How most of the West got the pandemic so badly wrong?

It takes a lot to shock me nowadays, but the failure of most OECD countries
over this pandemic I do find shocking. Not in the case of the UK
under Johnson, the US under Trump, Brazil under Bolsonaro or India
under Modi, as the reasons for their failures are all too obvious.
After all Johnson had the
idea
before the pandemic that the UK should be the one
country to opt out of restricting the economy to save lives, and that
this would give the UK some big global economic advantage. Only when
the implied NHS chaos was explained to him did he change his mind.
What I find shocking is the failure of mainland Europe almost without
exception

A few countries did
completely understand what they needed to do, which was to follow an
elimination strategy. If you are still not convinced of the wisdom of
this strategy, a recent article
in the Lancet should help. It compares the small number of OECD
countries (Australia, New Zealand, South Korea, Iceland and Japan)
that did undertake an elimination strategy (sometimes called
zero-COVID) with most of the other OECD countries that did not. Here
is the first chart from that study:

Quite simply the
elimination strategy is infinitely better at avoiding COVID deaths.
It is infinitely better at avoiding cases of long-COVID. It is also
better for the economy as the chart below from that study shows (the red line represents the elimination
countries):

Elimination
countries saw a smaller fall in GDP, and a faster recovery at the end
of 2020 and so far in 2021. The big lie perpetuated in the majority
of OECD countries that failed to go for elimination is that there was
a health/economy trade-off. As this table shows that is not true, and
as I argued
quite soon after the pandemic hit we knew it was not true. The reason
it is not true is very simple: if you fail to lockdown hard and early
to eliminate the virus, it will carry on growing exponentially either
forcing a much longer and stricter lockdown later on and/or people
will just stay at home anyway which will have a huge impact on the economy. This is shown clearly in the final chart from
the Lancet article:

Were the countries
that adopted elimination worse off in any way? As far as I can see in
only one way: freedom of overseas travel. Elimination requires hotel
quarantine or just travel bans to stop COVID cases coming in from
abroad. Of course if more countries had adopted an elimination
strategy, the less severe those travel restrictions would be because
travel would often be possible between elimination countries.

Could the extent of
international travel explain why most OECD countries rejected
elimination? There is one major reason why this may be important. The bigger your tourism industry is, the bigger is
your loss if you essentially end it. However it is
difficult to argue that this provides a clear difference between the few
countries that have adopted an elimination strategy and those who
have not. France certainly has a large number of inward international travellers per head of population compared to most countries, but not
compared to Iceland. Germany has a similar level of inward tourism
per head as Australia and South Korea, and less than New Zealand. So
while pressure from the tourist industry and the airline industry
matters, it does not seem critical in preventing countries adopting
an elimination strategy.

Having heard
countless arguments about why the elimination countries can adopt
elimination and other countries cannot, I’ve concluded that looking
for any kind of demographic explanation is futile. It is, I believe,
much more productive to look at the quality of expert advice received
and the quality of governments involved. With just one exception, all
the countries that have adopted anything like an elimination strategy
(including outside the OECD like China and Vietnam) are in or are close to what we
call the far East, and have had recent experience with severe
pandemics. Australia and New Zealand have undoubtedly been influenced
by that experience. In contrast the West has not, and is more used to
pandemics involving much less fatal flu viruses.

The exception is
Iceland, but it is a small island run by a pretty rational government
with excellent testing facilities. New Zealand also had good advice
and a rational government. COVID policy in Australia is state
specific, and it was states run by Labour that led the way in
pursuing an elimination strategy and closing their state borders.

However it is not
the failure to adopt an elimination strategy that I find shocking.
After all there was no clear consensus among epidemiologists in Europe in favour of elimination before the pandemic started, and there still
isn’t even today despite the evidence above. What is true is that this evidence requires before the next pandemic that some consensus is
reached among epidemiologists in the West about when (in terms of how
infectious and deadly a virus is) eradication becomes a sensible
strategy.

What I find shocking
is the failure of governments to learn a much simpler and less
controversial point, which is that when cases start increasing you
lockdown hard and quickly. In other words the second and now third
waves we are seeing in Europe is a terrible indictment of the quality
of the politicians leading these countries. No one disputes that if
countries had locked down earlier and with full severity during the
first wave less people would have died and the lockdown would have
lasted for less time. (Eradication is about going the extra mile
after any lockdown has brought cases right down.)

Yet despite this
obvious truth, European politicians have failed to implement this
lesson. Failed not once, but twice. In the cases I know about they
rejected advice from experts, and tried to get away with weaker
restrictions that failed to stem the rise in cases. As I have
previously speculated
during the second wave, one way to explain it is that businesses hit
by lockdowns have a loud voice heard by governments, while the
elderly and medics have a much weaker voice. But that explanation is
hardly an excuse, particularly as governments are simply responding
to myopia or lack of understanding by those pushing against lockdown.

One answer to this
political failure is to get better politicians, but that is hard to
do. Another which should be much more achievable is to give a greater
and much more public voice to experts, so that politicians find it
much harder to deviate from their advice. But we also need, and this
is a sentence I never expected to write, to give loss of life a
greater weight in political calculations. The average COVID death
leads to between 10 and 20 years of life lost (e.g. here),
but those lost years seem to carry far too little weight among the
politicians of the West. That is shocking.

Original Article

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