Lock down, don’t shut down
When authorities imposed a quarantine on the sprawling Monrovia, Liberia, slum of West Point in 2014 in order to stem the Ebola epidemic, people escaped by sneaking through abandoned buildings or bribing soldiers. For some public health experts, the failed containment offered a lesson in what not to do. But in light of China’s draconian sealing-off of Wuhan to fight the novel coronavirus, Italy’s national lockdown and restrictions imposed in New Rochelle, New York, it is worth considering anew the merits of physical separation to fight a spreading respiratory disease.
We are all vulnerable to the coronavirus, since there is no vaccine or therapy or antibody to protect us. The virus can spread in a cough, so keeping people apart makes good sense. But dictating how and where individuals can move about is difficult for governments, especially in democracies.
China gets no praise for its coverup of the first covid-19 illnesses in Wuhan in December, which allowed the virus to spread. But in late January, as cases were rising, China imposed harsh containment measures. This belated action, and a clear message that fighting the epidemic was a national priority, seems to have slowed the virus’s spread in Wuhan and beyond. It is not easy to separate out precisely what worked, but some credit must go to ending large gatherings, closing businesses, encouraging people to stay at home, closing schools and demanding people change their behavior. Of course, some of China’s methods – including the pop-up hospitals and mass mobilizations – may be unique to its authoritarian system and not possible elsewhere.
Italy, with a sizable elderly population especially at risk, at first responded by closing off 11 small towns in the north. But the virus had apparently already escaped the region, and a surge in respiratory cases overwhelmed the Lombardy hospital system. Prime Minister Giuseppe Conte announced on Monday restriction of movement on an unprecedented scale, essentially locking down the entire country of 60 million people. It is too soon to know if this will work, but here again there seems to be value in canceling large events, urging people to work from home where possible, closing schools and insisting on changes in daily habits. Conte properly declared, “I’m about to take a measure that we can summarize with, ‘I’m staying home.’ Our habits need to change.”
In New Rochelle, a one-mile radius “containment area” was imposed this week by New York Gov. Andrew Cuomo, a Democrat, with a midpoint at a synagogue at the center of the state’s outbreak. Cuomo is sending in the National Guard and shutting schools, churches and synagogues. Again, that makes sense: The contagious nature of this virus demands physical separation. But governments must be careful not to strangle a society while trying to save it. People should be urged to avoid crowds, forego concerts and cope with closed schools, but they should be allowed to shop for groceries and visit a doctor or their family. Normal goods and supplies need to flow. In other words, lock down but don’t shut down.