COVID-19 Library. Filling the Gaps

Abstract

Objectives: The present coronavirus crisis shook the modern world as only the world wars have shaken it before. In this review we analyzed the lockdown-based crisis management which was implemented by nearly all the countries, lessons learned and ways to improve the management of similar events in the future.

Methods: An extensive review was performed to collect articles filling the following gaps in most discussions related to COVID-19: the historic experience of previous pandemics, connection of health and wealth, machinery of decision making, and evidence-based evaluation of the crisis management.

Findings: (1) Historic experience. Influenza-like pandemics are a natural consequence of human development and, therefore, should not be considered a global threat. The history of the Spanish Flu and numerous less-severe pandemics is well documented. It proves that the COVID-19 problems are not new, unlike round-the-globe governmental reactions that are unprecedented and definitely not based on any successful policy in the past. (2) Health and wealth (risk-benefit analysis). Enormous progress in life expectancy, health status, sharp decrease in infant mortality – all followed the economic progress and were clearly explainable by economic progress. Lost income means lost lives. In Israel, e.g., at least 500,000 life-years were lost to lockdowns. (3) Decision making. Several governments had prepared (years ago) detailed plans of response to influenza-like pandemics. The response plans mentioned lockdowns as a means of last resort only. All these plans were abandoned at the beginning of the COVID-19 crisis, with lockdowns becoming the first and main instrument. Actually, no scientific discussion took place. The extent of human life loss due to lockdowns themselves has never been taken into consideration in the decision-making process. (4) Crisis management. The forecasts which were chosen for political decision making systematically overestimated the threat, supporting excessive measures. The pro-lockdown evidence is shockingly thin, and based largely on comparing real-world outcomes against dire computer-generated forecasts derived from empirically untested models.

Discussion: Special interests of the decision-making groups provide partial explanation of the unprecedented policy. But the policy of depriving citizens of their basic rights could not be implemented without citizens’ readiness to accept such deprivation. However, it has been stated that at some advanced stage of social development, the citizens – clients of the welfare state – tend to abandon the care of public affairs to the State.

Conclusions: Neither special interests nor people’s qualities can be changed in a short time. It seems therefore that the only way to avoid the mistakes of the COVID-19 management in the future is to avoid managing any future medical crisis by means of emergency powers. Emergency powers should be used only in case of war.

Keywords: Health and Wealth, Spanish Flu, Nursing Homes, Compulsory Mask-Wearing, Factors Behind Decision Making, Conflict of Interest

JEL Classification: D72, D73, D78, H51, I15, I18