It's Time to Suppress the Economy to Eliminate COVID-19

A 2019 study found the US and UK to be the two best-prepared nations to handle a pandemic, but they are now in the top ten globally in terms of deaths per million people. How did this happen? 

During the COVID-19 pandemic, nations have largely chosen one of two strategies: one that preferences people by aiming to rapidly eliminate transmission of the disease, and one that preferences the economy by working to suppress transmission. Repeated efforts to rush reopening in the US and UK have made them models of the latter strategy. Given the outcomes, the choice has proven to be a willful delusion.

The people-first strategy is straightforward. Leaders pursue maximal measures to eliminate transmission within a nation's borders, while also working to keep the virus from entering. Healthcare professionals isolate and care for infected people and track down their recent contacts. China, New Zealand, and Vietnam exemplified this approach. While the US approaches 1,600 deaths per million and the UK nears 1,800, the people-first approach kept that figure under four in China, just over five in New Zealand, and just over one death per three million people in Vietnam.

This strategy undoubtedly strains communities. We put our lives on hold—curtailing liberties while losing time and opportunities—as we work to drive the disease out. Lives are affected in countless ways. Frustration is natural. But what’s the alternative?

The economy-first strategy seeks to keep commerce humming along while suppressing the virus. Its advocates decry the logic of shutdowns, accusing the cure of being worse than the disease. 

Restrictions are added and removed in response to case counts. Removing restrictions offers relief to people struggling through lockdowns, missing friends and activities that make life enjoyable. But as I wrote in my book Pandemic Capitalism, "the problem with this approach is that we are always a few days—if not weeks—behind in our understanding of the breadth of the pandemic’s spread." We learn that a new spike has been incubating when it erupts.

This strategy has proven to be patently absurd. Both the US and the UK have seen repeated efforts to reopen their economies lead to sharp upticks in infections. Italy is now going back into lockdown. With three-quarters of European countries seeing a rise in cases, others may soon follow. And while the approach claimed to sacrifice some people to maintain the economy, it failed both. China and Vietnam experienced growth in 2020, while GDP shrank in the US and the UK during the same period. If our leaders won’t take my word for it, they might read the IMF blog post from last October, which stated that “One enduring lesson from the COVID-19 pandemic is that any lasting economic recovery will depend on resolving the health crisis.”

Déjà vu settled in as leaders in both countries threatened to reopen after cases peaked in early January. Boris Johnson asserted that the discovery of six cases of the worrisome P1 variant would not delay the UK’s “route out of lockdown.” California notably chose April Fool's Day to reopen theme parks and stadiums. Texas Governor Greg Abbott announced that businesses in Texas could fully reopen as he ended the state’s mask mandate. Federal officials warned against doing so, and a number of scientists are now predicting another spike in infections. (I wrote this a couple of weeks ago…) On the same day as Abbott’s announcement, an article from a medical journal announced that each of the important variants being tracked had been found “among Houston Methodist Hospital patients residing in the greater metropolitan area.” This made Houston the first US city to have all “variants of concern” and “of interest” identified via genome sequencing. Houston, we may have a problem.

Our leaders have long downplayed the threat of COVID-19, and the risks from variants are virtually ignored. They tell us business closings do far more harm than keeping them open, but the outcomes tell us otherwise. 

The approach that puts the economy first rests on the flawed belief that society is dependent on the economy. However, human societies have existed for millennia without anything like our modern economy, whereas economies are systems that depend on societies to exist. We need to remember that.

Governments contributed billions towards vaccine development. If they chose to put people first, they would waive intellectual property rights for the good of humanity. Bernie Sanders lobbied for such a waiver as he called the choice of prioritizing profits, during a pandemic, to be unconscionable. Sanders has been joined by a growing contingent of UK-based business leaders, academics, economists, and trade unions. A pharmaceutical lobbying group attempted to pre-empt any such moves by sending a letter to Joe Biden — signed by senior executives from Pfizer, Johnson & Johnson, and AstraZeneca — which argued that intellectual property protections “facilitate sharing of technology and information to scale up vaccine manufacturing to meet global needs.” It also noted that eliminating IP protections “would undermine the global response to the pandemic, including ongoing effort to tackle new variants,” which seemed a threat that they would stop developing responses to variants if they were not allowed to maximize their returns from their vaccinations.

Available manufacturing capacity could greatly increase production. President Biden could order idle facilities to join the effort. That would be a sign of the global leadership promised in his COVID-19 plan. We ought to work together to eradicate the virus. Instead, wealthy nations at the front of the line are blocking the rest of the world’s access to vaccines. Bernie Sanders recently called for a reversal of this position as he asked the Biden administration to support the temporary waiver of “intellectual property protections on COVID-19 medical technologies during the pandemic.” His comments echoed the position of the bulk of the WTO’s member nations.

Map of countries supporting or opposing the Covid IP Waiver at WTO

The IP blockade is a crime against humanity. It increases the risk of problematic variants and the likelihood of COVID-19 becoming endemic. Given the choice of advising pharmaceutical firms to eradicate this plague from the earth—joining the likes of Salk and Sabin as heroes to humanity—or merely suppressing the disease and milking the perpetual returns of booster shots, what would the McKinsey team that advised Purdue Pharma recommend?

If viruses were static entities, the path ahead might be straightforward; quickly get vaccines under everyone’s skin. But viruses mutate regularly and some become problematic. That does not make vaccines the wrong answer to the challenge, but alone they may be insufficient. Rather than put all of our hopes in that option, we should look to the model that’s already proven successful in multiple countries. They took a systems-based approach “in which non-pharmaceutical interventions were widely used to eliminate transmission.”

We already have variants that spread more easily and may increase mortality, render vaccines less effective, and increase the risk of hospitalization. One even appears to put up to 61% of people who were already infected at risk of getting COVID-19 again. That one could become a staggering new problem.

The pandemic has deepened and revealed divisions between us. Dr. Mike Ryan, who leads the World Health Organization’s Health Emergencies Programme, recently called out escalating inequality, stating, “Healthcare can be a force of good but it can also be a weapon of oppression if you don’t have access to it.” That the leader in charge of health emergencies for the WHO gave a talk focused on inequality—during a pandemic—should be a clarion call for humanity.

Dangerous variants have tended to arise where transmission grew out of control. Given the growing risk they represent and the progress we’re making with vaccines, we need to pursue the people-first approach that has worked in multiple countries. Doing so can clear a path for the vaccines to fulfill their purpose. We also need to fully engage the global pharmaceutical system to maximize the production and administration of vaccines without obstructions related to intellectual property. We must now eliminate COVID-19 within our borders and lead the charge for global eradication. Doing so offers our best hope of regaining normalcy.

Our COVID-19 response to date is cause for great concern. If we stick to the untenable approach that favors the economy in the pandemic, what hope will we have of addressing spiraling crises like climate change? If we cannot come together at this moment, maybe it's time to admit that “humanity” is a misnomer.

Chris Oestereich is the publisher of the Wicked Problems Collaborative, an independent press that tackles humanity’s biggest challenges, and a lecturer at Thammasat University’s School of Global Studies in Bangkok, Thailand. His latest book, Pandemic Capitalism, did not look at capitalism in the pandemic, but rather as one.

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