From the bubonic plague to COVID-19, why lockdowns seem to persist

A year after the lockdown imposed in the Chinese city of Wuhan shocked the world, the tactic is proving to be a lasting tool to suppress the coronavirus almost everywhere.

When the first large-scale lockdown in modern times was implemented in China on January 23 at the start of the COVID-19 pandemic, this was deemed unproven and unthinkable, particularly by democratic governments opposed to the human rights violations impact of the freedom of movement of citizens on such an enormous scale.

But almost 12 months later, the UK is in the middle of its third nationwide lockdown as it battles a mutated form of the coronavirus. In Australia, the recent discovery of one case in Brisbane led to a three-day lockdown. And China, which is experiencing the largest outbreak since the start of the pandemic with more than 500 cases, has shut down three cities around Beijing this month.

“Prior to COVID-19, there was a strong global health discourse advocating against lockdowns and similar mass quarantines. This is just one of the areas where the current pandemic is believed to have turned, ”said Nicholas Thomas, associate professor of health security at City University of Hong Kong.

As far as possible, lockdowns will become part of the essential toolkit that governments can use to address both current and future outbreaks, he said.

Wartime measures

The speed at which China locked up millions of people when the pandemic broke marked the first time the measure was taken on such a large scale in modern times.

Until last year, severe lockdowns were synonymous with the waves of bubonic plague that swept Europe from the 14th century. Even during the Spanish flu of the early 20th century, no central lockdowns were imposed. However, China has imposed three major lockdowns in recent history: during a bubonic plague outbreak in the Northeast in 1901, and two shortly after the 2008 Sichuan earthquake and another in the midst of a bubonic plague outbreak in Gansu province in 2014.

Strange countries surprised by the Wuhan shutdown found themselves doing much the same just a few months later, when the virus spread uncontrollably.

After an infectious disease reaches a certain number of people, lockdowns cannot be avoided because no other measure can stop its spread, said Jiang Qingwu, a professor of epidemiology at Fudan University in Shanghai.

However, it is clear that there remains a wide gap between what the Chinese government can impose on its citizens during a lockdown compared to democratic countries. Local authorities were consistently quick to declare what the government routinely refers to as ‘wartime’ measures in response to relatively low rates of infections, but also enforced compliance through measures such as the complete closure of housing complexes. In some cases, people are not allowed to leave to get food, but deliveries are arranged for them instead.

According to the authors of a study conducted by Bloomberg Economics comparing how democratic countries fared with more authoritarian countries in dealing with the pandemic, “a quick and stringent lockdown is the kind of jerky response that is more natural to authoritarian than democratic regimes. . “

At China’s latest incarceration in Shijiazhuang, the capital of Hebei province, the harsh measures are reminiscent of the incarceration in Wuhan, which ended on April 8 after infections had fallen to zero. Residents in the northeast city, 180 miles southwest of Beijing, must stay at home for seven days as the city embarks on a second round of mass testing for its entire population of 11 million, as there have been more than 500 cases in the region. Flights and trains to and from the city have stopped, as has almost all public transport.

By contrast, democracies like the UK, in their versions of lockdowns, have generally allowed people to leave the house to buy essentials such as food and medicine, walk their dog or exercise. Schools remained open during France’s fall lockdown, while Israel during the last two-week lockdown this month allows people to congregate outdoors in groups of up to 10, with exceptions for religious activities.

But there are also examples of democratic governments imposing extreme rules. A state government in Australia, where officials have responded strongly to flare-ups, even banned outdoor activities and dog walking during a brief lockdown in November.

Winter revival

The Chinese authorities argue that the recovery from the crisis proves that their approach is working. And a winter resurgence of the virus in countries like South Korea, Japan and Sweden, which were initially successful with a minimal disruption approach that avoided lockdowns, supports the case for tougher action, especially as tired citizens ignore advice to stay at home .

“Given China’s sheer number and density, we have proven that (these measures) are very effective,” said Mi Feng, a spokesman for the country’s National Health Commission.

Beyond their concerns about civil liberties, many governments remain reluctant to impose the kind of full-blown lockdowns seen in China due to the economic costs – though research by the International Monetary Fund’s most recent World Economic Outlook showed that if countries were decisive to Taking such measures, they performed better in terms of protecting the economy. New Zealand is one such example: it records just 25 deaths after quickly enforcing lockdowns, and life returns to near normal shortly afterwards.

But even China, whose economy has been revived, is aware of the economic pressures. Since the closure in Wuhan, authorities have clearly refrained from closing economically important cities like Beijing, despite significant flare-ups. Officials largely turned to aggressive contact tracking during an outbreak in the capital last summer.

“As effective as lockdowns are, they are expensive,” said Yanzhong Huang, director of the Center for Global Health Studies at Seton Hall University in New Jersey. “It’s unsustainable even for China in the long run,” he added, comparing reflexive lockdown decisions to “shooting cannonballs at mosquitoes”.

With vaccination rides now rapidly rolling out in major Western countries and China, the hope is that lockdowns will be much less frequent in 2021, although great uncertainty remains about how long it will take to vaccinate enough of the world’s population to be safe. to be vaccinated again. open the world economy.

Despite the economic implications, the legacy of COVID-19 is likely that lockdowns will be practiced in the future during outbreaks of highly communicable diseases, especially as they are now a concept known to people around the world for the first time in a century.

“Restrictive quarantine in itself is not a new invention and its application dates back to the Middle Ages,” said Huang. “But it is ironic that such an old method remains the most effective despite the tremendous advances in the medical sciences.”