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Managing COVID-19 Tradeoffs: An Economic Lesson by a Pediatrician

By Shlomo Maital

   Well, it took a pediatrician to teach everyone a simple, powerful lesson in Economics. The pediatrician is Aaron E. Carroll, and he is Professor of Pediatrics at the Indiana University School of Medicine. His Op-Ed in today’s global New York Times * makes an important point.

   “…as we loosen restrictions in some areas, we should be increasing restrictions in others.”

   Simple? Obvious? As kids go back to school today, and joyously huddle with their friends, whom they haven’t seen for ages, the assumption is, if we’re clustering together in school, it’s OK to cluster together everywhere.

   It’s a free lunch. The logic is “both-and”. Both at school, and at home, and at parties, and …everywhere. Both-and is today’s social norm. We want it all.

   But there is a tradeoff at play here. If you take more risk in school, then you have to take less risk elsewhere, because – we cannot let risk rise infinitely, it is a kind of resource that is fixed in amount, and if we use too much of it, it will for sure come back and bite us hard…

     This is a very hard lesson for everyone to swallow, especially when the feeling is: We’ve quarantined, social-distanced for so long – now it’s over, time to huddle and cluster and gather.

     Not so. The second wave of COVID-19 has occurred mainly because of this false assumption.

     So let us each of us take responsibility and manage our risk tradeoffs. The question should be: what am I doing, that increases the risk of infecting myself and others? What can I do to reduce that, so that when I do join 10 others for prayer or socializing, my risk allocation is not excessive.

     Long ago, I taught managers a useful tool for managing business tradeoffs, known as “Even Swaps”, co-invented by Harvard Professor Howard Raiffa, a game-theory expert.** The idea here is simple. List all your options. Discard those that are ‘dominated’, that is – all other options are better in every way. This is easy.

    Next part is hard. For the remaining options, list the six common things for each that bring you joy. Score each 1 to 5, with 5 being “most joy”. Now — a short cut (Raiffa’s approach is more complex): Imagine yourself choosing each option: A, B, C….  and ask which– brings more joy? (Note: joy is not happiness…it is less ephemeral, less transient, deeper, with more meaning).

     And a supplemental tool. Of all the things I am now doing – ask yourself, which can I stop doing, totally, and as a result, find greater joy? In new product development, ‘addition’ (what feature can we add?) creates cluttered, costly, complicated, unfriendly devices. Best to start with subtraction: What can I REMOVE from this device, to make it better, friendlier, simpler, cheaper?   The same works in life. What can I stop doing? Specifically, what can I stop doing, that reduces risk of becoming infected and infecting others?

     The notion of giving up things we like is a tough one for modern society. Climate change policy, and its failures, are proof. But in a pandemic, as Dr. Carroll points out, recognizing trade-offs and managing them are vital. Thanks, Doc!  It took an MD to explain some basic Economics.

* “Most of us have the risk of COVID-19 exactly backwards”. Sept. 1, P. 11

** J S Hammond, R I Keeney, Howard Raiffa. “Even swaps: A rational method for making trade-offs”. Harvard Business Review, March-April 1998.