COVID-19: Who lives, who dies, who decides

I used to work on some of these issues in the government: should we ban a pesticide that will cause two cancers a year if banning it will raise the price of a bushel of strawberries 50 cents?

As this article discusses, we are terrible at making these trade-offs. When one child falls down a well, we spare no expense in rescuing her, clearly the right choice. But when it comes to deciding whether all wells should have walls around them to make sure no other child falls down, we are not very good at figuring out the right answer. If there is one.

How would have you responded if a year ago the President asked everyone to make a plan in case there was a pandemic? Would you vote for a candidate because he or she had an expensive contingency plan for a virus?

An isolation-induced recession would reduce economic activity by roughly 21 percent, compared with 9 percent under a more lax approach, according to a ballpark estimate by economists Martin Eichenbaum, Sergio Rebelo and Mathias Trabandt. It’s not unreasonable to assume that strict containment could cost $2 trillion. These same authors estimate that such measures would prevent more than half a million deaths and protect millions of other Americans from becoming infected. If their analysis is even roughly right, these are huge health benefits and huge economic costs. Which path has more value? The answer isn’t obvious.

American policymakers have rarely been forced to consider such trade-offs during a massive pandemic. But we have spent decades trying to understand other trade-offs that help put them into context: How much should Medicare pay for a new lung cancer treatment? Should we require a car to have a $700 air bag? Should a company have to spend millions of dollars to remove contaminated soil beneath a remote and abandoned industrial site?

Who lives, who dies, who decides