Pride goes before destruction, and a haughty spirit before a fall. – Proverbs 16:18
. לִפְנֵי-שֶׁבֶר גָּאוֹן; וְלִפְנֵי כִשָּׁלוֹן, גֹּבַהּ רוּחַ. – משלי ט”ז: י”ח
On May 1, Israeli news reported on pronouncements from the government’s ministries of health and finance, that the spread of the Chinese Virus, COVID19, had been halted. On that basis, these ministries have announced imminent regulatory changes to open up the national economy and public spaces. Some took this as evidence that Israel’s approach of extreme lockdown and economic disruption was proven superior to more lax approaches which kept businesses open while they utilized limited quarantine and social distancing methods of contagion mitigation. Such a perception would be very premature and rank with perilous hubris.
In the second week in March, Israel enacted a comprehensive lockdown, halting almost all economic activity and isolating citizens. The first to be isolated were the country’s soldiers, whether through shelter-at-home or through billeting of entire units at bases distant from cities and townships. Days later, strictly-enforced guidelines for shelter-at-home and social distancing were enacted country-wide. Except for essential errands, citizens were allowed no further than 100 meters from their homes. Intercity travel was forbidden without acceptable purpose. Special precautions were instituted for nursing homes. At the same time, it was announced that Israeli labs, private and military, were developing vaccines. Even though much of Israel’s GDP is generated from an information economy, much of the country’s workforce was furloughed or fired. The rest worked from home.
Around the same time, in the United States, President Trump followed the letter and law of the Constitution, which accords state governments, headed by their governors, with ultimate authority to safeguard the health and welfare their respective citizens. By late March, the larger cities were locking down. New York, with New York City having the densest population in the country as well as the most active international airports, enacted strict lockdowns and safeguards with two baffling exceptions. City health officials decreed that infected elderly patients would be forcibly hospitalized in nursing homes, where the most vulnerable, at-risk citizens lived. Subway travel continued, which entailed waiting on crowded platforms and traveling in packed train cars, veritable microbe farms dank with condensation. In fact the frequency of subway routes was lowered, thus increasing both waiting time on the platforms and the number of riders packed into the trains.
State governments varied in their regulatory responses. Almost every stated mandated the closing of less-than-clearly-defined “non-essential” businesses. While all states reasonably allowed supermarkets to remain open, while maintaining social distancing and masking guidelines, Michigan Governor Gretchen Whitmer inexplicably forbade the purchases of gardening tools and supplies. In contrast, South Dakota Governor Kristi Noem did not impose any business closures, instead exhorting the state’s businesses to voluntarily exercise prudent judgment on infection mitigation according to federal and state guidelines. California Governor Gavin Newsom eventually forbade any citizens from visiting the state’s beaches, despite the fact that the virus dies in sunlight and seawater.
In most countries, including the US and Israel, the original strategy was to “bend the curve,” to slow the rate of infection in order to give hospitals time to prepare for the anticipated tidal wave of COVID19 patients inundating emergency rooms and admissions. The virus characteristically devastated the respiratory system and clinical respirators were scarce in some states. This was the justification for the worst mandated surge of unemployment and small business closings in American history.
It’s worth noting that every model indicated a very low infection mortality rate for people under 50 with much higher and steadily rising infection mortality rates as one’s age past 60. The general infection-mortality rate reached 0.5% whereas those infected older than 80 had a 20% probability of dying. Thus, the vast majority of the work force had very low probability of dying, and a quarter were predicted to be asymptomatic. Even so, businesses closed and workers were laid off. This was also the situation in much of Europe.
The most notable exception to this was Sweden, which instituted social interaction policies very similar to South Dakota’s. Sweden didn’t close down a single business. Nobody was fired. The elderly and other at-risk citizens were quarantined while social distancing and masking guidelines took effect. But stores remained opened and something approaching “normal” seemed possible in Sweden. Citizens freely frequented the country’s many public parks.
Sweden has suffered higher rates of infection and infection mortality than some, but not all, of its European neighbors. However, it’s estimated that Sweden is now much closer than the rest of Europe to a state of “herd immunity,” wherein enough members of the population (eventually approaching 90%) are naturally producing antibodies to COVID19, so the paths or “chains” of infection between persons are shutting down, effectively eradicating the virus.
Neither Israel nor the United States are close to naturally achieving herd immunity through the infection and recovery of healthy individual. However, now that the hospitals have been prepared for the coming wave of infected, the two countries are slow to relax their social interaction restrictions.
Interestingly, some in Israel and the USA express ridicule and righteous indignation against Sweden for its relatively lax restrictions on social activity during the pandemic. Some are claiming that selfish, political libertarianism, approaching personal anarchy, informed Sweden’s COVID19 policies. “The young are unconcerned about the dangers to their elderly,” has been stated about Sweden. But this approach, ostensibly waving the banner of “for the sake of a single life,” is terribly inaccurate and very hypocritical.
For 90 years, the epidemiological method of confronting viral pandemics, based on herd immunity, has saved lives while eradicating disease. It consists of:
- the selective isolation of infected and increased-risk individuals
- the natural production of viral antibodies in healthy people
- the synthesis of a vaccine from antibodies of recovered patients.
Sweden has not downplayed the terrible loss in human life from the COVID19 virus. In fact, Sweden’t approach of selective isolation is far more humane and responsible because it recognizes the cost in lives of general lockdowns.
Human costs of a lockdown do not end with unemployment. Along with business closures and surging unemployment, there are massive, sometimes catastrophic disruptions to national and personal economies. These disruptions can affect, and sometimes cost, lives due to
- surges in cases of clinical depression and suicide
- undiagnosed diseases and untreated critical conditions
- increased domestic violence
- increased crime
- mandated poverty
- lost life savings and retirement assets
- disruptions in supply chains of essential goods, including food, which can significantly raise the cost of living
Perhaps the most misleading aspect of those who advocate total lockdown is the implicit denial of the fact that, without achieving herd immunity, the COVID19 virus is literally waiting at the door. The videos of dancing physicians and nurses celebrating a day without a new COVID19 case is premature and sends an irresponsible, overly-sanguine message that the virus has been defeated. Israel’s announcement of the virus’s halt was been made before a single public bus route has been restarted. The only lasting and significant achievement of the lockdown has been the time purchased, at huge expense, to prepare Israel’s hospitals for what’s ahead.
While there have been announcements of vaccines to artificially achieve herd immunity, their final development will likely result in their availability no earlier than late fall of this year. Seen in this light, Sweden’s faster track to herd immunity might even be more effective in saving lives from COVID19 while it clearly saves both lives and livelihoods obliterated from economic asphyxiation.
As we re-open the economy, we can and should go to great lengths to help those who are high-risk to protect themselves. The vast resources and assets expended should be prioritized towards people at-risk, not 15-60 year olds who have almost zero probability of dying from COVID19. If they continue to self-asphyxiate, the economies of the USA and Israel will have far fewer resources with which to selectively help the people who need them the most.