01 May Divergent roads
Were we condemned to suffer from both economic havoc and the pandemic?
No one denies that is easier to suggest measures on how to face difficult times in retrospective, or in plain words once they have happened.
It is true. It is easier. But at the same time, it is our responsibility as citizens, locked down for the common good to assess different scenarios that could serve as options for achieving the same goal.
In particular, what if instead of following China’s whole population lockdown model we opted for a different set of measures. Is it possible? I truly believe it is, and I’ll try to explain to you how.
COVID19 firsts alerts (2019-nCOV by that time) were issued on January third week (W3 2020), through the World Health Organisation’s twitter account. Even there are reports that the Taiwanese government was alerted to the World Health Organization on December 31st, 2019.
On January 23rd (W5 2020) Chinese government restricted the movement of people, by shutting public transport, airports, and road traffic with other provinces. It preceded Wuhan’s full lockdown that occurred on February 20th (W8 2020).
World Health Organization declared Coronavirus as a pandemic on March 11th (W11 2020). This means that lockdown measures precede in eleven days the notion of the global impact the virus could have, and this is not a trivial fact.
There’s always someone that makes that question. In my experience, that might upset those who were in charge of making decisions, but this is not the case. It is obvious that we didn’t pay attention to the warnings of renowned personalities like former President Barack Obama, Microsoft’s founder Bill Gates or infectious disease expert Michael Osterholmthrew to all of us.
Also, it was easy to copy a model that apparently proved to work, especially if it was suggested by the entity in charge of overseeing the outbreak, the World Health Organization. The range of maneuver was extremely limited, the lockdown as a one, and the only alternative had become the unique narrative available.
There are some guiding lines that the virus described in those early days, it is particularly harmful to older people and those with preexistent conditions such as respiratory deficiencies or cardiovascular diseases. Human to human contagious was confirmed, and asymptomatically carriers as a variable for spreading patterns were considered.
With this in mind, an alternative model would be possible if those in more severe risk were put in quarantine, limiting their social contacts. How attainable was to recreate the same lockdown situation but with targeted portions of the society, instead of an all-in model?
All about trends
COVID19, as the WHO called after a couple of weeks of its appearance, makes two clear statements to us humans. First was, even though we have recurring seasonal influenza, which kills around three hundred thousand people a year mostly in the US, transmittal speed would be different. Infection numbers followed from the beginning was a perfectly defined exponential trend. It was simply explosive.
Second, it would impact our daily activities, aggressively getting into our bodies taking advantage of the proximity we tend to have in offices, subway, stadiums, airports, and so on.
There wasn’t room for ambiguous answers, authorities had to act fast, establishing clear and mandatory measures to be applied over society as a whole. But, how to get the data that serves as a base for articulating proper policies on such an abnormal time? There wasn’t.
The rapid growth of the number of cases led governments to have a dual approach to the virus, countries like Taiwan, Singapur, or South Korea implemented tracking tools to locate infection multipliers. Authorities relied on apps created specifically for this nuisance.
On the contrary, countries in Europe and the US minimized COVID19 impact by comparing its potential impact with other known illnesses, incapable of grasping the real threat that this novel virus poses on them timely measures were not taken.
In Spain data suggests that the government didn’t realize how deep the country was getting into until the number of cases simply exploded. It was on week eleven (W11 2020). Even though Italy was having a hard time dealing with the virus, conferences were organized to communicate how harmful the pandemic could be, the country lacked solid leadership from the executive branch of the state when facing the threat.
But, let’s try to recreate the situation, what if we could get valuable insights from Hubei’s lockdown. What if we can understand how to avoid massive contagion while finding the best combination of measures.
Deconstructing the stages
For the sake of the analysis let’s divide the virus occurrence timeline into three:
- First: Contagion starts, no lockdown measures have been taken.
- Second: Lockdown enabled. The Health system gathers and analyzes data.
- Third: Measures adjustment, based on each country particular conditions.
Source: Our World in Data Reports
From this chart, we can affirm the following:
- There was a window of at least six weeks for Spain to learn from Chinese data.
- At the end of W8 2020, there was enough data to understand the age cohorts affected by the virus.
- On March 3rd, the University of Bern published a paper containing the following statement:
…” We find that 1.6% (1.4-1.8) of individuals infected with COVID-19 during that period with or without symptoms died or will die, with even more important differences by age group than suggested by the raw data. The probability of death among infected individuals with symptoms is estimated at 3.3% (2.9-3.8), with a steep increase over 60 years old to reach 36% over 80 years old”…
The numbers in Spain
There are multiple reasons to believe that cases and disease reporting is not doing right. It is not clear if it obeys to an express intention from the authorities or it is one of the consequences of a not expected pandemic for which we were far from comprehending how to deal with it.
National authorities report describes the following situation after a month of confinement (W16 2020):
Source: Ministerio de Sanidad del Gobierno de España
- 44,8% of the cases require hospitalization, which is 54,677 patients.
- Out of those cases, age range from 0 to 49 years old accounts for 7.2% of the patients that required a bed in the health system, which is 8,798 patients.
- Intensive care cases among 0 to 49 years old patients are equivalent to 0.51% of the total cases.
- Cases requiring special attention either hospitalization or Intensive Care start to soar for 50–59 and older ranges.
In a graphical way, here is the data:
What if after the fourth week of confinement the Spanish government would change the rules, using as a reference not only the local situation but what has happened on those places where a partial lifting of the lockdown has started?
Allowing people ranging from 18 to 49 years old to get back to their jobs would be an invigorating move. Clear rules and guidelines, accompanied by technological tools would be the first step for avoiding what looks like a free fall for our economic system.
It could be adapted either to each autonomous community, industry, or service, keeping a close eye to the reports from the health care system. The private sector wouldn’t be working at full capacity, many people on that have kids who are not going to school.
Nevertheless, it is the first tryout to understand how to get out of the swamp involuntarily we got in. It was not our society’s fault to get impacted by a virus from overseas but we cannot dismantle our way of creating wealth either.
On March 22nd, Thomas Friedman in the New York Times quotes Dr. John P.A. Ioannidis, an epidemiologist and co-director of Stanford’s Meta-Research Innovation Center who said:
…“locking down the world with potentially tremendous social and financial consequences may be totally irrational. It’s like an elephant being attacked by a house cat. Frustrated and trying to avoid the cat, the elephant accidentally jumps off a cliff and dies.’’…
We cannot be on our houses indefinitely, there is no vaccine on the horizon, and a new collective behavior arose as the only way out. Contagion rates may soar, and new lockdowns will be required. If this is the case, why not finding the best alternatives for dealing with our new reality.
Analyzing numbers is nothing without an opinion. Everyone will see the world based on their personal beliefs, on what is their current situation and what expect from the future.
Data from both places allow me to synthesize what I guess would be my advice as an economist in case of being asked. There are millions of pieces on information to be reviewed, singularities, and deviations that break whatever approach we suggest for solving a crisis like the one we are in the middle of.
My conclusions led me to think that all these measures were taken with the only intention of not surpassing national health system capacity. This may be obvious but it draws more severe implications.
Of course, we have to keep our elders safe and try to minimize virus impact in society as a whole but, it is true that we cannot rely on one restrictive model based on Hubei’s experiences. It is mandatory for us to find the best possible system on which our economic system and our liberties get the lightest impact possible.
In the meantime, I will remain concerned about how our future would look, if we keep prioritizing our health systems putting all the other options out of the table.