“How many lives will be lost due to our attempts to prevent loss of lives”

Those making decisions about how to combat Covid-19 have an unenviable job with lives and deaths at stake. Not only do they have to try and limit deaths from the virus, they also need to prevent deaths from increasing due to related effects, in particular re-prioritising of health care.

And important question raised is “How many lives will be lost due to our attempts to prevent loss of lives” but it  doesn’t come close to being answered here.

Ananish Chaudhuri, Professor of Experimental Economics at the University of Auckland has A different perspective on Covid-19 (but I think while some of his arguments are valid he goes off the rails a bit).

In his book “Risk Savvy”, the behavioural scientist Gerg Gigerenzer notes that, in the immediate aftermath of September 11, 2001, many Americans decided that flying was too risky. Instead, they chose to drive. In the 12 months following the attacks, an additional 1,500 people lost their lives on the road while trying to avoid the risk of flying. This is more than the total number of passengers in the planes used in the attack.

A similar phenomenon is playing out right now as the world essentially comes to a standstill to prevent deaths from Covid-19. But in doing so, we are focusing on what the psychologist Daniel Kahneman calls “identified lives”; the loss of lives that are right in front of us. Gigerenzer calls this the “fear of dread risk”: the apprehension about losing a lot of lives within a short time.

In focusing on identified lives, we ignore the loss of “statistical” lives. It is likely that the total impact of that loss will be greater than any loss of lives due to Covid-19. But those deaths will register less on our collective psyche since they will be diffused, scattered all over the world and will not be reported on in the same manner.

Like it or not, there is a trade-off here: how many lives will be taken by Covid-19 (identified lives) and how many lives will be lost due to our attempts to prevent loss of lives from Covid-19 (statistical lives).

In fact, at the time of writing, hospitals in Washington State, which has been hard hit by the virus, are engaged in a bleak triaging of which patients should receive treatment and which should not, since providing everyone with adequate treatment is no longer an option.

This is a real dilemma for hospitals and doctors. They have to make life and death decisions all the time, but with the huge added pressure and workload due to Covid-19 these decisions become more complicated and perhaps more critical.

Already, we are seeing a spike in unemployment claims and business insolvencies. We know that unemployment results in significantly lower life expectancy.

But does that apply to short tern unemployment, or long term unemployment. I expect that the shorter the time unemployed the lower the lowering of life expectancy, so you can’t just look at a snapshot and say that doubling unemployment will have drastic impact on life expectancy. If unemployment as a result of Covid-19 has a significant long term impact then reduced life expectancy becomes an issue.

The human cost of job losses and bankruptcies will be massive. Much of the pain of this shut-down will be borne by the socio-economically disadvantaged.

I don’t know how that “will be massive” can be confidently claimed at this stage. We don’t know yet how much extended unemployment there will be, nor what the impact on people’s lives that will have statistically.

Does the Government (or Treasury) have realistic estimates of how much the economy will shrink, how many jobs will be lost, how many businesses will go bankrupt? How large is the relief package required to prevent an economic catastrophe if the lockdown ends after four weeks or if it continues beyond that? Surely, this calculation should play a role and dictate how long a shut-down we can survive.

The Government should certainly be considering all this and they should be weighing up various risk factors, but claiming adverse effects “will be massive” is a bit like warnings of massive deaths from Covid, but based on virtually no data.

It is clear a crucial factor is population density. So a lockdown in places like Auckland or Wellington may make sense. It is not clear to me that large parts of the South Island, with low population density, need to be locked down.

What’s not clear about this – the Southern District (Otago and Southland) is one of the most sparsely populated parts of New Zealand yet it has the has the highest number of cases of any region, and by far the highest cases per head of population.

For much of the country outside the large metropolitan areas, we should be able to do what we were doing before. Avoid large gatherings and implement self-isolation as needed.

Let people decide their risk-tolerances. Offer all those above 60, those with a history of respiratory problems or ones with compromised immunity the opportunity to work from home, should they choose to do so.

Giving everyone choice seems misguided. This doesn’t just involve personal risk, community risk is a key reason for community restrictions and safeguards. Chaudhuri does acknowledge this to an extent.

What we face right now is a social dilemma; those who have been infected need to make sure that they do not spread the infection. But, evidence suggests Kiwis were and are doing a pretty good job with self-isolation.

Evidence suggests that until we went into lockdown the virus was spreading, with major clusters that began before the lockdown being a school, two weddings, a bar event and a farm conference. So self-isolation by choice only was not working.

My research suggests people can be quite good at solving such collective action problems; that exhortative public messages asking people to choose cooperative actions can succeed. It may need to be backed up with sanctions for hard-core violators.

The problem with a virus is that it only takes a few risk takers and violators to increase transmissions, and that can easily impact on those who don’t want to take risks. If someone went to a risky wedding, contracted the virus, and then chose to visit someone in a rest home it could create a serious problem.

At the very least, the Government should track the path of the infection and selectively loosen restrictions in different parts of the country as and when appropriate.

That’s what is being considered and planned.

Ideally, much of the country should be restriction-free before four weeks have passed.

There’s no chance of that withing the first 4 weeks of the lockdown. And it is very unlikely much of the country will be restriction-free for months at least. The best we can hope for is some areas to be dropped to level 3 after 4 weeks, but that will have to be carefully managed and monitored. Coming back to level 2 looks some time away in the best of scenarios.

I started this post thinking the article was exploring “How many lives will be lost due to our attempts to prevent loss of lives”, an important thing to consider, but it paid scant notice of that and switched to nothing more than promoting a big and rapid relaxation of restrictions with very questionable and in some cases straight out uninformed reasoning.

Leave a comment

47 Comments

  1. David

     /  8th April 2020

    There is a noticeable amount of activity starting to happen from shops being able to do internet sales, supposedly limited to essential items but not. Road work crews were back out on a small scale in Christchurch although the guys from Isaac were huddled in a group of 3 with no ppe gear which seemed pretty dumb given the opportunity they have that others dont.
    We are seeing a loosening by stealth at the moment which is smart.

    Reply
  2. artcroft

     /  8th April 2020

    There will be lots of long term unemployment as well. Air NZ is laying off hundreds of pilots and expecting to be a much smaller organisation when travel resumes. If you’re a pilot in the 50+ age bracket, what are your chances of working again? If you’re a young pilot with lots of debt from training, how do you feel about all the new competition you face when lock down ends and airlines have a choice of who to hire and little incentive to offer big wages. This goes for almost every industry in the nation. Long term/permanent unemployment is a reality for many. Hence I think the pressure on the Govt to reopen at the end of four weeks will be HUGE. In fact Ardern may not have much room to manoeuvre at all. She might squeeze out another week but that’s it.

    Reply
    • lurcher1948

       /  8th April 2020

      Not much point having a job if you die obtaining it

      Reply
      • artcroft

         /  8th April 2020

        Yeah, crossing the road to the job interview can be dangerous.

        Reply
        • Blazer

           /  8th April 2020

          Unfurl the banners from the 80’s…’unemployment isn’t…working’!

          Reply
      • Alan Wilkinson

         /  8th April 2020

        Not much point in staying safe if you die doing it either Lurch. Better to die free than live as a prisoner?

        Currently the UK has no exit plan. Ours is merely an aspiration.

        Reply
      • Pink David

         /  8th April 2020

        “Not much point having a job if you die obtaining it”

        Men have pursued dangerous occupations for as long as history goes back. Men go down coal mines knowing it will kill them, they go offshore fishing, they fell trees.

        It seems very much like people makes this choice millions of times a day.

        Reply
        • Blazer

           /  8th April 2020

          men with limited choice undertake the vocations you mention.

          Reply
          • Pink David

             /  8th April 2020

            History shows this is not true. Men work in these fields because they like it.

            Reply
            • Gezza

               /  8th April 2020

              Could be right for some, if the job pays big money. But in many cases a scarcity of jobs sees jobless men working in some dangerous or high risk occupations (like mining) because they have little education and/or no other option to feed their families, Pinky.

              I’m intrigued by your claim though. Do you have a link to any articles or research that backs up what you say there?

            • Pink David

               /  8th April 2020

              “Could be right for some, if the job pays big money.But in many cases a scarcity of jobs sees jobless men working in some dangerous or high risk occupations (like mining) because they have little education and/or no other option to feed their families, Pinky.”

              Money is a significant motivator for men, far more so than women. It is not clear than men pick these careers just because there are no other options. Men still chose to go deepsea fishing when its not well paid and there are plenty of other choices that pay better with less risk. People choosing to join the military are very clearly not doing so for money, nor because it’s the only option.

              “I’m intrigued by your claim though. Do you have a link to any articles or research that backs up what you say there?”

              In terms of preferences? It’s been looked at quite a lot and the oddest thing is that these difference maximise in societies that are most equal. I’ll did out what I’ve read.

            • Blazer

               /  8th April 2020

              ‘Money is a significant motivator for men, far more so than women. ‘
              b/s on this one ,money=security for women.

              Men still chose to go deepsea fishing when its not well paid’….like hell,most crews are Filipino,Mexican , Asian.


              People choosing to join the military are very clearly not doing so for money, nor because it’s the only option.’

              It is the only option for the majority, in the U.S at least.

            • Kitty Catkin

               /  8th April 2020

              In 1920s England, a man working in a mine earned less than a woman working as a secretary.

              Mining is well paid now (as it should be) but it wasn’t always. Men in the North of England and Wales were miners because there was virtually nothing else.

  3. Also regarding ““How many lives will be lost due to our attempts to prevent loss of lives” there is also a good chance of reduce losses of lives in some ways. For example in the short term road deaths will be reducing, as will air accident deaths and drownings.

    Drastic reductions in air and water pollution will have positive benefits.

    The lost of access to unhealthy takeaway and cafe foods and drinks will benefit some people, as long as they don’t just by junk from the supermarket.

    Reply
    • Alan Wilkinson

       /  8th April 2020

      I don’t see drastic reductions in water pollution for NZ

      Reply
    • Alan Wilkinson

       /  8th April 2020

      And I had to explain to the checkout lady that Mrs Al regards chocolate as essential. She agreed with her.

      Reply
    • Pink David

       /  8th April 2020

      “The lost of access to unhealthy takeaway and cafe foods and drinks will benefit some people, as long as they don’t just by junk from the supermarket.”

      Your starting to sound like the head of Public Health England, who wants to use this crisis to take over everyone’s diet through rationing.

      Reply
      • Alan Wilkinson

         /  8th April 2020

        I suspect he’s liable to lose his job through rationing virus testing when providing it was actually his job.

        Reply
        • Pink David

           /  8th April 2020

          His job is to tell people that sugar is bad and make attempts to run their lives. He has no role in people’s health.

          Reply
  4. David

     /  8th April 2020

    The models are being revised down by huge amounts in terms of deaths, ICU beds, ventilators which is very pleasing. The overwhelming of hospitals outside of Spain and Italy hasnt happened.
    Denmark is going to start opening schools as is Norway.

    Reply
  5. Alan Wilkinson

     /  8th April 2020

    Any cop who arrests someone for non-essential driving should be sued for making an unlawful arrest and endangering life by taking the victim from the safety of their car to the highly unsafe prison.

    Reply
    • Gezza

       /  8th April 2020

      Jeez. Who’s been arrested for non-essential driving?

      Reply
      • Alan Wilkinson

         /  8th April 2020

        Cops are threatening to. Even setting up roadblocks. Supine media should be pushing back.

        Reply
        • Duker

           /  8th April 2020

          National State of Emergency, people can be prevented using a road. Quarantine restrictions mean only essential travel for food/medical reason allowed.
          Only persistent people are arrested/given a ticket. All the others are warned and turned back
          certainly locals on holiday spots dont want ‘out of towners turning up and they are the ones along with the local civil defence officers who working with police.
          Nothing to push back from the media as they know the legal basis is sound

          Reply
          • Alan Wilkinson

             /  8th April 2020

            It’s utter crap, Duker, like a lot of what you write. If you can exercise/walk for an hour you’ll cover 5km. Why the hell shouldn’t you drive it? If you are social distancing what on earth is the difference between doing it 100m or 10km away? Bloody ridiculous.

            Reply
            • Gezza

               /  8th April 2020

              No point expecting the supine media to be pushing back, Al.

              A job for the aggro media, that one.

              Corky might know of someone suitable in radio ? In the current state of the nation, what’ve those talkback hosts & shock jocks got to lose – apart from maybe their job & a dedicated audience of feckin whiners? o_O

            • David

               /  8th April 2020

              I cant see why you arnt allowed to go to your bach, if you are still in your bubble what is the problem.
              Our health and emergency services have literally nothing to do at the moment its hardly likely to over burden them if someone has an accident. The roads are pretty much empty and you are hardly likely to meet a chinese tourist on the wrong side of the road.

            • Alan Wilkinson

               /  8th April 2020

              It’s the usual Lefty issue, David. They’re terrified someone, somewhere might enjoy themselves.

            • Blazer

               /  8th April 2020

              ‘They’re terrified someone, somewhere might enjoy themselves.’

              settle down Al…go and have a cuppa and a wee lie down.Blood pressure.

            • Kitty Catkin

               /  8th April 2020

              Alan, you will then be using more petrol so might be spreading the infection via the pump…no, it doesn’t make sense to me, either.

            • Duker

               /  8th April 2020

              The nationwide quarantine means only essential travel for food/medicines is allowed. ( Outside of those still working -)
              Just as the health minister was put on notice for travelling 40Km so should others who have a second home.
              Unless you are 3 homes-Simon

            • Conspiratoor

               /  8th April 2020

              Think it through Al. Once you open it up to allow driving in a car, all practical measures of control are lost

            • Duker

               /  8th April 2020

              Yes . You want to think those that did travel longer distances did so for extreme reasons , maybe a family bereavement , I would .

            • Alan Wilkinson

               /  8th April 2020

              @C, sorry, is the object to control the population? I had the mistaken idea that it was to prevent spread of disease and everyone’s car and bach is part of their safe bubble.

            • Duker

               /  8th April 2020

              How many are going to stay ‘in bubble when travelling’- but you forget the bubble is in the home not the car.
              You just want visitors to come to your little places over the easter…. dont pretend other wise the car is just about getting them there so they can be in and around the bay.
              Just face it , your income is screwed for the next 3 months

            • Alan Wilkinson

               /  8th April 2020

              Rubbish, Duker. Our places are full till the lockdown ends.

              I just want rational policies instead of idiotically unnecessary destructive ones based on Lefty control fuckery rather than safety.

  6. Duker

     /  8th April 2020

    The claim about more people died in year after 911 because of Fear of Flying ?
    debunked…You are right to be skeptical about the Prof ( whos research methods seem poor)
    Driving deaths and injuries post-9/11
    “Our results failed to confirm Gigerenzer’s findings that there were more driving fatalities in 2001 after 9/11 than would have otherwise been expected.

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3233376/

    Its the old story, cant get the same results plus US traffic deaths are something like 40,000 pa around that time , so the variations of a few hundred are lost in the noise

    ps..Gigerenzer7 tested this supposition by looking at aggregate US traffic fatality rates in the 3 months of 2001 after 9/11 and comparing them to previous years. He concluded that there were approximately 353 excess fatalities caused by people choosing to drive when they would have otherwise flown.”

    Reply
    • Kitty Catkin

       /  8th April 2020

      Am I right in thinking that that’s not even .1% more ? No country is likely to have exactly the same number of traffic deaths every year.

      Reply
      • Duker

         /  8th April 2020

        They seem to have choosen the states around New York…not a place much flying happens, being US they will fly generally longer distances , even Boston or Florida

        Reply
        • Kitty Catkin

           /  8th April 2020

          Very roughly indeed, it’s as if we had 2-3 more than a previous year. Far too small a sample to prove anything.

          Reply
  7. Pink David

     /  9th April 2020

    This is an anecdote, but does demonstrate the very real impact of our reaction to C19 and why the reaction will certainly kill more than C19.

    https://drmalcolmkendrick.org/2020/04/06/covid-with-of-or-because-of/

    Reply

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s