by epochepoque
Mon Nov 16th, 2020 at 02:50:15 PM EST
As we are living through the massive second wave of Covid in the darker months of the year, it's time to wonder what has gone wrong with the response to the plague in Europe.
Back at the beginning the of the year countries in Europe were simply unprepared. Most countries in the world that have managed better had been burned by SARS in 2003. Pain is a powerful teacher and fear can reliably chase away complacency. Therefore Taiwan (No. 1!), Vietnam, Cambodia, New Zealand, etc. acted decisively and quickly. Measures included strict quarantine, contract tracing (the thorough kind), border control, mask wearing, sometimes lockdowns, all of which the population bought into. It's not just Asia. West Africa (burned by Ebola) is doing so much better than Europe with daily case counts we can only dream of.
Frontpaged - Frank Schnittger
From Eastern Europe to Greece, who had been doing really well, from best-in-class Finland to Southern Europe, the wrecking ball of Covid is following the same general trajectory. An initial wave of new cases in the spring, low numbers in the summer and now an eruptive second wave.
It's certainly better to be Finland than Belgium. I'll keep such differences aside for the moment to discuss matters of principle.
Though we may laugh at the comical record of wrong predictions by the Swedish authorities, the curve is not that different.
The only explanation I have for that is that no matter what the different strategies, it all comes down to similar practical circumstances in the European sphere. The public health infrastructure sprang into action (with varying performances). People mostly followed the rules. Then came the summer of relaxation, of ill-advised travel across Europe and parties. The virus was not eliminated, community spread went on. Low numbers engendered a false sense of security. Exponential growth was forgotten and thus we find ourselves with another explosion.
The initial difference in strategy and perceptions of them can be explained by a difference in philosophy. The people in charge in Sweden reportedly had their practical training by fighting HIV/AIDS where the war has been going on for more than a generation. Thus, the received school of thought is that illnesses are eliminated over a long slog if ever. Having managed to keep the healthcare system from buckling (until recently) would seem to be a vindication.
On the other hand: even if other EU countries implicitly wanted to drive cases to zero - they couldn't. Because of practical inability/incompetence and lack of coordination between EU members. Sweden never had that intention and just wanted to 'manage' the virus, only to find now that the virus can take over management in a hostile bid. The facade of success cracked in most places, no matter what the purported strategy.
'Living with the virus'
'Managing the virus' (inadvertently or not) may be epidemiologically legitimate but to a political decisionmaker who has to weigh in the economy and social matters, it should be unacceptable in an acute crisis like this one. I wouldn't want this to go on long term. I want this over as quickly as possible. Yes, people may be able to stay the course for months or years with all those social distancing measures - voluntary or not. (Can they really?). But why should they have to? Why should they take the economic damage? All those early deaths? As a politician, I'd want to go back to normality post haste.
Just managing the crisis by trying to keep the numbers low doesn't seem to work for an affluent society that is highly mobile and connected. It is an illusion of control to extinguish a fire only halfway.
It means diffusing the virus more broadly over time through community spread. That's a setup for truly wild exponential growth later on. First the fireworks (superspreaders), then the glimmering expanded fire, and then the firestorm.
When the virus is not really eliminated, societies run the danger of wanting to be too smart or too differentiated. Comprehensive 'hygiene concepts' are introduced, elaborate scientific studies are conducted to see for example how dangerous choir practice is or how to hold corona-safe concerts. Discussions about the merits of PCR tests abound. All those high concepts are for the bin if the plague explodes in the background.
Also, we obviously don't want recurring lockdowns. We can't afford 5%-10% recessions that go on for years. If the virus is not suppressed the damage will come anyway even if there aren't any lockdowns. Because freedom goes both ways. You can't force people to stay at home for months on end but you can't force people to go out, be merry and spend money, either. Additionally, the social dislocations from delayed education are significant. A prolonged state of crisis is turning some normal people meshugge with denialism. Wild conspiracy theories are gaining traction.
The old temptress: 'Letting it go'
The concept of natural herd immunity is even worse. It implies a triple illusion of control. Just the right kind of people have to get infected at just the right rate per day for a prolonged period of time. Exponential growth -which would wreak havoc even in the younger population- somehow doesn't exist in that scenario. Meanwhile the vulnerable parts of the population are somehow perfectly protected from the raging plague. And it's not just 80 year old grandmas in nursing homes. It's younger people with preexisting conditions. Altogether those were found to comprise up to 20 million people in Germany alone. How do you isolate them from the rest? No dice.
The future
In the end, that leaves only one strategy that truly controls and manages the crisis: elimination. Which is what all those successful industrialized countries have been doing. Be alert, act quickly, be consistent with your control measures, and lockdowns may not be needed. Then you can enjoy the benefits in the economy, society, and culture.
Use historical insights instead of waiting for evidence in ten scientific studies with n>1000.
Reinventing the wheel costs precious time. By the time you have decided that, yes, masks do indeed work, that the virus spreads through aerosols, that asymptomatic spread is real, that strict quarantine control is necessary to protect whatever success you have, it is too late to eliminate the virus [without traumatic measures]. Simple common sense in place of scientific evidence can save lives. We need battle-hardened practice instead of thousands of pages of 'pandemic preparedness plans'.
This needs to become the EU's standard for pandemic response because the time after this pandemic will be the time before the next pandemic. It requires a bit more competence and determination in concert with all EU countries. E.g. cross-border contract tracing, strict quarantine measures at the EU's external borders and so on. And please don't waffle about some magical AI technology (yet to be invented) that will serve as an early warning system.
For these are the things that have historically ended civilizations: wars, resource depletion, natural catastrophes, climate change, and plagues. Next time the virus may be deadlier, a vaccine may not be coming to the rescue. Be proactive not reactive. In light of uncertainty it is best to get out the hammer and eradicate the disease. Instead of treating it as some kind of live research project.