One-dimensional strategies to defeat the coronavirus could lead to more poverty and mental health-related deaths than lives saved if the strategy does not consider the economic implications of the pandemic, according to a new report.
The report published by the Actuaries Institute argues the Australian government “went hard and late” in its response to the coronavirus outbreak, but avoided disaster with its subsequent social-isolation measures.
Report authors from Rice Warner — Michael Rice, Alun Stevens, and Michael Berg — grouped the tactics used by other nations as follows:
- Do nothing much — the US and UK did this initially. Brazil and Iran continue to do this, causing the virus to spread “much further into their populations”. However, the report argues the tactic is “the least bad option” for countries with young populations that lack the economic resources to sustain lengthy lockdowns.
- Herd immunity while flattening the curve — Sweden is systematically allowing the virus to spread, while urging high-risk and elderly people to self-isolate. Despite this, death rates are rising. The UK’s brief herd immunity strategy was abandoned as the National Health Service couldn’t take the strain.
- Hard and late — Italy, Spain and France quickly ran out of medical resources and have suffered many deaths. The report argues the UK is at risk of joining this group. It says “adequate medical resources seems to be one of the most critical items to reducing the death rate”.
- Whack-a-mole — In the US, individual states are vastly differing in their responses. The report presents Bill Gates’ view that “until the case numbers start to go down across America … no one can continue business as usual or relax the shutdown. Any confusion about this point will only extend the economic pain, raise the odds that the virus will return, and cause more deaths”.
- Hard and early — South Korea, Taiwan, Singapore, New Zealand and Ireland have enforced social distancing and quarantined those carrying the virus in a bid to eliminate it, with extensive testing characterising the more successful strategies.
The exit strategy
The report argues governments should assume they will need to come out of lockdown long before a vaccine is available. In the case of Australia, governments must try to isolate “riskier lives” (and the people living with them), while allowing the “safer lives” to return to the economy.
The report proposes that Australia must:
- Recognise there are no risk-free options, with a carefully balanced approach between expanding economic activity and preventing the virus spreading exponentially. The report argues “one-dimensional strategies” which target COVID-19 without also considering the economic implications “will kill more people from poverty and mental health issues than they save from the virus”.
- Implement a phased introduction — perhaps by geographical region — and starting with schools.
- Have a plan to deal rapidly with localised outbreaks by identifying, quarantining and testing people who may have been exposed to infection.
- Have a plan to lockdown again (possibly by region) if the strategy does not work, while acknowledging that some people won’t follow the rules.
- Acknowledge that mild or asymptomatic cases could lead to further outbreaks.
- Implement full testing within regions to ensure local elimination, like that of the Italian town of Vo.
- Recognise that frequent heavy exposure kills healthy people – Australia must minimise people needing hospital care.
Australia should also maintain:
- Closed borders, with possible travel between cleared countries in the future, possibly starting with New Zealand.
- Limited travel between regions until they are “all clear”, or until reliable tests can be carried out before travel and at points of entry.