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On March 3rd, the UK government released a publication detailing its Coronavirus action plan, which contains the four-stage plan that will be implemented throughout the country, in all four devolved nations, as the impact of the disease continues to worsen. Below is a brief summary of each stage:

  1. Contain - identify cases as soon as possible, and attempt to prevent wider community spread of the virus. Powers have been given to enforce quarantines and extra funding granted to healthcare centres. The goal is to stop the virus from taking hold in the country.

  2. Delay - if containment does not work, measures such as closing schools, banning large gatherings, and incentivising working from home will be introduced. The goal is to delay the inevitable spread of the virus for as long as possible.

  3. Research - if measures taken to delay the virus prove ineffective, focus efforts on researching how to best fight the virus; working out how it spreads, and the best treatment methods. This includes research into vaccine development and deployment.

  4. Mitigate - the last resort scenario, at this point the government will focus on keeping essential services such as police/fire/ambulance functional, as well as bringing retired and newly graduated doctors to the frontlines.

At the moment, the UK Government insists that the country is still in the containment phase, despite the country's Chief Medical Officer and the government's chief medical advisor, Prof. Chris Whitty telling MPs as early as March 5th that the UK "was now "mainly" in the delay phase".

At first glance the government's refusal to move to the delay phase, despite 460 total cases, and confirmed community spread, seems stubborn and almost deluded, however, the Scottish Cabinet Secretary for Health and Sport, Jeane Freeman told MSPs after attending a COBRA meeting on the 10th that

The timing of moving into the ‘delay’ phase, and what measures are judged to be the most effective in that phase, must be and are driven very firmly by scientific and clinical advice. Understandably people will be looking to the situation in other countries and questioning why some of the moves they are taking are not being made here yet in Scotland and in the UK.

[...]

Timing is critical. If we take those measures too soon, we will not have the impact we need. If we take them too late, we will not reduce demand [on the NHS] to the level we need

What is the risk behind taking these measures - i.e. moving into the delay phase - too soon? I note that Poland, for example, which has a fraction of the cases of the UK, will close all museums, cinemas, & schools from Monday. Why might this be a mistake? Is there any research that has evaluated this?

(Note that although the example I have given is UK-based, I am also interested in answers that refer to the general postponement of more extreme countermeasures internationally)

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    This is more about strength of the measures than timing so it doesn't directly answer the question, but this paper argues that measures which are too strong actually prolong epidemics as you still need a large fraction of the population to be infected in order for herd immunity to kick in: pnas.org/content/104/18/7588 – llama Mar 12 at 16:55
  • Scotland is now officially in delay. – Martin Schröder Mar 12 at 18:18
  • I'm wondering if their four-stage plan is a reimplementation of the classic four-stage strategy youtube.com/watch?v=nSXIetP5iak – Peteris Mar 14 at 10:54
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Specifically with reference to the UK, an article in the Guardian reports that

Experts have warned about the risk that if tough measures are taken too soon, “fatigue” may set in, prompting the public to disregard the advice just as the virus reaches its peak.

Effectively the argument is that, absent some sort of enforcement squad if people are told to stay in lockdown for a significant period, without a significant scare factor to justify it, then people will assume the risk is actually overblown and start mingling again, just at the moment that many of them are at their most contagious, starting a whole new outbreak in the herd of uninfected.

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    To be more precise about "fatigue". Just closing schools is not helpful if students go to the cinema instead. Closing public places only has an effect if people actually stay at home at avoid contact with other people. This works only for a few days until everybody is tired of watching TV/netflix/whatever – Manziel Mar 12 at 9:51
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    This is obviously not true. One only has to look at the situation in China to come to that conclusion. I bet a lot of people upvote this rather than to deal with the realization of why their government is actually doing it. – dan-klasson Mar 12 at 18:04
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    @dan-klasson Isn't it enforced in China though? – user253751 Mar 12 at 18:39
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    Also, I'd think people in China are more used to restrictions and the Government telling them what to do. I would also think that their culture teaches more focus on the community/group than on the individual - and the right of the individual. – Baard Kopperud Mar 12 at 19:12
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    @dan-klasson Just because people aren't being arrested en masse doesn't mean that the quarantine isn't enforced. I'm sure that if people started breaking lockdown, the police would do something. It's just that in China, people are used to the government having the power to tell them what to do, and know that it's a bad idea to disobey. This is a government that deployed tanks to prevent the spread of a political ideology; I'm sure they'd have no trouble taking steps to prevent the spread of a lethal virus. – anaximander Mar 13 at 9:01
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Shutting down schools, banning large gatherings and pushing people to do home office has a massive economic cost. Of course you never get the exact numbers on either death or cost but essentially you have to answer questions like: How many death does one need to prevent to make a 10% reduction of annual GDP worth it? This is a complicated ethical question and I don't have an answer for it either. But 'reduce Corona death at any cost' is not a wise government strategy. Maybe the UK should fully move into the delay phase right now, but this is not an easy decision and people can have very different equally valid opinions on when would be the appropriate time.

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It's a balancing act. You want to save as many people from the virus as possible, but you also don't want to disrupt the economy any more than you need to. This isn't just people being greedy either, many people living paycheck to paycheck cannot handle a recession. Some of these people will, after losing everything, commit suicide. Others will turn to dangerous drugs to cope.

Even excluding economics-related deaths, how many people will forgo routine medical exams, for fear of catching the coronavirus at the doctor's office, and will then die from some disease that would have otherwise been caught early enough to treat? How many people will hesitate to see a dermatologist while a funny-looking mole turns into a full-blown melanoma? How many people will hesitate seeing their primary care physician about constant fatigue, and not find out about their atrial fibrillation until it causes a heart attack?

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    +1 for balancing. Sinking economy gets its death toll in many ways. Less economy brings less taxes, less health funding, worse food/drinks/means of transportation/recreation for everyone, more crime and so on. Most of these cascade effects don't disappear right after the quarantine is over and some of them have their own exponential growth over time that needs more and more effort to clear later. – fraxinus Mar 13 at 11:26
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Because you would potentially destroy some businesses

Understand that minor and temporary inconveniences can be absorbed by the market, but if those distortions last for long periods of time, they can carry serious consequences. For instance, Royal Caribbean Cruise Lines is offering full refunds through the end of July

Effective March 6, 2020, the new Cruise with Confidence policy allows our guests to cancel any cruise departing on-or-before July 31st, 2020, up to 48 hours before departure, and receive a Future Cruise Credit that can be applied to any future cruise departing in 2020 or 2021.

Now, you might be wondering why this applies here. Well, there's real economic consequences to that

RCL stock price

RCL will likely recover, but they're a big company. Smaller companies might not be able to run mostly empty ships and some have opted not to run at all

I am writing today because the situation has now become such that operating as a travel company involves significant risks of quarantines or medical detentions, which could diminish the travel experiences for which our guests have been planning. As a private company with strong finances, we do not have to worry about quarterly profit expectations – and that flexibility allows us the ability to do what is best for our guests and our employees, as we have always done.

Therefore, we have made the difficult decision to temporarily suspend operations of our river and ocean vessels embarking from March 12 to April 30, 2020

We're talking massive work stoppages. These cancellations will have ripples

  • Dock workers
  • Food vendors
  • Tourist attractions and tertiary beneficiaries (i.e. small tour operators)
  • Ship crews

And we're just talking the cruise industry. Airlines are in the same boat and that boat is starting to fill up

The major NCAA conferences have cancelled their postseason basketball tournaments amid continued fears over outbreaks of the coronavirus.

Most economies are service based, which means that a full-on quarantine translates into businesses unable to meet whatever economic activity brings in money. As such, people get furloughed, lose jobs, and the whole effect can spiral out of control.

In Seattle, bracing for the coronavirus also means preparing for what could be a devastating economic impact. Business owners and residents have already seen a drop-off in tourists in areas of the city that heavily depend on foot traffic.

"It's like a ghost town," Francisco said about the famous Pike Place Market where she has her shop.

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    And not doing it will most likely kill people. – Martin Schröder Mar 12 at 18:16
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    @ReinstateMonica-M.Schröder It's a balancing act. The number of people who have died from cruise ship infections is fairly low at this point (compared to volume of deaths elsewhere). People are acting out of an abundance of caution, but the post-coronavirus market may not look the same... – Machavity Mar 12 at 18:18
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    @ReinstateMonica-M.Schröder Driving kills people (a LOT of people), yet we still allow people to drive to restaurants, events, and all kinds of other optional leisure pursuits. Although most people don't like to admit it, a price is attached to lives, even our own. Even if you don't know you're doing it, the very act of leaving your house to see a movie puts lives at risk, and you've weighed the value of those lives against the cost of not going out and made a value judgement. The same holds true each time you eat out or go to a concert instead of donating that money to lifesaving charities. – Nicholas Mar 12 at 19:24
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    @ReinstateMonica-M.Schröder, doing it will most likely kill people as well. It's just that someone dying of a heart attack because they put off a doctor's appointment because they'd lost their job isn't as dramatic as someone dying of a COVID-19 infection. – Mark Mar 12 at 21:21
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    To move the discussion away from the US (and bashing US healthcare/pensions etc. which will happen otherwise). Just because the Europe has a "free" health care system and pensions doesn't make the economic reality different. A serious decline of economic output will have an effect on lives that might easilly be greater than the losses likely to be suffered from Covid-19. Someone has to pay for, and produce, food, healthcare, pensions etc. The fact we don't pay out of pocket just means a lot of those costs are hidden and a general slowdown effects everyone. – DRF Mar 13 at 13:56

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