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Brian Lehrer: It's The Brian Lehrer Show on WNYC. Good morning again, everyone. Everyone is trying to figure out how much to lock down and how much to open up. People are conflicted. Dr. Fauci was warning people about risky labor day weekends. Just as restaurants are suing New York City to allow indoor dining. Some parents are changing schools so their kids can attend in-person. Others are changing schools so their kids can stay home. While the restaurants are suing New York to reopen, teachers are suing to keep schools closed. The college scene everywhere is a jumbled hot mess. South Korea led fans back into baseball stadiums then locked them back out.

The UK is considering how much to reclose with a spike taking place there. Suicides by farmers in India are reported up as much because of the lockdown there as because of the virus, The Times has an article called 'The Lockdown Killed My Father': Farmer Suicides Add to India's Virus Misery. The Wall Street Journal's Greg Ip has a really interesting article about different approaches around the world to managing the virus and the economic pain. We'll talk to him in a minute.

First, I thought you might be interested in some comparative coronavirus stats to get a partial sense of where things stand. I pulled these together on Sunday for the week that just ended. These numbers are for the average number of deaths reported from coronavirus last week. New York State averaged 9 deaths a day. Florida, with about the same population, averaged 101 deaths a day over last week. 9 versus 101. The US nationally last week averaged 828 reported deaths a day from coronavirus. The world averaged 5,000 deaths a day. I did the math. We have 4% of the world's population, 16% of last week's deaths, and we just passed 190,000 total deaths. That means will be over 200,000, probably around the end of next week. By comparison, Germany averaged five deaths a day last week. Spain, 57. France, 18. Italy, nine. The UK, seven.

That makes a total of 97 deaths last week in those 5 main West European countries combined. They have a total population very close to that of the US so it's apples-to-apples in that regard. 97 deaths a day in the 5 allied countries last week, 838 here. Those numbers are all from The New York Times. As the US and the world grappled with very inexact science of how to control the deadly virus with the least crippling economic pain, now we turn to Greg Ip, chief economics commentator for The Wall Street Journal. One of his very interesting articles recently is called New Thinking on Lockdowns: They're Overly Blunt and Costly. It's a survey of many different countries' responses and various alternative approaches. Greg, thanks for joining us for this. Welcome to WNYC.

Greg Ip: Thanks for having me on, Brian.

Brian: First, can you define how you're using the word "lockdown" for the sake of this article because people often mean different things when they say lockdown?

Greg: You're right. There's quite a wide variety of measures that governments have taken to restrict movement to contain the virus. When I say lockdown, I mean cutting basically all nonessential activity. It would be, for example, a stay-at-home order and a closure of all nonessential businesses, which is more or less what you saw, for example, in Italy in March, and then followed closely by similar actions in New York City and many parts of the United States.

I would not consider a lockdown. What we have in most states right now is partial restrictions. For example, most construction sites and factories are open. Most retail stores are open although with limited capacity. Then with things like beauty salons, restaurants, and bars, it's a mixture of approaches. In some cases, they're completely closed. In some cases, they're allowed to open, but with a lot of restrictions, for example, only outdoors.

Brian: Now you report that some countries, of course, did achieve virus suppression through real lockdowns and you cite especially China and Wuhan and also New Zealand. Of course, they're very different countries. China is run by authoritarian command and control, New Zealand is not. Can you describe each a little bit and their success?

Greg: Sure. Let me first start out by saying a lockdown is a novel approach to containing a pandemic. The entire century before the COVID-19 pandemic, no country had really employed a lockdown in the sense that we're talking about now. Even if you go back to, for example, the 1918 flu pandemic, there were a lot of cities throughout the United States that limited large gatherings. They banned parades, they closed schools, and so forth. There really wasn't any city that went as far as most states in the US have gone, which is basically get shut down almost all activity. The same is true of other pandemics that we've had since then.

The decision in this pandemic to go much further is in some sense unique. One of the reasons that a lot of is that there was a hesitation to do this in the past was, I think, first of all, there was no experience with a virus like this one, which is very dangerous even when it's asymptomatic. That is to say, it's hard to control cases when the people who are spreading the disease aren't showing any symptoms. I think the other reason for skepticism was there was a lack of confidence that it would be possible to keep people locked down long enough to really make a difference.

Now, let's talk about two countries that really did actually succeed. One is China. They locked down the entire province of Hubei where Wuhan is located. One of the reasons China was able to make that actually work was because, of course, it's an authoritarian government that doesn't really have to worry too much about suppressing people's freedoms. In that case, they were able to make the penalties extremely high if people so much has left their home.

The other country, I think, which is an interesting example is New Zealand, which made the decision at the outset that it wasn't just going to-- As we say "flatten the curve" which is just get infections low enough that the hospitals aren't overwhelmed. They were going to go further. They were going to actually suppress the disease. They were going to get new infections down to zero and to do that, they committed to a complete and total lockdown of the country that lasted more than two months and they did succeed for a while. They went 102 days without new cases and they were able to reopen most of the economy. Then a few weeks ago, some cases apparently were imported and there was a outbreak and they had to reimpose part of that lockdown.

What I think sets China and New Zealand apart from most other places including the United States is, well, in the case of China, it's not a democracy. They can do things that are contrary to people's freedoms that we in the United States just aren't going to put up with. In New Zealand's case, it's a relatively small, compact, coherent country where there was, I think, a national will and resolve and a patience to do what it took to keep this virus down and because it's an island nation, it's relatively easy to control its borders. Those conditions are really rare to find elsewhere and so I think they made difficult templates for the United States to follow.

Brian: What about Italy? Should Italy be added to this list because Italy too after its initial horrific outbreak in the spring, and obviously a much bigger, more complicated country than New Zealand, they locked down pretty hard compared to the US and they had 9 deaths a day last week compared to 838 in the United States.

Greg: They did, but you have to look at the circumstances in which they locked down, and then France locked down, and then New York locked down which was that they did so because the epidemic had basically taken root. You had what you call community spread. The cases were doubling every several days and there wasn't a lot of experience with how to contain as deadly a pandemic using anything less than a lockdown.

In some sense, they went for the "break the glass" method which was to shut everything down and it did work. I think it's important to point that out is that if you are actually willing to lock everything down for an extended period of time, we do know that this will slow the rate of infections. It did so in Italy and it did so in New York. We have to remember two things.

First of all, it was still the case that in a lot of places, they ended up with a lot of infections and a lot of death. The economic class has been extremely high. Italy has endured a very, very severe recession and I don't think we fully know what the long-term costs of that recession will be because we know that it'll result in sustained high unemployment for a long time. For a lot of people, that has health consequences. There are various other psychological and health consequences that I think that we have yet to fully ascertain.

Brian: You mentioned New York, which obviously in the United States has such a unique success story having been the worst and now among the best in terms of coronavirus positivity rates. How do you see the New York experience and integrating the economic cost as well as the lives saved?

Greg: With New York, I think it's important to remember just how serious conditions were in March when the lockdown occurred. I think that it's difficult to second-guess the decisions of the policymakers who chose to restrict those activities because given how mysterious and deadly the virus was and the fact that we had a population that was completely susceptible, there was no workable therapy, there was no vaccine. There was very little prior exposure and thus no inherent immunity. That locking down did what it was designed to accomplish which is it broke the chain of transmission and it brought things down.

What I think the question has to be asked is knowing what we know now. If cases were to come back again, is there a better way to achieve the same result? I think this is what we've discovered over the last five or six months, is that in fact there might be better ways to achieve the same reduction in infections without so severe in economic cost. What are a few of those things that we've learned? Well, we know that certain types of events are much more conducive to spread than others. These so-called super spreader events. If you look, for example, at tracking by the state of Louisiana, 1/3 of their cases have occurred in restaurants, bars, and casinos.

If you look at Japan, they found that roughly 16% of all their multiple case outbreaks occurred in bars and restaurants and karaoke bars. Whereas workplaces in both cases were much less likely. What do we ascertain from this? It suggests that you should probably be much more restrictive in terms of allowing people to return to places like bars and restaurants where there's lots of close contact and singing and not very much mask-wearing. You can probably be more accommodating with allowing people to return to workplaces like construction sites, retail stores, and factories. That's one thing we've learned.

Another thing we've learned is that masks seem to be very effective at slowing the spread of transmission. There's an interesting study in Germany where masks were first mandated in one city and only several weeks later in other cities. Comparing that city to other German cities, infections completely came to a halt after the mask mandate was put in place that did not happen elsewhere because masks-- Well, they're not very much fun to wear, I'll admit that. They aren't great, but they allow most normal economic activity continue. That's a kind of intervention we know about now that we didn't know about five or six months ago. Using that in addition to some of these other interventions, we should be able to allow some semblance of normal life to continue without having the pandemic re-erupt.

Brian: Listeners, if you're just joining us, we're talking to Greg Ip, Wall Street Journal, chief economics commentator, and the author of a number of books. One from a few years ago that's relevant to this is his book, Foolproof: Why Safety Can Be Dangerous and How Danger Makes Us Safe. Also, The Little Book of Economics: How the Economy Works in the Real World. We're talking primarily about his recent article in The Wall Street Journal called New Thinking on Lockdowns: They're Overly Blunt and Costly. It is a detailed look and how various different countries have handled suppressing the coronavirus or at least the spread of the coronavirus.

We can take your stories if you have connections with any other country around the world and want to add something or your questions for Greg Ip at 646-435-7280. 646-435-7280. You can tweet a question or a comment @BrianLehrer. I want to take a break here and when we come back, we're going to dig a little bit into the unique attempt by Sweden which leaves many Americans when we know the top line of the story horrified because they apparently are going for a herd immunity approach, which means basically not closing things down to protect people. Greg took a look at how that's working out. Stay with us for Sweden and more with Greg Ip here on The Brian Lehrer Show right after this.

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Brian Lehrer on WNYC with Wall Street Journal, chief economics commentator Greg Ip, mostly on his article, New Thinking on Lockdowns: They're Overly Blunt and Costly. I want to get into the Sweden section of this with a caller who's calling on Sweden. Let's see what he has to say or ask. Ebi in Westchester. You're on WNYC. Hi, Ebi.

Ebi: Hi. Sweden didn't shut down businesses, didn't shut down schools, didn't require wearing face masks, and listening to NPR this past spring, one would think that by now their health system should have collapsed. Since then, they've dropped off the radar completely. Haven't heard a thing about them. I would like to ask, what can we learn from the Swedish example?

Brian: Greg, where do you start?

Greg: I think what's interesting about Sweden is that they were one of the few countries that decided not to implement the lockdown strategy. Now, they did have some restrictions. They did reduce large gatherings. They did require restaurants and bars to operate a much lower capacity and they closed some of the higher grade schools. By and large, they avoided this strategy. What was the result?

One of the results was they definitely had more deaths than some of the neighboring countries like Norway and Denmark on a per capita basis. Interestingly enough, though they had approximately the same experience as the United States. Cumulative deaths per capita, almost exactly the same in Sweden as in the United States. They're not that much higher in Sweden than in some other European countries. They're actually lower than in Great Britain. Sweden's economy has been hard hit. They're a very open export-oriented economy so that was almost unavoidable, but their economy has not been as hard hit as most have been in Europe.

Interestingly, one of the things that we've discovered the last few weeks is that as cases have started to rise again in places like France and Spain as they've reopened, they have not risen in Sweden. In fact, the big drop in cases and deaths in Sweden has taken a lot of people by surprise. What can we learn from this? I think we can learn a couple of things. First of all, Sweden, you can debate whether they made the right choice, but it was a choice. You have countries that decided to make a very large economic sacrifice in order to suppress the virus. We talked about New Zealand and China, and you have at the other end, Sweden that decided not to pay that economic price and simply try and manage the virus and accept that there would be more infections. That was a choice.

One of the problems I think the United States has is it really never made that clear choice and so we locked down for six to eight weeks and without staying locked down long enough to truly suppress the virus and then we reopened. We ended up with a little bit of the worst of both worlds, a lot of infections and deaths and a lot of economic harm. Another interesting thing that I think epidemiologists are beginning to wonder about is whether the fact that Sweden's cases have fallen so much suggests that the epidemic can die out of its own accord at a relatively low level of infection. This gets to the question of herd immunity.

Herd immunity refers to that point when enough of the population is immune, either because they've been vaccinated or they were previously exposed, or they have some intrinsic immunity that the virus really can't spread very much any further. The view up until now is that most of the country would have to be infected before you got to herd immunity with respect to COVID-19. The fact that the diseases is not spreading very far in Sweden right now suggests that maybe after a certain point, you reach herd immunity and that point comes sooner than we've been expecting. I think that might be one of the things that a lot of experts are going to be looking at in the future.

Now it's important to remember, of course, that Sweden still has a lot of these restrictions in place. As those restrictions are lifted, they might see cases rise again. The same goes for places like New York City where the number of infections is very low. That might partly be because many people have already been exposed to the virus, but it may also be the case that as restrictions are lifted in coming months, we'll see a resurgence. We'll see at least some, possibly not large, but some uptick in cases.

Brian: They do have some restrictions in Sweden?

Greg: They do indeed. As I mentioned, I think large gatherings are still restricted.

Brian: Just large gatherings. It seems it's still hard for me to accept, to be perfectly honest because it seems intuitively dangerous and callous to life and contrary to what we're seeing in a lot of places here which did shut down. Like California is interesting. You write about California in your article. They had a shelter in place order early and with success, but then reopened too much under political pressure at the county level and has been suffering a summer spike. Why would reopening cause a summer spike if the Sweden model of doing almost nothing could work?

Greg: First of all, I should say right here, Brian, I'm not an epidemiologist. All the answers I'm giving you are based on my reporting and research, but I would never hold myself out as an expert. I would also like to emphasize there's enormous uncertainty around all these questions, things that we don't really know. The question of whether you reach/achieve herd immunity at a lower level than as previously thought is a hotly debated question right now.

I think you're exactly right, that I think most societies would find it impossible to accept that trade-off that you're going to allow the pandemic to rip and infect a lot of people, and you're going to accept a very large number of deaths that you might have prevented with a stricter approach. One of the questions you have to ask yourself is, "Well, is a vaccine going to come along, and if so, when?" Because at the outset, there was a lot of debate that it could be years before an effective vaccine was available. If that's the case, then perhaps it made some sense to simply manage. the pandemic and accept the fact that eventually everybody would be infected and try and make sure that the hospital and health care system could minimize the risk of death as much as possible for those that were infected.

If that was your starting view, then maybe the sweetest strategy makes sense. As we now know though, we've made remarkable progress on testing vaccines and it's possible that one could be available before the end of this year. If that's the case, then it would have made sense to stay locked down longer because you would have been able to reopen at a time when you could then protect all the people who haven't been exposed.

Brian: Hank in Somerville, New Jersey. You're on WNYC. Hi, Hank.

Hank: Hi, how are you doing?

Brian: Good. How are you doing?

Hank: Okay. [chuckles]

Brian: I see you just returned from China.

Hank: I did about six weeks ago.

Brian: And?

Hank: I have a couple of things that I wanted to mention and take a little issue with. First of all, I was in Beijing. I was not in Wuhan. I was in Beijing for the last six years and I lived under the coronavirus restrictions from February 10th when I came back from vacation until I left in July. The one thing I did not experience is fear from the government. I think there was much more social pressure with the restrictions. I felt more pressure from my neighbors. No policeman ever barked at me. No one ever pulled me over or threatened me. Everyone just followed the directions.

Another reason that I think that China was more successful is that it's just basic question of the structure of Chinese cities. Even cheap apartments are in big complexes. 20 buildings with only two entrances, in and out. It's easy to station a guard there to take your temperature, to check you in, make sure there aren't any outsiders, non-residents coming and going. They were just able to control things much more easily.

The third thing that I'd like to mention is that I think-- People always ask me, do I believe the numbers in China? Yes, I do. From what I saw in Beijing at least. I won't speak about Wuhan because I wasn't there, but I think the Chinese have painted themselves into a corner. I think they were very successful at controlling and in some cities eliminating the virus. Now the problem is how do they go back to being an international economy?

I had trouble getting out of Beijing. There were no international flights coming and going from Beijing. I had to eventually fly out of Shanghai. There the airlines were limited to only one flight per week. Right now, people going into China, even with a valid visa, have to quarantine for two weeks in a hotel and then for a third week in their apartments. China is [chuckles] it's going to have problems getting back to being a normal international economy.

Brian: When you said that the Chinese government didn't enforce a lockdown through fear, what did you mean? Because wouldn't it be fear of spreading the virus or getting the virus that would be the motivator?

Hank: That's a very different thing. I think when people say it through fear, they think military or police. Yes, of course, people were afraid of the virus and that's why they went through with the restrictions.

Brian: Hank, thank you so much for your call. Very illuminating. Do you want to react to that at all, Greg? Any new information in there that you want to put in the context of what you've been writing about?

Greg: Sure. I think Hank made a very interesting point at the outset where he talked about how people were taking these precautions just because of pure pressure or the sense that's what you should do for your community, not because the government was forcing you to do that. I think that raises an interesting point because we know that a lot of people, a lot of the social distancing that is taking place around the world has been voluntary. It hasn't been ordered by the government. People naturally fear getting the infection. They stay home, they avoid going to the stores, they avoid going to work. That raises an important question that we don't specifically know what the contribution was of government-mandated restrictions versus people's own voluntary behavior.

The other thing that it raises is that because different societies have different levels of compliance when they're asked to do something by the government. It's interesting to note that a lot of the countries in East Asia, which have had the best records in terms of containing the virus without lockdowns like South Korea, Hong Kong, and Japan, wearing masks is a very instinctive thing to do. Even in hay fever and a flu season in normal years, it's very common to see everybody wearing masks.

Now, if you go to a shopping mall or a train station in Tokyo, for example, mask-wearing is almost universal. You go to places here in the United States, even cities and states that have masked mandates in place, it is often the case that the compliance is very low. What I think Hank is pointing out is that regardless of how resolute the government is in terms of wanting to take various measures to contain the pandemic, a lot of it depends on what at the ground level society is doing and you can't just turn it on and off at a moment. A lot of, perhaps, compliance comes as a matter of habit. For example, I would say that the willingness to wear masks in most states right now is much higher than it was three or four months ago. Not because just because the governments are telling us to do it, but because the growing awareness and appreciation that it ought to be done.

It reminds me of when we had to persuade people to wear seatbelts which was difficult to do for a long time because most people thought they were safe drivers and didn't think it was very risky to drive without a seatbelt. It took a long time to get people in that habit. In some sense, we have the same task ahead of us now except that we have much less time to accomplish it in.

Brian: Wall Street Journal, chief economics commentator, Greg Ip. We've been talking about his recent article, New Thinking on Lockdowns: They're Overly Blunt and Costly with some of the alternatives being laid out. Actually, let me take one final question because you cite a model prominently in this. From Dr. Mina at Harvard and his partner in a report named Stock. They're not trying to be apologists for reopening or the Trump approach to reopening for his reasons, but they're looking at alternatives to re-locking down where real spikes do occur. You want to just give us a thumbnail of what Dr. Mina is looking at and how it might apply to our judgment going forward when spikes do occur?

Greg: Sure. I think what they are doing is really very simple. They're basically saying, "Look, there are literally dozens, if not hundreds of possible interventions we can make to contain the virus. Let's compare each intervention on two factors. How disruptive is it to the economy and how effective is that at containing the virus?" We know now that there are a lot of things that are very effective at containing the virus, but that are not very disruptive such as mask-wearing. At the other end of the scale, we know there are things that are very dangerous in terms of spreading the virus, but having those activities in place is not very important to the economy. Keeping bars open.

What they're basically saying is they've constructed a model. They've looked at various types of people and many different sectors of the economy and they've come up with a series of steps they think that if we implemented those, we could have the economy reopened without the virus taking off. There's a couple of examples that are offering real-life examples of this. Arizona, for example. After they reopened, they had a surge in cases. They started imposing restrictions, but they did not have a full lockdown and they've more or less got new cases and deaths back down to where they are. In fact to a very, very low level.

Same with California. Even though California still has a lot of cases, they've managed to get hospitalizations almost down to where they were before this second wave began. They did that by, to be sure imposing a lot of new restrictions, but not having a full-scale lockdown like they did in the spring. I think that if you look at the types of research that people like Dr. Stock and Dr. Mina at Harvard are doing, you look at the lessons we've learned by examining each state. If you manage to be open-minded about the science and you're willing to try a few things, it is possible that we should, in fact, not just possible, but likely that we can come up with a blended approach that allows the economy to mostly return to normal without having the virus take off again.

Brian: In their view, it's not a black or white thing.

Greg: Exactly.

Brian: It's [crosstalk] to close and what.

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