On March 16, the Imperial College London published a coronavirus study that had an enormous impact on officials in the United States and UK. Disseminated widely and rapidly by the media, its predictions about the course of the outbreak alarmed officials into ratcheting up both voluntary and involuntary restrictions on daily activities to slow the pandemic, while also shutting down much of the economy. Its conclusions about the future were especially dire. Government officials in the United States were already beginning to move in the direction of more aggressive disease containment. The day before its publication President Trump declared the coronavirus outbreak a national emergency. But the study’s findings provided the official scientific rationale for the change in course that had already been brewing, and in the process added momentum to it.
The study performed an important service in this regard. Even the public already knew by March 16 how important it was to “flatten the curve” to slow the rise in the number of cases, so as not to overwhelm the health care system, but no one knew what it would take to do so, and officials still spoke as if washing our hands and coughing into our shirtsleeves would do the trick. The study demonstrated how this was insufficient, and how more aggressive measures were needed. I agree with the study in this regard. The study’s emphasis on social distancing, which has led to the closing of non-essential businesses and restrictions on small gatherings, will help to lower the anticipated April peak in COVID-19 cases. My concern is with what follows the April peak, for by then economic issues will start to rival in importance the public health issues. The two trillion-dollar stimulus plan likely to be passed by Congress cannot be renewed every month going forward. There’s not enough money. In addition, the severe economic dislocation resulting from aggressive public health measures such as lockdowns and “shelter-in-place” orders might cause public health problems in their own right, stemming from mass unemployment that causes people to lose their houses and their ability to buy food. True, the study’s authors specifically state that economic policy is outside their bailiwick. Theirs is a purely epidemiological analysis, they say. Yet policymakers who use the study’s findings do not have the luxury of ignoring the economic dimension. For this reason, policymakers would be wise to make a closer inspection of the study, and especially its simulation parameters and unwarranted assumptions. These reveal not only an alternative approach to the pandemic, but also reasons for more optimism.
The study distinguishes between disease mitigation, in which the rate of viral infection is slowed to prevent the health care system from being overloaded, and disease suppression, in which the pandemic is stopped dead in its tracks. With neither mitigation nor suppression, the study predicts 2.2 million deaths in the United States from COVID-19. With mitigation the number of deaths is only halved. Although the demand for critical care beds decreases with mitigation, it is still estimated to be eight times higher than the existing number of beds, leading to many deaths from lack of health care. In addition, many people during mitigation will still get the disease, and some of them will die, even with health care.
Read the full article in The American Interest