European governments are rolling out plans outlining how they will start to cautiously unlock their countries and fire up their economies, but the lifting of lockdowns is being complicated by a string of studies suggesting that even in cities and regions hit hard by the coronavirus, only a small fraction of the population has contracted the infection.
That presents governments with exactly the same dilemma they faced when the virus first appeared: Lock down and wreck the economy to save lives and prevent hospitals from being overwhelmed with the sick, or, allow the virus to do its worst and watch health care systems buckle and the death toll mount.
There had been hope that sizable numbers — many more than confirmed cases — had contracted the virus, protecting them with some immunity, even if temporary, from reinfection. That would help ease the complications of gradually lifting restrictions.
“The choice we face is no different to the one we faced at the beginning,” noted British commentator Daniel Finkelstein, a onetime adviser to former British Prime Minister John Major. “How long can we socially, economically and politically sustain the lockdown before we decide that the cure is worse than the disease?”
It is a question every government is asking.
Hopes of swift exits from lockdowns have been dealt a blow in Europe, as well as in the United States and Asia, by a series of studies indicating how few have been exposed so far to the coronavirus, thanks to the lockdowns. A study in California by public health officials and scientists at Stanford University and the University of Southern California suggests that 2.5% to 4% of residents in Santa Clara County, south of San Francisco, and Los Angeles County have had the virus.
A French study suggests less than 6% of France’s population will have been infected by the coronavirus by the time the country begins to unlock slowly in May, according to a study led by the prestigious Pasteur Institute. That would mean few people would have developed any possible immunity by the time the lockdown ends, meaning that if people mix more, more will contract the virus and more will go on to develop the disease COVID-19.
“To achieve a sufficient level of collective immunity to avoid a second wave, you need 70 percent of the population to be immune,” said one of the authors of the study, Simon Cauchemez. He and his fellow Pasteur Institute researchers warn that a rapid lifting of restrictions could prompt a second huge wave of the epidemic. Collective immunity, also known as herd immunity, means the virus is less likely to spread to people who aren't immune, because there are not enough infectious carriers to transmit it.
Officials across Europe also say that the lack of testing capacity, or even of reliable enough quick antibody tests, is further hampering their plans to ease home confinement. Without better and speedy testing, public health officials won’t know if, when or where a second wave of virus infections is taking shape, making it harder to take preemptive measures with contract tracing. There remains a fierce debate among public health officials, virologists and government leaders about whether prior infection affords people any immunity, and if so, for how long.
The World Health Organization has said it's not known whether people who have been exposed to the virus become immune to it, and if so, for how long. Maria Van Kerkhove, an infectious-disease epidemiologist at the WHO, told reporters this week that some preliminary studies suggest “some people will develop an immune response.” She added, “We don't know if that actually confers immunity, which means that they're totally protected.”
Some European governments are trying to prepare their citizens for highly complicated unlocking plans, which will involve ambitious and long-term road maps to manage the impact of the unprecedented medical, economic and social stress the pandemic has caused.
In Britain, the government’s medical and scientific advisers say that it is highly unlikely that a large percentage of people have already been infected. Chris Whitty, the chief medical officer, said at a news conference that Britain will have to live with disruptive social measures for at least the rest of the year, saying it is “wholly unrealistic” to expect life will return to normal anytime soon.
“This disease is not going to be eradicated; it is not going to disappear,” he said at the government's daily coronavirus briefing. “So, we have to accept that we are working with a disease that we are going to be with globally ... for the foreseeable future,” he added. He warned that the chance of having a vaccine, or even highly effective therapy for COVID-19, within the next calendar year was “incredibly small.”
As the government remains highly cautious, Conservative lawmakers are becoming restive, warning midweek that its “safety-first” strategy was putting tens of thousands of businesses at risk. Senior Conservative lawmaker Charles Walker said, “There has got to be an economy to go back to. All MPs right now are dealing with dozens, if not hundreds, of local businesses that are fearing for their future.”
Germany’s chancellor, Angela Merkel, is also coming under mounting pressure to ease restrictions quickly. She said Thursday that the coronavirus pandemic is “still at the beginning” and warned, “We will be living with this virus for a long time.” Merkel told the country’s parliament that she understood public frustration and the urge to relax coronavirus restrictions as soon as possible, but moving too fast, she added, risked setting back what had already been achieved with the restrictions.
“Let us not squander what we have achieved and risk a setback. It would be a shame if premature hope ultimately punishes us all,” she added. Germany has the fifth-highest COVID-19 caseload behind the United States, Spain, Italy and France, but extensive and early testing has allowed fatalities to remain low. The country’s authorities have reported more than 150,700 infections and 5,354 deaths to date.
The problem for all governments is they are running out of money to support their deflated economies. And Europeans are showing signs of tiring with the lockdowns and draconian restrictions. A study of data this week by Mannheim University in Germany suggests that the proportion of people avoiding friends and relatives has slipped from nearly 70 percent maintaining strict social distancing to less than 50 percent.
Most European governments have started to offer some concessions and are feeling their way nervously to relaxing some restrictions. In Germany, the latest case figures show that people who are recovering outnumber new infections. “It is precisely because the figures give rise to hope that I feel obliged to say that this interim result is fragile. We are on thin ice, the thinnest ice even,” Merkel told lawmakers.
Nonetheless, Germany’s gradual easing of restrictions will see schools and hairdressers allowed to reopen on May 4. And stores no bigger than 800 square meters were permitted to resume business this week, along with bookshops and car showrooms.
In the coming days, France too will present a plan detailing how slowly to unwind its lockdown after May 11. Protective masks, increased testing and maintaining social distancing will likely be highlighted, say officials. French retailers are to be allowed to restart their business on May 11, although with some curbs in areas with high infection rates.
The easing comes as the government of President Emmanuel Macron has come under mounting pressure to get the economy running again. Restrictions may remain in place on traveling between regions.
Italy has earmarked May 4 for relaxing some quarantine restrictions. Pressure has mounted on Prime Minister Giuseppe Conte to get the country working again, with southern regions reporting zero infections. Across the nation, the numbers of new infections are declining daily. But problems remain in the north of the country, especially in Lombardy, the hardest-hit Italian region of all and the country’s commercial and manufacturing powerhouse, which accounts for a quarter of Italy’s GDP.
Italy’s representative on the executive board of the WHO, Walter Ricciardi, has warned it would be highly premature to ease Lombardy’s lockdown. “May 4 is just too optimistic for Lombardy,” he said. Stefano Patuanelli, Italy’s economic development minister, has argued publicly for a patchwork approach, with regions with fewer cases being allowed to lift lockdown restrictions sooner.
Some southern governors have warned that if a lockdown is not maintained on Lombardy and another hard-hit northeastern region, Marche, they will bar entry into their territories to anyone arriving from the north.