Covid-19 is not nearly as deadly as the other pandemic diseases, such as the Spanish ‘flu or the Bubonic Plague, that have periodically swept the globe since the Plague. In this latest case the damage caused by our own contemporary plague appears to be one mostly of our own self-infliction, the result of overreaction to a misjudged threat. Historians will debate far into the future how it came to be that mankind caused itself such wanton harm. Yet for now, the goal must be to unlock Europe as quickly and comprehensively as its creaking supply chains permit. We need to start rebuilding.
By Matthew Parish*
Now we understand more about the Covid-19 coronavirus, it is time to unlock Europe. Coronavirus, it turns out, is predominantly a disease of the elderly and dying. It may hasten the deaths of those who would already soon die. As such, there is little a country’s healthcare system can do cost-effectively to save the lives the virus is taking early. Locking people inside their houses to prevent infection has ceased to appear a credible response to the virus, and not just by reason of the massive psychological, economic and social damage such a restriction upon basic liberties entails. There is no point taking measures to prevent overload of a national healthcare system if there is little the healthcare system can do anyway to prevent death, and/or the number of cases makes it inevitable that the healthcare system will be overloaded no matter what.
A data-based comparison undertaken by the author of Coronavirus infection and death rates across Europe indicates that the principal variant in determining the proportion of each country’s population so far infected with and dying of Coronavirus is the quality of the country’s healthcare system. The correlation is the reverse of what might be expected: the better the country’s healthcare system, the higher the rate of infection and death. Therefore Russia and Ukraine, with the worst healthcare systems in Europe, have the lowest rate of recorded infections and deaths; whereas Italy and the United Kingdom, with two of the best healthcare systems, have very high recorded rates of infection and deaths.
Underlying this prime facie unusual correlation is something doctors have known all along, namely that far more of the population is infected than anyone is caring to admit. Treating or even diagnosing everyone who has been infected is virtually impossible. Coronavirus causes premature death in proportions of the population who are inclined to die anyway, and because a large proportion of the population (perhaps some 1% per year) do die each year, Coronavirus is liable to overload healthcare systems. No country has anything like a number of hospital beds for the 1% of the population that will die each year anyway. Very few people can die in hospital. The net result is that by reason of the nature of Coronavirus as a catalyst of otherwise natural death, all healthcare systems across Europe are overloaded. The bad ones, when overloaded, record fewer cases of infection and death, while the the better ones, when overloaded, record higher numbers of infection and death, ex hypothesi. “Overloaded” in Italy means a lot more people in hospital than “overloaded” in Ukraine, where there are far fewer hospital facilities of any quality.
On the other hand, note that the ratio of infections to deaths across Europe remains roughly constant at about 3-4%. The statistics measured are the number of people who arrive in hospital infected, and the number of people who die in hospital having arrived there. This percentage is not substantially correlated with the quality of the healthcare system. This may be evidence for the proposition that there is nothing medical care systems can do to save lives in people infected with coronavirus; they either die or they get better. Otherwise one would expect a lower mortality rate in Italy than in Russia; but in fact they are much the same.
The foregoing does not mean that coronavirus has a mortality rate of 3-4%. It has a mortality rate far lower than that, in all likelihood only a mere fraction of a per cent, because only a small fraction of those who contract the virus enter hospital. This author contracted clear symptoms of the virus and cared for himself in self-imposed seclusion for a period of approximately four days, which seems typical as a recovery period for the 70-80% of persons who contract the virus and notice that they have symptoms. There is also an unknown proportion of persons who contract the virus without ever knowing it, bringing the mortality rate down still further.
The consequence of all this is that the pan-European government policy of response to the Coronavirus infection has been a failure because it was misconceived in its premises. That policy was premised upon the assumption that hospital treatment of the severest cases of Coronavirus was the best way of reducing the death rate; there was a danger of the hospitals becoming overloaded; to prevent the hospitals being overloaded was by lowering the infection rate (variously referred to as “R” – the mean number of people infected by every infected person) measures were taken to slow the spread of the disease; these involved locking everyone in their homes so they could not come into contact with one-another. The flaw in this logic is now apparent at every turn. Hospital treatment does not substantially reduce death rates. Therefore taking measures to reduce hospital overloading makes no sense. Had better testing data been obtained initially (as the World Health Organisation had advised at the early stages), we would have been able to reach this conclusion sooner.
As it is, locking people in their homes has not been sufficiently effective at reducing “R” to prevent hospitals from being overloaded. The result has been damage to each country’s healthcare system, as overloading has prevented people sick with other illnesses or problems from being treated. Nobody has even attempted to measure the economic or psychiatric costs of forcing everyone to stay at home, still less the costs in terms of rule of law (the lockdown measures have eviscerated the provisions of virtually every European constitution). Therefore Europe must be unlocked.
Governments will fudge the data to create a medical pretext for unlocking Europe. What we are told now is that the number of recorded cases in various countries is plateauing. The hidden inference we are invited to draw is that this means the infection rate across the population is lowering and that the disease has come to an end. This is a fallacious inference, because the data that is plateauing is not for a cross-section of the population but instead the number of hospital admissions with Coronavirus. Given that Europe’s healthcare systems are grossly overloaded. There are all sorts of possible explanations why hospital admissions might be plateauing.
One is that the hospitals are not functional and cannot accept or are turning away new patients. There is a lot of anecdotal evidence for this. When this author telephoned the United Kingdom’s National Health Service complaining of Coronavirus symptoms, he was refused treatment and told to stay in bed and not to come to a hospital or doctor’s surgery. He has heard several stories that to obtain treatment in a pharmacy, his friends and colleagues had to pretend they did not have the symptoms of Coronavirus in order to get into the shop and buy the medications they needed. In such circumstances, a second reason why hospital admissions may be plateauing is because Coronavirus patients are so frustrated with a healthcare system that does not work, that they are not using it and are staying at home and self-medicating instead.
Another reason why hospital admissions with Coronavirus may be plateauing is that governments are instructing hospitals not to receive more than a certain number of cases over any specific period. This can include government instructions only to treat the most serious cases. Virtually every European country is issuing instructions of these kinds. It is inevitable that if government restricts the numbers of people entering hospital then the infection rate, so defined, will go down. In fact there is no consistent evidence that death rates have slowed recently; each country is producing different figures, and there is no country-specific explanation why Coronavirus should hit different countries to different degrees, save that there is a correlation between deaths and average population age. This is to be expected, because for the most part Coronavirus kills people who are already terminally ill or reaching the end of their lives, and there are more such people in an older population for the obvious reason that most people die when they are old.
It may therefore be a fair inference that the act of unlocking seems to be driven not my medical considerations at all (because governments have not been collecting the correct data to make any correct medical assessments) but instead by macroeconomic pressures. This hypothesis is born out by the fact that Eastern European countries, with weaker balance sheets, have been the first to announce that they are unlocking. The Czech Republic has announced it will unlock completely on 25 May 2020. Serbia, Slovakia, Hungary and Poland may all follow shortly thereafter.
These countries will have their restaurants, bars and hotels open, and this is the definition of unlocking this article uses. That is because the opening of hospitality establishments represents the final lifting of the restriction of constitutional freedom of association so necessary for private enterprise to keep functioning. The first countries to unlock will be those that have domestic tourism economies they will be desperate to maintain over the summer. Summer holidays seem destined to be spent in Eastern Europe. Spain is also desperate to unlock for the same reason; even if if cannot get foreign tourists this summer, at least it can, it hopes, kickstart its domestic tourism industry.
Unlocking will be a stepwise process in most countries, by reason of supply chain management issues. Only countries with agricultural autarchies will be able to unlock at speed; international supply chains of agricultural products, now so comprehensively disrupted, will take time to piece back together. The shops may continue to appear sparse for some time to come. Nevertheless unlocking, once it begins, will trigger a domino effect as it becomes a competitive process. As each state unlocks, others will have to follow suit or lose a competitive advantage to early unlockers in the re-establishment of exports and the welcoming of tourists.
Immigration is likely to suffer from permanent restrictions. Much immigration has been suspended in the course of the Coronavirus crisis, although not in the ways commonly understood. For an EU or Schengen passport holder (including a British citizen), travel across the Schengen Zone, and in and out of it, has been possible throughout the lockdown even though governments have issued all sorts of assertion to the contrary. Air travel has been diminished but not excluded entirely. International train travel within Europe has been cut to perhaps 50 per cent of what it was, but again not excluded. The immigrants who will suffer are those seeking to enter Europe from Africa and the Middle East. For them, Coronavirus has been used as a pretext to strengthen further borders, and this is unlikely to be reversed.
Oil markets should be watched. Currently there is no physical market; nobody is buying gasoline. Therefore the market forward prices we are witnessing (e.g. Brent crude at USD18 per barrel) are random; they are pure guesswork by traders about what future demand may be. It is impossible to guess accurately, because nobody has been even thinking about a mechanism to measure the macroeconomic damage caused by a continent-wide removal of people’s most elementary civil liberties such as to walk down the street, to go to work or to meet friends and associates. Businesses would be well advised to hedge their exposure to potentially dramatic future fluctuations in hydrocarbon prices, as genuine demand for oil slowly re-begins. The extraordinary reduction in air travel may be an important factor in this regard; nobody knows whether people will start flying again as much as they used to.
Finally, a note should be made about the media, that has suffered shockingly through dramatic drops in advertising revenue: nobody wants to advertise in a crisis. Journalists have been laid off or furloughed; media across Europe is now infested with the worst sort of cheap Coronavirus journalism, unthinkingly publishing government statistics and failing in their critical role of holding government to account. The quality of government now is poor; governments across Europe have made a hash of the Coronavirus crisis, and other governmental functions have been put on hold.
As we move into a new era of state-commanded economies because private enterprises have been so comprehensively crushed by lockdown, it will be more important than ever for the media to undertake its proper role in constitutional democracies. An independent media will need to be kickstarted; but this is something that will prove particularly difficult to do by way of government subsidy, because the role of the media is to hold government to account which it will be loathe to do if it is dependent upon government largesse for its funding and survival. Let us hope some philanthropic billionaires are prepared to step in to help.
Covid-19 is not nearly as deadly as the other pandemic diseases, such as the Spanish ‘flu or the Bubonic Plague, that have periodically swept the globe since the Plague. In this latest case the damage caused by our own contemporary plague appears to be one mostly of our own self-infliction, the result of overreaction to a misjudged threat. Was this the result of over-responsive democratic institutions, enlarged healthcare systems holding excessive political power, globalisation, or the proliferation of information technology? Historians will debate far into the future how it came to be that mankind caused itself such wanton harm. Yet for now, the goal must be to unlock Europe as quickly and comprehensively as its creaking supply chains permit. We need to start rebuilding.
*Matthew Parish is an international lawyer based in Geneva, Switzerland. He has been named as one of the three hundred most influential people in Switzerland and was a (now retired) Young Global Leader of the World Economic Forum. He is Visiting Professor at the University of Leicester. He has written several books and over 400 articles. www.matthewparish.com