We would like to think that we can eliminate COVID-19, but doing so is far from certain. The medical system has not been successful in eliminating HIV/AIDS or influenza; the situation with COVID-19 may be similar.
We are discovering that people with COVID-19 are extremely hard to identify because a significant share of infections are very mild or completely without symptoms. Testing everyone to find the huge number of hidden cases cannot possibly work worldwide. As long as there is hidden COVID-19 elsewhere in the world, the benefit of identifying everyone with the illness in a particular area is limited. The disease simply bounces back, as soon as there is a reduction in containment efforts.
Figure 1. One-week average new confirmed COVID-19 cases in Israel, Spain, Belgium and Netherlands. Chart made using data as of August 8, 2020 using an Interactive Visualization available at https://91-divoc.com/pages/covid-visualization/ based on Johns Hopkins University CSSE database.
We are also discovering that efforts to contain what is essentially a hidden illness are very damaging to the world economy. Shutdowns in particular lead to many unemployed people and riots. Social distancing requirements can make investments unprofitable. Cutting off air flights leads to a huge loss of tourism and leaves farmers with the problem of how to get their fruit and vegetable crops picked without migrant workers. If COVID-19 is very widespread, contact tracing simply becomes an exercise in frustration.
Trying to identify the many asymptomatic carriers of COVID-19 is surprisingly difficult. The cost is far higher than the cost of the testing devices.
At some point, we need to start lowering expectations regarding what can be done. The economy can protect a few members, but not everyone. Instead, emphasis should be on strengthening people’s immune systems. Surprisingly, there seems to be quite a bit that can be done. Higher vitamin D levels seem to be associated with fewer and less severe cases. Better diet, with more fruits and vegetables, is also likely to be helpful from an immunity point of view. Strangely enough, more close social contacts may also be helpful.
In the remainder of this post, I will explain a few pieces of the COVID-19 problem, together with my ideas for modifications to our current strategy.
Recent News About COVID-19 Has Been Disturbingly Bad