Archive for category: Pandemic
Image by Clay Banks.
We will soon be a year into the Covid-19 pandemic. Are you rolling in new wealth? No? Too bad you are not a billionaire.
With millions of deaths, unemployment soaring, millions threatened with losing their homes and economies struggling around the world, the world’s billionaires are doing fine. More than fine. So fine that they have added trillions of dollars to their composite wealth.
In other words, capitalism as usual. Or even better than usual, depending on your point of view and bank account.
Before we throw around some numbers, here’s one way of putting the pandemic into perspective: The world’s 10 richest people have seen an increase in their wealth that is larger than the cost would be of vaccinating every person on Earth. That calculation comes courtesy of Oxfam, which reports those 10 people increased their net worth by about US$500 billion since March 2020. They could finance a comprehensive global response to the pandemic and still have all the obscene wealth they possessed a year ago.
Naturally, billionaires in the center of the world capitalist system are no slackers here. In the latest of a series of reports on this issue, the Institute for Policy Studies reported at the end of January that the 660 billionaires of the United States had hoarded a composite total of $4.1 trillion, a nearly 40 percent increase in their wealth from the start of the pandemic. That total is in contrast to the $2.4 trillion in total wealth held by the 165 million United Statesians who constitute the bottom 50 percent of the country’s population.
As outrageous as this inequality on steroids has been, there are those who believe that billionaires taking advantage of a global crisis is a cause for celebration.
One example is a report issued by one of the world’s biggest banks, UBS, and Big Four accounting firm PricewaterhouseCoopers. The authors of the report, “Riding the storm: Market turbulence accelerates diverging fortunes,” can hardly contain their enthusiasm at how successful their clients have been during the pandemic. UBS and PwC “have unique insights into” billionaires’ “changing fortunes and needs” and in the report breathlessly extol “a time of exceptional, Schumpeterian creative destruction” by “billionaires [who] live in turbulent but trailblazing times.” As you can already surmise by the tone-deaf writing, the report is intended as a celebration of vast wealth inequality and is written in a style that comes as close to that of Hollywood celebrity publicists as you are likely to find produced by bankers and accountants.
The report breathlessly declares that “Some 209 billionaires have publicly committed a total of USD 7.2 billion” in donations, written within a passage told in solemn tones intended to make us gasp in awe at the selflessness of the international bourgeoisie. Yet we soon enough read that the wealth of the world’s billionaires totaled US$10.2 trillion in July 2020. For those of you scoring at home, that $7.2 billion in proposed donations represents 0.07 percent of their wealth. The average working person donates a significantly bigger portion of their income.
In just three months, from April to July 2020, the world’s billionaires added $2.2 trillion to their wealth! Technology billionaires did particularly well during the pandemic, the UBS/PwC report says, due in large part to the surge in technology stock prices. During the first seven months of 2020 alone, technology and health industry billionaires saw their wealth increase by about $150 billion. Yes, never let a crisis go to waste.
The number of the world’s billionaires, the UBS/PwC report tells us, is 2,189. To put these numbers in some kind of perspective, there are exactly two countries in the world (the United States and China) that have a bigger gross domestic product than the wealth of those 2,189 billionaires. Or, to put it another way, their wealth is greater than the economic output of Japan, Germany and Britain, the countries with the world’s third, fourth and fifth largest GDPs and which have a combined population of 277 million.
Wall Street has been amply taken care of in the current economic crisis, as it was in the wake of the 2008 collapse, and industrialists also have had massive amounts of subsidies and tax cuts thrown their way. For working people, crumbs. The Federal Reserve, the U.S. central bank, committed US$5.3 trillion to corporations on its own initiative in the first weeks of the pandemic, and most of the $2.5 trillion offered in the two 2020 congressional stimulus packages (the CARES Act of March 27 and the supplement of April 24) went to big business. (There was nothing unique about that as Canada, Britain and the European Union pushed through similar programs.)
There is plenty that could have been done with the towering piles of money thrown at financiers or with the wealth that trickled up to the most wealthy. The $1.1 trillion in gain in billionaire wealth, for example, is double the two-year estimated budget gap of all state and local governments, which is forecast to be at least $500 billion. By June 2020, state and local governments had already laid off 1.5 million workers while public services, especially education, faced steep budget cuts. The Economic Policy Institute predicts that if federal aid is not forthcoming, as many as 5.3 million public-sector jobs — including those of teachers, public safety employees and health care workers — will be lost by the end of 2021.
As difficult as the damage inflicted by the pandemic has been, it is no surprise that the least well off in the advanced capitalist countries and most everybody in the Global South has it the hardest. In the first months of the pandemic, the International Labour Organization issued a report predicting that half of the world’s working people are in danger of disaster, forecasting that “1.6 billion workers in the informal economy — that is nearly half of the global workforce — stand in immediate danger of having their livelihoods destroyed” and that “The first month of the crisis is estimated to have resulted in a drop of 60 per cent in the income of informal workers globally.”
Destruction this certainly is, but by no rational measure is it “creative,” Schumpeterian or otherwise. Unfortunately, capitalists have usually understood their class interests better than do the world’s working people in what remains a most one-sided class war.
It’s inauguration day. There is a new president in the US, the most powerful capitalist economy and state in the world. Joe Biden’s four-year term begins today, as Donald Trump slinks off to his Florida estate and golf course, after saying that his “movement is just beginning”.
What is the state of the United States as Biden takes over? The COVID-19 pandemic has reaped huge damage on the lives and livelihoods of millions of Americans. Its impact has been far worse than it might have been for several reasons. First, the US government, just like the other governments, had done nothing to prepare for the COVID-19 pandemic. As previous posts have explained, governments had been warned that pathogens dangerous to human life for which there was no immunity were becoming more prevalent, leading to a wave of epidemics before COVID-19. But most governments did not spend on prevention (research into vaccinations) or on protection (robust health resources and testing and trace systems). On the contrary, governments had been cutting back on health spending, privatising and outsourcing it, and in the case of the US, operating a private health insurance system that left a sizeable minority of Americans with no protection at all, and the rest paying out huge premiums for health cover.
And in the US and other countries, like the UK, Sweden and Brazil, there was an open refusal of governments to recognise the deadly nature of the virus and to take action to save lives. For these governments, keeping businesses going, particularly big business, was more important. This attitude led to late lockdowns and social isolation measures, then ‘light’ lockdowns that did not suppress the spread of the virus ;and then too early relaxations, leading to a revival of the pandemic.
So as Biden takes his oath at the inauguration ceremony, Americans are still faced with near record levels of COVID cases and deaths. At the same time, economic activity and people mobility remains well below pre-pandemic levels. According to the latest Google mobility report, US economic activity is still some 20-25% below where it was this time last year.
Indeed, the economic cost of the pandemic during 2020 has been equivalent to 80% of US 2020 real GDP output, if you take into account the lost GDP, premature deaths, long-term health impairment and mental health.
So the outgoing US government (like many others) failed to save lives and also failed to save livelihoods. And this is particularly the case for the lowest paid, often unable to work from home, forced to work in dangerous conditions or being laid off; and that mainly means, black and other ethnic minorities, women and young people.
Overall, the US economy has shrunk by about 4-5% in 2020. That is the largest contraction since the early 1930s – or 90 years ago! Employment has fallen by over 25m, with millions now on emergency benefits, unemployment benefits or given up. Swathes of American businesses, mainly in the services sector but not just there, have been closed and will not return as the economy recovers (once the vaccinations reach enough Americans).
All the evidence suggests that there has been permanent ‘scarring’ to the economy in employment, investment and incomes. Most studies suggest that the US economy in GDP terms will not return to the levels of 2019 before the end of 2022 at the earliest, and certainly not to the levels that GDP would have reached if there had been no pandemic slump.
So there will be no V-shaped recovery as was hoped – indeed of the major economies globally, only China is achieving that. Instead, there is what I have called a ‘reverse square root’ recovery where output falls but then does not recover to the same trajectory of economic growth that was there before. That output is lost forever, as the forecast for the US from Oxford Economics below shows.
But what about the economic policy actions adopted during the pandemic slump under the Trump administration and those that are planned by Biden during 2021 and beyond? Will they not restore the US economy to ‘business as usual’?
In the last year, there has been the biggest injection in history of credit into the monetary system through Federal Reserve Bank purchases of government and corporate debt and loans to businesses. The Fed’s balance sheet has nearly doubled in one year, to reach nearly 40% of US GDP and is set to rise further this year. Has it saved businesses from bankruptcy? Well, yes to some extent, but mainly the large travel, auto and fossil fuel industries, while many small businesses are going bust.
With interest rates more or less at zero and the Fed pumping yet more credit into the coffers of banks and businesses, will this largesse help to get the US economy going at a fast pace in 2021? Well, the evidence is against it. The history of what is called ‘quantitative easing’ (where it is the quantity of credit money that is injected, not reducing cost of this money in interest, that matters) has proved that it fails to restore the productive sectors of the capitalist economy. As empirical study concluded: “output and inflation, in contrast with some previous studies, show an insignificant impact providing evidence of the limitations of the central bank’s programmes” and “the reason for the negligible economic stimulus of QE is that the money injected funded financial asset price growth more than consumption and investments.” balatti17.pdf (free.fr)
Indeed, what has happened to all these credit injections is that they have been used by banks and big businesses to speculate in the stock and bond markets rather than to pay wages, preserve jobs or raise investment. After the initial panic of the pandemic in March, the US stock market has gone on an unparalleled binge.
It is now at all-time highs and, relative to earnings and productive assets, is at extreme levels. Yet with more Fed support to come, financial markets may well go rolling on up for a while longer. So all monetary policy has done is to keep businesses on life support, while boosting the wealth of the very rich.
The ineffectiveness of monetary policy to restore the US economy has meant that mainstream economists are “all Keynesians now”. The merits of increased government spending while running ‘emergency’ budget deficits are proclaimed by the IMF, the World Bank, the OECD and of course, the incoming Biden administration. Janet Yellen, the former Federal Reserve chief under Obama, is taking over as Treasury Secretary under Biden. Yellen made it clear in her testimony to US Congress where she stood. “We need to act big” because while “economists don’t always agree, but I think there is a consensus now: without further action, we risk a longer, more painful recession now – and long-term scarring of the economy later.”
Thus we have Biden’s new fiscal stimulus package to come in 2021. The main elements of Biden’s stimulus plan include payments to individuals of up to $1,400 each; more aid to state and local governments; the extension of emergency jobless benefits of $400 per week; funds to help schools and universities to reopen; financing of vaccinations, testing and tracing; more child tax credit; and raising the minimum wage.
At first sight this looks big, to use Yellen’s words, taking the total fiscal injection up to 25% of GDP. However, it is not really. First, many of these measures may not get through the US Congress despite the narrow majority that the Democrats now hold. Also, even this level of fiscal support is way short of what is needed keep 25m Americans from destitution or for local governments not to be forced into jobs and spending cuts to ‘balance their books’. Moreover, raising the minimum wage to $15 an hour would still mean that those on the minimum would be well behind average median wage. And Biden is not intending to implement this rise immediately but spread it over time.
Biden also plans a post-pandemic package that he calls “Build Back Better Recovery Plan” which encompasses $2trn in investment stimulus, much tilted towards green initiatives, with a Buy America government procurement, more investment in R&D, and infrastructure. Again, this is spread over the four-year term and adds up to about a maximum of 1% of GDP increase in government investment if fully implemented.
And here is the rub. On average, government investment to GDP in most major capitalist economies is about 3% of GDP, while capitalist investment is around 20% of GDP on average. So a revival of investment, growth and jobs in a capitalist economy ultimately depends on capitalist, not government, investment. Sure, Biden’s investment plan will ‘spill over’ into the capitalist sector, but not by much. Most recent studies show that the ‘multiplier effect’ of government spending on real GDP growth is no more than 1% point, and on average half that. So Biden’s plan would likely add, at best,1% point to the US growth, more likely half that. Given that the average growth rate of the US economy has been little more than 2% a year before COVID and even less per capita, then the Biden investment plan is not going to do much to achieve sustained and higher real GDP and employment growth over the next four years.
The problem is that the capitalist sector of the US economy is very reluctant to invest and the principal reason is that the profitability of such investment is so low. Indeed, the rate of profit of US capital is at a post-1945 low.
Sure, we hear all about the huge profits made by the likes of Amazon, Google, Netflix and the big banks during the 2020 pandemic slump, but the profits of the FAANGS are the exception to the rule. Total corporate profits (after government handouts are removed) have dropped by some 30%. And according to Bloomberg, in the US, almost 200 big corporations have joined the ranks of so-called ‘zombie’ firms since the onset of the pandemic. They now account for 20% of the top 3000 largest publicly-traded companies, with debts of $1.36 trillion. That means 527 of the 3000 companies didn’t earn enough to meet their interest payments! So there remains a significant risk of a credit crunch and financial crash down the road, perhaps in 2021, when the Fed largesse is curtailed.
And then there is the debate about the size of the public debt and inflation. US public sector debt has rocketed during the pandemic to over 110% of US GDP.
Now the current consensus view is that 1) governments have no alternative to spend more and run up their debt levels, otherwise there will be no recovery after the pandemic; and 2) it does not matter if debt levels rise because the cost of servicing those debts (interest) is really low and as real GDP recovers, government revenues will rise, emergency spending will taper off, and the cost of debt servicing will be manageable. The economy can grow its way out of the debt burden as it did after WW2.
There is no doubt that net interest on government debt is very low historically, only slightly more than 1% of GDP a year compared to a GDP growth rate of 2-3% a year ahead. But some mainstream studies are less sanguine. The Peterson Institute argues that those “who believe that rates will almost certainly not rise are too confident in their own views. The forces that have contributed to lower rates are universally difficult to predict, and, as noted above, even modest changes in rates can produce sizable movements in net interest as a share of the economy in the future.”
As the above table shows, just a 50bp rise in average interest costs on government debt would take interest costs above the likely growth rate. Moreover, if the average repayment term on government bonds falls (and it is falling), then the government would soon enter the territory of expanding debt to pay the cost and repayment of existing debt or alternatively have to make significant cuts in government spending, such as on medicare, social security or most likely, on so-called ‘discretionary spending’ like education, public services etc. It may be the debate on whether austerity is necessary or not may have been kicked down the road like the proverbial can. But the can is still on the surface of the road.
Of course, the suggestion that the US government will eventually need to stop running budget deficits and deal with rising debt has been strongly rejected by exponents of Modern Monetary Theory. MMT supporters argue that Biden can and should run permanent budget deficits until full employment is reached. There is no need to finance these annual deficits by issuing more government bonds. Because the government controls the unit of account, the dollar, which everybody must use, the Federal Reserve can just ‘print’ dollars to fund the deficits as the Treasury requires. Full employment and growth will follow.
I have discussed in detail the flaws in the MMT argument in other posts, but the key concern here is that government spending, however financed, may not achieve the necessary investment and employment increases. That’s because MMT does not take the decision-making on investment and jobs out of the hands of the capitalist sector. The bulk of investment and employment remains under the control of capitalism, not the state. And as I have argued above, that depends on the expected profitability of capital.
Let me repeat the words of Michael Pettis, a firm Keynesian economist: “the bottom line is this: if the government can spend additional funds in ways that make GDP grow faster than debt, politicians don’t have to worry about runaway inflation or the piling up of debt. But if this money isn’t used productively, the opposite is true.” That’s because “creating or borrowing money does not increase a country’s wealth unless doing so results directly or indirectly in an increase in productive investment…If US companies are reluctant to invest not because the cost of capital is high but rather because expected profitability is low, they are unlikely to respond ….by investing more.”
In a major slump, businesses go to the wall, unemployment rises and investment in means of production stops. Total profits fall, but the conditions have been created for a rise in the rate of profit as costs fall and the strong devour the weak. Joseph Schumpeter of the Austrian school of economists called this ‘creative destruction’, following Marx who argued that slumps eventually provide the environment for rising profitability and expansion – thus we get the cycle of boom, slump and boom.
The pandemic slump of 2020 matches that of the 1930s, so it should eventually provide a boost to profitability. But it required a world war to end the Great Depression of the 1930s. And if the Fed goes on ploughing credit into businesses to prop up the ‘zombies’ at the expense of productive investment, then the US economy under Biden will just return to the low growth, low investment, low wage growth economy of the last ten years since the Great Recession.
And if disillusionment in Biden’s policies rises, that could lay the political base for the return of something like Trumpism, which according to the Donald is “just beginning.”
Grim milestone comes as Joe Biden’s incoming chief of staff says 500,000 could die in US next month; EU states raise concerns about Pfizer slowdown. This blog is now closed. You can follow our new live blog here
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This liveblog has now closed. Our coverage of the coronavirus pandemic continues on our new live blog.
Pfizer’s reduction of its COVID-19 vaccine shipments will not delay Canada’s goal of getting most people inoculated by the end of September, the country’s procurement minister said as the country battled a second surge in infections.
“This is a temporary delay and we remain on track to have enough approved vaccines for everyone who wishes to get vaccinated by the end of September 2021,” Procurement Minister Anita Anand said.
White House coronavirus taskforce reports advocate for ‘aggressive action’ amid 23m confirmed cases in US
As coronavirus continues to tear across the US without any sign of slowing down, officials have warned there is a “full resurgence” in most major population centers – and that the country could see an additional 92,000 deaths in less than a month.
There have been more than 23m confirmed Covid-19 cases in the US and 385,503 deaths, Johns Hopkins University’s most recent data revealed.
The world is utterly shocked by the 362,000 certified Covid-19 deaths so far in Trump-ruled America. However US Covid-19 pandemic-related deaths, all preventable, now total 0.5 million. Further, non-Covid-19-related preventable American deaths from life-style choice and political choice reasons presently total 1.5 million annually. Softened by self-assertedly patriotic US Mainstream media, a total of 2 million Americans have died preventably[Read More…]
The post American Holocaust: 2 Million Americans Died Preventably In Trump’s Last Year As President appeared first on Countercurrents.
Editor’s Note: The Atlantic is making vital coverage of the coronavirus available to all readers. Find the collection here.
A new variant of the coronavirus is spreading across the globe. It was first identified in the United Kingdom, where it is rapidly spreading, and has been found in multiple countries. Viruses mutate all the time, often with no impact, but this one appears to be more transmissible than other variants—meaning it spreads more easily. Barely one day after officials announced that America’s first case of the variant had been found in the United States, in a Colorado man with no history of travel, an additional case was found in California.
There are still many unknowns, but much concern has focused on whether this new variant would throw off vaccine efficacy or cause more severe disease—with some degree of relief after an initial study indicated that it did not do either. And while we need more data to feel truly reassured, many scientists believe that this variant will not decrease vaccine efficacy much, if at all. Health officials have started emphasizing the lack of evidence for more severe disease.
All good and no cause for alarm, right? Wrong.
A more transmissible variant of COVID-19 is a potential catastrophe in and of itself. If anything, given the stage in the pandemic we are at, a more transmissible variant is in some ways much more dangerous than a more severe variant. That’s because higher transmissibility subjects us to a more contagious virus spreading with exponential growth, whereas the risk from increased severity would have increased in a linear manner, affecting only those infected.
Increased transmissibility can wreak havoc in a very, very short time—especially when we already have uncontrolled spread in much of the United States. The short-term implications of all this are significant, and worthy of attention, even as we await more clarity from data. In fact, we should act quickly especially as we await more clarity—lack of data and the threat of even faster exponential growth argue for more urgency of action. If and when more reassuring data come in, relaxing restrictions will be easier than undoing the damage done by not having reacted in time.
To understand the difference between exponential and linear risks, consider an example put forth by Adam Kucharski, a professor at the London School of Hygiene & Tropical Medicine who focuses on mathematical analyses of infectious-disease outbreaks. Kucharski compares a 50 percent increase in virus lethality to a 50 percent increase in virus transmissibility. Take a virus reproduction rate of about 1.1 and an infection fatality risk of 0.8 percent and imagine 10,000 active infections—a plausible scenario for many European cities, as Kucharski notes. As things stand, with those numbers, we’d expect 129 deaths in a month. If the fatality rate increased by 50 percent, that would lead to 193 deaths. In contrast, a 50 percent increase in transmissibility would lead to a whopping 978 deaths in just one month—assuming, in both scenarios, a six-day infection-generation time.
Transmissibility increases can quickly—very quickly—expand the baseline: Each new infected person potentially infects many more people. Severity increases affect only the infected person. That infection is certainly tragic, and this new variant’s lack of increase in severity or lethality thankfully means that the variant is not a bigger threat to the individual who may get infected. It is, however, a bigger threat to society because it can dramatically change the number of infected people. To put it another way, a small percentage of a very big number can easily be much, much bigger than a big percentage of a small number.
I dismissed the news initially because viruses mutate all the time and there have been too many baseless “mutant-ninja virus” doomsaying headlines this year. The exaggerated, clickbaity alarmism makes it harder to discern real threats from sensationalism. Given the constant reality of mutation, genomic variants should be considered innocent until proved guilty. Even an increase in the proportion of cases attributable to a particular variant is not definitive proof of an evolutionary advantage.
However, as data on the new variant roll in, there is cause for real concern. Trevor Bedford, a scientist at the Fred Hutchinson Cancer Research Center and a board member for the Covid Tracking Project at The Atlantic, points out that infections from the new variant are increasing very rapidly among the population in the U.K. Bedford also notes that this new variant seems to have a higher secondary-attack rate—meaning the number of people subsequently infected by a known case—compared with “regular” COVID-19. Finally, the new variant seems to result in higher viral loads (though this is harder to be sure about as viral loads can be affected by sampling bias and timing). As Kucharski told me, all of this does not rule out other explanations. This increased transmission could be due to chance or founder effects—meaning one variant just happened to get somewhere before the other variants and then got “lucky”; it was early, rather than more transmissible. It could be due to changed behavior among people—quarantine fatigue, less masking—leading to more rapid spread. However, given the current evidence, along with the specifics of the mutation, it’s getting harder to assume that those other explanations are more likely than the simple proposition that this is truly a more transmissible variant.
So how much more transmissible? We aren’t completely sure yet, but the initial estimates from the data suggest that this variant could be about 50 to 70 percent more transmissible than regular COVID-19. To make matters thornier, we aren’t yet exactly sure why it’s more transmissible, though reasonable theories are already being tested. This variant, now called B.1.1.7, has “an unusually large number of genetic changes, particularly in the spike protein,” which is how the virus gains entry into our cells. The new variant may be better at eluding our immune response and replicating, or be able to better bind to locations in our body more conducive to infecting others, but that is all speculative for the moment.
This uncertainty in understanding the variant’s exact mechanisms means that we don’t know if our existing tools—masks, distancing, and disinfecting—are as effective as they were compared with an identical scenario with the regular variant. To be clear: The variant is still a respiratory virus, so the basic tools will not change, and they will all continue to work. In fact, they have become more important, but we may need to be stricter—less time indoors, better masks, better ventilation, more disinfection of high-touch surfaces—to get the same bang for our protective buck. It may be a small difference, or not. We don’t know. We won’t know for a while.
Given that this new variant is already here in America, are we too late? No, but we are on our back foot. The United States does not have extensive genomic surveillance, or a rapid turnaround with what surveillance it has, so in some ways, we are flying without a map. We have some indications that the variant is—so far—probably relatively rare in the United States.
This could, of course, change extremely quickly, before we can even detect that change, but that highlights the importance of early action. In addition to the threat of exponential growth, we must remember that this pathogen is quite overdispersed—meaning some people seem to cause many infections, while many do not transmit it at all (though these ratios may change as well). Early on, there was a lot of hand-wringing about why some European cities were very badly hit while others were spared—spared only until later, it often turned out—despite similar policies. The answer could be just a bit of bad luck and a few weeks of delay: For exponential processes, small initial differences can mean gargantuan differences in the long run, and we are not helpless.
We can and should deploy whatever weapons we have in our arsenal, as soon as possible. If public-health officials can accelerate our ability to detect the new variant, they must. “You could imagine case-based interventions specifically targeting the early variant-transmission chains,” Bedford told me. “I wouldn’t expect to contain them, but I could imagine buying a week or two.”
A week or two may not seem like a lot, but combined with other aggressive public-health measures, we may actually gain a few additional weeks. Maybe all of that could delay this new variant’s widespread establishment until February or even March.
This moment is somewhat similar to America’s initial COVID-19 surge and shutdown in March. We need to once again talk about the importance of flattening the curve. We need to again preserve hospital capacity, so our fatality rate doesn’t increase. But this time around, we can be a lot more hopeful: We need to flatten the curve because delaying potential infections just a few weeks or a month can make a tremendous difference when highly effective vaccines are being rolled out.
We are in a race against time, and the virus appears to be gaining an unfortunate ability to sprint just as we get closer to the finish line. Although the initial rollout of the vaccines has been slow, it is expected to increase rapidly. The U.S. may have 50 million to 100 million people vaccinated as early as March. That is a huge difference, one that could save many lives, especially since we also have perhaps that many people with some degree of postinfection immunity.
Here’s how to think about it: Vaccinated people are a lot less likely to get sick in the first place. One hundred million vaccinated people will mean 100 million people with much less (or hardly any) risk for any symptomatic COVID-19, especially severe disease. That’s an enormous gain.
But that’s not all. Vaccines benefit not just the vaccinated, but potentially everyone else, too. Fewer people symptomatically sick with a contagious virus means fewer sick people infecting even more people. Every indication we have suggests that vaccinated people will also transmit less—how much less is still being studied, but the difference may well be substantive. The mRNA vaccines (both already approved in the United States) cut down symptomatic disease by about 95 percent. We already know that people who never develop symptomatic disease are a lot less likely to transmit COVID-19. (Note the difference between people who are truly asymptomatic and people who are just about to get sick—presymptomatic—but are highly infectious.) In a preliminary study, the Moderna vaccine was found to even prevent two-thirds of asymptomatic infections. Vaccinated people are thus not only much, much less likely to get any disease; they appear much less likely to get even a silent, asymptomatic infection. Although we need more data to be sure, all of this strongly suggests that vaccinated people will also transmit less. The fewer people there are to efficiently transmit a pathogen, the harder it is for that pathogen to spread.
Now that we have effective vaccines, flattening the curve into the future also means obliterating the curve. Dylan Morris, a postdoc at UCLA who studies who studies virus transmission and quantitative biology of infectious disease, and a co-author of a preprint paper studying the impact of timing on nonpharmaceutical interventions—such as reducing mobility and contacts, wearing masks, distancing, and avoiding indoor gatherings—told me that “delaying cases has always been valuable, but right now it is especially valuable. Buying even a bit of time to ramp up vaccination could avert a great deal of mortality and morbidity.” Every COVID-19 death is tragic, but with the existence of several effective vaccines, every death is now technically preventable too.
Even without a vaccine, Morris said, knocking down the virus through temporary suppression can be valuable even though the virus will grow again, precisely because of these exponential effects. The same percentage growth amounts to a much smaller number of infected people when the baseline number is much smaller. Bringing the baseline level of contagion down also allows for safer experimentation: What happens if we relax X a bit? What restrictions work best? Which ones are most sustainable? If cases are growing from a very large base number, however, that means the state of the world is changing very quickly, so small mistakes are magnified. As Morris said, “You can’t finesse the steep part of an exponential.” He noted that throughout the pandemic, we bemoaned the absence of silver bullets while underestimating the value of crude hammers. But now we are in a different situation: We do have a silver bullet—vaccines—just as we have this new threat thrown at us. How we react in the next few weeks will matter immensely.
Imagine it this way: There is a tsunami heading our way, and we are ferrying people to a high point. Everyone we transport up to the top is safe, but even better, they can also help other people get to safety (the exponential desirable effect of the vaccine). The reverse is also true, however: Everyone we leave behind also pulls down more people (the exponential unwanted effect of increased transmissibility). And the whole process is very sensitive to when we start; it’s much easier in the beginning but gets nearly impossible as the wave grows higher and gets closer. With this variant, at least in the United States, we are likely at the beginning, or near the beginning.
All this means that the speed of the vaccine rollout is of enormous importance. There are already worrisome indicators of slow rollout. Vaccination of a broad population, not vaccines in and of themselves, saves lives, and epidemics are fought with logistics and infrastructure. We should put every bit of energy, funding, and relentlessness into vaccinating as many people as possible as quickly as possible.
Meanwhile, the United States was reportedly planning to hold back half the vaccine it has in freezers as a hedge against supply-chain issues, and some states may be slowed down by murky prioritization plans. Scott Gottlieb—the former FDA chief and a current board member of Pfizer—has argued that the U.S. should also go ahead with vaccinating as many people as possible right now and trust that the supply chain will be there for the booster. Researchers in Canada—where some provinces decided to vaccinate now as much as possible without holding half in reserve, and will administer the booster with future supplies—estimate that this type of front-loading can help “avert between 34 and 42 per cent more symptomatic coronavirus infections, compared with a strategy of keeping half the shipments in reserve.” (Note that this strategy, which is different from the one the United Kingdom just announced it will adopt in prioritizing the first dose, does not even necessarily involve explicitly changing booster timing protocols in order to maximize vaccination now; it just means not waiting to get shots into arms when the vaccines are currently available.) These were already important conversations to have, but given the threat posed by this new variant, they are even more urgent.
Maybe—just maybe—this variant will turn out to be a false alarm, not nearly as transmissible as we feared. We will know soon enough. Our precautions will still be net positives. But if it is indeed much more transmissible, we may face a true tragedy: exponential growth with massive numbers of illnesses and deaths just as highly effective vaccines are being made available. We’ve had a year to learn—about the importance of early action, of acting decisively even in the face of uncertainty, of not confusing absence of evidence with evidence of absence. A year to learn to aim not for perfection in knowledge but for maximal impact even while considering the trade-offs. And most important, a year to learn to not wait when faced with threats with exponential dynamics but to act as early and as decisively as we can—and to adjust and tamper later, if warranted.
“Exponentials are so cruel that nobody wants to look them in the eye,” Dylan Morris told me. This is true, but averting our eyes doesn’t avert the outcomes. Each one of us is now counting on every person who serves the public—mayors, city-council members, health officials, nurses, FDA regulators, members of Congress, journalists—to speak up now, and to speak up loudly. We must insist on swift and aggressive action, along with more resources, in order to get this right. It is not too late. Many lives depend on what we do next.