That we are fighting a global war is often used as a way to describe the fight against COVID-19.
One cannot tackle the death and devastation caused by the pandemic devoid of emotion. The latest data (as of June 21): 463,000 have died out of 8.75 million confirmed cases worldwide.
The US alone has accounted for 121,000 deaths so far. This is equivalent to about a fourth of global deaths. This number is more than double the American deaths in the decade-long Vietnam War (1964-1975): 58,220. In fact, the American deaths from COVID-19 have surpassed the total number of American fatalities from the wars in the period after World War II. The Korean War, Vietnam War, War in Iraq, War in Afghanistan, plus the 9/11 terrorist attacks accounted for 104,647 deaths all in all (source of information: Nina Strochlic, “US coronavirus deaths now surpass fatalities in the Vietnam War,” National Geographic, April 28).
However, the number of confirmed COVID-19 deaths still undercounts the total fatalities during the pandemic. We also have to consider the additional deaths that are indirectly caused by COVID-19. Said differently, these non-COVID-19 fatalities occur because of the pandemic conditions. The factors that explain the non-COVID-19 deaths during the pandemic include the reluctance of sick people to seek hospitalization because of their fear of getting infected, the incapacity of overwhelmed healthcare facilities to attend to all critically ill people, and the inability of the weakened system to simultaneously respond to different diseases.
The information on non-COVID-19 fatalities during the pandemic can be drawn from the metric called “excess mortality.” The World Health Organization defines it as “mortality above what would be expected based on the non-crisis mortality rate” or “mortality that is attributable to the crisis conditions” However, the data for excess mortality are scant.
The pandemic has likewise caused extreme economic hardship, resulting in incalculable losses in terms of jobs, food security, and incomes. It is said that the economic crisis brought about by COVID-19 is the worst since the Great Depression in the 1930s. But if we use health as our primary indicator, the current global crisis is worse than the Great Depression. One study for example shows that “many of the changes the deaths from the different causes during the Great Depression were unrelated to economic shocks.” More to the point, all-cause mortalities declined between 1929 and 1937. (See David Stuckler, Christopher Meissner et al., “Banking crises and mortality during the Great Depression: evidence from US urban populations, 1929-1937,” Journal of Epidemiology & Community Health, 2012.) This could be explained by the New Deal, which improved health outcomes.
Our consolation is that COVID-19 is, so far, not as extreme as the 1918-1919 influenza pandemic that killed 50 million people worldwide. Without sounding deterministic, we can exude confidence that we will beat COVID-19, thanks to the rapid advances in science and technology in general and therapeutics in particular.
The optimistic scenario is that a vaccine can be introduced within two years. Even here, we face challenges. Having a vaccine does not automatically mean that it will be made available to everyone. And even given the access to the vaccine, the logistics and resources to vaccinate everyone are formidable.
In this light, a petition letter, initiated by global leaders and influencers, is calling for a “people’s vaccine” against COVID-19. Recognizing that making the vaccine available to all is a political challenge, the signatories want COVID-19 licenses on knowledge, data, and technologies be freely available to all countries and vaccines and treatments be provided free of charge to all.
Even before reaching that point of rolling out the vaccine, we face immediate obstacles. For countries that have initially flattened the pandemic curve (China, Singapore, Korea, Japan, New Zealand, among others), fresh cases have emerged. For countries like the Philippines that are struggling hard to tame the first wave, they have likewise been hit by new outbreaks.
In the Philippines, the latest basic reproduction number is >1 (in the National Capital Region, the number is 1.2; in Cebu, it is 2). Any reproduction number that is >1 means that COVID-19 continues to spread, and a higher value (like in Cebu) suggests that containment is more difficult.
To rely solely on a prolonged lockdown to contain the virus entails huge economic costs. It likewise causes severe physical and mental stress to the populace. Hence, government has to step up in implementing effective interventions like targeted testing, systematic contact tracing, requiring people to wear masks, and having the sick go through self-isolation. These are the standard weapons to fight COVID-19.
But having weapons does not make a solid strategy. Even if we are armed with these weapons, the enemy that is the virus lives with us.
Here, we can reflect on the Japanese strategy of seeing the forest for the trees. A Japanese doctor and professor of virology, Oshitani Hitsohi, explains this strategy in an interview with the Japan Foreign Policy Forum (June 5):
“The core of Japan’s strategy was not to overlook large sources of transmission. By accurately identifying what we call ‘clusters,’ which are sources that have a potential to become a major outbreak, we were able to take measures for the surroundings of the clusters. By tolerating some degree of small transmissions, we avoided overexertion and nipped [in] the bud… large transmissions. Behind this strategy is the fact that, for this specific virus, most people do not infect others, so even if we tolerate some cases [to] go undetected, as long as we can prevent clusters where one infects many, most chains of transmissions will be dying out.”
Note that the strategy allows some degree of toleration of transmission. The war that Japan has conducted is not a war of attrition. It is not about “completely annihilating the evil.”
It is a strategy that recognizes co-existence. And combined with the tools or weapons that are at their disposal, they learn to adapt.
Filomeno S. Sta. Ana III coordinates the Action for Economic Reforms.