COVID-19 is a useful warning: prepare for the next pandemic

Peter A.G. van Bergeijk, author of Pandemic Economics, explains that ‘we cannot sit back and relax because we flattened the curve’ and that we ‘need to think about the future after COVID-19’.

People all around the world are getting hope again. Quite a number of vaccines against the coronavirus have been developed at war speed. This is an unprecedented achievement  and the anticipation of an end to the current pandemic is the light at the end of the tunnel that we should enjoy and celebrate. This is, however, also a moment in time where we cannot sit back and relax because we flattened the curve. We need to think about the future after COVID-19. A period that is paradoxically both post pandemic and pre pandemic. Pandemic Economics confronts you with inconvenient truths, but is also a hopeful book about the possibilities to merge medicine and  macroeconomics and about the preparations that can help you and your country to survive the next pandemic.

Pandemics are here to stay

COVID-19 is certainly not the last pandemic that you will experience: the frequency of pandemics has increased since 1700 despite enormous improvements in housing, hygiene and living standards.  The reason is that health care improvements and social development were outpaced by higher pandemic risk. This risk is associated with global travel, human–wildlife interaction, intensification of global food production and densification of population. The next pandemic is therefore a certainty; only its timing is uncertain.

Modern medicine is not the answer to pandemics

We cannot rely on a medical cure for the next pandemic despite humanity’s success in finding a solution for COVID-9. For one thing, many of the medical interventions and new drugs and vaccines are not nearly as effective as commonly thought. The pandemic has exposed that we can be empty handed if we are hit by a new ‘disease X’. Comparing modern pandemic preparedness with the situation during the Spanish Flu in the 1910s, David Morens and Anthony Fauci, concluded a decade ago that ‘Almost all “then-versus-now” comparisons are encouraging, in theory.’ Their ‘in theory’ is not an innocent addition: antiviral and antibiotic resistance, medical capacity constraints and the vulnerability of the just-in-time character of the medical supply chain are by now familiar problems.  Also, we may not be able to find a vaccine against the next virus attack (Lassa fever is an eample of such a disease with pandemic potential). More importantly, we know that the key medical inputs (well-trained staff and access to high quality facilities) cannot be stored. During a pandemic these inputs will always be in short supply. A pandemic is therefore all about scarcity.  And economics, the science of scarcity, is therefore elementary for any viable strategy to beat the next pandemic.

Pandemic management

Because of the obvious limits to medical solutions, we need to prepare and find ways to structurally mitigate the impact of a virus on the move. We need to work on ‘pandemic management’ just as we have developed disaster management. Our main efforts need to be to develop more intelligent ‘non-pharmaceutical interventions’ – more intelligent than the short-term measures that we have used in 2020 and 2021. This is the first time in history that we have used lockdowns world-wide and in almost all countries at the same time. The costs of the short-term measures are becoming increasingly clear with unacceptable rationing of non-COVID care and a disastrous impact of the economy. The limits to lockdowns that require perseverance and discipline are also becoming increasingly clear. Lockdowns have worked during the first wave, but to maintain such a regime for more than a few months is doubtful if possible, at all. We thus need to start thinking about the long run.

The five P’s: prepare, prepare, prepare, prepare, prepare

Preparation should take place at the five relevant levels: individual (households and firms), local, national, international and global pandemic preparedness. It is important to realize that the strength of the defense against the next pandemic will be determined by the weakest link and it cannot be stressed enough that all five levels of defense need to be active. Basic hygiene, masks, social distancing and being well-informed provide the final line of defense at the individual level, but pandemics also require rethinking of city design and the proper roles of nations, regional cooperation and at the global level. Global pandemic management will not be effective if individuals are not prepared. The organization of society allows us some choices between a Darwinian Society that lets pandemics run their course and a Big Brother social order (or perhaps an Autocratic Autarky) but as the analysis of such settings in Pandemic Economics makes clear cannot stop pandemics. Individuals and firms you can prepare for a pandemic but without collective action viruses will always be able to win the battle.

A major global investment project

Pandemic preparedness must cover both prevention, delay and mitigation. A major global investment project is necessary in order to enhance humanity’s resilience and an economic analysis of the societal costs and benefits is key to its success.  Pandemic economics shows how economic analysis can play their role and how economics can provide new insights for epidemiology. Economics alone cannot solve the pandemic problem of course. We really need to marry medicine and economics. That requires perhaps the biggest investment: a mental investment to understand in a truly multidisciplinary way that pandemics are essentially about behavior and choices that need to be made on a rational basis despite the emotions related to an outbreak of a new disease.

*Coronavirus economic impact. Credit: ffikretow

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