Authors:
Reiner Eichenberger (University of Fribourg), Rainer Hegselmann (Frankfurt School of Finance & Management), David A. Savage (University of Newcastle), David Stadelmann (University of Bayreuth), and Benno Torgler (Queensland University of Technology).
The current COVID-19 pandemic is unfolding not only as a biological event but also a public health disaster, and it is imperative understanding the impacts from both economic and societal perspectives [1].
The corona crisis was triggered by a specific severity profile: the combination of very serious symptoms with a high reproduction rate of the virus. Clinics need urgent supplies of scarce resources such as ventilators and specialist medical teams to properly treat patients. Thus, hospitals risk being overwhelmed by critical cases requiring triage. If the virus had encountered a medical system equipped with the resources necessary to cope (which will be available in rich countries in a few months), there would not have been a crisis. Its direct health consequences would probably have been more like a severe or pandemic influenza epidemic which may ultimately still be the case [2]. At present, however, these resources are not yet in place and we are living in a state of emergency with unprecedented travel restrictions and lockdowns to contain the spread. These measures serve to avoid triage situations, however they can quickly lead to enormous and lasting economic and social devastation with further dramatic impacts on general health services. Besides psychological impacts due to quarantine [3] and other damages, there will be many deaths due to economic deprivation (in some countries lives will be lost due to starvation) and many lost years of life.
As the disease spreads, the crucial resource for overcoming the crisis is growing: people with immunity to SARS-CoV2. This vital resource must be searched for, it must be found, it must be certified, it must be employed effectively, and it may even be actively produced [4]. Immune individuals may be the most important resource in the fight against the coronavirus, as even partial immunity would allow them to return to normal economic employment and social activity. They could also work directly with health support infrastructure, but must be certain of immunity, and must be distinguishable from the non-immune. Thus, the need for a reliable immunity certificate or passport. Like other valuable resources, people immune from the novel coronavirus must be searched for, requiring broad tests not only for the illness but also for antibodies. Testing for antibodies will find previously infected people who were asymptomatic and are already immune. Immunity certificates will help find such individuals, as there are significant incentives for returning to normal economic and social activities. Healthy people who may have been infected in the past might recall past symptoms (e.g., mild indications of the disease such as sore throat, or loss of smell and taste), as cooperation with authorities is rewarded by receiving the certificate. Finally, like other resources, immunity may be actively produced as individuals may want to seek immunity voluntarily (under medical supervision) through self-infection, particularly for cohorts with lower potential risks of a severe consequence.
The above described tasks are not a health but a management problem, which is solvable by mobilizing public and private organizations (companies) alike. Companies routinely manufacture and deliver day-to-day products that are far more complex. If such a strategy leads people to actively seek out infection in an attempt to get back to normality, this is an indication of how bad the current situation has become and that the resource of immunity is extremely valuable. The costs of increasing, for example, the number of tests is substantially lower than the economic damages that are occurring. From a legal and moral philosophical perspective, not allowing immune people to move freely immediately is problematic as it prevents them from helping to reduce the burden of the crisis.
Pandemics and the reactions to pandemics exacerbate the general problem of scarcity that always exists in society. Understanding immunity as resource not only from a health but also from a societal and economic perspective opens new pathways of combatting the crisis. It would provide a realistic and gradual withdrawal out of the lock-down. Only if immunity is not possible would the value of such resource would be zero. But if that is the case, people will constantly be infected and some of the infected will die. Shockingly, deaths due to the virus would eventually be seen by society as “normal” deaths, in line with other diseases that we experience in today’s world.
References
[1] Snowden, F. M. (2019). Epidemics and Society: From the Black Death to the Present. Yale University Press.
[2] Fauci, A. S.; Lane, H. C. & Redfield, R. R. (2020), 'Covid-19 — Navigating the Uncharted', New England Journal of Medicine 382(13), 1268-1269.
[3] Brooks, S. K., Webster, R. K., Smith, L. E. .Woodland, L., Wessely, S., Greenberg, N., Rubin G. J. (2020). The Psychological Impact of Quarantine and How to Reduce It: Rapid Review of the Evidence, Lancet. 395: 912-920.
[4] Eichenberger, R.; Hegselmann, R.; Savage D.; Stadelmann, D. & Torgler, B. (2020). 'Certified Corona-Immunity as a Resource and Strategy to Cope with Pandemic Costs', Kyklos, forthcoming, DOI: 10.1111/kykl.12227, open access, see https://onlinelibrary.wiley.com/doi/abs/10.1111/kykl.12227
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