Why Containment Couldn’t Work

I wish you could see the eye-catching infographics in this article at the Wall Street Journal by Rob Barry, Joel Eastwood, and Paul Overberg. Some publications aren’t hiding their COVID-related content behind their paywalls as a public service. Maybe the WSJ is doing the same.

The article is mostly infographics so it’s hard to excerpt. Here are its opening paragraphs:

The Wall Street Journal interviewed disease detectives and reviewed hundreds of pages of new research to piece together how the coronavirus infiltrated the wealthiest nation on earth. The latest genetic, epidemiological and computational research suggests it was spreading inside the country before anyone started looking.

How did this happen?

It goes on to document, practically on a day by day basis, starting January 2, 2020, the spread of the disease in the United States as well as the presumed sources from which it spread. The short version supports a claim I made long ago: for the containment strategy actually to have worked we would have needed to ban all international flights arriving in the U. S. regardless of where it originated as well as all ship traffic originating elsewhere no later than the middle of December 2019. Most lockdowns in the U. S. didn’t begin until after community spread was well under way and they were so political in their structure as to be doomed to poor results from the outset. There is a long string of ifs that would have needed to happen for that to be otherwise. If the Chinese authorities had not suppressed bad news from the outset and if they had been more forthcoming from the outset and if they had banned flights departing China, the virus might have been contained in China. If it had been politically possible to ban all international travel inbound to the U. S. by the middle of December, we might have avoided it spreading in the U. S.

Not only does that explain why containment couldn’t work, it also explains why it was so much more effective in New Zealand. New Zealand is a small, socially cohesive country out in the middle of nowhere much more isolated from the global economy than the U. S. Which brings me around to a question posed by a frequent commenter here:

Here’s a thought exercise — with the exception of sub-Sahara Africa, there is a correlation between the geographic distance from Wuhan, China and severity of the pandemic. i.e. East Asia and SE Asia better then Eastern Europe / Mid East / India, Western Europe worse then Eastern Europe, North America worse the Europe, South America (the opposite side of the Earth from Wuhan) the worst.

Could that correlation be related to exposure to some other factor “X” that provides cross-immunity?

It’s not geographic distance but effective distance or economic distance that makes a difference. The cases per million population in Zimbabwe are higher than in most African countries because it has closer economic ties with China than most African countries.

While I’m on the subject of strategies that won’t work, doesn’t the outbreak at the White House illustrate why mass rapid testing won’t work? Not only does the instant test that produces no false negatives and no false positives not exist, the longer the test takes to produce results the more reliable it probably is. The outbreak at the White House is being used to show how avoiding wearing masks and social distancing leads to spread of the virus but I think it is an even stronger indication of the moral hazard that obtains through excessive confidence in repeated rapid testing.

Would more testing help? Sure. But it’s no panacea. IMO our public priorities should be (in descending order of importance):

  • isolating the most vulnerable
  • more effective treatment for COVID-19
  • a safe, effective, affordable vaccine for SARS-CoV-2
  • fast, effective, affordable tests for SARS-CoV-2
  • more testing

Of course our public priorities have been almost the reverse of that.

9 comments… add one
  • Greyshambler Link

    More effective treatment would be the most immediate and acceptable help that could happen. People may decline a vaccine but they won’t decline treatment when they are ill.

  • steve Link

    Forgot to addd distancing and masking. Other wise good. I would also add indoors large groups since I think outdoors is usually pretty low risk but that is more questionable.

    Steve

  • I chose my words carefully. I see wearing facemasks and social distancing as being private or, perhaps, personal priorities rather than public priorities. I wear a facemask when indoors and/or in a store because they have been mandated and for social reasons. I only wear a mask out-of-doors in one place: Evanston, again, for social reasons. I maintain social distancing primarily for social reasons. They might become public priorities if the appropriate measures were enacted into law and enforced but it’s hard for me to imagine their being enforced any more effectively than jaywalking is. It’s against the law but practically never enforced.

  • CuriousOnlooker Link

    I argue economic closeness to China was related to when the outbreak started — but not the severity of the pandemic.

    For example Taiwan, South Korea, Japan, Vietnam, Thailand, Malaysia are the countries most intertwined with China economically; and they reported the earliest outbreaks outside of China, yet had the mildest pandemics.

    One other comment — “isolating the most vulnerable” is really more then just isolating nursing homes. It includes how to isolate people that are infectious or potentially infectious. If I were king; I would figure out how to get as many mild / asymptotic cases to stay at a hospital instead of at home.

  • Greyshambler Link

    President Biden will order all those “ifs” done retroactively.

  • steve Link

    “I chose my words carefully. I see wearing facemasks and social distancing as being private or, perhaps, personal priorities rather than public priorities.”

    They have public consequences. Distancing and masks reduce spread. Not 100% effective but they help.

    Of note, we are now seeing hospitalized patients refusing to wear masks in the hospital. I have one provider at home now confined to her room because she foolishly rushed in to help a decompensating pt who refused to wear a mask. Hoping she doesnt test positive. At least that pt maintained her private rights.

    Steve

  • Everything has public consequences. Considering everything to be subject to public policy is an authoritarian position, rejecting the notion of fundamental rights.

  • steve Link

    Straw man. I didnt say everything. In this particular case they matter.

    Steve

  • Drew Link

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