How Society Will Change If A COVID-19 Vaccine Is Elusive

I have expressed a reasonably supportive level of optimism towards the likelihood of the development of effective vaccines and/or treatments for COVID-19 since my first updates and report in early February.

In my report in mid-February, however, when frustrated by how slow Governments and financial analysts were to recognise the challenges that we confronted, I was compelled to be more frank about my views:

To understand the ongoing impacts on people and thus on the economy we need to go back to the virus. Without the rapid emergence of an effective therapeutic treatment for COVID-19, amongst already developed treatments or those in the very late stages of development, the pandemic is likely to progress until either it spreads so widely that the majority of people have become infected or an effective vaccine is developed, produced and delivered en masse. This may take several years, so it is possible – probably even likely – that we will be living with this pandemic for a prolonged period.

If we are really unlucky, as some have suggested, it is even possible that the virus may develop the influenza characteristic of mutating sufficiently within a year so that immunity from prior infection does not make the person refractory or immune to infection when exposed the following year.

All in all, this is a very serious problem and we are in a wait and see pattern. However, it is clear that things are going to get far more serious over the short to medium term before things get better.

Repeat After Me, This is NOT SARS: COVID-19 is much worse” published on MacroEdgo on 24 February 2020

As I expressed in my most recent coronavirus (COVID-19) update, understanding the likely path forward in humanity’s challenge with this pandemic virus does not equate to emotional acceptance. (Still, what is occurring in global asset markets at present is an all together other level – that is not searching for acceptance, and it goes well beyond dissonance – it is out and out delusion!)

Like everyone, for me I have had to take a journey of processing what has happened, even though my level of understanding has permitted me to embark on that journey earlier and with greater depth than most others. Hopefully, my family, friends and readers of my posts have also benefitted.

Today I feel ready and compelled to take the next step and begin to countenance the medium to long-term – what I believe is likely to occur with the COVID-19 pandemic over the next several years and potentially beyond, and what will be the likely impacts of that on societies.

Observing rational leadership through this pandemic – yes I am intentionally suggesting the obvious bafoons be ignored in this discussion – it is clear that they walk a fine line between reaching a desirable level of concern amongst society, to guard against complacency, without overwhelming people with the enormity of the challenge we confront.

One way in which this has been done is to avoid discussing the long term and the many small challenges that we must confront over the medium term to overcome the entire challenge. This is a psychological trick that many athletes will recognise – shortening the time frame of each sub-goal, eg. an endurance runner might say “I will just keep running to the end of this street” as if that is when the choice to stop or continue will be made, when in reality they may be overwhelmed at any time and collapse in a heap.

Good leaders are continually saying things like “let’s get to this point in time and we will see how we are situated then” while knowing that it is likely that the situation will not be as resolved as many would be hoping.

This is exactly the approach that is being taken with vaccine development. From very early in the pandemic the timeline on vaccine development has been about as ambitious as is (almost) plausible (to an intelligent but not especially well informed observer). I myself did the same thing in my earliest reports discussing vaccine development when I said that the rush would be on to have a vaccine to be mass administered before the next northern hemisphere winter, all the while knowing that it would be a herculean task and only possible if it proved to be an extremely straightforward process with this virus.

I knew it would be the goal, and I dared to hope with my heart that it might be achieved, but I also knew that it was unlikely to be achieved. I must confess, though, that I felt that a vaccine may just be ready for mass deployment in time for the 2021 southern hemisphere winter and I still consider this a reasonable probability if we are fortunate.

On the other hand, one of the most troubling possibilities with the COVID-19 pandemic is that a vaccine is far more elusive than is hoped – that luck is not on our side and current technology is not amenable to straightforward and immediate production of a vaccine with this coronavirus, thus necessitating further research with this particular virus and innovation to achieve an adequately efficacious vaccine. And I have to say that my aggregated view of everything that I have heard and read said by vaccinologists, and not the CEOs of vaccine companies who sound more like politicians and salespeople, on this slips easily into pessimism and to believing that it may be more likely that we are without a reasonably effective vaccine for quite a few years.

Adding to the pessimistic view, and possibly related to the pessimistic view of some vaccinologists, is emerging views from immunologists that immunity within the population of people who have had the virus appears surprisingly weak and/or short-lived. Thus even herd immunity may not be achieved for those countries where it was a stated (Sweden), tacitly stated (the UK) or unstated but clearly their strategy of political convenience (the US) and thus where higher proportions of their populations have been infected. In other words, the enormous human impact that was endured to achieve herd immunity by direct infection brought no long-term benefit as people may be re-infected.

In “The COVID-19 Elephants In The Room” I stated that there was/is an infinite range of possibilities on the ways that this virus might impact humans which we could only guess at from the known ways other viruses impact us, and that there were likely other previously unseen ways that this virus new to mankind might impact us. In my subsequent post I highlighted this reality in underlining the imprudence in embarking on a strategy of developing herd immunity by letting the novel coronavirus spread throughout populations rather than doing everything possible to stamp it out and if possible aim at elimination.

My concerns have been proven several times over with the following (far from complete list of) discoveries for the novel coronavirus: it can cause serious disease in some children; it causes chronic infection and/or symptoms in some with unknown consequences; there is an emerging understanding that the nature of the COVID-19 disease is different to what was initially thought where its entropy involves blood vessels perhaps as much as the respiratory tract; and just yesterday there were press reports of an important journal article detailing novel and serious neuropathology (disease within the brain) with people only displaying mild COVID-19 symptoms.

I have said it many times before but it bears repeating – some political and medical leaders argued for and enacted a strategy of allowing the virus to circulate through their people, without attempting to prevent it spreading to all but the most vulnerable (and failed miserably at that), when they knew that they did not at all understand the full impacts on their people not even a proper understanding of the nature of the disease in its most common form of presentation.

For me, that is human arrogance at its most destructive.

The point that I wish to make here, again, is that we still can expect more surprises from this pathogen known to mankind now for just over 6 months (as the GAVI report linked to above also makes clear). Just one of those possibilities, if we are unlucky, is that instead of prior infection providing those people with immunity to re-infection it worsens the next infection as in dengue haemorrhagic fever thus increasing the mortality rate.

To this point good leaders have sort to keep as many people as safe as possible from the impacts of this pandemic while everybody looks on and hopes or prays or whatever for our scientific community to develop a silver bullet. Besides vague references to the long haul, the best leaders are mostly working on helping us to focus on the immediate and not think too far out into the future lest many of us become despondent and overwhelmed.

If we are very fortunate at least one of the 140 vaccine candidates currently being developed might be effective. Or perhaps a protocol with one or several might be effective. However, as we approach the end of this year, as the northern hemisphere enters autumn (fall), then I expect that we will begin to hear more honest assessments of the chances of success.

If success seems to be more elusive than humanity has dared to hope, then we will move into a new phase for society and individuals to deal with the challenge.

Already the conservative types that want our focus to be at least as much concerned with livelihoods – a synonym for economy and in their parlance, “aspiration” – are talking about “living with the disease” and we know from social media and even marches in the US that the (typically vulnerable) usual footsoldiers have been marshalled into action.

In the event that at the end of the year assessments of the likelihood of herd immunity being achieved by a mass vaccination program are not optimistic, then everyone will need to begin to consider exactly how we will go about our lives for an uncertain but prolonged period with COVID-19 severely impacting us increasingly as we age.

Those with a predisposition to brutally forthright discussion around the impacts of humans on our natural environment have always mentioned the real possibility of nature “striking back” to reestablish balance. Referring to nature, there need be no element of conspiracy or karma, just a simple recognition that in natural systems disequilibria are not sustainable and that consequences flow from changes to stable systems.

Events that lead to rebalancing can take the form of unrelated natural phenomena which might impact all living organisms, like an asteroid striking Earth leading to mass extinction, or it might be the consequence of the change to that equilibrium. One example often given is epidemic disease which is well known as a moderator of plant and animal populations.

The ability of disease to hold populations in check is a basic tenet of our understanding of biology – it is but one factor that prevents one or several species from dominating all others in plague proportions and causing widespread extinctions.

Does that sound at all familiar? Of course humanity, while avoiding extinction thus far, has experienced pandemics through our evolutionary history but our advanced cognitive abilities has allowed us to learn over many generations how to manage through these periodic challenges and to pass these tools to those who succeed us.

Our apparent success to those humans fortunate to have lived all of their lives in the developed world has created a level of complacency to the risk that our basic biology poses. Many of our contemporaries seem to believe that we are already part machine, and certainly post-biologic, and are ignorant to the costs that humanity paid in gaining our knowledge at overcoming our past disease challenges.

COVID-19 is certainly playing a part in re-educating those that wish to be informed.

Simple biology is at play and it relates directly to mathematics and probability. The larger our population becomes the more densely we live. The more densely we live the greater the chance that something that infects one person is passed onto another. However, living densely does not provide for primary production and those living densely must have all their resources and requirements supplied to them and that necessitates 1) greater utilisation of natural resources for producing goods required, and 2) wider geographic distribution and storage of those goods. As human success at wealth creation in the system developed by and for humans increases, more and a greater variety of those goods are desired from wider geographies. Thus humanity increasingly interacts with a wider range of organisms by expanding areas of production, and domesticated organisms increasingly interact with other organisms, and products are then stored and transported.

All of that increases the probability of pathogens jumping into human hosts, directly and then spreading amongst humans, and/or being spread within goods and then infecting humans.

The interaction of pathogens and hosts are extremely complex. The pathogens that have infected humans for a long period may appear well understood, especially if the disease is well controlled with a vaccine or other effective treatment, but talk to any researcher and you will always be told that their understanding is fairly basic and there is much, much more to be understood. That is not a justification for research funding. It is just the reality and with a limited level of research funding priority is given to what research is widely perceived to be highest priority.

Noteworthy through this pandemic has been the number of researchers who have been identified for warning potential pandemic disease was not receiving nearly enough research attention, and many even pinpointed coronaviruses as being of special concern.

Those predisposed to brutal forthright discussion on human impacts on nature will have already recognised that the novel coronavirus has significant potential to cull human populations based on what we already know. While the mortality rate from the acute phase (noting we do not yet nearly understand the long term impacts) of the COVID-19 pandemic may not be as high as the 1918 flu pandemic, though that is still open to debate centred around how many more cases and deaths go unreported, it is interesting within this context that in aggregate COVID-19 impacts increase in older cohorts while the inverse was true of the 1918 flu. While biologically it is true that the 1918 flu would thus have had greater impact on moderating human population growth, nowadays life expectancy is that much longer than 100 years earlier such that a prolonged COVID-19 pandemic has the potential to significantly reduce human resource utilisation especially when we consider that the later stages of life tend to require disproportionately higher resources.

I do not, however, wish to concentrate on (perhaps harsh) biological theory and reality and I realise that I have already run the risk of losing my readers with this rather dry but essential explanation of the underlying biological situation.

What I really want to discuss is the socioeconomics of all of this – how it is going to impact the choices we humans are likely to make going forward if the COVID-19 pandemic proves to be prolonged.

I was born in 1970 and was a teenager in the 80s living in rural Australia. Even then my father spoke with nostalgia of a period (the 60s) when inflation was very low and jobs were plentiful. However, the economy had experienced a good run through to the mid 80s – not as good as our most recent past, but still good by historical standards – and looking back the standard of living for most even in my rural area clearly improved as judged by decreasing numbers of rust bucket vehicles on the road, etc.

Perhaps the trend that I noticed most amongst adults at the time, besides the obsession with large suburban back yard BBQs with significant beer drinking and then driving home (with still lax drink-driving laws), was the apparent obsession with early retirement. Perhaps that view is somewhat coloured by my rural locale, where people had lower incomes but also had lower living costs (being partly self-sufficient) and lower aspirations, and where most were employed in blue collar work which took a greater toll on their bodies and general physical well being. Nonetheless, when I reflect on this period it does seem to me that it was somewhat of a national obsession, and in part a reflection of financial success (up until recession struck at the end of the 80s).

If I fast forward to our most recent run of financial success in Australia it seems that the opposite has been the case with our national obsession about accumulating as much wealth as possible such that many people approaching retirement are carrying high levels of debt, much of it to support or for tax benefits associated with their property portfolio. While these people could sell down their portfolio to retire, for many it has become a lifestyle and they continue beyond retirement age, while others have gotten entranced by the property ladder theme and thus need to continue to work to pay off their upsized homes and mortgages.

I suspect that this trend of increasing work intensity at later ages interacts with the increasing life expectancy of people at retirement age. While 40 years ago people dreamed of having a period of less demand on their physical and mental resources – a relaxed retirement when still in reasonable physical condition before reaching their declining years – many contemporary Australians fear retirement because it is such a great departure from the manic lives that they have led accumulating wealth and ticking off lots of other boxes (many with the aim of impressing others). And if they think their life will extend 10, 15 or even 20 years longer than their parents, as the media keeps suggesting, including with some predicting that the first people to live to eternity have already been born, then what is the hurry to retire anyway.

A prolonged COVID-19 pandemic will turn that equation around, especially when it will be accompanied by a prolonged period of economic recession or even a period of depression. While Australia’s economy has allowed many retirement-age Australians to continue to work as long as they wished – even though young Australians’ employment prospects only slowly recovered after the Global Financial Crisis – this will likely change in the current recession. As in the 90s recession, people made redundant in their 50s will likely struggle to gain active employment again and this will obviously necessitate a sharp repositioning on aspirations. It is possible that these unfortunate people, however, ultimately prove to be more fortunate than they realise because circumstances force them to be early movers.

As the pandemic progresses, and especially if prior infection does not create lasting immunologic protection from re-infection which is more lethal as we age, the experience of reducing life expectancy for the first time in centuries will cause every middle-aged Australian to re-think and re-organise their priorities.

This will have serious implications in our society and in our economy. I think it is clear that in such a scenario the long-anticipated sell down of housing assets by Baby Boomers and Gen X is a virtual certainty.

Essentially I would expect that people needing to confront their own mortality at an earlier age, like their grandparents, likely will develop a different set of priorities which revolve more around genuine quality (of life) over quantity.

In all of my writing on the COVID-19 pandemic from the beginning of February I stated that the world has changed as a consequence of a virus jumping species into humans. Within a few months of me first writing that most of humanity has come to understand this reality. Perhaps, because of the need for self preservation strategies, humanity does not quite understand yet just how much the world is likely to continue to change.

I have tried to play a constructive role in my writing by remaining positive in my outlook while placing maximum pressure on those in decision-making positions to act humanely.

I have always been of the position that Australia, with its rare advantages of being an island with excellent biosecurity know-how and infrastructure, should use these advantages to attempt to eliminate COVID-19 and enact powerful measures to prevent its reintroduction. But I always knew that we may be in the very early stages of a very prolonged battle. My view has always been that we would be in the best position if we did everything in our power – even if it meant sacrificing economic activity in the short-term – to absolutely minimise the number of people within our borders being infected by the virus. The point is that in such a position we have the flexibility to make decisions on how we wish to progress depending on how scientific research is progressing on vaccines and treatments, and based on what we have learned about the human impacts to that point.

It is clear now that other countries that chose early to not do everything possible to stop the spread of the virus have far fewer choices available to them.

While PM Morrison said he was going to the footy on the opening weekend of the NRL I said that large gatherings should have been cancelled weeks earlier along also with shutting of the international borders.

And when PM Morrison began to use his political capital to create considerable momentum towards opening up the economy, when elimination was so near as to suggest it is possible, and which New Zealand has since achieved, I made it clear that it was premature.

On 1 May I said:

Given all of the uncertainties around this new human pathogen, and given we in Australia have experienced a relatively low expression of COVID-19 thus far which suggests that eradication might be a real possibility, loosening of biosecurity measures at this point in mid-Autumn seems to me to be highly imprudent and suggestive of at least a hint of political hubris.

A far more prudent approach would be to continue with very strict biosecurity measures and increased testing, firstly of all those with symptoms of respiratory infections and then as and if capacity allows, all people (prioritising those who have been, through work requirements, more active in the community), to detect any and all cases so that eradication can be achieved.

In “COVID-19 and Food Safety in Processed Meat” published at MacroEdgo

(Since writing this I have adopted the contemporary terminology of elimination from a geography as eradication strictly applies to global eradication, which clearly is impossible with COVID-19.)

Throughout this pandemic the conservative leaders of the major English-speaking countries have exhibited a visceral Pavlovian reaction to the biosecurity measures to lessen human impacts out of fear of the economic impacts. But as the pandemic has progressed it has become clear that the best way to minimise impacts on economies is to minimise human impacts within society. New Zealanders are being rewarded for their patience and achieving effective elimination of COVID-19 by now experiencing essentially normal domestic lives secured by effective biosecurity at their international borders. On the other hand, American businesses are learning that it is difficult to run profitably when workers are afraid of returning to work, and clients and/or customers are behaving entirely different to before the pandemic out of prudent concern for catching the virus.

If my concerns expressed above play out, then we are about to re-learn the lessons of compounding, only the effect will be in reverse since the economic measure of growth has a negative sign. The consequences of all of this will have profound effects on our societies.

In “Toxic Masculinity and Political Footballs” I said:

We were fortunate to have a second chance at eliminating COVID-19 from Australia after PM Morrison dithered on closing the borders to international travellers in February and early March. I strongly doubt that we will be fortunate enough to be able to say “third time lucky”.

And in my second open letter to PM Morrison I said:

to loosen measures for the sake of perhaps an extra month or two of additional limited commercial activity may come at the cost of allowing COVID-19 to become widespread in our population for an entire winter season. If a vaccine does become available before the next northern hemisphere winter, then that would make us in the southern hemisphere the only region other than Wuhan to experience an entire winter season with COVID-19 running rampant.

That would scar the Australian people deeply and would have severe and long-lasting impacts on our society and our economy.

Events in Melbourne over the last fortnight prove these warning to be correct. Politicians know that any chance of COVID-19 elimination within Australia has been squandered, while our near neighbours success proves that it was possible, and thus any COVID-19 deaths from now on were clearly preventable; that is why we are frequently hearing that “elimination was never the Australian strategy”.

Perhaps conservative politicians will fall back on the doubts that I expressed earlier about developing an effective vaccine in the near term to justify “getting on with the inevitable” and learning to deal with the virus. If you come from the perspective that the impacts on the economy are your highest priority, then certain impacts on the economy by stringent biosecurity measures will always outweigh any issues of uncertain benefits for preventing infections amongst people over an undefinable length of time.

Mostly what is given up, however, is the flexibility to make better decisions when we are armed with greater knowledge. Those better decisions clearly can be for the benefit of people and for economies.

To this point decisions have been made mainly by elected officials. Increasingly going forward those decisions will be made by individuals. Collectively those decisions will have significant impacts on society, and the longer and greater the COVID-19 affects are felt, the greater the change in the way society behaves.

That, in a nutshell, is “The Great Reset“. It has already begun and it is irreversible.

High quality, effective leadership will nurture it so that the best outcomes are realised to the benefit of humanity. Scoundrels will try to harness it to bend society to a more warped and less inclusive version. We all must show leadership and engage with the process to achieve the best outcome for ourselves and those we love, and those who succeed us. And we should all prepare to be flexible and supple in thought to make the best decisions that we can with the information that we have as we emerge from the shock of our altered existence and as our future comes into clearer focus.

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© Copyright Brett Edgerton 2020

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