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  • Stefano Merlo and Hannah McHugh

A democratic duty to test for CoVid-19 infection rates?

Updated: Jul 12, 2022

There is nothing more impactful than an emergency to show us where power truly lies. As we are confronted with the silent destruction of CoVid-19 we have rightly accepted and obeyed the decisions of our governments. Nearly two months since our lifestyles and livelihoods have been restricted, and with the new chilling realisation that an unprecedented recession is underway, cameras are still pointed towards governments’ newly set-up podiums, expectant of updates on government strategy and instructions for citizens.

In this emergency situation we seem prepared to accept that those in power enjoy ample discretion in choosing a national strategy and in coordinating the herculean economic and public health response that is needed to keep our economies afloat and our citizens safe. At least at the beginning of the pandemic it seemed like the question of what governments should do was a purely technical one: what is the most efficient way to increase hospitals capacity, get protective equipment and enforce social distancing?

However, as it has become clearer that unfortunately CoVid-19 is not going to be eradicated any time soon, our worries have developed. We have begun to wonder how to balance two conflicting objectives. The discussion has been framed as one of 'we must save lives, or the economy'. Given the fundamentally interconnected nature of public health and economic prosperity, it’s not clear that there a right answer to this supposed choice. It may be then that in the absence of consensus as to which values ought to be prioritised, we must turn instead to ask how can government legitimately enact a choice that bears upon all of us.

Can government choose its priorities?

It is clear that different countries, which embody different political ideologies, differ in their response to the crisis. Governments represent and react to contrasting public cultures and sensitivities. We may hail China and South Korea’s success in preserving lives and containing infection rates but lambast the loss of citizens’ rights to privacy. The US’s ideological focus on individual responsibility is evident in rallying resistance to the economic lockdown. This sits in stark contrast to Italy’s more family-oriented model and public health system, which allows for a stronger interventionist role for the state.

Would it be though, that a country pursuing either a completely economy-friendly policy programme or a completely health-friendly policy programme is doing something unjust? It is not clear that there are universal principles independent of cultural difference that can answer these questions. For instance, governments may try to maximise some specific policy aim, say this aim is to achieve some level of equal access to economic participation for all citizens. In judging the appropriateness of this policy, we do not only disagree about whether targeting this form of equality is the appropriate goal, but also as to what is the best technical way of pursuing this goal. In other words, citizens disagree both about the goals and how to achieve them.

Given that we face reasonable disagreement as to what a just policy would look like, we need to determine which process we ought follow to make decisions that can legitimately bind all citizens. One solution, advocated by Habermas, would be to adopt a ‘conception of communicative ethics’. Habermas tells us that the only ground for a claim that a policy or decision is just is that it must be arrived at by a public which has truly promoted the free expression of all needs and all points of view. He argues that tyrannised publics, publics manipulated by officials and media publics with little access to information and communication do not satisfy this requirement.

This implies a lot for democracy. Legitimate governments may pursue a policy goal, provided it has been selected after due democratic process. Every interest group - be they the minority or majority - must have an opportunity to advocate for their needs and desires. Citizens must be able to hold government to account for their actions and must have sufficient resources to do this effectively.

Democracy demands a mechanism to adjudicate between values fairly. It demands that the government represents the self-expressed will of its people, and it demands that citizens participate in and contest decision-making. This is a significant challenge in a suspended democracy, such as we are currently experiencing.

What is troubling in these times, additionally of course to the substantive values our governments may or may not pursue, is our ability to track and react to those decisions. If we are to act as contestatory citizens in the context of restrictions on ordinary democratic processes, we must be given the tools to do so. Citizenship demands involvement in political life, political responsibility for the state, and public deliberation as to the nature of the public good. Citizens ought to be active in contesting the way we are governed and in holding our state institutions to account. 

Not only do we need to know the basis of government’s deliberation in reaching a policy aim, we also must be able to hold government accountable to its own decisions or avowed policy goals. The real conundrum that we face is how to fulfil our duties to contest government during a pandemic where we cannot protest or contest using the usual channels and where we are heavily reliant on government for our factual data.

The democratic duty to test

If we do not have access to reliable, unbiased statistics and data, we cannot assess the problem or the impact of chosen strategies during a pandemic. Governments may be able to legitimately choose to value either lives or the economy. However, we will struggle to contest whether they are pursuing their affirmed policy goals in earnest or efficiently, unless we have means to determine the likely success or coherence of their measures using reliable data. Without factual tools, we will struggle to effectively hold our politicians to their word. There is too much room for deception, incompetence, discrepancy, factual inaccuracy and risk-taking. Governments would be free to consistently change their narrative to sell us a story of success, even when they have failed to meet their objectives.

Consider how this week the UK Leader of the Opposition challenged the Prime Minister as the government, after weeks of publishing comparative data of global infection rates, ceased to divulge such information to the public. Clearly, if the Opposition has any hope of contesting the decisions of government, it must have access to consistent data to track progress in fighting the virus. Johnson retorted that

“The UK has been going through an unprecedented once-in-a-century epidemic, and [Starmer] seeks to make comparisons with other countries, which I’m advised are premature because the correct and final way of making these comparisons will be when we have all the excess death totals for all the relevant countries.”

Declining to provide consistent data, or to provide data only after a policy strategy as important as this one has been concluded, is unjustifiable. A democratic government cannot pursue goals in whatever direction it chooses without scrutiny. This would be selective dissemination of data intended to lead us to affirm government’s supposed success. It deprives us of the opportunity to assess and adjudicate. Granted, international comparisons may not be the most relevant source of data for this task. However, significant challenges to testing widely in the community has left us reliant on tracking the development of whatever data sources government has chosen to collect and share with citizens.

Although over the previous months many of us have come to consider ourselves armchair virologists and epidemiologists, of course, we are in fact citizens and therefore not all of us are data or medical scientists. This sentiment reflects our search and need for accurate data to assess the direction of our national fate. New terms such as “social-distancing” and “flattening the curve” have become everyday vernacular. One term in particular we all have reason to focus on is the “R number”. R refers to the “effective reproduction number” and reflects a way of measuring an infectious disease’s capacity to spread. R signifies the average number of people that one infected person will pass the virus to.

“Test, test, test” echoed the words of the World Health Organisation’s director general. This call for testing is not only for the purposes of contact-tracing the disease and understanding its development. It is a necessary element of determining an accurate R number. Imperatively though, it is also a key element in ensuring the legitimacy of our democracies. Without reliable statistics like R, based upon sufficient community testing, we can never know the effectiveness of our governments. It is not sufficient to reflect on their success or failure after the crisis; we need the tools to ensure they pursue the policy goals they have publicly avowed if we are to act as a democratic nation.

Public debate has focussed on what kind of strategy governments ought to pursue in response to this crisis. This is a matter of reasonable disagreement, but, what is essential is that governments enable us to fulfil our duty in holding them to account. We must not be beholden only to blind faith in the narrative our politicians present to us. There must be widespread virus testing with publicly available results, so that pursuit of any policy aim, whatever it may be, can be considered legitimate. Further, there are compelling reasons why the organisation of these tests should be handled by an authority that is independent of the executive. (Consider how earlier this month the UK Government was accused of artificially inflating the number of tests it was able to conduct, or how China has been accused of misrepresenting the true extent of infection in the country).

CoVid-19 has taken governments and citizens largely by surprise, policies have been reactionary, and testing has been constrained in part due to scarce resources. However, this does not justify disregarding the obligation to give citizens due resources, data and analysis. With the benefit of learning from this unfolding experience, we ought to see the need for a new duty to take forward for the future - for CoVid-22 perhaps. A democratic duty to test.

*Image created by Russell Tate.

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