March 10, 2020
We noted a number of economist friends of ours who tried to compare the rise in Covid-19 infections in Europe with those in Wuhan, and concluded that the lines are on the same trajectory. These analyses completely ignore that China took far more drastic action to contain the spread of the virus than Italy, for example. This statement remains true even after yesterday’s country-wide lock-down. There were 1600 new cases in Italy yesterday alone. The latest measures, and others, will have some effect, but we have no reason to assume that the effect will be nearly as strong as it was in China. It may dampen the curve, but will not flatten it. New cases in China are now arriving at a daily rate of under 100, which is virtually nothing in a country of 1.3bn people.
The kind of math that tell us more about the underlying dynamics is the approach taken Nicholas Christakis, an expert of how epidemics spread through social networks. He and his team at Yale University did some modelling on the effect of China’s extreme lockdown measures on the spread of the virus. On the week of January 23, China imposed what it called closed-off management on 930m people: military/police checks to ensure that only people with a permit were allowed to move; obligatory disinfection of vehicles; organised food delivery to apartment blocks; one only person per household allowed to leave, and this only every few days or so. Teaching has moved online.
Virtually none of this is happening in Italy. We reported yesterday on the Italian government’s botched attempt to implement a lock-down of Italy’s northern regions. Extending the lock-down to the rest of the country makes sense, but Italy does not have the centralised resources of the Chinese state. We should therefore not automatically assume that the increase of virus infections in Italy will take the same path as it did in the province of Hubei. Europeans are fighting the virus with the same seriousness as they were fighting the eurozone crisis.
A reader yesterday raised an issue with us that our worst-case scenario - of a 70% infection rate - could cause millions of deaths. This is not a prediction, but a catastrophic worst-case infection-rate scenario based on extrapolations by some virologists. In a situation like this, the mortality rate could exceed single-digit percentages if only because medical services will be overwhelmed. The high mortality rate in Italy is at least to some extent due to the age profile, but we believe also to different social habits of older people. But the reports we are now receiving from doctors in Italy are suggesting that the health service is already at the breaking point.
We noted a series of tweets by Jason Van Schoor, a doctor at a London hospital, to convey a message from an Italian doctor in Lombardy whose hospital had stopped treating all routine cases and many emergency operations. Coronavirus patients under 65 are not treated. An article of another Italian doctor, Daniele Macchini, made the rounds yesterday. He said the most irresponsible action people could take right now would be to downplay the significance of this virus. He goes into some technical detail to describe how this virus differs from flu. The interstitial pneumonia it creates in patients is of a different kind from the bacterial pneumonia that results from flu. He talks about an epidemiological disaster.
It appears that Spain is now becoming the next Italy, having climbed above Germany in the number of Covid-19 infections yesterday despite its lower population. The number of cases grew by 60% in a day, to over 1200, and in the region of Madrid they nearly tripled from just over 200 declared on Sunday to under 600 on Monday. In three areas, including the whole Madrid province, the authorities closed schools, and the government issued a recommendation that people work from home. More measures are to be announced today.
Despite the rise in cases in Germany, the German media reports this as a largely Italian crisis. One of the reasons is that Germany has an abnormally low death toll: 2 deaths out of 1200 infected, compared to 30 deaths in Spain and France with roughly similar total infection figures. Health minister Jens Spahn is recommending that meetings with 1000 or more participants should be cancelled. The German media have noted that the CDU congress scheduled for April will have 1001 delegates, and may also be at risk.
In the UK, the government’s strategy of delay seems to be working so far. The UK has only a little over 300 cases. We noted that paybooths for public toilets in London have been removed to allow people to wash their hands more frequently. Self-isolation is more widely accepted, too, whereas in Germany the media are still debating the pros and cons of such measures.