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we can’t simply replace one simplistic narrative, about the super power of mitigation policy, for another, focused only on the burdens it imposed and not at all on the costs of doing much less — or nothing at all.

Let’s start with the title. What is the big failure, as you see it?

McLean: I think it gets at things that had happened in America even before the pandemic hit. And among those things were, I think, a failure to recognize the limits of capitalism, a failure of government to set the right rules for it, particularly when it comes to our health care system; a focus on profits that may have led to an increase in the bottom line but created fragility in ways people didn’t understand; and then our growing polarization that made us incapable of talking to each other

How big is the failure? When I look at The Economist’s excess mortality data, I see the U.S. had the 53rd-worst outcome in the world — worse than all of Western Europe, but better than all of Eastern Europe.

McLean: I think one way to quantify it is to take all those numbers and then put them in the context of our spending on health care. Given the amount we spend on health care relative to other countries, the scale of the failure becomes more apparent.

o me, the most glaring example is the schools. They were closed without people thinking through the potential consequences of closing down public schools, especially for disadvantaged kids.

to compound it, in my view, public health never made the distinction that needed to be made between the vulnerabilities of somebody 70 years old and the vulnerabilities of somebody 10 years old.

In the beginning of the book you write, in what almost feels like a thesis statement for the book: “A central tenet of this book is that we could not have done better, and pretending differently is a dangerous fiction, one that prevents us from taking a much needed look in the mirror.”

This claim, that the U.S. could not have done any better, runs against your other claim, that what we observed was an American failure. It is also a pretty extreme claim, I think, and I wanted to press you on it in part because it is, in my view, undermined by quite a lot of the work you do in the book itself.

Would the U.S. not have done better if it had recognized earlier that the disease spread through the air rather than in droplets? Would it not have done better if it hadn’t bungled the rollout of a Covid test in the early months?

McLean: Everything that you mentioned — the point of the book is that those were set by the time the pandemic hit.

in retrospect, what we were doing was to try to delay as much spread as we could until people got vaccinated. All the things that we did in 2020 were functionally serving or trying to serve that purpose. Now, given that, how can you say that none of that work saved lives?

McLean: I think that the test failure was baked into the way that the C.D.C. had come to operate

But the big question I really want to ask is this one: According to the C.D.C., we’ve had almost 1.2 million deaths from Covid. Excess mortality is nearly 1.4 million. Is it really your contention that there was nothing we might’ve done that brought that total down to 1.1 million, for instance, or even 900,000?

McLean: It’s very — you’re right. If you went through each and every thing and had a crystal ball and you could say, this could have been done, this could have been moved up by a month, we could have gotten PPE …

When I came to that sentence, I thought of it in terms of human behavior: What will humans put up with? What will humans stand for? How do Americans act? And you’ve written about Sweden being sort of average, and you’ve written about China and the Chinese example. They lock people up for two years and suddenly the society just revolts. They will not take it anymore. They can’t stand it. And as a result, a million and a half people die in a month and a half.

Well, I would tell that story very differently. For me, the problem is that when China opened up, they had fully vaccinated just under two-thirds of their population over 80. So to me, it’s not a failure of lockdowns. It’s a failure of vaccinations. If the Chinese had only achieved the same elderly vaccination rate as we achieved — which by global standards was pretty poor — that death toll when they opened up would have been dramatically lower.

What do you mean by “lockdown,” though? You use the word throughout the book and suggest that China was the playbook for all countries. But you also acknowledge that what China did is not anything like what America did.

Disparities in health care access — is it a dangerous fiction to think we might address that? You guys are big champions of Operation Warp Speed — would it not have been better if those vaccines had been rolled out to the public in nine months, rather than 12

. But this isn’t “lockdown” like there were lockdowns in China or even Peru. It’s how we tried to make it safer to go out and interact during a pandemic that ultimately killed a million Americans.

McLean: I think that you’re absolutely right to focus on the definition of what a lockdown is and how we implemented them here in this country. And I think part of the problem is that we implemented them in a way that allowed people who were well off and could work from home via Zoom to be able to maintain very much of their lives while other people couldn’t

And I think it depends on who you were, whether you would define this as a lockdown or not. If you were a small business who saw your small business closed because of this, you’re going to define it as a lockdown.

n the book you’re pretty definitive. You write, “maybe the social and economic disasters that lockdowns created would have been worth it if they had saved lives, but they hadn’t.” How can you say that so flatly?

I think there are still open questions about what worked and how much. But the way that I think about all of this is that the most important intervention that anybody did anywhere in the world was vaccination. And the thing that determined outcomes most was whether your first exposure came before or after vaccination.

Here, the shelter-in-place guidelines lasted, on average, five to seven weeks. Thirty nine of the 40 states that had issued them lifted them by the end of June, three months in. By the summer, according to Google mobility data, retail and grocery activity was down about 10 percent. By the fall, grocery activity was only down about 5 percent across the country

Nocera: Well, on some level, I feel like you’re trying to have it both ways. On the one hand, you’re saying that lockdowns saved lives. On the other hand, you said they weren’t real lockdowns because everybody was out and about.

I don’t think that’s having it both ways. I’m trying to think about these issues on a spectrum rather than in binaries. I think we did interrupt our lives — everybody knows that. And I think they did have an effect on spread, and that limiting spread had an effect by delaying infections until after vaccination.

Nocera: Most of the studies that say lockdowns didn’t work are really less about Covid deaths than about excess mortality deaths. I wound up being persuaded that the people who could not get to the hospital, because they were all working, because all the doctors were working on Covid and the surgical rooms were shut down, the people who caught some disease that was not Covid and died as a result — I wound up being persuaded about that.

We’re in a pandemic. People are going to die. And then the question becomes, can we protect the most vulnerable? And the answer is, we didn’t protect the most vulnerable. Nursing homes were a complete disaster.

There was a lot of worry early on about delayed health care, and about cancer in particular — missed screenings, missed treatments. But in 2019, we had an estimated 599,600 Americans die of cancer. In 2020, it was 602,000. In 2021, it was 608,000. In 2022, it was 609,000.

Nocera: See, it went up!But by a couple of thousand people, in years in which hundreds of thousands of Americans were dying of Covid.

Nocera: I think you can’t dispute the excess mortality numbers.I’m not. But in nearly every country in the world the excess mortality curves track so precisely with Covid waves that it doesn’t make sense to talk about a massive public health problem beyond Covid. And when you add all of these numbers up, they are nowhere near the size of the footfall of Covid. How can you look back on this and say the costs were too high?

Nocera: I think the costs were too high because you had school costs, you had economic costs, you had social costs, and you had death.

McLean: I think you’re raising a really good point. We’re making an argument for a policy that might not have been doable given the preconditions that had been set. I’m arguing that there were these things that had been put in place in our country for decades leading up to the pandemic that made it really difficult for us to plant in an effective way, from the outsourcing of our PPE to the distrust in our health care system that had been created by people’s lack of access to health care with the disparities in our hospital system.

How would you have liked to see things handled differently?Nocera: Well, the great example of doing it right is San Fran

I find the San Francisco experience impressive, too. But it was also a city that engaged in quite protracted and aggressive pandemic restrictions, well beyond just protecting the elderly and vulnerable.

McLean: But are we going to go for stay-at-home orders plus protecting vulnerable communities like San Francisco did? Or simply letting everybody live their lives, but with a real focus on the communities and places like nursing homes that were going to be affected? My argument is that we probably would’ve been better off really focusing on protecting those communities which were likely to be the most severely affected.

I agree that the public certainly didn’t appreciate the age skew, and our policy didn’t reflect it either. But I also wonder what it would mean to better protect the vulnerable than we did. We had testing shortages at first. Then we had resistance to rapid testing. We had staff shortages in nursing homes.

Nocera: This gets exactly to one of our core points. We had spent 30 years allowing nursing homes to be owned by private equity firms that cut the staff, that sold the land underneath and added all this debt on

I hear you saying both that we could have done a much better job of protecting these people and that the systems we inherited at the outset of the pandemic would’ve made those measures very difficult, if not impossible, to implement.

But actually, I want to stop you there, because I actually think that that data tells the opposite story.

And then I’m trying to say at the same time, but couldn’t we have done something to have protected people despite all of that?

I want to talk about the number of lives at stake. In the book, you write about the work of British epidemiologist Neil Ferguson. In the winter of 2020, he says that in the absence of mitigation measures and vaccination, 80 percent of the country is going to get infected and 2.2 million Americans are going to die. He says that 80 percent of the U.K. would get infected, and 510,000 Brits would die — again, in the abs

In the end, by the time we got to 80 percent of the country infected, we had more than a million Americans die. We had more than 200,000 Brits die. And in each case most of the infections happened after vaccination, which suggests that if those infections had all happened in a world without vaccines, we almost certainly would have surpassed two million deaths in the U.S. and almost certainly would’ve hit 500,000 deaths in the U.K.

In the book, you write about this estimate, and you endorse Jay Bhattacharya’s criticism of Ferguson’s model. You write, “Bhattacharya got his first taste of the blowback reserved for scientists who strayed from the establishment position early. He co-wrote an article for The Wall Street Journal questioning the validity of the scary 2 to 4 percent fatality rate that the early models like Neil Ferguson’s were estimating and that were causing governments to panic. He believed, correctly as it turns out, that the true fatality rate was much lower.”

Nocera: I know where you’re going with this, because I read your story about the nine pandemic narratives we’re getting wrong. In there, you said that Bhattacharya estimated the fatality rate at 0.01 percent. But if you actually read The Wall Street Journal article, what he’s really saying is I think it’s much lower. I’ve looked at two or three different possibilities, and we really need some major testing to figure out what it actually is, because I think 2 percent to 4 percent is really high.

He says, “if our surmise of 6 million cases is accurate, that’s a mortality rate of 0.01%. That is ⅒th the flu mortality rate of 0.1%.” An I.F.R. of 0.01 percent, spread fully through the American population, yields a total American death toll of 33,000 people. We have had 1.2 million deaths. And you are adjudicating this dispute, in 2023, and saying that Neil was wrong and Jay was right.

hird, in the Imperial College report — the one projecting two million American deaths — Ferguson gives an I.F.R. estimate of 0.9 percent.

Bhattacharya’s? Yes, there is some uncertainty around the estimate he offers. But the estimate he does offer — 0.01 percent — is one hundred times lower than the I.F.R. you yourselves cite as the proper benchmark.

Nocera: In The Wall Street Journal he does not say it’s 0.01. He says, we need to test to find out what it is, but it is definitely lower than 2 to 4 percent.

Well, first of all, the 2 percent to 4 percent fatality rate is not from Neil Ferguson. It’s from the W.H.O.

But I think that fundamentally, at the outset of the pandemic, the most important question orienting all of our thinking was, how bad could this get? And it turns out that almost all of the people who were saying back then that we shouldn’t do much to intervene were extremely wrong about how bad it would be

The argument then was, more or less, “We don’t need to do anything too drastic, because it’s not going to be that big a deal.” Now, in 2023, it’s the opposite argument: “We shouldn’t have bothered with restrictions, because they didn’t have an impact; we would have had this same death toll anyway.” But the death toll turned out to be enormous.

Now, if we had supplied all these skeptics with the actual numbers at the outset of the pandemic, what kind of audience would they have had? If instead of making the argument against universal mitigation efforts on the basis of a death toll of 40,000 they had made the argument on the basis of a death toll of more than a million, do you think the country would’ve said, they’re right, we’re doing too much, let’s back off?

McLean: I think that if you had gone to the American people and said, this many people are going to die, that would’ve been one thing. But if you had gone to the American people and said, this many people are going to die and a large percentage of them are going to be over 80, you might’ve gotten a different answer.

I’m not arguing we shouldn’t have been trying to get a clearer sense of the true fatality rate, or that we shouldn’t have been clearer about the age skew. But Bhattacharya was also offering an estimate of fatality rate that turned out to be off by a factor of a hundred from the I.F.R. that you yourselves cite as correct. And then you say that Bhattacharya was right and Ferguson was wrong.

And you, too, Joe, you wrote an article in April expressing sympathy for Covid skeptics and you said ——Nocera: This April?No, 2020.Nocera: Oh, oh. That’s the one where I praised Alex Berenson.You also cited some Amherst modeling which said that we were going to have 67,000 to 120,000 American deaths. We already had, at that point, 60,000. So you were suggesting, in making an argument against pandemic restrictions, that the country as a whole was going to experience between 7,000 and 60,000 additional deaths from that point.

when I think about the combination of the economic effects of mitigation policies and just of the pandemic itself and the big fiscal response, I look back and I think the U.S. managed this storm relatively well. How about each of you?

in this case, Congress did get it together and did come to the rescue. And I agree that made a ton of difference in the short term, but the long-term effects of the fiscal rescue package were to help create inflation. And once again, inflation hits those at the bottom of the socioeconomic distribution much harder than it does those at the top. So I would argue that some of what we did in the pandemic is papering over these long-term issues.

I think as with a lot of the stuff we’ve talked about today, I agree with you about the underlying problems. But if we take for granted for a moment that the pandemic was going to hit us, when it did, under the economic conditions it did, and then think about the more narrow context of whether, given all that, we handled the pandemic well. We returned quickly to prepandemic G.D.P. trends, boosted the wealth of the bottom half of the country, cut child poverty in half, pushed unemployment to historical lows.

What sense do you make of the other countries of the world and their various mitigation policies? Putting aside China, there’s New Zealand, Australia, South Korea — these are all places that were much more aggressive than the U.S. and indeed more than Europe. And had much, much better outcomes.

Nocera: To be perfectly honest, we didn’t really look, we didn’t really spend a lot of time looking at that.

McLean: But one reason that we didn’t is I don’t think it tells us anything. When you look at who Covid killed, then you have to look at what the pre-existing conditions in a country were, what percentage of its people are elderly. How sick are people with pre-existing conditions?

I just don’t think there’s a comparison. There’s just too many factors that influence it to be able to say that, to be able to compare America to any other country, you’d have to adjust for all these factors.

But you do spend a bit of time in the book talking about Sweden. And though it isn’t precisely like-for-like, one way you can control for some of those factors is grouping countries with their neighbors and other countries with similar profiles. And Sweden’s fatality rate in 2020 was 10 times that of Norway, Finland and Iceland. Five times that of Denmark. In the vaccination era, those gaps have narrowed, but by most metrics Sweden has still done worse, overall, than all of those countries.

On the matter of omniscience. Let’s say that we can send you back in time. Let’s put you both in charge of American pandemic response, or at least American communication about the pandemic, in early 2020. What would you want to tell the country? How would you have advised us to respond?

McLean: What I would want is honesty and communication. I think we’re in a world that is awash in information and the previous methods of communication — giving a blanket statement to people that may or may not be true, when you know there’s nuance underneath it — simply doesn’t work anymore

o I would’ve been much more clear — we think masks might help, we don’t know, but it’s not that big of an ask, let’s do it. We think the early data coming out of Italy shows that these are the people who are really, really at risk from Covid, but it’s not entirely clear yet. Maybe there is spread in schools, but we don’t know. Let’s look at this and keep an open mind and look at the data as it comes in.

It’s almost impossible to decipher which path the UK government has chosen.

Without these measures in place, the past seven weeks of lockdown will have been completely pointless. As quarantine measures are lifted, the virus will continue to spread, the number of daily cases will rise and a second peak will become inevitable

this debate misses a more fundamental point: containment (the first path) is the best strategy for public health, the economy and society. The decision in early March to shift from containing to mitigating the virus was disastrous on all three of these fronts

Now, the key challenge facing the government is to replace this lockdown with a package of public health interventions involving mass testing, surveillance and real-time data to identify clusters of the virus and quarantine those who are infected.

The confusion turns on an internal struggle between two opposing camps. The first seems to think the government should attempt to get over the worst of the pandemic by allowing the virus to spread through the population, albeit at a slower pace to ease the strain on the NHS, and by creating more hospital and mortuary capacity to cope with a spike in deaths. The second camp wants to drive down the number of coronavirus cases and reduce the rate of infection – or R – to as close to zero as possible. It recognises the uniquely dangerous nature of this virus, and the emerging evidence that it can cause long-term health complications in survivors and that immunity may only be temporary.

Everyone agrees that we need to get out of the lockdown as soon as possible, but doing so will require massive investment in public health infrastructure. Countries such as South Korea, Hong Kong, Taiwan, New Zealand and Australia have already built this capacity

why has the government made such little progress in building the public health infrastructure necessary to control the virus and ease the lockdown? You could be forgiven for thinking that the lockdown was simply a way to reassure the public that the government was “doing something”. We need to be asking: what measures has the government put in place to ensure we’re in a better position to release the lockdown and prevent a second wave?

Everyone wants to know when the lockdown will end and life will go back to “normal”. The better question to ask is how we ease lockdown measures in the coming months and years while preventing a second wave of infections and keeping R well below one

There are a number of endings to this story. First, an accessible and affordable vaccine could become available within the next 18 months; second, the government could embark on a resource-intensive and gruelling campaign to eliminate the virus, particularly if emerging data proves coronavirus is as dangerous as diseases such as smallpox and polio; or third, antiviral therapies could become available to treat Covid-19 that make it a mild illness, so the population would gradually and safely build up natural herd immunity.

on our current path we seem destined for a disastrous ending. Lifting lockdown without the public health infrastructure in place to contain the virus will allow Covid-19 to spread through the population unchecked. The result could be a Darwinian culling of the elderly and vulnerable, and an individual gamble for those exposed to the virus. This should be avoided at all costs.

With more than 91,000 deaths, the country has one of the highest death tolls in Europe.

More than 4.2 million infections have been reported in France since the start of the pandemic,

Traffic jams were reported as thousands of people tried to leave the French capital ahead of the lockdown on Friday. Traffic volume and train reservations were both up 20%

Poland is taking its measures a step further and embarking on a nationwide three-week lockdown on Saturday after cases jumped 44% week-over-week. Health officials attribute the recent spike to the U.K. coronavirus variant, according to the country's health ministry.

Under the country's lockdown rules, only essential businesses — such as grocery stores and pharmacies — will stay open. The country will also cancel all in-person classes and return to online education over the course of the lockdown.Over 49,000 people have so far died in Poland from the virus,

Earlier in the week, Italy — which was the first country in Europe to impose a lockdown last year — issued new national restrictions to stop the spread of the virus. Hungary, Bulgaria and Bosnia have also tightened their restrictions in recent weeks. Other countries, including Germany, have warned of a possible return to stricter measures in the days ahead.

German Health Minister Jens Spahn urged residents on Friday to diligently follow coronavirus safety rules, warning that vaccines won't arrive quickly enough to prevent a third wave of the COVID-19 pandemic.

With Germany set for a four-day-weekend in early April to mark the Easter holiday, Spahn said the country is not yet ready to relax travel and physical distancing rules. In fact, he said, Germans should be prepared to revert to tighter restrictions.

In the United Kingdom, the conversation has turned away from lockdowns as the nation celebrated a milestone in its fight against the virus on Saturday with the news that half of its adult population has received at least one dose of the COVID-19 vaccine.

Health Secretary Matt Hancock said the country set a new record for daily vaccinations on Friday.

in Pakistan, Prime Minister Imran Khan is self-isolating at home after testing positive for COVID-19, a tweet from his office said.The prime minister is suffering a "slight cough" and the "mildest of fevers," according to two government officials.

news of the prime minister's positive test result came just two days after he received his first vaccine dose for the virus.The proximity of those two events could raise concerns that will deepen vaccine hesitation in the country. Health officials have tried to stress that Khan, 68, had likely been infected before he was vaccinated on Thursday.

Vaccine hesitancy is an issue in Pakistan, with a poll earlier this month showing that it is also high among healthcare workers. Hours before the announcement, authorities shut down restaurants across the Pakistani capital as the U.K. variant of the virus spreads.

The city said 95 percent of its adults were vaccinated by July. In the latest wave, it had reported 2,017 confirmed cases by Monday and no deaths.

The tragedies in Xi’an have prompted some Chinese people to question how those enforcing the quarantine rules can behave like this and to ask who holds ultimate responsibility.

“It’s very easy to blame the individuals who committed the banality of evil,” a user called @IWillNotResistIt wrote on Weibo, the Chinese social media platform. “If you and I become the screws in this gigantic machine, we might not be able to resist its powerful pull either.”

Chinese intellectuals are struck by how many officials and civilians — often driven by professional ambition or obedience — are willing to be the enablers of authoritarian policies.

When the coronavirus emerged in Wuhan two years ago, it exposed the weaknesses in China’s authoritarian system. Now, with patients dying of non-Covid diseases, residents going hungry and officials pointing fingers, the lockdown in Xi’an has shown how the country’s political apparatus has ossified, bringing a ruthlessness to its single-minded pursuit of a zero-Covid policy.

China’s early success in containing the pandemic through iron-fist, authoritarian policies emboldened its officials, seemingly giving them license to act with conviction and righteousness.

Still, it imposed a very harsh lockdown. Residents were not allowed to leave their compounds. Some buildings were locked up. More than 45,000 people were moved to quarantine facilities.

In Xi’an, there is no author like Fang Fang writing her Wuhan lockdown diary, no citizen journalists Chen Qiushi, Fang Bin or Zhang Zhan posting videos. The four of them have either been silenced, detained, disappeared or left dying in jail — sending a strong message to anyone who might dare to speak out about Xi’an.

“I only cared about whether I had food to eat,” the young man read, according to a widely shared video. “I didn’t take into account the serious consequences my behavior could bring to the community.” The volunteers later apologized, according to The Beijing News, a state media outlet.

Three men were caught while escaping from Xi’an to the countryside, possibly to avoid the high costs of the lockdown. They hiked, biked and swam in wintry days and nights. Two of them were detained by the police, according to local police and media reports. Together they were called the “Xi’an ironmen” on the Chinese internet.

Then there were the hospitals that denied patients access to medical care and deprived their loved ones the chance to say goodbye.

A deputy director-level official at a government agency in Beijing lost his position last week after some social media users reported that an article he wrote about the lockdown in Xi’an contained untruthful information.

In the article, he called the lockdown measures “inhumane” and “cruel.”

Some residents took to the internet to complain that they didn’t have enough food.

The Xi’an lockdown debacle hasn’t seemed to convince many people in China to abandon the country’s no-holds-barred approach to pandemic control.

A former athlete who is disabled and suffering from a series of illnesses cursed Fang Fang for her Wuhan diary in 2020. Last month, he posted on his Weibo account that he couldn’t buy medicine because his compound in Xi’an was locked down. His problems were solved, and now he uses the hashtag #everyoneinpositiveenergy and retweets posts that attack Ms. Zhang, the former journalist.

“A needle size loophole can funnel high wind,” he said.

“My first and biggest wish is that we had known early that Covid-19 was airborne,”

, “Once you’ve realized that, it informs an entirely different strategy for protection.” Masking, ventilation and air cleaning become key, as well as avoiding high-risk encounters with strangers, he says.

Instead of washing our produce and wearing hand-sewn cloth masks, we could have made sure to avoid superspreader events and worn more-effective N95 masks or their equivalent. “We could have made more of an effort to develop and distribute N95s to everyone,” says Dr. Volckens. “We could have had an Operation Warp Speed for masks.”

We didn’t realize how important clear, straight talk would be to maintaining public trust. If we had, we could have explained the biological nature of a virus and warned that Covid-19 would change in unpredictable ways.  

In the face of a pandemic, he says, the public needs an early basic and blunt lesson in virology

“The science is really important, but if you don’t get the trust and communication right, it can only take you so far,”

and mutates, and since we’ve never seen this particular virus before, we will need to take unprecedented actions and we will make mistakes, he says.

Since the public wasn’t prepared, “people weren’t able to pivot when the knowledge changed,”

By the time the vaccines became available, public trust had been eroded by myriad contradictory messages—about the usefulness of masks, the ways in which the virus could be spread, and whether the virus would have an end date.

, the absence of a single, trusted source of clear information meant that many people gave up on trying to stay current or dismissed the different points of advice as partisan and untrustworthy.

We didn’t know how difficult it would be to get the basic data needed to make good public-health and medical decisions. If we’d had the data, we could have more effectively allocated scarce resources

For much of the pandemic, doctors, epidemiologists, and state and local governments had no way to find out in real time how many people were contracting Covid-19, getting hospitalized and dying

Doctors didn’t know what medicines worked. Governors and mayors didn’t have the information they needed to know whether to require masks. School officials lacked the information needed to know whether it was safe to open schools.

people didn’t know whether it was OK to visit elderly relatives or go to a dinner party.

just months before the outbreak of the pandemic, the Council of State and Territorial Epidemiologists released a white paper detailing the urgent need to modernize the nation’s public-health system still reliant on manual data collection methods—paper records, phone calls, spreadsheets and faxes.

While the U.K. and Israel were collecting and disseminating Covid case data promptly, in the U.S. the CDC couldn’t. It didn’t have a centralized health-data collection system like those countries did, but rather relied on voluntary reporting by underfunded state and local public-health systems and hospitals.

doctors and scientists say they had to depend on information from Israel, the U.K. and South Africa to understand the nature of new variants and the effectiveness of treatments and vaccines. They relied heavily on private data collection efforts such as a dashboard at Johns Hopkins University’s Coronavirus Resource Center that tallied cases, deaths and vaccine rates globally.

With good data, Dr. Ranney says, she could have better managed staffing and taken steps to alleviate the strain on doctors and nurses by arranging child care for them.

To solve the data problem, Dr. Ranney says, we need to build a public-health system that can collect and disseminate data and acts like an electrical grid. The power company sees a storm coming and lines up repair crews.

If we’d known how damaging lockdowns would be to mental health, physical health and the economy, we could have taken a more strategic approach to closing businesses and keeping people at home.

t many doctors say they were crucial at the start of the pandemic to give doctors and hospitals a chance to figure out how to accommodate and treat the avalanche of very sick patients.

The measures reduced deaths, according to many studies—but at a steep cost.

The lockdowns didn’t have to be so harmful, some scientists say. They could have been more carefully tailored to protect the most vulnerable, such as those in nursing homes and retirement communities, and to minimize widespread disruption.

Lockdowns could, during Covid-19 surges, close places such as bars and restaurants where the virus is most likely to spread, while allowing other businesses to stay open with safety precautions like masking and ventilation in place.  

If England’s March 23, 2020, lockdown had begun one week earlier, the measure would have nearly halved the estimated 48,600 deaths in the first wave of England’s pandemic

If the lockdown had begun a week later, deaths in the same period would have more than doubled

The key isn’t to have the lockdowns last a long time, but that they are deployed earlier,

It is possible to avoid lockdowns altogether. Taiwan, South Korea and Hong Kong—all countries experienced at handling disease outbreaks such as SARS in 2003 and MERS—avoided lockdowns by widespread masking, tracking the spread of the virus through testing and contact tracing and quarantining infected individuals.

Had we known that even a mild case of Covid-19 could result in long Covid and other serious chronic health problems, we might have calculated our own personal risk differently and taken more care.

Early in the pandemic, public-health officials were clear: The people at increased risk for severe Covid-19 illness were older, immunocompromised, had chronic kidney disease, Type 2 diabetes or serious heart conditions

t had the unfortunate effect of giving a false sense of security to people who weren’t in those high-risk categories. Once case rates dropped, vaccines became available and fear of the virus wore off, many people let their guard down, ditching masks, spending time in crowded indoor places.

it has become clear that even people with mild cases of Covid-19 can develop long-term serious and debilitating diseases. Long Covid, whose symptoms include months of persistent fatigue, shortness of breath, muscle aches and brain fog, hasn’t been the virus’s only nasty surprise

In February 2022, a study found that, for at least a year, people who had Covid-19 had a substantially increased risk of heart disease—even people who were younger and had not been hospitalized

respiratory conditions.

Some scientists now suspect that Covid-19 might be capable of affecting nearly every organ system in the body. It may play a role in the activation of dormant viruses and latent autoimmune conditions people didn’t know they had

 A blood test, he says, would tell people if they are at higher risk of long Covid and whether they should have antivirals on hand to take right away should they contract Covid-19.

If the risks of long Covid had been known, would people have reacted differently, especially given the confusion over masks and lockdowns and variants? Perhaps. At the least, many people might not have assumed they were out of the woods just because they didn’t have any of the risk factors.

"They need to look at the European situation, and I mean, by no means what we have done in Europe is perfect, these governments are probably reacting a little bit slowly, but they are at least reacting

Many European countries followed in the Czech footsteps by initially refusing new lockdowns and then going for the nuclear option.

one problem is that the rules across different US states remain inconsistent. "The country is so vast and population density in Nebraska is not the same as New York State for instance or California, so you maybe do need to think about slightly more local action

But when Michigan Gov. Gretchen Whitmer banned indoor dining in an attempt to curb the rising spread of the virus, White House coronavirus task force member Dr. Scott Atlas criticized the move and urged people to "rise up" against the new public health measures.

"Over the last 10 days, there's been a decrease in the number of new Covid-19 cases, and the positivity rate has been declining so everything suggests that we have passed a peak of the epidemic,"

Germany, meanwhile, took a softer approach to lockdown. It closed restaurants, bars and clubs, but shops remained open and people were only advised, rather than ordered, to stay home and limit their social contacts.

The country didn't see the same slowdown in new cases as France.

The success of a lockdown also depends on the willingness of people to follow the rules.

Politicians are reluctant to impose lockdowns because of their undeniable negative effects, be it on the economy or people's mental health. But scientists like Tildesley say the repeated European experience shows the effect of this is even more damaging.

When England started its first phase five days earlier on 13 May, new daily cases had fallen but were still about 75% of its late-April to early-May peak.

There was another stark difference. Ireland started lifting lockdown only after testing and contact-tracing systems were fully scaled up. England took the plunge before its systems were ready.

he UK appeared to lack sufficient testing and contact-tracing capacity for such a surge, said L’Estrange. “Perhaps they can get it up and running quickly. But they’re behind the curve and playing catch-up. You have to have sufficient testing and contact-tracing capacity ready to go before you ease restrictions. They’ve put the cart before the horse. They released the virus without having the apparatus in place to control it, and they’ve released it at a high level.”

Ireland’s lockdown easing started after England’s and is scheduled to go more cautiously and slowly, with the last phase starting on 10 August, and schools opening in September. England’s plan envisages schools starting to open on 1 June and the final phase of lifting starting on 4 July.

the decision about schools was political. “It is not a scientific decision. Scientists can offer some advice.”

An editorial in the British Medical Journal this week excoriated the UK’s record on testing and tracing. “Meaningless political soundbites promising to recruit 18,000 contact tracers, test 200,000 people a day, or invest in unjustified contact tracing apps, divert focus and could lead to more deaths. These headline grabbing schemes should be replaced by locality-led strategies rooted in communicable disease control,” it said.

“According to our statistics, 90% of the causes of violence [in this period] are related to the Covid-19 epidemic.”

It is a pattern being repeated globally. In Brazil a state-run drop-in centre has already seen a surge in cases it attributes to coronavirus isolation

“We think there has been a rise of 40% or 50%, and there was already really big demand,”

Those alarming figures log only cases where women are able to seek help; many cannot make calls because they fear being overheard by abusive partners, or are stopped from leaving home.

In Italy activists said calls to helplines had dropped sharply, but instead they were receiving desperate text messages and emails.

“It happens in all crisis situations,” said Marcy Hersh, a senior manager for humanitarian advocacy at Women Deliver. “What we worry about is just as rates of violence are on the rise, the accessibility of services and the ability of women to access these services will decrease. This is a real challenge.”

In Spain – where lockdown rules are extremely strict, and many people are being fined for breaking them – the government has told women they will not be fined if they leave home to report abuse.

But on 19 March, the country saw the first domestic violence fatality since the lockdown began five days earlier, when a woman was murdered by her husband in front of their children in the coastal province of Valencia.

The increased threat to women and children was a predictable side effect of the coronavirus lockdowns, said activists. Increased abuse is a pattern repeated in many emergencies, whether conflict, economic crisis or during disease outbreaks, although the quarantine rules pose a particularly grave challenge.

“For sure there is an overwhelming emergency right now. There is more desperation as women can’t go out.”

A prosecutor in Trento, Italy, has ruled that in situations of domestic violence the abuser must leave the family home and not the victim, a decision hailed as “fundamental” by the trade union CGIL.

In Germany the Green party’s parliamentary leader, Katrin Göring-Eckardt, said this week she feared for the lives of thousands of women trapped with violent partners, and called on the government to free up money for safe houses.

In Greece, officials said they were stepping up a campaign to help women deal with problems clearly emerging from the issue of confinement.

They worried that a vaccine would initially elude scientists, that weary citizens would abandon restrictions despite the risks, that the virus would be with us from now on.

Most experts believed that once the crisis was over, the nation and its economy would revive quickly. But there would be no escaping a period of intense pain.

Exactly how the pandemic will end depends in part on medical advances still to come. It will also depend on how individual Americans behave in the interim. If we scrupulously protect ourselves and our loved ones, more of us will live. If we underestimate the virus, it will find us.

More Americans may die than the White House admits.

The epidemiological model often cited by the White House, which was produced by the University of Washington’s Institute for Health Metrics and Evaluation, originally predicted 100,000 to 240,000 deaths by midsummer. Now that figure is 60,000.

The institute’s projection runs through Aug. 4, describing only the first wave of this epidemic. Without a vaccine, the virus is expected to circulate for years, and the death tally will rise over time.

Fatality rates depend heavily on how overwhelmed hospitals get and what percentage of cases are tested. China’s estimated death rate was 17 percent in the first week of January, when Wuhan was in chaos, according to a Center for Evidence-Based Medicine report, but only 0.7 percent by late February.

Various experts consulted by the Centers for Disease Control and Prevention in March predicted that the virus eventually could reach 48 percent to 65 percent of all Americans, with a fatality rate just under 1 percent, and would kill up to 1.7 million of them if nothing were done to stop the spread.

A model by researchers at Imperial College London cited by the president on March 30 predicted 2.2 million deaths in the United States by September under the same circumstances.

China has officially reported about 83,000 cases and 4,632 deaths, which is a fatality rate of over 5 percent. The Trump administration has questioned the figures but has not produced more accurate ones.

The tighter the restrictions, experts say, the fewer the deaths and the longer the periods between lockdowns. Most models assume states will eventually do widespread temperature checks, rapid testing and contact tracing, as is routine in Asia.

In this country, hospitals in several cities, including New York, came to the brink of chaos.

Only when tens of thousands of antibody tests are done will we know how many silent carriers there may be in the United States. The C.D.C. has suggested it might be 25 percent of those who test positive. Researchers in Iceland said it might be double that.

China is also revising its own estimates. In February, a major study concluded that only 1 percent of cases in Wuhan were asymptomatic. New research says perhaps 60 percent were.

The virus may also be mutating to cause fewer symptoms. In the movies, viruses become more deadly. In reality, they usually become less so, because asymptomatic strains reach more hosts. Even the 1918 Spanish flu virus eventually faded into the seasonal H1N1 flu.

The lockdowns will end, but haltingly.

it is likely a safe bet that at least 300 million of us are still vulnerable.

Until a vaccine or another protective measure emerges, there is no scenario, epidemiologists agreed, in which it is safe for that many people to suddenly come out of hiding. If Americans pour back out in force, all will appear quiet for perhaps three weeks.

The gains to date were achieved only by shutting down the country, a situation that cannot continue indefinitely. The White House’s “phased” plan for reopening will surely raise the death toll no matter how carefully it is executed.

Every epidemiological model envisions something like the dance

On the models, the curves of rising and falling deaths resemble a row of shark teeth.

Surges are inevitable, the models predict, even when stadiums, churches, theaters, bars and restaurants remain closed, all travelers from abroad are quarantined for 14 days, and domestic travel is tightly restricted to prevent high-intensity areas from reinfecting low-intensity ones.

In his wildly popular March 19 article in Medium, “Coronavirus: The Hammer and the Dance,” Tomas Pueyo correctly predicted the national lockdown, which he called the hammer, and said it would lead to a new phase, which he called the dance, in which essential parts of the economy could reopen, including some schools and some factories with skeleton crews.

Even the “Opening Up America Again” guidelines Mr. Trump issued on Thursday have three levels of social distancing, and recommend that vulnerable Americans stay hidden. The plan endorses testing, isolation and contact tracing — but does not specify how these measures will be paid for, or how long it will take to put them in place.

On Friday, none of that stopped the president from contradicting his own message by sending out tweets encouraging protesters in Michigan, Minnesota and Virginia to fight their states’ shutdowns.

China did not allow Wuhan, Nanjing or other cities to reopen until intensive surveillance found zero new cases for 14 straight days, the virus’s incubation period.

Compared with China or Italy, the United States is still a playground.Americans can take domestic flights, drive where they want, and roam streets and parks. Despite restrictions, everyone seems to know someone discreetly arranging play dates for children, holding backyard barbecues or meeting people on dating apps.

Even with rigorous measures, Asian countries have had trouble keeping the virus under control

But if too many people get infected at once, new lockdowns will become inevitable. To avoid that, widespread testing will be imperative.

Reopening requires declining cases for 14 days, the tracing of 90 percent of contacts, an end to health care worker infections, recuperation places for mild cases and many other hard-to-reach goals.

Immunity will become a societal advantage.

Imagine an America divided into two classes: those who have recovered from infection with the coronavirus and presumably have some immunity to it; and those who are still vulnerable.

“It will be a frightening schism,” Dr. David Nabarro, a World Health Organization special envoy on Covid-19, predicted. “Those with antibodies will be able to travel and work, and the rest will be discriminated against.”

Soon the government will have to invent a way to certify who is truly immune. A test for IgG antibodies, which are produced once immunity is established, would make sense

Dr. Fauci has said the White House was discussing certificates like those proposed in Germany. China uses cellphone QR codes linked to the owner’s personal details so others cannot borrow them.

As Americans stuck in lockdown see their immune neighbors resuming their lives and perhaps even taking the jobs they lost, it is not hard to imagine the enormous temptation to join them through self-infection

My daughter, who is a Harvard economist, keeps telling me her age group needs to have Covid-19 parties to develop immunity and keep the economy going,”

It would be a gamble for American youth, too. The obese and immunocompromised are clearly at risk, but even slim, healthy young Americans have died of Covid-19.

The virus can be kept in check, but only with expanded resources.

Resolve to Save Lives, a public health advocacy group run by Dr. Thomas R. Frieden, the former director of the C.D.C., has published detailed and strict criteria for when the economy can reopen and when it must be closed.

once a national baseline of hundreds of thousands of daily tests is established across the nation, any viral spread can be spotted when the percentage of positive results rises.

To keep the virus in check, several experts insisted, the country also must start isolating all the ill — including mild cases.

“If I was forced to select only one intervention, it would be the rapid isolation of all cases,”

In China, anyone testing positive, no matter how mild their symptoms, was required to immediately enter an infirmary-style hospital — often set up in a gymnasium or community center outfitted with oxygen tanks and CT scanners.

There, they recuperated under the eyes of nurses. That reduced the risk to families, and being with other victims relieved some patients’ fears.

Still, experts were divided on the idea of such wards

Ultimately, suppressing a virus requires testing all the contacts of every known case. But the United States is far short of that goal.

In China’s Sichuan Province, for example, each known case had an average of 45 contacts.

The C.D.C. has about 600 contact tracers and, until recently, state and local health departments employed about 1,600, mostly for tracing syphilis and tuberculosis cases.

China hired and trained 9,000 in Wuhan alone. Dr. Frieden recently estimated that the United States will need at least 300,000.

There will not be a vaccine soon.

any effort to make a vaccine will take at least a year to 18 months.

the record is four years, for the mumps vaccine.

for unclear reasons, some previous vaccine candidates against coronaviruses like SARS have triggered “antibody-dependent enhancement,” which makes recipients more susceptible to infection, rather than less. In the past, vaccines against H.I.V. and dengue have unexpectedly done the same.

A new vaccine is usually first tested in fewer than 100 young, healthy volunteers. If it appears safe and produces antibodies, thousands more volunteers — in this case, probably front-line workers at the highest risk — will get either it or a placebo in what is called a Phase 3 trial.

It is possible to speed up that process with “challenge trials.” Scientists vaccinate small numbers of volunteers, wait until they develop antibodies, and then “challenge” them with a deliberate infection to see if the vaccine protects them.

Normally, it is ethically unthinkable to challenge subjects with a disease with no cure, such as Covid-19.

“Fewer get harmed if you do a challenge trial in a few people than if you do a Phase 3 trial in thousands,” said Dr. Lipsitch, who recently published a paper advocating challenge trials in the Journal of Infectious Diseases. Almost immediately, he said, he heard from volunteers.

The hidden danger of challenge trials, vaccinologists explained, is that they recruit too few volunteers to show whether a vaccine creates enhancement, since it may be a rare but dangerous problem.

if a vaccine is invented, the United States could need 300 million doses — or 600 million if two shots are required. And just as many syringes.

“People have to start thinking big,” Dr. Douglas said. “With that volume, you’ve got to start cranking it out pretty soon.”

Treatments are likely to arrive first.

The modern alternative is monoclonal antibodies. These treatment regimens, which recently came very close to conquering the Ebola epidemic in eastern Congo, are the most likely short-term game changer, experts said.

as with vaccines, growing and purifying monoclonal antibodies takes time. In theory, with enough production, they could be used not just to save lives but to protect front-line workers.

Having a daily preventive pill would be an even better solution, because pills can be synthesized in factories far faster than vaccines or antibodies can be grown and purified.

Goodbye, ‘America First.’

A public health crisis of this magnitude requires international cooperation on a scale not seen in decades. Yet Mr. Trump is moving to defund the W.H.O., the only organization capable of coordinating such a response.

And he spent most of this year antagonizing China, which now has the world’s most powerful functioning economy and may become the dominant supplier of drugs and vaccines. China has used the pandemic to extend its global influence, and says it has sent medical gear and equipment to nearly 120 countries.

This is not a world in which “America First” is a viable strategy, several experts noted.

“If President Trump cares about stepping up the public health efforts here, he should look for avenues to collaborate with China and stop the insults,”

If we alienate the Chinese with our rhetoric, I think it will come back to bite us,” he said.“What if they come up with the first vaccine? They have a choice about who they sell it to. Are we top of the list? Why would we be?”

Once the pandemic has passed, the national recovery may be swift. The economy rebounded after both world wars, Dr. Mulder noted.

In one of the most provocative analyses in his follow-up article, “Coronavirus: Out of Many, One,” Mr. Pueyo analyzed Medicare and census data on age and obesity in states that recently resisted shutdowns and counties that voted Republican in 2016.

He calculated that those voters could be 30 percent more likely to die of the virus.

In the periods after both wars, Dr. Mulder noted, society and incomes became more equal. Funds created for veterans’ and widows’ pensions led to social safety nets, measures like the G.I. Bill and V.A. home loans were adopted, unions grew stronger, and tax benefits for the wealthy withered.

If a vaccine saves lives, many Americans may become less suspicious of conventional medicine and more accepting of science in general — including climate change

Ferguson said their analysis “provides some hope for countries currently in various levels of lockdown that once case numbers are brought to low levels, it might be possible to relax social distancing – provided equal measures to limit the risk of the resurgence of transmission are introduced”.

The analysis shows that “intermediate levels of local activity can be maintained while avoiding a large outbreak”, the report says

That would mean testing everyone with symptoms and following up and isolating their contacts, in order to stamp out any further flare-ups of infection.

He stressed, however, that relaxing the lockdown policies would depend on “rapid and ubiquitous testing and rigorous case and contact isolation policies”.

after very intense social distancing which resulted in containment, China has successfully exited their stringent social distancing policy to some degree.

The report adds: “Globally, China is at a more advanced stage of the pandemic. Policies implemented to reduce the spread of Covid-19 in China and the exiting strategies that followed can inform decision-making processes for countries once containment is achieved.”

For weeks, scientists have been calling for a total lockdown to stem the surge, but President Recep Tayyip Erdogan held off, mainly for economic reasons. He changed course after a cabinet meeting on Monday, and announced a new three-week lockdown to take effect Thursday evening and last through the end of Ramadan.

The announcement prompted a rush to stock up on groceries, alcohol and other supplies for the lockdown, which will include Eid al-Fitr, the three-day festival to mark the end of Ramadan. And many city dwellers hurried to reach rural hometowns or holiday resorts while travel was still allowed.

The lockdown will land hardest on the many Turks who depend on informal day work. A single mother with five small children in Istanbul who collects and sells paper said her family can eat only on days when she can work.

“I really don’t know what to do,” she said, speaking on the condition of anonymity to avoid jeopardizing her welfare payments from the government. “I wish the state would give me a job.”

America's daily new cases topped 100,000 on Wednesday, and its death toll exceeds 234,000, a staggering figure even accounting for its greater population than Australia, which has recorded 907 deaths.

Meanwhile, in the United States, 52,049 people are hospitalized and 10,445 are in an ICU

No new cases were reported on the island continent Thursday, and only seven since Saturday, besides travelers in hotel quarantine. Eighteen patients are hospitalized with covid-19, the disease caused by the coronavirus. One is in an intensive care unit. Melbourne, the main hotbed of Australia's outbreak that recently emerged from lockdown, has not reported a case since Oct. 30.

"We told the public: 'This is serious; we want your cooperation,' 

Several practical measures contributed to Australia's success

The country chose to quickly and tightly seal its borders, a step some others, notably in Europe, did not take.

Health officials rapidly built up the manpower to track down and isolate outbreaks.

And unlike the U.S. approach, all of Australia's states either shut their domestic borders or severely limited movement for interstate and, in some cases, intra­state travelers.

Perhaps most important, though, leaders from across the ideological spectrum persuaded Australians to take the pandemic seriously early on and prepared them to give up civil liberties they had never lost before, even during two world wars.

Australia provides a real-time road map for democracies to manage the pandemic. Its experience, along with New Zealand's, also shows that success in containing the virus isn't limited to East Asian states (Singapore, South Korea, Taiwan) or those with authoritarian leaders (China, Vietnam).

A lack of partisan rancor increased the effectiveness of the message

The conservative prime minister, Scott Morrison, formed a national cabinet with state leaders — known as premiers — from all parties to coordinate decisions

Political conflict was largely suspended, at least initially, and many Australians saw their politicians working together to avert a health crisis.

After a sick doctor in his 70s treated more than 70 people in the city before being diagnosed, Hunt accelerated a 10-year plan to phase in video consultations with physicians. Within 10 days, almost anyone in Australia could see a doctor over the Internet under Australia's highly subsidized health-care system, including psychiatrists.

Australians' willingness to conform — especially in Melbourne, where residents endured a lengthy state-ordered lockdown — reflects political attitudes that differ from those in parts of the United States

In a nation where compulsory voting produces conventionally center-left or center-right political leaders, governments tend to be regarded as the solution to society's problems rather than the cause.

Australia's national response was led by Health Minister Greg Hunt, a former McKinsey & Co. management consultant and a Yale University graduate. Hunt and Morrison worked with the state premiers, who hold responsibility for on-the-ground health policy, to develop a common approach to the pandemic.

The government closed Australia's borders to travelers from China on Feb. 1, the same day as the Trump administration in the United States. But unlike the Trump administration, which has criticized its primary infectious-disease adviser, Anthony S. Fauci, Hunt relied heavily on health experts from the start.

"In January and February, we were focused on containing the risk of a catastrophic outbreak," Hunt said in an interview. "We had a clear strategic plan, which was the combination of containment and capacity-building."

"We closed the border and concentrated on testing, tracing and social distancing," he added. "We built up our capacity to fight the virus in primary and aged care and hospitals. We invested in ventilators, and vaccine and treatment research."

Hunt's department oversaw the purchase of huge amounts of protective equipment and clothing, including masks, which became mandatory on Aug. 2 in the state of Victori

"Regardless of who you vote for, most Australians would agree their leaders have a real care for their constituents and a following of science," McLaws said. "I think that helped dramatically.

When private hospitals said they were in danger of going broke because non-urgent surgery had been canceled, the government stepped in with emergency funding, securing beds that could be used for coronavirus patients.

In private, Hunt swapped ­practical stories with his wife, Paula Hunt, a former infectious-diseases nurse who kept a 1995 bestseller by U.S. science journalist Laurie Garrett, "The Coming Plague: Newly Emerging Diseases in a World Out of Balance," on her bedside table, he said.

While opinion polls show strong support for the tough measures, many people have been badly affected. Australia entered its first recession in 29 years, small businesses have closed, and reports of depression are up. On Tuesday, an anti-lockdown protest in Melbourne turned violent. Police arrested 404 people.

for a time, it appeared Australia's early success was imperiled, after lax security at hotels in Melbourne that were housing returned travelers led to a second outbreak in July. By August, more than 700 cases a day were diagnosed. It looked like Australia could lose control of the virus.

Almost all public life in Melbourne ended. After 111 days of lockdown, the number of average daily cases fell below five. On Oct. 28, state officials allowed residents to leave their homes for any reason.

Australia currently bans its citizens and residents from overseas travel, a decision that has been particularly tough on its 7.5 million immigrants.

Most Australians will have access to a vaccine by the middle of next year, Hunt said, a major step toward allowing them to travel.

Prime Minister Jacinda Ardern is adamant that New Zealand will complete four weeks of lockdown — two full 14-day incubation cycles — before letting up. She has, however, given the Easter Bunny special dispensation to work this weekend.

this heavily tourism-reliant country — it gets about 4 million international visitors a year, almost as many as its total population — did the previously unthinkable: It shut its borders to foreigners March 19.

Two days later, Ardern delivered a televised address from her office — the first time since 1982 that an Oval Office-style speech had been given — announcing a coronavirus response alert plan involving four stages, with a full lockdown being Level 4.

A group of influential leaders got on the phone with her the following day to urge moving to Level 4.

“It’s inevitable that we will have to shut down anyway, so we would rather it be sharp and short.”

On March 23, a Monday, Ar­dern delivered another statement and gave the country 48 hours to prepare for a Level 4 lockdown. “We currently have 102 cases,” she said. “But so did Italy once.”

with strict border control, restrictions could be gradually relaxed, and life inside New Zealand could return to almost normal.

From the earliest stages, Ar­dern and her team have spoken in simple language: Stay home. Don’t have contact with anyone outside your household “bubble.” Be kind. We’re all in this together.

there has been a sense of collective purpose. The police phone line for nonemergencies has been overwhelmed with people calling to “dob in,” as we say here, reporting others they think are breaching the rules.

The response has been notably apolitical. The center-right National Party has clearly made a decision not to criticize the government’s response — and in fact to help it.

After peaking at 89 on April 2, the daily number of new cases ticked down to 67 on Monday and 54 on Tuesday. The vast majority of cases can be linked to international travel, making contact tracing relatively easy, and many are consolidated into identifiable clusters.

The nascent slowdown reflected “a triumph of science and leadership,”

“Other countries have had a gradual ramp-up, but our approach is exactly the opposite,” he said. While other Western countries have tried to slow the disease and “flatten the curve,” New Zealand has tried to stamp it out entirely.

The government won’t be able to allow people free entry into New Zealand until the virus has stopped circulating globally or a vaccine has been developed

From that Wednesday night, everyone had to stay at home for four weeks unless they worked in an essential job, such as health care, or were going to the supermarket or exercising near their home.

Ardern has said her government is considering mandatory quarantine for New Zealanders returning to the country post-lockdown. “I really want a watertight system at our border,”

Hospitals in the Chinese city of Wuhan, where the pandemic began, have discharged the last coronavirus patients, while some of Europe’s worst-affected countries are preparing for the cautious easing of restrictions.

Boris Johnson is back in No 10 after recovering from Covid-19, and once again taking charge of the UK government’s faltering response to the pandemic.

xplained his country’s more successful approach, telling Laura Spinney how Angela Merkel rose to the challenge of the pandemic:

But it didn't stop thousands of people attending anti-lockdown demonstrations in London on Saturday.

Britain's speedy vaccine rollout — it was the first in the world to administer a fully tested vaccine — has been a surprise success for the government of Boris Johnson, who has received heavy criticism for his response to the virus.

"at the start of the pandemic Germany was a global model for how to manage it." But a year into it, the opposite appears to the case. Just 8.5% of Germans received their first shot, as of Friday, far behind other nations including the U.S. and the U.K.

In Hyde Park, police were forced back into their vans as demonstrators lobbed bottles and cans at them. The BBC reported that few protesters appeared to be wearing masks. London Metropolitan Police said 36 people had been arrested during the rallies, most of them involving violations of COVID-19 regulations.

The protests came the same day as 60 members of parliament urged the home secretary to ease restrictions on demonstrations. Due to coronavirus restrictions, it's currently unlawful for groups to gather for the purpose of protest. But the measures came under direct assault this week.

The outcry over lockdowns has combined with a groundswell of rage at the abduction and death of Sarah Everard, a 33-year old woman who went missing earlier this month while walking home. Her body was found a week later, and a serving police officer has been charged with her murder. Police are under scrutiny for their alleged heavy-handed tactics in breaking up a well-attended outdoor vigil for Everard last Saturday that ignited three nights of protests.

Prime Minister Boris Johnson is reportedly planning to introduce a controversial new law banning protests that are noisy or cause "serious annoyance," and would carry a maximum jail term of 10 years.

The country's R rate is now at 1.6 with coronavirus variants increasing the spread of the virus, according to the health ministry.The variant B.1.1.7, which was first identified in the United Kingdom, is also now prevalent in the country, according to the health ministry, who also said that they are worried about the presence of small clusters of the Brazilian variant.

Meanwhile, the variant first reported in Brazil, known as P.1, may be up to 2.2 times more transmissible and could evade immunity from previous Covid-19 infection by up to 61%, according to a modeling study, released earlier this month by researchers in Brazil and the UK.

Italy was under a national lockdown from March to May 2020, however there have been many localized lockdowns in regions across Italy since.

On Thursday alone Italy reported more than 25,000 new daily cases. That was its highest record since November -- and it jumped to over 26,000 cases on Friday.The last two weeks have also seen an additional 5,000 people in hospital with Covid-19, with the number in intensive care increasing by more than 650, he said.

On Saturday, Italy's new Covid-19 commissioner Paolo Figliuolo said, "By this summer, all Italian adults will be vaccinated," noting that the Johnson and Johnson vaccine, which is expected to be the next coronavirus vaccine authorized by the EU, will be "decisive."Only 3.08% (1,861,852 people) of Italy's eligible population has been fully vaccinated so far, with 6,219,849 doses administered, according to the latest data from Johns Hopkins University (JHU).

Italy, once the epicenter of Covid-19 in Europe, has marked 3,149,017 Covid-19 cases in total. The country ranks sixth highest in the world for coronavirus fatalities, with 101,184 deaths recorded, according to JHU.

But unlike spring's lockdown, nurseries will not be shuttered, elite sports can go ahead, and places of worship will remain open on the basis that attendees adhere to social distancing rules.

"Many parts of the health systems in the four nations are already under immense pressure. There are currently very high rates of community transmission, with substantial numbers of COVID patients in hospitals and in intensive care,"

British teachers unions criticized the "chaotic reopening" of schools this week, "while the rate of infection is so high is exposing education sector workers to serious risk of ill-health and could fuel the pandemic,"

But the country is long way from vaccinating the millions in the top priority groups mentioned by Johnson, including people "over the age of 70, all frontline health workers and everyone who is clinically vulnerable,"

Johnson suggests those groups are expected to have been offered their first doses by mid-February.

Over the weekend, the prime minister announced that pubs, restaurants, gyms, nonessential shops and places of worship would be closed starting Thursday.

Johnson, who has received heavy criticism for his handling of the crisis, had initially refused to consider a second lockdown, despite the advice of scientists who warned the country was risking a new spike in cases and deaths.

The decision from No. 10 Downing St. to renew extraordinary measures to control the spread of the virus that causes COVID-19 comes as other countries in Europe are facing similar dilemmas.

France imposed a stricter lockdown on Friday

Germany also ordered the closing of restaurants, bars, gyms and theaters starting this week

Other European countries, such as Spain and Italy, have seen a surge in new cases as well.

South Korea did everything the UK government could have done, but refused to implement. Its death toll so far: 263. It still has an occasional cluster of infection, which it promptly contains. By contrast, the entire UK is now a cluster of infection.

Had the government acted in February, we can hazard a guess about what the result would have been, as the world has conducted a clear controlled experiment: weighing South Korea, Taiwan and New Zealand against the UK, the US and Brazil.