What We Don’t Know About COVID-19
Two new studies bring more questions than answers.
Dave Schuler has been a fair-minded analyst of public policy surrounding COVID-19 internationally, nationally, and in his own Illinois. Two of his most recent posts are especially interesting.
He points us to Elaine He’s report at Bloomberg titled “The Results of Europe’s Lockdown Experiment Are In.” She looks at “the relative severity of Europe’s restrictions based on work done by the University of Oxford‘s Blavatnik School of Government, which tracks a range of measures and scores how stringent they’ve been each step of the way.” The findings are rather confounding.
While not a gauge of whether the decisions taken were the right ones, nor of how strictly they were followed, the analysis gives a clear sense of each government’s strategy for containing the virus. Some — above all Italy and Spain — enforced prolonged and strict lockdowns after infections took off. Others — especially Sweden — preferred a much more relaxed approach. Portugal and Greece chose to close down while cases were relatively low. France and the U.K. took longer before deciding to impose the most restrictive measures.
But, as our next chart shows, there’s little correlation between the severity of a nation’s restrictions and whether it managed to curb excess fatalities — a measure that looks at the overall number of deaths compared with normal trends.
In Europe, roughly three groups of countries emerge in terms of fatalities. One group, including the U.K., the Netherlands and Spain, experienced extremely high excess mortality. Another, encompassing Sweden and Switzerland, suffered many more deaths than usual, but significantly less than the first group. Finally, there were countries where deaths remained within a normal range such as Greece and Germany.
Yet the data show that the relative strictness of a country’s containment measures had little bearing on its membership in any of the three groups above. While Germany had milder restrictions than Italy, it has been much more successful in containing the virus.
The overall impression is that while restrictions on movement were seen as a necessary tool to halt the spread of the virus, when and how they were wielded was more important than their severity. Early preparation, and plentiful health-care resources, were enough for several countries to avoid draconian lockdowns. Germany, with better testing and contact tracing and more intensive care units than its neighbors, could afford to keep the economy a bit more open. Greece, by acting quickly and surely, appears to have avoided the worst, so far.
Lockdowns as such are not an effective method of reducing mortality but they are an effective method of reducing economic activity. It doesn’t matter much how early they were imposed or how strict they were.
1. Lockdown measures as such do not reduce excess mortality. Despite imposing lockdown measures as early as February, Italy still suffered considerable excess mortality.
2. Confounding factors are probably more significant in reducing excess mortality than testing or contact tracing. Confounding factors include demographics, the level of health of the populace, the robustness of the health care system, who knows how many other factors, and, probably dumb luck.
I continue to believe that we should be looking more closely at Portugal’s example. They imposed their lockdown measures later than most and, initially, rather lightly, they’re opening up earlier than many, and their excess mortality has been relatively low. Maybe Portugal’s success is just a matter of being small, comparatively isolated, and having high social cohesion.
As we’ve seen from the case of Sweden, the fear created by the pandemic seems to be enough to shutter the economy with or without a lockdown.
But I agree that the severity of the lockdowns doesn’t seem to matter all that much. Possibly, it’s just because it’s next to impossible to make apples-to-apples comparisons. Portugal’s population is roughly that of the New York City metropolitan area and its largest city, Lisbon, has fewer residents than Sacramento.
Dave also points us to a report from Rachel Rettner in LiveScience titled “Antibody that inhibits the new coronavirus discovered in patient who had SARS 17 years ago.”
A person who had severe acute respiratory syndrome (SARS) 17 years ago could help scientists in the search for therapies to fight the new coronavirus, SARS-CoV-2, according to a new study from a biotech company.
The study researchers found that blood samples from this patient, who had SARS in 2003, contained an antibody that also appears to inhibit SARS-CoV-2.
Antibodies form part of the body’s immune response to pathogens. This particular antibody, which the researchers call S309, showed a strong ability to bind to and disable the “spike protein” on SARS-CoV-2 that allows the virus to enter cells, according to a statement from the University of Washington School of Medicine, which was involved in the research. Multiple authors on the study work for Vir Biotechnology, and the company is developing a therapeutic based on the study findings.
Dave’s takeaway strikes me as right:
We have a pretty good idea of which countries saw the greatest prevalence of SARS cases (China, Hong Kong, Taiwan, South Korea, et al.)
I would like to suggest that we should be prepared for the possibility that the reduction of severity in the outbreaks of COVID-19 in Hong Kong, Taiwan, and South Korea may be a result of more widespread distribution of SARS antibodies in those place than has been commonly recognized as well as the actions those places have taken in response to SARS-CoV-2. I don’t even know how you’d go about disaggregating those two factors.
We and the Europeans haven’t been willing to implement the measures that the countries mentioned above have taken to combat the virus but it’s not beyond the realm of possibility that even were we to do so we still wouldn’t get the same results.
The bottom line is that we’re stumbling through this crisis without much to go on.
That virtually every country on earth decided that some form of lockdown and social distancing were a reasonable response would seem to indicate that these were reasonable responses. And common sense would tell us that it’s less likely that a disease spread from human-to-human contact will spread if there’s less human contact.
But the fact that the severity of the lockdowns doesn’t correlate with the increased mortality numbers would seem to demonstrate that it’s just one variable in a complex equation. And we’re still discovering new variables, like prior exposure to other SARS variants.