Jack Cohen – Controversy over Covid-19 Strategy
There is a controversy over the strategy taken by most Western countries against the Covid-19 pandemic. Most countries have followed the excellent example of South Korea, in which everybody wears masks and maintains social distancing, and everybody is ordered to stay home unless it is essential to go out. Also, they engaged in extensive testing, by doing this they not only identified those who were infected, but also were able to release those who were not from onerous limitations and that way they were able to return to normal quickly with a minimal death rate. However, other countries that adopted this approach did not fare so well, such as Italy, the US, Spain and the UK.
This is partly because they don’t have a highly disciplined population that follows orders and they did not prepare a very large number of test kits. As a result the strategy broke down and the death rate soared, partly because people at first ignored the essential social distancing and staying home orders, especially the young, who might have less susceptibility to the coronavirus than old people, but who could also be carriers. The lack of test kits was also a serious problem, in the US the CDC is tasked by federal regulation with producing kits in the event of a pandemic, however, the kits they did produce turned out to be faulty. As a consequence, Pres. Trump called on private industry to step in, but so far that has been a slow process.
The alternative approach is that of the “herd immunity” one, that says that putting everyone on lock down makes no sense because only a small percentage of those infected actually get ill. This approach has been used effectively by several countries such as Denmark and Sweden, but in the Netherlands it has proven a disaster (https://www.forbes.com/sites/joshuacohen/2020/03/27/caught-between-herd-immunity-and-national-lockdown-holland-hit-hard-by-covid-19/#4897dd703557). In this approach they allow life to continue as normal, but they focus on getting all those who show symptoms of the disease (high temperature, cough, difficulty breathing) and who test positive quickly out of contact with others and into isolation. The hope is that even if the virus spreads, those who have natural immunity will not be affected or after a possible short illness will recover and go back to business as usual. The problem with this approach is that young people are also susceptible to the Covid-19 illness, and it essentially allows people to either get the disease or not, in other words the survival of the fittest.
Current rates of death/infected: USA, 3.2%; Sweden 8.2%; UK, 11.7%; Israel, 0.75%; Denmark, 4.0%; Italy, 12.7%; Spain, 9.9%; Holland, 10.9%
Comparing the usual two curves -for the unlimited spread of the disease and treating only the sick (purple) and the implementation of extreme social measures with widespread testing (green) – in effect the area under the curve that represents those who die from the disease in each case is about the same. The main difference is that in the herd immunity model more may die more quickly, but the population recovers faster, while in the test and isolate model there may be the same number of deaths, but the system can cope with them more effectively, however the effects of the pandemic are stretched out for a much longer time period, leading perhaps to severe disruption in society (loss of jobs, bankruptcies, etc).
In the UK, the medical and scientific advisers to PM Boris Johnson at first advised him to follow the herd immunity strategy. However, it soon became clear that the NHS was being overwhelmed by sick people and unable to cope, so he quickly reverted to the isolate and test model. It appears to depend on the size of the population, how disciplined they are and how effective the medical services are to cope with the new sudden influx of Covid-19 cases. It may also depend on the average age of the population, the lower it is the easier it will be for the herd immunity approach to work. There seems to be no simple way to tell in advance which approach will work most beneficially for a given country.