By Michael Klein
March 30, 2020
Across the globe, different countries have responded to the coronavirus pandemic with varying degrees of urgency and with vastly contrasting success rates.
What is becoming clear, three months into the COVID-19 crisis, is that the consequences of that global response – the freeze on travel, restrictions on movement, the ubiquity of protective face masks and social distancing – will be with us for quite some time.
Perhaps, most worryingly for the Cayman Islands, the ineffectiveness of the US response has turned our closest neighbor into the new epicenter of the virus. The consequences that flow from that are still emerging, but it will be impossible for Cayman to reopen its borders, as initially planned, on 12 April.
In all likelihood, the island will remain closed to travellers for several months, if not longer. The idea of cruise ships returning to these shores any time this summer now seems fanciful.
Cayman can and has put measures in place to control its own destiny, but we remain at the mercy of global forces we cannot control.
The global response
By now, everyone has heard about ‘flattening the curve’, the term used to explain why social distancing and lockdown policies are necessary to alleviate the pressure on health services.
Measures to minimize social contact will not only reduce the total number of coronavirus cases, but more importantly, they will lower the maximum number of people who fall ill at the same time.
South Korea is a textbook example for flattening the curve in the ongoing crisis. The country had learned from its experience with H1N1 and used large-scale testing, social distancing and quarantine early on. South Korea did not enter total lockdown, but used mass testing in combination with stringent isolation of anyone with symptoms and those they had been in contact with.
If there was a case study for how not to do it, it would be the US.
US President Donald Trump first described the coronavirus pandemic as a Democratic hoax, then as a ‘Chinese virus’. He has since flip-flopped between wanting to reopen the economy by Easter and stating that if his administration keeps the death toll to 100,000, it will have done “a very good job”.
Refusing World Health Organization coronavirus tests, the US initially attempted and failed to develop its own tests, most likely losing precious time in the process.
Infection rates in the US have increased enormously in recent weeks. Only 17 days after the first 1,000 cases were reported, the US had more than 100,000 coronavirus cases. Another two days later, on 30 March, active cases in the US were almost twice as high as in Italy, the second worst-hit country in the world, and two-and-a-half times higher than in China, when that country reached its peak of the epidemic.
An end is not in sight
Coronavirus has an incubation period of five to six days. It takes several more days for any tests to be reported. Current figures therefore do not show infection numbers today but what the situation was like about two weeks ago.
This is why any lockdown or social distancing measures will not have any effect on the statistics for two or more weeks.
Trump attempted to downplay the health crisis the US would be facing when it overtook China as the country with the most coronavirus infections. He argued that the true number of cases in China is not known. Unfortunately, that applies to the US, too.
Despite the protestations of the US president, the state of New York alone has more reported cases than France and the UK combined. If New York state were a country, it would rank sixth in the world, with more than 60,000 cases and more than 1,000 COVID-19-related deaths.
When can borders reopen?
The rise of infection rates in the US poses a serious problem for Cayman. More than 80% of the tourists who come to the Cayman Islands are American. A bungled healthcare response in the US will undoubtedly prolong the time it takes until Cayman can reopen its border to visitors from the north.
This is especially the case if Cayman successfully limits community transmission of the virus in the islands. If Cayman’s approach is successful, life on the island will be able to resume as normal in a matter of weeks.
But when Cayman can reasonably let foreign visitors return is anyone’s guess. The experience in other countries shows it may well be months.
After reaching its highest number of active cases (58,016) on 17 Feb., it took China 33 days to reduce active cases to 10% of the peak figure and 40 days to reach 5% of the maximum number. Officials in China are now gradually starting to reduce lockdown measures, although schools are not scheduled to open for several weeks in hotspot regions.
But China’s experience may be more of an exception than a guideline for countries like the US.
China used rapid detection and isolation of those who showed symptoms and quarantined anyone who had been in contact with them for 14 days. Apps are used to chart the location of every known case, color-coded depending on how recently it was detected. And there is an army of enforcers tasked with detecting and isolating cases.
These methods are not available in Europe, where countries responded with strict, blanket lockdown measures.
Meanwhile, in South Korea, reported coronavirus cases peaked on 11 March at 7,382. Today, 20 days later, that figure still has not halved. Because the peak of the epidemic in South Korea was lower, and the curve is shallower, it will also take longer to lower case numbers. That is, in effect, what flattening the curve is about: not so much reducing the total number of cases but spreading it out over time.
Perhaps by the same logic, the US administration’s failure to flatten the curve could reduce coronavirus cases quicker after its peak.
Speaking at a White House press briefing on Sunday, Trump declared that “the peak in death rate” in the coronavirus pandemic “is likely to hit in two weeks”.
While the US president has been known to be overly optimistic, it is widely assumed that the most affected US states are still at least two to four weeks away from reaching the worst of the crisis. It will then take at least four to eight weeks to get case numbers down.
However, if the US healthcare crisis develops in stages across states, the timeline of the epidemic could be stretched for much longer.
Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, estimated in an interview with CNN that the pandemic could cause between 100,000 and 200,000 deaths in the US. So far about 2,500 people have reportedly died from COVID-19 in that country.
In the UK, which has far fewer cases than the US, the deputy chief medical officer for England, Dr. Jenny Harries, said on Sunday that lockdown restrictions could remain in place for up to six months. Lifting them too soon would risk a second wave of infection.
Professor Neil Ferguson, of Imperial College London, an epidemiologist who advises the UK government, said equally in an interview with the Sunday Times the lockdown in the UK would need to last for months.
“We’re going to have to keep these measures in place, in my view, for a significant period of time, probably until the end of May, maybe even early June. May is optimistic,” he said.
Jim Hepple is an Assistant Professor at the University of Aruba and is Managing Director of Tourism Analytics.