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Coronavirus has shattered the myth that the economy must come first

Since the 1990s, faith in ‘the market’ has gone unchallenged. Now even public shopping has become a crime against society.

The coronavirus shutdown of 2020 is perhaps the most remarkable interruption to ordinary life in modern history. It has been spoken about as a war. And one is reminded of the stories told of the interruption of normality in 1914 and 1939. But unlike a war, the present moment involves demobilisation not mobilisation. While the hospitals are on full alert, the majority of us are confined to quarters. We are deliberately inducing one of the most severe recessions ever seen. In so doing we are driving another nail into the coffin of one of the great platitudes of the late 20th century: it’s the economy stupid.
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Once upon a time we thought we knew what was up and what was down. According to the lingua franca of the 1990s, in the wake of the cold war, it was obvious that the economics were the fundamentals, and the rest followed. It was the west’s economic success that felled communism. And the economy ruled not only over creaky communist dictatorships, it defined the scope of possible politics in democracies. Arguing against globalisation, Tony Blair insisted, was as absurd as arguing against the seasons.

Then came 2008 and we were left wondering who the economic masters of the universe actually were. It was followed by the extraordinary, politically induced catastrophe of the eurozone debt crisis, in which conservative fiscal populism and dogma – disguised as expertise – ruled over the need to ensure employment and grow the pie. Then in 2016 the UK referendum delivered a majority for Brexit in the face of predictions of economic disaster. Months later, Donald Trump, a narcissistic billionaire, was swept to power by working-class votes in the face of opposition by the great and the good. Both the UK and the US have since pursued policies of spectacular economic irrationality without fear of a crushing veto by the markets. Liberal elites waited in vain for the market vigilantes to arrive.

And now Covid-19. Imagine if blunt economic interest was, in fact, dictating our response. Would we be shutting the economy down? What we know about the virus tells us that it most often kills what are by the numbers the “least productive” members of society. The majority of the working population experience symptoms barely more significant than a regular flu. Unlike regular flus it does not threaten children, the future workers. The virus may be bad, but simplistic economic logic would dictate that until we have a vaccine it would be best to keep life going, because, you know, “it’s the economy stupid”.
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That was indeed the first reaction of the British government. The headline was that Britain was staying open for business. Journalists with good memories dug up Boris Johnson’s fondness for the mayor in Steven Spielberg’s Jaws who insists that despite the fact that a sea monster is eating his constituents the beach should stay open. The higher wisdom of public health, we were told, was that the productive workforce would acquire immunity. We know how that bold experiment in heroic economism has ended: a panic-driven withdrawal in the face of the disastrous scenario of hundreds of thousands of excess deaths, overwhelmed NHS hospitals and a crisis of political legitimacy.

It suddenly became obvious that when matters of life and death are concerned the calculus is different. Of course, old and sick people die. We all will in due course. But it matters fundamentally how and under what circumstances. A huge surge in mortality, even if it is limited to “vulnerable” populations with pre-existing conditions, is existentially unsettling. So too are the apocalyptic scenes that will unfold in our hospitals. In an earlier age, they might have remained behind a decent veil of obscurity. (No doubt the NHS and the BBC will work out the protocols for “embedded” reporting from the clinical frontlines.) But the words and images that have already come to us from northern Italy and Wuhan are bad enough. Faced with all of this, the stupidity lies in not recognising promptly that we must act, that we must shut down, that even the most essential individual activity of the market age, public shopping, has mutated into a crime against society.

This is not to say that economics is not shaping the crisis. It is the relentless expansion of the Chinese economy and the resulting mix of modern urban life with traditional food customs that creates the viral incubators. It is globalised transportation systems that speed up transmission. It is calculations of cost that define the number of intensive-care beds and the stockpiles of ventilators. It is the commercial logic of drug development that defines the range of vaccines we have ready and waiting; obscure coronaviruses don’t get the same attention as erectile dysfunction. And once the virus began to spread, it was the UK’s attachment to business as usual that induced fatal delay. Shutting down comes at a price. No one wants to do it. But then it turns out, in the face of the terrifying predictions of sickness and death, there really is no alternative.

It is once you have overcome that political, intellectual and existential hurdle – to realise that this is a matter of life and death – that economics enters back in. And it does so with a vengeance. The logic revealed by the well-organised Asian states is that it is best to conduct a severe quarantine regime in the hope of being able to return to normal activity as soon as possible. The Chinese economy is already resuming step by step.

In the west, the scale and breadth of the epidemic is such that our response now will have to be a blanket shutdown. And that begs gigantic questions of economic management. Even conservative governments on both sides of the Atlantic are pulling every lever of monetary and fiscal policy. In a matter of weeks they have embarked on gigantic interventions on a scale comparable to those in 2008. They may be able to soften the blow. But it is an open question how long we will be able to persist, how long we will be able to freeze the economy to save lives.

In making the difficult choices that lie ahead we have at least gained one degree of freedom. The big idea of the 1990s that “the economy” will serve as a regulating superego of our politics is a busted flush. Given the experience of the past dozen years we should now never tire of asking: which economic constraints are real and which imagined?

▻https://www.theguardian.com/commentisfree/2020/mar/20/coronavirus-myth-economy-uk-business-life-death
#économie #economy_first #priorité #santé #coronavirus #covid-19

Germany’s coronavirus anomaly: high infection rates but few deaths | Financial Times
▻https://www.ft.com/content/c0755b30-69bb-11ea-800d-da70cff6e4d3
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In one crucial way, however, the country is proving remarkably resilient: relative to known infections, the number of deaths has so far been minuscule.

According to data from Johns Hopkins University, there were 13,979 coronavirus infections in Germany on Thursday afternoon, more than in any other country except China, Italy, Iran and Spain.

According to Lothar Wieler, the president of the Robert Koch Institute, German laboratories are now conducting about 160,000 coronavirus tests every week — more than some European countries have carried out in total since the crisis started. Even South Korea, which is conducting 15,000 tests a day and has been held up by virologists as an example to follow, appears to be testing less than Germany.

“This is about capacity. The capacity in Germany is very, very significant. We can conduct more than 160,000 tests per week, and that can be increased further,” Prof Wieler told journalists this week. Test capabilities would be boosted not least in part by switching laboratories that specialise in animal health towards coronavirus checks. There was no sign that test kits were running low, Prof Wieler added.

In the short term at least, mass testing feeds through into a lower fatality rate because it allows authorities to detect cases of Covid-19 even in patients who suffer few or no symptoms, and who have a much better chance of survival. It also means that Germany is likely to have a lower number of undetected cases than countries where testing is less prevalent.

In one Italian town, we showed mass testing could eradicate the coronavirus

By identifying and isolating clusters of infected people, we wiped out Covid-19 in Vò.

It’s now about one month since Covid-19 began to sweep across Italy. With more than total cases topping 40,000 as of 19 March, it is now the worst-affected country outside of China.

But in the last two weeks, a promising pilot study here has produced results that may be instructive for other countries trying to control coronavirus. Beginning on 6 March , along with researchers at the University of Padua and the Red Cross, we tested all residents of Vò, a town of 3,000 inhabitants near Venice – including those who did not have symptoms. This allowed us to quarantine people before they showed signs of infection and stop the further spread of coronavirus. In this way, we eradicated coronavirus in under 14 days.
Scientists say mass tests in Italian town have halted Covid-19 there
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While we believe it is too late to enact this approach in a city such as Milan, where infections are out of control, there could still be time to do this in the UK before the crisis gets even worse: the government could identify and isolate clusters, quarantine everyone affected, trace their recent contacts, and quarantine and isolate them, too – whether they had symptoms or not.

Our experiment came to be by chance. The Italian authorities had a strong emotional reaction to news of the country’s first death – which was in Vò. The whole town was put into quarantine and every inhabitant was tested. The tests were processed by us at the University of Padua. It became clear that this was a unique epidemiological setting – and an application was put in to keep the town in lockdown and run a second round of tests after nine days.

In the first round of testing, 89 people tested positive. In the second round, the number had dropped to six, who remained in isolation. In this way, we managed to eradicate coronavirus from Vò, achieving a 100% recovery rate for those previously infected while recording no further cases of transmission.

We made an interesting finding: at the time the first symptomatic case was diagnosed, a significant proportion of the population, about 3%, had already been infected – yet most of them were completely asymptomatic. Our study established a valuable principle: testing of all citizens, whether or not they have symptoms, provides a way to control this pandemic.

The nature of this crisis means that establishing a structured response like this is key, while widespread testing is crucial in telling an accurate story of how many people are affected, and what the mortality rate of the virus actually is. In Italy, we have struggled with a rampant rise of mortality (the number of casualties divided by the number of infected people), which has reached an apparent value of 8% – far higher than the mortality rate in China and grimly close to that during the 2002-2003 Sars outbreak.
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This high rate is misleading, though. After the first few days of the initial outbreak, cases were classed as all of those found to be infected by the virus. Yet since then, only the obviously symptomatic subjects – those needing medical care – have been tested for the virus and thus counted as cases.

The decision to only test those who presented for treatment with symptoms of the virus was taken by major Italian public health experts, apparently in line with World Health Organization (WHO) suggestions. The consequence has been that people who haven’t asked for medical attention have only been tested very occasionally in Italy. Nonetheless, asymptomatic or quasi-symptomatic subjects represent a good 70% of all virus-infected people and, still worse, an unknown, yet impossible to ignore portion of them can transmit the virus to others. Full testing would give us a clearer picture of how many people actually have the virus, and how many pass it on.

If the fact that only those presenting with the virus were being tested was accounted for, the mortality percentage would fall to more “normal” levels. This is shown by the mortality in the Veneto region, which is steadily around 2.5-3%, still high but threefold less than the ones in Lombardy and Emilia-Romagna.

Why this marked difference? Veneto is comparable to the other two northern regions for education, general lifestyle, personal income and age of the population – all factors, particularly the last one, believed to influence Covid-19 mortality. Although a non-homogeneous data collection and other variables could explain the difference, there is one main factor that is likely playing a role. In Veneto, the virus was more actively sought out through testing, a programme that included part of the asymptomatic population. Official numbers speak of roughly eight in every 100 people tested in Veneto, against about half and one-third of that proportion in Lombardy and Emila-Romagna, respectively.

Unfortunately, it would be near impossible to repeat this model in a large city, due to the number of people who would need to be tested. However, our findings warrant careful consideration by health policymakers in Italy and around the world. They invite researchers to eradicate the virus through extensive testing of both symptomatic individuals and all of their social contacts – including relatives, friends and neighbours. In this way, we catch out the disease before it has the chance to spread – and, most importantly, before the carrier has the chance to unwittingly pass it on to other people.

In the absence of specific therapies or a vaccine, quarantine, distancing and identification of asymptomatic carriers remain the only real measures to control this epidemic. In the UK, authorities could still identify and isolate clusters, and test everyone who has come into contact with those infected. Wisely, though probably belatedly, WHO has just this week recommended what we have found in our research to be the best line of defence: testing, testing, testing.

▻https://www.theguardian.com/commentisfree/2020/mar/20/eradicated-coronavirus-mass-testing-covid-19-italy-vo?CMP=Share_iOSApp_
#Italie #dépistage #tests #coronavirus #covid-19 #dépistage_de_masse #Vò