The Economist USA - 21.03.2020

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The Eeonomist March 21st 2020

~ hold until April, and the hiatus is likely to
be a lot longer. This summer's internation-
al Euro 2020 tournament has been put off
until 2021 (as has the Copa Am~rica, which
was to take place in Colombia and Algenti-
na).11te Glastonbury festival has been can-
celled; so will much of the summer be.
Not all the steps being imposed are well
supported by evidence. Size limits on
smaller gatherings-Austria, which is im-
posing some of the strongest mles, wants
no more than five people together at a
time-are open to question. Anastasia
Pharris of the European centre for Disease
Prevention and Control, the Bu's public-
health agency, says she knows of no data
supporting specific cut-offs for gathering-
size with regards to covid-19 transmission.
Politicians also seem much keener on
banning international tr.wet than epide-
miologists are. 11te World Health organisa-
tion does not recommend broad interna-
tional travel restrictions, or the closure of
borders. But on March 17th the BU banned
non-essential travel into the bloc for 30



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days (see Burope)-at the same time that
other countries, from India to America,
have banned non-citizens arriving from
the BU. Experts agree mrdons sanitaires
around whole regions will make no differ-
ence to the epidemics in individual coun-
tries at this point.
Perhaps the most interesting area of di-
vergence has been school closures. For
continental countries, they were among
the first controls to be put in place, as they
have been worldwide (see Intemational). It
was not until March 18th that first Wales,
then Scotland and finally England said they
would close theirs, too.

Be careful of Grandma
How useful this will be will vary from place
to place. School closures make most sense
in societies where old people spend a lot of
time with children and young people and
disrupting those ties is hard. Italy, where
about two-thirds of adults aged l.8-3S live
with their parents, and many houses con-
tain three generations, is a case in point. At

Italy

South Korea
France

log sale
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3 s 7 9 11 13 15 17 19 21 23 25
Days since 1ooth case

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Date Df 100th e1se Feb20th

Total number of cases • 8,
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Feb 23rd Feb29th
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Mar 1st Mar 2nd Mar51h

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Briefing The pandemic 17

the same time, closing schools means par-
ents have to find someone else to look after
their children or do it themselves. In 2009
researehers at the Brookings Institution,
an American think-tank, estimated that
closing schools and nurseries for a month
would cost America somewhere between
0.1% and 0.3% of GDP. And if the parent
works in health care, the losses will be
more than financial. The Brookings paper
estimated that between 6% and 19% of
health-care workers would have to stay at
home during a school closure; the English
closures allow for the children of health-
care workers to continue to go to school.
There is also the question of when to in-
troduce such closures. In the Imperial
modelling the closure of schools and uni-
versities has a prompt, if not overwhelm-
iog, effect. But they also have a delayed
cost. This is because of the effect they have
on the second wave of the disease.
Interventions which suppress the re-
production number save a lot of lives. But
they do not make the population immune
to the disease. so if you relax the interven-
tions, thus letting the disease's reproduc-
tion number rise back up, it will promptly
set about infecting the large pool of people
it missed the first time round.
The model from Imperial showed this
well-known effect in action. After its five
months of restrictions were brought to a
close, a second wave started to build in late
autumn. When the model was run with
schools and universities closed down at
the beginning of the first outbreak, this
second wave was considerably worse, be-
cause immunity built up through infec-
tion-in-the-course-of-education was ab-
sent (see chart 2 on next page).
Concerns about a second wave are one
ofthereasonsthatgovemments cannot re-
assure citizens over just how long the dis-
ruption to normal life will continue, in-
stead bandying about "the time beings"
and •coming weeks and months·. Few are
as open as the Robert Koch Institute, a Ger-
man government health agency, in saying
that, in extremis, tough restrictions may
need to remain in place until a vaccine can
be made, tested and put into use-a period
it sees as lasting up to two years.
Even if governments were forthright
about how long they expected their impo-
sitions to last, it is not clear that the deci-
sion will be theirs to make. In free societies
the duration will, in practice, depend on
how compliant people are, and for how
long. The team at Imperial reckons that, if
their measures are to show the desired re-
sults, compliance with each of those mea-
sures must be at least S0-7S'%. In the early
days that may be possible: the chastened
and fined French will not be out in the
same numbers over the coming weekend
as they were over the previous one. And as
hospitals start to fill and then oveiflow, ~
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