If the number of water lilies on a pond doubles each day and it takes them 29 days to cover the entire pond, what day is the pond half covered?
This puzzle is how Martin Hirsch, head of the Paris region hospital network, describes the brutal first wave of Covid-19 which triggered lockdowns across Europe in March and April. The answer is 28, because once the pond is half covered it only takes an extra day for the water lily spread to double in size. “A one day delay means doubling the cases, doubling the seriously ill and doubling the deaths,” he writes in a new book on hospitals battling the virus. “Every day counts.”
Hirsch’s metaphor is relevant to the new wave of Covid-19 cases currently hitting Spain, France and the UK. The pickup certainly looks like a water lily in full flow.
Deaths are increasing at a slower rate, but they are also clearly on the rise. The solace here is that they’re averaging 100 or less per week in those same countries – although tragic, it’s a far cry from the peak levels of 1,000 seen in lockdowns last spring. Mass testing and screening programs put in place this summer detected asymptomatic and mild cases earlier, while critically ill people are better treated and less likely to die, doctors say. But the fear is that by the time death rates skyrocket, it will be too late to do anything.
This is why epidemiologists and stock market investorssee national lockdowns as a growing risk, even as French leaders from Emmanuel Macron to Britain’s Boris Johnson have said they would rather learn to live with the coronavirus rather than impose another set of draconian restrictions on the popular movement. Government scientistspredict the UK could report 50,000 cases a day by mid-October, up from nearly 4,000 now; France and Spain already have around 10,000 on average. The temptation to shut down stores, businesses and schools for a short time, painful as it is, might be impossible for governments to ignore if the situation worsens.
Rather than assuming that the water lily will spread out of control like before, there are a few reassuring factors to keep in mind.
Unlike the first wave, when lockdowns seemed the only way to save time to relieve overwhelmed hospitals and save lives, we know a lot more about SARS-Cov-2. Governments have improved top-down surveillance by screening, tracing and isolating positive cases to identify and break the chain of transmission. Individuals have stepped up prevention – wearing masks, hand washing and social distancing – to hamper the ability of the virus to spread. Curatively, as we wait for vaccines and game-changing therapies, steroids and blood thinners have improved patients’ recovery in hospital. The equipment shortages that have left frontline workers, from supermarket cashiers to medical staff, sorely exposed are nowhere near as severe as they were in April.It is still possible to re-emphasize all of these interrelated measures and more stringent local restrictions. that were used in cities and regions when the crates jump, without putting entire countries in a bell. It is not just a question of economic interest. The high price of edging included increasing inequality, asharm children’s education for little epidemiological gain and delay screening for potentially life-threatening cancer.
The challenge is time and public confidence. Targeted measures are slow to arrive and hospitals are starting to fill up again. Patients with Covid-19 now represent 20% to 30% of ICU bedsParis andAreas of Madrid. The test systems arestretched to the limit, in some places to the point of collapsing. It’s easy to see how confidence in the authorities could evaporate. People can just take matters into their own hands, switching between fear (self-imposed restrictions on movement) and fatigue (letting go of social distancing). The result would be sleepwalking in the lockdown.
This is where transparency and trust come in. Governments need to be clear about their strategy, which sometimes seems to oscillate between letting the virus circulate (eg restoring nightlife and tourism in a hurry) and eliminating it altogether. . They should avoid doing an about-face on public health messages, taking a page from the book from Sweden, which has by and large followed its rules.stable since the start of the pandemic. And they should take solace in Italy’s current success in containing the virus, as well as the effectiveness of local lockdowns seen in several countries. The second waves can still be stopped, or at least slowed down.
It is clear that several major European countries have been late on Covid-19. They lack the pandemic muscle memory of Asia and the natural defenses of a low population density. But that doesn’t mean they’re doomed to lock up again. Sometimes the water lilies can be contained without draining the pond.
This column does not necessarily reflect the opinion of the Editorial Board or of Bloomberg LP and its owners.
To contact the editor responsible for this story:
Melissa Pozsgay at [email protected]