UK: On second thought, our coronavirus strategy could kill 250,000 people

Say what you will about Trump’s approach to this crisis (which got noticeably better today), at least it wasn’t “Let people get sick.”

Which was, it seems, the UK’s strategy until this afternoon.

Sort of. Boris Johnson’s government believes that mass infection of the population is inevitable and, what’s more, could actually produce a much worse outbreak than the current one this fall via a “second wave” of contagion, as happened with the flu in 1918. Solution: Use the current outbreak as an opportunity to let healthy younger people get infected and build “herd immunity” among themselves. Don’t shut anything down. Don’t try to test every suspect case. Rather, have the old and the chronically ill quarantine themselves for four months or more while people who are less at risk of dying are out and about, passing the virus among themselves. By the time senior citizens emerge in the fall, many younger Britons will have already had the disease and recovered, which will make them immune from contracting it again. That means they won’t need hospital treatment at a moment when seniors will be falling ill from the disease and crowding ICUs.

In other words, Britain was going to try to control the spread with an eye to maximizing health-care capacity.

Just one problem. A new study shows that the first wave of mass outbreak among “healthy” people wouldn’t have been so healthy.

The UK only realised “in the last few days” that attempts to “mitigate” the impact of the coronavirus pandemic would not work, and that it needed to shift to a strategy to “suppress” the outbreak, according to a report by a team of experts who have been advising the government.

The report, published by the Imperial College COVID-19 Response Team on Monday night, found that the strategy previously being pursued by the government — dubbed “mitigation” and involving home isolation of suspect cases and their family members but not including restrictions on wider society — would “likely result in hundreds of thousands of deaths and health systems (most notably intensive care units) being overwhelmed many times over”.

Glad they figured it out in the final few days before committing to it fully, when they’d be beyond hope of shifting to a social-distancing strategy that might help slow the disease down.

William Hanage, an epidemiologist at Harvard, has a piece out today titled, “When I heard about Britain’s ‘herd immunity’ coronavirus plan, I thought it was satire.” What was wrong with the UK strategy? Well, as this Atlantic piece explains, it’s an open question at the moment whether contracting and recovering from COVID-19 confers immunity at all, and if it does, for how long. Immunity among SARS patients lasts a long time; immunity among patients who’ve contracted other coronaviruses is much shorter. Imagine the Brits letting tens of millions of younger people get the disease, watching many thousands of them die, and then discovering that … they’re actually no longer immune once the “second wave” begins in the fall.

Another problem. Obviously, many elderly and chronically ill Brits will need help to function in their day-to-day lives over the next four months while they’re in self-quarantine. Who’s supposed to be helping them while everyone else is out getting infected? “Who do you think works at those nursing homes? Highly trained gibbons?” said Hanage.

Yet another problem: “The [British] government has thus far recommended that people with mild symptoms isolate themselves, even though people can clearly spread the virus before symptoms appear.” Not only can they spread the virus before symptoms appear, one study claims that people are at their most infectious at the earliest stages of the illness, possibly before they’re even showing symptoms. In other words, the UK’s hope of limiting the contagion during its “first wave” by asking only symptomatic younger people to self-quarantine is flawed from the start. Preemptive social distancing by the general population is the only way to slow the spread.

They were plotting a long-term strategy to cope with a problem that’s about to plunge them into an Italy-style catastrophe in a matter of weeks. Why not try to delay the catastrophe for as long as possible and hope that the collective ingenuity of the world’s scientific community comes up with a treatment in the meantime that will grossly mitigate casualties once the illness is spreading rapidly?

The Brits have at least steered out of the path of the oncoming train at the last moment. The Dutch appear to be sticking to the strategy:

If infection is spreading more or less freely in the Netherlands, how can any country allow travel from the Netherlands? Under EU rules, citizens of member nations are supposed to be able to travel freely across each other’s borders. That can’t possibly continue in a system where they’re following wildly different mitigation strategies.

There’s one interesting wrinkle to Britain’s now aborted approach: Behavioral scientists advising Johnson have warned him that people won’t tolerate social distancing forever. The initial idea, it seems, was to try to time the government’s calls for widespread social distancing to when the “first wave” of the disease was likely to be reaching its peak, around 14 weeks from now. How many millions of people would have been already infected by the 14-week stage under the original strategy, thus minimizing the benefits of social distancing at that late point, God only knows.

Here’s a, er, viral video of Italians describing messages from the future that they wish they could have sent themselves 10 days ago. The obituaries in local newspapers go on for many pages. A new proposal prepared by a crisis management team in Turin calls for flatly denying treatment to anyone who’s 80 or over or in poor health in the name of preserving scarce resources.

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