The United States and United Kingdom received information from an Imperial College London coronavirus report that was published on March 16.
Dozens of experts had informed policy makers that modeling showed millions would die and that health systems would be overwhelmed, the report said. A fight against the virus could go on for 18 months, it said.
To mitigate the disaster, new measures would need to go into place immediately and last for months before being relaxed. Life would never be the same, the report said.
This shocking study appears to have caused both US President Donald Trump and UK Prime Minister Boris Johnson to shift course and increase testing and measures.
In Israel, the virus threat was taken seriously much earlier, but cases have increased to beyond 500 nevertheless. Israel has more cases per capita than either the UK or US. With a very limited capacity in hospitals, Israel is correctly concerned about what the models produced at the Imperial College and by other experts show.
These models don’t only affect Israel, they affect the entire Middle East. Jordan is closing off roads with the army. The Gulf states are stopping flights. The Kurdistan region of Iraq is under curfew.
The language of the coronavirus crisis, such as “flattening the curve,” concerns of ventilators and intensive-care units and social distancing, are all found in the March 16 study.
We can conclude that Israel is entering into this model, hoping to mitigate the peak of deaths or flooding of hospitals that could occur if the virus spread too quickly.
While the UK was mocked for discussing “herd immunity,” the term is actually found in the report.
At its essence, the report tells us that governments are not trying to really win a war against this invisible enemy. Instead, they are trying to contain it and fight a war of attrition to triage parts of our society so that a massive social rebellion does not occur when hospitals collapse. What this means is that the public is not being told how long they will likely be locked down or how long the crisis will continue.
Optimistic projections about life returning to normal and the economy getting back on track appear to be unrealistic in light of this model. If airports are closed for a year and travel is limited for the same period, our lives will become increasingly similar to the 18th century in terms of what we do every day.
The study and its aftermath raise important questions about known unknowns and unknown knowns. These tautologies were made famous by former US secretary of defense Donald Rumsfeld and are necessary in dealing with this virus.
Why has South Korea had so few deaths? Why has the virus, according to China, appeared to stop spreading in the very place it began? Are estimates correct about it primarily affecting the elderly who have other illnesses? What happens if you have to quarantine a major portion of your medical staff when you most need them?
Worst of all is the known unknown of testing. We know people have the virus, but we can’t test them all quickly enough to stop the spread or identify the hot spots.
What we are left with is a series of complex questions. Egypt reportedly has only 206 cases of the virus and six deaths. Could a large country like that, without much testing, simply miss large numbers of cases?
Iran, which suppressed information about the virus’s spread in February, claims it has 18,000 cases and 1,200 deaths. If countries lie about the number of deaths, or if they don’t test at all, what do we know? We know enough to close borders, which is what countries are doing. Is that a death sentence for millions across the Middle East? It may be.
However, since many of those who reportedly die suffer from other illnesses, there is reason to believe that in places like Yemen the virus could spread openly and most of the deaths will be misidentified.
Ironically, the virus is, in some ways, more of a threat to advanced countries than those with weak or nonexistent medical systems. This is because wealthier countries are more vulnerable to breakdown when life changes and people demand a certain level of treatment. Poorer countries where millions are subjected to failed state structures have had to get by with existing health crises such as malaria or famine.
Israel is at the pinnacle of a type of developed OECD country that nevertheless lacks some qualities in common with either the Gulf or the US. Israel’s government was particularly concerned about the virus threat because it senses it is already in a vulnerable position, not only in the Middle East where there are security threats, but also in it not breaking the delicate social balance that underpins an already strained democracy.
Israel can’t suffer the death toll Italy is suffering. Israel also likely can’t use the methods China used. However, channeling the battle against the virus into a national security issue, in a country that is generally supportive of institutions like the army, is the chosen method.
The question now for most countries is whether the models produced after the China and South Korea examples were correct. Changes in some inputs and assumptions can have dramatic outcomes.
For instance, publics in democracies demand results, and the Imperial College study shows that results will take months to appear.
Governments also do not react slowly like a flattening curve. Their tendency is quick fix solutions. That is why Israel is being warned about a total lockdown.
However, the authors of the report noted that four interventions: social distancing, case isolation, household quarantine and school closures would have the largest impact “short of a complete lockdown which prevents people going to work.”
The elephant in the room at the end is the study never looked at the economic impact. It did note that after the initial suppression of the virus was enacted, interventions would be relaxed in September and infections would rise again.
World leaders are not telling the public that this is what they face. They may be concerned that panic could result in civil strife and mass protest. In Israel, the authorities have banned gatherings anyway, so there can’t be protests.
The end goal of the study and government policies is now to prevent the system from being overwhelmed. The question is which system will crack first, the medical, economic or governmental and security one. Those are the unknown knowns.