We want people to social distance right now, it’s extremely important. But we want people to do it strategically and, ideally, voluntarily because if they’re doing it voluntarily, they're probably doing it at least cost. The challenge that we're facing right now is there's been a lot of discussion in the media in recent days about the balance between killing people or killing the economy, and that’s the wrong way to look at it. What we really need to worry about is how do we manage this so we minimize total
mortality. Putting aside economic concerns for a moment, we want to make sure that our response to COVID-19 isn’t causing more non-COVID-19-related deaths. There’s a mortality/mortality trade-off here... More people are going to die this year; there’s no way out of that. The question is how do we manage that, how do we manage those trade-offs, and how do we manage future
You raised the question of the role of government. What should the government response be when the rate of contagion is so high, and people aren’t voluntarily distancing?
The Number 1 thing the government needs to do is provide clear, accurate information. The next thing that the government needs to do is coordinate things that the private industry might not be very good at doing. That includes testing. The other thing is getting the incentives right for people to social distance. I mean, I think the most important thing the government has done on that front so far is offering paid sick-leave.
In our research, we looked at models of whether people will social distance. We found that people who are susceptible to pathogens tend to do some social distancing because there’s a private benefit to not getting sick. No one wants to get sick, especially with a pathogen that has a high mortality rate. The problem is, once someone gets infected — and becomes infectious — there have no incentive to social distance. It’s like, “I’m already infected. But, if I don’t feel so bad, why bother?” Especially if the trade-off is not paying the rent or not buying medicine or something else. That's a huge problem.
What do your models show in terms of how social distancing might most effectively curtail or reduce the impacts of an epidemic?
There’s only three ways out of an epidemic. One that I call “the miracle,” in which summer comes and somehow this disappears. Unfortunately, that means it’ll just come back with a vengeance in the fall.
But, it’ll buy us some time. It’s not very likely. Another is what we call “stochastic die-out.” That could occur if you got people to isolate just enough to see a significant decrease in the number of cases. Then, those people who are infectious don’t come into contact with people, and the thing dies out. But, we have way too many cases to hope for that anytime soon.
The only other way out of an epidemic is to exhaust the susceptible population. And, there are two ways of doing that. You get a lot of people sick, and they acquire immunity through being sick, or you get a vaccine.
One of the projects you published in the past couple of weeks is an online dashboard [produced with the Yale Child Study Center and the Zigler Center in Child Development and Social Policy] which illustrates childcare needs for those people working in key sectors responding to this pandemic. How did that come together?
Well, Jude Bayham
[a former F&ES postdoc who is now an assistant professor at Colorado State University] and I have been working on a paper for a long time looking what happens to children during epidemic-related school closures. We finished it four or five years ago but couldn't get anyone to pay attention to it because they thought what we were talking about was absurd. So, we’ve continued to try and refine it and make it more appealing to economists as, at least, an interesting thought experiment. In that paper, there was a footnote about the childcare demand for healthcare workers. When this happened, we decided to revisit that question.