On March 10, Tomas Pueyo published a widely read and praised article called Coronavirus: Why You Must Act Now. Yesterday, in the wake of the Imperial College paper and the criticism of it, Pueyo has published a second article: Coronavirus: The Hammer and the Dance. I urge you to read it — it’s sobering yet hopeful. A summary:
Strong coronavirus measures today should only last a few weeks, there shouldn’t be a big peak of infections afterwards, and it can all be done for a reasonable cost to society, saving millions of lives along the way. If we don’t take these measures, tens of millions will be infected, many will die, along with anybody else that requires intensive care, because the healthcare system will have collapsed.
As the title indicates, Pueyo and his collaborators are suggesting an approach that combines initial aggressive action followed by a longer period of efficient vigilance. First comes the Hammer — we use aggressive measures for weeks, giving our healthcare system time to ramp up & scientists time to research the hell out of this thing and for the world’s testing capability to get up to speed.
And then we Dance.
If you hammer the coronavirus, within a few weeks you’ve controlled it and you’re in much better shape to address it. Now comes the longer-term effort to keep this virus contained until there’s a vaccine.
This is probably the single biggest, most important mistake people make when thinking about this stage: they think it will keep them home for months. This is not the case at all. In fact, it is likely that our lives will go back to close to normal.
But, here’s how the Dance works:
How come South Korea, Singapore, Taiwan and Japan have had cases for a long time, in the case of South Korea thousands of them, and yet they’re not locked down home?
In this video, the South Korea Foreign Minister explains how her country did it. It was pretty simple: efficient testing, efficient tracing, travel bans, efficient isolating and efficient quarantining.
That way, most people aren’t locked down, just those who need to be — the sick, the people who have been with those who have gotten sick, etc. Most people can go back to work, back to fairly normal routines.
I call the months-long period between the Hammer and a vaccine the Dance because it won’t be a period during which measures are always the same harsh ones. Some regions will see outbreaks again, others won’t for long periods of time. Depending on how cases evolve, we will need to tighten up social distancing measures or we will be able to release them. That is the dance of R: a dance of measures between getting our lives back on track and spreading the disease, one of economy vs. healthcare.
This piece in the Atlantic, This Is How We Can Beat the Coronavirus by Aaron E. Carroll & Ashish Jha, advocates for essentially the same approach.
We can create a third path. We can decide to meet this challenge head on. It is absolutely within our capacity to do so. We could develop tests that are fast, reliable, and ubiquitous. If we screen everyone, and do so regularly, we can let most people return to a more normal life. We can reopen schools and places where people gather. If we can be assured that the people who congregate aren’t infectious, they can socialize.
We can build health-care facilities that do rapid screening and care for people who are infected, apart from those who are not. This will prevent transmission from one sick person to another in hospitals and other healthcare facilities. We can even commit to housing infected people apart from their healthy family members, to prevent transmission in households.