Lockdown should only be for the old and vulnerable

Prime Minister Justin Trudeau, Ontario Premier Doug Ford and Toronto Mayor John Tory are right to panic over a coronavirus explosion. Next to Mexico, our hospitals are the poorest equipped of all OECD countries. As put by Frances Woolley, professor of economics at Carleton University, “a cold hard look at the numbers suggests our hospitals cannot cope with the most flattened of curves. Indeed, they cannot cope with any kind of curve at all.”

That chilling assessment means our leaders are wrong to try to lock down much or all of the economy to “flatten the curve” — jargon for preventing a spike in hospitalizations. Italy failed at this despite having one-third more acute-care hospital beds per capita than Canada and twice as many per capita as Ontario, ground zero for Canada’s looming crisis.

Half of Ontario’s hospitals are already at overcapacity for much of the year. The U.S., in contrast, is in trouble despite a hospital sector that is only at 64-per-cent capacity. South Korea did do well in flattening the curve but it has more than four times as many hospital beds per capita as does Canada. Germany, which is attempting a lockdown, has more than three times as many.

Because our government-controlled hospitals aren’t up to the job and private hospitals don’t exist, Canadians and Ontarians in particular have little choice but to rely on self-discipline and individual responsibility. Luckily, the data indicate that such a can-do approach could well succeed — and with relatively little harm to the economy or to the financial security so important to our sense of well-being.

According to a March 17 survey from Italy’s national health authority, more than 99 per cent of its coronavirus fatalities suffered from previous medical conditions. It found just three individuals who weren’t already ill, representing 0.8 per cent of deaths among the 18 per cent of fatalities it investigated.

Italy’s findings are consistent with those elsewhere. The great majority of the population that becomes infected — well over 90 per cent — survives, typically with symptoms resembling the common cold. Often those infected don’t even realize they had contracted the coronavirus. The survivors then become immune, no longer at risk to either themselves or to others, creating what the medical world calls “herd immunity” — an immunized, infection-free population unable to infect the unimmunized. A simple test can confirm the immunity.

A can-do approach to dealing with coronavirus in Canada — a no-brainer, really — is to clearly discriminate between those who should avoid infection and those who should invite it.

Those with existing illnesses who should avoid infection — chiefly those of all ages with high blood pressure, diabetes, heart disease or active cancer — should isolate themselves for several months, knowing that they otherwise risk death. Those especially at risk are those who have three or more existing illnesses (almost half of all who died in Italy were so severely compromised) and those with two existing illnesses (another 25 per cent of all deaths). The average age of death in Italy was 80, with very few deaths under age 50 and vanishingly few under age 40, all of whom were males with serious existing illnesses.

Those who care about this at-risk population — friends and family members — should likewise exercise extreme caution, interacting with at-risks only at a distance and taking all measures needed to keep them safe. Given the alternative of death, all involved have every incentive to be self-disciplined and scrupulously conscientious.

This lockdown of the at-risk population not only saves the lives of the atrisk, it spares the hospitals from an inundation they cannot cope with, allowing them to avoid the triage that would otherwise become necessary. It also allows the healthies of all ages — those without existing illness — to work and play, frequenting bars and restaurants and attend schools and sporting events. Because these healthies won’t need to be vigilant in most of their daily activities, it will be easier for them to exercise discipline on necessary occasions. Most healthies will inevitably become infected — that is the predicted fate of 70 to 80 per cent or more of the entire population — but more safely so. The relatively few who will need hospital care will be able to get it, because those at risk are safely quarantined, freeing up the scant hospital capacity for the rest of the population.

With every infection comes a growth in the immunized portion of the “herd,” a lessening of panic and a virtuous cycle in which an ever-increasing liberated population will be able to interact more freely with loved ones at risk. Month by month, the general public will grow increasingly immune, until the herd is sufficiently safe to allow those in the at-risk population to leave their quarantine on foot, rather than on a stretcher, and to enjoy with everyone else the restaurants, cultural events and other pursuits that a healthy, well-functioning society offers.

THOSE WITH EXISTING ILLNESSES WHO SHOULD AVOID INFECTION ... SHOULD

ISOLATE THEMSELVES.