As the world increasingly eases its various lockdowns, first in Asia and Australasia and now with gathering momentum in Europe, we move from a simpler world of black and white into a much more interesting and challenging one of shades of grey.
Scientists and politicians alike realised from the start that this could be a difficult period. The extreme simplicity of the rules under the earlier stages of total lockdown – stricter in some countries than others – is giving way to restrictions with more nuance. There’s no guarantee of the general population’s ability to understand what is and is not permitted. And that is before factoring in ‘lockdown fatigue’, as those initially willing to obey increasingly chafe at the bit and start to take liberties.
Yet Covid-19 has neither been defeated nor disappeared, and that’s worrying authorities. True, some countries increasingly appear to have entered a ‘post-Covid’ state – step forward, before all, New Zealand: no new cases for well over a week and, as of 31 May, only one person (out of a population of 5 million) who is known to still have the disease. But even in New Zealand, life is not yet fully back to normal, and their borders remain completely closed; the country’s important tourism industry faces a long wait before once again welcoming overseas visitors.
For most of the rest of the world, fear of a second wave appearing at any time remains pressing, whether the disease is already in the country and latent or waiting to be brought in by international travellers. And so the restrictions on normal life, while easing, still remain as well, particularly the social distancing that has made so much of society, especially urban society, so challenging – if not outright unworkable.
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As the world increasingly eases its various lockdowns, first in Asia and Australasia and now with gathering momentum in Europe, we move from a simpler world of black and white into a much more interesting and challenging one of shades of grey.
Scientists and politicians alike realised from the start that this could be a difficult period. The extreme simplicity of the rules under the earlier stages of total lockdown – stricter in some countries than others – is giving way to restrictions with more nuance. There’s no guarantee of the general population’s ability to understand what is and is not permitted. And that is before factoring in ‘lockdown fatigue’, as those initially willing to obey increasingly chafe at the bit and start to take liberties.
Yet Covid-19 has neither been defeated nor disappeared, and that’s worrying authorities. True, some countries increasingly appear to have entered a ‘post-Covid’ state – step forward, before all, New Zealand: no new cases for well over a week and, as of 31 May, only one person (out of a population of 5 million) who is known to still have the disease. But even in New Zealand, life is not yet fully back to normal, and their borders remain completely closed; the country’s important tourism industry faces a long wait before once again welcoming overseas visitors.
For most of the rest of the world, fear of a second wave appearing at any time remains pressing, whether the disease is already in the country and latent or waiting to be brought in by international travellers. And so the restrictions on normal life, while easing, still remain as well, particularly the social distancing that has made so much of society, especially urban society, so challenging – if not outright unworkable.
So where do we go from here? Well, there are at least three reasons why we are probably stuck with the current situation for a while, and rather neatly they fall into the three categories: ‘before infection’, ‘during infection’, and ‘after infection’. The first is concerned with controlling and reducing the spread of the disease to new victims; the second with the experience and survival rates of those that do catch the disease; and the third with the status of those who have had the disease and since recovered.
Before Infection
The biggest challenge society faces is knowing who might be a spreader of the disease. This is because of two features of Covid‑19 that have been known for some time: first, you can spread the disease before showing symptoms; second, there are a significant number of people who can both carry and pass on the disease without ever showing the symptoms themselves at all or therefore ever knowing the role they have played in the disease’s spread.
Asymptomatic transmission is not unknown in other diseases. The best-known early example of an asymptomatic carrier was the well-documented case of Mary Mallon, a cook in New York City at the start of the last century who spread typhoid to almost every household she worked for while herself showing no symptoms. Media ultimately nicknamed her ‘Typhoid Mary’, and authorities forced her to spend the last 23 years of her life in solitary isolation.
But Mallon’s singularity was a rarity. The same does not appear so for Covid-19: by some (inherently uncertain) estimates, there may be more asymptomatic than symptomatic cases.
This makes the world’s current primary strategy for controlling the disease – track and trace – very difficult. For as opposed to a world where people are assumed healthy (and so safe for others) unless visibly sick, we move closer to a dystopian world where the safest option is to assume that people are unhealthy (and so a potential spreader) unless proven otherwise. As well as being deeply unsettling per se, such a world would probably need frequent, ubiquitous, and indiscriminate testing; the whole population might need to be tested fortnightly. To put this in perspective, at the current rate of testing in the UK, it would take well over a year to test the population just once each.
Setting aside logistics, the general mental health consequences of telling everyone they must be repeatedly tested because ‘at any time you might have the disease without even knowing it’ are concerning.
During Infection
This second challenge concerns Covid’s uneven health effects and survival rate. Most who catch the disease seem to experience only a relatively short period of illness, admittedly for some a very unpleasant period, but nevertheless it is something from which they recover shortly. Some people suffer much more, though, and of course a small number do not recover at all.
This poses a difficult question: should the great majority of society, who risk only an unpleasant but survivable spell of illness, continue to have their lives heavily curtailed to protect a more vulnerable minority? Or should we move to a state where, now that the threat of overwhelming our health services has receded, the majority are allowed to live much more normal lives (including meeting others socially) while the more vulnerable minority are still encouraged to observe greater care, social distancing, even isolation?
The question is made more difficult by the fact that the identity of those who are likely to suffer more is not random. Evidence overwhelmingly suggests that men are worse affected than women, that the disease is more serious for the BAME population, that people who suffer from obesity are at much greater risk, and that the disease is particularly dangerous for the elderly.
This poses society with a direct dilemma. To ask such people to take special care, maybe even to the point of requiring them to observe stricter isolation, opposes society’s equality agenda. No government could reasonably instruct that ‘you can visit your mother but not your father’. Meanwhile, making overweight people subject to extra restrictions would cause a torrent of criticism that they were being ‘fat-shamed’. And even to suggest that the BAME population must observe a separate and stricter lockdown raises the spectre of apartheid and would destroy racial harmony.
It is perhaps revealing that the only sector that does not have a raft of equality legislation and lobby groups galore defending their status is the very old, and that the only overtly discriminatory feature of the lockdown that the government has felt able to introduce is the extra curtailment of freedom for those over 70.
But society does need to address this question because the willingness of the young, fit and healthy to go on accepting restrictions on their daily lives to protect those more at risk will not be unlimited.
After Infection
A lot of hope is riding on the discovery of a vaccine – absent the ability to banish the disease completely, the next best solution is to make the general population immune to it. But this does rather assume two things: firstly that, after a mild dose of the disease, reinfection is impossible (something vaccination relies upon); and secondly, that the period for which one is protected is long – ideally a lifetime but at least long enough to require only infrequent booster jabs.
Unfortunately, scientists have yet to show even that those who have had the full-blown disease are fully immune to catching it again – there are examples of people testing positive a second time after having had and recovered from the disease. If these are more than just isolated incidences, it calls into question whether any vaccine can be reliably effective. And certainly, there is as yet almost no evidence for how long immunity lasts.
There is therefore a risk that medical science will not find a reliable vaccine – not this year, not even next year. Perhaps they never will. We still have, for example, neither a cure for nor a vaccine against the common cold. At such a point, society will have to make an interesting choice: if we cannot become immune to the disease, should we simply become inured to it and accept it as part of human existence?
The answer will depend on how much risk society is willing to take in its pursuit of normality. There is no such thing as a totally risk‑free existence; we all take risks every day, from crossing the street to meeting a stranger to walking around our cities. Driving at speed is one of the most dangerous things we do, but society long ago decided that the advantages far outweigh the costs of injury or death from road accidents; the requirements for cars to travel at less than 4 mph and to have a man carrying a red flag walk in front of them have long since been abolished.
So in time we might become as resigned to and accepting of Covid‑related deaths as we are of road deaths, deciding that life must go on despite them because the alternative, a life in permanent semi-lockdown with stifled economies and limited social engagement, travel and the like, is worse.
The Bottom Line
We have not yet reached resignation. A vaccine remains the first best solution and progress towards one is encouraging. As long as this remains the case, the world is probably right to stick to Plan A: semi-lockdown and social distancing to hold the fort until we can all be made immune.
But at some point, if a vaccine is delayed and delayed again, we may yet have collectively to consider Plan B: normalcy but with slightly elevated death rates. The alternative, a semi‑existence, afraid to live because we are afraid to die, has never in the end been mankind’s way.
John Nugée has over 40 years of professional experience. Currently, he’s an independent consultant and commentator on key financial, economic and political issues. Prior to this, he was Senior Advisor at OMFIF, Senior Advisor at MEFMI and Chief Manager at the Bank of England.
On the private side, he set up State Street Global Advisors’ Official Institutions Group in 2000 and oversaw the company’s investment management services.
(The commentary contained in the above article does not constitute an offer or a solicitation, or a recommendation to implement or liquidate an investment or to carry out any other transaction. It should not be used as a basis for any investment decision or other decision. Any investment decision should be based on appropriate professional advice specific to your needs.)