With every day that passes, the war seems more scary. People will certainly continue to die. The guns… we don’t know yet. The governments around the world assume dictatorial powers to steam the epidemic. In France, the country that defined freedom and democracy, people have to fill an online form when they go out to buy bread, and are fined if they forget. Spain and Italy adopt similar stringent measures with police officers everywhere and measures include extreme prison sentences for leaving certain zones. In the UK, when all schools finally closed, Boris Johnson attempts to police families by advising grandparents to not spend any time with their grandchildren. Children are not sent to prison as of yet. It would be a great danger if the dictators will remain in power after this is all over. It could turn in revolutions and wars with guns if the measures continue for too long.
Quarantine cannot be a way of life. It will have to end within a month or so to still have manageable economies. Otherwise, supply chains will break in an irretrievable fashion, and there will be more deaths resulting from the measures taken than from the virus itself. While flattening the peak is crucial to making the pandemic manageable, one worries that when the quarantine is effective, not enough of the population is infected to gain immunity to the virus. Then if there is no vaccine that works, the death toll goes up again once the quarantine stops, and it has to be reinstated. It could thus be placing each country in dictatorship in conditions that cannot work over extended periods of time without complete economic collapse, more illnesses and eventually, bloodshed and hunger.
Below is my take on how various countries react to the coronavirus pandemic and the outlook for the future:
Germany
The quarantine works. There is vastly less social contact and less opportunity for the virus to spread. Germany will probably flatten the peak of the COIVID-19 pandemic. It may even be sufficient for the healthcare system to cope to some extent. They have also been successful at keeping people away from hospitals, thus allowing critical patients to be reasonably looked after.
There are over 13 000 confirmed cases today, 31 deaths and only 2 people in critical condition. The death rate still hovers around 0.2%. Germany introduced the quarantine earlier than Italy, largely because of aggressive testing that allowed a large number of cases to be seen, and before people started to die.
The Northern Provinces in Italy were quarantined on March 8, when Italy had 366 deaths and 6387 positive tests. On March 15, when Germany introduced the quarantine, it had only 13 deaths and 5813 confirmed cases. The deaths in Germany are a much better estimate of the number of active cases than the number of people tested. The dead are less likely to not be counted.
I think the goal of the German approach is to allow the population to be infected at a high rate, so the length time the economy is shut down is manageable.
What next? In the near future, we should probably see the testing capacity overwhelmed. That means, only severe cases will be tested. We will stop seeing the mild cases and the apparent mortality will increase.
Austria
They are testing at a similar pace to Germany. It has a smaller population of only 8 million people, and close to 2000 cases and 5 deaths. As my colleague Werner points out, it is notable that most people who tested positive are under the age of 60, and the death rate is close to Germany's 0.2%. Schools are closed. People are homebound.
China
The Chinese are protecting their claim to success by expelling foreign journalists and, perhaps, soon, they will also bring out the real guns — the sort that shoot bullets.
If the quarantine did work, there should be a new wave of infections as soon as the quarantine is lifted. Maybe the second wave will be better managed, but it will be there.
If the quarantine didn’t work, the infection is burning through all of China, albeit at a slower pace then Wuhan.
A 0.2% mortality rate means China would have to deal with 2 people in every thousand dead due to Covid-19. They would probably be the older and more frail. Maybe, their pre-existing conditions can be listed as the cause of death. The normal death rate is, roughly 0.1% a month. So, China would probably have twice the normal death rate for a few weeks when the disease strikes. I believe it is possible to hide that. The number of new infections and deaths seem to obey Xi’s orders too well.
Xi has also cemented his position as a dictator through this.
Russia
Russia is one of a kind. Their response to COVID-19 crisis was to change the constitution to allow Putin two more terms as president. It is certainly a good time to bring about the constitutional changes now, that the world and media is looking away due to the epidemic.
Romania, Bulgaria, some other Eastern European countries.
As the Romanian currency loses power, I worry that outside the Eurozone the economic impact will not be cushioned and that the economies will not recover.
Can quarantine be too stringent or start too soon? With 200 000 confirmed cases worldwide, there is no way to avert the epidemic. The quarantine does slow it down, but, if you slow it down too much, you will just postpone the problem. People have to become infected in order for herd immunity to stop the virus. It happens with all the other coronaviruses that cause common colds.
I think the goal is to allow the population to become infected at a relatively brisk pace, as quarantines can’t be kept in place forever due to economic reasons.
Is it reasonable to start the quarantine nationwide with under one hundred confirmed cases and, maybe a thousand or two that are not detected? Sure, it is a fast moving pandemic, but is it time wasted? Quarantine is expensive.
There are some very interesting changes to the Romanian law including very heavy jail sentences for spreading all contagious illnesses. They look very much like the sort of legislation a government would pass in times of war.
South Korea
Here, I would believe they did stop it. Thus, they should expect a 2nd wave of infections when they return to life as normal.
Italy
The deaths in Lombardy should stop growing soon. Lombardy has 10 000 000 people and, as of March 17, 1640 deaths. This is close to the 0.2% death rate I would expect in general. Sure, Lombardy has a relatively old population (like the rest of Italy) and they are therefore more susceptible. Furthermore, the hospitals are overwhelmed, and, therefore, a lot of people die in situations that would not have been lethal at other times.
A statistics of the dead show that 99% of those who died suffered from pervious medical conditions, which include high blood pressure (75%) and diabetes (35%). The average age of those who died is 79.5 and the median age of the infected is 63, which likely means that they do not have the ability to test effectively. So far 17 people under 50 died, and only 3 of those did not suffer from pre-existent conditions. The life expectancy in Italy is around 82, which is close enough to the average age of those who died to still see the coronavirus as a 'natural' vehicle for death.
Using my estimate of a death rate of 0.2%, I would predict nonetheless that the number of daily new deaths in Lombardy should stop growing soon as, probably, about half of the population has been infected. I don’t believe the deaths can come anywhere near 7% of the population. That would be 700 000 if everyone got infected or 350 000 if only half.
On an interesting note, Italy seems to have a lot of flu deaths. This may have to do with how people count the dead and how often they test older patients for flu before or after they die. In 2013-17, there were 68 000 flu deaths in Italy during a 4-year period. This would make colds a lot more deadly than usual in Italy than in the rest of the world. For example, the Swine Fu had a mortality of 0.02% worldwide, 10 times less than the 0.2% I expected for Coronavirus.
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