We find that the benefits of protection are disproportionately higher for older people. Consider two extremes: the 18-year-old and the 85-year-old. If the 18-year-old dies, he loses 61.2 years of expected life. That’s a lot. But the probability of the 18-year-old dying, if infected, is tiny, about 0.004%. So the expected years of life lost are only 0.004% times 35% times 61.2 years, which is 0.0009 year. That’s only 7.5 hours. Everything this younger person has been through over the past year was to prevent, on average, the loss of 7.5 hours of his life.
This is from Charles L. Hooper and David R. Henderson, “Youth Pay a High Price for Covid Protection,” Wall Street Journal, May 3 (May 4 print version.)
The article is gated but in 30 days I will post the whole thing.
READER COMMENTS
Jerry Brown
May 4 2021 at 10:35pm
I will be interested to read the whole article. Where does the 35% in your equation come from?
18-year-olds do get a bad deal in many respects even without this particular pandemic. They get considered as adults in all things criminal, few older adults ever take them seriously, they can’t legally drink alcohol, they have to pay for car insurance at extraordinary rates, but they can still be sent to war if their elders decide to make a war. Oh and they cant be the President until they are 35.
When I was 18 I was happy to point out these various ‘inequalities’ all while being considerably subsidized by my parents. Which most American 18-year-olds probably are.
Sometimes it sucks to live in a society that expects you to make personal sacrifices for other parts of society.
Vivian Darkbloom
May 5 2021 at 2:25am
I was about to criticize this post for failing to take into account the *chances* that an 18 year-old will become infected without protection, but then I realized that this is likely 35 percent as explained elsewhere in that Op-Ed (I no longer subscribe to the WSJ). If I’m correct in my assumption, then even so the 35 percent likely overstates the overall effect of the various measures imposed on youth (and all others). It is probably impossible to tease out the amount of risk of infection those various measures have achieved. Nevertheless, I think the actual computation of actual prevention (as expressed in the last sentence) would be risk of infection without measures minus risk of infection with measures times 0.004 percent.
I further think that Hooper and Henderson are “generous” in their estimate of the life expectancy of those 18 year-olds who died from Covid in that co-morbidities have played a large role in the death rate for all ages.
Thomas Lee Hutcheson
May 5 2021 at 7:00am
Even if policy were aiming at minimizing loss of QALY, I suspect we STILL should have been doing massive screening of asymptomatic individuals so as to isolate them before they spread the virus more. Masks are a low cost way to prevent spread. Using public health expertise to regulate how businesses should operate (ventilation, capacity limits) makes sense.
It seems very unlikely that our mistakes stem from trying to minimize LY instead of expected value of QALY. Rather it was in not doing enough (any?) cost benefit analysis of alternative NPIs, including vaccine approval and distribution.
It will be interesting to see the alternative set of interventions that H&H derive from what they believe is the proper objective function, taking into account that restrictions protect not only the restricted person but the people that person does not infect if the restriction successfully prevent their infection.
I certainly hope it will not amount to a re-discovery that closing beaches was sub-optimal.
JFA
May 5 2021 at 8:26am
“Everything this younger person has been through over the past year was to prevent, on average, the loss of 7.5 hours of his life.”
I do look forward to reading the whole thing, but the above statement doesn’t quite do justice to the reasoning of the various mitigation efforts. The argument (which I assume you discuss in the piece, and I’d probably agree with your evaluation of the argument) is that the efforts were to prevent (or lessen) the potential loss of life faced by everyone. In the case of Covid, it would be strange and wasteful indeed if the restrictions imposed on the 18-year-olds were only for the benefit the 18-year-olds.
Charley Hooper
May 5 2021 at 2:08pm
I assume you are getting at the externality issue. The 18-year-old has more than just himself to worry about. He doesn’t want to spread this disease to others and they concur.
Consider two cases.
In one, a potentially infected 18-year-old puts another 18-year-old at risk. But the risk for the second person is just as small as the risk for the first. Neither should invest very much in protection.
In the second case, a potentially infected 18-year-old puts an 85-year-old at risk. But, based on our logic, the older person should already be protected from the younger person. Therefore, the younger person won’t put the older person at risk.
JFA
May 5 2021 at 2:54pm
I’m more commenting on the framing in the concluding sentence. Maybe (most likely?) vast restrictions are not justified, but to say the restrictions were only for the benefit of the younger person (especially when many younger people were restricting their activity when they didn’t have to… read about the travails of dating during Covid) is not engaging in good faith with the main arguments of your interlocutors. (NB: I also do not always engage in good faith arguments… something I need to work on.)
Additionally, I think those who advocate against lockdowns (I’d call myself “lockdown agnostic”) don’t usually acknowledge how much voluntary action there has been in younger people (over 18… the no school thing has been absurd) restricting their interactions. It seems that the hypothetical world of only protecting the old would mean that all younger people would just go about their lives as if it were 2019 and all 70+ would be in their homes (I know that’s a caricature but I don’t know how much of one). That may be the case for some, but more research needs to be done on the magnitudes. Perhaps your hypothetical 2020 doesn’t look that much different from the actual 2020.
Charley Hooper
May 6 2021 at 4:53pm
My hypothetical 2020 looks a lot different from the actual 2020 in two main regards: the vulnerable were protected more and the young were protected less.
Nursing homes should have been more secure. Schools and businesses that cater to the young and healthy should have stayed open with minimal restrictions.
Vivian Darkbloom
May 5 2021 at 11:02am
” In the case of Covid, it would be strange and wasteful indeed if the restrictions imposed on the 18-year-olds were only for the benefit the 18-year-olds.”
That seems to be the standard rejoinder. I’m not convinced that severely restricting the activities of everyone under threat of punishment is the proper policy. While I accept that it is possible for an 18 year-old to infect a much more vulnerable 80 year-old, I would submit that there are less restrictive solutions to the problem than restricting everyone’s movement and activities. As someone much closer than I would like to be to 80 than 18, why shouldn’t the burden be on *me* to avoid contact with those 18 year-olds if I am not willing to take that risk? Surely, this is the less costly alternative. I believe that Professor Coase would agree! Also, if you have a younger person in your household, I suggest that a family discussion might be more appropriate than a government diktat.
And, why shouldn’t the decision be left up to that 70 year-old, 80 year-old or even 90 year-old person? It strikes me that the public health experts and politicians believe that those most at risk are not only feeble physically, but also mentally. If find this reasoning suspect given the fact that a majority of the public recently voted a 78 year-old to be in charge of the nuclear arsenal.
JFA
May 5 2021 at 12:13pm
“I’m not convinced that severely restricting the activities of everyone under threat of punishment is the proper policy.”
I agree. I’m waiting to be able to read the whole piece to comment more on it, but just from the snippet David posted, he’s rebutting an argument that no one was making (or maybe only a few people were making… there was lots of chatter that first month or so of the pandemic). What you call “the standard rejoinder” is the usual argument for extended restrictions and compares benefits accrued by everyone to cost born by everyone, not cost for a certain age group compared to the benefit of that age group.
Another way to look at it is this: getting infected by Covid adds about a year’s worth of risk to each age (https://www.bmj.com/content/370/bmj.m3259). Is the cost of the expected mortality risk greater than or less than the value of the loss of time the resulted from government restrictions. So did people lose an entire year’s worth of value due to government restrictions? The biggest cost would probably be loss of employment and loss of time at college. It’s not clear how much of a difference the government restrictions made on the college part. Lots of private colleges were closed and those that were open had lots of restrictions. Lots of state schools were closed and those that were open had lots of restrictions. I do get the sense that public colleges were more likely to be closed by I couldn’t find the numbers to see the magnitudes.
I’m interested to see if (in the piece) the cost imposed specifically by government restrictions are separated from the cost created by voluntary decisions (if you want those effects of voluntary decisions to be considered imposing cost). Restaurants, movie theaters, bars, many local sports teams, etc., have been open and active in many places since the summer. There are capacity restrictions in some places, but my experience (and those of my friends in other places) hasn’t been that there were huge crowds waiting in line for their spot (especially in the fall and winter). The BBQ place near my house has rarely filled up its large outdoor dining area. Ditto for the few other restaurants that I’ve been to during this period. And maybe not all establishments would have voluntarily imposed capacity restrictions, but I get the sense that a significant number would have. If you want to go out and have a good time, you can. The government isn’t keeping you from going to a friend’s house. Maybe the way the risks have been communicated has not been optimal (to say the least), but how much of that is on the government officials and how much is a result of the talking heads. And how much of that should be considered a “governmental restriction”.
While the cost is not zero, my guess is that the cost of governmental restrictions regarding people’s daily lives is over-estimated by many people arguing against them (except for the continued school closures of K-12 schools in many places).
Jon Murphy
May 5 2021 at 1:05pm
People make that argument all the time. Fauci made it just 4 days ago. It was the policy of many federal, state, and local governments throughout the past year. Still is the policy in many places.
JFA
May 5 2021 at 1:34pm
I didn’t see anything in the article about Fauci saying India should lock down so that young people wouldn’t get sick and die. There were general comments about reducing spread, etc., etc. From what I recall the government restrictions have been mostly justified on total body count and that 18-year-olds shouldn’t go out because they will contribute to the spread of Covid which will eventually kill grandma. Everyone seemed pretty cognizant of the age gradient of Covid mortality early on (except for the “journalist” who continued to write about Covid’s threat to young people’s health (and somehow 50 became young all of a sudden)).
“Lockdown” has been an incredibly overused and overly broad term. One needs to define terms. What percentage of what activity has been restricted, and is government lockdown the main thing keeping people from those activities? California has been more restrictive than most, but a significant swath of the country (aside from K-12 school closures (which have been mostly justified through arguments about teacher safety or spread to older family members)) has been able to go about their lives relatively normally. Most of my activity has been restricted by the risk tolerance of my friends, not government restrictions. I’m not one to generalize from individual experience, but a big chunk of the reduced activity is voluntary.
Jon Murphy
May 5 2021 at 2:16pm
That’s quite the weasel, eh? I agree one should define one’s terms, but not when they allow one to just weasel out of one’s claims like this.
You claimed that “severely restricting the activities of everyone under threat of punishment is the proper policy…is an argument that no one was making.” And yet, lockdowns are exactly that. So, to try and weasel out of your claim by post hoc modifying it to say it’s about young people is not correct.
JFA
May 5 2021 at 2:29pm
I’m sorry if I wasn’t clear. Here is what David said: “Everything this younger person has been through over the past year was to prevent, on average, the loss of 7.5 hours of his life.” My comment was related to that (which I referenced in the part you omitted with the ellipsis: “just from the snippet David posted, he’s rebutting an argument that no one was making”). I don’t know of many people (especially after, say, the first month) who were saying that activity of the young needs to be restricted to protect the young (or that was very low down on the list of priorities).
No weaseling whatsoever… just selective reading on your part.
JFA
May 5 2021 at 2:37pm
I just noticed that I can see the first few paragraphs and was disappointed by this line: “For our purposes we are combining voluntary and coercive (e.g., government lockdown) nonpharmaceutical precautions—mask-wearing, hand-washing, quarantining, distancing and isolation of infected people—under the umbrella of protection.” A strange conflation since the intro paragraph discusses the failure of policy makers and not the average Joe.
Again, I’m looking forward to reading the whole thing, but what H&H appear to be saying is that private decisions in response to the pandemic are imposing cost on the young. So how much would we need to consider age restricted access to various things as cost to the young? How much would we need to consider many people’s unwillingness to date during the pandemic as a cost on others (this seems very relevant to the young)? Should we chastise Floridians who (up until March) were still going to restaurants at only about 70% of the frequency they had in 2019 (despite restaurant restrictions and face-mask mandates being lifted in September), keeping young from gainful employment opportunities?
Dylan
May 5 2021 at 4:58pm
This is one thing that has consistently disappointed my in the debate over lockdowns.
Lockdown proponent:
“Without lockdowns hundreds of thousands or millions more people would have died” And the cost of the lockdowns isn’t all that much, because most people were voluntarily social distancing anyway”
Lockdown skeptic:
“People voluntarily social distance, so deaths would have been similar even without government mandated lockdowns.” Then some calculations on the cost that attribute the entire cost of lockdowns to the government mandates and not the voluntary action.
What I would expect people like David to say (but don’t think I’ve ever seen this made explicit.) “Yes, voluntary choices people make have a large cost associated with them. However, people are good at adapting and choosing the lowest cost way to get a similar benefit, so we would see people adopting low cost methods of saving lives and reducing transmission voluntarily, in ways that they were not able to do given the top-down mandates. So, cost per live saved was much higher than it would have been in a world where people were free to adapt their behavior in the way best suited to their situation.”
To which, I’d expect an economically-minded proponent of lockdowns to reply with something along the lines of “Yes, in cases where the costs and benefits are borne by the individual, we can expect them to adapt in the most efficient way possible to minimize risk and personal cost. However, in a situation where costs are borne on the individual and the risk is borne primarily by others, we would see excess risk taking.”
I’m honestly not sure which side of that argument I fall on, but I know I’ve been disappointed that so many of the smart people I read, never seem to get to the point of thinking on the margin on this particular topic.
Jerry Brown
May 5 2021 at 5:15pm
That was a very good comment. Although I do not think most people are so selfish that they would knowingly expose more vulnerable people to the risk of disease. But this corona virus seems contagious before a person could know they had it, which makes it much more difficult to deal with.
“I’m honestly not sure which side of that argument I fall on”- me neither.
Alan Goldhammer
May 5 2021 at 5:21pm
The authors and commenters on this post would do well to read Michael Lewis’s new book, “The Pemonition: A Pandemic Story” that covers a lot of the inside information that some of us know and others have ignored. The book was puclished this week and is excellent. Lewis is interviewed on Barry Ritholz’s podcast Masters in Business which summarizes some of the key points. He does discuss school closures and notes that this was one of the key things identified by the person who drafted one of the early pandemic preparedness documents way back in the G.W. Bush administration. Countries that were successful in curbing SARS-CoV-2 transmission closed schools as their first action.
This was never about protecting children, it was about stopping transmission which as anyone knowledgeable about infectious disease realizes is the critical step.
JFA
May 5 2021 at 6:59pm
“Countries that were successful in curbing SARS-CoV-2 transmission closed schools as their first action.” From what I recall of a few lit reviews I read, the results were mixed regarding this intervention.
“This was never about protecting children, it was about stopping transmission which as anyone knowledgeable about infectious disease realizes is the critical step.”
Yet when overwhelmed with evidence that schools aren’t environments of major Covid-19 spread (especially with common sense mitigation strategies, evidence started arriving last May), people kept advocating to keep schools 100% closed. It may have started as an effort to stop transmission, but it quickly stopped being about that.
Matthias
May 5 2021 at 10:15pm
Getting sick costs you qaly, even if you don’t die.
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