarrhoeal Diseases kill around 525,000 children under 5 every year. More than half a million children every single year.

We don’t need drugs or vaccinations to control these diarrhoeal diseases we just need clean water. The vast majority of deaths could be prevented by the very simplest of interventions, the provision of clean water and adequate sanitation.

Life is precious, everyone deserves love, respect and care. Death is inevitable and delaying death is expensive. Making moral and ethical judgments will never be easy. I for one don’t envy those making these really difficult decisions.

Just something to think about.

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