Nearly three months after the WuFlu outbreak was first reported to the World Health Organization, the total official global death toll of this once-in-a-century pandemic remains modest – even trivial, on the scale of the human population – notwithstanding relentless wall-to-wall media coverage, social media hysterics, and deliberately scary-looking “trackers” like that sinister map from Johns Hopkins. Although the death toll will certainly rise a great deal in the coming months as the virus spreads, it is currently a tiny fraction of the ~1 million global deaths from each of the influenza pandemics of 1957-58 and 1968; neither of which brought society and commerce to a screeching halt.
We don’t know if the repressive measures that are being taken to “flatten the curve” in the West, such as turning Britain into an Orwellian dystopia where you are only permitted to walk your dog once a day, will be beneficial overall, given the speculative nature of the epidemiological models used to justify them and the (unaccounted-for) public health costs of putting hundreds of millions of people under de facto house arrest. But it seems obvious that if these mega-interventions continue for the duration that is apparently required for them to be effective, then they will trigger a violent collapse of the global economy, and with it, widespread immiseration, political chaos and a truly Biblical scale of human suffering and death.
Yet that crazy, nation-wrecking strategy is precisely what is being rolled out around the world. The US is extending its “social distancing” guidelines to April 30, while the UK government is signaling that social distancing measures will be in place for three to six months; while similar measures are being taken in Europe, Australia, New Zealand, India (which has imposed a total ban on leaving the home for 21 days)…
It would appear that the epidemiologists have staged a global coup d’état. The Anglo-American policies are heavily influenced by Neil Ferguson’s team at Imperial College London, whose March 16 study recommended the adoption of Chinese-style “suppression” measures:
We therefore conclude that epidemic suppression is the only viable strategy at the current time. The social and economic effects of the measures which are needed to achieve this policy goal will be profound. Many countries have adopted such measures already, but even those countries at an earlier stage of their epidemic (such as the UK) will need to do so imminently.
Our analysis informs the evaluation of both the nature of the measures required to suppress COVID-19 and the likely duration that these measures will need to be in place. Results in this paper have informed policymaking in the UK and other countries in the last weeks. However, we emphasise that is not at all certain that suppression will succeed long term; no public health intervention with such disruptive effects on society has been previously attempted for such a long duration of time. How populations and societies will respond remains unclear.
But for how long? Earlier, the study notes:
The main challenge of this approach is that NPIs [non-pharmaceutical interventions] (and drugs, if available) need to be maintained – at least intermittently – for as long as the virus is circulating in the human population, or until a vaccine becomes available. In the case of COVID-19, it will be at least a 12-18 months before a vaccine is available. Furthermore, there is no guarantee that initial vaccines will have high efficacy.
Elsewhere in the Discussion section, the authors write (emphasis mine):
However, there are very large uncertainties around the transmission of this virus, the likely effectiveness of different policies and the extent to which the population spontaneously adopts risk reducing behaviours. This means it is difficult to be definitive about the likely initial duration of measures which will be required, except that it will be several months. Future decisions on when and for how long to relax policies will need to be informed by ongoing surveillance.
The measures used to achieve suppression might also evolve over time. As case numbers fall, it becomes more feasible to adopt intensive testing, contact tracing and quarantine measures akin to the strategies being employed in South Korea today. Technology – such as mobile phone apps that track an individual’s interactions with other people in society – might allow such a policy to be more effective and scalable if the associated privacy concerns can be overcome. However, if intensive NPI packages aimed at suppression are not maintained, our analysis suggests that transmission will rapidly rebound, potentially producing an epidemic comparable in scale to what would have been seen had no interventions been adopted.
In his testimony last Wednesday, Ferguson seemed to offer another possibility:
Ferguson said the current strategy was intended to keep transmission of the virus at low levels until a vaccine was available. Experts say that could take 12 to 18 months and Ferguson acknowledged it was impractical to keep the UK in lockdown for so long, especially because of the impact on the economy. “We’ll be paying for this year for decades to come,” he said.
The UK government is aiming to relax restrictions on people’s movements only when the country has the ability to test more people for the virus, said Ferguson. Some have criticised the UK for not following the advice of the World Health Organization to “test, test, test”. But Ferguson said community testing and contact tracing wasn’t included as a possible strategy in the original modelling because not enough tests were available.
He said the UK should have the testing capacity “within a few weeks” to copy what South Korea has done and aggressively test and trace the general population.
But if the country’s deputy chief medical officer is to be believed, Britain is going to be on some form of lockdown for months. What most people don’t seem to understand is that the massively complex, interdependent nature of the world economy means that switching off large parts of it for an extended period of time is likely to bring the whole system crashing down. I don’t expect infectious disease experts to consider this, but then again, who put them in charge of the world?