As the Delta variant spreads across the United States and the world, a growing number of public health officials and public leaders are once again sounding the cry for immediate action. Australia locked itself into a seemingly never-ending cycle of lockdown-type restrictions whereby they automatically take drastic measures anytime they discover a case. Although not as extreme as Australia, the US also points to the spread of the Delta variant as being an impetus for tighter public health actions. For instance, Los Angeles County, Washington, DC, and the state of Louisiana recently reimposed masking mandates in all indoor spaces. Starting August 16, New York City will require proof of vaccination for indoor dining, gyms, entertainment and performances. Other locales and states are likely to follow suit after the CDC recommended that vaccinated people in some parts of the country start to wear masks again and that schools maintain social distancing.
We’ve been down this path of thinking about public health before, and the past demonstrates that we see some improvement in outcomes related to the virus but at the expense of potentially significant costs. Economists recognize this reality as trade-offs: by choosing to do one thing we necessarily foreclose some other choice. Much of last year’s struggles can be traced to a refusal to consider the costs alongside the benefits of public health measures. The costs of making a choice, like stricter public health measures, must account for what opportunities we forego by doing so, and what costs we will incur.
Time tells us that policymakers throughout the pandemic placed emphasis on the benefits and disregarded the costs of their measures. What was “two weeks to flatten the curve” quickly unraveled into multiple months of mandates and a subsequent deluge of unintended consequences from missed cancer screenings to soaring unemployment.
Their goal singularly focused on eliminating community spread with the ultimate solution of a vaccine. None of these goals were problematic in their own right and may well have been a good idea for public health. But public health is not the only outcome that provides benefits or creates costs to society. If public health outcomes are the only or primary measure, then many assume that any action that does not completely eliminate the virus is insufficient and new actions must be taken regardless of the costs.
Today, we are in a measurably different place than a year ago with several effective and demonstrably safe vaccines available and accessible to the vast majority of US residents, surely a triumph of both science and public health. Despite this accomplishment, the temptation to fall back into concentrating solely on utter virus eradication, regardless of how high the costs, would be unwise.
As Los Angeles and other regions with relatively low vaccination rates confront an increased spread of the Delta variant, well-intentioned public health officials return to an argument that they sought to advance over the last year. They assert that only public health concerns are relevant in the face of these changing conditions, and in doing so dismiss the economic costs. Beyond the economic costs, these lockdown-type policies harmed our psychological health, educational outcomes, personal autonomy, and general sociality. The core of this single-minded logic is the central assumption that we must do whatever is necessary to combat the spread of the Delta variant and that no other concerns are socially relevant.
Many who read this will rightly point out that today we are only talking about mask mandates in Los Angeles and a few other places, and they are correct. While today’s measures are limited, we can easily revert to ignoring tradeoffs and fall into a cascade of measures and policies, ones that will have costs that are real and should be accounted for in the policymaking process.
Together, we have spent at least the last ten years, and other public policy experts exhausted even more time, pointing out this same issue of the tendency to ignore the trade-offs of political action. We observed this proclivity when demands arose for dealing with terrorists, global warming, immigration, and other matters. What is different now is that because of the pandemic’s immediate danger and pressing concern, we allow public health to dominate the policy discussion for a prolonged period.
As Thomas Sowell famously wrote, “There are no solutions, only trade-offs,” and this scenario is not different. No policy is costless, and no policy is only to the upside. In every policy discussion including those around public health, understanding that trade-offs will occur is an important part of the policy process. When we refuse to engage with that reality, we will almost always pay far higher costs than are warranted.
By Ryan M. Yonk and Amelia Janaskie Via https://www.aier.org/article/the-refusal-to-acknowledge-trade-offs/