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On March 3rd, the UK government released a publication detailing its Coronavirus action plan, which contains the four-stage plan that will be implemented throughout the country, in all four devolved nations, as the impact of the disease continues to worsen. Below is a brief summary of each stage:

  1. Contain - identify cases as soon as possible, and attempt to prevent wider community spread of the virus. Powers have been given to enforce quarantines and extra funding granted to healthcare centres. The goal is to stop the virus from taking hold in the country.

  2. Delay - if containment does not work, measures such as closing schools, banning large gatherings, and incentivising working from home will be introduced. The goal is to delay the inevitable spread of the virus for as long as possible.

  3. Research - if measures taken to delay the virus prove ineffective, focus efforts on researching how to best fight the virus; working out how it spreads, and the best treatment methods. This includes research into vaccine development and deployment.

  4. Mitigate - the last resort scenario, at this point the government will focus on keeping essential services such as police/fire/ambulance functional, as well as bringing retired and newly graduated doctors to the frontlines.

At the moment, the UK Government insists that the country is still in the containment phase, despite the country's Chief Medical Officer and the government's chief medical advisor, Prof. Chris Whitty telling MPs as early as March 5th that the UK "was now "mainly" in the delay phase".

At first glance the government's refusal to move to the delay phase, despite 460 total cases, and confirmed community spread, seems stubborn and almost deluded, however, the Scottish Cabinet Secretary for Health and Sport, Jeane Freeman told MSPs after attending a COBRA meeting on the 10th that

The timing of moving into the ‘delay’ phase, and what measures are judged to be the most effective in that phase, must be and are driven very firmly by scientific and clinical advice. Understandably people will be looking to the situation in other countries and questioning why some of the moves they are taking are not being made here yet in Scotland and in the UK.

[...]

Timing is critical. If we take those measures too soon, we will not have the impact we need. If we take them too late, we will not reduce demand [on the NHS] to the level we need

What is the risk behind taking these measures - i.e. moving into the delay phase - too soon? I note that Poland, for example, which has a fraction of the cases of the UK, will close all museums, cinemas, & schools from Monday. Why might this be a mistake? Is there any research that has evaluated this?

(Note that although the example I have given is UK-based, I am also interested in answers that refer to the general postponement of more extreme countermeasures internationally)

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CDJB
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    This is more about strength of the measures than timing so it doesn't directly answer the question, but this paper argues that measures which are too strong actually prolong epidemics as you still need a large fraction of the population to be infected in order for herd immunity to kick in: https://www.pnas.org/content/104/18/7588 – llama Mar 12 '20 at 16:55
  • Scotland is now officially in delay. – Martin Schröder Mar 12 '20 at 18:18
  • I'm wondering if their four-stage plan is a reimplementation of the classic four-stage strategy https://www.youtube.com/watch?v=nSXIetP5iak – Peteris Mar 14 '20 at 10:54

4 Answers4

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Specifically with reference to the UK, an article in the Guardian reports that

Experts have warned about the risk that if tough measures are taken too soon, “fatigue” may set in, prompting the public to disregard the advice just as the virus reaches its peak.

Effectively the argument is that, absent some sort of enforcement squad if people are told to stay in lockdown for a significant period, without a significant scare factor to justify it, then people will assume the risk is actually overblown and start mingling again, just at the moment that many of them are at their most contagious, starting a whole new outbreak in the herd of uninfected.

origimbo
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    To be more precise about "fatigue". Just closing schools is not helpful if students go to the cinema instead. Closing public places only has an effect if people actually stay at home at avoid contact with other people. This works only for a few days until everybody is tired of watching TV/netflix/whatever – Manziel Mar 12 '20 at 09:51
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    This is obviously not true. One only has to look at the situation in China to come to that conclusion. I bet a lot of people upvote this rather than to deal with the realization of why their government is actually doing it. – dan-klasson Mar 12 '20 at 18:04
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    @dan-klasson Isn't it enforced in China though? – Reasonably Against Genocide Mar 12 '20 at 18:39
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    Also, I'd think people in China are more used to restrictions and the Government telling them what to do. I would also think that their culture teaches more focus on the community/group than on the individual - and the right of the individual. – Baard Kopperud Mar 12 '20 at 19:12
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    @user253751 No. People are not getting arrested in masse for violating the rules. They opt to stay in for their own and the well being of their family members. – dan-klasson Mar 12 '20 at 19:44
  • How does this relate to the "research" step? Surely the concept of fatigue does not apply to researchers who presumably want to be able to work? – rtpax Mar 12 '20 at 21:12
  • @rtpax I'm not sure they're meant to go strictly sequentially, pretty sure the research is already being done. I think the significance of that stage is just that the people previously doing delay or contain would switch over to research. – Segfault Mar 13 '20 at 00:03
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    @dan-klasson you only have to look at what happened when Italy tried northern quarantine to see China is not typical. https://www.theguardian.com/world/2020/mar/08/leaked-coronavirus-plan-to-quarantine-16m-sparks-chaos-in-italy – Jontia Mar 13 '20 at 05:41
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    @dan-klasson Just because people aren't being arrested en masse doesn't mean that the quarantine isn't enforced. I'm sure that if people started breaking lockdown, the police would do something. It's just that in China, people are used to the government having the power to tell them what to do, and know that it's a bad idea to disobey. This is a government that deployed tanks to prevent the spread of a political ideology; I'm sure they'd have no trouble taking steps to prevent the spread of a lethal virus. – anaximander Mar 13 '20 at 09:01
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    @anaximander I doubt it. There is a big difference between the hive-mind mentality of China and their individual sense of responsibility to the state, and the neanderthal thuggery of British youth. Simply put, the UK will require an "enforcement squad" because as soon as pubs get shut down there will be looting and riots – Frank Mar 13 '20 at 12:40
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    I think this is a minor concern. quarague, in another answer, gets it right: a lockdown has massive economic costs. You can't just tell everyone to stay home indefinitely and not have businesses collapse. – Wayne Mar 13 '20 at 13:13
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    @Jontia They obviously did not do a very good job. Not only did it leak, but they also didn't shut down the trains. Leading everyone to leave the area forcing them to just a couple of days later to shut down the whole country. The Chinese did something similar, but to their defense it was in the begining of the outbreak and it was right during their new year celeberations. It's very hard to defend the actions of our EU politicians. Italian or the EU in general. – dan-klasson Mar 13 '20 at 19:13
  • @anaximander Actually that's exactly what it means. That's the very definition of enforcing something. Whether Chinese people stayed at home because of cultural reasons, fear of reprisals, or just being more intelligent is basically just an educated guess. – dan-klasson Mar 13 '20 at 19:15
  • @Wayne It costs a lot of money and I think it's a valid question to ask if the cost is worth it. The problem with that though is that they're already implementing those measures. When it would have been a lot cheaper to just shut down the borders, to begin with. Them shutting down borders now is just way too late. Completely pointless. The second aspect of that is that even though the death rate is relatively low, is that it puts a strain on our health care system. There is something very inhumane about turning away dying people from hospitals because of lack of resources. – dan-klasson Mar 13 '20 at 19:29
  • @Frank I'm not so sure. Look at the protesters in Hong Kong. They were even burning health clinics in protest at the beginning of the crisis. But since then I haven't heard anything from them. I bet they're staying indoors and riding it out right now. So whether you're a hardcore Communist, don't care, or tear the whole system down, kinda Chinese. They're all responding the same way right now. Or that's my humble guess. – dan-klasson Mar 13 '20 at 19:38
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Shutting down schools, banning large gatherings and pushing people to do home office has a massive economic cost. Of course you never get the exact numbers on either death or cost but essentially you have to answer questions like: How many death does one need to prevent to make a 10% reduction of annual GDP worth it? This is a complicated ethical question and I don't have an answer for it either. But 'reduce Corona death at any cost' is not a wise government strategy. Maybe the UK should fully move into the delay phase right now, but this is not an easy decision and people can have very different equally valid opinions on when would be the appropriate time.

quarague
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It's a balancing act. You want to save as many people from the virus as possible, but you also don't want to disrupt the economy any more than you need to. This isn't just people being greedy either, many people living paycheck to paycheck cannot handle a recession. Some of these people will, after losing everything, commit suicide. Others will turn to dangerous drugs to cope.

Even excluding economics-related deaths, how many people will forgo routine medical exams, for fear of catching the coronavirus at the doctor's office, and will then die from some disease that would have otherwise been caught early enough to treat? How many people will hesitate to see a dermatologist while a funny-looking mole turns into a full-blown melanoma? How many people will hesitate seeing their primary care physician about constant fatigue, and not find out about their atrial fibrillation until it causes a heart attack?

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    +1 for balancing. Sinking economy gets its death toll in many ways. Less economy brings less taxes, less health funding, worse food/drinks/means of transportation/recreation for everyone, more crime and so on. Most of these cascade effects don't disappear right after the quarantine is over and some of them have their own exponential growth over time that needs more and more effort to clear later. – fraxinus Mar 13 '20 at 11:26
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Because you would potentially destroy some businesses

Understand that minor and temporary inconveniences can be absorbed by the market, but if those distortions last for long periods of time, they can carry serious consequences. For instance, Royal Caribbean Cruise Lines is offering full refunds through the end of July

Effective March 6, 2020, the new Cruise with Confidence policy allows our guests to cancel any cruise departing on-or-before July 31st, 2020, up to 48 hours before departure, and receive a Future Cruise Credit that can be applied to any future cruise departing in 2020 or 2021.

Now, you might be wondering why this applies here. Well, there's real economic consequences to that

RCL stock price

RCL will likely recover, but they're a big company. Smaller companies might not be able to run mostly empty ships and some have opted not to run at all

I am writing today because the situation has now become such that operating as a travel company involves significant risks of quarantines or medical detentions, which could diminish the travel experiences for which our guests have been planning. As a private company with strong finances, we do not have to worry about quarterly profit expectations – and that flexibility allows us the ability to do what is best for our guests and our employees, as we have always done.

Therefore, we have made the difficult decision to temporarily suspend operations of our river and ocean vessels embarking from March 12 to April 30, 2020

We're talking massive work stoppages. These cancellations will have ripples

  • Dock workers
  • Food vendors
  • Tourist attractions and tertiary beneficiaries (i.e. small tour operators)
  • Ship crews

And we're just talking the cruise industry. Airlines are in the same boat and that boat is starting to fill up

The major NCAA conferences have cancelled their postseason basketball tournaments amid continued fears over outbreaks of the coronavirus.

Most economies are service based, which means that a full-on quarantine translates into businesses unable to meet whatever economic activity brings in money. As such, people get furloughed, lose jobs, and the whole effect can spiral out of control.

In Seattle, bracing for the coronavirus also means preparing for what could be a devastating economic impact. Business owners and residents have already seen a drop-off in tourists in areas of the city that heavily depend on foot traffic.

"It's like a ghost town," Francisco said about the famous Pike Place Market where she has her shop.

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Machavity
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    And not doing it will most likely kill people. – Martin Schröder Mar 12 '20 at 18:16
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    @ReinstateMonica-M.Schröder It's a balancing act. The number of people who have died from cruise ship infections is fairly low at this point (compared to volume of deaths elsewhere). People are acting out of an abundance of caution, but the post-coronavirus market may not look the same... – Machavity Mar 12 '20 at 18:18
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    @ReinstateMonica-M.Schröder Driving kills people (a LOT of people), yet we still allow people to drive to restaurants, events, and all kinds of other optional leisure pursuits. Although most people don't like to admit it, a price is attached to lives, even our own. Even if you don't know you're doing it, the very act of leaving your house to see a movie puts lives at risk, and you've weighed the value of those lives against the cost of not going out and made a value judgement. The same holds true each time you eat out or go to a concert instead of donating that money to lifesaving charities. – Nicholas Mar 12 '20 at 19:24
  • On the positive side, cruise industry and civil aviation not doing well is a great news for our fight against oil dependency and climate change. – Eric Duminil Mar 12 '20 at 21:00
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    @ReinstateMonica-M.Schröder, doing it will most likely kill people as well. It's just that someone dying of a heart attack because they put off a doctor's appointment because they'd lost their job isn't as dramatic as someone dying of a COVID-19 infection. – Mark Mar 12 '20 at 21:21
  • @Mark why would you put off a doctor's appointment if you lost your job? – Eric Duminil Mar 12 '20 at 23:45
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    @EricDuminil, because you can't afford to pay the doctor? Because you're too busy looking for a new job? – Mark Mar 13 '20 at 01:57
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    @Mark that's what I feared the explanation was. The problem isn't COVID, then, but a completely broken healthcare system. – Eric Duminil Mar 13 '20 at 06:41
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    You are mentioning "real economic consequences", then linking to stock exchange prices, which are not real. Real economic consequences would be: purchasing power, poverty rates, unemployment, human development index. Stock prices are just a theoretical fictional "value" that can jump up and down by 10% in days, which means they cannot possibly be real. – gerrit Mar 13 '20 at 08:29
  • @EricDuminil Although the NHS is underfunded, why would you say the healthcare system is completely broken? The question is about the UK. – gerrit Mar 13 '20 at 08:32
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    @gerrit: I was answering to Mark's comment. If you cannot take your heart taken care of because you're unemployed, something must be really broken indeed. – Eric Duminil Mar 13 '20 at 08:36
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    @gerrit My 401k absolutely disagrees with you that stock prices "are not real". Stock prices are more susceptible to price shocks (prices reflect what people are willing to pay for something), but in this case people do not want to own stock in a company all but closing its doors for 3 months. The general market is down some 20%, but the RCL stock is down nearly 70%. Imagine what would happen if RCL were told it could not run any cruises in the US until 2021. My point is that stocks are a real-time indicator of what people value a company at. It will be months before we see financials. – Machavity Mar 13 '20 at 13:17
  • @Machavity Your pension fund is a long-term investment, why would you care about daily fluctuations? – gerrit Mar 13 '20 at 13:23
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    @gerrit 401k, not pension. Pensions are guaranteed income based on some contributions made on my behalf. My 401k is an investment account I contribute to via my employer and it's an asset I fully own. More importantly, there's reasons to sell investments unrelated to the market status. I have a personal investment account and I would take a 20% hit selling right now. My mother has a trust investment account for her medical needs and I regularly have to dip into that as well. So, yes, major drops like this have real effects on peoples' lives. – Machavity Mar 13 '20 at 13:49
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    To move the discussion away from the US (and bashing US healthcare/pensions etc. which will happen otherwise). Just because the Europe has a "free" health care system and pensions doesn't make the economic reality different. A serious decline of economic output will have an effect on lives that might easilly be greater than the losses likely to be suffered from Covid-19. Someone has to pay for, and produce, food, healthcare, pensions etc. The fact we don't pay out of pocket just means a lot of those costs are hidden and a general slowdown effects everyone. – DRF Mar 13 '20 at 13:56
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    @DRF I've asked this elsewhere, but is the fall of stocks a symptom or a cause of economic decline? – gerrit Mar 13 '20 at 15:15
  • @gerrit Symptom. I posted an answer on your Money.SE Q, but here's a rundown of why the 2008 recession happened – Machavity Mar 13 '20 at 15:18
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    @DRF is right: A socialized health care system just shifts the issue of unemployed people not affording doctor visits to unemployed people not paying taxes that pay the doctors. – dan04 Mar 14 '20 at 01:06