Decisions: Relying on the Correct Information, Finding the Right Balance

The reopening of the economies and the resulting – and expected – increase in the number of reported infections, have intensified, and deepened, the discussion over the economic and social lockdowns of the past three months, and the right approach in the face of more infections, let alone a second wave later in the year.

Juliet Samuel writes that the enormous costs of the lockdown so far do not mean that lockdowns will not be re-imposed – especially if a better approach to containing the more serious effects of the virus is not offered. Sweden has offered a better, “light touch” alternative, but has now come under criticism for having a higher deaths-per-million ratio relative to its Scandinavian neighbors, which opted for strict lockdowns. Carl-Johan Karlsson writes that a close examination of the Swedish case shows that it was not that the “light touch” approach was wrong, but rather that its architects have overlooked a major problem: changes made to the Swedish senior care system in the last decade left Swedish elderly exposed (3,200 of Sweden’s 5,000 deaths are over 70 years old).

There are terminological issues (does “infection” equal “sickness”?) and measurement issues (How do you find, with precision, what the R0 is?), and Ross Clark (also see here) addresses these issues.

Have political leaders got the balance right between listening to scientists and medical experts, and respectfully taking additional issues – say, the economic, social, psychological, and medical consequences of a lockdown — into account when formulating a response to the epidemic, issues beyond the scientists’ and medical experts’ remit? Because if these leaders have not done so, then they have abdicated their leadership responsibility. Alistair Haimes and Greg Weiner discuss these issues (note: keeping scientific advice and expertise in the proper perspective does not mean boorishly dismissing science and denigrating experts, as Brazil president Jair Bolsonaro has been in the habit of doing, with grave consequences for his country).

Finally, this question: Are governments and societies set up properly to deal with overlapping crises and costly catastrophes, both the low-probability, high-impact events (say, a meteorite hitting Earth; a new virus), or the slower moving but predictable (say, climate change). Arnold Kling, Philip Wallach, and the Economist argue that governments must fundamentally change the way they assess risks, prepare for them, and fashion policies to cope with and recover from them.

America's COVID Spike Shows How a Second Wave Could Bring a Second Lockdown

So far, we have found only two ways to contain fresh outbreaks.The first, and by far the least costly, is contact-tracing and isolation. It can be done manually without a tracing app, but it requires lightning-fast reactions and extreme efficiency. The second containment method: lockdowns. But lockdowns are destructive for the economy, and they carry with them an exceedingly high cost in personal, social, and medical terms. Juliet Samuel write in The Telegraphthat in the face of a possible second wave, “the stage is set for the great experiment. The top priority must be to get the tracing system working. But even if our Government is somehow incapable of that, it may yet find a set of distancing policies that keeps virus deaths at a low enough level without shutting everything down. Perhaps there is a balance to be struck, involving a mix of mask-wearing, better care-home procedures, loosening rules for the young before the old, keeping people outdoors and planning ways to do so in winter.”

Crisis Government

Henry Kissinger once quipped: “There cannot be a crisis next week. My schedule is already full.” That was back in the 1960s, when it appeared that responding to crises required the government to take a break from its ongoing work. Philip Wallach writes in National Affairs that when we step back and regard 21st-century American politics, we ought to see that the crisis responses are not “anomalous,” but rather that they vastly exceed the “normal” actions of the government in terms of importance. “This change of perspective compels us to reject the idea that polarization is the defining feature of our era, and we must reassess our understanding of the American political system’s capacities and infirmities accordingly. The overall picture is still a negative one, of course, but for reasons that differ from those we are used to hearing about.”

Sweden’s Coronavirus Failure Started Long Before the Pandemic

Many countries have criticized the Swedish government’s lax lockdown, but the deadly mistakes of defunding elder care and decentralizing public health oversight were made before anyone had heard of COVID-19. Carl-Johan Karlsson writes in Foreign Policy that Sweden has become a global outlier in ignoring calls for coronavirus lockdowns, with the government’s public health agency issuing recommendations rather than mandating certain behaviors, what’s considered a “light-touch strategy.” Critics of the Swedish approach point to the fact that Sweden has a higher death rate relative to its Scandinavian strict-lockdown neighbors (Denmark, Norway, and Finland). But Karlsson notes that a closer look reveals a more complex reality: the overwhelming majority of Swedish COVID-19-related deaths occurred in senior citizens care centers, so some criticisms of the Swedish COVID-19 response may still be premature, and others should rather be directed at mistakes made long before the current health crisis—namely the decline of central government oversight and, especially, a decadelong neglect of Sweden’s elderly population.

How the Coronavirus Short-Circuits the Immune System

At the beginning of the pandemic, the coronavirus looked to be another respiratory illness. But the virus has turned out to affect not just the lungs, but the kidneys, the heart and the circulatory system — even, somehow, our senses of smell and taste. Gina Kolata writes in the New York Times that now researchers have discovered yet another unpleasant surprise. In many patients hospitalized with the coronavirus, the immune system is threatened by a depletion of certain essential cells, suggesting eerie parallels with HIV. The findings suggest that a popular treatment to tamp down the immune system in severely ill patients may help a few, but could harm many others.

We Ran the CDC. Here’s How to Talk to the Public in a Health Crisis.

With just a few words uttered during a media briefing in Geneva on Monday, the World Health Organization’s technical lead for coronavirus response sent a lightning bolt of doubt around the globe as to how transmission might occur during this pandemic. Jeffrey P. Koplan and Richard E. Besser — they each ran the CDC during a public health emergency – write in Barron’sthat when Maria Van Kerkhove walked back her statement about asymptomatic transmission a day later, noting that how often people without symptoms spread the disease “is a major unknown,” the damage already had been done. Communication failures like this, and the muted voice and ignored expertise of the Centers for Disease Control and Prevention during this pandemic, undermine the institutions we need and can have a dramatic impact on people’s health. Without trust, transparency, and truth, public health officials and government leaders will struggle to inform people and drive behaviors to serve the greater good.

Ignoring the COVID Evidence

There is no need to wait for history books to analyze and dissect every aspect of the disease and the U.K. governments’ response to it, Alistair Haimes writes in The Critic, “but it is already clear that there has been an unexampled disregard for the foundational pillars of the scientific method even as governments trumpet that they are ‘following the science’.” He argues that at every stage, the U.K. government has failed to apply scrutiny where it is due, or even to stop and check that it was on the right ladder before it carried on climbing. He adds: “I have no idea whether there will be either a second wave or a totally different epidemic in the next few years. But we urgently need to repair the infrastructure not just of our healthcare and procurement systems but also of the decision-making processes underpinning our scientific advice, our policy response and our legislative safeguards, ready for the next crisis that comes along. It should start with ensuring that the right questions will be asked, and that scrutiny is maintained and sustained when the going gets tough. We did not have to get this wrong the way we did: we must not repeat the fatal steps that brought us to where we are now.”