After nearly two months of watching on the sidelines as China grappled with an increasingly concerning viral outbreak, nearly all corners of the world have finally witnessed the arrival of the COVID-19 disease. What has unfolded across hundreds of nations demonstrates the wide variety of different social, economic, and governmental approaches that people have taken to attempt to prevent and combat the disease. In this week’s post, we’ll take a look several different approaches to this global pandemic and what we can learn from these measures.
But First, Why Is This So Bad?
We summarized the basics of the Coronavirus in our previous post, but this bears repeating again. THIS IS NOT JUST THE NORMAL FLU! First off, it isn’t actually the flu at all. It spreads and behaves a lot like the flu though, so you could be forgiven for thinking this. This disease is substantially more lethal than the average flu and takes days or weeks to show symptoms (if symptoms appear at all). This is why dramatic preventative measures like social distancing and widespread closures are so important early on. You may think “But there are only 50 cases in my home state,” but what are you seeing today isn’t what is actually accurate. Due to the long incubation time of this disease, you are seeing the number of people who were infected 1-2 weeks ago! The number of current cases right now is likely substantially higher. Since one person can infect two or three others, the growth rate is exponential and can sneak up on a region very quickly.
But I Thought The Death Rate Was Supposed To Be Low?
It is, if properly treated. Most cases only develop mild symptoms, especially in younger people. Still, somewhere around 10-20% of cases require hospitalization. When the epidemic is out of control, thousands of people suddenly need hospital care all at once, meaning there literally are not enough beds and respiratory aids for all of the patients. In the hardest hit places like China and Italy, doctors have to perform something similar to battlefield triage. (They basically have to decide who gets life-saving care and who doesn’t.) So rather than let everyone get sick all at once, the idea is to slow the spread of the virus enough so hospitals have time to treat smaller numbers of patients over a longer period of time. This is know as “flattening the curve.” The data analysis site 538 provides an excellent summary of this problem in a recent post. As they put it, if roughly 20% of the people in Hennepin County (Minneapolis) get infected around the same time and another 20% of that group require hospitalization, the total number of hospital beds needed is 47,000! Hospitals operate on very lean resources, and the Hennepin County hospital network usually only has a couple dozen empty beds at any given time. Of course, this example takes it to the extreme, but demonstrates how things can go so bad so quickly. With all that said, let’s now turn to several examples of different responses to the virus.
#flattenthecurve
China’s Response
As the center of the global outbreak, China has received intense criticism for its initially handling of the virus. Its oppressive government suppressed information about the virus in the critical early days and weeks of the outbreak. This allowed it to spread throughout large portions of the country before any meaningful response could be galvanized. Once the Chinese government realized the extent of the problem, it quickly imposed harsh restrictions throughout the country. Entire cities and regions were locked down with citizens being legally forced to remain indoors. However, the extreme power of the Chinese central government has also helped mobilize a massive project of emergency clinic and hospital building. Now, China has hundreds of “fever clinics” where anyone can go to get tested if they have symptoms of the infection. These measures have helped dramatically slow the expansion of the virus in China. But such measures have come at the expense of individual liberties throughout the nation.
Italy’s Response
As the virus ravaged China in January and early February, many nations were skeptical that the infection could be as bad elsewhere. After all, it started in China and was circulating around the country for weeks with almost nothing being done. But in places like Italy, community spread had also been going on for weeks. Most people and governments underestimated the threat until it was far too late to stop a major outbreak. Remember from earlier that viruses tend to spread exponentially. For the most extreme example of this, look at Italy’s infection rate. The entire nation of Italy went into full lock-down a little over a week ago. At that time, cases were in the low thousands. A week later, Italy has thousands of new cases daily and had almost 400 COVID-19 deaths in a single day. Because of delays in drastic measures, many other nations will also likely experience a sudden surge in cases until the effects of a full lock-down begin to slow the virus once again.
America’s Response
Here in the U.S. a similar story is starting to play out now. The United States acted quickly to ban most flights from China in the initial weeks of the outbreak. This has undoubtedly helped slow the advance of the disease to America. However, this additional time has been almost completely squandered. The political right in America spent weeks pretending the virus wasn’t a problem (or worse a Democratic conspiracy) while attempts to work with other nations on rapid testing and collaboration were dismissed. The response was so inadequate that by mid-March, South Korea had been testing more people in a single day than the United States had up until that point. Now, the president has finally begun to admit the severity of this problem, and has declared a national emergency. This action essentially frees up lots of money and political power to fast-track measures designed to combat the outbreak. This declaration was very helpful (as are recent bills proposed by Congress). But the government doesn’t have the same ability to command entire populations like China. Instead, the power of American mobilization comes from our collective ability to do what we all agree is right. Governments are (fortunately) limited in their abilities to restrict individual liberty and free movement. That’s why you see individual mayors, governors, and companies closing services and discouraging groups without always banning certain activities. This is also why it is so important that individuals realize and appreciate the potential for disaster and take precautions to protect the community, even at the expense of their own personal convenience.
South Korea’s Response
South Korea presents an interesting case study in attempting to monitor and control the viral spread. It is a democracy just like the United States, but has also passed many laws that allow it to perform mass surveillance and individual restrictions similar to China. After a major outbreak was detected within a secret cult in South Korea, the authorities there acted immediately to scale-up testing capabilities. It’s impossible to combat a pandemic without knowing who is infected and who isn’t, which is why South Korea now has dozens of drive-through testing centers that provide results within hours. The rapid response and wealth of data-collection on infection rates has dramatically improved South Korea’s situation. In the last few days, more recoveries than new infections have been reported, so the virus appears to be on a downward trend for now in South Korea.
The Global Response
Unfortunately, a coordinated global response to the virus has been practically non-existent. For the past few decades, the world has often looked to the United States for leadership and guidance on how to coordinate a response to major events. But the current administration has spent the last several years trashing America’s leadership role and its allies. This is exactly the time we need strong global leadership. China is stepping in to fill the gap by demonstrating some containment of the virus and by sending medical equipment and technology to heavily impacted countries. We cannot stop this by focusing only on America First. Just like every other issue before it, we must work together with the entire world to solve this. It’s just that now the stakes are so obvious, and the implications so immediately dire.
Remember, the long incubation time means this is the number of people infected as-of a couple weeks ago.
So What’s Next?
This can only be stopped with large scale and disruptive measures. This will go on for a long time. We aren’t talking about just a few weeks here, some closures will likely still occur for months at least. Keep in mind that even if it is contained in one location, it can pop up in another. There will be many, many more cases before this is under control. We don’t need to panic, but we do need to be ready for long-term disruption. This isn’t a Democratic or Republican issue. The reality of the situation does not necessarily conform to your personal political persuasion and confirmation bias. The president isn’t at fault for the virus, but the leader of the federal executive branch is best positioned to manage a coordinated government response and mobilize American citizens to take necessary measures. It’s impossible to tell if we overreact to this problem, but it will be very easy to tell if we have under-reacted.
Every day that immediate and free testing is not available is another day that health experts are flying blind. Other nations already have large-scale testing capabilities with the ability to get results within hours. We can’t necessarily count on this to go away in the summer (like the flu) and we can’t count on a vaccine any time soon (this will take at least a year or more). So measures like social distancing and bans on public gatherings will be the new normal for quite awhile. Because of the economic impact of these measures, social welfare support like that already found in European nations will probably be necessary. Paid sick leave and even a temporary universal income may be the best options we have to keep the economy afloat long enough to get through this. The various global responses to this crisis have a lot of lessons to offer the United States, so let’s learn from them. Nations like Italy waited too long to take dramatic measures and are paying the price now. Ultimately, what this outbreak has taught us is something that we ought to have known all along: what happens around the world impacts us all at home too.