Governments across the globe are scrambling to contain the spread of Covid-19. Developed countries with near universal healthcare such as the UK, Italy and Spain are also trembling under pressure. The first and perhaps only priority at this point for policymakers everywhere is to make sure people don’t leave their homes and congregate except for absolute necessities such as food and medicine. For this purpose, lockdowns have been enforced around the world.
It goes without saying that the global economy and the livelihood of millions across the globe is in jeopardy. Developing countries like Pakistan with limited testing capacity for Covid-19, face tough challenges ahead as the virus continues to spread.
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Despite all this, deep down, we all seem to expect that things will soon return to normal. A wide range of conspiracy theories offer different explanations as to what Covid-19 is and how and why it’s spreading but all these theories come with the premise that at some point, it’ll be over. Surely, all this suffering must come to an end. We are all waiting restlessly for an escape from this crisis to resume our lives, but we have no idea how this crisis ends.
Number game
Let’s consider some numbers to get a sense of the severity of this viral outbreak. At the time of writing this piece, there are over 1.5 million cases of Covid-19, with less than 40,000 deaths worldwide. As per the WHO, that’s a death rate of about 3.4% but the real death rate varies from country to country, depending upon the state of healthcare and the response from authorities to contain the outbreak.
The mortality rate of 3.4% may not seem much but the real danger, however, lies not only in the death rate but the fact that the disease spread to virtually every country in the world in less than quarter of a year.
Unless extreme measures are implemented, this virus could infect up to 70% of the global population. 3.4% deaths out of even a billion infections is a number that’s extremely difficult to imagine. Furthermore, not enough people have been tested which could have helped in ascertaining an accurate mortality rate for this virus.
For all we know, it could be significantly greater than 3.4%. When you’re talking billions of people, a decimal percentage point could mean millions of lives. President Trump also admitted that the virus could cause at least a 100,000 deaths in the US alone.
A professor at Imperial College in London, who helped to shape #coronavirus #policy following a #damning report into the Governments initial #strategy, has said the number of deaths could rise above 20,000.@Qasimsoomro @shoro @zamirghumro @murtazawahab1https://t.co/onBpM1d6y1
— Nadeem Mirbahar (@nadeemmirbahar) April 6, 2020
Imperial College London: Policy options available
How do we move forward now when the lockdown seems to have become a reality in every city and town across Pakistan? A much discussed study by Imperial College London lays out two policy options to manage the threat of Covid-19. The study applies a microsimulation on the US and UK, but as far as policy is concerned, the course of action available is more or less the same for every country.
The first option is mitigation, which focuses on slowing but not necessarily stopping epidemic spread. The second option is suppression, which aims to reverse epidemic growth, reducing case numbers and maintaining that situation ‘indefinitely’. The authors of the study also realize that “measures will need to be reintroduced if or when case numbers rebound”.
The efficacy of lockdown in the long-term as a healthcare measure vis-a-vis Covid-19 is something that only time can tell. With China having lifted the lockdown in Wuhan, it remains to be seen whether or not Covid-19 returns to Hubei Province in the People’s Republic of China.
It goes without saying that these measures are not a permanent solution to Covid-19. With the lockdown, the goal is to prevent healthcare systems get overwhelmed by a sudden surge of coronavirus patients and to delay the spread of infections as much as possible till a vaccine becomes available. The estimated time frame for that is about 18 months or more.
Herd immunity to defeat coronavirus
The other way out of this is ‘herd immunity’. Herd immunity is what happens when a significant percentage (say 70%) of a human or an animal population develops antibodies to effectively stop the spread of a particular disease. This can only be done through exposure to that disease. To ‘manage’ the development of herd immunity, we must take a look at the first of the two options discussed in the Imperial College study i.e. mitigation.
Mitigation refers to a slowing down of the spread of the virus but not necessarily impeding the spread in its entirety. This is to allow the virus (counter-intuitive as it may seem) to spread in a population to develop herd immunity against Covid-19. This almost sounds insane but that’s exactly what the British Government at one point was considering as the most viable policy option.
Even the Netherlands is not locking down and instead letting people get infected (albeit in a controlled manner) to beat the coronavirus. Sweden seems to have made the same wager. The tricky part: How to control the spread of the virus without subjecting the healthcare system to unbearable pressure.
Furthermore, with this option, we have to make sure that the disease doesn’t spread to people more vulnerable to its symptoms i.e. the elderly, the sick or otherwise immuno-compromised. The hope is that enough healthy people recover from the disease to build immunity for the human species as a whole. Presently, we’re unable to engineer herd immunity through biotechnology. We can’t even be sure as to how long it would take. We can only let it happen while hoping we survive the process.
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There are no good options here. Policymakers are facing difficulty making decisions. We seem to be caught between letting the disease spread ‘under control’ to enable the development of herd immunity, and locking down people long enough to prevent healthcare systems from collapsing altogether, while hoping that scientists are able to come up with a vaccine soon.
Pakistan seems to have chosen the latter of the two options. There are known unknowns with both policy interventions. We don’t know how long it takes for herd immunity to mature and we don’t know long it will take for a vaccine to develop. But given the state of our healthcare system, it’s arguably the right decision.
In the meanwhile, we must adapt to a new way of life for the foreseeable future. The way we work, shop, get educated, celebrate and mourn all need to change till we get to the end of this. Sooner or later, we will get to the other side of the lockdown. The end is inevitable. What kind of ending we get depends on the choices we make today.
Saqib Manzoor is an Engineer and a CSP officer. The views expressed in this article are the author’s own and do not necessarily reflect the editorial policy of Global Village Space.