Covid vaccine is important but it’s only a beginning

Never let a crisis go to waste, said Rahm Emanuel, President Obama’s first Chief of Staff.  In the Covid-stricken northern hemisphere, some people have taken the message to heart.

The mood feels different from in the first wave.  Despite London moving into tier three measures, the volume of traffic is consistent with many people having adapted to new conditions.  The roll-out of the UK’s vaccination programme indicates a clearer direction and sense of urgency from the British government.  There is now a path, with the possibility of rapid improvement.

But it would be too much to expect better news to be free of Covid politics.  The European Medicines Agency has gone public with criticism of the UK’s ‘hasty’ approval process.  The extraordinary bluntness says something about Brexit-driven estrangement and the political pressures on the EU. Certainly Dr Fauci in the US moved at lightning speed to qualify reports that he also shared this view. 

He may have been wise to do so.  Approval process delays are hard to justify with 3,000 people dying every day.  

But the row has helped draw attention to the fact that there are likely to be some beneficial outcomes coming out of the epidemic, and perhaps more significant than we might have expected.

Vaccine development seems to have moved to a new level: faster, cheaper and more effective.  We have been reminded of its payoffs for public health, with the likelihood of greater emphasis by public agencies.  And the crisis has demonstrated the costs of lengthy and bureaucratic procedures for medicine and drug approval, giving hope of reappraisal.

Meanwhile, the roll-out of vaccination in the UK, the US and Europe is shaping as a case study in comparative public policy.

Quite apart from uncertainty over vaccine efficacy and debates over vaccination priority, it is unclear how strong anti-vax sentiment will be (if opinion polls are to be believed, more than half of France’s population are not planning to be vaccinated).  This problem may of course diminish.  It will take some months to get through the willing 50%, and that level of vaccination itself ought to have a substantial impact on Covid spread. And if vaccination goes smoothly, some of the worried may get over their fears.  

At the same time, there are voices making an argument for global ‘vaccine fairness’, wanting to put distribution in the hands of a benign global planner like the World Health Organisation.  But in countries which have been at the sharp end of Covid, there seems little appetite for giving others priority for vaccines developed and paid for at home.

The urgency surrounding vaccination may signal that countries like the UK and US are now on a faster track to ‘return to normal’ than some of the more shielded places, like NZ and Australia.  

However, a return to normality – opening borders, restoring business activity to former levels and reining back the growth of debt – challenging as this might be, is unlikely to be sufficient.

The need will be to go beyond normal.  Most obviously, by accommodating changes in economic patterns generated by the crisis.  This means adjusting to loss of traditional activities and embedding productive forces released during the crisis (eg, tech-based ways of working and shopping and faster adoption of medical and biotech innovations). But also by clearing the thickets of the most wasteful and distorting forms of regulation which have proliferated in recent years (aspects of climate policy spring to mind).

Going beyond normal might just prove easier for those countries which have suffered the most profound Covid shocks, if this has tempered expectations on the part of their electorates that the state can turn back the clock and compensate all the losers.

Either way, the outcomes of normalising policy choices will show up in countries’ relative economic growth over the next 5 – 10 years and the consequences of postponing difficult choices will be compounded.

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