“There are decades where nothing happens; and there are weeks where decades happen.” -Vladimir Lenin
Imagine you are a bank and are witnessing a recent phenomenon of other banks around you getting robbed on a constant basis. At this point in time none of the banks, including yours, has any locks on the doors, security cameras, or protective measures for the vault. With an increasing amount of would-be robbers feeling inspired based on how easy it is to rob the banks, robberies start to increase exponentially. Thankfully, all the banks are insured, but with the increasing amount of robberies, insurance premiums are skyrocketing and some insurers won’t even give out policies or have gone out of business due to the inability to honor the increase in claims.
Further imagine that some of the initial banks who have been robbed the most have decided to start implementing measures to mitigate future robberies. At first they decide to install surveillance cameras, then they lock the vaults and doors. Ultimately they decide they have to barricade the entire bank and prevent customers from using it. “If we can just get the robberies under control”, they reason, “perhaps we can remain solvent in the future for when the robbery problem finally stops.” As your own robbery problem increases you realize that, on some level, it’s like you have a crystal ball of the future given the robbery problems that the first banks experienced in the weeks or months prior to your own problem, allowing you to see the different techniques that the individual banks used to prevent future robberies and which have had the greatest effect in mitigating these events. What do you do?
This is a hard problem. Though it is not a perfect analogy for the coronavirus, I hope it is comparable enough to see the similarities in decision making that I will analyze below. Government officials are dealing with imperfect information, future uncertainty, and extreme pressure. Nevertheless having evidence of other countries’ responses that are weeks or months ahead of us in terms of initial infections is better than nothing.
A Tale Of Two Countries
Let’s look at Singapore and Italy. Based on new infections and deaths, Singapore has had one of the most successful containment strategies of any country so far. They preemptively instituted travel restrictions (despite the WHO saying that a travel ban was not necessary at the time), locked down the country, offered aggressive testing for anyone with symptoms, and offered a financial subsidy for certain affected employees, amongst other proactive measures. As of today, Singapore has had zero deaths from the coronavirus. Italy, on the other hand, has been nothing short of a disaster. I will concede that Singapore is significantly smaller in population and geography, which makes the response easier than a country that has a large population and landmass, but that doesn’t take away from our ability to observe the measures they implemented and their efficacy as opposed to doing nothing. Now let’s look at a timeline of the coronavirus in Italy.
- Day 0–21 Feb — 20 cases — We notice the outbreak.
- Day 2–23 Feb — 150 cases — Closed schools, 11 cities in quarantine.
- Day 10–1 Mar — 1700 cases — First hospitals saturated.
- Day 11–2 Mar — 2040 cases — 10% of Lombardy doctors are sick or in isolation.
- Day 17–8 Mar — 7400 cases — Lombardy & 14 provinces in lockdown, 12 million people affected, first reports of patients who cannot get care, prison riots.
- Day 19–10 Mar — 10150 cases — All Italy in lockdown.
- Day 21–12 Mar — 15000 cases — Most retail shops closed in all of Italy, enforced isolation, army given police powers.
The US response is much closer to the Italian blueprint than Singapore. We are at roughly Day 11 just going on case numbers. In a week, things are going to look dramatically different. It’s important to note that even after a country goes into full lockdown, the cases are likely to grow 10x-100x due to the lag in detection and incubation period for infections contracted prior to the lockdown. Looking at Wuhan, we see that the city was quarantined when there were about 600 cases, and there are now 62,000.
New York City Must Shutdown Completely
This is not a game where multiple options exist. Time is the enemy until the necessary decisions are made and only then can it become an ally. De Blasio can either proactively shutdown the city this week or he can shut it down reactively after hospitals are overcapacity and people are dying in their homes. These are his choices — same decision, vastly different outcomes. At this point in time, there are no other solutions. Subways, airports, or anywhere else you can think of that involves many people going through a similar chokepoint (not necessarily at the same time either) are problems that need to be managed. Policy response at every level of government has been an abysmal failure. Other cities will inevitably have to follow suit. Hopefully the politicians in those areas will take heed. It will be important for us to remember the differences in outcome in each city or region weighed against the differences in response. We must hold these decision makers accountable for their successes and failures.
Oops
These are pictures from Dallas Fort Worth and O’Hare airport taken March 14th. TSA seems to be doing an excellent job of implementing best practices to mitigate the spread of the virus by lining people up in crowded corridors waiting to get screened…
And here’s a picture from India, AKA a third world country. Thailand is also using thermoscan machines as a precautionary measure for people traveling from certain areas. Granted, airport temperature screening is not a perfect system but it’s the fact that we are doing next to nothing to try to smooth the rate at which people are getting infected, and when we do implement something, it ends up looking like the pictures from the American airports above.
Which brings me to my central point of this essay: WHAT. THE. FUCK. How is this happening in America? We have evidence of some solutions that seem to be more effective than others and we are creating a compromise of conditions that ultimately yields a lose-lose in terms of containment and economic destruction. How did it come to this?
Embracing Quarantine And Isolation
Life will never be perfect and life may never be the same. The massive disruption to our day-to-day existence will be a difficult adjustment filled with many challenges. I’m not trying to make light of this. Nevertheless, this is an opportunity. I’ve seen several references recently about Isaac Newton’s discovery of calculus while he was quarantined during the bubonic plague. We’re not all going to do this, but there will probably be several people who have a stroke of insight during this time of isolation that wouldn’t have otherwise. More importantly, we can make choices about how we embrace this time. Do we replace the autopilot of our buzzing lives with a different form of distraction, or do we try to be alone with our thoughts and confront them for the first time? Perhaps this is one of those times where we take inventory of the things that really matter. We can use this time of panic to make individual decisions that help combat the spread of the virus and help each other, without building a bridge of despair. That’s what I plan to do, and I hope you do too.
Sources:
https://www.bangkokpost.com/business/1875989/inbound-arrivals-face-mandatory-measures
Luca Dellanna
https://time.com/5802293/coronavirus-covid19-singapore-hong-kong-taiwan/
