MIT Sloan study finds no tradeoff between lives and livelihoods in the COVID-19 pandemic

Feb 23, 2021

MIT Sloan study finds no tradeoff between lives and livelihoods in the COVID-19 pandemic

CAMBRIDGE, Mass., February 23, 2021 – Policy debates around COVID-19 often presume a tradeoff between lives and livelihoods. Is there a point where the disruptions caused by social distancing and lockdowns outweigh the public health benefits? Two studies by MIT Sloan School of Management,, and PhD student Tse Yang Lim find that this apparent tradeoff is a false one. Countries that quickly implement strong policies to reduce transmission suffer early interruptions of normal social and economic activity, but are able to limit cases and deaths, setting the stage for reopening. In contrast, those with weak responses experience severe outbreaks that eventually force strong restrictions.

The researchers sought to understand why some countries have COVID-19 death rates more than one hundred times higher than others. They modeled the epidemic’s spread, including behavioral factors such as: how people perceive and respond to the risk of infection and death; the development of “adherence fatigue;” how testing and hospital capacity are allocated when the need exceeds capacity; and how learning and changes in contact patterns have lowered the risk of death.

Examining all nations that publish sufficient data—a total of 92, spanning about 5 billion people—they estimated the actual magnitude of the epidemic. They found that inadequate testing and asymptomatic cases mean cumulative cases are more than seven times larger than official reports. They also found COVID-19 death rates are about 44% higher than reported.

Such under-reporting, however, does not explain why outcomes differ so much across countries. Nor do factors like demographics, weather, and hospital capacity, which all play a role, but only explain a small fraction of the observed variation in death rates. The researchers found the primary driver to be how each nation responds to the threat of COVID-19. Specifically, it depended on how many deaths it took to spur individuals and governments to bring their interactions down enough to contain the epidemic.

Lim explains, “Outbreaks grow until they are severe enough that people start staying home, or governments impose lockdowns and other restrictions that cut transmission. How responsive societies are to deaths determines how many people will be dying until the large majority of people are vaccinated, which may take until late 2021, and longer in developing nations.”

Sterman points out that the response differed significantly across countries. “Nations like Singapore, China and New Zealand responded to the initial outbreak swiftly and then remained vigilant. They deployed testing and contact tracing. Their populations kept wearing masks, distancing, and avoiding large gatherings, even after caseloads and deaths fell. Any new cases were met with a swift response. While remaining vigilant, life in these nations has largely returned to normal, with few cases and deaths.”

Other nations, he adds, including the U.S., U.K., and Mexico, were less responsive. Seeing the decline in cases after the first wave, and under pressure to boost their economies, many governments eased restrictions and their people began to interact with one another again.

“A community that attempts to keep the economy open will see their outbreak grow until hospitals are again overwhelmed and deaths rise so much that they are forced to lock down again anyway. Over the entire course of the pandemic, the resulting disruption to families, communities, and the economy is similar or worse, but with greater loss of life, compared to communities that respond quickly and strongly,” says Rahmandad.

Lim explains, “Small outbreaks can be controlled with less disruptive measures, like masking, testing, contact tracing, and targeted quarantines. But large outbreaks require much stronger, more heavy-handed responses like full lockdowns.”

Rahmandad sees reason for optimism in the team’s findings. “By being more responsive, countries can come out of the pandemic with much brighter prospects: less traumatized, less polarized, and having built social capital from effective cooperation to save their citizens. We have months to go before most people are vaccinated, so there is still time for countries, including the US, to take action, even as we work to accelerate immunization.”

To help policymakers—and the public—learn about these complex dynamics, the team created a free online version of their model. The interactive simulator allows everyone to experiment with their own scenarios for vaccination and other policies, and to explore how to change the course of the epidemic over the coming months. Rahmandad, Sterman, and Lim are coauthors of “Behavioral dynamics of COVID-19: estimating under-reporting, multiple waves, and adherence fatigue across 19 nations,” which is forthcoming in System Dynamic Review. Rahmandad and Lim are coauthors of “Risk-Driven Responses to COVID-19 Eliminate the Tradeoff between Lives and Livelihoods.”

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