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.)
There was a surge in interest in this newsletter last week with a large number of new subscribers. So I thought I would take a moment to reset and outline where I thought we are with regard to the pandemic.
The Pandemic Information Gap
For newcomers, what I have been doing has been providing an economists’ perspective on Covid-19. My primary framework is the following:
Pandemics represent an information problem. The better we can identify who is infectious and isolate them from others, the fast we can control the pandemic and shield everyone from its health and economic costs. Without such information, we treat everyone as equally infectious which results in harm.
I developed this thesis in my book The Pandemic Information Gap: The Brutal Economics of COVID-19 that was published by MIT Press last year.
The ways in which we achieve this are primarily through widespread testing/screening and contact tracing. The countries that did this (mainly in Asia) were able to weather the pandemic without lock-downs and were able to keep cases very low. Had the rest of the world followed suit, the pandemic likely would have been over in a matter of months.
The other insight from economists is that there is an important behavioural component to how people manage risk. While mandates such as lockdowns or mask-wearing as seen as necessary, invariable most of the work in slowing the spread comes from individuals choosing to do less risky things. This means that cases rarely rise to levels that epidemiologists send out warnings about. When there is an outbreak in a region, people react and a couple of weeks later it turns around. But there is a cycle to these things and the pandemic continues.
The Pandemic Information Solution
It has been very challenging to get the public health and medical community to accept widespread testing. They did not trust individuals with information about whether they were infectious or not. This is controversial but in August 2020, based on an idea in my first book, a consortium of 12 Canadian companies was formed to roll out rapid antigen screens at scale to break chains of transmission in workplaces. I am part of that effort and you can read more about it at the CDL Rapid Screening Consortium website. That program is about to move beyond its pilot stage and into scale and, if you know of workplaces or other places that want to be part of it, applications are now open.
The idea is that all people coming to a place will be screened for Covid-19 twice weekly. We have already seen that this has provided considerable comfort to people who feel safer coming to work and more able to protect their families. If it gets to scale, it will be able to prevent continued lockdowns and a more normal life.
There are many issues involved in this and so in January 2021, I wrote another book, The Pandemic Information Solution: Overcoming the Brutal Economics of Covid-19 and you can download a free pdf here.
The Future
Where are we now?
Endemic: Covid-19 is never leaving us. It is too far gone and it will continue to circulate requiring, at a minimum, vaccine boosts and efforts to contain new variants.
Vaccines: Vaccines are a miracle but vaccine hesitancy is a very real thing. The combination of that and new variants mean that we will likely have large outbreaks, potentially, even in North America and Europe in 2021-22. This also means that countries that have done well are going to have real, painful challenges in re-opening to the rest of the world.
Variants: Variants have evolved precisely to evade our current measures. I’ll write more about this soon but we are not taking them seriously enough.
What do we need to do? My current belief is that all three of the above considerations mean that we need to learn to live with Covid-19 in a responsible manner. That means moving beyond government interventions to mitigate risk and towards providing individuals and organisations with the ability to manage their own risk. Thus, my current (and this can change with new information) view is the following:
Immediate: We need to ensure that workplaces, where people are gathering inside, are properly protecting their workers. That means (i) sick leave for those who are at risk or are infectious; (ii) better and more sensible protection — moving to N95 masks and ending pandemic theatre (see this article from The Hamilton Spectator that I published today); and (iii) a way of having, encouraging and, in some cases, mandating regular screening of people for Covid-19. On (iii), we have that way for workplaces but we also need screens available for purchase.
Summer: We need to have a vaccine push. That means making vaccines available, possibly at workplaces and then at schools. That also means understanding that the best cure for hesitancy is that people are worried about catching Covid-19 and setting a timeline for re-opening that communicates the necessity of being vaccinated before that opening happens.
Beyond: In the fall and beyond, we need to plan for decentralised management of Covid-19 risk with the ability to flexibly react to large outbreaks and new variants. I haven’t written much about this yet but will soon.
This is an ongoing project. I will continue to write when I have new things to say. I can’t promise that what I write will be uplifting or comforting. The best I can do is go for accuracy.