On Friday evening, hours after a London hospital declared they had run out of intensive care beds, Boris Johnson tightened the restrictions on Londoners a notch, closing pubs and restaurants. Part of London’s extensive public transport network is already closed. London is moving closer to lockdown, but it isn’t there yet. In my north London neighborhood, there are plenty of people on the streets, darting in and out of shops, where shelves of necessities have been emptied. The next step, one the government hopes it doesn’t have to take, is enforcement.
The empirical evidence for a lockdown couldn’t be clearer: To slow and stop the spread of the novel coronavirus, go early and go hard. The more stringent the measures to keep people physically apart and isolate those who have become infected, the quicker the curve of infections is flattened.
So why haven’t all heavily affected countries — especially Britain and the US — rushed to follow the same protocol? The answer tells us less about the pathogen’s progression than about how different societies, or at least their governments, approach the trade-off between public health and civil liberties.
National responses have fallen into roughly two groups. There is the lockdown path set by Wuhan in China, and now followed in Italy, Spain, France — and now California. And then there is the gradualist approach adopted by Britain and the US, and which also characterizes responses by the Netherlands, Switzerland and a few others. Boris Johnson has only this week changed the government’s more laissez faire approach to confronting the virus threat. That was in response to a new study from Imperial College’s Covid-19 team, showing that the government’s path would lead to a much higher death toll and quickly overwhelm the National Health Service.
Lockdown is a take-no-chances approach in which the clear priority is suppressing the growth of infections and saving lives. It acknowledges that when the number of people who need a respirator outnumbers the capacity of the health system to provide one, far more people die. Lockdowns may vary a little from place to place, but they are compulsory; they have the force of both law and policing behind them.
When China announced a lockdown in Wuhan, the severity of it shocked the world. There was no travel into or out of the city, and all transport and private cars were suspended within the city boundaries. Shops, schools and restaurants were shut; only grocery stores and pharmacies stayed open. Those who went into the streets to pick up essential supplies had to wear a mask.
There were also horrors, such as forcible removals from homes and lonely deaths. But ultimately the stringent measures seem to have done the trick. In the first seven days of the lockdown, the number of people infected by each individual with the virus dropped. Two months later, China is reporting no new new local cases.
Italy’s lockdown has been nationwide; again, only supermarkets and pharmacies remained open, as well as some religious institutions. France also closed shops, restaurants, bars, schools and other meeting places. It barred people from leaving home except for essential visits to buy food or medicine or for jobs that cannot be done from home, for which people need a special certification. French President Emmanuel Macron deployed 100,000 police officers to enforce the news measures, which he called a “public health war.”
In the gradualist group of governments, there are stringent guidelines that are tightened over time — but they are voluntary. The strategy is a bit woolly. Worse, the anticipation of more restrictions to come creates confusion and encourages panic buying. A charitable reading would be that those following a gradualist approach believe they have this under control without draconian measures; and if not, they will be able to introduce them in time. On Wednesday, Dutch Prime Minister Mark Rutte warned the nation that most people would get the virus. The Dutch, like the Johnson government initially, seemed resigned to the idea of herd immunity — allowing the disease to spread until enough of the population, about 60%, is infected so that wide scale immunity can be achieved.
As I wrote Tuesday, the Imperial College team shows how mad this is: The number of infections would quickly overwhelm even the most equipped health system. Many more hundreds of thousands would die. And, of course, viruses mutate. The Dutch government later said that herd immunity wasn’t the goal, but made no apologies for the gradualist approach.
Had China acted three weeks earlier, the world might not now be experiencing the economic and health care crisis it must now contend with for months ahead. Of course, the virus may surge again in China. Until a vaccine is found or governments are able to determine the balance of measures that keep its transmission rate below one — that is, one additional infection per case — then that risk exists. But the important thing is buying time,an argument made by Tomas Pueyo, the entrepreneur and analyst whose data-driven articles on the crisis and response have been widely praised by health experts.
The argument that gradualists have the same goal as lockdown countries but slightly different means grows weaker by the day. Why wouldn’t you suppress infection as much as possible and buy time for health services to get reinforcements and for vaccines to be tested?
There are of course broader economic implications of lockdown. The U.K., which is still part of the EU’s single market for now, imports half its food supply. The Dutch ports of Rotterdam and Amsterdam are among the busiest in the world. These are highly open economies and there is reluctance to do anything draconian that might further slow down these channels. But they have something else in common too. Britain, the US and the Netherlands are highly individualistic societies. In a model of national values by Hofstede Insights, all score substantially higher than, say, France and Italy on measures of individualism. Citizens of the latter two countries also like a higher degree of certainty, which may be why lockdown measures are more tolerated.
What if countries that have the greatest attachment to the individualist “I” over the collectivist “we” find it hardest to make the sacrifices required to squeeze through the eye of the needle and reach the land of post-infection without great human cost? That is a disturbing thought. It may also be that politicians who have stoked and benefited from polarization have a hard time convincing individualist publics to trust the government, and each other.
Johnson spoke Thursday of Britain being able to “turn the tide in 12 weeks.” That’s a hopeful thought, though it wasn’t entirely clear what he meant. Perhaps a vaccine will come sooner than many thought possible, or increased testing will help reduce the spread of infection. And yet, no government can count on it. Gradualism might have preserved individual liberties for a while longer, but continuing down that road will come at a cost even the most “I”-centered societies will likely find intolerable.