Longevity Bulletin – the coronavirus issue

Covid-19

In this blog, Matthew Edwards, Editor of the Longevity Bulletin, discusses the many facets of the pandemic and the challenge of drawing conclusions during a global crisis that is still ongoing.

One of the most important characteristics of viruses is their propensity to mutate, and thereby survive from year to year in gradually different forms. Looking back over this year, the pandemic situation has itself seemed to be constantly mutating (irrespective of the mutations of the SARS-CoV-2 virus).

In March, it was a nascent pandemic that could be modelled with classical ‘susceptible – exposed – infected – recovered’ techniques, at which point it became clear that the potential mortality impact could be (approximately) a doubling of typical annual deaths. By April, with lockdown under way across most of Europe and the worst-affected Asian countries, the situation had become more one of impending economic catastrophe (the UK, for instance, saw a GPD shock in the second quarter of around 20%).

By May, attention was shifting to multifactorial analysis – what risk factors were important, over and above age and sex? Was ethnicity an important factor, and if so was the risk more to do with severe infection, or subsequent death, or both? What did these analyses tell us about how policy responses could move from blanket lockdowns to more focused restrictions?

In summer, attention moved to the role of masks, and whether they helped to reduce spread. Here the debate seemed to founder on a misunderstanding of the precautionary principle, whereby new drugs are assumed potentially harmful until proven safe – an assumption of guilt until innocence is proven (hence the extensive testing being applied to candidate vaccines). Countries that followed this approach, waiting months for evidence to emerge about the efficacy and safety of masks, therefore missed months of benefit – and all in a context where early response is vital.

As lockdowns were loosened, we then had more thinking about behavioural science: how could people be persuaded to be suitably prudent about social distancing, for instance, while seeking to get the economy moving again?

And then another month, another mutation of the main concerns – in September, ‘long Covid’ emerged as a major worry, with many survivors of Covid-19 being left ‘scarred for life’ with residual cardiological, respiratory and mental health problems. We also started to understand the increased risk from ‘normal’ causes of death due to reduced access to health services throughout lockdown (a problem in many countries).

Most recently, the challenge has shifted again, this time to that of vaccine roll-out – what is the most efficient prioritisation? Here we can consider efficiency using what we know about risk factors, but also with regard to the importance of reviving the economy, and thinking about the behavioural aspects – how best to convince people of the safety of vaccination?

The above comments are intentionally simplistic in presenting events as if laid out sequentially, but it highlights how many facets there are in this catastrophe, where (somewhat paradoxically) ‘classical’ pandemic risk modelling seems to be one of the least discussed aspects – partly because of widespread distrust of the models.

This coronavirus issue of the Longevity Bulletin seeks to cover many of the key topics, while deliberately avoiding those that are most sensitive to timeliness. We look at second waves, the prospects for a deadly winter, the impact of deferred medical treatments, and what we know so far about ‘long Covid’, among other aspects. One of the main ways actuaries can add value is thinking practically about the longer-term impacts, and we pay particular attention to these – with the economic and mental health consequences likely to exact a heavy toll.

I hope you find this edition useful in thinking about many of these problems, and we would welcome your thoughts on what we can most usefully cover in the next issue. Please email any suggestions to journals@actuaries.org.uk.