By Daniel Healy
The current COVID-19 pandemic has paralyzed public life. And in such a crisis, much has been said on the comparison of different countries’ varying responses to the outbreak, in particular through the lens of the eastern vs. western hemisphere; of authoritarian states vs democratic ones. Indeed, other opinion articles have already been published in The Daily making this comparison. An article by Hagar Gal makes the compelling point that framing global responses as that of “China vs. the democratic west” is problematic; after all, democratic Eastern Asian states such as South Korea or Taiwan have fared remarkably well compared to the U.S. or the U.K. Similarly, Ravi Jacques article raises several good points regarding the efficiency and competency of the Chinese model in containing the virus, given the government’s initial missteps.
However, both articles somewhat misconstrue the reality of what the focus of the public debate should be. In response to Gal, who argues that “this interpretive East/West state split makes absolutely no sense,” I suggest there is a fundamental connection between governmental structure; its influence on the relationship between the government and its people; and the country’s response to the outbreak — specifically its ability to put in place heavy restrictions on the individual liberty of its citizens. Jacques, similarly, is hasty in stating that “the current [coronavirus] crisis has fully demonstrated the superiority of Chinese governance.”: It is dangerous to conflate a holistic assessment of governance with one response to a domestic emergency. The greater public debate must focus on the crucial tradeoff between individual liberty and public health protection.
There are a few pivotal points to be made. First, countries that have implemented more sweeping regulation on the movements and interactive ability of their people have been more successful in containing the virus. Second, countries with authoritarian tendencies, due to greater state authority and fewer restrictions on their ability to pass legislation, can more easily enact such sweeping regulation. As such, it should be no surprise that states with more authoritarian tendencies, on average, perform better in their containment efforts.
To at times forgo the mantras of individual liberty and privacy for the greater public good in times of crisis like these, however, does not necessarily mean sacrificing the various crucial elements of democracy that have guaranteed the stable functioning of society for hundreds of years. Rather, it is this fixation on specific elements central to democracy — in particular personal privacy and individual liberty — that harms not only the democratic response to the COVID-19 pandemic, but indeed also the wider functioning of the state as a whole.
This is also not to say that all democracies have fared poorly in response to the pandemic. Democratic South Korea in the four months since its first case of the virus was confirmed, has managed to contain infections — as of mid-April — to just over 10,000, with only 200 deaths (South Korea’s population is around 51 million). Hong Kong — which remains a democracy despite increasing pressure from China — has also, in spite of the recent wave of imported cases from abroad, been able to contain cases to around 900 (with a population of roughly 7.3 million). New York City, on the other hand, has seen almost 90 times the number of infections, nearing 80,000 as we enter the third week of April.
To better understand how places like Singapore, Hong Kong, China or South Korea have been so effective in containing the virus, one must analyze their system. The answer: plentiful and early testing, as well as aggressive screening of contacts and strict enforceable quarantine rules. As of legislation recently passed, Hong Kong citizens, upon returning home from abroad, are not only first tested for the virus, but then legally required to self-quarantine at home for 14 days. To ensure compliance, everyone is provided with a tracking bracelet and a downloadable app where you are to — in under 60 seconds — physically set your house perimeter. In a recent press briefing by the territory’s Chief Executive Carrie Lam, the more than 70 people that have violated the roughly 50,000 home quarantine orders have been sent to government isolation centres with the possibility of criminal prosecution.
In Singapore and South Korea, aggressive contact tracing is coupled with the public release of personal information of confirmed cases — including where the patients approximately live, work and have recently been — so that those who suspect potential interaction are able to quickly self-isolate and seek testing if needed. This information is made public via a central website as well as regional text messages. Testing is free in Singapore, Hong Kong and South Korea. Despite reporting its first cases at essentially the same time, the U.S. had — roughly a month into the pandemic — tested only five people per million population compared to South Korea’s 4,000 tests per million population. In the time since, however, it should be noted that the U.S. has rapidly ramped up testing capacity, with Trump reporting mid-last week that official numbers had risen above 2 million.
It is strict regulation, which some view as infringing on individual liberties and privacy rights, that has governed the successful containment efforts of these East Asian states, such as Singapore, Hong Kong, Taiwan and South Korea, whether they be democratic or authoritarian. And it is also this strict regulation — in particular aggressive contact tracing and the public release of patient information — that will have particular difficulty manifesting in western democracies, given the prominence of the debate on the potential infringements on individual liberties.
In times of crisis like these, we must objectively assess the true ramifications of “infringing upon individual liberties” (to the extent of what South Korea or Taiwan have done, for example) and weigh this relative to the crucial containment of the spread of the virus. Aggressive contact tracing can only be performed effectively with tracking the location and whereabouts of confirmed cases. And although the public release of patient information may compromise the dignity of some individuals — for example, those in South Korea who have been exposed by family members of having visited “love hotels” — it is important to recognize what is at stake: the public health and lives of hundreds of thousands, if not millions, of people.
This debate between personal privacy and greater public health is ongoing, and will evolve over time as the pandemic peaks, then eventually subsides. Yes, individual privacy is important and is often a definitive characteristic of a laissez-faire approach to governance. However, it may be crucial to re-evaluate the prevalence of certain democratic mantras that consistently emphasize the individual over the state, especially when confronted with a crisis that so powerfully exposes the true vulnerability of the individual.
Contact Dan Healy at danhealy ‘at’ stanford.edu.
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