COVID-19 is now a pandemic. This week, a lot more leaders finally take more serious approach to this global issue. Some countries have announced partial lockdown, some others worry about the economic impact of a lockdown. Misinformation within the people couldn’t be worse. Some still think COVID-19 issue is hoax (yes, seriously I still hear this on 15 Mar 2020), some others keep comparing it with flu, some others are busy referring to other diseases with a lot more victims to make their argument that COVID-19 is not a big issue and responses from governments were overreactions.
Almost in every corner of social media we could read pros and cons of lockdown and travel ban. Some people think more strict travel ban should be enforced. Some others wonder why their governments hasn’t announced lockdown before it’s too late.
There are some fundamental misunderstanding that many people seem to have. For starter, they seem to think that total ban of international travel will save them from SARS-CoV-2 virus (novel corona virus 2019). Guess what, if your country already have even 1 person with the virus inside the country, internal spreading is possible. By “1 person” here I do not mean people who are tested positive and announced by their governments, the “1 person” here includes the undetected carriers who might show only mild symptom or no symptom at all.
Second misunderstanding is about the intention of lockdown. Here’s the fact: lockdown is not to prevent spreading because lockdown will never stop SARS-CoV-2 from spreading. Lockdown is to slow down spreading. The idea is so that the number of people going to hospital at the same time remains manageable.
Why do we need to slow down spreading? Imagine a certain city with X million population. Its health care systems (doctors, clinics, hospitals) are capable to handle up to 80,000 patients per months. This can come from many factors from the number of hospital beds to doctors and nurses availability.
It is better for 1 million people in that city to go to their hospitals over 10 months (100,000 per month) compared to all 1 million in 1 month.
100,000 per month is already overcapacity. But with careful crisis management, it is still possible to handle 100,000 with minimum casualties. But if somehow 1 million people need medical help in the same month, 900,000 people who couldn’t get any treatment would be highly vulnerable for severe consequences.
A lot of people seems to miss the point that vast majority of us (perhaps around 70%) will end up catching this at some point, it’s only a matter of when. So the government intervention is to ensure that medical treatment will be available when we need it. So many people still think they can really avoid the virus. Even more people still think they can wait this up without doing anything until someone else solves the situation.
What about washing hands with water and soap, or with hand sanitiser? I was quite surprised that many people seem to learn to do this for the first time. Well, washing hands and the habit to keep our hands clean are good for our general health. Not touching our face with (possibly contaminated) hand sounds to be basic common sense to me. If one really could do these correctly and consistently, it will significantly reduce his/her risk, but never down to zero.
COVID-19 death rate is somewhere between 0.5% to 9% when we look at it by country. Worldwide, the fatality rate is somewhere between 3% to 4%. This is far higher than influenza’s fatality rate (0.1% of people infected will die) but still way below Ebola virus (90% of people infected will die).
In the USA, CDC estimated that influenza virus caused 12,000 to 61,000 deaths annually. As per 14 Mar 2020, COVID-19 has caused less than 6,000 deaths globally. Some people tried to use this statistics to build their argument that COVID-19 is nothing to worry about. My friends from Indonesia cited that dengue fever is causing 100,000 deaths per year in their country, making it something more serious than COVID-19 and they should worry about dengue fever instead.
Guess what? Influenza and dengue fever are not new diseases. Health care system in every country on the planet already consider them in their estimations of hospital size, doctors and nurses recruitment etc. It is already part of the system. COVID-19 is not. It is a new disease that will bring additional load on the health care system on top of all the existing diseases. Majority of COVID-19 will show only mild symptoms. This disease, for a single person, is treatable. The real threat here is the number and timing. If too many people suddenly need hospital treatment at the same time, some are bound to be left without treatment because of capacity limitation. This is the real danger of COVID-19.
If sudden influx of patients are not handled by a country’s health care system, the high number of fatalities will bring even more severe impact to a country’s economy. And this impact will take longer to recover because dead people won’t come back to life. Replacing the missing workforce with the same skill set will take some time, making full recovery a lot harder and will take longer time.
The choices for countries are super clear:
Option 1: lockdown, causing bad economic impact
Option 2: many people die when health care system is unable to keep up, followed by far worse economic impact
What if a lockdown will make people in a country unable to access basic needs? That’s a problem that each government needs to solve based on each country’s unique situation. A lockdown does not necessarily mean everyone has to stay at home all the time. Some people handling critical tasks could probably still perform their job with some extra precautions. Critical jobs during lockdown usually involves people in health care system (doctors, nurses, pharmacists), people transporting the goods of basic needs, people in producing of basic need products, people working for food markets, people doing deliveries. It is a lot easier to control this specific subset of people rather than having to control the whole general population. There are many ways to implement a lockdown. It is about how a government executes lockdown and ensures that basic needs are still accessible for everyone. If you feel that your government might not able to perform this responsibility, at least know and understand that the problem lies with their execution of lockdown, not with the need of a lockdown itself.
Lockdown essentially means restricting people in manageable areas. Different countries implement different styles of lockdown. Just because one country (China) does it draconian-style, does not mean it’s the absolute definition of the word lockdown. Italy and South Korea, for example, have their own versions of lockdown.
How is lockdown different from social restrictions? In social restriction, businesses still have the freedom to decide whether they want to stay open or not. In lockdown, government decides which businesses are considered essential. The rest are required to either stop activities, or work from home when possible. People are given strong recommendation on how to interact with others, but there is no punishable restrictions for cross area travels.
Is the practice of washing hands more important than lockdown? They are two separate matters. One is good practice for general health (but will not fully shield anyone from nCoV-2019), the other is a strategy to slow down the spreading from macro systemic perspective. They are both needed and not to be competed which one is more important.
Finally, I strongly believe that human life is far more valuable than economy.