In recent days, I have been seeing an increasing number of op-eds making the following argument: 1. Because we are not yet able to test widely, we don’t really know how many cases of COVID-19 are out there. There are certainly more cases than have been reported 2. Of the cases that have not been reported, most are likely to have been mild. 3. Therefore, the estimates of the global hospitalization rate and mortality rate for COVID-19 are probably lower than the estimates that were reported early on during the outbreak (hospitalization rate 15-20%, mortality rate 3.4%). 4. As a result, there is a lot of uncertainty about how many people will be hospitalized and how many will die from COVID-19. 5. We know that large scale countermeasures such as lockdowns, shelter-in-place orders and social distancing will have dire economic consequences. 6. Therefore, we should hold off on implementing further measures and roll-back existing measures to preserve the economy until we get more information.
Superficially, this sounds like a reasonable argument, but upon closer examination it has serious flaws.
Why? No serious scientist or doctor who understands epidemiology would dispute points 1-5. But the jump to point 6 is a massive leap!
Notice that we could make the exact same type of argument in FAVOR of countermeasures.
1. Because the current situation is unprecedented due to the scale of the pandemic and the severity of the measures that governments are taking, we don’t really know the extent of the economic harm people are experiencing and will continue to experience. 2. There is a lot of uncertainty about how many people will lose their jobs and how much the economy will be impacted by COVID-19 and any countermeasures. 3. We know that that large-scale countermeasures such as lockdowns, shelter-in-place orders and social distancing are effective at slowing the spread of viruses. 4. Therefore, we should immediately institute strong countermeasures to halt the spread of the virus until we get more information.
If you can take the same argument and come to two opposite conclusions, then it is a sign that there is a flaw in the argument!
Upon closer examination, this is not an argument at all. The conclusion is merely an opinion. The costs and benefits of the two approaches are not quantified and compared in any substantive way. There is no evidence presented for why one approach is better than other. People who make either of these arguments are calling attention to the uncertainty on one side of the equation and ignoring the uncertainty on the other side. Pointing out the flaws in someone else’s argument is not the same thing as making the case why your approach is the correct one.
The issue is that we have uncertainty about BOTH the health consequences and the economic consequences of COVID-19 and the effects of any countermeasures. It is clear that the stakes are very high and the consequences of ANY course of action will be far-reaching. Predicting the impact on the healthcare system and the economy involves modeling complex dynamics on highly interconnected systems. This is an incredibly difficult problem especially when the data we have is unreliable and incomplete.
This puts us in a difficult position: 1. There is no reason to expect that there will be a dramatic improvement in the quality of the data that we have on either phenomenon in the near future. So the uncertainty is not going away. 2. In both cases, the clock is ticking. The virus is spreading and the economy is suffering. The longer we wait to respond, the worse the damage will get and the less effective the countermeasures will be. 3. There are trade-offs to any course of action. The optimal solution for the economy is not the optimal solution for public health and vice versa. If we want to minimize the loss of wealth, we would need to relax some of the restrictions on movement and commerce that many governments have put in place. If we want to minimize the loss of life, then we would need to strengthen some of the restrictions on movement and commerce. 4. Any forecasts we make about the effects of a course of action will necessarily involve a great deal of uncertainty.
Unfortunately, some are trying to exploit the uncertainty that we face and use it as an opportunity to try to persuade others to support policies that favor their own interests. (Ironically many of those who are arguing most strongly that we prioritize the economy over health claim to be pro-life.)
It is reasonable to be concerned about what this all means for your job or 401k. It is also reasonable to be concerned about what this virus will do to your loved ones if they become infected. But, let’s not forget that public policy affects everyone and what is best for you may not be best for us. One would hope that when people start advocating for a particular policy that, at a bare minimum, they would acknowledge this fact and make their arguments with the interests of others in mind as well as their own. One would also hope, that when people decide whether to abide by the recommendations and restrictions put in place but government officials, that they will take into account the needs and well-being of their neighbors in addition to their own.
We face a difficult problem. The solution is not to freeze and do nothing. It is also not to blindly prioritize one objective (health or the economy) at the expense of the other. It is not to make sweeping statements about policy issues without substantive expertise or having carefully considered the evidence. It is not to ignore evidence that does not line up with your (self-interested) point of view. It is not to second guess the actions of every government official based on whether you like them.
The solution is to continue to collect as much information as we can and to do our best to understand the implications of all the alternatives. This involves using data and building models to come up with the best quantitative estimates that we can for the impact of each alternative based on the information available right now. I know that there are countless scientists, doctors, economists and mathematicians who are working on this. Their forecasts will be imperfect, and they will have uncertainty, but they are better than blind speculation and opinion.
Once we understand the alternatives (as best we can), then and only then, can we really evaluate the alternatives and decide the best course of action. I hope that policy makers are actually doing this i.e. making use of the evidence and expertise that is available and objectively weighing the costs and benefits of the alternatives. I know that I will be praying that they will have wisdom as they make these difficult decisions and that they will be surrounded by wise and informed counselors as they seek to manage this crisis.
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