COMMENTARY

Is Reopening Worth the Risk to People's Lives During COVID-19?

Arthur L. Caplan, PhD

Disclosures

August 03, 2020

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This transcript has been edited for clarity.

Hi. I'm Art Caplan. I'm at the Division of Medical Ethics at NYU's Grossman School of Medicine.

I've been in my home, which is in Ridgefield, Connecticut, for months. I am about 60 miles north of New York City, where I'm not going to work, but I'm also not going out to do things that I used to do and that my family enjoyed doing: going to a movie, going to a Broadway show, going to a sports event, going to an art museum or a concert. These are things we love doing but we're not doing them.

Obviously, in many parts of the United States, governors and local officials are making decisions to open up the quarantine/self-isolation, and many people are taking those opportunities very enjoyably and trying to get a haircut, go to a bar, eat in a restaurant, and do many other things.

It remains a matter of dispute as to how you make the calculation about when to relax quarantine and isolation, reopen businesses, and reopen places that are just fun and that add value to life.

I think there tends to be an equation. On one side, there is public health. We've got to save lives and prevent hospitalizations — that's the top value. On the other end, we've got to open up the economy and get everybody back to work. That's the way to advance the most health, to make sure that people have food on the table and to avoid economic catastrophe.

There are some other values that have to be put into the mix. For one, not everybody values health as number one. I have friends who ride around on motorcycles who don't wear helmets. I know people who still don't put their seatbelts on when they should. I know people who will do risky things like zip lining, hang gliding, or flying small planes where danger of death is high. Some people speed when they need to get somewhere quickly and they don't think the police are around.

My point is that not everybody puts health as the number-one value they want to pursue. That's sometimes a little hard for doctors and public health people to accept, but it's true. We have to not make health the be-all and end-all of every public policy.

At the other end, it's important to have a business running, but not every business is essential. Although we certainly want to value fun and the opportunity to socially interact, it's obvious that there are some things that I think we can go without because they're hugely at risk.

I'm not going to a Broadway theater or to my local movie theater anytime soon, even if they told me everybody's wearing a mask. I'm going to sit home and watch streaming movies on my own television set. By the way, it's cheaper.

Sports? Well, I'm not sure I'm going to join the softball league unless we're all going to socially distance, or re-up my participation in sports that require contact like rugby or football. These aren't things that I think are going to prove safe. I think we can live without them.

I hesitate to say it, but reopening college sports, like football, is just way too risky for our student athletes to be involved in. That part of the equation, risk vs benefit, even with a nation watching and getting enjoyment out of it, just seems hugely difficult and far too risky to pull off.

How do we do the equation? Health counts, but it's not the only thing; it's not everything. At the other end, freedom counts, but it's not the only thing; it's not everything. The freedom to go to work and to put food on the table? Sure. The freedom to see sports return and to put young student athletes at risk? I don't think so.

We have to be more sensible and compromising. That's what ethics is all about. You have two goods — health and liberty — and then you have to find a balance between them not by being political about it but by being sensible about it.

I'm Art Caplan at the Division of Medical Ethics at NYU's Grossman School of Medicine. Thanks for watching.

Arthur L. Caplan, PhD, is director of the Division of Medical Ethics at New York University Langone Medical Center and School of Medicine. He is the author or editor of 35 books and 750 peer-reviewed articles as well as a frequent commentator in the media on bioethical issues.

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