What is not worth risking in life

How much is a life worth

In the guest commentary, Wolfgang Schreiner from the Medical University of Vienna addresses the easing dilemma in the pandemic.

Originally it was said: "Cost what it may" and expressed that health and human life are not bargaining chips. This is now being softened and some seem to be seeing alternatives. The debate is coming to a head: continue to lockdown or open it at all?

While experts and the government are laboriously weighing up, hundreds are demonstrating on the streets of Vienna, quite aggressively: away with the masks and other corona measures, away with the government, in with the freedom that was allegedly restricted for no comprehensible reasons. This is how it is roared and played by many media.

But what does open mean? None of those who call for it say it clearly. High time to show your colors.

Economic damage

As long as there is no vaccination, every corona infection means permanent damage or death with a certain probability. Even if this probability is small, everyone who died of Covid can be traced back to it - you can find it on the dashboard. Anyone who increases the number of infected people also increases the number of permanent damage and deaths. That is exactly what those who call for easing or even lifting of the measures are doing.

But they do this for a reason. In fact, social and economic values ​​stand against overly strict measures. Simulation experts have already calculated which measures are effective in relation to others. Let us assume that this could be used to calculate the number of infections that a measure, such as the closing of shops, avoids and the economic damage this would cause. This immediately results in the "value" of a avoided dead or permanently injured person in euros.

Would any caller for easing dare to name a specific limit here? Only in this way could a measure or its omission be reasonably argued. Assuming that you would vote on it: What percentage of the population would have 10,000 euros or more opened? Or only from 100,000 euros? How big would the difference be if the voting was secret or open?

Indicator for quality of life

In fact, similar estimates are already in circulation. They are called QALYs (Quality Adjusted Life Years) and indicate how many additional years of life - weighted according to quality - a certain therapy provides. Anglo-Saxon health insurers only pay therapies up to £ 30,000 per QALY won. There is, however, a crucial psychological difference: If you refuse therapy for reasons of cost, it goes to the heart - you see the patient specifically in front of you and shy away from it. If you run on a demo together with hundreds without a mask, no direct damage is visible, and it is much easier to do it. Even if the damage is only "statistical" and you do not know the person (s) affected, he (s) will still be dead.

It is surprising that opponents of the corona measures have also used helmets and seat belts all their lives. Here, too, the specific probability (of damage) is negligibly small; most people drive their entire life with a seat belt or helmet without actually using them. We remember the absurd arguments against seat belts: "I'm so cramped" - or: "If the car falls into the water, I have to drown with my seatbelt on." Today helmets and seatbelts are the norm. No matter how insignificant the probability may appear in individual cases, the high numbers of people involved make it significant. In the case of helmets and belts, the insurance companies notice it in the amount of damage. In the case of Covid, it is "only" the few severely affected or even deceased patients.

This dilemma should be kept in mind before any call for Covid easing. Even if the calculation of harm and benefit (QALYs) would be complex and we do not know the resulting amount for Austria, every decision de facto amounts to: What we do shifts the limit amount in one direction or the other.

A disservice

Apart from the harm to life and limb - not even the economic advantage is certain: What use are the few days gained with holiday guests if a previously wonderful ski resort falls into disrepute worldwide? Was there carelessness instead of prudence? How much profit does the refusal of an immediate quarantine for a few days bring in comparison to the damage of a released virus variant that makes the vaccination obsolete, into which hundreds of millions of EU funds have flowed? The taxpayers can say thank you - even those abroad - they have also paid. You will choose your vacation destinations in the future. State politicians have proven one thing: They can do bear service, not just to individual places, but to the whole country.

When all experts advise caution and local politicians refuse to do so, they set the "value of life" lower than that of the economic gain of their electorate and of maintaining their own power. Actually, they have gambled away both and are therefore unsuitable for professions in which they are responsible for others. (Wolfgang Schreiner, February 20, 2021)

Wolfgang Schreiner is head of the Institute for Biosimulation and Bioinformatics at the Medical University of Vienna.

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