Now that the Covid-19 pandemic seems to be waning, now is a good time to look at the lessons that observers have learned or should learn. The list of bugs is long, but the most obvious was the misunderstanding and effect of the virus’s tendency to attack the old and vulnerable. In other words, politicians failed to understand the enemy.
Clear thinking, based on data available last spring, would lead to two insights. First, the benefits of protecting the elderly and vulnerable outweigh the costs. Second, the costs of protecting the young and healthy outweigh the benefits.
For our purposes, we combine voluntary and coercive (eg state locking) non-pharmaceutical precautions – wearing masks, washing hands, quarantining, distancing and isolating infected people ̵
The death rate from infection is the probability that a person will die after becoming infected, whether they have symptoms or are unaware of the infection. The average global mortality rate from infections with SARS-CoV-2, the virus that causes Covid-19, is approximately 0.23%. The average death rate in the United States is higher, probably 0.3% or 0.4%, because Americans are older and less healthy than those in most other countries. Below this average, mortality from infection increases exponentially with age. For an 85-year-old, it can be 2,000 times higher than for an 18-year-old. This increase in mortality with age is due in part to comorbidities that increase with age.
The main risk of SARS-CoV-2 is infection leading to death. Those who die lose years based on statistical life expectancy. Life expectancy per person is equal to the mortality rate from infection multiplied by life expectancy multiplied by the probability of infection.
If the Moderna, Pfizer / BioNTech and Johnson & Johnson vaccines had never been developed, the pandemic would have continued until the herd’s natural immunity was reached. This is the meaning in the life cycle of an infectious disease, when a sufficient population has immunity that the average number of people to whom a newly infected person transmits the disease falls below one. In fact, those who are immunized protect those who are still vulnerable and the disease largely disappears. Herd immunity to SARS-CoV-2 will be reached after perhaps 70% of the population is infected.
While perfect protection would eliminate the risk of infection, few people can practice it. Based on data analyzed by economists at the University of California, Berkeley, we suggest that actual protection reduces the risk of infection by about half. Therefore, imperfect protection reduces 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 is a lot. But the probability of an 18-year-old dying if infected is small, about 0.004%. So the expected years of lost life are only 0.004% at 35% at 61.2 years, which is 0.0009 years. That’s only 7.5 hours. All this younger man has experienced in the last year is to prevent the average loss of 7.5 hours of his life.
Now think of the 85-year-old. If he dies, he will lose 6.4 years of life expectancy. He is much more likely to die if he is infected, about 8%. So the expected years of lost life are 8% to 35% to 6.4 years, which is 0.179 years – 65 days. The benefits of protection, measured in life expectancy, are 210 times higher for the elderly.
Protection costs include reduced learning, reduced economic activity, increased drug abuse, more suicides, more loneliness, reduced contact with loved ones, delayed cancer diagnosis, delayed childhood vaccinations, increased anxiety, lower wage growth, restrictions for travel, reduced choice of entertainment and fewer opportunities to socialize and make friends.
In a 2020 study by the Organization for Economic Co-operation and Development, Eric Hanuszek and Ludger Wosmann estimated the loss of lifelong income of individual students at 6% (assuming that schools were closed or reduced to the equivalent of 67% of the year). Considering the average income in the United States of $ 1.7 million, this 6% turns into $ 102,000 per student. This loss of defense income disproportionately affects younger Americans. Those who are retired are largely unaffected.
Assuming reduced lifelong income is the only cost, and reduced life expectancy is the only benefit, the 18-year-old faces protection costs of about $ 102,000 and a benefit of 31% per day. Would you pay $ 102,000 to live an extra 7.5 hours? What 18-year-old estimates his time at $ 13,600 an hour? The cost of the 85-year-old is close to zero (remember that this person is probably retired) and the benefit is 65 days. There are certainly other costs for both groups. For 18-year-olds, this makes defense an even less good deal. In contrast, an 85-year-old may be willing to take more risks because of time with loved ones.
Looking back, the 18-year-old had to invest only minimally in protection; the costs outweigh the benefits. Work, school, sports and communication had to continue, perhaps with some minor precautions. But the 85-year-old had to work hard to protect himself – the benefits outweighed the costs.
SARS-CoV-2 is highly discriminatory and treats the old as easy targets. If politicians understood the enemy, they would adopt different protocols for young and old. Politicians would practice targeted defense, narrowing their efforts to the most vulnerable 11% of the population and freeing the remaining 89% of Americans from extravagant burdens.
Mr. Hooper is president of Objective Insights, a company that consults with pharmaceutical clients. Mr. Henderson, a research associate at the Hoover Institution, was a senior health economist on President Reagan’s Council of Economic Advisers.
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