We can exploit the way the virus develops in people, opening activity for four days, closing it for ten, and repeating the cycle, writes Eran Yashi

Yashiv, Eran

English

LSE Research Online

A	cyclical	strategy	to	manage	COVID-19,	save	livesand	avoid	economic	ruinOn	September	22,	2020,	in	a	forum	jointly	hosted	by	the	CBI	and	the	LSE,	my	co-author	Ron	Milo,	from	Israel’sWeizmann	Institute	of	Science,	and	I	presented	a	strategy	to	return	to	work	in	COVID-19	times	in	a	way	that	willimprove	both	health	and	economic	outcomes.	In	this	article	I	present	the	“big	picture”	and	the	possibility	ofimplementing	this	at	the	firm	or	institution	level.This	is	particularly	pertinent	now,	when	a	second	COVID-19	wave	is	manifest	in	the	UK	and	other	countries,	andwhen	second	lockdowns	are	being	imposed.The	FT	runs	a	highly	informative	website	with	a	chart	of	new	daily	deaths	per	million	people.	The	second	wave	inEurope	is	apparent	while	the	U.S.	has	not	really	“flattened	the	curve”	on	its	first	wave.	The	appropriate	policyresponse	is	now	the	topic	of	debate,	dominating	news	everywhere.	Before	the	second	lockdown,	countries	havebeen	taking	stronger	and	stronger	measures,	but	most	of	them	did	not	seem	to	work.	A	major	problem	is	that	mostcountries	have	been	unable	to	actually	implement	effective	and	refined	measures	and	are	now	at	loss	as	to	what	todo.As	a	way	out	I	propose	that	governments	think	in	terms	of	time	restrictions	rather	than	populations	or	sectorrestrictions.	I	discuss	an	approach	that	keeps	the	epidemic	under	control,	avoids	economic	ruin,	and,	in	doing	so,lessens	some	harsh	tradeoffs.	Importantly,	the	proposed	strategy	is	fair,	does	not	single	out	specific	populations,and	engenders	predictability	and	stability.	It	also	has	the	unique	advantage	of	a	record	of	successfulimplementation	in	recent	months,	at	the	company	and	institution	level.Let	me	first	briefly	reiterate	four	main	lessons	from	this	year’s	dismal	experience.	One	is	that	the	possibleresolutions	to	this	pandemic	are	either	going	for	herd	immunity,	which	implies	a	heavy	death	toll	and	may	not	lastlong,	or	waiting	for	a	vaccine,	whose	arrival	rate	and	efficacy	are	not	yet	clear.	All	countries	have	effectively	optedfor	the	latter	route.The	second	lesson	is	that	there	is	a	basic,	harsh	trade-off:	do	strict	public	health	policy,	such	as	lockdown,	and	yousave	lives	and	lighten	the	burden	on	the	health	system,	but	ruin	the	economy.	Do	not	do	any	of	that,	and	deaths	willspiral	and	hospitals	will	crumble.LSE Business Review: A cyclical strategy to manage COVID-19, save lives and avoid economic ruin Page 1 of 3		Date originally posted: 2020-11-03Permalink: https://blogs.lse.ac.uk/businessreview/2020/11/03/a-cyclical-strategy-to-manage-covid-19-save-lives-and-avoid-economic-ruin/Blog homepage: https://blogs.lse.ac.uk/businessreview/The	third	is	that	there	is	scope	for	refined	or	targeted	measures,	going	beyond	a	coarse,	“blanket”	lockdown,	tolessen	the	trade-off.	Indeed,	no	European	country	has	yet	instituted	a	full,	second	lockdown.	The	policy	game	to	beplayed	is	to	do	something	effective	while	waiting	for	the	arrival	of	a	vaccine.	The	latter	is	likely	to	happen	gradually,with	fits	and	starts,	in	the	course	of	2021.The	fourth	is	that	in	practice	there	has	been	a	large	diversity	of	government	reactions	and	choices	regarding	thistrade-off	across	the	world.	Therefore,	there	have	been	very	different	outcomes	across	countries.	Relatedly,	innumerous	places,	politicians	have	proved	inadequate	in	the	face	of	a	once-in-a-century	pandemic.The	current	problem	is	that	measures	undertaken	thus	far	have	often	had	limited	success.	In	particular,	a	majorform	of	targeted	policy	–	an	efficient	trace	and	track	system	−		has	often	failed.	Few	countries	have	managed	itpractically,	Germany	being	a	notable	exception,	and	most	are	struggling	to	establish	a	workable	system.	Thesesystems	have	had	only	marginal	impacts	on	reducing	the	spread	of	coronavirus.Another	important	policy,	targeting	particular	towns	or	regions,	has	proved	to	be	difficult	too.	Restrictive	measuresin	different	regions,	such	as	the	Northern	parts	of	England,	have	failed	to	stem	the	rise	of	the	epidemic.		Social	andpolitical	forces	offer	resistance	to	any	measures	differentially	targeting	populations	or	sectors.I	suggest	that	a	viable	alternative	exists	in	the	form	of	time	restrictions	rather	than	population	or	sector	restrictions.One	such	scheme,	was	proposed	by	Uri	Alon	and	Ron	Milo,	from	Israel’s	Weizmann	Institute	of	Science,	and	meback	in	April-May;	see	FT	Op	Ed	on	21	April	“How	to	Reopen	Society	More	Quickly,”	and	NYT	Op	Ed	on	11	May“10-4:	How	to	Reopen	the	Economy	by	Exploiting	the	Coronavirus’s	Weak	Spot.”The	idea	is	to	exploit	the	way	coronavirus	develops	in	human	beings	to	open	our	societies	for	four	days	out	of	every14.	Most	infected	people	are	non-infectious	for	the	first	three	days	after	infection	and	are	at	peak	infectiousness	atdays	4-7.	So	a	14-day	cycle,	that	sees	people	go	to	work	for	four	days	and	then	be	locked	down	for	ten,	wouldminimise	the	spread	of	the	disease.	Most	of	those	infected	during	workdays	would	reach	maximum	infectiousnessduring	lockdown,	reducing	the	spread.	The	plan	has	the	added	advantage	that	it	can	be	implemented	at	thenational,	regional,	city,	company,	or	institutional	levels.	This	idea	builds	on	epidemiological	features	and	can	also	beimplemented	by	dividing	the	relevant	population	into	two	halves,	each	working	4	days	on	alternate	weeks.This	plan	has	some	very	attractive	features.It	is	fair.	All	populations	are	included	and	no	age	group,	sector,	region,	or	ethnic	group	is	singled-out.	It	is	multi-levelled.It	can	be	implemented	at	the	national,	regional,	city,	company,	or	institutional	levels.It	engenders	predictability	and	confidence.	In	places	where	variants	of	it	have	been	implemented,	infection	rateswere	low	and	confidence	was	re-instated.	For	example,	the	ophthalmology	section	of	a	hospital	system	in	LosAngeles	implemented	a	similar	plan	and	achieved	exactly	that.It	is	flexible.	One	can	allow	for	various	configurations,	such	as	5	days	of	work	and	9	days	of	lockdown,	then	6	daysof	work	and	8	days	of	lockdown	etc.,	adjusting	the	plan	following	actual	experience.It	actually	works.	Ever	since	the	FT	and	NYT	publications	we	have	seen	widespread	interest	in	this	plan,	fromschools,	universities,	companies,	and	various	towns,	globally.	Notably,	the	Austrian	school	system	did	a	version	ofthe	plan	starting	mid-May	and	the	global	company	Mastercard	has	been	successfully	implementing	it	since	June,	indozens	of	offices	around	the	world	with	thousands	of	employees.		The	plan	has	proved	to	be	very	workable,infection	rates	are	low,	and	its	implementation	is	relatively	straightforward.It	has	very	good	economic	AND	health	implications.	Examination	of	this	plan	in	a	series	of	academic	papersfound	substantial	benefits,	both	in	terms	of	health	outcomes	(reduced	infections	and	deaths,	and	a	lighter	burdenon	the	health	system),	and	in	terms	of	significantly	reducing	economic	loss.This	is	not	some	kind	of	miracle	solution.	The	underlying	rationale	is	partial	opening	and	partial	lockdown	tobring	down	average	R,	the	reproduction	parameter.	While	not	guaranteed,	R	may	even	decline	to	below	1.	Hence	itoffers	some	control	of	the	epidemic	while	allowing	for	economic	activity,	albeit	at	reduced	levels.LSE Business Review: A cyclical strategy to manage COVID-19, save lives and avoid economic ruin Page 2 of 3		Date originally posted: 2020-11-03Permalink: https://blogs.lse.ac.uk/businessreview/2020/11/03/a-cyclical-strategy-to-manage-covid-19-save-lives-and-avoid-economic-ruin/Blog homepage: https://blogs.lse.ac.uk/businessreview/This	is	a	call	for	realistic	and	constructive	action	–	to	save	lives	and	avoid	economic	ruin.	In	face	of	a	second	wave,the	time	is	now.♣♣♣Notes:This	blog	post	expresses	the	views	of	its	author(s),	not	the	position	of	LSE	Business	Review	or	the	LondonSchool	of	Economics.Featured	image	by	Joe	Green	on	UnsplashWhen	you	leave	a	comment,	you’re	agreeing	to	our	Comment	PolicyEran	Yashiv	is	a	research	fellow	at	the	Centre	for	Macroeconomics	at	LSE	and	a	professor	ofeconomics	at	Tel	Aviv	University.	E-mail:	e.yashiv@lse.ac.uk			LSE Business Review: A cyclical strategy to manage COVID-19, save lives and avoid economic ruin Page 3 of 3		Date originally posted: 2020-11-03Permalink: https://blogs.lse.ac.uk/businessreview/2020/11/03/a-cyclical-strategy-to-manage-covid-19-save-lives-and-avoid-economic-ruin/Blog homepage: https://blogs.lse.ac.uk/businessreview/

A cyclical strategy to manage COVID-19, save lives and avoid economic ruin

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A cyclical strategy to manage COVID-19, save lives and avoid economic ruin

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