‘Externality Argument’ for Lockdown Isn’t as Strong As It Seems, Argue Economists

Since the start of the pandemic, one of the main justifications for lockdowns – at least in democratic Western countries – has been the “externality argument”. This is the argument that government is justified in restricting our freedom in order to prevent us from harming others – which we might do by transmitting a deadly virus. 

As the scientist Richard Dawkins stated back in September:

You can argue over whether masks, handwashing, banning groups etc are effective. What you can NOT argue is that you are personally entitled to take the risk as a matter of individual liberty. You risk other lives as well as your own. It’s just elementary epidemiology.

Proponents of this argument sometimes appeal to John Stuart Mill’s harm principle, which states, “the only purpose for which power can be rightfully exercised over any member of a civilised community, against his will, is to prevent harm to others”. 

While the “externality argument” does have merit, the situation is more complicated than its proponents would have us believe. In a recent article for the Southern Economic Journal, the economists Peter Leeson and Louis Rouanet explain why.

Before getting to their arguments, it’s worth explaining what an “externality” actually is. In short, it’s a cost imposed on someone who did not agree to bear that cost. The classic example is pollution. When a factory releases toxic waste into a lake, this may poison the water, leading to illnesses or deaths among users of the lake. Since the lake users did not agree to be poisoned, the release of toxic waste is an externality. And most people would say it justifies government intervention.

However, the externalities associated with COVID-19 aren’t quite like this, as Leeson and Rouanet point out. First, when one individual transmits the virus to another, this has both negative and positive effects. It has a negative effect on the person who catches the virus. But it has a positive effect on vulnerable people who are self-isolating, since each infection reduces the time until herd immunity. And the sooner herd immunity is reached, the sooner those people can return to the community. 

Second, COVID-19 externalities are often self-limiting. Since most people would prefer not to catch the disease, they have an incentive to avoid behaviours that increase the risk of transmission (such as attending large gatherings). This is in contrast to the factory example, where the owners have an incentive to release as much waste into the lake as possible. And indeed, evidence suggests that voluntary social distancing has much more impact on the epidemic’s trajectory than mandatory lockdowns.

Third, many interactions that result in transmission occur on privately owned sites that individuals enter voluntarily (e.g., shops, restaurants, cinemas). Absent force or fraud, there is therefore no on-site externality. What’s more, since businesses compete for customers, they have an incentive to take measures that reduce customers’ risk of infection (e.g., increasing ventilation or imposing capacity limits). 

Fourth, the main externalities associated with COVID-19 are actions taken by individuals at one site that affect the infection risk of others at different sites. For example, if someone attends a party that results in a super-spreader event, he and all the other party-goers impose costs on society by increasing the general level of infection. This requires individuals and businesses to take measures to reduce the risk of infection they and their customers will face.

Almost Five Million People Waiting to Start NHS Hospital Treatment in England Alone

The number of people waiting to start hospital treatment has risen to 4.95 million in England alone, according to the latest NHS figures. “It’s the highest number since records began back in August 2007,” Sky News reports.

The Express and Star has more.

Data from NHS England also showed that the number of people having to wait more than a year to start hospital treatment stood at 436,127 in March.

This is the highest number for any calendar month since August 2007, when the figure was 578,682.

In March 2020, the number having to wait more than a year to start treatment was significantly lower at 3,097.

This record again highlights the disruption caused to the nation’s health by a year of lockdowns and the NHS’s focus on Covid. The number of people admitted for routine treatment in hospitals in England was up 6% in March 2021 compared with a year earlier – but for many, lockdown has already taken its toll.

The Express and Star report is worth reading in full.

Stop Press: The NHS is to receive £160 million to help tackle this backlog. The Guardian has the story.

Hospitals will use the money to buy mobile CT and MRI scanning trucks, put on extra surgery in evenings and at weekends, and look after patients at home in “virtual wards”…

NHS England has designated groups of NHS trusts working together in 12 parts of the country as “elective accelerators”. They will be given up to £20 million each if they manage to carry out 20% more planned activity – diagnostic tests, operations and outpatient appointments – by July than they did at the same point in 2019-2020, before the pandemic struck.

Worth reading in full.

Stop Press 2: NHS consultants are asking for a “minimum 5% pay rise” and have produced a glossy brochure setting out their case. “After a year in which the NHS has experienced its greatest crisis, and in which consultants have been leading on the frontline since day one in the fight against COVID-19, it is time that consultants were rewarded fairly for the vital clinical leadership they bring to the NHS,” it says. No mention of the ~20% of all people hospitalised with Covid having caught the disease in hospital.

Some Funeral Venues Still Imposing 30-Person Limits on Services After May 17th

The 30-person limit on the number of mourners who can attend funerals is set to end in England on May 17th, but some venues are still imposing this restriction beyond the next step of the “roadmap” out of lockdown, along with time restrictions on services. The Guardian has the story.

A grieving mother said she had “nowhere left to turn” after dozens of possible venues for a funeral service near London refused to let her invite more than 30 mourners, despite England’s coronavirus restrictions being about to change.

Stacey O’Donnell, whose 19 year-old son, Tai O’Donnell, was stabbed to death in his home in Croydon on March 3rd, said she was “shattered” by her attempts to find a venue for the service.

She had delayed the funeral until after May 17th, when the Government’s limit on mourners is to be lifted allowing any number of people to gather as long as venues can comply with social distancing. She wanted to invite 50-60 guests whose lives “had been touched by Tai”.

But dozens of sites in Croydon and the surrounding area in south London, including those with large indoor and outdoor areas that would make social distancing possible, were restricting mourners to a maximum of 30, with many also limiting the service to 30 minutes, O’Donnell said.

She said: “I have a young boy who was very much loved by a lot of people, and it just seems completely wrong that we can’t come together to remember him and give thanks for the moments we shared. I would understand if it was prior to restrictions being dropped… but vaccinations have gone out, the people who are most at risk are covered. So for people to choose to enforce these restrictions just feels wrong.”

O’Donnell had found a private venue in Surrey but it could accommodate only 30 mourners, and religious venues had also said numbers had to be limited and insisted on religious ceremonies. Many hotels, golf courses and other venues were shut until June 21st, she added.

She felt the search for a venue had taken a toll on her mental health. “It’s killing me, to be honest. It has taken so long to get him back, and now to have so many doors close in my face is just awful. I don’t feel like I’m asking for a great deal, just a space to be able to say goodbye to my baby.”

Deborah Smith, from the National Association of Funeral Directors, said the Association had received other reports that some councils were reluctant to allow more than 30 guests at funerals. “We urge funeral venues or councils that are taking this approach to think again,” she said.

Worth reading in full.

New York Times Fact Checks “Deceiving” CDC on Masks and Outdoor Transmission

When the New York Times weighs in to fact check the CDC, you know something is in the wind. On Tuesday, reporter David Leonhardt wrote a scathing criticism of the U.S. Federal Health Authority’s recent advice that “less than 10%” of COVID-19 transmission is occurring outdoors.

Leonhardt points out that while this is technically true, it is like saying “sharks attack fewer than 20,000 swimmers a year” when the actual number is around 150 worldwide. “It’s both true and deceiving,” he says.

He calls this “an example of how the CDC is struggling to communicate effectively, and leaving many people confused about what’s truly risky”. The CDC places “such a high priority on caution that many Americans are bewildered by the agency’s long list of recommendations”.

They continue to treat outdoor transmission as a major risk. The CDC says that unvaccinated people should wear masks in most outdoor settings and vaccinated people should wear them at “large public venues”; summer camps should require children to wear masks virtually “at all times”.

However, in reality, “there is not a single documented Covid infection anywhere in the world from casual outdoor interactions, such as walking past someone on a street or eating at a nearby table”.

Leonhardt digs into the studies that supposedly underpin the CDC’s advice and finds layers of conservative over-caution.

Many of the instances of “outdoor transmission” in the literature turn out to be from construction sites in Singapore. This appears to be a classification issue.

The Singapore data originally comes from a Government database there. That database does not categorise the construction-site cases as outdoor transmission, Yap Wei Qiang, a spokesman for the Ministry of Health, told my colleague Shashank Bengali. “We didn’t classify it according to outdoors or indoors,” Yap said. “It could have been workplace transmission where it happens outdoors at the site, or it could also have happened indoors within the construction site.”

The decision that they were outdoors was made by researchers making conservative assumptions.

“We had to settle on one classification for building sites,” Quentin Leclerc, a French researcher and co-author of one of the papers analysing Singapore, told me, “and ultimately decided on a conservative outdoor definition.” Another paper, published in the Journal of Infection and Public Health, counted only two settings as indoors: “mass accommodation and residential facilities.” It defined all of these settings as outdoors: “workplace, health care, education, social events, travel, catering, leisure and shopping.”

Even with this conservative definition, however, the studies still found only a maximum of 1% of infections were caught outdoors.

So where did the CDC get 10% from? Leonhardt enquired and received this statement:

News Round Up

CDC Finds More Clotting Cases After Johnson & Johnson Covid Vaccine

The Centers for Disease Control and Prevention (CDC) has said there is a “plausible causal association” between the Johnson & Johnson (J&J) Covid vaccine and blood clotting after finding more U.S. cases of the condition among people who received the vaccine. Reuters has the story.

The CDC said in a presentation the Agency has now identified 28 cases of thrombosis with thrombocytopenia syndrome (TTS) among the more than 8.7 million people who had received the J&J vaccine. TTS involves blood clots accompanied by a low level of platelets – the cells in the blood that help it to clot.

So far, three of the 28 have died. Previously, as of April 25th, the CDC had reported 17 cases of clotting among nearly eight million people given vaccines.

The Advisory Committee on Immunisation Practices (ACIP), which advises the U.S. CDC, recommended on April 23rd that the U.S. lift a 10-day pause on the J&J vaccinations imposed to review safety data on the clotting issue. The panel will review the new data later on Wednesday…

Scientists are working to find the potential mechanism that would explain the blood clots. A leading hypothesis appears to be that the vaccines are triggering a rare immune response that could be related to these viral vectors.

The syndrome does not appear to be associated with either of the Covid vaccines produced by Pfizer or Moderna.

Most of the cases were among women aged 18 to 49, the CDC said, with rates among women aged 30-39 at 12.4 cases per million and those aged 40-49 at 9.4 cases per million…

Symptoms typically occur several days after vaccination to up to two weeks.

Norway, which has stopped using the AstraZeneca Covid vaccine because of fears over blood clotting, has delayed a decision on whether to include vaccines made by J&J in its national rollout efforts. A Government-appointed commission recently recommended that neither vaccine should be used in the country due to their harmful side effects.

The Reuters report is worth reading in full.

“He Had Won the Victory Over Himself. He Loved the Lockdown.”

We’re publishing an original piece tonight by Dr Sinéad Murphy, an Associate Researcher in Philosophy at Newcastle University, about why it is the public have put up so little resistance to lockdowns. She was prompted to wonder about this by recent pieces on why the Conservatives did so well in last week’s election, from Freddie Sayers’s piece in UnHerd attributing it to Stockholm Syndrome to Noah Carl’s piece in Lockdown Sceptics discussing status quo bias. Dr Murphy thinks it is something more sinister – and deeper – than that.

In an essay from 25 years ago on contemporary conditions of work, the Italian philosopher Paulo Virno identified the phenomenon of uprooting as increasingly operative in societies like his own. Not a once-off uprooting, such as moving from one job or career to another, but an unending process of uprooting, the effect of precarious employment and its continual auditing, in which workers must always be ready to move onwards or upwards and to cultivate the commensurate skills of adaptability and virtuosic sociability.

Most pertinent in Virno’s analysis is the alliance it indicated between this endless uprooting and a certain brand of gullibility. The erosion of stability gives rise to a hyperbolic and free-floating feeling of belonging, even though occasions for it are slight or implausible.

“The impossibility of securing ourselves within any durable context,” Virno wrote, “disproportionately increases our adherence to the most fragile instances of the here and now… to every present order, to all rules, to all games.”

Does the phenomenon of uprooting that Virno described apply to our situation now? Does it explain the curious adherence of so many in our society to the present Covid order and to those who dictate it, no matter how fragile it, and they, have become?

Worth reading in full.

Not So SAGE After All: A Review of the Latest Models

Glen Bishop, the second year maths student at Nottingham who was the first to spot that none of the modelling teams feeding into SAGE had taken seasonality into account last February, has taken a look at the new, improved models from Imperial, Warwick and the London School of Hygiene and Tropical Medicine that led to headlines earlier this week saying SAGE was no longer predicting an apocalyptic ‘third wave’. (Yipee!) The good news is, the teams have corrected their seasonality mistake when modelling the likely impact of the lifting of restrictions and now graciously allow that summer sunshine will ameliorate the spread of the virus – one of the reasons their latest projections are less gloomy. But there’s also plenty of bad news, as you’d expect.

Here is an extract:

A rational group of scientists would advise that risks are now within the normal accepted range and thus the end of restrictions is nigh and normal life will return. Unsurprisingly, that is not what these three modelling teams have done. Their models have failed to deliver the pessimism and danger craved by scientists clinging on to power, but a new obsession is taking over – the danger of variants. Imperial elaborates: “preventing the importation of variants of concerns (VOC) with moderate to high immune escape properties will be critical as these could lead to future waves orders of magnitude larger than the ones experienced so far.”

Previous Imperial models have made only passing reference to new variants and never tried to model them, yet Imperial’s latest paper, which shows (even with their modelling) the risk from covid to now be incredibly low, is half filled with predictions of theoretical super variants. The most pessimistic of the predictions entails an imaginary ‘high escape’ variant, which, if we stick to the current roadmap, would lead to a peak of over 4,500 deaths per day and a total of 225,000 deaths this summer. To put this into perspective, it would mean a death rate this summer of 3,300 per million, that is double the death rate in Florida since the pandemic began of 1,669 per million despite Florida being near fully open for the last eight months. It’s a higher total than anywhere in the world since the pandemic began. This is void of reality, but even if it weren’t, what is the proposal? Lockdown for another year until a vaccine for this new variant can be distributed, by which time even more variants will have appeared? One might as well include in the modelling a super infectious variant of Ebola or a new improved laboratory leak from our friends in the Wuhan Institute of Virology.

Worth reading in full.

Pfizer and Moderna Vaccines to Be Offered to Under-40s From Thursday

The Covid vaccine rollout is set to extend to those below the age of 40 from Thursday, with the Pfizer and Moderna vaccines being offered as alternatives to that made by AstraZeneca “where possible”. MailOnline has the story.

An NHS bulletin showed adults aged 38 and 39 will be invited to come forward for their jab from Thursday morning.

They will be offered either the Pfizer or Moderna vaccine on the back of guidance from medical regulators last week.

The Joint Committee on Vaccination and Immunisation (JCVI) said under-40s should be given an alternative to the AstraZeneca jab due to its link to rare blood clots.

The NHS Digital bulletin said 38 and 39 year-olds already booked in for a first dose of the British vaccine will have their appointment cancelled…

The vaccine rollout is currently in phase two – which includes people between 20 to 49 – and is moving down by age. 

The Government says it is on track to fully vaccinate every adult in Britain by the end of July.

Everyone in phase one of the scheme, which included elderly people and patients with underlying health conditions, has already been offered a vaccine.

Uptake is thought to be around 90% in the over-60s U.K.-wide, while coverage in the over-50s is above 50% and still climbing. Over-50s only started to be invited last month…

The JCVI – which advises the Government on how best to vaccinate the population – said younger people should be offered an alternative to the AZ jab because of its link to blood clots. 

So far regulators have spotted major blood clots in 242 people given the AZ vaccine, of whom 49 died. But they are occurring more in younger adults, with a rate of around one in 60,000 under-40s.

Experts said the infection rate in the U.K. is now so low that the risk of the rare clots outweighs that of Covid in younger adults, who often only suffer mild illness. 

They will be offered the Pfizer or Moderna vaccines instead, so long as there is enough supply and it won’t delay the rollout.

Given that the risk of blood clots after taking the AstraZeneca vaccine outweighs the risk of Covid in younger adults, it is strange that the JCVI has only advised for alternatives to be given “where possible and only where no substantial delay would arise“. Why not just restrict its use for those below the age of 40 altogether?

The MailOnline report is worth reading in full.

Boris Tells Commons that Pandemic is Currently at Peak and U.K. Should Expect New Surge in Autumn

Speaking in the House of Commons, Prime Minister Boris Johnson has said the Indian coronavirus variant is of “increasing concern” as outbreaks have been detected across the country. 

He said that despite increasingly encouraging data in the U.K, the threat of the virus remains “real” and new variants “pose a potential lethal danger”.

The end of lockdown is not the end of the pandemic. The World Health Organisation has said the pandemic has reached its global peak and will last throughout this year. The persistent threat of new variants, should these prove highly transmissible and elude the protection of vaccines, would have the potential to cause greater suffering than we had in January.

He added there is “high likelihood” of a new surge in infections and hospitalisations this autumn when “the weather helps the transmission of respiratory diseases, when pressure on the NHS is at its highest”.

Earlier today, junior minister George Eustice said that local lockdowns and tiers could make a comeback in response to local outbreaks.

What happened to the lifting of restrictions being irreversible? Wasn’t that supposed to be the reason it was happening so cautiously and slowly?

Despite the fast vaccine rollout and the example of states like Florida and Spain that have ended the state of emergency, the noises coming from the U.K. Government increasingly suggest they have no intention of returning the country to a normal footing any time soon. Perhaps a permanent state of emergency, and a posture as saviour, is good for elections?