Sunday, January 17, 2021

The perfect strategy to fight Covid-19 is… everything?

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The pandemic has changed – and it’s worse than ever.

Cases of Covid-19 are on the rise in almost all states. The statistics are grim. With over 100,000 new cases and 2,000 deaths every day, hospital intensive care units are filling up everywhere. It’s a whole New York country in April. And yet, Covid’s skepticism – about how to fight disease, and sometimes even the reality of the disease itself – remains a hallmark of right-wing politics.

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There is a light at the end of the tunnel – vaccines may well be available for millions of people before the end of the year. It’s a scientific triumph, of course, but until then, we’re still in the tunnel. The challenges of manufacturing and distribution mean that it will take at least until June 2021 to vaccinate everyone, according to the head of logistics for the government program of Operation Warp Speed. Until then, the same public health measures that are slowing the spread of the virus – curve-flattening “non-pharmaceutical interventions” like wearing masks and canceling gatherings – remain the only tools in the toolbox.

Policymakers and leaders therefore have a difficult choice: to force everyone, once again, to comply with effective but potentially expensive public health measures, or to let hundreds of thousands of people die. It is a more difficult choice than it seems. Anti-lockout rhetoric and a year of stress wrecked people emotionally and hurt the economy. In addition, it is a basic principle of public health which abstinence and shame don’t work. If the curve-bending efforts are not politically and socially viable, they will fail and hundreds of thousands of people will die. Like Mike Ryan, executive director of the World Health Organization’s Health Emergencies Program, said at a press conference Last Friday: “These countries right now in the fight of their lives, you have to stick with that. You must try to control this transmission, otherwise your health systems will not be able to cope. “

What you would really like to know here is which specific interventions give the best value for money, the greatest reduction in disease transmission with the least possible impact on the social fabric and the economy. Is this … a mask warrant? Closure of bars and restaurants? Close schools? Temperature controls at building entrances? It would be very, very good to know that, because all of these things have benefits, but also costs. But scientists and public health experts have no answers. They know these things work globally, but not how they overlap and synergize, how behaviors change in response to new rules, and how politics and sociology affect membership.

This is why nothing seems to make sense today: the meals inside are open, the places of worship closed; closed outdoor playgrounds, open gymnasiums; outdoor dining rooms open and then closed; curfews in place in bars. In many countries, early measures combined with financial support and rigorous screening, testing and isolation programs have crushed the disease. The United States and Europe have done part of the first thing and almost none of the others, dooming these places to a bloody swing: cases are skyrocketing, lockdowns are coming, economies and sanity crumble, places reopen, cases increase, repeat themselves. And now, well, we’re where we are.

In the initial pandemic month, everyone has ruined it. “Ideally, you want interventions that have maximum effectiveness with the least social and economic inconvenience,” says Lawrence Gostin, director of the O’Neill Institute for National and Global Health Law at Georgetown University. . “This is the rational way to do it. But there has been no rationality around tackling this pandemic, especially in the United States and Europe.

Public health experts know, in the broadest terms, what measures will bend the curve, but science really is more of an art. All countries around the world have deployed roughly a series of similar public health interventions to fight Covid-19 in roughly the same order, at roughly the same times in their encounters with the disease. According to research Led by Thomas Hale at the Blavatnik School of Government in Oxford, most countries began communicating to their citizens in February about potential issues ahead and instituted border checks before they had even confirmed cases. About 25 days later, in mid-March, countries began canceling public events and closing schools, then closing workplaces five days later. Four days later, on average, there were home orders and transit closures – lockdowns.

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