Page - 523 - in VULNERABLE - The Law, Policy and Ethics of COVID-19

523“Flattening the Curve” Through COVID-19 Contagion Containment effective containment of contagion, as was done in the Southwestern Indian state of Kerala, in Vietnam, and in Argentina. Flattening the Curve? The principal strategy adopted by most governments is to “flatten the curve,” so that countries’ health systems can cope with new infections by tracing, testing, isolating, and treating those infected until an approved vaccine or cure is available to all. But this is easier said than done. Vulnerability to infection and capacity to respond depend on many factors, including health care system preparedness, leader- ship experience, and ability to manage specific challenges posed. Government capacity to respond depends crucially on system capac- ity and capabilities—for example, authorities’ ability to speedily trace, isolate, and treat the infected—and available fiscal resources—for example, to quickly enhance testing capacity and secure PPE. Funding cuts, privatization, and other abuses of recent decades—in the face of rising costs, not least for medicines—have further constrained and undermined most public health systems, albeit on various pretexts. Physical distancing, mask use, and other precautionary mea- sures, besides mass testing, tracing, isolation, and treatment, have been able to check contagion without resorting to draconian lockdowns. Such measures have been quite successful so far in much of East Asia, Vietnam, and Kerala. Precautionary measures must be appropri- ate and affordable. To minimize the risk of infection, authorities can encourage and enable, if not require, changes in social interactions, including work and other public space arrangements, including for offices, factories, shops, public transportation, and classrooms. Lockdowns can have many effects, depending on context. Good planning, implementation, and enforcement of movement restric- tions, and adequate provisioning for those adversely affected, are crucial, not only for efficacy, but also for transitions before, during, and after the lockdowns. Nonetheless, lockdowns typically incur huge economic costs, distributed unevenly in economies and societ- ies. Governments must therefore be mindful of costs, including of dis- ruptions, and also of how policies affect various people differently. Hence, the effectiveness of a lockdown has to be judged primarily by its ability to quickly “flatten the curve” and to ensure no resurgence of infections. Success should not be measured by duration, enforcement stringency, or even unsustainable declines in new cases.