I wrote this for the Cleaner Air Collective, who used it as an input to their submission to the Productivity Roundtable
Given the purpose of the exercise, the discussion is framed in terms of productivity though many of the issues are broader
Covid-19 is a serious economic problem for Australia, not only as a major cause of death, but because of serious impacts in productivity.
Although most Covid-19 deaths occur among people over 80, there were over 200 deaths from Covid among people aged 40-64. This is a mortality rate comparable to that of road trauma (377 deaths in this age group in 2022) As of 2023, excess mortality remained high at 5 per cent
With the effective abandonment of most forms of reporting, it is hard to assess the prevalence and impact of Covid-related morbidity. However, there is substantial global evidence of increased worker absenteeism associated with both acute Covid-cases and post-Covid conditions (long Covid). Evidence also suggests cumulative damage to various organs associated with repeated infection.
The economic loss associated with Covid-related work absence and chronic illness is substantial. For example, Goda and Saltas (2023) found that workers with week-long Covid-19 absences are 7 percentage points less likely to be in the labor force one year later compared to otherwise-similar workers who do not miss a week of work for health reasons. Our estimates suggest Covid-19 absences have reduced the U.S. labor force by approximately 500,000 people (0.2 percent of adults). Konishi et al found substantial productivity reductions associated with long Covid.
Long Covid also generates substantial costs for the health system. Rafferty et al give estimates for Canada ranging from $CAD 8-50 billion in annual costs
(Source: Wall Street Journal)
As is now well understood, Covid-19 is an airborne virus. Transmission risk depends on primarily on time spent in environments with high virus loads. However, workplace health and safety policy has not adjusted significantly from the initial phase of the pandemic in which it was assumed that transmission was primarily via droplets. Posters giving advice based on this assumption are still present in many workplaces and other locations.
In the absence of appropriate measures to reduce the risk of Covid-19 transmission, employers are in breach of their legal obligation to maintain a safe working environment. With the abandonment of mask and vaccination requirements, improved air quality is the only practical option for reducing workplace transmission.
The formulation of appropriate ventilation standards is a complex issue, depending on the number of people occupying a given space, the prevalence of Covid-19 among them, and whether people are coming and going. The simplest measures relate to concentrations of CO2 in the indoor atmosphere.
Standards for CO2 concentrations developed prior to the Covid-19 pandemic typically suggested a threshold of 1000ppm. However, the increased danger associated with airborne Covid implies the desirability of a lower threshold.
The Association of Consulting Architects states “Outside air is 400–415 parts per million (ppm) CO2 and a well-ventilated indoor environment will be less than 800 ppm with best practice being around 600 ppm”.
Similarly, Wang et al, responding to evidence of airborne transmission, suggest a range of 700ppm to 800 ppm
In summary, continued endemic transmission of Covid-19 represents a serious threat to productivity in Australia. A sustained policy effort to improve ventilation in workplaces and other public buildings is one of the few remaining policy responses available to mitigate this threat.
John Quiggin 
Agreed, productivity is important and there are also many broader and perhaps even more important issues as well, like public health, protection of the vulnerable and enven the future of our society.
Agreed Covid-19 is “a serious economic problem for Australia, not only as a major cause of death, but because of serious impacts in productivity.”
However, it is sad that we have to come to the conclusion that “A sustained policy effort to improve ventilation in workplaces and other public buildings is one of the few remaining policy responses available to mitigate this threat.”
It very depressing that we all have to feel this way and conclude that this is all we can do and lobby for, if we are to remain realistic and keep our blood pressures down. Has the full set of eminently possible and very desirable policy options been so effectively foreclosed, shut down and denied that we must give up forever on any other enlightened responses? I hope this does not remain the case but it appears as though it is substantially the case at present and likely to remain so for a long time yet
The Deeper Ramifications of COVID-19.
The real and ongoing damage from COVID-19 disease to people, populations and nations is widespread, insidious and almost certain to compound into ever worsening problems over time, without a far greater public health response. We have never seen this pathogen’s like before. It is sui generis: a pathogen in a class by itself and uniquely dangerous to modern societies due its particular characteristics. It is also shows rapid adaptation to exploit our mobility, our connectedness, our ignorance, our greed, our laziness, our economic shibboleths and our obsession with continuing business and recreation as usual in a manner which states “our lifestyle is non-negotiable no matter what its effect is on the natural world including on us”.
How can such a claim be supported? A Google AI overview states:
“SARS-CoV-2, the virus responsible for COVID-19, exhibits several unique characteristics. It causes a respiratory illness, similar to SARS and MERS, with symptoms like fever, cough, and chest discomfort. However, SARS-CoV-2 is distinguished by its rapid and widespread transmission, its ability to cause a loss of taste or smell, and its potential to trigger severe complications like pneumonia and acute respiratory distress syndrome. The virus’s genetic makeup also differs from other coronaviruses, and its ability to mutate rapidly contributes to the emergence of new variants.
Genetic Uniqueness:
SARS-CoV-2 has a unique genetic sequence that distinguishes it from other known coronaviruses.
Mutations and Variants:
The virus has a high mutation rate, leading to the emergence of new variants with potentially altered characteristics, including increased transmissibility or immune evasion.”
It is the full combination of these characteristics which makes SARS-COV2 uniquely dangerous and a unique problem long term if it is permitted continued endemicity. We can go a little further here and point out that SARS-COV2 is in a kind of Goldilocks Zone for both its continued survival and its continued degrading of broad human health and human success as a species. The problem is indeed that serious.
If it had a higher case fatality rate, perhaps considerably higher, including for middle aged and younger people, upon the first infection, then its endemicity would never have been contemplated, let alone be permitted and even facilitated. Instead its fatality rate and obvious damage upon a first infection are low enough, except for old people whose plight can be somewhat ignored, to induce complacency and false feeling of invulnerability. But upon multiple infections (because it evades immunity) the damage slowly increases.
Where is all this leading? That explanation will take another post.
To follow up my above post, this paper, “Neoliberal disease: COVID-19, co-pathogenesis and global health insecurities”, by Matthew Sparke Owain David Williams, is well worth reading. First, the abstract.
“The COVID-19 pandemic has at once exposed, exploited and exacerbated the health-damaging transformations in world order tied to neoliberal globalization. Our central argument is that the same neoliberal plans, policies and practices advanced globally in the name of promoting wealth have proved disastrous in terms of protecting health in the context of the pandemic. To explain why, we point to a combinatory cascade of socio-viral co-pathogenesis that we call neoliberal disease. From the vectors of vulnerability created by unequal and unstable market societies, to the reduced response capacities of market states and health systems, to the constrained ability of official global health security agencies and regulations to offer effective global health governance, we show how the virus has found weaknesses in a market-transformed global body politic that it has used to viral advantage. By thereby turning the inequalities and inadequacies of neoliberal societies and states into global health insecurities the pandemic also raises questions about whether we now face an inflection point when political dis-ease with neoliberal norms will lead to new kinds of post-neoliberal policy-making. We conclude, nevertheless, that the prospects for such political-economic transformation on a global scale remain quite limited despite all the extraordinary damage of neoliberal disease described in the article.”
Here is the link to the paper,
https://journals.sagepub.com/doi/10.1177/0308518X211048905
The authors refer to the “socio-viral co-pathogenesis that we call neoliberal disease”. When it comes to evolution, the authors focus mainly on the virus-like evolution of neoliberal capitalism itself and note its symbiosis, as a co-pathogenesis (for all poor and indeed non-high-wealth people), with the real, novel virus, SARS-CoV2.
They do mention the instantiation or rather perhaps the concrete materialisation of neoliberalism’s viral-like characteristics into a real virus via the blueprints of market fundamentalism. That is if this is a fair characterisation of what they are saying at this point in their argument. I don’t think they go far enough in a certain sense. They pay excess attention, in my view, to neoliberal viral-like “evolution” and insufficient attention to real viral evolution in the symbiotic co-pathogenesis.
Neoliberal prescriptions, for market fundamentalism, for unregulated markets and high-wealth individuals dominating the economic agenda, when blueprinted, promulgated, enforced, propagandised-for and enacted, affected the real viral evolution. SARS-CoV2, with its quite sui generis qualities (which may themselves have come from human lab creation and escape via the inadequate regulation and poor safeguards typical of neoliberalism) exploited (the virus exploited that is) the overall operations of neoliberalism. Neoliberalism itself further “force evolved” the virus and turned it into the insidious and underestimated danger it is today.
The virus found approximately and continues to find more finely, the “Goldilocks zone” of characteristics which best fit it to exploit humans living under neoliberalism and including both neoliberal and not strictly neoliberal conditions of high population density, high mobility, high poverty, low equality, low public health values, low value placed on human life in many classes and demographics (except the lives of the elites).
The viral characteristics thus force-evolved, in the virus growing mediums we may call humans and neoliberal cities, include:
(a) higher transmissibility;
(b) higher immune evasion or immune escape;
(c) higher vaccine escape;
(d) lower or non-excessive lethality permitting longer, expanding chains of transmission;
(e) frequent and even rapid re-infection;
(f) erosion of immune system resistance upon multiple infection;
(g) the transition from walking spreaders in general society to;
(h) hospitalised spreaders in hospital wards (hitting other vulnerable people and medical staff).
The last two points are particularly important. Walking spread selects for high transmissibility and for a walking (still active) spread phase where the infected are physically and socially active. This is person-to-person selection as it were.
Hospitalised incubation of the virus in a patient kept alive on life sup[port when very ill and weak faciliatates inside-the-patient selection and evolution: the battle between internally mutating variants which can then select for more methods for penetrating more organs and tissues. If this variant then jumps to other patients or medical staff and this variant still possesses adequate transmissibility person to person then this hospital-force-evolved evolutionary variant spreads back out into the general population with possibly new, nasty ways to damage more organs.
This is what happens because neoliberal capitalism devalues, in the epidemiological sense, all forms of control of viral spread both pharmaceutical and non-pharmaceutical. Indeed, neoliberalism extols full and endless spread and re-infections involving this virus in the completely false pursuit of immunity which only exists in weak and time-limited form for COVID-19.
When you do things this stupid in a stupid political economy system, the virus easily “out-thinks” you. Evolution is smarter than you are… when you play its game.