With a vaccine imminent, it’s clear we need a plan
COVID-19 has not proved a disease that produces contagious optimism. We have gotten used to bad news with a second wave still raging around us.
But the news this week that Pfizer appears to be close to a viable COVID-19 vaccine is cause for optimism. The vaccine appears to protect 90 per cent of people who received it, well above the projected “acceptable” thresholds of just 50 per cent.
Whether it also can stop people from being carriers of the coronavirus is not known, but again, there is cause for optimism. The vaccine uses a leading-edge mRNA technology that is targeted toward the coronavirus and is far easier to produce as it can be manufactured and not “grown.”
A vaccine candidate does not end the pandemic magically. We have work to do. Let me outline the big issues that governments need to grapple with.
First, even with significant pre-production of vaccine doses, there will not be enough vaccine to go around initially. The government needs to prioritize who gets it first.
For flu vaccines, the priority is given to the vulnerable and the essential. Essential workers should be at the front of the line for a COVID-19 vaccine as well, but it is far from clear that the vulnerable (those over 50 years of age — myself included) should be near the front. The reason is that we are not just interested in protecting the population but in ending the pandemic.
The virus is being spread by people who are active. The vulnerable, precisely because they are that, have been more cautious and have, where possible, reorganized their lives to protect themselves. Others have been less cautious and were people who faced a greater personal cost associated with distancing.
As an economist, my concern is ending the pandemic, and that suggests that we might prioritize the less vulnerable first. In particular, should it prove safe, younger people and school-age children might be candidates for early doses.
Second, there is actually an economic reason why those who are more willing to be active should receive priority. Compared to a situation where a vaccine is not imminent, people take fewer precautions to protect themselves. This is because there is a sense you might end up getting the virus anyway — a fatalism — and so you are not as careful socially distancing from others.
Being able to get vaccinated soon changes that calculus. Those people will now see hope and a way of taking precautions more seriously in the near term and avoiding being infected with the virus. Thus, the immediate consequence of an imminent vaccine will be to cause those people to back off their current activity.
That has an economic implication. Small businesses limping along may receive another shock to their demand that may be their death knell. No one is suggesting we should pay people to go out, as they did in the U.K., but this increases the need for short-term support of those businesses during the period from now until the vaccine starts to do its work. The government needs to accelerate rather than decelerate support programs.
Finally, it may take many months for the vaccine to be distributed. What do we tell people who receive the vaccine about how they should act? Is the vaccine a passport to being able to freely engage in economic and social activity? Or do we need to continue to measure outcomes and take precautions? Do vaccinated people need to wear masks? Do we have a solid information infrastructure to give people a verifiable means of convincing others — notably governments in other countries — that they have been vaccinated?
I ask these questions because, despite having written a book about COVID-19, I do not know the answers to these questions and there appears to be a reluctance from public health officials to, up until now, give clear guidance on the answers to these questions. They may not have the answers either. Regardless, we need to know what they believe so that we can plan.
A vaccine is terrific news. But it is not the end of the matter. Let’s ensure the right information fills that gap.
Joshua Gans is professor of strategic management and chief economist of the Creative Destruction Lab at the University of Toronto’s Rotman School of Management. His latest book, “The Pandemic Information Gap,” has just been published by MIT Press.