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Lifting restrictions

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Tough decisions: we do not want the sacrifices of the past few months to have been in vain (Photograph by Blaire Simmons)

Politicians the world over are finding that it is a lot easier to start lockdowns than to end them. Bermuda is no exception. The imposition of shelter-in-place policies came into effect quickly and were willingly accepted by the vast majority of people, despite the hardship that this was bound to cause.This was a remarkable act of trust and consent on the part of Bermuda’s general population and showed a strong understanding of the threat posed. It remains very difficult to say definitively whether Bermuda’s curve has flattened and if so, whether we are now on the downslide of the slope.But here are two numbers that may help. As of Tuesday, there were 139 confirmed cases, including the six that were announced on that day. At the same time, there were 91 people who had the virus diagnosed and had recovered, and nine deaths — meaning there were 39 active cases. Compare that with a month earlier on April 27 when there were 110 confirmed cases, 44 recoveries and six deaths, meaning there were 60 active cases — 21 more active cases than there are now. At the same time, to date in May there have been three deaths. That compares with six recorded in April. If — and it’s a big “if” with four days to go — there are no more deaths this month, then the number of deaths will have been halved. These are signs of improvement which suggest Bermuda has been successful in its goal of containing the virus and reducing the rates of infection and deaths, albeit at a massive and growing socioeconomic cost.Now, as the shelter-in-place restrictions are relaxed, tensions are rising between those who would like to see the relaxation accelerated and those who continue to be uncertain about their safety. Stuck in the middle is the Government, which has the unenviable task of making critical decisions. Open the community too fast and there is a risk of a renewed and uncontrolled spike in infections and deaths, not only among the most vulnerable, but more widely. Open the community too slowly and the Government risks doing lasting harm to the economy and people’s livelihoods. It is easy to be an armchair-quarterback from the comfort of home, but having actual responsibility is a different matter. The decisions being made now are literally life and death.In these times, it is best to deal with the facts as we know them. We know that the rate of infection is gradually slowing and the number of people who are actively ill is declining. We know that the official death rate appears to be slowing. We know the virus is still with us and still poses a possibly fatal threat to all of us, but especially older people and those with underlying conditions such as heart disease, diabetes and respiratory problems.We know this threat will grow without adequate social-distancing. We know a reliable vaccine is months or years away and that one may never be found. We know we cannot remain paralysed for ever. We know, and this is the most important fact of all, that no one knows exactly how this virus works. Anthony Fauci does not know. David Burt does not know. Donald Trump certainly does not know.We know more than we did in January or February, but only a fool would predict an outcome to this. But there are lessons from history. One tells us that Philadelphia chose to hold a parade in the middle of the Spanish flu epidemic in 1918, while St Louis, a city of similar size and demographics, introduced and enforced social-distancing and therefore suffered a far lower mortality rate.What is less well known is that St Louis, having successfully contained the outbreak in the first instance, lifted restrictions too quickly and suffered a second, more severe outbreak, which forced it to clamp down again. Given that no one knows with any certainty how this virus will last or behave, but that we do know what happens when a city or country imposes social-distancing and what happens when it relaxes it too quickly, it makes sense, as frustrating and painful as it is, to move cautiously. The Government has developed a plan for a phased relaxation as the island reaches certain benchmarks. The plan is sensible and transparent.So far, it does appear that Bermuda has managed to contain the outbreak to a few areas, including, tragically, some care homes. The danger in reopening too quickly is that the virus will spread through the community. The Premier is right to be concerned about an “asymptomatic superspreader” who could spark further outbreaks that cannot be traced or contained. So the solution has to be twofold. First, shelter-in-place requirements need to be gradually lifted and individuals need to adhere to the rules as they stand. Bermuda has not had any of the suicidal scenes that were seen across the United States over last weekend, but it is galling to see people sitting on bar porches making no effort to socially distance. It is even more galling when there are masked shoppers adhering to six-feet social-distancing requirements while waiting to enter a grocery store just feet away. This makes no sense.At the same time, the Government has to accelerate its efforts to put its contact-tracing machinery in place. Bermuda has a testing regime that is capable of testing hundreds of people a day. But that is of little use if contact-tracing is not being fully implemented. If Bermuda does open up further, and if there is an increase in infections, which seems to be logical, it is critical that those individuals are identified early and those whom they have been in contact with are identified and tested as well. If this does not happen, the entire effort and the sacrifices of the past few months will have been in vain.

Photograph by Blaire Simmons