Now that the Covid-19 pandemic seems to be subsiding, it’s a good time to look at lessons observers have or should have learned. The list of errors is long, but the most obvious was the lack of understanding and acting on the virus’ tendency to attack the old and vulnerable. In other words, political decision-makers failed to understand the enemy.
Some clear thoughts based on data available last spring would have led to two insights. First, the benefits of protecting the old and vulnerable cost outweigh the costs. Second, the cost of protecting the young and healthy benefits outweighs the costs.
For our purposes, we combine non-pharmaceutical measures with voluntary and coercive (eg State locking) – mask wearing, hand washing, quarantine, distancing and isolation of infected people ̵
Infection mortality is the likelihood that a person will die once he or she becomes infected, whether that person has symptoms or is unaware of the infection. The global mean infection mortality rate for SARS-CoV-2, the virus that causes Covid-19, is approx. 0.23%. The average U.S. death rate is higher, probably 0.3% or 0.4% because Americans are older and less healthy than those in most other countries. Below this average, disability mortality increases exponentially with age. For an 85-year-old, it can be 2,000 times as high as for an 18-year-old. This increase in mortality by age is due in part to comorbidities that increase with age.
The primary risk of SARS-CoV-2 is infection leading to death. Those who die lose years based on statistically expected life expectancy. An individual’s expected lost years equals infiltrate mortality times life expectancy times the probability of infection.
Had the Moderna, Pfizer / BioNTech and Johnson & Johnson vaccines never been developed, the pandemic would have continued until the natural herd immunity had been reached. It is the point in the life cycle of an infectious disease when enough of the population has immunity to the fact that the average number of people that a newly infected person transmits the disease falls below one. In fact, those who are immune protect those who are still vulnerable, and the disease largely disappears. Herd immunity to SARS-CoV-2 would be reached after perhaps 70% of the population has been infected.
While perfect protection would eliminate the risk of infection, only a few can practice it. Based on data analyzed by economists at the University of California, Berkeley, we assume that actual protection reduced the risk of infection by approx. half. Therefore, imperfect protection reduced the risk of infection for the average American from 70% to 35%.
We find that the benefits of protection are disproportionately higher for the elderly. Consider two extremes: the 18-year-old and the 85-year-old. If the 18-year-old dies, he loses 61.2 years of life expectancy. That’s a lot. However, the probability of the 18-year-old dying if infected is small, approx. 0.004%. So the expected lost life years are only 0.004% times 35% times 61.2 years, which is 0.0009 years. It’s only 7.5 hours. Everything this younger person has been through over the last year should, on average, prevent the loss of 7.5 hours of his life.
Now consider the 85-year-old. If he dies, he loses 6.4 years of life expectancy. The probability of dying if infected is much higher for him, approx. 8%. So the life expectancy that has been lost is 8% times 35% times 6.4 years, which is 0.179 years – 65 days. The benefits of protection measured in life expectancy are 210 times as high for the elderly.
The costs of protection include reduced schooling, reduced economic activity, increased substance abuse, more suicides, more loneliness, reduced contact with loved ones, delayed cancer diagnoses, delayed childhood vaccinations, increased anxiety, lower wage growth, travel restrictions, reduced entertainment choices, and fewer opportunities for socializing and building. friendships.
In a 2020 survey for the Organization for Economic Co-operation and Development, Eric Hanushek and Ludger Woessmann estimate the loss of lifetime income for individual students to be 6% (assuming schools were closed or reduced equivalent to 67% of a year). Given the median lifetime salary of $ 1.7 million, this 6% equates to $ 102,000 per annum. Student. This loss of income from protection is disproportionately affecting younger Americans. Those who are retired are largely unaffected.
Provided that reduced lifetime pay is the only cost and reduced expected lifetime loss are the only benefits, the 18-year-old faces a protection cost of approx. $ 102,000 and a benefit of 31% of a day. Would you pay $ 102,000 to live an additional 7.5 hours? Which 18-year-old values his time at $ 13,600 an hour? The cost to the 85-year-old is close to zero (remember, this person is probably retired) and the benefit is 65 days. To be sure, there are other costs for both groups. For 18-year-olds, it makes protection even less of a bargain. The 85-year-old, on the other hand, may be willing to endure more risk for the sake of time with loved ones.
Eventually, the 18-year-old should have invested only minimally in protection; the costs outweighed the benefits. Work, school, sports and socializing should have continued, perhaps with some minor precautions. But the 85-year-old should have worked hard to protect himself – the benefits outweighed the costs.
SARS-CoV-2 is very discriminatory and considers the old as easy targets. Had politicians understood the enemy, they would have adopted different protocols for big and small. Politicians would have practiced focused protection by narrowing their efforts to the most vulnerable 11% of the population and freeing the remaining 89% of Americans from wasting burdens.
Mr. Hooper is president of Objective Insights, a company that consults pharmaceutical clients. Mr. Henderson, a fellow from the Hoover Institution, was a senior health economist with President Reagan’s Council of Economic Advisers.
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