From the Economist's Chair - Covid-19: Anatomy of a crisis and identifying the new normal

Author David Fyfe, Argus Chief Economist

In this edition of From the Economist's Chair, David Fyfe is joined by Conor Browne, an independent consultant specialising in biosecurity, to examine the Covid-19 pandemic's progress to date, and how policymakers might prepare for similar episodes in the future.

After beginning his career in epidemiology with the World Health Organization, Conor then added a Master’s degree in security studies to his academic qualifications and has subsequently consulted for UNHCR, NATO, NGOs, government research institutions and commercial enterprises. Since the Covid-19 pandemic began he has focused on biosecurity, business continuity and forecasting for the energy sector.

Looking at the commodity markets generally, after becoming rather becalmed in March, prices rebounded over the course of April, with unprecedented fiscal stimulus underway in a number of markets; and commodities are again being seen as a potential inflation hedge. There is even talk of a commodity super cycle in the air once more, but we are still living with the Covid-19 pandemic, which risks derailing economic recovery. For every positive macro indicator out there from China or the US, there remain offsetting concerns about resurgent Covid cases in parts of Europe, Latin America, and most recently in India.

Conor provides an in-depth examination of the pandemic's progress to date, and also how policymakers might prepare for similar episodes in the future.

Conor Browne: contact details

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Transcript

David: Hello, I'm David Fyfe, chief economist with Argus Media. Welcome to another podcast in the "From the Economist's Chair" series. Looking at the commodity markets generally, after becoming rather becalmed in March, prices have rebounded over the course of April. We've had energy and agricultural prices up by between 5% and 10% over the month, metals gaining an even stronger 15%. We've got unprecedented fiscal stimulus underway in a number of markets. And commodities are again being seen as a potential inflation hedge. There's even talk of a commodity super cycle in the air once more, but we're still living with the Covid-19 pandemic, which, frankly, risks derailing economic recovery. For every positive macro indicator out there from China or the US, there remain offsetting concerns about resurgent Covid cases in parts of Europe, Latin America, and most recently in India. So, today I thought we could examine the pandemic's progress to date, and also how policymakers might prepare for similar episodes in the future.

And to do that, I'm delighted to welcome today Conor Browne as our guest. Conor is an independent consultant specialising in biosecurity. He began his career in epidemiology with the World Health Organization. And after adding a master's degree in security studies, he has subsequently consulted for bodies such as the UNHCR, NATO, various NGOs, government research institutions, and commercial enterprises. And indeed, since the Covid-19 pandemic began, he has very much focused on biosecurity, business continuity, and forecasting for the energy sector. Conor, a very warm welcome to Argus, and thank you very much for joining us.

Conor: Thank you very much for having me, David. It's a pleasure to be here.

David: The pleasure is all ours. And I wonder if we could start by turning the clock back a little bit to just over a year ago, because I think Covid-19 confounded many early expectations that it was likely to mimic the duration, the spread, and the scope that we've seen from similar outbreaks, such as SARS and MERS in the 2000s and 2010s. And partly, this was about the nature of the virus perhaps, partly about policy choices, and partly about social responses. I wonder if you could spend a little bit of time explaining to us some of the reasons why in some senses, we were blindsided by Covid-19 in this way.

Conor: Sure. I think probably the first thing to do is to actually let's look a little bit at the pathogens that you're talking about and also the diseases that they caused. So, sort of in temporal order, we first have SARS, so, that's severe acute respiratory syndrome, and the virus that causes SARS is SARS-CoV. And immediately I can tell you that CoV of course stands for coronavirus, so that's the first disease that we had that became epidemic that was caused by a coronavirus. Then we move on to MERS, which was Middle East respiratory syndrome. And again, the virus that caused that was MERS-CoV, so again, another coronavirus. And now, we flash forward to today, where we haveCovid-19, caused by SARS-CoV-2. Again, another coronavirus. So, these past three diseases that you've mentioned have all been caused by viruses from the same family, the family of coronavirus.

Now, from the point of view of how the pathogens themselves work, so the actual viruses, a useful and kind of almost a thumbnail figure, and you may have seen this in the media, is something referred to as the R number or the R0. Now, what the R0 represents, and I can't emphasise this enough, it's a very rough indicator, but it gives you a good indication of the transmissibility of each of the viruses. The R0 for the original SARS, so SARS-CoV, somewhere between two and three. So what that means is that if you're unfortunate enough to have SARS, you would, on average, pass it on to two or three other people. The R0 for MERS was actually less than one, which meant it was a particularly difficult virus to pass on and to actually contract. In fact, most cases of MERS either occurred with very, very close contact with someone else who was ill for quite a prolonged period of time, or in a healthcare setting. That's where you would get that kind of close contact.

Unfortunately, even though, and this is where the picture tends to get a little bit more complicated, even though the R0 for SARS-CoV-2 started off...so, the current virus that's causing Covid-19, started off at around two to three, which is the same as the original SARS, that appears to have increased a little bit. And in fact, recently, in February of this year, in an article in the Journal of Theoretical Biology, the R0 of the current situation regarding Covid-19 places R0 squarely around five. So, you can see that that is a much more transmissible virus.

Now, of course, the R0, as I said, is a rough and ready figure. It doesn't really take into account things like population density or whether one is masking up or whether one is social distancing or anything like that. But as I said, it's a rough indicator as to how transmissible the virus might be. The other thing to note is the diseases themselves, because obviously, one thing is about the virus and the other thing is actually about the illness. So, both the original SARS and MERS were much more dangerous illnesses in terms of case fatality. SARS, on average, about 14% to 15% of people who contracted SARS, sadly, passed away. That's an all-ages aggregate, tended to be much higher in the elderly. MERS is even more dangerous, 30% case fatality rate. So, a very dangerous pathogen and very dangerous illness indeed.

Obviously, Covid-19 tends to sit about 1% to 2%. So, at first glance, one would look at that and say, well, actually, Covid-19 is the least dangerous out of the three viruses that you're talking about as examples. But, of course, herein lies the problem. Because the current virus, SARS-CoV-2, the one that causes Covid-19, has got such a low case fatality rate, so if 2%, let's say 2% of the people who have it, unfortunately, pass away. That of course means 98% don't. And, of course, the 98% of people who develop either severe illness, and much more importantly, for the purposes of your question, develop mild symptoms or are even asymptomatic, in other words, don't have symptoms at all, this is where this disease differs from the past two.

Because the people who are asymptomatic, which we think is about 20% of people who happen to contract Covid-19, they develop no symptoms whatsoever, or people who are presymptomatic, in other words, they get infected by the virus and then maybe two or three days later, they're able to transmit the virus on to other people, but they're not yet symptomatic themselves. And even though they tend to develop symptoms on day 5, that can last right up to day 14. So, you have a vast population of people out there who don't have any symptoms, but are merrily transmitting the virus. And that's the big difference between this virus and the past two, because with both SARS and MERS, effectively, you couldn't transmit unless you were symptomatic. So that's the first, that's kind of the pathogen element why this disease kind of surprised us, I suppose.

In terms of policy choices, and in terms of social responses, we can very easily map the countries that have done well. I mean, if we look at countries in East Asia, if we look at, especially also countries in West Africa, so Sierra Leone and Liberia, countries like Hong Kong, and also Singapore, Taiwan, as I said, East Asia, in general, all of these countries have dealt with outbreaks in the recent past, and I include Ebola in this. And we maybe can talk about this later, because the principles, fundamentally, of public health don't really alter regarding the nature of the pathogen. So, the countries that have done well have had recent experience, and that's the first thing.

So, they didn't underestimate Covid-19, because they had a recent memory of what an epidemic can do to a country. So they acted very quickly. If you contrast that to, say, the United States, the United Kingdom, most of Europe, first of all, they recently have not had an epidemic in their past. So they don't have that kind of institutional memory of how one responds at a governmental level. And also, and this is probably the biggest tragedy, is that while a lot of pandemic preparedness was done, it was done for the wrong disease. So, both the UK, the US, and Europe tend to focus a lot of their pandemic planning on influenza.

And, of course, as I mentioned earlier, which was a little bit odd, really, because the epidemics that we had faced in the world in the recent past, none of them had been influenza. They had been either coronaviruses, SARS and MERS, or a family called filoviruses, which is what Ebola is part of, but yet everything was placed on planning for pandemic flu. Now, this is actually a point that's worth just sitting on for one tick, because there's a particular quote from the UK Influenza Pandemic Preparedness Strategy of 2011, which is the most recent document I can get. And if you imagine you're...and again, no blame is being placed here, but if you're a governmental leader, and suddenly something like this hits you in the face, you reach for the nearest instructions that you've got, and you try to follow them.

So, if I just can quote this, and you can see immediately how this will apply to the UK and the US And again, this is from an official government strategy document. "It will not be possible to stop the spread of or to eradicate the pandemic influenza virus either in the country of origin or in the UK, as it will spread too rapidly and too widely." So, there was an assumption in the pandemic document that you couldn't stop it. And that informed response at the start, because in the UK, in the US, in Europe, we were kind of following an influenza model, whereas, of course, East Asia was following a coronavirus model because they'd experienced, and West Africa was following a generic public health model.

So that's kind of the reason we got blindsided. And then, just as a very final quick point on top of that, there was a bit of a double whammy with the UK and the US, because the pandemic happens at precisely the time when politics are terribly polarised. So, the minute the pandemic happens, it itself becomes politicised. And we saw that happening in the US, and to a certain extent the UK, with things like masking, they became political issues. And that, again, hampered and restricted response. So, you can see the reasons, multiple layers, of why essentially we underestimated the virus and we didn't respond to it correctly at the start.

David: I think that's really interesting. And I think maybe towards the end, we can talk a little bit about looking forward to the inevitable next pandemic. We'll come back to that in a second. You know, one area where perhaps if the US and the UK and others were sort of caught short at the start, thankfully, they seem to have caught up a bit in terms of vaccine developments and deployment. And obviously, that seems the most obvious route out of this phase of the crisis, if not the crisis itself. But if we think more broadly, globally, you know, I remember maybe, you know, 9, 12 months ago, the WHO was saying, you know, potentially with vaccines, you might see the developed world by the summer of 2021 potentially doing well in terms of vaccination levels, but it could easily take 12 or 18 months longer for parts of the developing world to achieve the same coverage. I mean, if you look at the concept of herd immunity, what sort of timelines do you think might be feasible in that sense?

Conor: Yeah. So, I think the first thing to kind of note here is that, I think we always have to remember that herd immunity has become a very loaded term. So, let me just very, very briefly explain what herd immunity is not, because obviously, this has been in the media quite a lot, especially at the start. Herd immunity took on a meaning of its own at the beginning of the pandemic that kind of implied this idea of letting the virus just run through the community. So, you protect the medically vulnerable, but everybody else, you kind of just let it through. Now, for a number of reasons that I'm happy to go into in more detail if you want me to, but that is not a strategy, that simply will not work with Covid-19.

And to give you a particularly tragic example and a very current one, even though Prime Minister Modi is not actively pursuing a policy of herd immunity, by that, in the wrong sense of the term, in India right now, what you're seeing in India right now is exactly what happens when you don't intervene, and you try to just let the virus run through. So, it's just important to remember whenever we're talking about herd immunity, herd immunity is intrinsically linked with vaccination. That's, I think, the point I'm trying to get across.

So, if you want me to talk about that, I think the first thing to establish is that to get herd immunity, you have to have enough of the population with sufficient immunity to stop the infection being able to spread. That's kind of your basic definition. Because remember, there's always going to be a small group of people within your population who either, for one medical reason or another, can't take the vaccination. Or they're severely immunosuppressed, and that means that whenever they're vaccinated, the vaccine won't work. It won't spin up enough antibodies for them to develop a response.

So, herd immunity is about getting as many people vaccinated, that's number one, the virus stops spreading in any kind of exponential fashion within your community, and you also protect the people, as I said, who can't take the vaccine. So, if you think back to what I was talking about regarding the R0 of the virus, so, you think about the number of people on average, if you have the virus, that you will infect in the absence of non-pharmaceutical intervention, in the absence of vaccines, the R0 number is crucial to working out the percentage of the population that you need to vaccinate to achieve herd immunity.

To give you an example, if we assume for right now that, let's say the Indian variant, or potentially the South African variant, because some of these variants will have different R0s, they'll have different levels, but let's assume one of them is sitting at five, which is quite a good possibility, to achieve herd immunity, where anywhere where the dominant variant of this particular illness, the R0 is sitting at five, you have to vaccinate 4/5 of your population, because that then drops the R0 from five to one. And when the R0 is at one, that means, by virtue of probability, you're only going to give the virus to one other person. And ideally, you want to get it below one, so that you're, by virtue of probability, unlikely to pass it on at all.

But then again, that's only the start. So, because it's not one virus, as I've indicated, you've got these variants, you've got two things to worry about. First of all, you have to worry about the importation of variants from other parts of the world. So you've got to start off by vaccinating your own population. You've got to also make sure that you're not importing variants from other part of the world that may render your vaccines a little bit less efficient. And you also need to, and I think we'll probably have to do this probably for the rest of our lives, have annual vaccinations every year, like we do with the flu, to keep our protection up, and those vaccines potentially may have to be tweaked.

Now, this is a kind of a point about herd immunity. Just because you've achieved herd immunity in your own country doesn't mean you can stop there and kind of rest easy. I mean, we might see this happening in Israel quite soon, because they've got some cases of the Indian variant. So we'll see whether, even though they're doing very well, they could go the wrong way very quickly if one of their vaccines is not effective against one of the variants. So, what I would say about herd immunity is that you need to vaccinate a serious proportion of your population, but you also need to make sure that you vaccinate that same proportion of the population of the entire world.

I couldn't imagine that happening for at least another year. From the rate of deployment that we're seeing with organisations like COVAX, I just couldn't imagine us being able to churn out that much vaccine that quickly, and, crucially, get it distributed. And I think what's happening is nations are beginning to realise that's important, rather than just simply keeping vaccines for your own population, the idea that this is a global problem that only has a global solution. So, I think it will be at least a year of constant vaccination before we get the developed world. And we're not safe until they are. That's just how it works.

David: I think you're right. That seems that it's been a very gradual realisation. It's I suppose natural that governments, first of all, try to ensure they have stocks for their own population, but then the logical next step is how do we prevent our citizens, whether they're based abroad or they're based here, catching this elsewhere? So, of course, that depends on a much broader deployment of the vaccine. I mean, I wonder, thinking about broader government strategy, I mean, what are the key elements of a sort of playbook for dealing with Covid or Covid-like episodes in the future? You know, essentially, have governments learned some key lessons, three or four key steps that are going to be important for dealing with this sort of occurrence, which will inevitably happen again in years to come?

Conor: Yes. So, I think yes. This answer may not particularly excite you very much, because it's actually quite boring, but it's kind of based upon the maxim of you need to do the basics very, very well indeed, right? The idea of there being a universal playbook for dealing with epidemics or pandemics, future pandemics, future outbreaks of disease, it really comes down to some very, very simple things that need to be done very, very well. So, the first thing, and you may have seen the viral clip that Dr. Mike Ryan of the WHO has talked about this, the first thing is speed. It's the ability to recognise the threat and move on it very, very, very quickly indeed. Because, as Mike Ryan has pointed out on several occasions, if you don't, the virus will always get ahead of you. And that's the nature. So, regardless of the nature of the pathogen, whether that's Ebola, whether that's a future coronavirus, whether that's influenza, it doesn't really matter. The speed is important. You need to move fast and decisively.

The second thing really is just fundamentally utilising the basic principles of public health, and doing them very, very, very well. That's kind of key. So, for me, that means things like concentrating on very timely and efficient contact tracing, which, unfortunately, the UK did not do particularly well. It means financial support for those who have to isolate, because if you create a situation where you ask someone to isolate, but you can't financially support them, then they won't isolate. And therefore, the disease will spread. It's emphasising things like the value of masking. The vast majority of illnesses that I can think of that potentially could cause pandemics will be transmitted by a respiratory basis.

And, you know, we learned the lesson of masking in the Spanish Flu, and then promptly forgot it. The East Asian countries didn't. It's all these simple things. So, the value of social distancing, the importance of ventilation, none of these things are expensive. It's just making sure they're done, and done quickly. And I think probably an important point, especially in our age of social media, is the importance of very, very clear and unambiguous messaging. Now, that's where we move back into the realms of politics. Because, while it's very easy, and it does sound very easy to do all of these things, the problem is that the response is always going to be based within the political environment, and that itself will never change.

So, even if we have the perfect universal playbook, which I think we already do, it will always be subject to the vagaries of politics. And sadly, in this day and age, it will also be subject to the vagaries of social media and the influence of social media. And, I mean, at this point, I think, essentially, politics and social media are fundamentally the same thing.

So, all you have to do is look at the United Kingdom, look at the US and see how quickly their response was thrown off by the influence of let's say Twitter or Facebook. Had hugely detrimental effects. And I don't think that's going away anytime soon. So, I think we need to find a way to reconcile... we have to find a way to not politicise any response. And that's a big ask. All of the things, the innovations we've had, things like immunity passports, the proximity apps that we would use on our phones, all of these things are very, very useful, but fundamentally, what would stop a future pandemic, and what would have stopped this pandemic, are lessons that are 30, 40, 50 years old, if we'd done them properly.

David: Yeah. We've just forgotten how to do some of these things.

Conor: We've forgotten them. Yeah. And, you know, if you look at documents and archive posters from the Spanish Flu, they are eerily similar to advice that we only got six months into the pandemic here.

David: Yeah. Interesting. I wonder if we could broaden it out a little bit and touch on some of the sort of policy responses that affect what some of our listeners will be very interested in in the commodity markets, energy, and metals and agricultural commodities and so on. I mean, we've heard a lot about how the experience of this pandemic is going to change things. Things like work from home, which I always think is a sort of slightly middle-class, you know, Western world concept, because not everyone can work from home. We've heard a lot about the end of globalisation, or at least reshoring of manufacturing and things like that. And also the energy transition, which is, you know, very central to a lot of the markets that Argus and Argus subscribers deal in. Any thoughts on, you know, for any one of those or a couple of those, how you think the pandemic might shape policy formation? For example, is it an impediment or an accelerator for the energy transition?

Conor: Well, I mean, I'm quite...I don't want to use the word cynical, I think realistic. I think the way you can look at this, you can look at what's going to happen to the world after the pandemic in two particular ways. You can use this idea that I'll expand upon, called "societal psychology," and you can look at it through economics. And they're not mutually exclusive concepts. Because societal psychology touches on every single issue that you've mentioned, right?

So, I'll talk about this again in quite broad strokes, but if you think about all the talk you've been mentioning in the media, so even, let's take an example, your basic one of working from home, if you think about the pieces that have appeared in business periodicals, in websites, in lifestyle pieces, things like that, that the world will somehow kind of dramatically change after the pandemic, I don't think it will at all. And the reason for that is that the desire of the vast majority, and I'm sure you've heard this, but the desire for the vast majority of people is to "get back to normal. "Now, I underline the word "normal," because what normal means in this context is what life was like before the pandemic. So, that's a yearning, I think, that a lot of people have.

And this is where this idea of societal psychology comes into play, because a lot of the concepts that we may be dealing with right now, that could actually be objectively better. So, things like working from home could be an objectively better thing, or, you know, a simple behavioral change, like if one has a cold, put on a mask. You know, some way that might change the world. Or, if people have been in lockdown, they're enjoying nature or things like that. Or, let's face it, video calling. These are all objectively good ideas, but the problem is they will also rapidly become symbols of the pandemic. They will become very symbolic. I hate to single a particular company out, but something like Zoom, Zoom will have issues, I think, going forward, because people will kind of associate that word with a very bad time.

And I think you will see that certain things that even though objectively may make people's lives better, they will be kind of in a hurry to get rid of because they want to forget the symbols of what they've gone through right now. So, I think there'll be a lot of that. And I think I think the talk of a new normal is massively over-hyped. My feeling is that people will want to get back to the old normal, and that will drive a lot of business decisions and a lot of behavior. If we think about the economy, again, I think there's a lot of, kind of almost over-complication to this.

What will change as a result of the pandemic are basically elements that do two principal things. First, things that we have shown during the pandemic that are actually good economic practice. So, good practices that actually will turn a profit. I think those changes will remain. I think, potentially, businesses and practices, whether this is international, you know, local, it doesn't really matter, but practices that have been shown to be resilient to shocks, so this has been a massive shock, right? I think those practices will probably stay on. And I think the reason for that is that, tragically, most businesses right now, from the biggest to the smallest, are being taught a very, very hard lesson in the virtues of having a business that is both agile, resilient, and is able to maintain its business continuity effectively, and I think agility, in general.

So, this is why I'm talking in broader themes, because I don't think anything is going to necessarily stay, and anything is going to change. It's going to be economic decisions that will drive these, whether these things actually will enhance, essentially, the amount of money or the amount of efficiency within the business. The only specific thing that I think is actually going to be a real change is the environment, because there is a recognition... So, if you're looking at things like deforestation, if you're looking at things like factory farming of animals, or the encroachments, essentially, of human beings into environments that they weren't there before, there is a growing recognition, I think, amongst governments, amongst health authorities, and also amongst businesses, that this is where zoonotic events happen. So this is where people come into contact with animals that perhaps they haven't come into contact before, and this is where we get these transfers, these zoonotic transfers that actually cause disease. So, I think there could be something that changes there.

But, in general, I don't really think as much will actually change in either the personal world or the economic world as people think. I think there'll be a rapid return, because there'll be such a drive for this to be over that I think a lot of things will just go back to the way they were.

David: Yeah. A yearning to get back to the old normal, as you said.

Conor: Yes. Precisely, yeah.

David: I guess we're all a little guilty, with a momentous event like this, of sort of overthinking the future, and it may be a little closer to what we were used to before, with some important changes. We are coming close, I think, to running out of time, but I wonder, just for our audience of commodity market professionals and others listening to the podcast, do you have two or three takeaways just to conclude, Conor? Because it's been really great to hear from you. So, any key takeaways for us?

Conor: Well, the first takeaway for sure is, and I cannot emphasise this enough, this was not a black swan event. This was not unpredictable. Literally, every single person I know in biosecurity, in virology, in epidemiology, in public health, in biodefense, any one of these fields, no one was in the slightest bit surprised. And the analogy I would use for that would be, let's say there was a major earthquake on the San Andreas Fault. You wouldn't find a single geologist in the world who had expressed surprise. I mean, this was not an unpredictable event. This was very much a case of not if but when, and we all knew this. So, I think the lesson there is there's a lesson about it's important for governments to listen to experts.

So, whenever experts are trying to paint very plausible scenarios, it's tempting for a politician or a government leader or anyone like that, to almost see it as a kind of a science fiction. But in fact, it's not, it's very real. And as I said, the lesson is if you listen to scientists and act on their advice, as long as those scientists are acting in good faith, you will get a good outcome. And that's precisely what happened in New Zealand. If everyone had acted the way Jacinda Ardern had acted in New Zealand, we would be in a much better place right now. So, that would be the first lesson, I think.

The second, and I'll conclude on this, is that as you've said yourself through the course of this podcast, there will be another pandemic. It's absolutely inevitable. And we need to start preparing for it right now. We don't even want to start waiting until this one is over. We need to start preparing absolutely right now, because we cannot afford...this has cost so much in terms of lives, so much in terms of economic activity, economic growth, everything. We can't afford to be caught by surprise again. We absolutely can't.

So, two things need to happen. We need much, much stronger international collaboration for things like disease surveillance. So, we need to give a lot more money to the WHO to be able to make sure that whenever emerging viruses or emerging pathogens that have pandemic potential pop up, we can identify them and act on them quickly. And that's really important. And the second is we need stockpiles. This was what really stymied a lot of our response at the start. We need to have stockpiles of the kind of items like PPE, essential medications, equipment, that can be really applied to any disease. We need to have those stockpiles, and crucially, we need to maintain them. Because this is one of the unfortunate things that happened in the United States. They had a very good stockpile, that actually had its genesis in 9/11, but then they just kind of let it decay.

So, we need to make sure that when the next one comes, and it will, that not only do we have very, very good international cooperation, surveillance, to catch it in the bud, and also the equipment we need so that our healthcare workers and anyone else who's in a caring role is not unprotected. And that's pretty much what I would like to see happen.

David: Okay. A prescription for dealing with things better next time round. Thank you very much, Conor Browne, for joining us today. Some sobering words, but some real positive routes for dealing with the crisis next time round. Thank you again for joining us, Conor.

Conor: Thank you, David. My pleasure.

David: And thank you everyone else for listening. If you go to www.argusmedia.com, you can find Conor's contact details. And I want to thank everyone very much for joining us. This has been a podcast from Argus Media. Thanks again.

Conor Browne: contact details

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