The coronavirus chronicles: The European lockdown

With growing degrees of dread I’ve followed the spread of the pandemic and the responses to it. In some ways it reached a peak with the announcement on March 23 in the UK that the Prime Minister would impose a total lockdown on the country. (read my previous posts on the pandemic, March 19 on the models that inform government approaches  and March 20 on the “Second economic curve.” See my video blogabout the crisis.)

The announcement, apparently without any debate in parliament or much input from the populace, includes police measures that will break up gatherings of more than two people and make it so people can only leave the house once a day for exercise. Already businesses were closing, such as McDonalds and its 135,000 employees across the UK.

Many countries have imposed a version of what the UK is doing. Some have done it on an open-ended basis, the UK at least has said it will last for three weeks. The European response has been lockdowns. This is in contrast to most other parts of the world that have not imposed total lockdowns. It illustrates in some ways the fragility of European countries. Oddly, it seems only in Hungary was there much pushback against sweeping new powers to enforce things like a lockdown. The Hungarian version sought to give the government powers to imprison people for up to five years for spreading “fake news.” This didn’t sit well with the EU.Christian Wigand, a European Commission spokesman, reminded member states that “any emergency measures taken to address the crisis… should be proportionate and necessary”.

Meanwhile in Italy, where the European lockdowns began, there has been no success in confronting the pandemic. Instead their lockdown has banned people from traveling outside the municipality they are currently in, even to return to their normal place of residence, except for urgent work or health reasons. Another 4,789 people were diagnosed with the virus on March 23 and 601 deaths were recorded. 63,900 Italians now have the virus. They will soon surpass China in the number infected, and in deaths they have already surpassed the official Chinese toll.

Italy has begun to receive aid from China, Cuba, the US, Germany and Russia. BBC notes “Russian military transport planes began delivering desperately needed ventilators, disinfection equipment and medical teams to Italy, which has the highest death toll in the world.”

Russia, officially, has only 438 cases of coronavirus. With one death and 70 new cases recorded on March 23, the country appears an anomaly. CNN says “Putin’s strategy seems to have worked.” What was the strategy. Not lockdowns. “Russia’s early response measures — such as shutting down its 2,600-mile border with China asearly as January 30, and setting up quarantine zones — may have contributed to the delay of a full-blown outbreak, some experts say…Rospotrebnadzor, Russia’s state consumer watchdog, said Saturday that it had run more than 156,000 coronavirus tests in total.” Russia has also stopped “misinformation,” which means it removes internet reports that the true numbers are higher. It says many of its cases came from Italy.

Numbers seem to play a big role in causing countries to act. Italy, which has a huge death toll has never explained exactly why its curve and its death toll look so different than China’s. The percent of those who seem to die of the virus is very high. A Telegraph article that looked at the numbers wondered about them also. “According to Prof Walter Ricciardi, scientific adviser to Italy’s minister of health, the country’s mortality rate is far higher due to demographics – the nation has the second oldest population worldwide – and the manner in which hospitals record deaths.”  The professor had this to say: “On re-evaluation by the National Institute of Health, only 12 per cent of death certificates have shown a direct causality from coronavirus, while 88 per cent of patients who have died have at least one pre-morbidity – many had two or three,” he says.

Some of the only people living in a bubble during the crises have been those remaining at sea. Of major 277 cruise ships that operate in the world, a few are still at sea. One named the Pacific Princess left port on January 20 for a 111 day cruise. It was forced to skip stops in Bali, Singapore, Phuket and Sri Lanka. It headed for Australia and will eventually head back to the US. Life continued as usual for the cruise passengers, they left early enough that none of them had the virus. Life will continue normally until they will arrive at a port that accepts them and then they will enter the dystopian world of lockdowns and policing.

Perhaps that shows the fragility between normalcy and control. A March 21 article notes how the stock markets have been decimated over the last thirty days. “Monday, February 17. The novel coronavirus outbreak is raging in China, but fewer than 1,000 people have been infected outside the country. With the virus out of sight and mostly out of mind, the Dow Jones Industrial Average stands just shy of 30,000 points, driven by the longest US economic expansion in history.” It is now at 18,500 points.

While Europe has been hardest hit with the number of cases of the virus, the numbers in the US are also rising rapidly. A new chart online will let you look state-by-state. What is interesting is that it shows the number who test positive and negative. So in New Mexico, of 5,973 tests by March 24, only 83 were positive. By contrast in New Jersey of 3,203 tests, fully 2,844 were positive. New York shows 57,414 negative and 21,689 positive. Even Washington, where there had been a hot spot shows 31,712 tested negative and 2,221 positive. Many states show only around 5-10% of those tested were positive.

Testing numbers are always a bit unclear. Because they never test everyone in one demographic, or do random testing, so it’s unclear if the numbers represent only those who had symptoms or some other category. Countries continue to make policy and limp around in the dark without accurate numbers. The usual refrain is “we have no choice” and “do we want to be like Italy.”

An interesting article at The Guardian gives some insight into the way these countries have made decisions. It contrasts several European countries. In Italy it notes that the “lockdown begins 9 March with death toll at 463 and 9,000 infections.” We now know there are 63,000 infections in Italy on March 23. It’s not clear that the famed “two weeks” to begin to “flatten the curve” has worked.

In Spain the same article notes “Lockdown begins 15 March with death toll at 288 and 7,753 cases.” Spain has 33,000 cases now and had 47,000 by March 25. A lot of these countries sought to compare themselves to China’s “curve.” So France on March 8 had as many deaths as China on January 23 when China locked down Wuhan. The insinuation is that had the China model been followed then France might have been fine. Instead it waited until March 16 with 148 dead and 6,633 cases to begin the lockdown. France now has 19,000 cases and 860 dead. The US “curve” also, with more than 470 deaths, now looks like Iran’s curve at the same time of its outbreak, reports note.

 

Other countries are continuing the progressive rise of the virus, such as Turkey. Most countries have only thought about the economic impact after they decided to send most people home from work and children home from school. There are major differences in the level of economic support these countries can and will give. In the end of the day countries can’t simply print money to pay for half or more of their population to be at home rather than at work.

The virus is rapidly balkanizing countries that had open borders or even US states, from one another. With no real coordination globally or even regionally, most countries are isolating themselves. This crises has shown the fragility of most western systems in the sense that they don’t actually work well together and fight this virus as a group. Most democracies have simply declared forms of martial law and gone it on their own. There was no EU-wide response. Even the US is a patchwork of responses. Some US states have used Executive Orders to keep people at home. In other instances companies and countries don’t seem to follow the guidelines. Iran’s Mahan air keeps flying to China.

Testing remains one of the major question marks globally. Turkey, for instance, said on March 23 that “3,672 tests have been completed in the past 24 hours to a total of 24,017. There are currently 1529 confirmed cases of the virus and 37 related deaths in Turkey.” Turkey had 293 new cases on March 23. That is about 10% of those tested.

There are many rumors on social media. People freaked out by seeing tanks or drones are worried about the new dystopian reality.

The impact of the changes on daily life are immense. In some ways parts of the world are now on “pause” basically. Air travel has almost ceased and will continue to contract. There are also many questions about the exact nature of the virus. Many carriers are “asympotmatic” or “silent carriers.” Many voices have accepted the lockdowns but want to know what comes next. Governments say there is no plan B. There is no real clear exist strategy. The US, like many places, has a stimulus package of trillions of dollars but isn’t sure how to administer it. People make comments like “NYC is a bellweather” and “we will see if it works.” In the UK the Prime Minister says “Rules will be reviewed in three weeks…there are no easy options.”

Nevertheless there is a lack of transparency and communication by most western governments. They don’t want to tell their publics that there is no way to stop this pandemic. At best they are fighting a war of attrition and hoping to triage things. They don’t want their health systems overwhelmed. That’s all they keep saying. If they do nothing, they say, the death toll will be too high, too fast. They want to “flatten” it and have less people come over a longer time and build up “herd immunity.” It appears most of them accept that many people will get the virus over a long period of time, hoping maybe a cure can be found.

What’s unclear is what are the government goals, what is the bar, for any kind of success. They want the number of cases  to  go down. But to what number. The KRG has shown that the number apparently is zero. But the chances of reaching zero cases, unless one just makes up the numbers as some countries appear to do, doesn’t seem likely. Even if you get to just a few  new cases a day, you still have to cut off travel from abroad because other countries will not all follow the same model. This could create  a system of “corona-countries” and non-corona states, where travelers can fly to those countries with certain restrictions, but not others.

How will countries in the global south adopt a UK-style lockdown and enforce it. The Ivory Coast says it is trying. But in rural areas? How do you stop people farming and selling food at market unless you want to cause a famine. US President Donald Trump has been critiqued for his comments about not having the cure be worse than the problem. He has said  after fifteen days he will make new decisions.  Tiffany Trump reminds Twitter that there are only 8 days to  go.

This is optimistic. The US hasn’t even really tried to stop the virus. Some states are trying different measures. There are some general guidelines, but the US isn’t arresting and threatening people with deploying the army. Many Americans simply ignore the social distancing concepts. Unlike in Israel where people have tried to abide by the guidelines.

An unprecedented set of actions have been let loose in Europe.  It is not entirely clear how they will go back to normal. Many may already know that in fact what they have embarked upon is a months-long or year long process. But they can’t tell the public that for fear of social strife. Most publics probably  won’t accept being locked in their homes for months on end with their children out of school and hoping government checks will cover it. These governments believe they have no choice. But if they don’t seem some changes  in the numbers of infections in several weeks they will have to wonder. They will wonder how did South Korea do it without  a lockdown. How did China do it. How did Russia do it. Those questions will have to lead to one of several conclusions. Either some countries in the world were able to act faster and identify cases better, or they have made up their numbers. And if they have made up the numbers and simply said there  are fewer  cases then there are that leads to a second question: Shouldn’t their hospitals be overwhelmed with cases anyway. Regardless of testing, if the virus is as  bad as models say it is then countries that don’t test or don’t have good  numbers, will still be overrun. And that is an important question to ask as well. We know what is happening in most European countries due to transparency and US media is making us hyper-aware of the numbers in the US. But what about all those data-black-holes out there?

Some nuggets  to ponder:

  1. Trials have been postponed in California and elsewhere.
  2. Questions over which stores to  shut in the lockdown, potentially reducing people to just  food  not items they might need for electronics, kids play, or  other activities.
  3. Are there contrarian viewpoints about whether the US could “reopen the economy in two weeks,” some think there might be.
  4. The pandemic on social media has led to calls to “cage” people and demands that  US states be “closed
  5. In Australia  they refer to  restrictions keeping people from shopping as  “stage 2” restrictions while India is concerned it is heading toward “stage 3.” There are 4,400 cases in Australia and only  499 official cases in India.
  6. Italy’s numbers game:  Despite a dip in cases: “Right now in Lombardy the contagion is so widespread that we should consider every person potentially positive,” said Roberto Burioni, a prominent virologist at the San Raffaele University in Milan.
  7. Some American voices have said they support Trump’s decision to not shutdown, in  favor of keeping economy afloat.
  8. Questions about a New England Journal of Medicine report that shows  the virus survives for hours in the air and also on plastic and other places.
  9. NYT: ‘How South Korea Flattened the Curve.’ The subheading: ‘The country showed that it is possible to contain the coronavirus without shutting down the economy, but experts are unsure whether its lessons can work abroad.’
  10. “Michael Levitt, who received the 2013 Nobel Prize in chemistry for developing complex models of chemical systems, is seeing similar turning points in other nations, even ones that did not instill the draconian isolation measures that China did….He fears the public health measures that have shut down large swaths of the economy could cause their own health catastrophe, as lost jobs lead to poverty and hopelessness. Time and again, researchers have seen that suicide rates go up when the economy spirals down.”  He  added “In exponential growth models, you assume that new people can be infected every day, because you keep meeting new people. But, if you consider your own social circle, you basically meet the same people every day. You can meet new people on public transportation, for example; but even on the bus, after some time most passengers will either be infected or immune…In Wuhan, which had the highest number of infection cases in the Hubei province, everyone had a chance of getting infected, but only 3% caught it,” he explained. “Even on the Diamond Princess (the virus-stricken cruise ship), the infection rate did not top 20%.”
  11. NYT  Oped: ”I am deeply concerned that the social, economic and public health consequences of this near total meltdown of normal life — schools and businesses closed, gatherings banned — will be long lasting and calamitous, possibly graver than the direct toll of the virus itself. The stock market will bounce back in time, but many businesses never will. The unemployment, impoverishment and despair likely to result will be public health scourges of the first order.”
  12. BBC: Wuhan has been shut off from the rest of the world since the middle of January. But officials now say anyone who has a “green” code on a widely used smartphone health app will be allowed to leave the city from 8 April.
  13. What we are told: “When coronavirus is allowed to spread unchecked, health systems get overwhelmed, deaths rise exponentially, and the case fatality rate jumps to near 10%. I can’t believe this has to be said, but that is not any better for the economy than a prolonged shelter-in-place.” – Max Fischer. “There will be no normally functioning economy if our hospitals are overwhelmed and thousands of Americans of all ages, including our doctors and nurses, lay dying because we have failed to do what’s necessary to stop the virus.” – Liz  Cheney.
  14. Singapore study: Singapore models its data but can’t  figure out if end result, 80 days after first 100 infected, is 1,800 or  280,000  infected “Researchers from the National University of Singapore saw a dramatic drop in projected cases when all three physical distancing measures were done at once. But they warned that if a large number of infected people in the community had no symptoms, or if infection rates were very high,the policies had a muchreduced effect. Singapore has used a policy of testing and tracing of COVID-19 patients to limit the spread of the virus, without ordering a widespread lockdown of society and the economy.”
  15. CNN, as part of its narrative that China is  “returning to normal,” claaims China’s  Great Wall  re-opend a small section: ” To be permitted entry, visitors must first book a ticket in advance, either on the Badaling Great Wall’s official website or through China’s WeChat app. Then, upon arriving at the Great Wall, they will have their temperatures checked. Visitors must have a registered Health QR code — a system through the AliPay or WeChat app that is connected to their ID card — that shows as green, or healthy, before being permitted entry. Visitors also must wear face masks and stay at least one meter away from each other at all times.” China is  trying to re-vive its economy.
  16. China now denies  virus originated in China.CNN notes  “Tensions have been brewing for weeks between Washington and Beijing over who is to blame for the outbreak. China continues to deny that the virus originated there while top US officials, including Secretary of State Mike Pompeo, have pointed the finger directly at Beijing. US officials have long been skeptical about information coming from China, including the number of cases it has publicly reported, but the diplomatic row between the two countries has escalated in recent days.”
  17. Israel wants to use military to deliver food.  “Our goal is that by the end of Passover we will allow certain groups to return to their daily lives based on data gathered and how vital these groups are to the economy,” he said. The government was expected to sanction more restrictive measures Tuesday that may include restrictions on all movement outside the home that is not for vital work or purchasing supplies as well as a ban on all public transport. Commenting on the rising daily rate of confirmed patients, Grotto said that this was is due to a higher number of testing, and that the most recent patients were exposed to the virus 7-10 days ago. According to Grotto, only when we pass the 10-day period for the harsh restrictions will we be able to quantify their effectiveness.
  18. Russia is using 100,000 cameras to  track people.
  19. India puts 1.3 billion on nationwide lockdown. What new information have they and others seen that requires this?
  20. Economies are like organisms. If you cut off part of them it will surely have a ripple affect and affect others.
  21. Black Swan events: The reactions to the virus could lead to civil strife or a new religious awakening.
  22. How come Singapore, Japan, South Korea and China didn’t lock down their entire society, but other countries did?
  23. Diamond Princess study showed that RNA of the virus was still found 17 days later before disinfecting. Also it found 46.5% were asymptomatic and 17.9 infected never develop symptoms.
  24. A study in Israel has shown that while a quarter got the virus at  synagogue, others got it from supermarkets and  friends. Symptoms include fever and respiratory issues, but 8% had neither in Israel.
  25. An Oxford study concluded that half of the UK might already be infected.
  26. Without mass testing, coronavirus will keep spreading.
  27. EU leaders call for debt issues to fund coronavirus spending.
  28. Sweden and Netherlands avoid lockdowns.  Netherlands has closed some activities but people can use parks. However the death toll is adding up. Brazil, Mexicoand Nicaragua also chart a different course.
  29. Stories of the disasters unfolding at hospitals “Because I don’t want to spend a moment longer in a Covid-19 patient’s room than I have to. Even with a mask firmly in place, even with a gown and eye protection, I do not want to share the same air. So I do what I need to do and then I leave. I don’t take the time to reassure, to explain, surely not to hold a hand….But I worry that unless we find some way to mitigate the overwhelming isolation this virus has created, we will leave a fleet of wounded patients and family survivors in its wake.” CNN reports on adoctor “You’re notified of another really sick patient coming in. You rush over. They’re also extremely sick, vomiting. They need to be put on life support as well. You bring them back. Two patients, in rooms right next to each other, both getting a breathing tube,” he wrote. “It’s not even 10 a.m. yet.”

 

 

 

 

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