Gates Package — page 967

ding the United <~?~NO CAPTION FOR THIS ILLUSTRATION (Illustration describing the paradox of NPIs-- when implemented measures work, fewer cases occur, which leads people to think the measures weren't necessary in the first place.)> Nor was that the first time that St. Louis had led the way: Virtually the same thing had happened a century earlier. Shortly after detecting its first flu cases during the 1918 pandemic, St. Louis closed schools, banned large public gatherings, and put social distancing measures in place. Philadelphia, on the other hand, waited to do these things. For two weeks after its first case, it allowed large public gatherings, including a citywide parade. As a result, Philadelphia's death rate was more than eight times higher than St. Louis's. Later, studies found that the pattern held across the country: Cities that put multiple measures in place, and did it early, had death rates that were half that of cities that had waited. Compare countries instead of cities, and you'll get similar results. During the first wave of COVID, Denmark and Norway implemented strict lockdowns early on (when fewer than thirty people in the two countries had been hospitalized), while the government of neighboring Sweden relied more on recommendations than requirements, keeping restaurants, bars, and gyms open and only encouraging but not requiring physical distancing. One study found that if Sweden's neighbors had followed its lead instead of locking down stringently, Denmark would have had three times as many deaths as it did during the first wave, and Norway nine times as many as it did.2 Another study estimated that NPIs in six large countries, including the United States, prevented nearly half a billion COVID infections in the first few months of 2020 alone.3 Not only should you appear to overreact at first, as Tony Fauci said, but you also have to be careful about relaxing NPIs too soon. When the most effective public measures are relaxed-- such as restrictions on large gatherings--case numbers tend to go back up (all other things being equal). The problem with relaxing these measures early is that you end up with large numbers of people who are what experts call "immune-naïve"--since relatively few people have been