Despite the unity the European Union is to provide members states, apparently no unified approach in dealing with the coronavirus threat exists. This is evidenced by different paths upon which Italy has already embarked and England is considering embarking upon. Comparing their approaches, we see one seeks to assume greater risks up front, leaving behind less fear about future resurgence, while the other assumes much less risk up front, leaving such fears to be dealt with later.
English Prime Minister Boris Johnson calls coronavirus "the worst public health crisis for a generation." But deciding how to confront it has placed him on the horns of a dilemma as to whether he delivers a risky one-two punch up front, aimed at preventing a resurgence, or opts for the safer approach that might have to confront a resurgence later.
Johnson is considering an approach that initially smacks of a leader being detached from one's people on a level not witnessed in Europe for over two centuries. In 1798, French Queen Marie Antoinette infamously said as her people starved, "Let them eat cake." Today, Johnson's coronavirus plan says to his people, "Let them get sick."
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Recognizing the coronavirus advance – like an invading army – cannot be stopped, Johnson is considering an option that puts the focus on mitigation rather than – as does the plan embraced by Italy and the U.S. – on suppression. Thus, the U.K. may implement a plan that manages the population's exposure to and treatment of coronavirus incrementally in hopes of developing a "herd immunity" over time. But, this approach is made on certain risky assumptions that, if inaccurate, could potentially spell disaster.
The plan assumes at least 80% of England's population eventually will be impacted by coronavirus, regardless of what the government does. So, rather than leaving population exposure to chance, the U.K. is considering a more controlled, incremental approach. And, because younger people will not get very ill, it involves using them – by means of opening/closing schools and controlling large scale events – to facilitate the infection of low-risk people as needed for the good of the herd. As this is done, it would only leave the older population and those with weakened immune systems isolated.
Such controlled population exposure is much like controlling the water flow from a faucet. But there is a purpose to this madness. It seeks to avoid a resurgence of the flu as was experienced in the 1918 epidemic. The plan gradually allows an immunity to be built up among the general population so any later resurgence by those who avoided exposure during regulated quarantines could be more easily managed as fewer people are susceptible.
Success of an incremental exposure approach depends on authorities initially maintaining an equilibrium between incoming and outgoing hospital patients, thus making medical attention much more manageable. But, obviously, there are inherent risks in accurately managing this equilibrium that, in turn, depends on accurate and timely infection rate data.
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Supposedly, as patients are treated, other mildly ill people are recovering so the general population grows a higher percentage of immune people unable to infect others. Put back out to pasture, they contribute to building up the herd's immunity.
Those advocating this approach believe countries like Italy, in isolating their populations from exposure, may only be forcing coronavirus underground, lying dormant, left to rear its ugly head later. People who avoided it earlier by effective quarantines would then be susceptible to its resurgence as happened in 1918.
It is ironic that while one country's approach seeks to stop cornoavirus infection, another's would seek to infect as many low risk people as possible to develop immunity. Clearly, by adopting the latter, England would hope to avoid a pandemic resurgence roller coaster ride that could once again disrupt daily life and create economic chaos of the kind we are witnessing today.
However, a new study on the U.K.'s mitigation approach is now causing Johnson to reconsider this option as death toll projections climb to 250,000 and the success of being able to maximize health care capacity appears to be more questionable than was originally thought.
The approach to fighting coronavirus in Italy and the U.S. is one of suppressing the threat. As the U.K. faces a fork in the road in determining how it will fight the epidemic – with one leading to suppression, the other to mitigation – it hopefully will opt for the road more traveled.