Helena Bonham Carter as the Red Queen in Tim Burton’s 2010 adaptation of Alice in Wonderland. Source: YouTube
The world is at a critical inflection point in summer 2022. Russia’s war in Ukraine and the ravages of the pandemic over the last couple of years have triggered and sustained worldwide economic stresses. On top of this, there is not inconsiderable uncertainty over the best way to deal with sub-variants of the novel coronavirus being able to escape vaccine-induced immunity.
Last week, BioNTech chief executive Uğur Şahin told Financial Times that it could take three months to go from selecting a strain to mass-producing vaccines targeted at new sub-variants. Meanwhile, the number of COVID-19 cases is rising in countries around the world.
This Red Queen challenge manifests itself through evolutionary biology and in the economics of pharmaceutical innovation. Public health expert Anthony Fauci has also highlighted it, in the context of the evolution of antibiotic-resistance among certain bacterial strains.
The idea comes from the Red Queen in Lewis Carroll’s 1872 book, Through the Looking-Glass, and What Alice Found There. The Red Queen says to Alice that “it takes all the running you can do to keep in the same place. If you want to get somewhere else, you must run at least twice as fast as that!”
This should sound familiar to those trying to keep pace with the emergence of new strains of the novel coronavirus.
It also creates a rather pesky source of market failure for social planners – because incentives and regulation to fast-track biopharmaceuticals and vaccine innovation are fraught with more uncertainty than usual. At one end, private firms may take advantage of the situation and could try to push through market-suboptimal extensions, arguing also for fast-track regulatory approval. At the other end, social planners will struggle to mitigate the imbalance between producer and consumer welfare, with inadequate clinical trials and post-launch data on effectiveness and safety.
That said, there are some solutions to this challenge – in the race for securing our immunity against the novel coronavirus.
First, antiviral drugs like Paxlovid will need to be further tested and extended to normalise COVID-19 treatment at an early stage of the detection. Second, the time is ripe to pursue a ‘universal coronavirus vaccine’. Early efforts on this began in 2020 but we may still be at least a year away from a testable version. And then there will be distortions in access and availability between the rich and poor world.
Third, we must increase the uptake of seasonal doses of existing vaccines, such as by developing nasal-spray versions, and ideally over the counter at more accessible prices. Last, with long COVID-19 still stressing our workforce, and future variants continuing to pose risks for labour markets, organisations must take their lessons from the last couple of years, when their staff worked from home, and adopt more empathetic workforce policies. Forcing people to return to work in-person, like Tesla tried recently, is out of place.
If we don’t take these measures quickly, the negative spillover effects of the COVID-19 pandemic – beyond the stagflationary decade that the World Bank has said is coming – will only become worse, and 2020s may well become the lost decade.
Even Alice wouldn’t have wanted that as she prepared for her Red Queen challenge.