The price of life

In public health, we understand that commonplace assertions to the effect that human life is infinitely precious, or you can't put a price on human life, just don't work. Nobody treats human life as priceless, especially people who are inclined to say that sort of thing. Each of us personally takes risks such as riding in a car or climbing a ladder every day. Some people smoke tobacco, some people don't wash their hands after they handle raw meat. Some people work in dangerous occupations.

And obviously we don't structure public policy around the proposition that human life is priceless. We don't provide affordable universal health care, to begin with. We allow the air to be polluted -- even more than before under the present administration. We could go a good deal farther than we do in the way of occupational safety and health regulations, consumer product safety, fire codes, you name it. But the political system weighs the costs and benefits of policy, with much more of the weight going to more powerful interests. Wealthy capitalists want to pollute, put their workers at risk, and don't want to pay taxes to support public health measures. Nevertheless even in my ideal world there would still be risks because wherever you want to draw it, there is a limit to what it's worth paying to avert a death. Actually I should say delay a death because we are all mortal. That's because resources are finite, and paying for one measure means you can't pay for something else.

So it's very much a legitimate question how much economic damage and other suffering is worth it to mitigate spread of the coronavirus. Chris Christie is not the most artful speaker but he is within the realm of sanity in saying this:

"Of course, everybody wants to save every life they can -- but the question is, towards what end, ultimately?" Christie, a Republican tapped to lead President Donald Trump's presidential transition team in 2016, told CNN's Dana Bash on The Daily DC Podcast. "Are there ways that we can... thread the middle here to allow that there are going to be deaths, and there are going to be deaths no matter what?"

Christie told Bash that "we've got to let some of these folks get back to work, because if we don't, we're going to destroy the American way of life in these families -- and it will be years and years before we can recover." His comments Monday echoed similar characterizations by other Republicans -- including President Donald Trump -- that the economic impact of coronavirus is just as devastating to the nation as the virus itself.

When Bash pressed Christie on whether people would be able to accept reopening in light of news of a Trump administration model projecting a rise up to about 3,000 daily US deaths from coronavirus by June 1, Christie responded, "They're gonna have to."

The problem is that as with environmental and workplace safety regulations, the people who are worst affected have the least voice in finding this balance. Deaths and suffering from the epidemic highly disproportionately affect poor people and people who are not of the dominant European settler ethnicity. Here's the heartbreaking story of a rural, mostly African-American county in Georgia where the virus has run amok.

By nearly every measure, coronavirus patients are faring worse in rural Georgia than almost anywhere else in America, according to researchers at Emory University in Atlanta. Although New York City had thousands more deaths, the per capita death rate in these Georgia counties is just as high.

“They are vulnerable people living in vulnerable places, people who are marginalized on a variety of measures, whether we’re talking about race, whether we’re talking about education or employment, in places that have fewer resources,” said Shivani Patel, an epidemiologist at Emory. Then COVID-19 arrived: “It’s like our worst nightmare coming true.”

Read the whole thing and weep. So when governor Kemp decided it was time to reopen massage parlors and bars and bowling allies, he wasn't thinking about the people who are actually at risk. He was thinking about himself and his rich friends and the powerful business interests who have the resources to protect themselves. They don't have to go to unsafe workplaces, they can easily isolate themselves from anyone who might be infectious. Yes, there is a balance to be struck and there is room for legitimate dialog and disagreement about where that is. But we don't all face the same risks, and the voices of the people at highest risk are least likely to be heard.