The worst will come in 2021-22
Welcome to Plugging the Gap (my email newsletter about Covid-19 and its economics). In case you don’t know me, I’m an economist and professor at the University of Toronto. I have written lots of books including, most recently, on Covid-19. You can follow me on Twitter (@joshgans) or subscribe to this email newsletter here. (I am also part of the CDL Rapid Screening Consortium. The views expressed here are my own and should not be taken as representing organisations I work for.)
A reader tells me that when a newsletter from me appears in their inbox, they know it’s bad news. It wasn’t always the case but that is a pretty accurate impression of what my writing process has become.
By far the most shared newsletter was this one in April, 2021, called “The worst may come in 2021-2022.” It takes a special talent to depress people a year into a pandemic when vaccines of high effectiveness had just arrived but apparently I have that talent. But, as it turns out, the “may” qualifier was the optimistic part of that newsletter. It looks like that “will” is more accurate.
To remind you, here were the forecasts back then for Europe and the United States.
There was a predicted surge in early 2022 peaking around late February in the worst-case scenarios. The reasons were that people would stop engaging in mitigation activities like social distancing and masking, vaccination take-up would be insufficient and there would be new variants that would weaken the effectiveness of vaccines in preventing disease spread.
It is looking like those worst-case scenarios were actually optimistic. Omicron, as I wrote a long three weeks ago before it even got its name, is bad in the sense that it spreads like no infectious disease we have seen except perhaps measles. The effective reproduction number (R) has been measured at about 3.5 compared with around 1 for Delta. In other words, whatever we are doing to keep Delta at bay keeps Omicron at high pandemic levels so much so that we would expect it to rip through the population using our April 2020 like social distancing and masking policies. (That is, Covid Classic had a basic reproduction number (R0) of 2 to 2.5. We don’t know what the basic reproduction number is for Omicron but it may be in excess of 9.)
What this means is that January is going to be when outbreaks occur in many regions. The good news is that the coronavirus is no longer novel for most people given acquired immunity or vaccinations. That may stem hospitalisations although not enough to stop many systems from being overloaded.
But the problem is that it is unlikely past social distancing and mask policies will stem this one. It just seems to spread too quickly and too easily.
From an epidemiological perspective, however, this means an outbreak is going to be straight up and then straight down. In other words, nasty, brutish and short which is better than nasty, brutish and long. Thus, the message is patience rather than panic.
The right preparation this time seems to be the following:
Get yourself some N95 masks and rapid tests. No need to go overboard. Just enough to cover necessary interactions with other people outside your household for 2-3 weeks.
If you have vulnerable people in your care or that you care for, have a plan for managing that care with extreme caution through an outbreak. Ensure they have what they need to minimise interactions with others and reduce the number of people with who they might come in contact.
The older you are, the more essential it is that you get boosted and boosted soon. That’s cold comfort here in Canada where most of the population are not eligible for boosters so that needs to change right now. (I’m not boosted yet but hopefully will be tomorrow).
If this sounds like a prediction that you are likely to get Covid in the coming months, I have to admit that is my expectation. With vaccines and our knowledge of how to treat it, hopefully, this will just be more like a miserable flu season.
Take care everyone.