It’s becoming clear what the future will be like. We know what we know, we know what we don’t know, and the main features are now coming into focus. It’s going to be a balancing act.
The first thing that we know that is highly unlikely to change soon, is that Covid-19 is endemic, globally. Around two billion people are living in countries reporting significant rates of fatality, and the realities are that under-reporting is almost certain, making this a low side estimate. Sixty five countries make up this infection pool, including several with huge populations and relatively weak infrastructure. These numbers also exclude China. The list of countries range right across the world and most of these populations are far from being vaccinated in the near future, so we can safely assume that the virus is endemic and will remain so for at least years, if not many years.
We also now know that mutations have been, are now, and will be a feature of Covid-19 that we must adjust to. While this virus doesn’t mutate as fast as HIV, for example, it is mutating repeatedly and these mutations must be of concern. Mathematical logic dictates that some mutations will fall in ways that give the virus an edge, and this edge will lead to a greater spread. So far we’ve seen mutations that make the virus more transmissible. We’ve also seen mutations that improve its ability to sidestep antibodies formed by prior infection or immunisation. We’ve not yet seen much definitive evidence of mutations that increase its potency, but it would be foolish to assume that this won’t happen. There are some troubling signs of what may be out there in the future, and some were discussed in the recent BBC podcast: The Real Story.
Enough data are beginning to be collected about the realities of large scale deployment of the vaccines so far developed, and we can begin to understand their effect in the real world. For the foreseeable future, we must assume that mutations will continue, and that these will compromise vaccines, to a greater or lesser extent. Another safe and logical assumption is that continued and continual vaccination will be required for a long time to come. The 2bn people who are subject to high degrees of viral exposure include large numbers who won’t be vaccinated soon, some that don’t want to be or can’t be vaccinated, and some that have been. All will be exposed to mutations, and all will be potential hosts for the creation of new mutations. Only a very big programme of continual vaccination of all these people will break this cycle.
The logical conclusion is that international borders will remain compromised until this cycle is broken.
The actions of the public cause infection to spread and the impact to increase, and that’s true of mutations as well. There is only tenuous influence and control over these two forces. Laws and muscular, intrusive police intervention can control the public, but only up to a point, and we have already seen the beginnings of major dissent as the public grows tired of restrictions. There are limits to what can be done about the Grumbling Public. Likewise, borders can be closed and restrictions imposed, vaccines developed and injected, and these things will control mutations to some extent, but not completely, and it’s not certain when mutations will emerge that get around these controls, or when. Strains of the virus have been identified in places that no apparent links to other pools of the same strain. Grumbling Mutations are here to stay and with only imperfect ways of influencing them.
Acting and reacting
Business and Healthcare are in much the same place as one another. Both have to deal with whatever happens, for good and bad. Both have to do what they can but are more or less passengers, dealing with their responsibilities and opportunities, with much less influence or control than they’d like over events and circumstances caused by the grumbling turmoil between the virus and the public.
Business and Healthcare can gain by having as much insight as they can muster. There is a growing amount of information and data out there, and conclusions can be drawn and reasonable, logical assumptions made. Both should do what they can to improve their chances.
The impossible balancing act in the middle
Executive politicians have the uneviable task of trying to balance the four forces around them, to make compromises in situations where there are only wrong decisions and the judgement is in how to spread the wrongness around.
Insights for decision makers
- Watch the primary actors – these are the Grumbling Mutations and the Grumbling Public. These are the willful actors that are driven by self-interest and can, and do, act in ways that are unpredictable yet can be forseen.
- Sense the balance of events – the situation is essentially predictable while the tug-of-war is in some kind of balance. Things go non-linear when the balance between the muscularity of mutations, and the discontent of the public gains unusual momentum in one direction or the other.
- Take your chances where you can – neither Business nor Healthcare has the kind of direct power to do more than nudge at the margins and pick up gains and opportunities where these occur. Best to get used to that situation
- Hope for continued responsiveness and flexibility in our executive politicians – since they have only incidental influence on the Primary Actors, politicians can only try to anticipate the unpredictable, and react everywhere else. We should hope for continued flexibility and responsiveness in those faced with the blame for everything and the praise for nothing.
Peter is chairman of Flexiion and has a number of other business interests. (c) 2021, Peter Osborn