Decoding The Economic & Contagious ‘Enigma’ Of COVID-19
ANDREA GALEOTTI & PAOLO SURICO
British mathematician Alan Turing designed the curiously named Bombe machine during the early stages of World War II.
A forerunner to the computer, the Bombe was able to rapidly intercept messages, quickly decode them, and thereby allow allied forces to react within hours
rather than weeks.
Stories from the world of codebreaking, especially those at the world-famous Bletchley Park, are legion, but still today bring to vivid life the speed of action required in times of crippling need and the necessary creative energy that is so often important to remedy crisis situations. The global pandemic created by the coronavirus is one such moment in time, where a Turing-style application of inventive skill and intellect should be given urgent consideration.
The nature of this urgency is worth pausing to consider: the world has been brought to a grinding halt by a pandemic that, while not unexpected, has carried with it a level of reality that differs from earlier expectations. The speed of the rate of infection, the alarming death toll, the potential for economic coma – put together, the scale of events is both devastating and potentially paralysing.
Dealing with the health crisis is foremost in the minds and actions of governments around the world and it is this particular respect that new thinking needs to be given urgent consideration. From the start, the World Health Organisation (WHO) has recommended that everyone needs to be tested. In the UK, Italy and the US, testing is being directed toward the worst of the symptomatic cases.
There is, however, a third way that ought to be considered - one that potentially yields benefits for both the clear and present danger of the ongoing health shock, while also addressing the looming economic crises.
With the twin, complex and frightening narratives brought about by a pandemic which presently has no known cure and an economic threat that is bigger than the financial crisis of 2008-09, dealing with these two situations will require strong and intelligent leadership. While central banks have made a good start on the latter, the responsibility now falls on governments to address both the health and impending economic crises.
First, there is an urgent need for governments to be deeply intelligent in their management of the health crisis itself. Concurrently – and this is where Turing style genius needs to come into play - for the good of social cohesion, the equilibrium of the markets and the health of businesses great and small, governments must also convey an abundant sense of surety in order to best support businesses, institutions and people.
With particular regard to the pandemic, it is worth considering the following. Most countries are implementing strict social distancing measures and this policy choice is mainly influenced by two factors. First, there is a low capacity of intensive care beds within the health system, and second, there is an expected high demand for beds due to the fast rate of infection among the population (think of Prime Minister Boris Johnson’s stark warning that the UK may be two weeks away from the crisis presently experienced in Italy).
If properly enforced, any measure of social distancing decreases the flow from healthy people to people infected by COVID-19, and so it follows that it flattens the demand for health care. Numerical analyses based on standard and sophisticated epidemiology models predict that only strict social distancing measures can reduce the spread of COVID-19 in a way that the capacity of national health systems is sufficient to cope with the demand.
At this present moment, this is the best policy to implement. The spread of COVID-19 will not go down sufficiently quickly unless we all understand that the behaviour of each one of us, if irresponsible, will create direct costs to the most vulnerable within the population. In addition, the impact to everyone economically will be on a scale that will be difficult to comprehend.
However, a close reading of the information that is available to the public, presents governments with the following challenges. First, health policies currently being implemented are based on incomplete and biased data. For example, most of the infections seem to be generated by asymptomatic individuals. Those individuals are less contagious relative to symptomatic patients, but as they are so much more numerous, they prove to be the most responsible for the rise in infections. If the numbers that have been estimated in different studies are correct, then it is likely that, even with strict social distancing policies, the peak of the contagion curve will be much higher than expected because those policies have been implemented too late in the day.
Second, the benefit of strict social distancing policy may, in the short term, decrease the spread of the virus so drastically that the capacity of the health system may indeed cope with the demand. There is however a drawback to this approach, and we may see that once the restrictions are lifted society is still very vulnerable to COVID-19, thereby leading to likely new waves of infection.
Lastly, it is not a feasible policy to adhere to strict social distancing for any great length of time. There is no need to elaborate on this, as it is obvious – the societal impact will be too great to bear.
With these thoughts in mind, we can begin to see with greater clarity what further measures might be taken. By flattening the infection curve, the ensuing suppression offers time between bouts of infections to gather data on the prevalence of the virus in the population, so that proper surveillance strategies can be conducted when the period of suppression is lifted.
Managing these waves of infection as a form of ‘intelligent triage’ offers the greatest opportunities of avoiding greater structural damage to the economy, particularly the most vulnerable in the population such as renters and mortgagors with little cash-on-hand, zero-hour contract workers, smaller and younger businesses with little to no cash reserves.
The only way to develop such strategies is to collect reliable data. This means countries should test a representative sample of the population, independent of their symptoms, while recording social, economic, demographic and locational characteristics at the household level. With the collection of this data, we can then use standard statistical methods to infer the household characteristics that are more important to decode the economic and contagious enigma of COVID-19 to develop effective surveillance and social-economic strategies.
COVID-19 can only be defeated by mobilizing experts, although not solely experts in medical research. The development of simple-to-use serological tests, and eventually the COVID-19 vaccine, are priorities, but it is also a priority to collect better data, to develop better containment strategies, and to support all different disruptions in our society that this COVID-19 crisis is creating.
In wartime, governments spent freely and put to use every brain and resource they had to prevent disaster. For this crisis, one needs the collaboration of scientist and social scientists and, above all, an open-minded willingness to try for those sometimes-elusive solutions that Turing and his team of mathematicians and technicians provided so brilliantly.
Now, brothers and sisters, about times and dates we do not need to write to you, for you know very well that the day of the Lord will
come like a thief in the night. While people are saying, “Peace and safety,” destruction will come on them suddenly, as labor pains on a pregnant
woman, and they will not escape. 1 Thessalonians 5:1-3