Coronavirus conference call: Q&A with Professor Michael Barrett - replay

05 May 2020

Following a conference call in February, we were delighted to welcome back Professor Michael Barrett of the Institute of Infection, Immunity and Inflammation at the University of Glasgow. He joined Investec's chief economist, Philip Shaw, to provide an update on the Covid-19 pandemic. Listen to the recording and read the summary below.

Listen to the recording

Michael and Philip provide a timely update around the COVID-19 outbreak. Topics included the economic reaction, returning to work and, perhaps crucuially, the status of various vaccines. 


If you cannot play the podcast above, you can listen to or download it from Iono. 
 
Please note: these podcasts are provided for information purposes only and should not be construed as an offer, or a solicitation of an offer, to buy or sell financial instruments. These podcasts do not constitute a personal recommendation and are not investment advice. The audio is also not for wider media publication.

COVID-19: Rebuilding the workplace for the 'new normal'

Is your business prepared for the new normal in the workplace and beyond?

As the government sets out its phased exit strategy from lockdown, Michael Barrett, professor of biochemical parasitology at the University of Glasgow's Institute of Infection, Immunity, and Inflammation, returns to give an update on how the situation is evolving and how the future of work may look.
 
In his last analysis for Investec in February, Professor Barrett foresaw the coronavirus had the potential to become a global pandemic. He also warned asymptomatic carriers of the virus could aid transmission. Joined by Philip Shaw, chief economist at Investec, they analysed the current shape of the outbreak, the global race to find a vaccine, the economic implications, and suggest what a new normal might look like for Britain's employers and workforce.

The scale of the challenge

The impact of the outbreak has been devastating on victims and their families, while businesses and global supply chains have been disrupted on an unprecedented scale. However, Professor Barrett believes social distancing has been an effective tool in getting the disease under control and preventing an even more damaging scenario.
 
"The lockdown has had a drastic impact on the economy and societies, but it has unambiguously brought the incidence of the disease to a level where, if it can be sustained, according to the laws of epidemiology, it disappears," says Professor Barrett.
 
By suppressing infection levels, the disease's so-called R0 (its rate of reproduction) has dropped below one. This means the virus is transmitted from one person to fewer than one other person. This has two potential outcomes, according to Professor Barrett: extinction or, in this case, endemicity, where the virus keeps infecting people but at nothing like the levels previously seen. Covid-19 could turn into a variant of a common cold in populations over time.
"What seems probable is that we are going to see higher unemployment on top of the number of furloughed workers, which now stands at 6.3 million. Sadly, a number of businesses probably will not make it through the crisis."

The shape of the recovery

On the economics front, analysis has moved from the short-term picture to the longer term. Investec Chief Economist Philip Shaw says while he expects some long-term scarring to the economy, he believes there is reason to be positive.
 
In terms of the depth of the economic contraction, the epicentre in most countries, including the UK, should be the second quarter. In terms of the shape of the recovery, there has been debate around whether the economy is looking at a U-shaped trajectory. However, according to Shaw, this seems unrealistically pessimistic.
 
"We think as the government begins to reopen various sectors, there will be a recovery in the pace of activity. We are looking at a sharp rebound in the economy on the basis that we begin unwinding restrictions, perhaps from late May, early June. Our figures for the third quarter is a rebound of 31%.
 
"What seems probable is that we are going to see higher unemployment on top of the number of furloughed workers, which now stands at 6.3 million. Sadly, a number of businesses probably will not make it through the crisis."
 
This effect will dampen long-term demand, believes Shaw. He envisages a sharp rebound in gross domestic product growth before things begin to slow down. "In terms of the size of the economy, looking at the level of GDP, we do not think we are going to return to where we were at the end of 2019 by the end of next year."
 
"The good news – and this is a positive takeaway from the crisis – is we have seen what industry and entrepreneurs can do when the government is helpful and there is a degree of regulation," says Shaw.

Workspaces for the post-corona age

"Over the coming months, we are going to see some ingenious ways of organising offices to develop systems where we do not risk contaminating each other in the way we have to-date. This means balancing work and health considerations."
 
While the virus outdoors is less problematic, as fresh air breezes diminish the possibility of transmission, indoors remains a potentially dangerous environment until immunity is established. Therefore, Professor Barrett says businesses and engineers need to start thinking creatively about future workflows and workspace design.
 
"People thinking about designing offices in the future and engineers will need to consider whether you can create safer airflows in offices, that will minimise the volume of the virus in the air and diminish contamination.
 
"Airflow is crucial to suppressing the virus. For example, a business could consider getting employees walking around a building in just one direction, having one door to exit by, and one door to enter by. This simple measure will reduce the prevalence of the virus."
 
This is what the professor is currently doing in his Glasgow laboratory, where his team also wear masks and exercise ultra hand and surface hygiene.
 
Professor Barret envisages we may see the reorganisation of offices. This may entail smaller open-plan spaces, but he believes we can adapt.
 
A critical trade-off will be between maintaining distance between employees to protect their health and allowing staff to work closely enough to complete business processes that require closer interaction.
 
"Over the coming months, we are going to see some ingenious ways of organising offices to develop systems where we do not risk contaminating each other in the way we have to-date. This means balancing work and health considerations."
 
He says the evidence is that beyond two metres indoors, gravity will take most viral particles towards the ground and beyond the respiratory tract of the person next to you.
 
A critical trade-off will be between maintaining distance between employees to protect their health and allowing staff to work closely enough to complete business processes that require closer interaction. At what point could we say that the risk of reducing social distancing to one metre is worth taking to ease the impediment to activity? This decision should be based on the level of immunity we have achieved and the R factor.
 
Professor Barrett also advocates the wearing of masks as he says the evidence is extremely strong that somebody who is unknowingly infected, perhaps asymptomatic, will breathe out far fewer viral particles that can get to somebody else if they are wearing a mask.
 
"I know people do not like the idea of wearing masks, and we would not have to wear them forever. We just need to get the incidence of the disease to very low levels to decrease the risk.
 
"Beyond the two-metre social distancing rule or masks, in the workplace, there is a whole gamut of different approaches to suppress the risk of infection. But it is not just keeping a distance from each other that is important. It is keeping a distance from viruses, which one person may be secreting, and anything we can do to diminish that should be considered."

What we have learned so far

  • At the time of writing, cases are at about 3.8 million globally, with more than 250,000 dead. In the UK, nearly 190,000 are infected, with approximately 31,000 dead. The consensus is that the real number of infections is significantly higher, by ten- or twenty-fold, partly because of asymptomatic or weakly-symptomatic people.
  • Numbers are alarming in their volume, but with only 2 or 3 million people infected in the UK, fewer than 10% of the population has been infected and 90% is still susceptible
  • There is high variability in the severity of symptoms. In more than 70% of people, symptoms are a dry cough and fever, which are typical of an upper respiratory tract infection.
  • The virus binds to a receptor called ACE-2, which is present in the respiratory tract and why the disease is associated with respiratory difficulty. However, this receptor exists in other parts of the body, such as the intestine. 

  • The key to symptoms is how the virus interacts with the body and the receptor, which is why we are now discovering a wide range of symptoms.
  • The worst symptoms occur when the body produces a massive inflammatory response to the virus. This can cause multi-organ failure because the immune system overreacts in its response, similar to septic shock.
  • The disease is indiscriminate but more dangerous to those above 70. It is far more threatening for those with comorbidities, such as hypertension and heart disease.
  • There appears to be a strong ethnic component concerning the severity of the disease. Black people, Asian people and other minority ethnic groups have been much more severely affected than Caucasians. This may indicate socioeconomic or genetic factors. There may also be a correlation between vitamin D, which is known to enhance respiratory immunity and which White people tend to have higher amounts of.

The global fight against COVID-19

How near is a vaccine?

  • By taking parts of the agent that causes the disease and exposing the immune system to antigens, we can mount an immune response. When the infectious agent itself comes into the body, we can neutralise the infectious agent because we already have antibodies and immunity against the antigens.
  • The potential vaccines in the news at the moment, such as the one Oxford is developing with AstraZeneca, or the Moderna or Inovio vaccines, all take an antigen from the Covid-19 virus and put it into a different virus, which would express it and enable us to mount a response against the coronavirus antigen.
  • We need to be careful when we use vaccines to produce antibodies, as these can enhance the infection. Antibodies bind to the infectious agent and, once bound, other cells beyond those which the virus normally infects can engulf the virus. If they do not destroy it, the virus can replicate and cause a more severe infection.
  • We have not seen many successful single subunit DNA or RNA vaccines yet. There are no HIV vaccines. Therefore, there are still question marks as to whether any vaccines are going to work. 
  • Efficacy is going to be a problem. In a year or two years, we may find the old fashioned mutated, attenuated virus is the best vaccine.

Track, test, trace, repeat

  • Diagnostics are incredibly crucial in the fight against Covid-19. I have been running one of the lighthouse labs to diagnose people with Covid-19 and infection testing is going to be a significant part of the strategy we use to remove ourselves from the lockdown.
  • Antibody tests have been poor, but Public Health England is currently testing several very promising antibody tests. I am hopeful we will have antibody tests coming out in May.
  • Immunity passports are not assured. The reason is we still do not know how long antibodies are going to last for, and how long we could remain immune to the virus.
  • Governments are looking to the South Korea model. This means testing, tracking, tracing and isolating. An app being tested now will enable us to see whom we have been close to and those infected can self-isolate. 
  • Until we get a vaccine – if we get a vaccine – tracking, tracing and isolating is the optimum solution.

Repurposed existing solutions

  • Other interventions are beginning to come online. Remdesivir, the compound, has been through successful trials now. The drug has been shown to bring the viral load down and enable people to survive but is not a perfect solution. Other antiviral drugs are being evaluated.
  • Chemotherapeutic intervention is also being examined. Due to the link to inflammatory response, there have been trails on anti-inflammatory drugs—for example, Tocilizumab, an anti-interleukin-6 receptor compound which stops inflammation.
  • The government has started recommending people taking vitamin D during the lockdown, primarily because they are not getting enough sunshine. If people start taking vitamin D supplements, we could see fewer serious cases of the disease.

Read more about how the spread of Coronavirus could affect you and your business