Controlled Avalanche – A Regulated Voluntary Exposure Approach for Addressing Covid-19

The ongoing Covid-19 pandemic has created an unprecedented crisis whose optimal means of control and mitigation are still unknown. Most strategies that have been implemented so far have targeted the population as a whole, using mandatory comprehensive measures such as radical social distancing, non-discriminatory testing based on symptoms and potential exposure, and total closeouts of transportation, businesses, and education institutions.

We suggest an alternative strategy. Instead of using non-discriminating measures targeted at the population as a whole, we propose regulated voluntary exposure of its low-risk members. Individuals whose probability of developing serious health conditions is low would be allowed to participate in the voluntary exposure program. The state would issue “immunity certificates” to everyone who has developed antibodies and is verified as non-contagious. Certified individuals would be allowed to reenter society and the workforce.

Let us explore here the ethical implications in terms of three distinct considerations: consent, paternalism, and public health. Consent considerations apply to exposure to risks that the person herself is willing to take. Note that to prevent any undue social pressure, the authorities would have to verify that the consent is indeed genuine. Paternalism applies to risks that society permits or prohibits a person to expose herself to (even against the person’s will). Public health criteria apply to the type of risks that society requires individuals to expose themselves to or to avoid exposing themselves to in order to promote the interests of the public as a whole.

Since there is no vaccination against Covid-19, the only way to become immune is through infection by the virus. Since exposure is voluntary, consent-based criteria support the proposed program. Furthermore, since exposed people become immune, their exposure reduces negative externalities to other people, and hence public health concerns also support their exposure. The question, therefore, is whether such exposure is justified on paternalistic terms. Given the low fatality rate among infected individuals aged 20-40, it seems that paternalism does not preclude their exposure.

Our proposal provides the option to be infected only to young, healthy individuals. Denying this option to older, higher-risk individuals, must therefore be justified. The justification rests on both paternalistic and public health considerations. It is both dangerous for old people and, furthermore, infecting them imposes huge costs on the medical system.

To sum up, given the low probability of serious harm, given that the risk is voluntarily taken, and given the public health benefits that would ensue, it seems morally justifiable to seriously consider this proposal.  

ABOUT THE AUTHOR

Alon Harel is Professor of Law at The Hebrew University of Jerusalem. He studied Philosophy of Law at Balliol College, University of Oxford. The text was written in cooperation with Eyal Klement, Alon Klement, David Chinitz, Eyal Fattal, and Ziv Klauzner. In 2019/2020, Alon Harel is a Fellow at the Wissenschaftskolleg zu Berlin.

More articles of the series "Wiko Briefs - Working Futures in Corona Times" can be found here.