Could the cure for COVID-19 could become worse than the sickness?

#Coronavirus lockdown – the reaction from businesses and individuals

While most European countries have instituted some kind of lockdown, and the measures are broadly popular in countries that have, there is still no broad consensus on precisely what degree of measures is appropriate.

Politicians and people world over are pushing hard to ease the lockdowns; the US has seen nationwide protests (organized by a shadowy organisation with links to pro-gun groups using tactics which some commentators have compared to Russian disinformation tactics.)

Closer to home, Spain has seen opposition parliamentarians calling for the removal of its socialist government over the country’s lockdown, while the UK cabinet is reportedly “split” on the issue.

It’s hard to argue against the necessity of lockdowns, and it’s widely agreed by experts that many countries’ health systems would have been quickly overwhelmed without some kind of drastic measures. The experience of places like Lombardy and New York is illustrative: overburdened health systems can quickly lead to massive fatality rates. New York City has seen 1 in 1000 of its population die already, while so many died in the worst-hit Italian region of Lombardy that Italy’s army was called in to transport corpses to neighbouring regions for proper disposal.

Comparing approaches to coronavirus lockdown

Spain and Italy Instituted some of the harshest lockdowns much earlier than other countries. In spite of the fact that Italy has one of the world’s best healthcare systems, it has a higher fatality rate than most, and Spain hasn’t fared much better.

In Sweden, compulsory lockdowns have not been introduced, and bars, restaurants, schools, and businesses remain open – along with the country’s borders. In recent weeks, there have been suggestions that this approach may be backfiring for Sweden, which has a high fatality rate compared to its Nordic neighbours Norway and Denmark. Nonetheless, the country’s government continues its policy of a relaxed response.

South Korea has been touted as the leading example of a very different approach. Following its past experience with SARS and MERS, South Korea rapidly introduced widespread testing, contact tracing, and selective quarantines of those who tested positive or those who have come into contact with someone who tested positive. Tests are available to anyone who wants them and it appears that the strategy has been effective; the country has been able to reduce its daily rate of infections to as low as 9 per day and has a correspondingly low rate of fatalities. Like South Korea, Germany has instituted widespread testing and boasts an extremely low rate of fatalities compared to countries like Spain, Italy, and the UK.

It’s not clear so far just how effective lockdown measures have been; the only obvious thread shared between countries who have avoided the worst of the pandemic is widespread testing. Europe has seen its rate of new infections reduced to manageable levels, but most countries still lack a clear plan to ease restrictions.

Downsides of the lockdown

I don’t mean to argue against continuing the lockdowns for the time being – if infection rates explode once again, we could be facing an imminent and devastating health disaster. However, what has perhaps been insufficiently acknowledged is the fact that the lockdowns themselves come with very serious downsides. Not just in abstract terms of “the economy” and the effects of social isolation, but in terms of health effects: poverty, sickness, and death.

Just considering one group of diseases, specifically, cancers, an NHS consultant oncologist suggested that a 6-month lockdown could result in 50,000 cancer deaths in the UK long-term. Diagnostic tests for cancer have all but halted, and hospital wards nationwide are sitting empty of non-COVID-19 patients. Add to that the countless surgeries which have been cancelled and medics’ concerns that patients are avoiding the hospital for serious conditions like heart attack and stroke and it’s clear that the lockdowns themselves could be creating a health emergency.

Economic damage

It’s easy to make the argument that our economy is unsustainable, to begin with, and I’m inclined to agree. The never-ending race for growth is utterly destructive to our planet. The changes we’ve seen in the past months with reduced pollution, spending more time at home and changes in work-life balance are something we should definitely look to expand once the pandemic burns out.

But, short term, we’re seeing massive job losses and massive numbers of businesses face shutting their doors permanently – not least in the training industry. We may still be looking at an unprecedented recession and recession in itself is known to increase all-cause mortality i.e. recessions kill people, too.

It’s easy to say that we should institute universal basic income and massively increase taxes on the super-rich. Problem solved, right? But changing the entire world’s social, economic, and political systems is not something that can be instantaneous; the history of revolutions is a chequered one and, as often as not, they lead to massive social upheaval and fail to sustainably meet their objectives. Moreover, realpolitik enters into the equation; the people pulling the strings don’t have a strong vested interest in overhauling the way the world does business.

Stay at home, protect the NHS, save lives

Again, I’m not arguing that we should just lift the lockdowns and “let God sort them out.” For now, it’s necessary to “stay at home, protect the NHS, and save lives.” But it’s clear that there’s a conversation to be had.

If governments want to secure buy-in from the populace for an extended period of quarantine, we need to see well-researched numbers and people need to be trusted to draw their own conclusions. My concern is that someday in the near future, the balance of risk-benefit will flip on its head and, over time, the cure for COVID-19 could become worse than the sickness.

Benn Carson, Founder, Carson Recruitment