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Between Complacency and Panic




Truth is the first casualty of epidemics. Theodore Dalrymple writes:

Much is still unknown about the virus and its mode of spread. Even its fatality rate is unknown because many infections may have been without symptoms and therefore not come to the attention of the public health authorities. If this is indeed the case, the fatality rate would be considerably lower than the 2% at present estimated, though it would also indicate that the spread is more difficult to control. All that can be said for certain is that the old are more at risk than the young, as are those with pre-existing medical conditions such as diabetes and high blood pressure. If a vaccine were developed but was initially in short supply, it is they who should be immunised first; but in any case, it is unlikely that one will be developed quickly enough to affect the course of the epidemic. (Even the need to immunize the old first might be disputed, for more years of human life might be saved by preventing the death of one thirty year-old than by preventing the deaths of five eighty year-olds.)

As in the Cold War, we now talk of containment rather than of eradication. Early hopes that the United States might be spared the epidemic have proved what they always were, illusory. It is not only goods that are globalised.

For the moment, containment relies on case-finding, contact-tracing, and isolation or quarantine. In essence we are employing the methods used during the Black Death of 1347-1349. (They were unsuccessful in the Black Death, which killed a third to one half of the population of Europe, because, unknown at the time, the disease was carried mainly by a non-human vector.) Those who have symptoms of the disease, and those who have been in contact with them, are asked to isolate themselves for two weeks, until they are no longer—according to current ideas—infectious to others. Large gatherings are to be cancelled or postponed, as during the Black Death, and people are advised to travel as little as possible, especially by public transport, where the possibility of contagion is high. In the fourteenth century, walls were washed with vinegar and fumigated with burning herbs; we are told to wash our hands often and not to touch our own eyes or mouths, though how far this is actually effective in preventing spread to oneself is unknown. Sometimes it is necessary to go beyond the evidence.

[Theodore Dalrymple, "Between Complacency and Panic,” Law & Liberty, March 9]


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  1. What we are lacking at the moment is good data. You don’t measure the health of the nation by polling doctors’ waiting rooms or hospitals – that’s where the sick people go. That’s precisely what happens with COVID-19 testing, because under current guidelines only people with suspected infections are tested. At the same time the number of tests administered daily is increasing, and not surprisingly the number of new infections detected.
    Only with good data can we know the success of our efforts to mitigate the epidemic. Only with good data can we titrate the economic disruption so that the cure doesn’t kill the patient, so to speak. The same methods by which we sell products and predict elections can be applied to testing to remove these distortions.