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.