How many deaths are acceptable in ‘zero-Covid-19’ economies? From Australia to Hong Kong, that’s the tough question

The likes of New Zealand, Singapore and Vietnam will also have to confront unprecedented fatalities if they are ever to return to a pre-pandemic way of existence, experts say

Through lockdowns and border closures, many Asia-Pacific territories have kept deaths below a typical flu season, but now face scientific and philosophical considerations over the value of a human life

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A lone person walks through Melbourne’s usually bustling Federation Square amid the city’s Covid-19 lockdown. Photo: AAP

Published: 8:00am, 17 Jun 2021Updated: 11:20pm, 18 Jun 2021

As the Asia-Pacific’s “zero-Covid-19” economies pick up the pace of their sluggish vaccination drives, a difficult question looms on the post-pandemic horizon: how many deaths should a society accept?

Even if they can achieve high vaccination rates, low-Covid-19 bubbles such as Australia, New Zealand, Hong Kong, Singapore and Vietnam – which saved countless lives with border closures, sporadic lockdowns, and social distancing measures – will likely have to confront unprecedented coronavirus fatalities if they are to ever return to pre-pandemic life.

Herd immunity – the threshold at which widespread transmission ceases, which experts currently place at above 80 per cent of the population – is expected to remain out of reach for many jurisdictions due to vaccine hesitancy and the emergence of mutant virus strains. Even when that threshold can be reached, small, sporadic outbreaks are still likely to occur once governments ease border restrictions that kept the virus out, helping avoid the massive toll in North America and Europe, which have reported some 1.8 million deaths. Among the unvaccinated, small numbers of people will sicken and die. In rarer cases, some deaths will occur even among those who are fully vaccinated.

“With Covid-19 circulating, it will become just another cause of infectious disease, and possibly death, but for most, death and serious illness will be vaccine preventable,” said Catherine Bennett, a public health expert and epidemiologist at Deakin University in Melbourne.

While much of the world has been exposed to mass death and disease during the pandemic to the point of desensitisation, many Asia-Pacific economies have kept death rates below that of a typical flu season. Down the track, that leaves them facing uncomfortable decisions that authorities appear unwilling to discuss or even acknowledge out loud. Unless they remain cut off from the world indefinitely, even as North America and Europe restart travel and learn to live with the virus, societies that avoided the worst of the pandemic will ultimately have to reassess their tolerance for death.

Tables are cordoned off at a hawker centre in Singapore, which in May tightened Covid-19 restrictions following a rise in cases. Photo: EPA

“It is going to be difficult to refocus and see the big picture because people have been terrorised into myopically focusing on Covid-19 deaths,” said Julian Savulescu, a philosopher and bioethicist based between the University of Oxford and University of Melbourne. “There has been little or no honest discussion about the value of life, how much we should spend to save a life, how we should consider length and quality of life, of risk for specific groups, of the value of liberty and the costs in terms of other lives and well-being of the policies adopted.”

Nancy Jecker, a bioethics professor at the University of Washington who serves as an adviser to the Centre for Bioethics at Chinese University of Hong Kong, said societies needed to have an open discussion about acceptable levels of death and disease.