By Jude Fernando –
Human rights are not a privilege conferred by government. They are every human being’s entitlement by virtue of their humanity ~ Mother Teresa
The current conditions, as well as the future, of pandemic-stricken Sri Lanka are far bleaker than the thirty years of war or the 2004 tsunami. Globally, the daily number of COVID-19 deaths compared to the daily infections is as low as 1.4 percent, whereas the figure is as high as 5 percent in Sri Lanka, indicating the severity of the current situation in the country. The Sri Lankan Government must be transparent regarding its reasons (epidemiological, social and moral) for choosing to implement travel restrictions rather than a national lockdown as an effective means of responding to the pandemic. The Institute for Health Metrics and Evaluation at the University of Washington projects that the government’s continuing disregard for evidence-based reasons behind the demand for a complete lockdown will make it complicit in 20,000 COVID-19 deaths by September, 2021.
Claiming that the hospital network in the country is at grave risk of being crippled, on 13 August 2021, former Chief Epidemiologist Dr Nihal Abeysinghe urged the Government to impose a two-week lockdown. Failure to do so, would not only result in the inevitable increase of COVID mortality, but also deaths due to other diseases. In an interview with the Lankadeepa newspaper on August 15, 2021, W.A. Wijewardena, former Deputy Governor of the Central Bank of Sri Lanka stated that if we prioritise protecting human life over protecting the economy and close the economy for few weeks, we will lose only about five percent of country’s total production of goods and services which will not lead to a complete breakdown of the economy. He went on to say that it is futile to sacrifice lives for the sake of protecting the economy.
In terms of the widely accepted evidence-based epidemiological knowledge, and norms of social equity and justice, the government’s narrative of protecting livelihoods and saving lives to justify its refusal for a national lockdown is irrational, misleading, unethical, and unjust. The arguments favouring travel restrictions over lockdowns are deleterious red herrings, the outcomes of which will outlive the pandemic.
Lockdown measures are commonly misunderstood and mistakenly compared to those of travel restrictions. Differing opinions about lockdown are held by our government and many acclaimed medical professionals. The latter claim that implementing travel restrictions (either relaxed or strict) as a substitute for a lockdown is based neither on sound epidemiological evidence nor common sense. The fear surrounding lockdown is unfounded, and it detracts from the fact that travel restrictions disproportionately impact the efforts of the most marginalised to cope with the effects of the pandemic and widens the inequalities between them and the others. The promise of vaccinations to contain the virus does not excuse the government for the deaths or the social and economic consequences arising from its refusal for a lockdown unless it can provide epidemiological and social evidence to the contrary. In fact, travel restrictions are counterproductive to the health outcomes government expects from vaccinations, upon which the government places its hopes of economic recovery and popular legitimacy.
There is nothing new about the idea of lockdowns. They have been used to slow the spread of diseases since the 13th century Black Death spread across Europe. The basic assumption underlying lockdowns is that the closer the proximity of people and the longer they spend with each other, the more virus transmission increases. However, the prevailing fear of lockdowns as incarcerating people and completely shutting down all human activity is unfounded. While longitudinal studies on the impact of lockdowns are still emerging, they endorse the favourable outcomes of lockdowns.
A lockdown does not promise to eradicate a virus or to function as a perfect substitute for other measures such as vaccination and social distancing; rather, it complements the multipronged strategies necessary to manage the pandemic and help to achieve good intentions of the travel restrictions more efficiently. Lockdowns, as opposed to traveling restrictions promise:
Mitigation by ‘slowing but not necessarily stopping epidemic spread – reducing peak healthcare demand while protecting those most at risk of severe disease from infection.’ Mitigation results from isolating suspected cases and their households and socially distancing the elderly and people at the highest risk of serious illness.
Suppression, or lockdown, ‘aims to reverse epidemic growth, reducing case numbers to low levels’ by socially distancing the entire population ‘indefinitely’ and closing schools and universities (Ibid).
Complementarity enhances the efficiency of other pandemic mitigation efforts that are vital for expediting the return to sustainable normalcy.
Proactiveness prevents the virus from taking charge of the progress of the pandemic. The epidemiological vulnerability being their central focus, the lockdowns are also sensitive to context-specific challenges in pandemic response efforts that provide decision-makers with greater autonomy to act.
Distributive Justice. Lockdowns minimise the adverse effects of a pandemic on the most marginalised groups and place more pressure on the government to adopt equality and justice as the main principle in allocating resources to safeguard people’s survival during the pandemic, and the wellbeing, safety, health of other essential service workers.
Epidemiology should drive the reasons behind the application, timing, and duration of lockdown strategies and other control measures such as social distancing and mask-wearing to achieve predetermined public health outcomes. Lockdowns promise to make pandemic peak incidence manageable: they split the peak of hospitalizations into smaller and manageable peaks. They might even prevent a peak and pandemic caseload from exceeding hospital capacity. They provide breathing space for countries to adjust and respond to the realities of their specific pandemic context, particularly the unexpected and unpredictable mutations and impact of COVID-19. The effectiveness of lockdown strategies varies according to the outbreak context. For example, China – the country that provides most vaccines to Sri Lanka – used aggressive city and regional lockdowns to prevent virus transmission spread, thus flattening the epidemic curve and delaying the peak. The transmission and mortality rates of the virus are far lower in most of the countries that adopted intentional lockdowns than in those countries that refused to do so. Australia is another good example of using lockdowns and contact tracing to delay a surge of the virus.
Lockdown measures do not advocate a blanket shutting down of all activities outside the home; instead, they allow certain essential activities to continue in ways that do not lead to the spread of the virus. Lockdowns are crucial for those countries that are under-resourced and cannot maintain contact tracing and virus testing. “…a pure test-trace-isolate strategy is likely not practicable in most countries, and a degree of social distancing, ranging up to full lockdown, is the main public-health tool to mitigate the COVID-19 pandemic” (Lytras & Tsiodras, 2020, p. 1). The time needed to achieve herd immunity, preferably through vaccination rather than natural infection, determines the duration of a lockdown. Uncertainty concerning how the virus could evolve and impact society makes an even stronger case for a lockdown as it promises to contain the spread of COVID-19 and its debilitating effects on people and the economy, including alarming increases in deaths.
In contrast to a lockdown, travel restrictions as the preferred pandemic management strategy of the Sri Lankan government is not epidemiologically and socially justifiable, and practical. The ostensible intention of the travel restrictions is to limit people’s mobility between and within provinces, both of which have failed to achieve their objectives thus far. Checkpoints at selected places at the provincial boundaries do not prevent routine movements of most of the country’s population because they occur mostly within the provinces. At the same time, provincial boundary crossings continue despite the restrictions. For example, people from the north-western province travel by bus to the province’s border, walk over the Maha Oya bridge and take another bus to western province points. In this situation, the travel restrictions apply more to the buses than to the people. Movement within and between provincial boundaries negatively impacts only those forced to take crowded buses and trains. Late-night curfews to supplement provincial boundaries are meaningless as Sri Lanka does not have a vibrant urban night life, as they do in developed countries. Lockdowns, however, focus on vulnerable and risky contacts between people wherever they gather, rather than simply on roads between the provinces, as with travel restrictions. Epidemiological boundaries are porous and do not always correspond to administrative boundaries.
The travel restrictions policy focuses on the province, whereas typical lockdown measures typically focus on households. Containing the spread of the virus in smaller units is far more manageable than in larger ones. Arguably, larger administrative units are prone to higher infections rates. However, travel restrictions have done little to restrict contact between people within the provinces. Provincial units with a high population density are likely to have more and faster virus transmission rates than low population density provinces. The focus on provinces neglects the transmission within the regions. Epidemiologists recommend small units as the best option for controlling the virus. “Guided by reliable surveillance data, distancing should be continuously optimised down to the lowest sustainable level that guarantees a low and stable infection rate to balance its wide-ranging negative effects on public health” (Lytras & Tsiodras, 2020. p.2). Smaller units contain the spread of infections. Moreover, smaller units, down to the bottom of the administrative system, i.e., the Grama Niladhari level, make people less anxious about pandemic spread, help the state improve their pandemic management efficiency and potentially, reduce the pandemic’s duration.
Virus control methods within provinces mimic counterterrorism strategies as they involve closing the areas reported to have a high incidence of infected people and apprehending and isolating them. The site is reopened for civilian movements after it is free of infected people. This approach has completely failed to contain the virus. The implicit assumption of the government’s strategy is that the behaviour of the virus and enemies during a war are similar. A virus, however, is an invisible force that moves from person to person, unobstructed by physical or administrative boundaries, and armies cannot shoot it or regulate its behaviour. Hardly, any person (except the bats) infected with the virus moves around during the curfew imposed by the government between 10 am and 4 am.
Bringing epidemiological sites under control is very different from areas saturated by terrorists. The government appears to measure the success of travel restrictions as it does the 30–year civil war against the Tamil militants rather than on the epidemiological realities of the pandemic. The notion that ‘Sri Lanka did not close the economy during the 30 years of civil war, why should it do now?’ Is a disingenuous justification to oppose a lockdown. The war did not disrupt the economy the way the pandemic does now. The lockdown mitigates the extent to which COVID-19 can disrupt the economy. Unlike during the war, there is no justification for sacrificing human lives for economic interest or political expediency.
The preponderance of military rationality in epidemiological governance during the current pandemic manifests the peculiar character of the current regime’s decision-making culture. Ironically, this could stand in the way of maximising the use of Sri Lanka’s armed forces, which have proven their capabilities to assist during humanitarian crises, as we have witnessed during past natural disasters and the early stages of the pandemic. A top-down decision-making culture values loyalty-induced political expediency more than socially just knowledge and expertise; this creates more personal risks and obstacles for professionals trying to maintain standards and integrity. Consequently, public faith in them is undermined, increasing the burden on individuals to take care of their health.
Echoing the professionals’ frustrations with the current situation, on August 14, 2021, the State Minister of Primary Health Care, Epidemics, and COVID-19 Disease Control, Sudarshini Fernandopulle, a trained public health physician, said, “My opinion does not matter. Decision-makers will make decisions. But the country is at risk. Do not wait for the Government and the Ministry of Health. The value of your life is yours. Protect your family; don’t wait until a lockdown is imposed, or someone makes a rule”. Also, on 14th August 2021, Ajith Rohana, Head of the Public Health Inspectors Union, while pleading with the public to practice self-quarantine, concurred with general sentiments among health care professionals: “Public Health Officers are bitterly disappointed with the Government for not declaring a lockdown in such a juncture that the country is plunging into a catastrophic situation due to highly contagious Delta variant.We will no longer insist the Government impose restrictions or lockdown as they continuously ignore our suggestion and the opinion of medical experts.”
The idea of self-quarantine is a desperate plea in response to over one year of the government’s failure to prepare a comprehensive plan for a lockdown, despite the repeated demand for it by the health professionals.
The advocates of travel restrictions should take their fair share of responsibility for the current state of the pandemic and its short and long-term consequences because these consequences are directly a result of the government’s conscious policy decisions and mismanagement since the pandemic. Blaming the people for the failures of travel restrictions is irresponsible. We need a government-imposed lockdown because people, in general, are unlikely to comply with restrictions voluntarily/self-quarantine, nor do they have the means to do so by themselves. If that were not the case, the world would be a far better place than now. Public Health officials’ desperate pleas for ‘self-quarantine’ is unlikely to be effective as it cannot be sustained without a systemically organized lockdown that we find in other countries. The government’s responsibility in imposing compliance is an ethical imperative because it holds the primary responsibility for the collective good, especially during the pandemic when non-compliance with health guidelines can negatively impact others, including those who comply with the restrictions.
Selectively blaming certain groups such as teachers that are on strike during certain days of the pandemic for ‘irresponsible behaviour’ deflects and politicizes a productive conversation about the merits of lockdown versus travel restrictions. Why do we treat teachers’ strikes as an exception when the government selectively allows all sorts of non-essential public gatherings to continue, especially within the provinces? In terms of possibilities of spreading the virus, there are no fundamental differences between people forced to work in crowded places and travel in crowded buses and trains during the pandemic and the protesters. In fact, the teachers strictly observed social distancing and wore masks during protests in public places, and in response to an escalation of infections, they reduce the days and duration of protests in public places and later voluntarily suspended them altogether.
Suppose the government’s priority is to protect the wellbeing of the entire society. In that case, it could have been proactive and banned all public gatherings in response to desperate requests by the healthcare professionals. The government selectively blaming certain groups for the status of the pandemic only reveals the deeply political nature of the travel restrictions, rather than its interest in safeguarding the lives of people. No, there exists no epidemiological link between the reasons for the governments’ continuing refusal for a lockdown in favour of travel restrictions (that continue to frustrate the health professionals) and teachers’ protests. We must understand these protests as public reactions to impacts of the government during the pandemic rushing far-reaching legislative changes, for example, in the areas of education, law, and agriculture.
Lockdowns are not opposed to the progress the government is making in terms of vaccinations. In fact, lockdowns help manage the coordination issues in vaccination programs, and reduce the number of infections and fatalities until vaccinations reach their epidemiological targets and the virus reaches a dormant stage. It also improves the efficiency of vaccination delivery. It eases the emotional and physical burden of the already overstretched healthcare workers, and it takes the pressure off and the healthcare system’s financial, material, and human resources capacity to attend to the seriously ill. We must keep in mind that the healthcare system has many other needs to respond to besides COVID-19. Failure to check the infection rate disproportionately impacts economically and socially marginalised groups. These people are unable to afford the costs of private hospitals or oxygen cylinders at home. In addition, they often lack the influence and means to get access to a hospital bed and are forced to share or sleep under beds in hospitals. Knowing the precarious conditions of hospitals, many seriously ill people may refuse to go there, and instead, they perish at home. Thus, the government’s narrative on travel restrictions is counterproductive to the positive health outcomes of vaccinations, upon which the government seems to place its hopes of economic recovery and popular legitimacy.
Refusal to lockdown disproportionately favours privileged groups. The dwellings, modes of travel, and workplaces of the elite are already socially distanced from the areas where the virus is more widespread. The elites could escape to safer areas without significantly disrupting their sources of income. Incidents of people in this class using their economic power and political influence to escape the scrutiny of the law when they participate in prohibited activities during the pandemic are not uncommon. Refusal to lockdown provides greater opportunities for the rich to increase their wealth by exploiting labour and through socially and politically sanctioned inequalities in society.
No wealth is gained without the exploitation of labour and nature. The idea that those who invest capital have a natural right to wealth is misleading – acquisition and expansion of capital result from disposing and depriving the poor of their entitlement to natural resources. During the pandemic, the survival of the elite, especially their ability to maintain their dominant status in society by exploiting the opportunities the pandemic provides for them, has depended on the continuity of the services that marginalised groups offer- the so-called ‘essential workers’.
With a systematic analysis, the government could reduce the number of workers in many government institutions without disrupting the number necessary to maintain essential services during a lockdown, and therefore reduce the number of people that are vulnerable to the virus. Protecting the livelihoods of the most vulnerable people from the pandemic as an argument for not locking down is misleading. Compelling the poor to work makes them disproportionately vulnerable to the virus, as they must travel, work, and inhabit crowded places. The rapid spread of the virus continues to disrupt the livelihoods of the labour force in congested sites whenever the Government randomly opens and closes workplaces to contain the virus.
The erratic and unpredictable way travel restrictions have been imposed has not been successful in preventing the virus from disrupting the economic activities within the country compared to other countries that have closed their borders to Sri Lanka. Disruptive travel restrictions will only prolong the pandemic recovery and disrupt the production of staple and export crops, making the country vulnerable to food shortages and the loss of revenue from exports, remittances, and tourism. There is no epidemiological justification for the Minister of Tourism’s claim that opening the country for tourists under the bio bubble has not resulted in the pandemic spread; nor that keeping the country open for tourists will safeguard the three million jobs in the tourist trade.’ Tourism will, however, come to a standstill when countries ban their airlines and citizens traveling to and from Sri Lanka, and more tourism sector employees are forced to stay out of work if the infections continue to increase at the current rate. In turn, the government will lose export markets to competitors that are successful in shortening the duration of the pandemic, and the Sri Lankan people will face restrictions on overseas employment, which is one of the most sustainable sources of foreign exchange. An increase in infections will force the government to allocate its hard-earned foreign earnings, for example, shown by the import of oxygen as the country has moved from a surplus to a shortage of oxygen.
The argument that Sri Lanka is a ‘poor country’ and that, unlike rich countries, it cannot afford a lockdown is a cliché that overlooks an important fact- the systemic nature of vulnerabilities during the pandemic. In this respect, pandemics, far from being an abnormal situation, are a continuation/entrenchment of the economic and political forces we take for granted as normal and which are responsible for inequalities in society. First, the refusal to lockdown in many countries is ideological rather than arising from the systematic analysis of resource scarcities, the government’s capacity to distribute necessities, or whether lockdowns are more harmful than ‘protecting livelihoods.’ Second, a country like Sri Lanka has plenty of supplies of basics necessities for the entire country, which means it can refrain from work during the pandemic. The pandemic has not disrupted nature’s ability to produce. Continuing the production and supply of most necessities during the pandemic is possible with minimum exposure to the virus.
The difficulties of maintaining a lockdown that arises from resource scarcities do not result from natural conditions; instead, they are rooted in a monopolistic control over food chains, often initiated by those politicians patronise. In other words, shortages result from a crisis of underproduction that arises from the unwillingness of the monopolists to sell the products for profit. This is not a matter of unequal distribution but deprivation under the state patronage. The dispossession and deprivation that the poor experience due to the artificially created shortages of necessities compels them to travel and work during the pandemic and thereby make them more vulnerable to the virus.
Employers do not become more generous during the pandemic. Travel restrictions do not prevent infected people from going to work, creating chaos at workplaces which then become sites of spreading the virus to society. Travel restrictions are complicit with precarious, and anxiety-driven work environments of the most vulnerable workers. Opponents of the lockdown are primarily concerned with earning foreign exchange than the ethical imperative of protecting human lives. Employers are not held responsible for the spread of the virus in their workplaces. Instead, it is not uncommon to hear people blaming the irresponsible behaviour of the workers when they are infected with the virus but are still forced to go to work.
The goal of livelihood protection should be primarily about life. We should work to live, not live to work. ‘Essential workers’ just like everyone else, are entitled to refrain from work during the pandemic and still survive and satisfy their needs because they have contributed immensely to the nation’s wealth during both normal times and the pandemic. Workers in many of the sectors that bring the most sustainable income to the country before and during the pandemic are the most vulnerable to the virus. Sri Lanka has a well-developed infrastructure and institutional network to distribute production. Lockdowns help to decentralise the distribution of essential items to the Gramasevaka Divisions. Decentralised services also minimise the necessity for long-distance travel and time spent in crowded places, thus reducing the transmission of the virus to immediate family members.
Thus, the refusal to lockdown under the guise of protecting the livelihoods of the poor is a false narrative that hides the government’s lack of political will, creativity, and imagination to take charge of abundantly available food supplies and make them equally accessible to everyone. The pandemic did not disrupt all economic activities. Indeed, it provides more lucrative opportunities for some. The wealth acquired during the pandemic by food monopolies and other private sector industries, along with the money squandered by unnecessary travel abroad, e.g., for the Olympics, could help finance essential items during a lockdown. However, the government’s sudden fertiliser ban is likely to contribute to a decline in food production (at least in the short term), making maintaining a lockdown even more challenging.
The refusal to lockdown is a sign of ideological and moral bankruptcy arising from a refusal to place lives over profit and political expediency. Leaders in the many countries that refused to lock down measure their success in managing the pandemic in terms of ‘keeping the economy open’ even if it has meant high infection and mortality rates. Such measures reflect neoliberal ideology, which advocates that the poor must work for their survival, rather than depend on government subsidies that neoliberals think as given the poor free of charge. The workers are not asking for anything free but for their entitlement to resources that nature freely provides–the resources that they, in turn, transform into goods and services. Privileged groups in society and the state appropriate a major portion of what the workers produce in terms of taxes and profits. Free access to necessities during a lock down is an entitlement of all people, not a handout that the government gives to them. Refusal to work to save life is also a basic human right, and the government is responsible for safeguarding that right as efficiently as it could.
The Government’s continuing refusal to lockdown points to a breakdown in the moral responsibility of the state to safeguard citizens’ right to life. The catastrophic consequences of this government’s stubborn position will outlive the pandemic!
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