Thoughts in a triple lockdown
Here are five facts: 1.) the overwhelming majority of people do not have any significant risk of dying from COVID-19; 2.) we have a clearly defined population at risk who can be protected with targeted measures: older people and others with underlying conditions; 3.) protecting older, at-risk people eliminates hospital overcrowding; 4.) vital population immunity is prevented by total isolation policies, prolonging the problem; and, 5.) people are dying because other medical care is not getting done due to hypothetical projections.
That’s according to Scott Atlas, the David and Joan Traitel Senior Fellow at Stanford University’s Hoover Institution. He made the assertions on April 22, a month’s data behind him, backed by studies from Stanford University and New York University Medical Center.
That in turn is supported by Thomas Meunier’s findings (“Full lockdown policies in Western Europe countries have no evident impacts on the COVID-19 epidemic,” May 2020) that insistent lockdown policies tried by some countries were of no effect compared to the more basic social distancing policies.
Which in turn is backed up by Hua Qian and other’s recent study (“Indoor transmission of SARS-CoV-2,” April 2020) which showed that 80% of coronavirus infections happen inside the home. The New York government validated this when it found 66% of infections were of citizens locked-down inside their homes.
Now New York has a population density of 10,194 per km², which alone made imposing a lockdown difficult. Compare that with a city such as Tokyo (6,158/ km²) or a country like Taiwan (649/ km²) which did not impose lockdowns but had their coronavirus situations seemingly under control. Our National Capital Region has a population density of 21,00 per km², Manila alone would be 42,000 per km². A lot, including families, live in homes averaging between 50-70 sq.m.
What makes the entire thing complicated is the seemingly moving target of our community quarantine (and its varied permutations). The official documents don’t seem to indicate specifically what it is. The original understanding was to “flatten the curve.” Then it became “squashing the curve,” to “allow completion of mass testing,” to “wait for vaccine,” and then to “save every single life.” Even “flatten the curve” has evolved into something new: to “prevent overwhelming our hospitals.”
But this just leads to further questions: as to hospital capacity, one needs to only look at the hospital bed utilization rate dedicated to coronavirus patients and extrapolate from there. And surely at two months one would have the data to determine how many beds and other resources are needed considering 91% of those tested yielded negative results and that 80% of those positive are asymptomatic.
Complete contact tracing? Why? What good will it do at this stage? From the looks of it contact tracing is commonsensically helpful to prevent a pandemic in its early stage — but we already know many of our population are infected and according to epidemiologist Dr. John Wong we’ve been actually infected since January (ie., the first wave was January, the second wave is now or already happened last April; “Epidemiologist warns of ‘3rd wave’ of infections,” PDI, May 7).
Complete mass testing? Why? At this stage of the pandemic, what for? If somebody is asymptomatic or having very mild symptoms, as 80-90% of infected likely are, then what’s the point? You can’t isolate everyone or put them in the hospital. So why not focus testing for clinical/diagnostic purposes on those exhibiting severe symptoms? But if Stanford and other studies shows that only around less than 0.01% — 1.7% of those infected need hospitalization and the infection fatality rate (IFR) is between .1-.2% (a University of Washington study declared an IFR of 1.3% but admits their calculation excluded asymptomatic patients) then why lock down everyone, including reasonably healthy people, when the hospital system can focus their attention on the elderly or those with chronic illnesses, which apparently is what’s crucial at this point, particularly when the feared next wave does come.
Another suggestion is to retain lockdowns until a vaccine comes. But how many years will that take? The fastest vaccine developed was for Ebola and it took five years. HIV and SARS still don’t have vaccines. We have vaccines for flu but they are only 55% effective and the flu still kills 76,000 Filipinos annually.
And about saving every life? As of May 15, representing the second full month of our lockdown, 806 have died from the coronavirus. To put that into context without minimizing the tragedy of those deaths, on monthly average, 300 Filipinos die by suicide, 1,000 from car crashes, 5,000 from stroke, 5,333 from cancer, 6,333 from pneumonia and flu, and 7,000 from heart disease.
And, yes, one can die from hunger too: a UNICEF study showed that 95 Filipino children die from malnutrition daily. That’s 2,850 deaths monthly, 32,000 yearly. For children alone, during ordinary economic times.
One can only speculate how many lives will be put in dire straits in the coming post-lockdown economy.
Jemy Gatdula is a Senior Fellow of the Philippine Council for Foreign Relations and a Philippine Judicial Academy law lecturer for constitutional philosophy and jurisprudence.
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