It’s an intimidating picture. But the weaker the freeze, the more people die in overburdened hospitals — and the longer it ultimately takes for the economy to restart.

Donald G. McNeil Jr in the NYT

Yes folks, I normally don’t go in for all that MALARKY WITH CAPITAL LETTERS IN A POST, BUT THIS TIME IT’S DIFFERENT.

The government didn’t take coronavirus seriously at first. As it’s amped up the seriousness of its response, it’s done so reluctantly and now it’s in no man’s land, with strong social-distancing measures that will cost the economy a bomb. But those measures are not strong enough to rid the country of the virus. So they’re with us until we gain herd immunity, which will take the best part of the year.

We’ve picked a scenario that is the second-worst for health (the worst being doing nothing) but it seems to me to be the worst possible option for the economy. (The best is probably to do nothing — but that was never an option — the people would rightly have rejected it.)

Right now, panic is the friend of anyone who doesn’t want to get this disease, which continues to surprise on the downside (i.e. the bad side). Thus in yesterday’s Fin:

China is not reporting any new cases in Hubei province, but the deaths continue, as patients who are healthier and younger lose their long battles with the virus. This has pushed China’s death rate from the 2.3 per cent cited in the study to 4 per cent today.

Those ratios are misleading because the denominator is people who have tested positive to coronavirus, not all people who actually had it. But they still show how important humility is in all this. There’s still much we don’t know, including the stability of immunity.

Extreme social distancing is effective, however, in massively reducing the rate of spread and getting the rate at which one person infects others (the “R0” we’ve all suddenly adopted to demonstrate our coronasavvy) from around 2.5 to below 1. And, as complexity scientist Yaneer Bar-Yam concluded on Joseph Walker’s excellent podcast two weeks ago now, once R0 falls below 1, exponential growth goes from being your enemy to being your friend. The virus runs out of business halving, then halving again, and so on to oblivion.

Then one rebuilds the world from ‘green zones’ (they’re probably called something else on that podcast but this is an emergency). Life as normal can resume and the only economic restriction remaining is strong restrictions on travel. However, even here this will be mitigated by a system of building travel links between other ‘green zone’ countries and various forms of certified safe travelling that would include placing all arrivals not able to certify their coronavirus-free status into self-funded quarantine for 14 days before release.

This would produce extreme disruption in the short term — but it’s hard to imagine it being more than (say) 50% worse than what we have now or will have by the end of the week. But we ought to be able to announce some relaxation of the more extreme measures within six weeks. By then, tracing and testing would be massively improved, so we might be able to return to normal relatively quickly. Rather than have this thing drag on for the rest of the year as the travel restrictions will have to — although our own and other countries doing the same will draw other countries into wanting to be in the green zone if they haven’t twigged already.

I’d also like the government to publicly commit to some timetable letting us know when it thinks it can meet certain milestones. They should also commit to releasing an independent report on the state of play each week, with expert recommendations on whether and when to relax measures and in what order. It would be clearly telegraphed where we were meeting and missing our targets (there’d likely be a mix of both).

But I think people would be impressed that their interests were being taken into account — as fairly and as efficiently as practically possible.

Postscript: Since writing the words above, it seems New Zealand has adopted the strategy I’ve suggested — right down to the specification of targets by which it is hoped to have the virus under control and safely heading towards zero — perhaps with the odd breakout which is rapidly tracked down.

I’ve also watched tonight’s episode of Q&A on which the Deputy CMO repeated the idea that this will inevitably go on for six months or so. That’s doesn’t seem to be what Jacinta Ardern has been advised and I can’t see why it makes sense. However though Norman Swan didn’t directly challenge the Deputy CMO on the point he did say that we’re about to observe the results of the first easing up of restrictions in China — although at least at the epicentre, it will be from a much more heavily infected area than anywhere in Australia is — at this stage.

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12 Responses to PANIC IS OUR FRIEND!

  1. paul frijters says:

    hi Nick,

    I do like your pragmatic attitude. Good to keep focused on “what to do” at times like these. Have you truly so quickly come to terms with the enormity of what has just happened to our social and economic life?

    As to content.
    “We’ve picked a scenario that is the second-worst for health (the worst being doing nothing”

    you know I now believe the opposite to be true. The health effects of the social isolation and the economic destruction make it untrue. However, what is politically unfeasible is politically unfeasible and we have to make the best of it, worrying later about institutions that would make better choices.

    In very densely populated countries the notion of green spaces of course doesn’t work. No areas are distinct enough from the others. Our populations are so connected in Europe, with massive cross-migration of workers, that green countries wont stay green for long if they mix with anyone. Herd immunity or a vaccine/cure are the only longer-term outcomes, and herd immunity is achieved quicker the more quickly the virus is allowed to spread, which goes to the general point of what really is best for health.

    I am not sure targets and time-tables will make any difference. What if they are not met? It just opens up a blame-game, a distraction at such times. It’s like taking the answer to too much bureaucracy to be …. more bureaucracy. Maybe as a communication device – a sign that the politicians think they know what they are doing – it has some value but because it is so obvious none of them really know what they are doing (its seat-off-pants-time), its a bit of a con.

    • TN says:

      I agree with Paul on this. The best thing to do – if the three options are go hard to try to eliminate, flatten the curve, and do nothing – is probably the latter (although without being privy to the medical science its difficult to be too definitive). Of course, ideally one might want to risk rate people and isolate the most vulnerable, but there is a case for most of the rest of us to get sick and then get on with it, or, in a few cases, be burried. Nick thinks the people “would rightly reject” that approach. Probably that’s right, given the difficulties most people have dealing rationally with risk and concepts such as opportunity cost and the true (non-infinite) value of life.

  2. I am and will always be Not Trampis says:

    The question no-one can answer is why so few people have died here.

    If the worst people can expect is living at home for 14 days then that is not so bad.

  3. Nicholas Gruen says:

    I heard that we can expect the rate to climb in the next couple of weeks.

    But there’s also the fact that we’ve tested more than anyone else per capita, so our denominator is higher.

  4. I am and will always be Not Trampis says:

    Thanks Nick I have also heard a few things but nothing from people who should know.

    highly frustrating

  5. desipis says:

    “The question no-one can answer is why so few people have died here.”

    The government has repeatedly been stating that the vast majority of cases detected have been from people coming into the country. I would guess that these people are far less likely to fall into the at-risk categories than the general public. The deaths so far have come from elderly people in an infected retirement home and from a couple of cruises. If the at-risk groups (and their carers) take the threat seriously, then the Australian fatality rate should be well below Italy’s. Still, as it spreads around the community, it’s likely to infect at least some of the at-risk demographics, and that will mean more deaths.

    I can’t quite fathom why the government is refusing to release it’s modelling. The only reason I can think of is that it doesn’t have faith in it. Surely it would be better than the infinite variations on the extremes that are floating around the internet.

    • I am and will always be Not Trampis says:

      that was the same for all countries to start with. It does not answer the question on why death rates are way higher in the Northern Hemisphere.

    • derrida derider says:

      I can’t quite fathom why the government is refusing to release it’s modelling. The only reason I can think of is that it doesn’t have faith in it. Surely it would be better than the infinite variations on the extremes

      If the modellers are any good (and knowing some of them I think they are people who know their stuff) then they will themselves be producing all those “infinite variations on the extremes”. Sure, policy advice coming from the models is based on the central case, but it has also to keep the pollies well aware of both upside and downside risks (especially the latter, as welfare losses – in lives and money – are very unsymmetrical).

      They probably aren’t publishing because they do NOT want to just present the base case – rightly, because people will not understand the different models’ weknesses and strengths, and they will be far too busy to publish detailed sensitivity and meta analyses (which would be ignored anyway).

  6. Jeff Berger says:

    Yes, this has been super frustrating to be honest. I think that the government providing a timeline would be extremely helpful to businesses trying to outlast the economic downturn this has caused.

    • derrida derider says:

      No one, including the experts, knows the timeline; it depends on a whole lot of things we still can’t know. As usual the mark of an expert is that they’re very conscious of what they DON’T know; anyone claiming to have a handle on the timeline is not an expert.

      If things go really well we could be looking at a few weeks, if things go really badly over a year.

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