Tuesday, March 24, 2020

More support for several weeks of China followed by a few months of South Korea

 - by New Deal democrat

Yesterday the Buffoon in Chief all but demanded that mitigation efforts be stopped, and that the pandemic be allowed to run its course except for the aged and infirm, on the theory that the economy would be better off, and really, what’s a few million lives in comparison to the loss of profits he is suffering by the closure of six of his properties? 

I’ve crunched some numbers to show why that wouldn’t work, but since part of the response is that there is a far more effective way to confront the pandemic that actually would accomplish a relatively quick economic rebound, I wanted to present that first.

Remember that last week I suggested that the best way to attack the coronavirus pandemic both from the public health and the economic perspectives was 2 weeks of China (total lockdown) + 1 month of South Korea (extremely aggressive testing).  Since that time several others have weighed in with nearly the same suggestion. 

First, Yaneer Bar-Yam, an MIT-trained physicist and complexity scientist who studies pandemics a physicist at the New England Complex Systems Institute, wrote an editorial in USA Today opining that “We need an immediate five-week national lockdown to defeat coronavirus in America, and saying that: 
Locking down the country would reduce infections and allow time for massive testing. There will be staggering human and economic costs if we delay
He explained his alternative as follows:
During a five-week national lockdown, federal, state and local authorities would ensure that all Americans stay home except to obtain food and other essentials, access medical care or do work essential to the functioning of society. Travel would cease: We would close our borders and airports and prohibit all unnecessary travel across state and county (or town) lines within the United States. The U.S. government would have to provide aid to citizens separated from their sources of income and ensure care for vulnerable members of society. 
During the first two weeks of a lockdown, infected individuals will either recover from mild cases of COVID-19 at home or seek medical attention for the 14% of cases that are severe. During the third, fourth and fifth weeks, any newly infected family or cohabitants of infected individuals will recover or seek medical attention, and their isolation will prevent further spreading. By the end of the lockdown, the number of infections will be a small fraction of what they are now. 

The lockdown will give us time to dramatically scale up our supply of COVID-19 test kits and capacity to process them. If we reduce the number of infections using the lockdown and start a massive testing regime in the United States, we can control COVID-19 after five weeks without such extreme social distancing measures. Isolating sick individuals and their immediate contacts will be enough.

The same strategy - an initial period of Suppression followed by an extended period of thoroughgoing testing and quarantining - was suggested by Tomas Pueyo, in an article entitled “The Hammer and the Dance” at Medium.com 
To jump to his conclusion,
They [countries] can lock down for a few weeks to buy us time, create an educated action plan, and control this virus until we have a vaccine.

  • Go hard right now. Order heavy social distancing. Get this thing under control.
  • Then, release the measures, so that people can gradually get back their freedoms and something approaching normal social and economic life can resume.

Why? Because not only do we cut the exponential growth of cases. We also cut the fatality rate since the healthcare system is not completely overwhelmed.

If you hammer the coronavirus, within a few weeks you’ve controlled it and you’re in much better shape to address it. Now comes the longer-term effort to keep this virus contained until there’s a vaccine. 

The diagnostics would keep going up for a couple of weeks, but then they would start going down. With fewer cases, the fatality rate starts dropping too. And the collateral damage is also reduced: fewer people would die from non-coronavirus-related causes because the healthcare system is simply overwhelmed.
This would be followed by a period of aggressive testing. As Pueyo notes:
For several weeks, South Korea had the worst epidemic outside of China. Now, it’s largely under control. And they did it without asking people to stay home. They achieved it mostly with very aggressive testing, contact tracing, and enforced quarantines and isolations.
Here’s what the time spent in sledgehammer suppression does for us:
  • With a few more weeks, we could get our testing situation in order, and start testing everybody. With that information, we would finally know the true extent of the problem, where we need to be more aggressive, and what communities are safe to be released from a lockdown.
  • We could also set up a tracing operation like the ones they have in China or other East Asia countries, where they can identify all the people that every sick person met, and can put them in quarantine. 
  • ....
  • We can quickly build up our production of masks, PPEs, ventilators, ECMOs, and any other critical device to reduce fatality rate.

In short, both Bar-Yam and Pueyo advocate for the same strategy as I wrote about last week: a period of a few weeks in which there is an extreme lockdown in order to bring spread under control, if not to a halt. During that time testing and medical equipment can be produced and expanded enough to made a very aggressive and thoroughgoing testing and quarantine approach successful. Deaths would be greatly reduced, the medical system not overwhelmed, and the economy would get back on track much more quickly.