The coronavirus pandemic has been fascinating for numerous reasons, from the way in which healthcare systems have responded, to the policy methods used to try and sustain people and organizations while economies have been locked down.  Except, of course, not all countries have chosen to lockdown their economy, choosing instead to manage the crisis in other ways.

New research from Hebrew University explores how this approach has worked in Israel, and other countries.  Lockdowns are essentially the fallback of the somewhat medieval practice of quarantining the population for a long enough period to eradicate a disease, but it obviously brings a huge emotional and economic burden.  Experts predict mass unemployment to result, alongside increases in domestic violence, depression, and poorer access to healthcare for people with non-covid conditions.  Collectively, these factors are predicted to weigh on economies for years.

The research explores whether the lockdown was really necessary by using the belief that lockdowns help to ‘flatten the curve’ and therefore allow healthcare systems to cope with the number of covid cases they receive.

A different way

The researchers developed a model to calculate the occupancy of ICU beds during the spread of the virus.  The model takes account of the various stages of the disease and draws a distinction between different population groups to calculate the rate of infection and hospitalization for each of them.

The model was calibrated using real-time data gleaned from research into the pandemic from across the world, including their infection rates, hospitalizations and deaths.

The model revealed that adopting social distancing was key, with 14 days quarantine for every person developing symptoms, and thorough testing of those with symptoms were all crucial.  The model also suggests that strong hygiene measures, such as hand washing and the use of face masks in public places, can result in economies remaining open during the pandemic.

Capacity to cope

Also crucial to this approach is the ICU capacity in a country’s health system.  The model suggests that in nations where the number of beds is above 60 per million, then the above measures are enough to keep economies open.  If bed numbers are below this figure, a temporary quarantine of high-risk populations yields the best result.

The model was tested on Israel, and showed that without any lockdown and under the worst assumptions regarding the virus, the number of ICU beds for covid patients wouldn’t exceed 600, which is well within the 2-3,000 beds the country is believed to have.  This, the authors believe, highlights that the lockdown was largely unnecessary, and other approaches could have been deployed instead.

The model was applied to a range of other countries, including Sweden and South Korea, all of whom kept their economies open during the crisis, and their health systems had sufficient capacity to cope with the increased demand.

The researchers argue that the lockdown seems to have had a limited impact in countries such as Spain, Italy, and the United States, because each country suffers high death rates per year from seasonal flu, suggesting underlying factors that render these societies vulnerable, and that by the time lockdowns were issued in each country, the infection rate was already very high.

They believe that there will be examinations of the effectiveness, and the unintended consequences, of lockdown procedures in the aftermath of the pandemic, and they fear that it may be similar to the ‘Iatrogenis’ effect in medicine, in which the cure is more harmful than the disease.