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Boris Johnson is about to face his coronavirus trolley problem

Pity prime minister Boris Johnson. He loves to be liked – but he exists in a timeline that does not allow for popular politicians.

For the past eight weeks, the whole country has stayed home to save lives and protect the NHS. Days have gone by, more than 30,000 people have died after contracting the virus, and the NHS has held up. Now, prime minister Boris Johnson is poised to loosen the lockdown. That might sound like a showstopper: the prime minister finally announces to the citizenry that life will, in some ways, return to some kind of normal. In fact, it is a trap, a point in time with all the potential to haunt Johnson for years to come, and even chase him into history books. It’s Boris Johnson’s trolley moment.

You might be familiar with the trolley problem, a thought experiment that uses faulty railways to assess someone’s moral compass. The experiment posits a runaway trolley careering down a railway track; at the end of said track, by some wicked accidents of fate, are five people, trussed up and bound to be mauled under the trolley’s wheels. There is a side track to which the trolley can be diverted by pulling a lever. But at the end of that track, there is an analogously trussed up person, who would be killed by the diverted trolley. Do you do nothing, and let the trolley run its murderous course? Or do you pull the lever, actively sealing the lone person’s fate in exchange for saving five lives?

The experiment has been hailed for being a litmus test of utilitarianism, and readapted in multiple ways – recently to war-game how driverless cars should behave in lose-lose scenarios, like choosing between hurting the passenger and hurting pedestrians. It has also been criticised for being overly simplistic. Whatever its utility, the trolley problem encapsulates the dilemma befalling politicians confronted with situations in which they have to weigh suffering against suffering, and choose how to minimise the number of people who get hurt. This happens a lot: in fact, in an ideal world where choices were led by that kind of calculus – as opposed to prejudice, electioneering, or partisanship – politics would essentially boil down to a long succession of trolley problems.

During the early phases of the pandemic in the US, Twitter was ablaze with zany memes riffing on the trolley problem. President Donald Trump’s dawdling over whether to adopt strong containment measures was caricatured as ramming a trolley through stacks of bodies while a memefied trader flipping “stonks” on the stock exchange grinned on the sidelines. The suggestion was that the government was sacrificing people’s lives and health on the altar of some one-percenters’ economic gains. Trump himself had hinted at seeing the equivalence in those terms, on March 23, when he expounded on possibly lifting social distancing guidelines earlier than public health experts recommended. “We cannot let the cure be worse than the problem itself," he said.

In fact, debating over the wisdom of social distancing while a deadly virus is ripping across the country was never really a trolley problem. Even if one accepted that a country’s health and a country’s economy should be pitted against each other – which sometimes happens: think about environmental regulation, or road speed limits – having a novel coronavirus outbreak carry on undisturbed would not have preserved the grinning trader’s stonks. A recent research paper by the University of California Berkeley made it crystal clear: when one factors in the cost associated with lives lost, lost workdays due to sickness, medical costs, and the economic cost of social distancing, “strict measures fare better than a hands-off policy”. (The economic figures coming out of Sweden, the only major European country not to adopt a lockdown, seem to lend some credence to that conclusion.)

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Squashing the contagion with strong, early restrictions is financially more sound than managing a sick, dying, and terrorised populace. When Britain enforced the lockdown – following weeks of faffing, hand-washing, and herd immunity cant – it didn’t send the trolley hurtling towards the trader: it prevented the trolley from mowing down both the people on the tracks and the trader, in one fell swoop.

A lockdown is an odd place for a politician to shelter: horrifying, maddening – but in a way strangely comfortable. Damning questions are swirling around about the government’s preparedness, the goodness and independence of the scientific advice – “the science”– it acted upon, and its support for care homes. But at least ministers can point at the lockdown and say they are doing all they can to blunt the intensity of the outbreak. Problem is: things change over time.

A country cannot stay stuck in the lockdown forever, not only because that would be a heck of a dystopian scenario to contemplate (Death Stranding, anyone?), but also because after a certain number of weeks, the lockdown itself starts exacting a deadly toll. Domestic violence surges, suicide risk goes up, and people with serious medical conditions steer clear of hospitals, dying in their homes rather than seeking treatment.

As Full Fact explained in a recent blog post, in the week of April 13 the UK witnessed more than twice the average number of deaths recorded for that week of the year since 2000; as far as we know now, a substantial number of those people died for causes other than coronavirus. The Financial Times reported that, within government, discussions are increasingly focusing on the matter of “avoidable deaths”. Those might not be as public, and as widely, and graphically detailed in the national media as the deaths from Covid-19 – but, over time, even the most timid politician will have to take notice. A Whitehall official quoted by the Financial Times said that, by mid-May, he thought that the cabinet’s position might shift as “the damage of keeping everything shut down could be just too great to ignore”.

Which brings us to Johnson and the trolley. At this stage, the trolley of coronavirus lockdown is barrelling along the rail, ready to cause more avoidable deaths by sheer inertia. Johnson wants to pull that lever. The trouble is that, in the Covid-19 age, the whole railway is shrouded in mist and we do not really know what’s on that sidetrack. Is it, again, the sky-high mounds of trussed up people that were there during the early, worst phases of the outbreak? Or has the situation improved so much that the collateral damage of re-opening the country will be limited to a few, dramatic but few, deadly cases?

The answer, of course, is that it depends. It depends on how well the country’s public health infrastructure has been prepared to spot and contain new outbreaks, were they to surface. It depends on how thorough and effective contact-tracing will be. It depends on how many people can be tested, and quickly. All those factors will have to be taken into account before making a call on when and how to start what has been dubbed “phase two”. Hopefully, the prime minister will think carefully before pulling the lever.

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This article was originally published by WIRED UK

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