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COVID-19 has put us in a state of “zugzwang.” It’s a chess term, applied to the pandemic by British public health expert Raj Bhopal.
It means a situation in which there are no good answers or, as Bhopal says, “a position in chess where every move is disadvantageous where we must examine every plan, however unpalatable.”
We can’t keep everything locked down because the economy can’t handle it. We can’t rely on herd immunity (Bhopal prefers to use the term “population immunity”) because many thousands of people will die. We certainly can’t allow the pandemic to just unfold naturally.
Yes, there are vaccines in the works (four of them in late-stage testing in the U.S. at last count) but that’s still months away at least, with a fall and winter flu season in between.
Look at the facts, as Bhopal wrote them:
“If 60 to 80 percent of the world’s population was infected without interventions there could be about 5-6 billion people infected with COVID-19, one billion seriously sick and up to 30 million dead prematurely,” Bhopal wrote.
Seasonal change is still an unknown with regard to COVID-19, and while “pandemics can fizzle out” and “we hope this will happen with COVID-19,” that’s not an actual strategy. “This is not a public health intervention”
Lockdowns are not viable long-term solutions, first because of the conomic impact but also, as Bhopal said, because fot he public health implications: “Prolonged lockdowns may cause more morbidity and mortality than COVID-19, especially in the poorest countries, where the populations are relatively young on average and at little risk of death.”
Attempting herd immunity through natural infection is a recipe for disaster, and “we cannot, unfortunately, pin all hopes on vaccines as they may only work for a short time especially if the virus evolves new strains,” Bhopal wrote. “A vaccine that is effective, proven to be safe, manufacturable in billions of doses and available globally is unlikely this year, and may take years, even decades.
Bhopal’s solution to the state of zugzwang is to apprach the pandemic like one would a game of chess: “COVID-19 has placed us in zugzwang so we need precise and detailed plans and well-calculated series of moves that minimise the harms, tailored for each country and region according to their context and resources.”