Financial Times Europe - 21.03.2020 - 22.03.2020

21 March/22 March 2020 ★ FT Weekend 7

Opinion

3 Britain’s colonial crimes come back to

haunt trade negotiations

It is probable China and India will impose

punitive terms, writesJamil Anderlini

Top reads at FT.com/opinion

3 This could finally be the end of the road

for Netanyahu

Can Benny Gantz and the Arab Joint List

end the deadlock? asksDavid Gardner

Jameel Institute of Disease and Emer-

gency Analytics. An adviser to the

World Health Organization, the World

Bank and sundry governments, he has

been at the scientific coalface of most of

the 21st-century’s disease outbreaks,

from Sars and swine flu to Ebola and the

Zika virus.

All of those pale before the corona-

virus pandemic, however. It poses

what Prof Ferguson has called the most

serious public health threat seen in a

respiratory virus since the 1918 Spanish

flu, which is estimated to have killed at

least 50m people worldwide.

The world now depends on the com-

puter models Prof Ferguson and his

team have developed as never before.

Their task may seem overwhelming

but Prof Wheater at Oxford says one

thing is worth bearing in mind. “If I

trust anybody’s calculations I trust

Neil’s,” he says. “He’s a very careful, very

solid person.”

[email protected]

As the Daily Telegraphreported at the

time, it was “the first time that epidemi-

ologists have modelled a major epi-

demic as it unfolds, then intervened to

change its course”.

“It was really Neil’s innovative think-

ing on the computational side of it

that made that possible,” says Deirdre

Hollingsworth, an Oxford university

epidemiologist who worked with Prof

Ferguson at Imperial.

In recognition of the role his work

played in helping to contain the out-

break, the father of one was awarded an

Order of the British Empire in 2002. He

stayed at Imperial, where he now heads

several research groups, including the

By the late 1980s he was at Oxford

university where he seemed destined to

become a physicist. He gained a first

class degree in physics and then a PhD

where he looked at aspects of a quantum

theory of gravity.

“He was one of the best graduate stu-

dents I’ve ever had,” said his doctoral

supervisor, John Wheater. “He is a very

smart guy.” One day, according to Prof

Wheater, his student came to him with

news. “He said, ‘John, I’ve decided I’m

not smart enough to carry on as a theo-

retical particle physicist’.” Instead, he

had decided to apply his modelling

skills to real-world problems by going

into mathematical biology.

He was soon working for one of the

top scientists in the field, Roy Anderson,

who took his team of infectious disease

experts from Oxford to Imperial College

in late 2000. Within months they were

called in to help UK officials grappling

with a devastating foot-and-mouth dis-

ease outbreak that would prove to be a

turning point in Prof Ferguson’s career.

L

ast Tuesday an email landed

in Neil Ferguson’s inbox from

his boss, Alice Gast, the presi-

dent at Imperial College Lon-

don. She had two things to say

to Prof Ferguson, an influential epide-

miologistwhose work ad just beenh

credited with helping to upendcorona-

virus response strategies n each side ofo

the Atlantic: thank you for everything

you’re doing and try to get some rest.

His initial response was typical, Prof

Gast said. “He asked me to write again to

his whole team with a message he could

forward... He’s a very collegial aca-

demic.” Then he said something star-

tling. “He told me he had a dry cough.”

That was a classic coronavirus symp-

tom. So was the high fever Prof Ferguson

soon developed. By Wednesday morn-

ing he was tweeting that he felt“a bit

grotty” s he hunkered down for sevena

days of isolation in his central London

flat. A test confirmed he had been

infected by the virus he was modelling.

It was sobering news from the bespec-

tacled 51-year-old, one of the first global

experts to warn at the start of this year

that the outbreak in the Chinese city of

Wuhan could beworse than reported

figures suggested. Since then, he and his

team at Imperial have had a more dra-

matic impact, not least at home in the

UK where he has been advising govern-

ment on the outbreak for weeks.

Britain has been slower than other

European countries toclose schools,

ban sporting matches or take other,

drastic steps to suppress infections.

Instead it has taken a less socially dis-

ruptive path of trying to slow but not

stop the spread of the virus, partly in the

hope that this wouldbuild up “herd

immunity” nd avoid more outbreaksa

in the future.

But this so-called mitigation strategy

was abruptly junked this week after

modelling in a study o-authored byc

Prof Ferguson suggested it could lead to

the deaths of250,000 people n the UKi

and up to 1.2m in the US. “Suppression

is the only viable strategy at the current

time,” the paper grimly concluded.

By Monday, when the research was

publicly released, UK Prime Minister

Boris Johnson hadbegun to tell

people o avoid crowded places andt

non-essential travel. White House offi-

cials cited the British study the same

day, as they unveiled similar measures.

Imperial College’s global reputation

for infectious disease modelling exper-

tise was one reason the research had

such an impact. Prof Ferguson’s reputa-

tion was another, says Andrea Crisanti,

an infections expert at the college who

has been working tocontain the virus in

Italy. “He is very well recognised as one

of the most influential scientists in the

field of epidemiology and modelling,”

says Prof Crisanti.

Yet it was not immediately obvious

that Prof Ferguson would ever enter

the field of disease control. Born in

England’s picturesque Lake District,

he grew up in the middle of Wales

where he went to Llanidloes High

School. His father was an educational

psychologist and his mother a librarian

who became an Anglican priest.

Person in the news Neil Ferguson|

A virus modeller

sounds the alarm

The epidemiologist and

his team revealed the

UK’s ‘mitigation’ strategy

could cost 250,000 lives,

writes ilita ClarkP

‘If I trust anybody’s

calculations I trust Neil’s.

He’s a very careful,

very solid person’

I

t’s really quiet,” said the proprietor

of Oxford’s best falafel stall when

I popped over to buy lunch on

Monday. It is even quieter now.

Meanwhile, my wife emailed

friends to ask if we could help: both of

them are doctors and they have three

children and a parent undergoing treat-

ment for cancer. “Thanks. We will be in

touch,” came the reply. No time for

more. It may be quiet for the falafel

man, but not for them.

There, in miniature, is the economic

problem that thecoronavirus pandemic

has caused, even in its early stages. For

everyone who is overworked, someone

else has little to do but wait. The super-

markets have struggled to meet a rush

of demand for some goods, but that

should pass. “We are not going to run

out of food, so chill,” Yossi Sheffi tells

me. He’s an MIT professor and an

authority on supply chains.

While the pressure on the super-

markets may ease, the strain on the

healthcare system will not. It is already

intense and will get much worse. Yet

while clinicians are overstretched,

others wonder when the next job is com-

ing from.

From the falafel seller to the celebrity

chef, the hotel porter to the millionaire

motivational speaker, many tens of mil-

lions of people around the world are fit

and eager to work,yet unable to. This is

a test of flexibility and imagination.

Gourmet restaurants are shifting to

takeaway service; conference speakers

are building portable studios.

Best of all is when we find ways to turn

idle resources into weapons in the fight

against the virus. It is hard not to cheer

when reading tales of distillers turning

their stills to the task ofproducing hand

sanitiser, or hoteliers offering their

empty rooms to doctors and nurses.

But it is a much tougher task, for

example, to make more urgently

needed ventilators.

In the mid-20th century, William

Morris, a man who made his fortune

manufacturing British cars, turned his

workshops to the task of producing

“iron lungs” for people paralysed by

polio. It’s an inspiring precedent for his

successors at Meggitt, McLaren and Nis-

sanscrambling to emulate him y build-b

ing ventilators to use in the current cri-

sis, but it took time.

Prof heffi reckons that it would beS

straightforward for, say, an automobile

parts supplier to retool in a matter of

months, and having many thousands

of extra ventilators by the autumn

would certainly be better than nothing.

But to produce complex equipment

from scratch in weeks, perhaps using

3D printing, would be a miraculous

achievement even if regulations are

loosened, as they should be.

Yet harder is to find more nurses and

doctors; intensive care units do not

operate themselves. And even for less

specialist staff, the task is larger than it

might seem because of what the late

Thomas Schelling, a Nobel laureate

economist, called “the acceleration

principle”.

Let’s say that Europe has 10m hospital

orderlies, with an annual turnover of 30

per cent. That means 3m need to be

trained each year, 1mat a time on a four-

month training course. Now let us aim

to expand gently to 11m over the next

four months. It doesn’t sound much —

just a 10 per cent increase. Yet the train-

ing programme must double in scale to

accommodate it, because now 2m

rather than 1m orderlies are enrolled in

the same four-month window.

The same logic applies to anything we

need more of, from the personal protec-

tive equipment that is in desperately

short supply in our hospitals, to the

internet bandwidth hat we will all bet

using more of, while working from

home.

The task, then, is immense. But

we must try. Under any conceivable

scenario, we would not regret trying to

expand emergency medical care several

times over. If it is impossible, so be it.

But if it is merely expensive and diff-

icult, such costs are trivial compared to

the costs of suspending everyday life for

weeks or months.

And there is some hope: efforts are

already under way to persuade doctors

and nurses who have retired or switched

careers to return, and to put medical

students to work at once.

We could quickly train new medical

support staff to perform focused and

limited roles. I can only imagine the

breadth of the skills needed to be an

intensive care nurse, but if we cannot

have more experienced nurses with

complex skills, let us at least support

them with people who can quickly be

trained to change an oxygen tank or

turn a patient in bed.

Even those apparently ill-suited to

intensive care duty — the 75-year-old

retired doctor, the community volun-

teer with first aid training, or evenfur-

loughed airline crews —could indirectly

support health systems. While medical

professionals staff the wards, I would

gladly pay taxes to fund online advice

from a retired doctor, a virus test

administered by an air steward, or

stitches and bandages from a St John

Ambulance volunteer.

Killing two birds with one stone never

sounded easy to me. But there is no

excuse now not to be radical. This crisis

is a test of many things. Not least among

them is our capacity to adapt.

[email protected]

Find ways to turn idle

resources to better use

We could quickly train

new medical support staff

to perform focused

and limited roles

Tim

Harford

The undercover

economist

P

olicymakers everywhere now

understand no country is

immune from coronavirus.

The response in industrial

countries, which finally

seems to correspond to the size of the

challenge, is tocontain the virus’

spread, limit the massive disruption to

households and businesses and position

the economy best for an eventual recov-

ery. As peopledistance themselves

physically, and business activity slows,

governments are stepping up to fill the

gaps. This is as it should be.

With large deficits, high leverage, and

little monetary policy room left after

their response to the global financial cri-

sis, industrial countries did not start in a

good position. Yet their strong adminis-

trative machinery, capable medical

establishments and substantial wealth

will allow themto do what it takes.

Spare a thought, then, for countries

who do not have the national capacity or

time to respond. Iran, Italy, and Spain

did not react quickly or forcefully

enough and nowtheir medical systems

are overwhelmed. With every country

looking inward, there are few with

resources to spare. The virus is yet to test

densely populated developing countries

such as Nigeria and Bangladesh.

Borders o not offer cast-iron protec-d

tion. Countries that seemed to have con-

trolled the virus are seeing clusters of

infection re-emerge, sometimes from

visitors. So, pending a cure or a reliable

vaccine, the world needs to fight the

virus into submission everywhere in

order to relax measures anywhere.

Since this is necessarily a global war,

we need to organise the production of

basic weaponry — testing kits, cleansing

chemicals, masks, protective clothing,

ventilators — across the world. All regu-

lar private-sector capacity is probably

already fully dedicated to production.

The private sector would create new

capacity if it saw the demand was large

(even if temporary) and backed by real

money. Here, there are opportunities.

The World Health Organization, for

example, could work with national

health systems, especially in developing

countries, to quickly estimate the medi-

cal equipment needed to mount a suc-

cessful response. The World Bank and

the African Development Bank could

swiftly organise a global fund, partly

through loans and partly through grants

from donors and foundations in rich

countries. They could help developing

countries float global tenders, especially

for more sophisticated equipment that

cannot be manufactured domestically.

All countries could nudge capable

goods manufacturers to shift capacity

towards medical goods production on

an emergency basis. Speed is of the

essence here, and ordinary bureaucratic

practice will be too slow.

Any fight will require trained front-

line medical personnel. Many develop-

ing countries have far fewer doctors per

head than Italy, and few industrial coun-

tries will have personnel to spare before

the virus is contained at home. Again,

global co-operation can be valuable.

Countries can share best practices

and the few, spare, experienced medical

personnel can be directed to countries

of greatest need. While they may find it

hard to leave their practices, it may be

possible for them to help overstretched

systems for a few hours a day, using

communications technology and local

assistants. The virus is already expand-

ing use of telemedicine domestically. Big

technology companies could help set up

the infrastructure.Google’s balloon

project as used to provide emergencyw

network connectivity in Puerto Rico

after Hurricane Maria.

Ideally, countries would have to fight

on only one front: the pandemic. Almost

surely, though, emerging markets and

developing countries will bepressured

by capital outflows as the dollar

strengthens, commodity exports fall in

value, and the easy money that flowed

in over the past decade leaves. Unlike

industrial countries that have access to

dollar swaps facilities with the US Fed-

eral Reserve, these countries will have

to go tothe IMF for dollar liquidity.

The IMF has reiterated its willingness

to put its $1tn lending capacity to work.

It shouldencourage and respond to

requests for its flexible credit line, pre-

cautionary liquidity line and rapid

credit facility (targeted at low-income

countries). If the fund’s resources prove

insufficient, proposals to channel

liquidity from reserve currency central

banks to the needy, while taking on the

credit risk, will have to be dusted off.

Another front is trade. The restric-

tions on exports of medical supplies that

countries are implementing are under-

standable politically but counter-pro-

ductive. Reasonable rules of conduct

are required. The trade warsthat have

proliferated ver the past few years areo

an impediment to post-virus growth,

especially in poor countries. China and

the US could support sentiment by roll-

ing back the tariffs they have imposed

on each other, and agreeing to a stand-

still on trade and investment measures

until a full-blown recovery is under way.

All of this requires strong global lead-

ership to organise, cajole, and persuade.

The US, the natural leader of the G7, has

not been a fan of multilateral action,

while the G20 president, Saudi Arabia,

seems otherwise preoccupied. The fight

will be won or lost on the issue of leader-

ship. Hopefully, the urgency of the

moment will produce the global

resource that is in the shortest supply.

The writer is rofessor of finance at thep

Chicago Booth School of Business and

author of ‘The Third Pillar’

Rich countries cannot win the war alone

Raghuram

Rajan

FT series

Coronavirus: the economic cure

MARCH 21 2020 Section:Features Time: 3/202020/ - 18:10 User:alistair.hayes Page Name:COMMENT USA, Part,Page,Edition:USA , 7, 1