What does our path to exit from COVID-19 look like, and when can we get back to business?

While we get settled into life in a COVID-19 world some are already getting restless understandably so, and some, and especially business people, are trying to think through how long this will last, what happens next and when, and what they can plan towards in getting back to business.

There are three possible scenarios to exit this thing. How we eventually exit will be either a combination of these, or specific routes within them. So think of this article as a main highway guide. The side-streets, short-cuts, lane markings and traffic signals will evolve as we go. 

Some of these side-streets will apply in only specific geo-defined areas or regions (i.e. across a state, a defined region or city). Some side-streets may open at a particular time and close again later. These details will only emerge as we progress over the coming weeks and months. No-body has all these answers yet.

First the three scenarios:

The first scenario is Waiting for a Vaccine

A vaccine would mean that we all (or most of us) become instantly immune to the disease and we can all go on with life as normal or any new normal that may emerge.

What are the risks

• Well the first risk is making sure we have enough people taking it. There could be some reluctance, particularly if it is new, or seen to be rushed to market. Some of us are old enough to remember the occasional misfiring of early medicines that created awful deformities in kids and other issues.
• And that brings me to the second risk….that it works. That is obviously a risk. There are things that aren't known about this virus but there are people much smarter than me working on this. And our regulations on new drugs are very sound. However it is possible that any vaccine may last only a short period and not be foolproof, just like a flu shot.
• The speed of manufacturer of any discovery and the speed of inoculation of 25M Australians, or perhaps 60-70% of us will be a timing risk.

When can this happen

• Highly enthusiastic optimists seem to be saying 6 months is possible. Hopeful realists are saying 12-18 months is more likely. But there are no guarantees. If we take an optimistic planning assumption of around March 2021, then depending on manufacturing and supply challenges (every nation will want this vaccine) there may be a further delay to get it on shore. Then we have to inoculate 60-70% of Aussies. So best case around May-June 2021.

How could it work

• It could be one or several different types of vaccine that emerge and are made available free of charge, and for all Australians to book in for a shot. Higher risk Australian may get priority. 
• I'd expect it would take at least 2-3 months to rollout across enough of the population. If 50% of Australia's 50,000 GPs do 20 shots a day for 20 days a month we'd get there in two months. That takes us to May 2021, at best.

In Summary

Our domestic economy can't wait until May/June 2021. No nation could stay half shut down until then. Some things will need to open earlier. So this isn't a realistic path for most businesses to plan against. Plus there is no guarantee a vaccine will ever be found, let alone in a defined timeframe. There is no vaccine for any coronavirus, for AIDS, and for many conditions. Yes, there are massive rewards for success here but it doesn’t guarantee it.

More concerning for international travel, tourism, international events and conferences, this is likely to be what they need before things get anywhere near being back to normal.

The second scenario is Generating Herd Immunity

This is where there are sufficient volumes of infection and recoveries where there are enough people in the community that are immune to the disease. Hence it becomes very hard for the disease to transfer from person to person because enough people cannot be carriers. Epidemiologists seem to believe that it would take at least 60% of Australians to have got the disease and recovered to achieve this. They can't say for sure, because like many things about COVID-19, they are still learning. This is effectively the same scenario as a Vaccine. With a Vaccine, we build herd immunity via an injection. In this case, we build it by getting sick and then immune.

What are the risks

• If we let people get sick, then some people will die from it. How many we don’t really know. Our death rate seems to be around 1% (allowing for the lag in deaths v cases). We haven't been through winter with this disease so death rates could increase. Not necessarily because COVID-19 is more potent, but getting it on top of other cold/flu conditions makes it worse. That is what I am being told.
• And remember that just because people don’t die doesn’t mean they are not damaged. The advice I hear is that survivors from bad bouts of this disease may have damaged lung function in the same way that pneumonia damages lungs. So the personal and health cost goes well beyond the death rate and will extend into the decades to come.
• By following this path as quickly as we can and letting people get sick to the virus, the virus may get out of control and we end up killing a lot more people.
• This scenario could expose our country to the ethical dilemma of who lives and who dies because we run out of health facilities. We have avoided this to-date and we should avoid (in my opinion) putting any of our fellow Australians in a position where these ethical choices need to be made.
• There are treatment options that may emerge and some are being trialed. This may reduce the death rate, but doesn't change our pathways out. We still run the risk of people getting this, getting sick, dying or damaging themselves.
• The vast majority of our health system is now dedicated to this one disease. There will be a time when this will have increasing impacts on our health in other areas. Elective surgery isn't just about face-lifts. There will be a lot of non-urgent procedures on hold. How long can we do that before there are other emerging consequences?

When can this happen

• It has taken us 4 weeks to get ~3,000 recovered. At that rate, to get to 60% recoveries across Australia, it would take 450 years. This is a ridiculous proposition.
• If we assume the rate of infection is higher than proven through testing then this will hasten this path, but with a 2% positive rate on our testing and some of the highest testing rates in the world, Australia is unlikely to have the rate of undetected cases that other countries have had.
• If we allow our daily case rate to go to a steady state 3,000 cases per day, then we should be able to stay within our health treatment capability. At this rate of infection it would take 15 years and we would likely kill 165k Australians or 11,000 per year (based on the estimates above). 

How could it work

• We try and control the spread within manageable levels. Which means that restrictions continue and are moderated based on the rate of spread of the virus. 
• So things don’t go back to normal until we reach 60%+ immunity….in this case ~15 years.

In Summary

This scenario just isn't realistic. Whichever way you look at this scenario, there is no good choices here. 

The third scenario is Achieve Zero Cases

Is that possible? Potentially, or at least close to it, particularly in a specific region. Once we have zero active cases then we have no chance of contagion and we can open up businesses again. Although not without risk.

What are the risks

• Sealing the borders around any region would be critical to avoid importing cases into these areas. South Australia and Queensland are being talked about. Whether they do this on a state basis, or they try and isolate specific regions within states is probably something being looked at. But we are a big country with a lot of space between populations so this seems possible.
• While we may have zero known cases in an area it doesn’t mean zero cases. There is always a chance of undetected cases in the community. And we know there are asymptomatic cases out there. 
• Contact tracing is being done very diligently and effectively in Australia but does rely on the contacts providing reliable information. Hence it is an imperfect science. Improvements in tracking will allow us to detect potential contacts and new cases more rapidly. 
• We could try to statistically sample the population to assess infection rate (inclusive of hidden and asymptomatic cases), but there is likely to be challenges compelling people to provide samples to get a statistically reliable result, so this may not happen. An alternate sampling design may also cater to this restriction.

When can this happen

• My "guess" would be that we will start to see some relaxation of some rules in specific regions in Australia within the next 1-2 months. It would vary markedly around Australia. There will be planning, risk assessments and modelling underway right now, looking at alternatives and how it might occur.
• They will need to plan how they continuously monitor and how to take back any relaxation, imposing fresh restrictions, should they need to. They will want to plan their measurements of this, to learn as much as they can, so they can repeat it in other regions. And they don’t want any fresh outbreak to get away from them. So this approach would need time to plan, especially the first region.
• If this could start within 1-2 months, then how long will it last. It will probably need to last until we have a vaccine or build herd immunity.

How would it work

• Some data they already have is on how effective the various policy settings were (social distancing, pub closures, personal services closures, work at home etc). They saw how these policies impacted as they scaled up the response. This is a benefit of incrementally introducing restrictions. They got to measure what worked to what extent, at least to some degree.
• They also have extensive contact tracing data on ~6,000 in Australia, plus the potential of getting this data from overseas. This provides insights into the how the virus is being transferred and what situations create the least and most risk. That amazing German story about "passing the salt shaker" in a work canteen recently is a case in point. That one gesture was the source of a particular outbreak there.
• So I would expect in these defined regions, they may allow some restaurants or cafes to open, maybe some personal services to open (Beauty Salons, Hairdressers, Gyms etc), some social activities to resume. But there may be strict protocols on them. And compliance may be monitored. It is possible that short-term regulatory changes may come into play (if needed) so that authorities could immediately shutdown non-compliant businesses/organisations.
• Judicious testing, quarantining and monitoring of any cases would be critical, and winding back up on restrictions may occur at any time.

In Summary

This is the most likely and most realistic scenario for most business in Australia. In reality it isn't one scenario, it is many scenarios full of the side-streets and traffic signals I mentioned earlier. And Governments are already giving signs in Australia that this is what they will adopt, we just don’t know where or when or what it might look like. Understandably, they may not know yet, there is a lot to work through here and without any guide book to show the way.

While these are the only three scenarios we have available, they are not mutually exclusive. As soon as we find a vaccine things could accelerate quicker. And ultimately for things to get back to normal a vaccine may be the only option we have.

If anyone has another scenario I'd be happy to hear it, but I suspect it will be some combination or variant to one of the above.

Applying this to your Business

If your business is impacted then considering three things will be important to determining when you get back to work:

Where is your business?

What is the case load in the area where you operate? If your area is in a high outbreak area, particularly high in Unknown Contact cases then stay patient, it may be a while. If your state and region is approaching no or negligible cases then you may be in with a chance to re-open to some degree in the future. 

I'd expect they may want to see no cases for at least two weeks before they start relaxing. So keep an eye on the stats in the state and region where your business operates. And stay in touch with your local political and policy representatives to stay on the radar of what is happening.

What does your business do?

What type of business do you operate? If you pass the location hurdle above, then next consider what business you are in. If your business requires high touch, high contact for long periods with lots of people then they are less likely to re-open quickly. If you can reduce the people and lower the contact then that will help. It may require some service redesign.

Any mass gatherings, events where groups come together, classroom training etc. would not occur for some time. One-on-one services may be ok but there may be restrictions. I see that Dr surgeries and supermarkets have plastic screens for receptionists and check out operators now. For example, you may still get your nails done, but maybe they install screen and restrictions on numbers and spacing in the shop.  Even if it's not required, steps like these may help build traffic anyway. We are moving towards a new normal, at least in the short-term.

Some counter services have remained open (eg. banks, social services) and they have implemented distancing and hygiene methods.  This could be replicated in other environments.

Who are your clients? 

For B2B business, if your main clients are in areas not re-opening because of the above two points then that aint good for you either. So you'll need to consider your ecosystem. And if they do open, immediate restart, cash flow and profitability will be priorities. So if you are helping that then great. If not, you may need to be patient. 

For B2C, if you have clients in the high risk cohort (over 60/70 or pre-existing conditions) then even if you re-open your clients may not re-emerge until a vaccine is available. So even if you can operate, those clients may not come back straight away. Plus it is likely that high-risk groups may still be encouraged to self-isolate even if an area partially re-opens.

Different Types of Businesses

• If you are a smaller, niche business, then you will be able to restart or not, perhaps under some restrictions using the guide above. Hopefully I've provided some ways of thinking about your circumstances.
• If you have multiple elements to your business then some parts may be able to restart and some not. For example, your restaurant may open, with defined spacing between tables, but no bar service. Your classroom training or seminars or shop may be restricted in numbers and spacing required. Golf and boating and fishing may be allowed but only in groups of two and appropriate spacing. Gyms may be able to re-open but only for 1-1 or small group personal training and restrictions on overall numbers.   Office environments may open but there may be guidelines on numbers. We'll all be working this out as we go. I would talk to your industry group about this.
• If you have multiple regions in which you operate then some of those may open and others not. The way they open may even be different depending on what the localised rules are. I'm not saying this will happen but it may. So there will be a need to be adaptable to these different conditions.

International perspectives

International travel

For businesses relying on international people movement, it is the hardest for you unless you can change the way you deliver. And if you can change delivery method you probably already have (eg. education moving to online classes). This won't be possible for some.  International travel may open up selectively. So for instance, if both Aus and NZ move towards zero cases then traffic between our counties may re-open. 

Maybe this won't require 14 day isolation, but it may require a negative test within the preceding 48 hrs (for example), and perhaps a followup test upon landing also. This is where the certificates type model is being proposed here and internationally. It is possible that this may happen over the next 3 months….perhaps, but I may be optimistic there.

We may open to other countries at some point on a similar basis. Early candidates could be Singapore, Taiwan and Japan. But I can't see wholesale border openings occurring for some time and perhaps not until a vaccine is rolled out to the Australian community.

International trade

As China has demonstrated, once they get their factories back up and running then international trade can also follow. There is no reason why trade in products and services cannot continue provided people movement doesn’t occur with it.

But how each country deals with this and comes out the other side may be different. There are some estimates that say that up to 40% of the Spanish population are or have been infected. If this is correct this is approaching the 60%+, which is believed to be sufficient to bring about a level of herd immunity. So for some countries or states their pathways out may be different to ours, and their timing may also be different.

Opportunities also

Already technology organisations are seeing the opportunities with large scale adoption of remote work, and the supporting increase in software and subscriptions for remote work, plus purchasing of home and mobile office equipment. This increase in demand is in contrast to the interruption to global supply chains as a result of the virus creating a slowing in supply. Also, many organisations have halted forward investment which has impacted many B2B industries including the technology sector.

Domestic manufacturing capability is being discussed as there is fresh consideration of what "strategic" means in our critical supply chains. This could, and perhaps already is, bringing opportunities for local manufacturing. The order in which other countries come back on stream could create opportunities in some areas.

There will be many more opportunities and some may be determined by the speed and order with which different parts of the world emerge from this pandemic. But that is beyond the scope of this article and is something for the coming weeks.

How is technology helping

Digital technology is helping many businesses continue to operate remote workforces and remote delivery of services to products. Without it, the shock to the economy would be even greater than it is.

Digital technology is also used extensively in health services. Every IT team in every health and essential service organisations is doing everything they can to ensure stability and scale-ability of those services. Plus some selective improvements are occurring. For example, we know of (and have been involved in) some targeted software releases specific to improving contact tracing capabilities.  

New digital technology solutions are also being considered to increase tracking of citizens. Apple and Google are collaborating already on this. Yes, there will be privacy concerns, but if I am able to get instant notification that I was within 2 metres of a contact who is now a confirmed COVID-19 case, then I would value that. And if that can rapidly close down any outbreaks that occur then surely this is worth some short-term privacy sacrifices while we get through this.

Why this article

My professional passion is about helping organisations thrive and survive in whatever conditions they face. Digital technology is my tools of trade in that. It provides a lot more capability for any organisation to adapt, adopt and excel.  But any digital technology investment has to start with the business and the business problem at hand and help solve that business problem. This is how many of my colleagues in Information Professionals Group thinks about #digitaltechnology. As I gravitate toward the wholistic view, today that means considering when business conditions change and what that might look like when they do. Digital Technology will help but will always be supportive of that.

Plus, my wife is in the high-risk cohort. For some time now we have established protocols at home for how we manage our way through this. Our objective is simple. She does not get infected. So we are working out how we continue to live our lives and not put everything on hold as we move through this. We know we are not alone in achieving that.

I hope this helps . Please reach out on any specific questions and I'll do my best to consider them.