Over the months, each step has got more rigorous, more effective and less intrusive, in a virtuous circle. It is worth testing every single member of a city to identify a small number of potentially infectious individuals because it should allow a return to normal life within in a few weeks. Strict local measures are popular because they allow freedom most of the time for the great majority of the population.
In the West the circle has instead started to turn vicious. There is not a lot of point in testing and tracing if infected people are not effectively isolated, nor is it valuable to isolate people if a large faction of infectious individuals go undetected. When public health measures are ineffective, faltering compliance with them is an inevitability.
The Chinese have had the right goals since January because their leaders listened to their best infectious disease epidemiologists, who came quickly to correct conclusions. In the West, many leaders have been reluctant to take painful measures until they are led to them by public opinion. Furthermore, heterodox views from within the scientific establishment get consistently amplified by politicians and the press even if they are nutty, especially if they justify government inaction.
The result is that the terms of the debate have been skewed from the beginning. The idea that we needed to “flatten the curve” this spring was a difficult enough sell but the reality was flattening the curve has never been enough. As long as the virus circulating, society and the economy stay in purgatory. Nevertheless, the idea that there is an acceptable level of viral transmission has become deeply ingrained. The opportunity to fully suppress the virus within the UK and Europe in the summer was lost and an unnecessarily painful winter has been the result.
Early in the year, I noted that the West’s response to Covid would have been much better if the media had shown scenes from the accident and emergency department in Wuhan during the darkest days of the intitial outbreak. This autumn I suggest that the live feed should instead be turned on the nightclubs of Shanghai. Seeing the fruits of an effective response to Covid will help the West to learn the lessons it needs from the current experience. I just wish I had something more immediately constructive to say about what to do right now.
- Daniel Falush is a professor of statistical genetics at the Institute Pasteur, Shanghai, China
Protect yourself and your family by learning more about Global Health Security