The sad truth about this pandemic is that people are going to die. This is not about a painless solution its about finding the one that minimizes total human suffering, be that economic or otherwise.
The only real way we get back to normal life is...
Solution 1- An effective Vaccine or Treatment: The problem with this solution is that we don't know we will every have a vaccine or treatment and if we get one that will probably be 18 months from now. Solution 2- Herd Immunity: The issue with this strategy is that it requires letting people get sick.
Bonus Solution- Eradication (not really viable): This is not really an option anymore. When it only takes one person to cause all this and with tens of millions with the virus and with a 20-60% rate of asymptomatic spread the ability for us to eradicate the virus is about 0.
Strategy 1: Hunker Down and Wait
Right now some people are thinking we should severely limit our economic output while we wait for vaccine/treatment (which may never come or that likely will take a long time). But is there a cost to this?
Economic lockdowns have a cost as the longer and more severe an economic lockdown the higher the risks become of long term damage. According to the UN an economic crisis could result in MILLIONS of deaths world wide due to famine in 3rd world countries not to mention the instability, and other health problems that increase due to higher poverty levels. Short term economic lockdowns may be reasonable. Long term economic lockdowns are not. So what do you do if the only way to stop the spread is via significant economic shutdown? Do you just let the spread happen? Yes... sort of.
Strategy 2 : Rip off the bandaid, the Sweden model.
Someone online recently showed me that Swedens death rates were higher than some of their Scandinavian neighbors. Besides pointing out that Swedens deaths per million were lower than UK, France, Netherland and Switzerland, I also explained that Sweden may be totally back to normal in a month. Yes thats right. There are some credible estimates saying Sweden may reach herd immunity in a month.
Essentially, what Sweden is attempting is to "rip off the bandaid". Yes in the short term it will hurt but if they let the virus spread in a controlled way they can take short term pain but then be done with this mess forever while other places spend the next year or 2 years dealing with this and all the economic issues that accompany it.
Herd Immunity
Based on the best available data let's assume that meaningful herd immunity requires 70% of the population to get infected a mortality rate of 0.2% and consider what that might look like. (Note: True Herd immunity may be higher than 70% however at 70% the infection would greatly slow to a manageable level and even when you get over 50% the spread would slow considerably)
Herd immunity model 1 (no controls)
If we just let people return to normal life and do nothing to protect the vulnerable we would potentially have 245 Million Infections and about 400,000 - 600,000 people would die. Based on our lethality rates we see this really is our new worst case scenario for the United States. It's truly a tragic number and far too high. So can we drop it? Yes. Herd immunity model 2 (Protect the vulnerable) If we let low risk people return to normal life but we protect the vulnerable what would happen is we would let the virus spread through the 70% of our population that was most healthy. The reality is that the virus poses an extremely low risk of death to people under 50 without pre-existing conditions. So, what we could do is allow a controlled spread of the virus throughout those who are at lower risk by opening back up economic activity but encouraging society to do all they could to protect those most at risk. By isolating and protecting these people as we work toward herd immunity we could likely save the economy and and keep our death toll round 80-150K over the course of the next 18 months as we work toward a vaccine. The cost of avoiding herd immunity
The reality is that every time a person gets the virus and recovers they become a human shield to the vulnerable. As we get more human shields the world becomes less risky for the vulnerable. On the other hand, if we avoid creating these human shields we leave the environment ripe for rapid spread of the virus and it makes it harder to protect the vulnerable. In addition, the preferred method to stop herd immunity is economic shutdown, which if carried on to long causes issues that are more serious than the virus itself. The unknowns So to be totally fair we don't know for sure that after a person has covid 19 they then become immune. And we don't know how long that immunity lasts. However, based on what we know about viruses we can be confident that it will grant immunity for anywhere from 6 months to many years. This is a considerable issue but until time passes we have no way of knowing this information and we must make decisions based on the information we have. Summary In the end we can either hunker down and wait while dealing with the extreme economic social and health risks or we can save our economies and confront the virus head on, managing the spread while we develop an army of human shields that protect the vulnerable as we work toward either a vaccine/treatment or herd immunity so we can finally put this ordeal behind us all.
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