“The Evidence and Tradeoffs for a ‘Stay-at-Home’ Pandemic Response: A multidisciplinary review examining the medical, psychological, economic and political impact of ‘Stay-at-Home’ implementation in America”

Will Marble writes:

I’m a Ph.D. student in political science at Stanford. Along with colleagues from the Stanford medical school, law school, and elsewhere, we recently completed a white paper evaluating the evidence for and tradeoffs involved with shelter-in-place policies. To our knowledge, our paper contains the widest review of the relevant covid-19 research. It summarizes research from a number of fields, including epidemiology, economics, and political science.

I just have a few comments:

1. You write, “By summer, we hope to identify effective medical treatments. By next year, we hope to find a safe and effective vaccine.” Do you have evidence for these claims? References?

2. I think the dollar-value-of-life thing (p. 7) is bogus. Not because I think it’s incorrect or immoral to assign a dollar value to a life-year—I agree that this is just a formalization of an inevitable tradeoff of risks—but because this tradeoff depends a lot on the risk and the scale of the loss of life. The dollar value appropriate to 10 lives cannot simply be multiplied by 1 million to get to the dollar value of 10 million lives. The numbers just don’t work out. So I don’t think those calculations on the top of page 7 make any sense.

3. I don’t quite follow the argument on the bottom of page 7 comparing to the 1918 flu. The economic depression of 1918 was not as severe as what we’ve already seen here, right? If things are already worse now economically, despite the death toll still being low, then, sure, that suggests things could get a lot worse, but it also suggests to me that the 1918 economic experience isn’t so relevant to what’s happening today. The level of economic interdependence is so much higher today.

4. On page 10, I think “causes” should be “is associated with/”

5. I didn’t notice any discussion of economic risks that can’t be priced in dollars and cents, for example breakdown of the food supply chain, essential workers not wanting to go to work, etc. Or, conversely, the question of what would happen if people start going back to work everywhere: will businesses still fail because nobody wants to go to the store to buy anything, will people stay at home anyway? Would there be a worst-of-both-worlds scenario in which lots of careful people stay home, but “superspreaders” go out and cause disproportionate damage.

In general I think the economic analysis is valuable but I feel like some gaps need to be filled in, as ultimately the problem is not a lack of “the economy” or even “economic output,” so much as potential problems with key sectors of the economy failing, along with economic insecurity. I’ve been thinking about this regarding government policy, that just throwing money at people doesn’t resolve these problems. Without at least some discussion of this, I think your report is missing something.

Just by analogy, it’s as if you wrote an article about fighting a war and you talked all about casualty rates and budgets and public opinion, and a very small amount about military strategy, but nothing about logistics. A war economy is not just GDP, it’s also what gets built, how resources are allocated, and how risks and burdens are shared. Just as a country can’t win a war by just throwing money at the army, I’m skeptical of an economic strategy against the epidemic that’s just a generic stimulus.