The lockdown conundrum
Published by The i paper (12th October, 2020)
As the nights darken, coronavirus cases surge and job losses soar, the debate over how best to respond to this strange new disease has intensified. Our Government, floundering from the start under its inept Prime Minister, has shifted from lockdown to loosening up restrictions and now drifts back towards rigid controls on citizens. A swelling number of critics cast covetous looks at countries such as Germany, New Zealand, Sweden and Taiwan, which fought the pandemic in different ways but all managed to retain some normality. Yet few people have clocked the significance of events in Africa and other parts of the developing world.
Perhaps we should listen to David Nabarro, Britain’s former candidate to lead the World Health Organization who is now its special envoy on Covid-19. This doctor has been desperately warning of the damage done by lockdowns in poorer parts of the planet. Last month he told MPs on the Foreign Affairs Committee that “containment measures” would lead to “vast increases in poverty, hunger, unemployment, and so on”. Now he has alerted The Spectator to “a ghastly global catastrophe” that is unfolding, stressing that his organisation does not advocate lockdowns “as a primary means of controlling this virus”.
This is good to hear – although Tedros Adhanom Ghebreyesus, his devalued boss at the WHO, could not stop praising China’s draconian response at the start of this pandemic and repeatedly warned against lifting lockdowns too soon. This influential body spooked the whole world with talk of developing nations’ fragile health systems overwhelmed by infections. Other UN experts issued terrifying warnings of 1.2 billion cases and 3.3 million deaths in Africa without effective interventions. Meanwhile the sanctified figure of Bill Gates, a key donor to WHO, claimed there could be 10 million corpses from coronavirus across the continent.
No wonder many countries in Africa followed the lead of richer nations and clamped down hard by closing borders, shutting businesses and ordering citizens to stay at home. But now take a look: this continent of 1.3 billion people has had fewer recorded fatalities from the virus than our island nation of 66 million people. It comprises almost one-fifth of the global population but just 3.5 per cent of deaths from this disease. Some data may be inaccurate, with deaths going unrecorded or blamed on other conditions as elsewhere, but it is clear from anecdotal evidence that those alarmist warnings were very wide of the mark.
The low fatality rates have puzzled scientists, although the most likely reason is age. We know this is the key indicator of risk: Cambridge statistician David Spiegelhalter calculates that a 65-year-old person is one hundred times more likely to die from this virus than someone of 25. More than one-fifth of Europe’s population is over 65 and the median age is 41 in contrast with Africa, such a young continent, where the median age is 18 and fewer than one in 50 people is aged over 65. Some nations, used to fighting infectious diseases, also responded well with community health teams and effective contact tracking while it is possible the climate, past exposure to coronaviruses in crowded areas or a tuberculosis vaccine played a role.
Curiously, there does not seem much difference in death rates between countries that locked down and those that ignored such measures, despite high transmission rates. Zambia shut borders, businesses and schools back in March and has since recorded 337 deaths among its 17 million people. Activists went to court to stop similar measures in Malawi after the issue became entangled in electoral politics, yet fewer Covid-19 deaths have been reported in this nation with a marginally bigger population than its neighbour. Experts predicted 16 million infections and 50,000 fatalities based on their modelling; to date there have been 5,821 cases and 180 recorded deaths.
Clearly such data raise concerns over lockdowns. One doctor in Malawi told me last month they had seen few coronavirus patients in their emergency wards, saying this was “a mystery” since they avoided shutdown of their society. So were some developing nations too quick to lockdown?
And is this really the best way to handle this new disease, especially when experts say we may have no return to normality for several years? Certainly the debate over how to balance control of a deadly virus with wider health, economic and social concerns is magnified many times over in places that have few safety nets, far poorer people and much deeper problems.
Health budgets, often already inadequate, were blown on fighting Covid-19 as priorities were switched from more serious diseases in Africa such as malaria and tuberculosis. Now reports show the horrific collateral damage. One study said suspending distribution of insecticide-treated bednets and falling use of drugs could lead to malaria death rates not seen for two decades. Another warned that interrupting programmes to dole out deworming medicines will worsen the impact of malnutrition. Others highlight surging levels of infant and maternal mortality –with 1.16 million extra child deaths in one worst-case scenario for the continent – plus hundreds of thousands more deaths from TB and Aids-related illnesses.
The economic impact, intensified by global economic downturn, is equally terrifying, with talk of poverty rates set back decades. One report suggested almost 10 per cent of Africans might slide into extreme poverty, with two-thirds of this blamed on lockdown. As the authors point out, the context is very different to richer nations since this can lead to hunger. The UN calls this a “global humanitarian catastrophe” as it warns an extra 130 million people could be pushed to brink of starvation this year. So will this be the biggest tragedy of the pandemic: how the rush to lockdown unleashed an epic man-made disaster that leads to millions of needless deaths?