For some of us the end of the emergency appears to be in sight - fully vaccinated, measured re-opening, a clear path to post-covid normality beckons. Can it be true?
Its perhaps time to get all reflective about our experience of the last 20 months and ask two intertwined questions ‘What we got right’ in our response, and ‘what we got wrong’.
The answers will differ between countries and I am keen to hear non-western thoughts.
It would be good to know where you’re from or talking about. I’d like it to be fairly empirical, so let’s not talk about luck as something we had a hand in creating - its okay to say something like the accelerated vaccine development programs were great, but it does not excuse mismanagement while hoping that someone would actually make a workable vaccine.
I’ll start off with:
RIGHT [Australia]
Creating a national cabinet at the start which meant that all state leaders, whose agencies do all the heavy lifting, were unified in their broad objectives, and received medical advice from a single clear source of expertise. Federal leadership was firmly put in its place and basically became Dad’s wallet.
WRONG [globally]
Failing to implement international agreements intended to provide affordable vaccines to poorer countries, leading to them being a continuing risk for the generation of the next super-evil strain of covid.
WRONG[Australia and maybe others]
Hotel quarantine which consisted of bussing the people you suspect of having an incredibly contagious disease straight into the most densely populated part of your cities, where their needs were served by inexperienced staff who went home to their families ALSO in the most densely populated part of your cities, and went shopping at supermarkets in the most densely yada yada yada…
RIGHT[Australia]
Cash to both businesses that needed to shut and workers that needed to stay home, with a pretty decent attempt at spreading it around between all the different actors affected
In the US, going into the pandemic, I and many others had an assumption of good faith. We were all affected by this, and we would all do what it took to end it. I can remember thinking that this might even be the death knell for anti-vaxxers. Boy is my face red!
In case you didn’t know, Velocity has openly said in the past that he’d favor stuff like (IIRC, please correct me if I’m wrong) suspension of civil liberties and gunpoint enforcement. I assumed that you wouldn’t go quite that far, so I figured I’d at least mention that.
The wrongest thing we did in the United States was to elect radical irrational politicians at all levels (mostly of a party I won’t name because, you know, no politics in the Quarantine Zone) who did everything they could to impede our response to this epidemic.
This isn’t so much a knock against those politicians, as it is a knock against the American voters who put them there.
I haven’t really followed the strategies of nations other than the US so I can’t comment on anything else but to go through a small list:
The order of cutting off travel to various nations was completely irrational. Cutting off China as the first travel restriction makes sense but everything after that (and probably even including that choice) was really just down to doubling down on our tariffs and unrelated to how diseases spread. The top regions that Chinese nationals travel to are (as I recall), Taiwan, Japan, Singapore, Hong Kong, Indonesia, and Italy so those all should have been the second highest priority to cut off. I don’t believe that we ever restricted travel to most or any of those places. (Yes, it was probably too late even by the point that we cut off travel from China, but we didn’t know that at the time.)
Covid Classic didn’t actually have all that fast of a transmission rate and it was severely restricted on its ability to move during summer of 2020. While it probably would have failed, a global effort to eradicate the disease by simply getting it to die out on its own had a plausible chance of success. If we had chosen - globally - to stock up through spring and early summer and then all go into super-quarantine for the month of September, just staying at home eating canned and frozen foods, it may have been possible to cut all of this off.
While masking, cutting off social gatherings, etc. are all good measures to take and should always have occurred, targeted handling of at-risk groups never seems to have had much focus. The state of California tried to break up homeless people and improving their everyday health by giving them motel rooms and supermarkets were asked to create special shopping hours for the elderly, but that’s about it. Ideally, everyone would have had a risk ranking (based on themselves and people they would be in regular contact with) and rules to follow based on that. Elderly homes tried to keep family from visiting, which was good, but there was no focus on ensuring that the elderly stayed happy and satisfied in life. Depression and stress are both going to raise their mortality rate. Overall, our approach was very shallow. I assume that they were thinking that they needed to keep it simple but I think that educating people about the risks and giving them individualized rules to follow would have been very doable and taking steps to mitigate secondary effects of loneliness and isolation, stale air, lack of sunlight, etc. could all have been tackled. We should have seen steep discounts on Vitamin D, as one small example.
There was already a large antivax movement and it was very clear that at least 40% of the country was going to push back on any centrally organized push to inject everyone with mystery fluid. Vaccine mandates were always going to be necessary and, I would argue, making them non-mandatory just helps to support the idea that it’s really not that big a deal if you don’t do it, ergo supporting the idea that the vaccine doesn’t do much or that the pandemic isn’t all that scary. If bombs are falling out of the sky but everyone is just like, “Eh, they always miss everything.” And walks around like nothing is happening, the guy who doesn’t know any better is just going to follow their lead and endorse the position to everyone new that he meets - right up to the day that he gets exploded, at which point he won’t be around to push back on the advice. If you want to sell that something is serious, you have to act like it’s serious. If you’re really worried that the bombs are going to kill everyone, they’ll take you serious if you start punching them in the face and tossing them towards the bomb shelters. However, they’re going to keep shopping if you’re just like, “Please everyone, if you could just be so kind…”
We probably don’t have enough hindsight to recognize this yet, but I still think that the CDC was right, that closing the schools was a mistake. We’re going to be feeling the effects of that for the next fifty years.
Of course, we made a lot of advances very quickly in the area of remote schooling, and if we were to continue to progress in that area as quickly for the next few years, we just might get to the point where it’s safe to do things like closing the schools. But now that most schools are re-opened, that line of advance has mostly been abandoned, so we’re going to be nearly as unprepared for the next pandemic.
This here is the biggest mistake all countries have made, multiple times the thinking the “end is in sight”. Its not.
What Pakistan did right/wrong.
We locked down early, but not as severe as most countries. Probably staved off economic disaster like we saw in India, and the decision to have a series of graduated lockdowns as needed was in retrospect the smart thing to do.
Ramped up production of medical equipment and (eventually) vaccines.
Excellent coordination between Government at all levels and the especially between health and LEA (something which is very important it turns out, but not much appreciated before).
Direct cash transfers to the poor and vulnerable and payroll support.
The track and trace system was very good, allowed us to identify and cut off places with high incidence of disease,
Wrong
The vaccine roll out stank at least initially. We relied too much on COVAX initially and didn’t expand our own local capacity fast enough. Ended up having to buy a lot at premium prices from overseas.
The number of times we started to celebrate and said, “this is the last wave”
From commentary by epidemiologists I think the world has worked extra-hard to create the necessary preconditions to ensure a huge reservoir of unvaccinated people will remain to provide the next major covid strain. I gather the G20 has resolved today to take collective action, but don’t particularly feel I should be holding my breath.
The rapid development of vaccines, especially the new use of mRNA technology in the Moderna and Pfizer vaccines.
The rapid development of the rapid COVID-19 test.
The quick ramping up of production of supplies needed to fight the pandemic. Masks, hand sanitizer, etc. were all readily available by 5/2020 IIRC.
The initial lockdowns in March and April of 2020 while we were busy with numbers 2 and 3. In retrospect, it was too late to have any hope of eliminating the virus, even as early as 3/11/2020 when the pandemic was officially declared. None the less, my guess is this let us avoid a large initial spike (in the US) that we were completely unprepared to deal with at the time.
What we got wrong / are still getting wrong in the US.
1a. Not being tough enough on the anti-vaxxers. No, we don’t need to go as far as China and physically hold people down. We should, however, not mess around with things like religious exemptions or letting the debate be framed as a matter of personal choice.
1b. Not being tough enough on conspiracy theories regarding COVID-19 in general. Posts advocating for treatment with ivermectin and hydroxychloroquine on social media should have been taken down.
Becoming too lax with mask wearing and social distancing whenever it looked like the virus was being beaten back.
The half measures we took regarding travel restrictions. The measures we took probably had no effect. When the various restrictions were imposed, COVID was already loose in the populations trying to be protected.
Building an incredibly expensive white elephant contact tracing system that doesn’t work, and continuing to double down on it. This is possibly the worst policy decision a UK government has ever made.
Creating an expensive furlough scheme so that workers were bankrolled to do nothing for a year and a half at 80% salary.
Spending a fortune in order to be the ones with first access to vaccines, and then when most UK citizens were vaccinated doing nothing to take advantage of it.
Expensive gimmicks like “eat out ot help out” that not only took money from public purse, encouraged gathering at exactly the time lockdowns would have been useful.
Still not respecting vaccines from the EU/US/other reliable areas for the purpose of contact self-isolation.
(Right):
Some of the early lockdowns.
Travel restrictions seem to have been well thought out
The actual vaccine rollout was quite efficient, but the cost/time balance of the EU was much better.
I agree with all of these. But I would characterize the biggest failure of the US as having a “vaccine-only” approach.
We should have wide-spread, easy, and rapid testing.
I have this app on my phone called “WANotify” which is supposed to tell me when I’ve been exposed to COVID. But a) it came way too late in the pandemic and b) I’m pretty sure it’s completely useless. It depends on someone who’s positive inputting that into their phone, and apparently they need a special code from the testing center. No one seems to get these codes with a positive diagnostic, so even folks inclined to play by the rules aren’t putting their positive diagnoses into the app. And why the fuck are these things state-by-state?
We should have had a large, public campaign to improve indoor air circulation. That would have done 10x the good of all the wiping down of surfaces and installation of plexiglass barriers.
