It is said that times of crisis reveal who we really are. If this adage works for civilizations as it does for individuals, Europe and America have reasons to worry.
The illusion of getting the new coronavirus under control was short-lived, barely surviving summer. Europe is seeing infections rising to spring levels; mortality remains lower but health care systems in parts of Spain and France are on red alert again. Meanwhile, the United States has successfully curbed several major outbreaks, most notably in New York, but remains the worst affected country in the world. The light at the end of the tunnel is rather faint.
There have been attempts to identify ritual scapegoats, most often the World Health Organization. Indeed, WHO made its share of missteps, from an initially hesitant stance toward face masks to cheerleading for the Chinese dictatorship. Still, it was WHO that declared COVID-19 a "public health emergency of international concern" on Jan. 30 and urged countries to set up strong measures ensuring early detection of the virus.
The West listened — and did next to nothing. That was the time to prepare tests, stockpile protective equipment, review the capacities of public health care. Donald Trump's lackadaisical stance towards the infection is well known and hardly surprising, but few Western leaders did much better in the beginning. Despite WHO's clear warning, governments across Europe were caught completely unprepared a month later. Why this time was wasted remains a mystery and it's difficult to understand how politicians who are usually scrutinized for every detail were able to get away with such a level of negligence.
Even more surprisingly, experts didn't fare much better. Their voices were muted and, if not careless, then certainly inclined to marginalize the risk. Germany's revered Robert Koch Institute labeled COVID-19's risk to the country "small to medium" as late as Feb. 28, when community transmissions were already soaring in nearby Italy. In my native Czech Republic, doctors and scientists raced to dismiss the virus as "media-fueled hysteria." Britain's top medical advisers came up with an outlandish plan for herd immunity, which was abandoned only after researchers at Imperial College London calculated that it could cost the lives of a quarter million people in the U.K. alone. We could continue this list ad nauseam.
But the worst was still to come. After draconian restrictions brought the infection under control in many countries by the end of spring, governments had the chance to look around, see what was working and determine a reasonable way forward. Inspiration was easy to come by — if only we had cared to look.
While Western countries reported thousands of victims each day, East Asia handled the pandemic remarkably well. Despite their proximity and business ties to the original epicenter of COVID-19 in China, and despite several strong but localized outbreaks, impact across the region was nowhere near the level of Europe and the U.S.
South Korea, Taiwan and Singapore have 80 million inhabitants combined, roughly one-fourth of U.S. population and larger than the populations of Britain or France. As of Oct. 1, the total number of fatalities in those three nations together stands at 449. That's less than Florida's Polk County or the English city of Leeds, with populations of less than 800,000 each.
To make things even more interesting, the Asian trio achieved that result without total lockdowns. OECD expects the South Korean economy to contract by 1% in 2020, while Taiwan's GDP is predicted to grow slightly. Even Singapore's 6% decline, which would be catastrophic in normal circumstances, is better than the European Union's forecast 8% downturn — and that was before the second wave of the pandemic hit Europe.
So what was the East Asian recipe for success?
- Face masks are a must indoors, with huge fines for offenders.
- Sophisticated contact tracing systems were in place.
- Testing was intensive and easily accessible.
- Social distancing measures limited the numbers of participants at public events.
- Temperature checks were in place at entry points to most indoor spaces.
- Strict quarantines were enforced on travelers from risk countries, subject to geo tracking and daily checks from officials.
- Production of protective equipment was ramped up, and citizens were informed where to get it.
First and foremost, safety measures were deployed before the pandemic hit hard — and ordinary people respected them.
Fact vs. fiction
East Asia's experience refutes two myths at once. COVID-19 is not an inevitable biblical plague, destined to kill millions no matter what. There also is no necessary trade-off between public health and economy, as far too many politicians and economists have claimed. Governments can save lives and jobs at the same time.
You'd be forgiven for thinking that Taiwan, et al., became the blueprint for Western governments to follow. You couldn't be more wrong. As the first wave of infections in Europe waned, so did precautions. Borders opened wide in a desperate attempt to save the summer season. Media treated us to images of crowded beaches and people sharing hugs over a drink. Both Europe and United States — where the first wave never really ended — wasted a golden opportunity to take a lesson from the Asian approach. Mask rules were introduced too late, if at all. Temperature checks are rare and haphazard, testing capacities remain insufficient in many regions, and quarantines are poorly controlled.
It would be tempting to place the blame solely on politicians, and without question the way they failed in their duty should get more scrutiny. As time goes by, however, it becomes more and more apparent that elected representatives are but a reflection of the electorate.
While Asians wear masks as a protective standard, big chunks of American and European societies struggle mightily with this idea. Refusal to wear face coverings became a badge of honor among libertarians and the right: What's life without the "freedom" to infect thy neighbor? Esoteric hipsters find masks insufficiently natural, while social media users share hoaxes about children in masks choking on CO2. People without a trace of medical education spread copy-pasted wisdom about the supposed ineffectiveness of protective equipment. British students complain to the media that restrictions on bars and pubs are damaging for their university experience. Celebrities refuse to respect public health laws … and on and on.
We may think of ourselves as the children of Enlightenment and the scientific method, yet our reactions to the first big crisis in 75 years made us look like mere children, full stop.
The virus-busting success of East Asian countries is no secret. Anyone can learn about their situation through open information sources. What remains a mystery is why, instead of taking a page from Asia's book, even sensible people in Western societies are periodically reviving dangerous nonsense about the "Swedish way" and "herd immunity," a pair of myths that finally need to be put to sleep and wiped from the face of the Earth.
Sweden — unlike neighboring Norway, Finland and Denmark — rejected a tough lockdown in the spring, in favor of softer and mostly voluntary measures. This approach resulted in nearly 6,000 deaths so far, the fifth wrst per capita in Europe. Denmark's death toll, adjusted for population size, is five times lower, and death rates in Norway and Finland are more like 10 times lower. Translated into the real world, more than 5,000 Swedes would still be alive, in all probability, had they lived across the border in a nearby nation.
Do I hear you saying, Well, at least the Swedish approach saved their economy? Not at all. Sweden's GDP fell by 8.6% in Q2, a notably worse result than Denmark's at 7.4%, Norway's at 7.1% and Finland's at 3.2%. Current infection rates are also worse in Sweden than elsewhere in the region. All in all, there isn't a single reason why Sweden, a nation that let an astonishing number of its citizens die needlessly without achieving anything in exchange, should serve as an example.
Still, even respected media in the English-speaking world, such as the Guardian and the Washington Post, keep comparing Sweden with the worst-affected countries, such as Britain, and triumphantly exclaiming that "in Sweden there has not been the same sharp increase in cases" (Guardian) or alleging that the "success or failure of [Swedish] policy is still being debated" (Post). Five thousand Swedes would beg to differ, if they could. They cannot, because they're dead.
This indifference towards human life, which has been spreading through public space during the pandemic, is most apparent in the "herd immunity" theory. According to its prophets — which appear to include Dr. Scott Atlas, a radiologist who serves as President Trump's virus-whisperer, COVID is unavoidable, so the best option we have is to get enough people infected and create antibodies, until the evil germ runs out of victims.
Herd immunity requires no less than 60% of population to contract the virus. Looking at stats from countries with the most diligent testing programs (Iceland, Bahrain, the United Arab Emirates and Malta), COVID-19's real fatality rate is likely around 0.5%, with higher values in some countries being the result of many undetected infections, especially during the first wave. Even that relatively low rate would mean 200,000 deaths in Britain, a quarter of a million in Germany, and close to 1 million in the United States, should these countries opt for herd immunity without a vaccine.
Funny how times change. It seems like yesterday when every single life lost to Islamist terrorism in the West was a sufficient excuse for denying help to millions of refugees and labelling an entire religion with roughly a billion adherents as an existential threat to our civilization. It's often the same people who consider hundreds of thousands of extra deaths to be an acceptable price for "getting our lives back."
An exorbitant human toll isn't the only reason why the concept of herd immunity is irrelevant. First and foremost, we have no idea whether herd immunity can be achieved at all. Just look at the common flu virus, which mutates all the time and requires re-vaccination every year. Herd immunity usually lasts only a few months, if it develops at all — and that's with widely available vaccines. Research suggests that the new coronavirus is no stranger to change either, which could easily mean that the only lasting effect of any pre-vaccine attempt at herd immunity would be a gargantuan pile of dead bodies.
Another big problem is that we have extremely limited insight into the long-term health impacts of COVID-19 infection. We almost certainly have to stop thinking about this disease in binary form. It's not only about deaths versus recoveries. Several recent studies warn that lasting effects of the disease are far from rare. Survivors with permanent health damage are no small issues for a plethora of reasons, from quality of life to economic impact.
Until we know more about antibodies and long-term effects, any attempt to allow the spread of this virus for the sake of herd immunity should be considered a crime against humanity, a totally irresponsible gamble using people instead of chips — a Nazi-doctor-style experiment that could destroy millions of lives and achieve nothing.
Better late than early
More than anything, COVID-19 is a game of time. Vaccines may not be the silver bullet we're hoping for. We may well have to learn to live with this disease. Perhaps most of us will eventually catch it. If that's the case, every month counts.
Viruses tend to get weaker over time, which helps them spread better. More experience gives medical staff the knowledge to identify the most efficient care. Each month can bring improved treatment and more prepared hospitals. Proper preventive measures limit the quantity of virus spreading around, which can lead to milder infection. Judging by the lower mortality rates of the second wave, several if not all of these factors are already having an impact. You are more likely to survive COVID-19 today than you were in April; odds are that your chances next year will be even better. Therefore, playing for time isn't delaying the inevitable — it represents an essential part of damage mitigation.
The Asian approach fits this goal like a glove. It's not perfect: Singapore mishandled COVID spread among foreign workers, and South Korea struggled to contain outbreaks associated with a religious group. But imperfect is nonetheless the best we currently have.
The only reason for our refusal to accept this is cultural arrogance. It's not just Donald Trump who sees America as the greatest country in the world. And it's not only nationalists who feel that Europe, as the supposed cradle of democracy, is superior to every other part of the world. It's a dangerous — and in current circumstances, even lethal — delusion.
The supposed dilemma between economy and health is a false construct. The East has shown how to protect both; the West looked for its own way, which has largely failed on both counts. There is still time to do things right, but it's running out. While Western governments are now moving closer to East Asia's policies, the public, increasingly distrustful of their elected representatives, is largely drifting in the opposite direction. Changing this mindset is the greatest challenge that American and European leaders are facing today.