The COVID-19 Dilemma: 2 Strategies, Which is Worse?

 

Maggie Mhanna

 

There seem to be two strategies to fight coronavirus: The ‘contain’ approach & the herd immunity strategy.

 

 

The ‘contain’ approach

The first strategy is to try and completely contain the virus longer and perhaps long enough for a treatment to emerge. This strategy seems to be adopted by the authoritarian government of China, which has applied some of the strictest control measures and responded by massive lockdowns and extreme digital surveillance. The impact of these measures has been remarkable. In Hubei Province alone, over 60 million people were placed under lockdown and most factories were shut completely. The economic costs are enormous. About one-third of the medium-sized businesses surveyed said they had only enough to survive for a month.

In Singapore, Taiwan, and Hong Kong, outbreaks were brought under control without resorting to China’s draconian measures. These countries reacted only a few days after the Wuhan Outbreak by implementing mass testing, retracing every step and contact of suspicious cases, and imposing mass quarantines & isolations.

In Taiwan, a specialized unit has collected national health insurance, customs, and immigration databases, generating data to trace people’s travel history and medical symptoms. It also used data from mobile phones to track people coming from areas with the virus, who were then quarantined.

The South Korean government has published the movements of people who presented a potential risk, retracing their steps using their GPS phone tracking, credit card records, and surveillance videos.

At the individual level, the SARS experience in eastern Asia has helped to prepare people to voluntarily exhibit a tremendous amount of self-discipline.

Challenges

While the ‘contain’ approach has proved to successfully control the outbreak rate, the nature of the methods used, such as collecting phone location data and using facial recognition to track people’s movements, cannot be readily replicated in many other countries, especially ones with institutional protections & data regulations for individual rights.

On the other hand, many countries do not have the necessary infrastructure to implement these strict containment measures, which include widespread testing, quarantines, production and distribution of medical & protective supplies… This will divide the world into red zones and green zones, and travel will be restricted between the two zones until adequate therapy is found.

On the economic level, it seems that the lockdown approach could take long. Scientists fear that as soon as the strict measures are lifted, the virus will repropagate again. With a long-term containment, many businesses might be forced to close. With such economic instability, will we be seeing a growing societal & political unrest triggered by confined people with little means of survival?

Herd Immunity

Herd immunity is a theory normally used when large numbers of children (around 60 to 70%) have been vaccinated against a disease like measles, reducing the chances that others get infected, and therefore limiting the chances of propagation.

The supporters of this strategy believe we can let the infection spread through the entire population until we have herd immunity, and just space out the infections over a longer timespan by implementing some mitigation measures without resorting to the severe lockdowns occurring in China. With such lighter measures, they hope to slow down the spread of the disease, instead of containing it, to flatten the curve (a popular curve trending on social media lately) in order to slow down the spread rate so that our medical system is not overwhelmed and that our mortality rate remains reasonable. This strategy also means a less drastic impact on the economy.

The US, Germany, France and especially the UK seem to be the main advocates of this strategy. It can be sensed when Merkel gave the Germans a hard truth saying that 60% to 70% of German people will be infected and when Macron used the word “slow down” in his speech instead of “contain” the epidemic.

Challenges

This tactic in fighting against a pandemic for which there is no vaccine is novel and alarming as we do not know yet how long this immunity lasts. The virus could evolve. We have already seen multiple strains of the virus in Italy and in Iran and will probably see many more, as a result of a large number of carriers.

Another worrying reason is that flattening the curve is not that easy. What’s dangerous about these curves is that they don’t have numbers on the axes in a way that the used scale suits the advocates. If we set some estimates on the axes of these curves and compare the “with protective measures” curve and the “without protective measures” curve, we find out that the difference is huge. Dampening the infection rate to a level that is compatible with the medical system capacity means that we would have to spread the epidemic over more than a decade (Ref.).

An estimated Curve for the US (Ref.)

Based on today’s data, we can estimate that about 20% of the cases are severe and require hospitalization. If the propagation rate fails to divert below the medical system capacity the way it’s intended following such a risky strategy, we would surely witness a much higher mortality rate.

Even under the most optimistic assumption that countries will be able to control the spread rate the way they desire and provide more medical resources & infrastructure, it seems like the western leaders have found that the best strategy is a one for which 70% of people gets infected (47 million in the case of France) and 3% dies (1.4 million for France).

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