COVID 19 Lessons

At our coffee group this week the idea that we may have overreacted to the pandemic at the expense of the economy. There is no question that our response has had a tremendous negative impact on the economy. It will take several years (in my opinion) to recover fully. Our only option to pay for the stimulus packages will be to borrow trillions of dollars with no plan to pay it back.

While there are numerous opinions on what we should have done, many of which are politically motivated, I prefer to look at the facts. Following are some of what we know for certain:

1. As of May 19 the USA had 4.5% of the world’s population and just under 29% of the COVID 19 related deaths.
2. As of May 19 the US COVID 19 mortality rate based on “reported” cases was 6%. Keep in mind that this is a fictitious rate since our test rate is so low, and we are not identifying all of the cases. If all of the cases were known, the rate would likely fall to the 1-2 % range.
3. The mortality rate for the Flu is less than .1% (that’s one-tenth of a percent).
4. As of May 19 our test rate was 3.8%. 3.8% of our population has been tested for COVID 19. The amount of testing increased significantly in the past week. As the number of tests increases, the reported mortality rate will decline (as mentioned in item #2)
5. The CDC made its prevention recommendations known to our leadership in January.
6. China publicly shared the genetic sequence of COVID-19 in early January. The actions they were taking were well known.
7.  The USA did not start taking action to prevent the spread of COVID 19 until late March. At that time, the virus was already significantly established in our country. At that time, most of the country implemented some or all of the actions recommended by the CDC.

There is another school of thought that the best approach would be to just treat COBVID 19 like another form of the Flu and rely on “herd immunity” to solve the problem. The vast majority of health professionals do not support this theory, but some do. The distinct advantage of this approach is that it will minimize the impact on the economy. Most healthcare professionals recommend taking immediate action before the virus gains a foothold and minimize both the mortality rate and impact on the economy.

Sweden, an unlikely candidate, chose the herd immunity approach. In Sweden (not considered a conservative society), there have been no invasive lockdowns to mitigate the spread of the coronavirus. Restaurants and even nightclubs are operating, though under guidelines to enforce social distancing. Schools for students under the age of 16 remain open. Large gatherings are restricted to a maximum of 50 people, a far cry from the enforced confinement imposed on entire cities in other parts of Europe.

These seemingly lax measures attracted the attention of lockdown skeptics elsewhere, who hailed the “Swedish model” as an example of how a Western democracy ought to deal with the pandemic. It became a cause celebre among American conservatives, who resent the economic toll exacted by social distancing restrictions. Even for non-conservatives, the Swedish approach is now being invoked as a distinct “alternative” to what prevails. New York Times columnist Thomas Friedman suggested that President Trump may hope to “follow Sweden” as he seeks to “reopen” the American economy.

Herd immunity relies on the idea that as more folks catch the virus, we build up antibodies that help fight against it. And it has been pushed for, by some, in the United States. But, according to the report, “scientists have called it dangerous rhetoric,” because it could take years to achieve and, in the process, “hundreds of thousands of people could die from COVID-19.”

According to most healthcare experts, no country in the world has reached herd immunity, and that they predict that as much as 50-to-70 percent of the population would have to get the virus to achieve such a goal. According to Business Insider, that could take four-to-five years in the United States.

We need to study Sweden’s performance. I  suspect that by August, we will be able to determine their results. As of May 19, their mortality rate is about 50% greater than ours. Since our number of CODID 19 related deaths stands at 92,000, this translates into 137,000 using the Swedish Model. Their mortality rate stands at 12% of reported cases.

A country that took early action (In  February) and essentially adopted the recommendations of the CDC was New Zealand. New Zealand, the first major country to see the sunrise every day, may also be the first to get a good look at life after COVID-19.

In early May, its 4.8 million citizens woke up to a reality, both different and familiar, as relaxed rules come into effect. They can flock to the beaches and parks. They can meet in cafés and restaurants. They may even hug, because the country’s top health official, a serious-minded man called Ashley Bloomfield, said that a careful hug given to family members or close friends would be OK.

And why not? While most of the world remains in the grips of a deadly pandemic, New Zealanders can take comfort from the fact that they are close to eliminating the virus. Fewer than 100 people have it, and in the past couple of weeks, there were no new cases at all. There have been no COVID 19 related deaths in over two weeks.  Seven weeks after Prime Minister Jacinda Ardern imposed harsh restrictions to contain the coronavirus, the nation will go back to something resembling a normal life. But what exactly is normal in a post-pandemic society?

Knowing there was little dissent, Ardern’s government ignored concerns that elements of the lockdown might have been illegal. The rest of the world would be well-advised to watch. With its borders closed, New Zealand operates under laboratory conditions. Some lessons learned will be universal. Others, I suspect, will be specific to New Zealand, an island nation, remote and sparsely populated, that defies comparison.

Ardern announced sweeping emergency measures. She had seen how European leaders had responded to the virus, acting only once the need to take action became blatantly obvious. Going into a nationwide lockdown at such an early stage seemed bold. And the restrictions were tough: no meetings with friends, no traveling by car unless it was to go shopping for food or medicine.

“We only have 102 cases,” Ardern said in the way of explanation. “But so did Italy once.”

When Ardern made her announcement — starting the clock on four long weeks of confinement, that would later be extended by another three — she said government modeling showed tens of thousands of deaths. This was a worst-case scenario, perhaps even a scare tactic.

If so, it did the trick. New Zealanders didn’t complain; they didn’t protest; they simply followed the rules. When the health minister, of all people, took his family for a 20-minute-ride to the beach, he was demoted. “I expect better,” Ardern said. “And so does New Zealand.”

The results of the New Zealand approach are already known. They have experienced only 21 COVID 19 related deaths. For the USA, this translates into less than 1,500 deaths based on our population. 91,000 less than what we have experienced so far.

There is one other country worthy of study, and that is Iceland. While they have also done a credible job combating the virus but, the primary reason to look at their experience is that they have done a great job with testing. As of May 19, they had tested 16.8% of their residents. The USA has tested 3.8%. Their statistics will give us a better picture of the ratios of the infected and their mortality.