A Premature Covid Retrospective

It is too soon for the pandemic retrospective that Nicholas Christakis’ Apollo’s Arrow promises when it claims to detail “The Profound and Enduring Impact of Coronavirus on the Way We Live.” Christakis actually admits as much in the preface: “The COVID-19 pandemic is still a moving target . . . As of this moment, there is much that is unknown—biologically, clinically, epidemiologically, socially, economically, and politically.  . . .  It’s hard to know for certain what will happen. And there is much that only the passage of time will reveal . . .” Because of these unknowns, what results in the book is little more than a rehash of what an ordinarily attentive reader will have read in the media since the start of the pandemic. That said, a rehash is not necessarily a bad thing for less-than-ordinarily attentive readers looking for a one-stop presentation of conventional wisdom on the pandemic.

The Evolution of Conventional Wisdom

Still, despite being quickly written only this last summer, this fall’s conventional wisdom has already moved beyond the book’s argument on several fronts. Take, for example, the hugely consequential question of school closings. To his credit, Christakis takes a somewhat circumspect position for the summer, pointing to likely social, economic, and psychological costs imposed by school closings on children. Nonetheless he ends up endorsing school closures to protect the broader public.

But that was based on the unknowns of this last summer. Today expert opinion in Europe suggests that schools are not a major mode of transmission, and scientific opinion in the U.S. seems to be catching up with this view. Despite the mounting evidence, many government officials in the U.S. still continue to favor school closures. Just follow the science, indeed.

Again and again, Christakis presents anti-COVID policies as binary choices: the policies are either all on or all off. There’s no reason for such reductionism.

Recent studies, in fact, suggest that even adult teachers are safer than previously believed: children, particularly younger children, do not transmit the virus as effectively as adults do. While there remains a heightened risk of infection, the evidence suggests that an adult teacher will be placed at much less risk in facing a classroom of eight-year-olds than he or she would be facing a room filled with the same number of adults. Normal precautions—spacing, masks, hand washing, increased ventilation—can reduce the residual risk even further.

Despite the unknowns of age and COVID this summer, Christakis is tone deaf to the implications that risk of infection varies with age. Rather than considering the possibility of individual choices and institutional policies that selectively protect older people—including selective isolation of at-risk older people—he blandly repeats the criticism that recognizing heightened risk to the elderly only reflects an attitude that “It’s just old folks who die” and that society should just accept their “sacrifice.” Little is said about policies that would selectively protect the elderly while allowing those less at risk to continue their lives and jobs, jobs that help to sustain the elderly as well as the rest of society.

Again and again, Christakis presents anti-COVID policies as binary choices: the policies are either all on or all off. There’s no reason for such reductionism. There is a continuum of policy responses in between total closure and acting as if everything were normal. Anti-COVID policies need not be the blunt instrument they’ve proven to be in so many states.

His simplistic, all-or-nothing approach leads Christakis astray when, for example, he argues that cost-benefit analysis easily justifies the draconian closure policies adopted last spring in response to the pandemic. (Keep in mind that I’m on record noting that cost-benefit analysis does not necessarily tip the balance against intervention.) Christakis writes:

These sorts of demographic calculations . . . allow us to benchmark the financial benefits of saving lives against the financial costs of shutting down the American economy during the deployment of [nonpharmaceutical interventions]. By using a standard benchmark of five hundred thousand dollars as the economic value of a year of life (or ten million per life, regardless of age), we can estimate one million coronavirus deaths . . . would be worth about six trillion dollars. Even at the highest end of a range of estimates of the consequences to our economy, including the expenditures of our government, we do not reach that sum. Strictly from an economic perspective, our response was commensurate to the threat posed by the pathogen.

It is here that providing serious consideration of the unknowns that Christakis himself notes in the preface—unknowns that mysteriously turn into knowns as the book progresses—would have come in handy.

An Absence of Alternatives

Even overlooking his somewhat high estimate of the value of a life, he misses critical aspects of the cost-benefit argument. First, we should think of possible interventions on a continuum of less costly to more costly policies rather than considering them to be all-or-nothing. Think of his methodology in a different domain: That I am willing to pay $1,000 for a television set of a particular quality in an all-or-nothing choice between that particular television or no television at all does not entail that I wouldn’t prefer to purchase a television set for $700 that still meets my desired threshold of quality, yet also leaves me with an additional $300 to spend on something else.

That is to say, while it may be the case that shutting down the economy cost less than the economic value of the lives saved, that does not take into consideration the possibility of less draconian policies that would have approximated similar health outcomes but at much lower costs. This goes double as we understand that the costs of closures proved much more harmful to poor folk relative to more affluent folk.

It is precisely in the face of the sort of radical uncertainty of the pandemic that we see benefits to the U.S. system of federalism, a benefit all but unremarked on during the pandemic.

The question is what would have occurred if policy-makers had emphasized (and enforced) only lower-cost interventions and had forgone most of the much higher-cost closures? For example, if interventions were limited to face masks, distancing requirements, and hand washing? It is not yet clear that those interventions, combined with the unforced choices of high-risk individuals (such as the aged) to isolate themselves from contact with others, would not have saved many of the same lives, but at far lower cost than the high-cost closure of “non-essential” businesses.

Or consider the evidence I mentioned above, that schools are not in fact a significant venue for the transmission of COVID-19. This suggests that closing them in the spring, particularly for younger children, was in fact a precipitate policy response. Not only do school closures reduce children’s learning achievements (let alone the consequences of their shrunken social circle), but parents—typically younger adults—need to stay home with their children and are unable to work. It was, and remains, a hugely costly policy response.

Of course, the response of interventionists to this line of argument is “we didn’t know at the time how infectious COVID would be.” But exactly. We didn’t know. The thing is, it is hubris to assume, as so many advocates of intervention did throughout the pandemic, that, in the face of real uncertainty, overreaction is superior to underreaction. Despite the continuing rationalization of “better safe than sorry,” when “safe” imposes draconian costs on both individuals and society, it is not obvious that the cost of “safe,” which is paid with certainty, is in fact better than a probabilistic “sorry.” Entire books have been devoted to the very dodgy issue of making decisions in an environment of “radical uncertainty.” And while it’s not always clear how to approach policy-making under such conditions, those experts don’t counsel that the extreme and costly risk aversion of “better safe than sorry” is in fact always the optimal policy route.

It is precisely in the face of the sort of radical uncertainty of the pandemic that we see benefits to the U.S. system of federalism, a benefit all but unremarked on during the pandemic. Despite all of the criticism heaped on President Trump for failing to provide centralized, national-level leadership in response to the pandemic, in the face of “radical uncertainty,” it is actually better to have 50 different state governments experimenting with different policy approaches. The U.S. states are large enough and diverse enough that there is no reason Americans should necessarily expect a one-size-fits-all national pandemic policy to be optimal in the face of the serious unknowns of this pandemic. We see different experiences between urban states and rural ones, between colder states and warmer ones, and among states in which citizens have different preferences about simply being left alone to judge their own best courses in light of the pandemic’s threat. On top of such differences, states that share common demographics are also governed by different people, and so will naturally adopt uncorrelated policies. 

As time progresses and uncertainties resolve themselves, judgments regarding which policies are optimal and which are suboptimal will become clearer because of this heterogeneity across states and their policy responses. There is more information to be had with a sample of policies from 50 different state governments than from the experience of a single, uniform policy of a centralized national government. 

Christakis correctly nodded at the significant and continuing unknowns of the present pandemic at the very start of his book. The problem is that one cannot write a retrospective on a pandemic when the unknowns are still unknown. And this pandemic still has a lot of play left in it. As a result, this hurried book sheds little new light on the epidemic, and ends up doing little more than repeating the shibboleths of intervention when the continuing uncertainties of the matter counsel humility and open-mindedness instead.