Lock­downs are a step too far in com­bat­ing COVID- 19

Pittsburgh Post-Gazette - - Weekend Perspectiv­es - Joe No­cera is a colum­nist for Bloomberg Opin­ion.

D. A. Hen­der­son was a re­mark­able man. An ex­pert in bioter­ror­ism, dean of what is now the Johns Hop­kins Bloomberg School of Pub­lic Health and fre­quent ad­viser to U. S. pres­i­dents, Hen­der­son was best known as the man who erad­i­cated small­pox in the 1970s. His knowl­edge of in­fec­tious dis­eases was un­sur­passed.

In the mid- 2000s, when the U. S. pub­lic health com­mu­nity was try­ing to de­vise a pro­gram to fight pan­demics, Hen­der­son, who died in 2016 at the age of 87, was in the thick of it. The 9/ 11 at­tacks had given rise to fears of bioter­ror­ism, and Pres­i­dent Ge­orge W. Bush, hav­ing read John M. Barry’s book about the 1918 pan­demic, “The Great In­fluenza,” was push­ing pub­lic health of­fi­cials to come up with a pre­pared­ness plan that could be put into ac­tion if a new virus took hold.

Some pro­posed in­ter­ven­tions, such as fre­quent hand- wash­ing, con­tact trac­ing and quar­an­tin­ing the sick, were un­con­tro­ver­sial. But one in­ter­ven­tion was the sub­ject of fu­ri­ous de­bate: lock­downs. They hadn’t been used as a pan­demic re­sponse since the Mid­dle Ages. On one side of the de­bate were the sci­en­tists who had been asked by the Bush ad­min­is­tra­tion to come up with the pan­demic re­sponse. They fa­vored lock­downs. On the other side was Hen­der­son.

In a pa­per he wrote in 2006 with three col­leagues, Hen­der­son con­cluded that lock­downs were likely to do far more harm than good and would “re­sult in sig­nif­i­cant dis­rup­tions of the so­cial func­tion­ing of com­mu­ni­ties and re­sult in pos­si­ble sig­nif­i­cant eco­nomic prob­lems.” What’s more, they added, there was sim­ply no ev­i­dence that lock­downs re­duced the toll of a con­ta­gious virus.

Hen­der­son lost that de­bate, ob­vi­ously. But now, seven months into the cur­rent pan­demic, it would ap­pear that the world is com­ing around to his point of view. The eco­nomic dam­age wrought by lock­downs has been im­mense. School clos­ings have done in­cal­cu­la­ble dam­age to stu­dents, es­pe­cially poor ones. This sum­mer, some 20% of the U. S. work­force was on un­em­ploy­ment, ac­cord­ing to Forbes. The ques­tion of whether lock­downs have saved any lives re­mains as un­set­tled to­day as it was in 2006.

Last week, Dr. David Nabarro, the World Health Or­ga­ni­za­tion’s spe­cial en­voy on COVID- 19, was in­ter­viewed by the U. K.’ s Spec­ta­tor TV. In the early days of the coron­avirus, the WHO had been an im­por­tant ad­vo­cate of lock­downs, and much of the world fol­lowed its ad­vice. Yet when the host, An­drew Neil, asked Dr. Nabarro about lock­downs, he replied:

“We in the World Health Or­ga­ni­za­tion do not ad­vo­cate lock­downs as the pri­mary means of con­trol­ling this virus. The only time a lock­down is jus­ti­fied is to buy you time to re­or­ga­nize, re­group, re­bal­ance your re­sources, pro­tect your health work­ers who are ex­hausted. … Look at what is hap­pen­ing to poverty lev­els. It seems that we may well have a dou­bling of world poverty by next year. We may have at least a dou­bling of child mal­nu­tri­tion. … Re­mem­ber, lock­downs just have one con­se­quence that you must never ever be­lit­tle, and that is mak­ing poor peo­ple an aw­ful lot poorer.”

With­out ac­knowl­edg­ing that this was a shift in its orig­i­nal po­si­tion, Mr. Nabarro said that the WHO is now ad­vo­cat­ing what he called a mid­dle path — “hold­ing the virus at bay while keep­ing eco­nomic and so­cial life go­ing.” This would re­quire a high level of or­ga­ni­za­tion by gov­ern­ments and en­gage­ment by ci­ti­zens. It would mean sig­nif­i­cant con­tact trac­ing, iso­lat­ing those who have come in con­tact with an in­fected per­son and tak­ing maskwear­ing and so­cial dis­tanc­ing se­ri­ously. “If we can com­bine these steps,” Dr. Nabarro said, “we can get in front of it.”

No doubt he is right. Sadly, in the U. S. right now, get­ting that kind of gov­ern­ment or­ga­ni­za­tion and buyin by the pop­u­lace is vir­tu­ally im­pos­si­ble — not as long as Don­ald Trump is

pres­i­dent and mil­lions of Amer­i­cans refuse to take even the most ba­sic mea­sure of wear­ing a mask. Even so, should there be a sig­nif­i­cant sec­ond wave of the coron­avirus, an­other lock­down would be a ter­ri­ble mis­take. In ad­di­tion to the eco­nomic dam­age and dis­rup­tion it would cause, it would also bring about enor­mous re­sis­tance. And it would create even more dis­trust in the gov­ern­ment’s pan­demic ad­vice. Just ask the peo­ple liv­ing in the New York hot spots that Gov. An­drew Cuomo put into lock­down re­cently. They are in open re­volt.

The truth is that us­ing lock­downs to halt the spread of the coron­avirus was never a good idea. If they have any util­ity at all, it is short term: to help en­sure that hos­pi­tals aren’t over­whelmed in the early stages of the pan­demic. But the long- term shut­downs of schools and busi­nesses, and the in­sis­tence that peo­ple stay in­doors — which al­most ev­ery state im­posed at one point or an­other — were ex­am­ples of ter­ri­bly mis­guided pub­lic pol­icy. It is likely that when the his­tory of this pan­demic is told, lock­downs will be viewed as one of the worst mis­takes the world made.

“Ex­pe­ri­ence has shown that com­mu­ni­ties faced with epi­demics or other ad­verse events re­spond best and with the least anx­i­ety when the nor­mal so­cial func­tion­ing of the com­mu­nity is least dis­rupted,” Hen­der­son and his col­leagues wrote in that 2006 pa­per. “Strong po­lit­i­cal and pub­lic health lead­er­ship … are crit­i­cal el­e­ments. If ei­ther is seen to be less than op­ti­mal, a man­age­able epi­demic could move to­ward catas­tro­phe.”

We should have been lis­ten­ing to him all along.

Fabrice Cof­frini/ AFP via Getty Im­ages

Dr. David Nabarro, the World Health Or­ga­ni­za­tion’s spe­cial en­voy on COVID- 19, said that the WHO is now ad­vo­cat­ing what he called a mid­dle path when it comes to lock­downs.

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