I have a soft spot for ad hoc theories, even bad ones, as long as they are funny. These early days of 2020, though, the fun has escaped us by and large, and creative minds can go to some dark places. I ended up getting into a brief Twitter discussion with Mattias Geniar concerning a blog post in which he puts forth the proposition that countries deliberately delay a their attempts to Flatten The Curve of the SARS-CoV-2 pandemic in order to “save money on medical expenses”.
This is preposterous
Mattias is making quite some assumptions here, and presenting them has hard facts.
First, I think there is a very fundamental misunderstanding of the metaphor that FlattenTheCurve is using to give weight to their message. The arbitrary “capacity of the health care system” line drawn into their hallmark diagram? That is not a hard number that anybody knows. Show me a medical professional who will, with a straight face, say that “we can handle 1.3 million infected at any point in time, but 1.4 million will overtax us”. I will show you a person who is making shit up as they go.
Sure, you can try and make estimates. In fact, some were made for the US health care system that suggest that it’s unfeasible to flatten the curve adequately. But here’s the other side of that coin: Even if you could produce reliable numbers (you cannot because spread and lethality of an infection usually varies between geographies, and we have little data to go on outside of China’s), how do you make sure that you choose the exact right time of engaging measures to max out at that exact number?
Your measures kick in at a time when the rate of infection is X, the number of infected is Y, with an effect of limiting the rate to Z. All of these can only be estimated quite roughly. You don’t know how many are infected. The number of confirmed cases is a very bare minimum. You don’t know how fast it spreads in your geography. And you sure as hell don’t know how well your measures will pan out.
The idea of Flatten The Curve is to make your best effort, and hope that the peak of the spread will stay at a manageable level. For most countries, it will not. But even by just lowering it by, say, a million people at the peak, thousands of lives could be saved.
Trading lives for cash?
Another assumption in the post is problematic in two ways. First, there is the proposition that a high but short peak with a significant death toll will incur lower medical costs than a prolonged period of fighting a creeping epidemic. And while this is not totally unreasonable, it does lack any backing facts. How can you be so sure the costs from a sudden outbreak, including chaos and death, will be lower than fighting a disease over time? Show your work. You don’t just get to just re-label axis on a diagram to prove an arbitrary point you’re trying to make. That’s not how any of this works. (This is some Trump level of misinformation.)
But even when this assumption holds true, it’s deeply cynical and a bad, bad accusation against world leaders, to conclude that this trade is being made willingly. “Well yes, we could take action now, but we will save a half trillion by waiting until Tuesday” is not a statement a normal person will make if thousands or more lives are at stake. This is some conspiracy theory level of bullshit and I will not stand for it.
So why were they slow?
I won’t get too far into my own assumptions on the matter. I’m pretty much in the camp of Jürgen Klopp on this one. Still, I will make just one minor counter-point from my actual (if second hand) experience.
Yes, politicians have to think carefully of how and when they act. Lives are always at stake, not only from impending public health risks. And bear in mind, politicians are just people like you and me, at the end of the day. They get inconsistent information as well, and not only from social media, but also from actual experts on all kinds of matters.
How do you Flatten The Curve as much as humanly possible? You lock the country down. You force everyone to stay at home. You pause daily business. You do whatever necessary to keep your grounded people from starving. Easy, right?
No, of course not. It’s very hard, very costly, and it has serious consequences for the nation, that may be felt for years to come, depending on how your economy is structured. Germany has been fairly late in taking actual action when faced with climbing numbers of confirmed infections. And when it happened last Friday, in order to take effect next week, the measures turned out to be quite low-key, a far cry what China, but also neighboring European countries resolved to do.
And yet, even with these slight modifications, people will be affected. My gym teacher tells me, if this “soft lock-down” persists for more than a month, he will likely starve and/or lose his home (along with his family) just from missed income. Millions of people will be hit hard by this type of consequence. You don’t just “do whatever it takes” to curb a disease and then life goes on. Some lives cannot go on depending on your choices. You don’t make these choices lightly, and hence you cannot really rush them.
Yes, our governments did not act as soon as they might have. They were kept by all kinds of factors that you or I are not even aware of. Yes, money plays a role. So does the public reaction (see: Panic Shopping). And yes, some politicians may even have been clinging to hope that maybe the infection would be contained in whatever areas it originally popped up. It’s called “human error”.
And I argue we all should hold on to our hope. But also act responsibly and each do our respective part to protect one another. Help out your neighbor whose livelihood is in danger. But for the love of god, don’t spread your half-assed opinions on what guides public decision making in these trying times. It’s actually harmful.