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Transcript: Episode 44

How do we build pandemic resilience?

Vivienne Parry  0:03  
Hello and welcome to another episode of Coronavirus. The whole story, the award winning podcast all about the pandemic as told from the perspective of UCL staff and students. My name is Vivienne Parry. I'm a writer broadcaster and UCL alumna, and each week, I've been sitting down with members of the UCL community to hear about their research and the incredible impact it's having in the fight against Coronavirus. Now in almost every episode, our guests whether they be health experts, educationalist or economists have talked about the extraordinary impact of COVID not just now in the lockdown moment, but well into the future. So today we're talking cheerfully about what are the existential global health threats might be on the cards and discussing pandemic resilience? What is it? And how are we going to get it not just for the UK, but for the whole world. I'm joined today by Professor Richard Blundell, a Professor of Political Economy and director of the esrc Centre for the micro economic analysis of public policy. Richard with the British Academy has just published the COVID decade, a report on understanding the long term societal impacts of COVID-19 and also joined by Julia Kreienkamp, a researcher at the UCL Global Governance Institute, working on the Horizon 2020 project, Global Governance and the European Union future trends and scenarios. Julia's research focuses on the global governance of human rights, health and climate change, and how we think about existential global risks. So I want to talk to you both about what we need to do next to help mitigate the long term harms of Coronavirus and indeed future pandemics. So perhaps we should begin by establishing what exactly it is we need to mitigate against, apart from obviously, all of this madness, Richard, you just publish this report about the COVID decade? What are the long term impacts of the pandemic going to be?

Richard Blundell  2:05  
Yes, I was part of the the set of authors that put together the report for the British Academy on the COVID decade, which looks at the long term impacts of COVID, as you said, in a holistic way on society, my expertise really is around the part that considered the impact on knowledge, employment, and skills. And that's what I've been looking at in my own work as well, in particular, to dig a bit deeper into what's happened, and what are the challenges going forward in terms of the inequalities in education skills, and incomes, and pick on the challenges which are certainly severe and interconnected. And as you said, a future pandemic could could open these up again, if we don't do something to build resilience. So it's important to understand what's happening now, and how it's likely to impact these things going forward over the next years, we also see a good reason now to make the most of the opportunities there require a kind of integrated policy response across society and across governments are kind of joined up response if you want. So if I pick on the three key challenges that I see, in relation to the work I described, going forward, there are there are kind of three there that are sitting there that really highlight and they're not short term things, these are things that will take some time. The first I think, is kind of clear cut, and that's on education - on education, inequality, or children, as we know, have missed out on learnings. But this has been much worse for children from poor families. And already we were having a stall in our move towards increasing social mobility. And this is just holding that even further back is you may have no surveys that we did and others during lockdown. And continuing showed the lack of access to digital technology is a key reason why children from lower socio economic groups were unable to access remedial tuition quite a contrast from children from better off families, in particular children from private schools where they were accessing normal learning up to 74% of the time, about half that for state schools and a quarter of all pupils had no access to any learning are quite extraordinary, really, and quite an extraordinary loss.

Vivienne Parry  4:34  
And actually, this pandemic couldn't have happened at a worse time because we hadn't really come out of the financial crisis.

Richard Blundell  4:42  
Yep, that's right. You know, what happened to inequalities generally, that grew out of the financial crisis and the period of austerity that happened after that has really hit. Younger people. People with lower age. And what we're seeing here is that those kinds of families and the children in them have been hit yet again, with loss of education. And indeed, as they come out of school, if you're thinking of the kind of teenagers now who are looking to go into the labour market, and those who already actually trying to look for work in the labour market, those with lower education qualifications, are doing much, much poorer in terms of access to apprenticeships, there's a large reduction in overall training and the sectoral nature of this COVID shot means that young people have been particularly hard hit in the labour market.

Vivienne Parry  5:43  
Yes, because they have no jobs, for instance, in the hospitality industry, which is traditionally the first step for younger people.

Richard Blundell  5:49  
Exactly.

Vivienne Parry  5:50  
And you're saying that it could last a decade. I mean, we've seen the impact of the financial crisis last decade, why a decade for this, and could it in fact, be longer.

Richard Blundell  6:01  
One thing we all note in economics about recessions is what we call a scarring effect. That is an that can last a hugely long time, we see scarring effects, much later in people's working life from when they entered the labour market, if they entered it during a severe recession, like we had, indeed, in the early 80s, in the early 90s. And again, in 2008, those are all panning out over a long time, this one has rather different effects. And they could be more severe, because the worst thing that can happen is that you lose out on your investment, let's say, as an economist would say, in human capital, when you're young, whether it be your mental health, the education you're getting, right the way through your schooling, years. And in particular, as you move into the labour market, the skills that you're developing there, that's where you make the big gains in a way that lasts with you for the rest of your working life and indeed, your healthy life. And those are the things that are really been hit in a way that we didn't see ever before, in a recession, because we haven't seen this severe loss of education and access to education that's happened in this recession, and in a very unequal way. As I pointed out,

Vivienne Parry  7:27  
I can't believe these words are coming out of my mouth. But Julia, what about the next pandemic? It's too old to contemplate, I mean, but let's start actually, what the risk is that there will be another pandemic, I'm guessing 100%?

Julia Kreienkamp  7:43  
Well, so I think it's important that we think about pandemic risk in the context of much wider challenges and how they develop and that includes climate change, biodiversity loss, but also poverty and of course, inequality. And as Richard has also said, all these risks are really deeply interlinked. And climate change and mass biodiversity loss is really massively increasing the health risks and the pandemic risks that we face at the moment. So COVID-19, of course, has put the spotlight on zoonotic diseases, so the kind of infectious diseases that jump from animals to humans, and we have seen an increase of these diseases in recent decades. And in fact, the kind of epidemics that we would have heard of Zika Ebola, SARS, MERS, it's a long list that have all been zoonotic diseases. And this is partly due to agricultural intensification. So the fact that animals are confined in a small space able to pass on diseases between themselves and to humans, easily the destruction of ecosystems that force wild animals out of their natural habitats, and closer into human settlements, the illegal trafficking of animals, the consumption of bushmeat, and also a warmer climate that helps viruses and virus transmitted to travel further. And of course, also, the increasing global interconnectedness that helps humans to travel further and spread viruses like COVID-19 incredibly fast.

Vivienne Parry  9:12  
I must admit, I was thinking about the next pandemic when I saw those plagues of mice in Australia, because when there have been plagues of rodents, and this is something that happens as a natural phenomenon, you get outbreaks of things like hantavirus, which mice and other rodents are the hosts. And so I was just thinking, oh my god, there's another pandemic ready to start right there.

Julia Kreienkamp  9:35  
The picture of course, isn't a terribly rosy one. I think what we want to do is not necessarily prevent surprises as much as build resilience to these health risks that we face and of course trying to keep outbreaks to small scale to epidemics if we can and prevent global spread. Do you think it's also important to say and just that beyond pandemics and infectious diseases, the health risks that we face from environmental destruction and climate change are even much, much broader. And it's estimated that about a quarter of the Global Burden of Disease stems from environment related risks. So that's quite a lot. And that includes not just those notic diseases that I've talked about, but it also includes health problems linked to malnutrition, pollution, extreme weather events, mental health, and so on. And many of these problems would then be an underlying risk factor for future pandemics. And of course, not everyone is equally affected by these risks. So these risks are also really as symmetrically distributed across the globe, but also within countries.

Vivienne Parry  10:48  
So as I said, we're thinking 100% chance of another pandemic. So we do need to make ourselves more pandemic resilient. I mean, this is something that we've had to do before, Richard, what happened after the 1918 flu pandemic?

Richard Blundell  11:08  
Yes, that well, in a way, we were less connected to society in those times, but it was very severe. The problem we're looking back at the flu epidemic, then was there were so many other things going on, it's very difficult to unpick it from the recovery after the First World War, and a number of other events. But clearly, what's happened now is that, you know, the effects of imposing social distancing, and people actually been scared, to become very close, has had these big impacts on, as we said, on learning on the economy, you could kind of see them in that point. But I think we can really see them happening. And now in a way, although we're more connected, I think there are opportunities here to, you know, I mentioned kind of digital world, we could be much more prepared for having to deal with social distancing, that might have to run for months or whatever in the future if we had better access to digital technology. And I think that's making us rethink what that means. It's not just a matter of rolling out broadband, it's all the things that have now been really accentuated, that have caused the difficulties, it's about space, it's about access to the right kind of devices, and the right kind of environment, you can't learn if you're in a crowded environment, you can't work from home if you're in a crowded environment, even if your job allows you to. So I think there will be there should be I'm pretty sure there will be a rethink of the way we organise our world of work and learning that does provide some opportunities there to be build more resilience in the future. And at the same time deal with some of these problems that have been sitting there for a long time. You know, it's not that we've had particularly good outcomes for for those poor families, as Julia said, in many, many aspects of their life, certainly in in education and labour market. And we can try and learn from this and do something, there are opportunities here. In other words, to perhaps address some of the bigger problems at the same time as making us more resilient, perhaps, you know, the way we organise our work could be good in a number of ways. But it's very challenging. Of course,

Vivienne Parry  13:32  
there are certainly a number of opportunities to and the phrases obviously build back better. But I wonder whether we will actually do that because these things fade into memory. really far too quickly, I suspect, because we think about getting ourselves back. And we don't then do the kind of preventive and resilience things that we need, either with infrastructure, for instance, global production for vaccines, or stocks of things like, pp, all those kind of things, which require quite a lot of upfront investment. Do you think that we will talk big but act small? Julia?

Julia Kreienkamp  14:17  
Yes, I share your concerns, of course. And I have to say on a personal level, I have my optimistic days and I have my pessimistic days from an environmental perspective. Of course, there have been many calls to build back better and greener. And there have been there have been real commitments to this as well. But if you look at the actual investment and the subsidies, there's still a lot of unconditional fossil fuel subsidies in the G 24 shore that have been promised or they have been paid. So there is definitely a problem here between what is being promised and what actually happens, but I think there are also reasons to be optimistic think COVID-19 really has brought home what systemic disruption looks like and the climate crisis of course looks it looks very different but i think it still has been a really radical reminder that there are hard limits to business as usual and as richard has said it presents a lot of opportunities to do things differently although that will be difficult and really complex

Vivienne Parry  15:26  
richard are you optimistic about us genuinely addressing resilience or do you think as i suspect we both suspect that things will just slip

Richard Blundell  15:38  
it's a great question you have to be optimistic in this world but i think it's good to be looking with caution our ability really to adjust and and our willingness in the political circles to adjust these are all things that take a long time to get returns and the political cycle of course is it's much shorter than that and maybe people's memories are even shorter and we haven't of course had a great recent history in fixing things that say went wrong during the recent recession so investment levels have been very low but on the other hand you know when you get something as big as this as julia mentioned you can kind of hit a tipping point and i think you may see some of that so when i talked about what's happened with digital learning and all of that then almost surely we've edited tipping point in that sense will surely change the way we work and of course that's something that requires coordination you know one company alone can't say oh let all my workers who want to spend two days at home and three days at work but it requires coordination both within the company and across companies that's a complicated thing to do but if you're forced to do it then of course it can happen in a coordinated way and everyone's better off otherwise you're in a prisoner's dilemma you know no one individual no one group is willing or has an incentive really to make the change i guess you can see that in climate change you can see a tipping point in moving towards say electric vehicles that could have happened many many times but there is a point of which if you can tip everyone to coordinate round that then of course it's easier for any individual to do it as well so there are optimistic things around that but at the same time they they often kind of highlight really problematic things in in society so we might move to digital learning but if we don't do that in a careful way that could be even worse for poorer families remember you know when you look at families and the new inequality the inequality of space and green space that was something we hardly worried about at least in economics before but now it's it's you know it's front and centre because if you try and work or learn at home in a difficult environment that's worse so that exaggerates the differences and we know that it's the educated and professionals and those on higher incomes who are in jobs where they're able to work at home and they have the space and what have you so you can see kind of variety of things going wrong in terms of the way we might want to reduce inequalities and reduce poverty so we have to do this in a kind of clever way and a way that really understands that by the way that's you know that was the idea of the british academy report to kind of think about how could we do things that is good for overall society where we do have concerns about left behind people left behind areas and the poor and certain types of people in occupation so there's a variety of things you can be optimistic about but you don't want to do it in a way that produces even more left behind generations and areas than we have already

Vivienne Parry  19:00  
and that's the issue isn't it julia that for instance let's say we said that we weren't going to travel as much because now obviously that has a major impact on climate change but if we take mass travel away then actually those who are the poorest are the ones who are not able to have holidays because they become too expensive so it becomes ever more unequal

Julia Kreienkamp  19:28  
yes absolutely i think we have learned partly through COVID that equality really is central to resilience and it will be central to really all the major risks that we will face over the coming decades and i also completely agree with richards point about complexities and unintended consequences and that is maybe even more important or even even clearer when it comes to our interventions in the in the climate and in the natural world we actually still don't understand nature Systems terribly well, neither do we understand social systems necessarily terribly well. Yeah,

Vivienne Parry  20:06  
I'm in the consequences, for example of everybody working at home is far more vans on the road, because we're having deliveries, I mean, even, I guess when we will get out of this, we shop more I suspect the trend for online is going to continue to grow. And actually, that has a huge impact. And people being at home means they're not in a city centres. So all those small businesses that rely on city centre trade, everything from you know, the dry cleaner to the little coffee shop, they're all going to go because there's no, there's no more business there.

Richard Blundell  20:43  
That's why I think you're right not to be over optimistic on some of these things, I think there will be still plenty of office work going on in the centre of towns, but the high street and some of those businesses are really going to, and the travel world more generally, is going to have to change quite rapidly, you can see the idea of kind of local learning and work hubs, you know, that could be one way of organising life where you don't go to work in the centre of town, you go to a local hub, which has quiet space and access for you to do your learning, or you're working. And that can be closer to home, but avoiding some of the problems of having crowded environment.

Vivienne Parry  21:27  
I want to move now to the changes, you know, the concrete changes we really need to make to get us into a state of pandemic resilience. Notice, Julia, what changes do we need to make?

Julia Kreienkamp  21:42  
So there is I think it's important to keep in mind that there isn't a magic bullet for this. And we will probably need to see many solutions and experiments on many different levels. But there are a real number of things that we need to increase pandemic and environmental resilience. So that starts with better early warning systems and better transparency, better global collaborative systems. And from the environmental perspective, also a change of mindset, I think that really sees us as part of these natural systems and not somehow magically outside of them, and maybe also appreciating more or the benefits that we derive from intact ecosystems, including many health benefits. So that's a benefits that are currently not reflected, for example, in many economic metrics that we use, such as GDP. So that could be a question Do do we find a way to put value on these benefits, there are some exciting, more concrete things that bring together the climate change and the biodiversity crisis that I think have really taken off in recent years. And there are a number of frameworks that can help us work with nature, rather than against it. So these are so called nature based solutions, or one health approaches that kind of start with the premise that we have to address the health of the planet, the health of animals and the health of humans together. But again, we have to be aware of unintended consequences. So for example, planting trees is not actually that easy. We have to understand how forests really work. If we have a monoculture forests that we're planting that might actually not be terribly good for neither biodiversity, nor the climate, nor human health. And of course, rather than starting to plant loads of new trees, we really want to preserve the old grown forests that we have. So there is actually a lot of stuff going on a lot of people thinking about how can we concretely put solutions in place that work with nature, and also work with people to increase human health and wellbeing? Richard, let

Vivienne Parry  23:53  
me challenge you as the economist here with the need for a different kind of economic metric one that includes the value of green spaces, for example, yeah, I,

Richard Blundell  24:07  
I've always thought that's an important thing, in a way, whether you think there's a single metric or not, there are plenty of people trying to come up with a single metric that includes everything and moves us away from GDP. I think certainly in our work, we've never really paid too much attention to GDP. We do worry about individuals, incomes and real spending power, of course, but we also worry about their mental health, their health, and their general well being and their happiness with their world of work. And most recently, and actually, in this report, we're looking for thinking of building an economy and our social support system that looks at all those things. And really, I think, you know, in designing social policy, we certainly have to move away from Single metrics like GDP GDP, of course, doesn't even reflect anything about inequality, let alone all the dimensions of health and well being that we clearly worry about here. So I think it's already obviously a kind of rather poor measure to get gather anything by nonetheless, you know, people, as you know, when growth hits zero, everybody starts worrying, because what they worry about really is that some people are hit very badly if their incomes are not growing. And I think the way I look at this is that we need to rethink the world of work, and the world of social support in a realistic way, that gives people a world of work that's kind of adaptable to change, and reflects the kind of changes that Julia was mentioning. So that we have people who are skilled in technologies that are directed towards green changes that are likely to happen, that's something we need to work on. And we provide, you know, the right kind of background to on things like social care. So work, work in social care is both something that we know is skilled, but it's not really reflected in the skills, we know, you can get a kind of level three qualification in, in social care. But that whole area of care, and health at the bottom has very poor career profiles. And it's really shown up as you as you know, in this pandemic, so I think there's a kind of world of work in a world of training, that's really important. And we can rethink that. And that may be good for overall GDP, by the way, in fact, I think it would be like looking at GDP on its own, of course, wouldn't tell you anything about what's going wrong. In particular, areas like that, and an individual's well being, I think, as well as that, you know, we we have to worry about how we deal with the social safety net, you know, the pandemics, you know, shine a bright light at all the holes in our social safety net. In fact, within a couple of months, the government had to completely reinvent the social safety net, we didn't have a furlough system before, we didn't have the level of that kind of support. And so when you find people on more moderate incomes, falling into out of work or losing their jobs, our Social Security system is very poorly adapted to that, in fact, pretty much worse than any other one in in Europe. And we had to adapt very quickly. So I think one of the big questions will be, you know, what do we do coming out of that? Do we Institute something more like a social insurance furlough system that you might find in Scandinavia or Germany? What do we do about sickness benefit, there are lots of people who are now in the current economy weren't eligible for sickness benefit, and we need to rethink that kind of thing. And so there's a whole set of issues that have come up, all of which would happen in any kind of pandemic. And I think building this resilience, there is kind of exciting, we're thinking, you know, is it time for a new beverage, which really rethinks the way we support people in work and out of work, and through their careers, through a kind of new way of looking at the world of work, kind of good jobs, jobs that provide good progression, group group profiles, as much as possible.

Vivienne Parry  28:28  
So we're really thinking of resilience of individuals, we're thinking resilience of society, one of the things that where you get that from is from a community spirit. And actually, that seems to have increased during COVID, which is good, but I'm just going to ask you now as we finish to each, and bearing in mind what you said, Julie, about no silver bullets, what would be the first thing you would do in order to help us develop resilience?

Julia Kreienkamp  28:57  
I think the good news is that we have so many synergies here. So everything we do to enhance environmental resilience. And I think I would really start here on the community level, as you just said, making local communities greener is something that can actually be quite exciting. Every everything we do in that regard helps us increase health, resilience, and societal resilience. And everything we do to increase societal resilience, including better social safety nets, and so on, will help us deal with the climate and environmental challenges in the future. But I think we also need good state level incentive structural framework. So resilience starts at the personal level. It's important at the community level, but we really, really need good governmental structures. And ultimately, we also need a global level effort, because pandemics do not care for borders, and neither do most environmental risks. One thing from you, Richard?

Richard Blundell  29:57  
Yeah, I would say let's look at the world. To work again a little more and think about how to design our training our apprenticeships and our education system to produce jobs that we're going to call good jobs, and have good career profiles, and that are resilient also to kind of changes in the kind of world of work that we've seen. I think we know how to do that. And we've learned a lot, very, very rapidly through this. But I think that's going to be absolutely key. And in fact, what we've often called a good jobs welfare state is a kind of good thing to be thinking of if we want to think about a new beverage, but it certainly requires coordination. As Dooley said, you know, this is a community state individuals alone whether the individual workers or individual firms are just not going to make these changes. And so there is room for a kind of coordinated action around that which of course, was exactly what the beverage report originally instituted and developed in British society.

Vivienne Parry  31:02  
Thank you both so much. You've been listening to Coronavirus: the whole story. This episode was presented by myself Vivienne Parry produced by UCL with support from the UCL health of the public and to UCL grand challenges and edited by the splendid Cerys Bradley. I was joined today by Professor Richard Blundell and Julia Kreienkamp. If you would like to hear more of these podcasts from UCL Minds. Subscribe wherever you download your podcasts, or visit ucl.ac.uk forward slash Coronavirus. This podcast is brought to you by UCL Minds bringing together UCL knowledge, insights and expertise through events, digital content, and activities open to everyone. Hope to see you again soon. Bye for now.