There were only two monumental, and conflicting, considerations in focus: the virus and the economy. Depending on the optic of the decision-makers, their quandary was either how to contain the pandemic without destroying the economy, or how to minimize the economic damage without making the pandemic worse. Every country made choices somewhere along that line between pandemic and economy hoping to contain the damage on both ends. Some came out better than others, yet the worst consequences were not from the direct effect of the virus but from the side-effects of the measures to contain it, the risks of collateral damage that were ignored earlier in the crisis.
As health care system resources were being shifted to deal with the coronavirus, they were being taken away from other patients. The first choice was naturally to cancel all elective procedures, then all non life-threatening diseases, then hard choices had to be made about diseases that are life-threatening, like cancer as the most obvious. As early as March, hospitals in Birmingham, UK acknowledged that they had to "make some difficult decisions" . At a larger scale and greater magnitude, Health Policy Watch warned that “COVID-19 lockdowns could lead to 1.4 million more tuberculosis deaths”..
The most damaging health issue associated with isolation and lockdown is mental health. In some countries, like in Thailand, the number of suicides had risen to nearly equal that of the casualties from the virus. In the US, the national public health group Well Being Trust predicted similar numbers also nearly equal to the number of deaths caused directly by the virus .
Without even considering the economic impact, the extensive collateral health damage caused by lockdown measures shows that risk management only focused on the virus, assuming there even was risk management considered, overlooking the overall impact on population welfare. Some degree of lockdown was necessary to slow the contamination and keep it within the health care system capacity for the shortest time possible. But setting lockdowns of several weeks in the future was more about crude and sweeping population control than about any health care predictive data.
The shortage of masks and PPE occurring so early in the crisis is also puzzling. Inventory of that type of health care supplies is not managed “just-in-time” like a car factory, six to twelve months supplies in ready stock would seem to be the norm to be ready for any disaster or crisis. That stocks would run low after a few weeks is expected, but then they would have had those few weeks to refill the pipeline without having to send military planes across Europe to pick up emergency supplies .
Social distancing leading to social isolation
The 2-meter (6ft) distancing that has been widely dictated is another case of tunnel vision. While it is scientifically correct, that magic number is neither effective nor practical in the real world. First, the number itself: given that it is actually the radius of a hemisphere, the concentration of the projected matter, the breath of the person, decreases exponentially with the distance, thus the risk of exposure decreases at the same rate. So, if a hemisphere has a radius of say 1 meter, then its volume is about 2 cubic meters, but if the radius is 2 meters, its volume is now 17, just for kicks, let’s say 3 meters: 56 cubic meters. Let’s apply some basic risk management principles with a risk factor of say 33% from the scientific reference so that instead of 17 cubic meters, we will only require about 11 cubic meters, which translates into a radius of 1,4 meter (4-5ft).
Ok, so, in the end, it is not much of a difference, is it? It does make a big difference all over the world. Let’s see what the natural social distancing is and compare it. The range is between 80 centimeters (Argentina) and 140 centimeters (Romania) . Compare that with our calculated 1.4 meters, just normal life for Romanians, and the scientifically correct 2-meter, really uncomfortable for Argentinians! And that is the point: 2-meter is too far outside the social norm to be acceptable and respected, while 1.4 meters is close enough to the global cultural average of 1.1 meters that is effective while still providing reasonable risk protection. Emphasis that the 2-meter scientific reference value is without mask, wearing masks further reduces the range of the projected matter.
The practicality of a 2-meter social distancing rule in many settings is nothing short of fantasy, public transports comes to mind, airplanes even with the middle seat empty, etc. While 1.4 would have been marginally ok.
The real problem is not measured in meters or feet, it is measured in human interactions. Humans are social animals, it is in our genes and there is no way couples will flirt and date 2 meters apart anymore than Middle-East traders can demonstrate their mutual trust by keeping such distance. Social, emotional, and business relationships are defined by the distance we keep from each other. In many cultures, not having a closer physical presence leads to social isolation which in turn affects society and mental health.
Then there is social distancing in business, especially restaurants and bars. Most of the restaurant business, and practically all of the bar business, is from leisure and pleasure, that is people who decide to eat out for social reasons, not because they have to eat. Would you really wish to have a dinner date with a plexiglass shield between you two? Fewer tables to keep distance? And pay comparatively more for your meal to make up the business loss? Going for a drink in a social bar in isolation, really?
Of course, there will be changes in social patterns, but impractical rules will not achieve that. There will be an evolution, not a revolution, of social behavior mostly driven by personal caution and some degree of fear, but lovers will still kiss across the table and you will still move closer to an attractive patron at the local bar.
- Cancer treatments in Birmingham suspended over virus 'pressures', BBC News
- Clinical guide for the management of cancer patients during the coronavirus pandemic, NHS UK
- COVID-19 Lockdowns Could Lead to 1.4 Million More Tuberculosis Deaths ..., Health Policy Watch
- Why coronavirus lockdown could see 6.3 million more people get tuberculosis, CNN
- 75,000 Americans at risk of dying from overdose or suicide due to coronavirus despair, group warns, CNN
- Coronavirus: RAF plane en route to Turkey amid row over NHS kit
- Preferred Interpersonal Distances: A Global Comparison, Journal of Cross-Cultural Psychology