It seems like it's mostly being taken as a given that we want to avoid panic. I'm sure avoiding panic is in fact desirable, but I don't quite understand why that's the case, so please interpret this post and my follow up comments as Socratic grilling.

If there was panic, here is what I would expect:

  • People would stay home as much as possible.
  • This would involve some staying home from work, which would hurt the economy.
  • There would be enough public support to get more government funding approved.
  • With that money, they'd find a way to continue to provide core infrastructure to people. Eg. by simply paying workers more to go to work.
  • There would be a huge demand for things like hand sanitizer and masks that wouldn't be able to be met. So the government would have to step in and regulate those items.
  • People would rush to the grocery stores to stock up, and stores wouldn't be able to meet the demand. So the government would have to step in again, perhaps to restrict purchases and distribute food to people. But that seems like something that is doable. Eg. give everyone a big bag of rice and beans.
  • With everyone staying home, it'd reduce the spread of the virus.
  • Which would buy us time to produce more tests.
  • Eventually we'd be able test the whole country and figure out who is infected and who isn't.
  • From there we can isolate and treat those who are infected.
  • And once we do that, the risk of transmission will be much smaller, and we can start to move back to normalcy.

Here is what I suspect might be wrong with that story I just told:

  • Maybe it wouldn't be so easy to provide core infrastructure to people. Maybe I'm underestimating how many moving parts there are.
  • Maybe the economic damage caused by all of this fear will really set society backwards.
  • Maybe the government doesn't have the authority to do a lot of the stuff I'm envisioning.
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TheMajor

100

Several of your bullet points read "X goes wrong, until the government steps in". What makes you think the government is able to put out these fires at the same rate as people run into them? The government also just consists of people. Declaring a national emergency, regulating supplies and stores, testing the literal whole county and providing food and healthcare packages takes time, planning and frankly skill that I'm not sure governments have.

That being said, I agree with quite a few of your points. But I think the negative impact of empty grocery stores, people hoarding hygiene products, shops closing because too many employees are staying indoors etc. will be very serious, and that it will take at least weeks before any centralised plan will be able to catch up with this.

Declaring a national emergency, regulating supplies and stores, testing the literal whole county and providing food and healthcare packages takes time, planning and frankly skill that I'm not sure governments have.

Do you mind elaborating on that?

But I think the negative impact of empty grocery stores, people hoarding hygiene products, shops closing because too many employees are staying indoors etc. will be very serious, and that it will take at least weeks before any centralised plan will be able to catch up with this.

Would it be such a bad thing if... (read more)

4TheMajor
Of course, although I do run into the problem that to me most of this is self-evident, which makes it hard to motivate. But I'll try to explain some of these claims in more detail. * Declaring a national emergency is a huge cost for a country in general and a government in particular. I think the best way to look at this is that the converse state, "everything is fine please continue operating as normal", is a very profitable and desirable state, and you're destroying that. At the very least this can disrupt economies and production chains, but also public trust (between members of the public, the public and industry, the public and government, the industry and industry, etc.) * Regulating supplies and stores is hard. How do you decide how much goes where, which stores need to stay open and which can close, how much to downsize your public transport and community spaces and services? How much extra money is this all allowed to cost? Below you mention to steve2152 that workers will keep working if you just increase their salary, but who pays for this (which department/ministry/bill in particular)? How high are the salaries supposed to be? How do new findings on the spread of the disease impact each of your answers, what are your tipping points for swapping to a globally different approach? Do you even have people at the right level of the chain of command to suggest these ideas (to be honest I've never heard of governments paying workers extra during national crisis to keep them working, outside of cleanup of nuclear meltdowns). On top of this I think governments have very little experience with epidemics like the one we are facing (globally) today. Like I said I think this is very hard, and if there wasn't any particular reason for my government to sort all of this out beforehand, I expect them to not have this sorted out at all. * (On testing the literal whole country) I don't know about the global situation, but at least where I live I know we're not doing doo
3Adam Zerner
Thank you, I appreciate it! I think that's a good point. I had been overlooking it. I have a tendency to use a "when death is involved, nothing else matters" heuristic. However, my impression is that if P(>10% of the population is infected) is reasonably high — say, >25% — then the cost to the economy would be tremendous, and it would be worth paying a huge cost right now to avoid that possibility. I'm no expert of course and am totally just eyeballing those numbers. This all is to say that if the reason why panic is so bad is due to the economic impact, it's not clear to me that it's better than the alternative of taking a chance at an even worse economic impact. For those questions you proceed to pose, my thought is that you have to just make your best guess and go with it. Best guesses may not be perfect, but I would expect them to be solid. In other words, none of those questions seem difficult enough where it would stop us in our tracks. I thought the CDC researches and plans for all of these scenarios? Isn't that their entire purpose? (Sorry for the sass; it isn't aimed at you :)) I can't find the link but I recall a YouTube video where a doctor mentioned that tests cost somewhere around $20, and talked about how here in the US you have to sit in a waiting room with a bunch of sick people sneezing around you, but in Korea it's a drive through where you get a quick swab and get your results a few hours later. If we say the cost is $50/person total, that'd be about $15B to test everyone. I have a bad intuition for the magnitudes of numbers that are used in macroeconomics, but the market for laptops was about $100B in 2017, so I assume the impact of the coronavirus is roughly in hundreds of billions or trillions, in which case $15B isn't that bad. My thinking with the healthcare box is that it'd be something that might be necessary if people isolate and if the panic is severe enough where people can't get food at grocery stores, not that it would fix the
4TheMajor
Are there any explicit approaches you're thinking of that can be taken? Truth be told I don't see how we would realistically stave off this scenario, other than the harsh quarantine measures that worked in China. This is (as far as I can tell) a main part of why so many people here are freaking out - we're headed straight for this scenario and governments are not seeing the smoke. As an example, consider Italy to see the lack of preparedness to take action (closing off a massive region now because it's too late to contain the Corona locally, 366 deaths total so far, leaked documents on containment causing people to move out of containment areas before containment set in). I totally disagree. I think "someone's best guess and go with it" is going to be horribly mismatched with what we actually want from stores and supplies, and will be actively harmful. I don't really know how to explain this in more detail, but I do not think most governments are adequate at the level needed to supply a whole country in an emergency. No problem ;). I don't know much about the CDC in particular, but I am currently seeing rather varying responses from health officials globally. This is one of the weaker points in my fears though, maybe our health officials have been preparing for an event like this outbreak for a long time, and have entire flow charts and calling lists and plans ready. I rather doubt it though, considering how (at least for me locally) they've been described as overwhelmed, and it's taking them rather longer to respond than I expected. Also I think most of these health officials have other tasks than specifically targeting novel epidemics, such as fighting the seasonal flu, informing the public and dealing with more 'mundane' but far more commonly occurring disease outbreaks. I would love to be wrong here. I think this is simply naive. First of all, there is (again) a huge difference between one test bought for yourself, and purchasing tests for everybody in a coun
7Adam Zerner
Harsh quarantining is the main one. Also promoting low hanging fruit like the stuff we've found on the CJPA thread. Fair enough. It seems this is a pretty important prior. If you're right about best guesses being horribly inadequate, then I do agree that it would be a bad idea overall. Perhaps. You make some good points, and planning fallacy is certainly a thing, so I think your estimate of $100B is probably closer to the truth than my $15B one. But even at $100B it still seems like a bargain. And I think that similar planning fallacy-related points can be made about estimating what it would cost us if it spread to eg. 10% of the world's population. Eg. it probably costs a lot more than what our first estimates would be. Is it? I'm not well-versed with politics but my impression is that doing things in the name of safety is good for electability. Eg. through the roof military spending. Well, that's just one example, and I can also think of counterexamples. There are of course those who want to cut health care spending. And departments like the CDC seem to be underfunded. So overall I get a weak sense that it'd be a risky career move. However, worrying about your career seems like a big lost purpose to me. Why acquire political power if you're not going to cash it in at a time like this? I doubt they're saving it up for something more important. It seems more like they seek power for power's sake. But I digress.
[-]jmh10

I would add that during a panic people tend not to listen to the government and all its actions to control the crowd are viewed as both harmful and dangerous to the people and, in standard mob mind think, get to "the government is doing this to us" and so really bad things start happening.

2Adam Zerner
In other types of panics I can see this being an issue, but here wouldn't it just lead to more isolation? If not, can you be more specific about what bad things you envision would happen?
1jmh
Situations where the emergency policy is seen (correctly or not) as endangering a population (town, city, metro area) or preventing them from protecting themselves. Consider the dynamics in situations like Ferguson MO stemming from the way the government there dealt with the shooting of Michael Brown or the increasing escalation in Hong Kong. Both cases were actions supposed to be in the public interests but were not seen as such. However, I have also said that well done, emergency actions by government can actually reduce and alleviate panic/potential panic.

Davidmanheim

90

Here are a number of points:

  • People flocking to the hospital now to demand treatment for a simple cough, or for influenza, will overwhelm hospitals just when we need them most.
  • It's far harder to do contact tracing and reaching out to the community to get them messages about what they should or should not do when people are panicking.
  • When there are sufficient supplies of things like food, like now, and people start hoarding, shortages become a self-fulfilling prophecy. (On the other hand, if there would be shortages anyway, then the only justification for encouraging hoarding is because you want to buy things instead of someone else who may need it more. From a utilitarian perspective, that seems obviously unjustifiable.)
  • "The government" in the US certainly doesn't have the authority to do most of these things. Governors can declare a state of emergency on a per-state basis, but commandeering resources would still be hard to justify legally. They would try to do it anyways, but a state government doesn't have enough people to actually do most of this.
  • Lots of essential industries like the water company and the electric company need other parts of the economy, like delivery trucks and computer-logistics systems to continue functioning. These can all break down in a panic. Worse, I'm very uncertain how robust the US economy is to shutting everything down, then trying to start back up.
"The government" in the US certainly doesn't have the authority to do most of these things.

Both the federal and state governments have vast powers during public health emergencies. For instance, the Supreme Court has made clear that the government can hold you down and vaccinate you against your will. Likewise, the Army (not just National Guard) can be deployed to enforce laws, including curfew and other quarantine laws.

Yes, it's unclear whether government officials would be willing to use these options, and how much the public would... (read more)

It's far harder to do contact tracing

Why is that? I'm assuming that panic would mean more isolation and only going out to gather essentials like food and medicine. With that assumption it seems like it'd be easier to do contact tracing.

and reaching out to the community to get them messages about what they should or should not do when people are panicking

If the internet stays up I don't see why there'd be a problem here.

Lots of essential industries like the water company and the electric company need other parts of the economy, lik
... (read more)
When there are sufficient supplies of things like food, like now, and people start hoarding, shortages become a self-fulfilling prophecy.

Would it make sense to encourage the panic to start too soon? First the customers would cause a shortage, then the producers would increase their production in hope for easy profit, then the shortage would end with everyone having enough stuff at home... and then the actual need would come.

More simply, if people are going to empty the shops eventually, I prefer if they do it one month before the actual crisis rather than one week before it. Because during one month, the market may fix the shortage, but one week is not enough time to do much.

2Davidmanheim
It sounds like a good idea, but won't actually work in practice for most goods. Supply chain resilience is minimal, the demand would be near-global, rather than local and possible to fulfill via redicrecting supplies, and forecasting of supplies and just-in-time production requires far more warning than the current crisis allows for most goods. It's not like there is tons of excess goods or farm capacity just sitting around to be used when demand suddenly jumps - and the dynamics in these systems can be messy.
3Adam Zerner
It seems to me that it doesn't have to work for most goods. People can make do with eg. beans and rice for a while until things settle down. Would the government be able to distribute big bags of beans and rice to people?

Elizabeth

60

Increasing perceptions of danger could lead people to refuse to take care of people they otherwise would have provided care for. This is undoubtably bad for the person who would have received care; whether it's good or bad for society as a whole depends on the specifics of transmission and care.

kithpendragon

20

Because people who think and act deliberately are less likely to blindly and actively hurt others than those who are acting on a fight/flight/freeze instinct. We are not evolutionarily equipped to handle threats of a nature such that:

  1. it just doesn't have a face to punch
  2. running away is just going to result in the formation of dangerous migrating packs of sick monkeys spreading the problem around and looking for something with a face to punch
  3. freeze looks like going about business as usual and ignoring the problem, which is good news for the invisible, unpunchable threat

Panic is what we call it when the elephant has gotten really freaked out and the rider stops trying to determine the best course of action in the face of what feels like an uncontrollable primitive mind. Panicky people tend to do stupid things like breaking quarantine, other-seeking for comfort, finding out those people are all panicking too and starting a riot instead of appropriate behaviors like staying inside whenever possible, making phone calls to authorities to report the riot outside, and washing their damn hands (and maybe sanitizing the phone as well).

I think it's axiomatically better if people do stuff on purpose instead of acting out of animal fear. I'd even think this if people were choosing to do the wrong stuff due to, let's say... inconsistent and unreliable messaging or something, because at least they're thinking and acting deliberately which makes them less likely to do the stupid panicky animal things that confer no benefit but add needless harm to the problem.

running away is just going to result in the formation of dangerous migrating packs of sick monkeys spreading the problem around and looking for something with a face to punch

Wouldn't people here be afraid of getting infected and just want to stay home? If the army was deployed, would this still be a risk?

1kithpendragon
Maybe, and maybe. I would expect to see a range of responses from panicking people acting on all parts of fight/flight/freeze instincts. And I think bunkering down safe at home is certainly one possible freeze reaction. One likely flight reaction is driving/walking aimlessly "away" from the threat (think, "if I just get far enough away from the city I'll be fine"). If enough people take the latter action, they are likely to meet up and start moving aimlessly as a group* despite the increased risk of infection ("Those people look healthy, and there's safety in numbers"), and I think we all know how groups of humans can act. :( *A group, BTW, with next to no planning or leadership structure, probably limited food and water supplies, not using sanitary facilities reliably, not washing their hands often, and most likely carrying lots of guns. As for the army, if they were able to help at all I think it would be because they were following orders given to them by an officer who had the distance and training to be able to think more clearly. Would a military presence in the street scare more people into staying inside? Probably, and especially if there were clear instructions being broadcast at regular intervals. I've seen some people behave very well when you take their need to think out of the equation. On the other hand, you're going to have the folks who freak out into fight mode because they think "they're here to take our guns!" or some such, resulting in more needless deaths. Furthermore, mobilizing a military force mixes people around more and further exacerbates exposure risks. This is not a step I would choose to take at this time.
2Adam Zerner
Hm, it does seem likely that some people would flee, thinking "if I just get far enough away from the city I'll be fine". And as jimrandomh mentions, this would lead to more spread of the virus. However, my intuition is that 1) there wouldn't be too many people trying to flee, and that 2) deploying the army would make that risk trivial. My intuition could very well be wrong though.

Derek Lomas

10

By analogy: most of the deaths from the Spanish flu are believed to have been caused by over-reacting immune systems. Our global response to disease has the potential to cause more damage than the disease itself.

That is not necessarily what is happening -- but it is a scenario we should be aware of.

are believed to have been caused by over-reacting immune systems

I'm not sure what you mean by this. Most who died from the Spanish flu, actually had a literal allergic reaction to the Spanish flu? That people died from the medical treatment meant to combat the flu?

4Elizabeth
I don't believe it counts as an allergy, but it was their own immune system overreacting. It's called a cytokine storm.

1 Related Questions

2Answer by Derek Lomas
What percent of 70+ year olds that enter a hospital for cold/flu symptoms end up dying? Without knowing that as baseline, it is hard to meaningfully evaluate the covid19 death rate, especially considering that only the seriously ill are tested. In this study, about 9% of non-elective geriatric patients admitted to a hospital die. https://academic.oup.com/ageing/article/34/5/467/40349 In this study, it was closer to 15%. http://www.scielo.br/scielo.php?pid=S1807-59322009000700002&...
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The main way in which panic causes damage during outbreaks is from people breaking quarantine to flee affected areas, and bringing the disease with them. This may be a problem later, when more areas have travel restrictions, but it isn't a problem if it happens right now. So I expect that early panic is better than late panic.

That makes sense, thank you.

I sure don't want the people who are supposed to be balancing the electrical grid to panic and stay home to keep themselves and their families safe. Or the police, or the government employees in charge of coordinating everything, or the waste treatment plant workers, etc.

I don't want people to have the emotion of "panic" when they're told to isolate themselves to protect the community. The logic of panic is: "Who cares about "the community", I'm doing what's best for myself!"

That certainly makes sense when it comes to core infrastructure, but it's not clear to me that core infrastructure would actually be compromised.

With panic I'd think the government would be able to get a ton of funding to fight this. Perhaps that can be used to pay workers in core infrastructure 2x their normal wages. Would they still stay home? More than 75% of them? What if it were 3x their normal wages? Are there no other incentives that would work?

[-]jmh10

Along the same lines, it seems that some of the panic causes declaration of national emergency and placing restrictions on various normal activities is not the full story.

I think, and a lot depends on the how it is done and perhaps when, declaring national emergencies can help to limit panic, provide a structure where most see they have a coordinating rule in place so end up trusting that others will act as they will (e.g., we get an equal share of the scarce resources and not some asymmetric distribution unrelated to a utility type allocation).

I think this might also have some implications for the claims about how the west could not possibly be successful in limiting the spread like China, Singapore or Taiwan have done. The West will simply do that in a different manner. It is not clear to me that only one way to accomplishing the same goal is possible (gross as the metaphor is cats do get skinned many different ways).

Why wouldn't the west be successful in that sort of socialist role? Would citizens resist? With physical violence?

[-]jmh10

What I was suggesting is that the western democracies do not have to use the same tool set as more authoritarian government seem to have used. Quarantines may well be imposed (on significant geographic areas) but might not need to issue commands for related supplies like waste disposal or resource deliveries. They can (and a lot more easily based on above comments than most seem to think, in terms of just pure governmental powers) but that might not be needed or even the most efficient way for western societies to do so.

Could people resist or resort to violence to resist such policies? Maybe but that will depend on a number of factors, including what what might be called something of a path effect -- the war could have been avoided but some early actions lead to a situation neither side could back out of so war ended up being the path of least resistance.

Ah, I see.