Initial blow must to stop spread, sustained steps needed after

ANALYSIS Strategy must work to first curb outbreak, then keep health care pressure low

NEW DELHI: The world needs to crack down hard in order to stop the coronavirus disease (Covid-19) pandemic, according to an analysis by Silicon Valley businessman Tomas Pueyo, who argues that the strategy can be l i kened t o a “hammer a nd dance” approach — with a first intense “hammer” move to stop the outbreak from growing followed by a sustained “dance” of lighter measures to keep the virus contained till there is a vaccine.

The analysis, posted on blogging website Medium as “The Hammer and the Dance”, takes into account several projections and infection trends that show how the spread of the disease can be interrupted by containment efforts, such as compelling people to observe social distancing and closing schools, offices and public transport to ensure people are not physically close enough to infect each other.

“Strong coronavirus measures today should only last a few weeks, there shouldn’t be a big peak of infections afterwards, and it can all be done for a reasonable cost to society, saving millions of lives along the way. If we don’t take these measures, tens of millions will be infected, many will die, along with anybody else that requires intensive care, because the health c are s yst e m wil l have c ol - lapsed,” Pueyo writes in the blog.

On Sunday, at least two billion people — nearly a third of the world’s population — were in a lockdown in 36 countries as the global death toll crossed 13,000 and the total number of people sickened by the virus exceeded 300,000. The latest 100,000 infections were added in the last four days.

“If we fight hard now, we will curb the deaths. We will relieve our health care system. We will prepare better. We will learn,” Pueyo writes, urging governments to immediately opt for the most intense of measures, a strategy many have avoided for the social and economic toll it will lead to.

To illustrate his point, Pueyo cites the cases of Wuhan and South Korea, where the virus hit in a wave of initial infections. The Chinese and South Korean governments immediately took strong but different strategies: Wuhan was virtually sealed off and shut down, while Seoul unveiled an aggressive testing strategy that screened thousands of people within weeks.

“During the Hammer, the goal is to get R (the reproduction number — a measure of how many people an infected person further sickens) as close to zero, as fast as possible, to quench the epidemic. In Wuhan, it is calculated that R was initially 3.9, and after the lockdown and centralized quarantine, it went down to 0.32. But once you move into the Dance, you don’t need to do that anymore,” the blog reads.

During the Dance of the R period, Pueyo adds, governments would want the number to hover as close to 1 as possible so that it prevents a new outbreak, while eliminating the most drastic measures.

The Dance phase will require several measures that governments need to first figure out – and while they are doing that, the Hammer strategy can keep the disease contained.

“What they need to do is formalize the process. Understand that this is a numbers game in which we need to learn as fast as possible where we are on R, the impact of every measure on reducing R, and their social and economic costs.”

CHART 2

Seoul unveiled an aggressive testing strategy that tested thousands of people within weeks. At the end of the three weeks, South Korea showed that aggressive and sustained testing is a powerful tool for fighting the virus and now the outbreak is largely under control

CHART 3

In Italy, which has reported the highest deaths, millions have been put under lockdown. But, the lockdown has not curtailed the rise in cases like the testing strategy did in South Korea. Local officials say that hospitals now face a crisis as ICUS faced intense pressure

02/15/2020

02/15/2020