The world’s taking its foot off lockdown brake
We are all refugees from the failed states of the coronavirus.
Clamouring not to be let in but to be let out.
Embarking on this quickmarch time travel to the land of freakish abnormal with eyes wide shut. Because the trending graphs are just that — data charts of what’s come before that can only guesstimate what might come next. The consensus is alarming: Models project a sharp rise in deaths as societies take their foot off the lockdown pedal.
But political leaders — not scientists — have made their devil’s pact with chance. European countries such as France and Italy, emboldened by declining death rates, are unshuttering, either incrementally or by leaping bounds. In Italy, first nation brought to its knees by raging contagion after China’s Wuhan province, has reopened parks, factories and building sites, restaurants and bars limited to take-out service. In the Netherlands, nurseries, primary schools and hairdressers reopened Monday. Bar terraces in Spain are back in business, restricted to one-third capacity while hotels and tourist accommodation in less-affected regions can reopen, with the exception of communal areas. In Germany, shops, playgrounds, museums and churches are already open and Bundesliga soccer matches will resume this week in empty stadiums.
Quebec reopened elementary schools outside the greater Montreal area on Monday, but has twice now delayed easing restrictions in the city. Last week, the province’s public health research institute warned of a spike in cases and deaths if confinement measures are lifted prematurely: As many as 150 deaths per day in July, and that doesn’t include fatalities in long-term-care facilities.
In Ontario, according to the latest Statistics Canada national labour survey (released Friday), approximately one in seven who were working before the pandemic struck have lost their jobs — 609,200 jobs vanished in April, 1,092,000 jobs shed since February. Unemployment now standing at 11.3 per cent compared to 5.5 per cent in February, though Statistics Canada warned those figures understate the crisis since many people are no longer looking for jobs.
While Ontario takes a go-slow approach under Premier Doug Ford, on Tuesday scheduled to extend the state of emergency until June 2 — other provinces such as British Columbia are further along the unshackling trajectory — in the U.S., it’s a state governors free-for-all, with pleased approval from the White House, where COVID-19 has now reached its tentacles right into the vicepresident’s staff. Texas Gov. Greg Abbott, in a conference call with lawmakers on the eve of last Friday’s restricted reopening, acknowledged: “The more that you have people out there, the greater the possibility is for transmission.” Adding that the goal was never “to get transmission of COVID-19 down to zero.”
What is the goal, then? What mortality table is acceptable?
When it comes to balancing the desperate need to reboot the economy against potential lives lost, it’s the science of money over the science of public health. Just as states and societies could apparently live with the sting of coronavirus quasi-eugenics that has decimated the elderly population in nursing homes.
But of course people need jobs to survive. Even though a Pew Research poll released on Thursday showed two-thirds of respondents were more concerned states would reopen their economies than take too long.
Some countries that have lifted restrictions, including South Korea and Germany, have seen recent surges in infections, WHO said on the weekend. In Seoul, the new cluster is centred around a reopened nightclub.
Health officials and scientists warn and warn and warn that this is all happening too fast. They’re screaming into deafened ears. Even as researchers at the Los Alamos National Laboratory issued a report last week that the coronavirus that emerged in Wuhan has since mutated; the new, dominant strain that’s spread across the U.S. appearing to be more contagious.
Politicians, too many of them, can live with the dying as the price of functioning.
Dr. Pier Paolo Pandolfi, a renowned oncologist — professor of medicine and pathology at Harvard Medical School, director of the cancer research institute at Beth Israel Deaconess Medical Center in Massachusetts — happened to be in Milan as the outbreak in Lombardy struck in February and watched as the fashionista hordes nevertheless converged on Fashion Week. Thinking: “These guys are completely out of their minds.”
Italy was unprepared. The U.S. was unprepared weeks later, Pandolfi said during a recent Facebook webinar. “Because we didn’t recognize the beast, we let the beast enter the hospitals and the nursing homes.
“If we reopen too early, we’ll have casualties because the infection will re-start, because there’s no treatment or vaccine.”
Phase 2 — the reopening — “is a tragic trial-and-error exercise,” said Pandolfi. Yet, “there is a real race on reopening first.” To get the economic engines churning before anyone else, certainly a strategic contest among many U.S. states and damn the torpedoes.
Frankly, because the world cannot stand still and be devoured by the tangential brutal economics of the virus, we will all have to learn to coexist with it until a vaccine is discovered or effective therapies provided for the masses. The best governments have to throw at it is lockdown orders, now extensively loosened, masks — Pandolfi says we should wear goggles too (preliminary data in an April report published by JAMA Ophthalmology, Journal of the Medical Association in the U.S., found that that the virus might be transmitted through the eyes) — and physical distancing perhaps forever and anon.
Just about everybody is resigned to a second wave of the pandemic, albeit with differing levels of concern and preparation, which for many jurisdictions means scarce preparation at all. What didn’t work the first time around will likely not work the second time around either, beyond a larger proportion of populations developing herd immunity — which doesn’t rule out reinfection because that hasn’t been conclusively established.
Epidemiologists generally concur on three possible scenarios, agreeing that the current outbreak will temporarily abate before veering in different directions. Various projections notwithstanding, it will be a very long time before any of us can brush off a cough or a sneeze in a group setting without feeling at least a bit of anxiety. Workplaces will remain existential hot zones.
An analysis released by the University of Minnesota envisions the three possible futures: recurring small outbreaks, a monster wave or a persistent crisis. But bottomline recommendation to governments: Prepare for the worst-case scenario.
“We have to understand that we’re riding this tiger, not directing it,” Michael Osterholm, director at the university’s Centre for Infectious Diseases and Policy said on “Meet The Press” Sunday.
Research released by Osterholm and his colleagues estimates the pandemic, fierce or weakened, could last beyond 2022 and won’t be controlled until about two-thirds of the global population is immune.
“Risk communication messaging from government officials should incorporate the concept that this pandemic will not be over soon,” says the report, “and people need to be prepared for possible periodic resurgences of disease over the next two years.”
Scenario One: Small recurring waves beyond the horizon, cresting and dipping. The crests might be less than half the size of this spring’s outbreak, peaking when COVID-19 coincides with flu season next fall, dropping to troughs through this summer and next. That view reflects emerging agreement that, while the virus may have some seasonal reaction, it won’t be eradicated by hot, humid weather. Summer might slow down the plague, but won’t stop it cold.
Scenario Two: History repeating, specifically the Spanish flu. In that global pandemic, the original modest wave was followed by epidemic explosion six months later. Rather than crests and troughs, COVID-19 would circle back with more intensity — monstrous — than what the world has already experienced, before settling down to small but near-constant infections, if mostly dissipating. The second wave would demand another perhaps even more extensive containment lockdown to snuff it out. This is what happened in Wuhan, which imposed more muscular mitigation measures from late January to early March, after officials thought the contagion had been reasonably contained.
Scenario Three: Groundhog Day from hell. “We just keep having outbreaks in this city or that city and we keep trying to smother them,” Osterholm told STATnews.com, a health news website based in Boston. The “slow burn” hypothesis.
Waves just keep on coming because the size of outbreaks following from the current one are smaller than the monster wave, thus taking longer for public immunity to build up, complicated by erratic testing and contact tracing. No past influenza pandemic has ever followed this pattern, yet COVID-19 might be exceptional because all coronaviruses — with the exception of the SARS version, effectively smothered — are biologically adept at continuing to circulate. Like the common cold virus.
And for those who do put their faith in a vaccine — at least 100 vaccines are in development around the planet’s labs, scientists working at a maddened pace — remember this: HIV, the virus that causes AIDS, was discovered in 1983.
Thirty-seven years later, there’s still no vaccine.