Unintended Consequences

“Since the end of human action, as distinct from the end products of fabrication, can never be reliably predicted, the means used to achieve political goals are more often than not of greater relevance to the future world than the intended goals.” 
― Hannah Arendt

Every decision, every policy, every strategy will have additional first or second order effects that no-one anticipates. Two interesting epidemiological examples have been reported this last week amidst our attempts to halt COVID-19.
First, in Australia there has been a massive drop in confirmed flu cases since the imposition of lockdown and physical distancing. New Scientist reports:

“6962 laboratory-confirmed flu cases in January and 7161 in February. However, cases have since nosedived, with 5884 recorded in March and only 229 in April, compared with 18,705 in April 2019. This is despite more flu testing being conducted this year.|

Read more: https://www.newscientist.com/article/2242113-australia-sees-huge-decrease-in-flu-cases-due-to-coronavirus-measures/#ixzz6MPWkYufa

Second, the UK’s Sexual Health specialists are seeing early signs that the lockdown here is doing the same for HIV:

On the one hand complying with social distancing measures seems to be reducing the amount of unprotected sex with new partners (clinicians are monitoring two proxies – the number of new cases of gonorrhoea and new prescriptions for post exposure prophylaxis). If these proxies are correct, then the rate of HIV transmission in the population will naturally be slowed because there will be fewer individuals with the virus exposing others to it during sex.

On the other, there is the tantalising possibility that the disease could be stopped dead. Already, the UK has used testing and treatment to drive the number from 2800 new diagnoses in 2012 to 800 in 2018, so this is on the back a long term epidemiological push.

“If we can now find the remaining people with HIV through testing and put them on treatment…we could remove anyone who is infectious from the population with long-lasting effects. We won’t get this two-month window of no sex again.”

Dr Alan McOwan, HIV Specialist 56 Dean Street in The Guardian

Heartwarming but completely unintended.