Covid-19: Path to ease restrictions poses difficult questions

The federal government continues giving confused, mix signals which initially delayed the locked down in three other provinces and Islamabad. Critical of Sindh for the restrictions, the prime minister is now aggressively pedaling to reopen the country as it cannot remain under lockdown forever, conveniently ignoring that the coronavirus cases have crossed the threshold levels to multiply exponentially from awfully low number of tests with 88 deaths. This we are reasonably sure of as the government informed the Supreme Court of the trends telling them that by April 25th, SARS-CON-2 (Covid-19 virus) would affect 50,000 people across the country. This model shows that we are staring at an unfolding disaster a fortnight from now requiring us to have a daily capacity of at least 50,000 tests to isolate the infected from the healthy ones and begin a symptomatic treatment where needed. But we are much below on the ladder primarily due to non-availability of test kits from the international markets because of the slumbering and reluctant government response to engage international market forces, for medical supplies, early in the day.

At this point of time, science denial behavior like that of President Donald Trump and UK PM Boris Johnson (even got admitted to hospital) turned their countries into epicenters of coronavirus is extremely risky. The populist rhetoric that “lockdowns will irreversibly damage the poor” has a perilous underlying message to “worry about economy and ignore personal safety.” Truly the grim domestic and international economic outlook is a nightmare scenario, giving endless headaches to governments, businessmen and low wagers which only gets compounded with absence of adequate health system and a comprehensive social safety net.

But would unhealthy workers or those who can turn colleagues sick (asymptomatic ones) drive economy, before thousands become sick collapsing the economy altogether. Historic facts tell that those who remained healthy in wake of an epidemic, helped economy rebound strongly, but those who hesitated in timely clamping down on public movements in the wake of 1918 Spanish Flu suffered from severe economic damage and massive deaths.

Crisis defines leadership. The prime minister must rise as a leader beyond narrow bipartisan considerations and take informed and difficult decisions. This is the time for the leadership to bring heads together to remove governance and capacity bottlenecks for strategic decisions about the safe treatment options and easing restrictions differentially based on mathematical models predicting the behavior of the virion.

Restrictions and aggressive tests are the only reliable critical step to break the chain of infection to be followed by aggressive testing to isolate the sick as done successfully by South Korea, Singapore, China, Hong Kong and Germany and particularly poor countries like Peru, El Salvador, Kenya and particularly Nigeria that started tests and restrictions way back in February. Discounting the medical opinion against easing restrictions without widespread testing would have a massive political and social cost and we must not be oblivious to the virulent resurgence of a second wave of coronavirus in China, Hong Kong and Taiwan who returned to business as usual too early in the day, but have now adopted newer and stringent measures.

Globally, similar economic pressures are shaping thoughts and policies. The US and UK political leadership was tempted to open up cities once “herd immunity,” a paper concept, under which when a very large number of people develop a certain level of resistance following the initial infection, the remaining population also acquires it. Both advocated it against the backdrop of high economic cost of the closures and the frustration people develop living under prolonged restrictions.

But London quickly backtracked realizing the Covid-19 virus would potentially litter streets, hospitals and mortuaries with millions of corpses and wreak havoc with the health system far more advanced than ours. Now even Washington, under Trump who felt the country is heading towards depression, is reconsidering it.

Life under restrictions pose difficult questions but the answers are more complex. We are practically staring into a black hole as it is the virus no one knows much about. Nobody, anywhere safely knows how long the restrictions would last. Americans are preparing for multiple periods of social distancing. Hong Kong is experimenting with alternatively tightening and relaxing restrictions to bring the contagion under manageable control. Germany has proposed immunity passports, allowing only those to work who have developed immunity, but require 100,000 experiments to understand if the immunity would last long enough or drop after a month or five months.

Against the backdrop of lingering debate, valuable guidelines to the economy-life paradox were found by the Booth School of Business at University of Chicago when they quizzed 44 economists if they expect “a very large contraction in economic activity” as a result of antivirus policies, whether the economic impact would be even worse if stringent rules were abandoned while “the likelihood of a resurgence in infections remains high,” and whether the US should invest more in building temporary hospitals, enhance testing and paying for more masks and ventilators. Stanford’s Darrell Duffie responded he expects high economic damage in the form of additional loss of human life. MIT’s David Autor said: “We could overdo this lockdown! (But we could under-do it as well.).” Wrote Bengt Holmström of MIT: “Crazy to give up fight now when worst still ahead.”

People definitely need answers for how long would the restrictions last without food on the table. The medical science has no timeline for that either. But they must be guided by the governments to understand without strict discipline, their health and those of their loved ones would not outlast the pandemic. The government needs to ensure indiscriminate social support for the poverty stricken, an area we always neglected and here we are. It is not the time for impulsive, incoherent political decisions without losing sight of the moral compass. We are not alone in quandary, the entire world is jostling with the riddle, but recklessness would turn it tragic.