The early answers are starting to emerge about when to expect the coronavirus crisis to end. After all, we all want to get back to ‘normality’ as soon as possible.
It is best to look at what has already happened (this article is being written on 7 April 2020). Wuhan is being slowly released from lockdown, ten weeks after first being quarantined in a severe regime on 23 January. Transport links were closed and people were confined at home. Now, with the aid of a QR-code-based phone app system which allocates users a green, yellow or red category according to a user’s location, health information and travel history1, restrictions are slowly being lifted and business is starting up again. Critically, those areas that are still suffering from ongoing infections remain under lockdown: medium and low-risk areas have lifted restrictions.2 However, officials are concerned about the risk of a second wave of infections. The threat of a rebound in Wuhan remains high, according to Wang Zhonglin3, chief of its Communist Party, ordering residents to avoid leaving their homes unless necessary. The number of new daily cases in China, according to official statistics, is fewer than 50, ironically with the majority imported from abroad.
South Korea did not have a lock-down, instead choosing to contact-trace every infection from the start, and rolling out mass testing. Daily new cases are now below 100, down from beyond 600 at the height of its outbreak. It took around six weeks (February 21 to 1 April 2020) from the day when new cases rose above 100/day to when they are back to below 100/day.
In Spain, the last day when the number of daily new cases was below 100 was on 5 March 2020. The country went into lockdown on 15 March 2020, with no-one allowed to leave their homes for anything that is not essential (and even exercise is not allowed). Daily new cases peaked at above 8000 per day between 26 March 2020 and 2 April 2020 and are now reducing fast. Spanish Prime Minister Pedro Sanchez said “Flattening the curve was our first objective. We’re getting close. The next objective is to reduce infections even more until the number of new contagions is lower than the number of people recovering each day. Once the curve is clearly descending, we will open a second phase - a progressive return to new social normality and the reconstruction of our economy.” However, the strict lockdown will continue until at least 25 April 2020 - around six weeks from the start.
Italy went into lockdown on 10 March, when it was already at a level of around 2000 daily new cases. The first day with more than 5000 new infections was 19 March 2020, and with new daily infections now steadily reducing, the last day with a daily new infection rate above 5000 was 29 March 2020. Citizens have been barred from all but essential travel and only essential businesses remain open.
The first day that daily deaths due to COVID-19 in the US rose above 20 was on 16 March 2020 (when there were 983 new daily cases of infection). New modelling numbers that have come out of the US4 suggest that daily deaths (not infections) will peak around 16 April 2020 at around 3000/day, but will reduce back down to around 20 per day by the end of May 2020 and reduce to nearly zero by mid-June. Due to the fact that the 50 states have a high degree of autonomy, the level of lockdown has varied enormously, with some states locked-down completely, and others not at all. The epidemic in the US looks likely to last about 12 weeks. As I mentioned in my previous Last Word, there may be one global pandemic, but there are many epidemics - villages, towns, regions, states and countries all experiencing different infection trends. From the information above, it appears that epidemics can be brought under control within six to ten weeks if severe enough restrictions are put in place, longer if less severe restrictions are applied. Ongoing measures will still be required. However, all of the countries mentioned above (and the UK, France and Germany could also have been included) have more-or-less strong and highly organised health systems, and the ability to expand and to fund them (through borrowing if required).
What is not clear is the likely length and severity of epidemics in those countries in the world without strong health systems. It is chastening to recall that 30% of the global mortality from the 1918 - 1919 Influenza outbreak was in densely-populated India. Useful also to recall that Africa’s population in 1918 was around 160m, but is now 1.3bn. What seems certain is that while some countries will rapidly return to ‘normal,’ other countries and regions will continue to suffer.
1 https://www.japantimes.co.jp/news/2020/03/24/asia-pacific/china-greenlight-alipay-app
2 https://en.wikipedia.org/wiki/2020_Hubei_lockdowns
3 https://www.worldometers.info/coronavirus/country/china/
4 https://covid19.healthdata.org/projections
