This op-ed was originally published by Project Syndicate.
Our recent experience with COVID-19 and the word “lockdown” once again illustrates the power of language to influence our lives and well-being. The infinite variety of reality, and the finite number of words and phrases we have to describe it, creates an inescapable philosophical challenge to articulating policy. Adding to the challenge is our tendency to regard a person’s usage of certain words as a signal of their political ideology.
In managing the pandemic, much of the policy discussion has coalesced around lockdowns. But reducing the issue to a binary question (Should we lock down or not?), or even a linear one (How much should we lock down?), oversimplifies a complicated problem.
The binary tendency has been prominent in U.S. President Donald Trump’s recent statements. At an Iowa campaign rally shortly before the presidential election, Trump claimed that, “The Biden plan will turn America into a prison state, locking you down.” He also tweeted that, “Biden wants to LOCKDOWN our Country, maybe for years. Crazy! There will be NO LOCKDOWNS.” Trump’s brazen politicization of the COVID-19 policy debate put left-wing groups on the defensive, because, unlike the president, they accepted the science and usually favored certain aspects of lockdowns.
To see why linearizing the lockdown debate is equally problematic, consider a restaurant where the menu asks how salty, on a scale of 0-10, you want your food to be. Chaos will ensue, with some customers who ordered a seven complaining that they received a salty dessert, and others who asked for a zero (because they wanted a pudding) grumbling about their bland pizza.
Tragically, this situation has parallels in the real world of pandemic management, where there are a thousand dimensions to policy. For example, governments can lock down bars while keeping schools open, or ask people who do not wear face masks to remain at home while allowing those who do to go outside. They can also insist on social distancing for vulnerable populations while imposing fewer restrictions on those with immunity to COVID-19. To ignore these choices when designing so-called non-pharmaceutical interventions is to court disaster.
That said, one big pattern that has not received enough attention is the geography of COVID-19. The difference between the Americas and Europe, on one hand, and Africa, Asia, and Oceania, on the other, in terms of cases and deaths is too great to be attributed to policy alone.
For example, it would be utterly disingenuous for Philippine President Rodrigo Duterte to proclaim the success of his pandemic policies by comparing his country’s crude mortality rate (CMR)—the number of COVID-19 deaths per million people—of 76 with Spain’s CMR of 964. In fairness, it would be equally fallacious to say that U.S. policy has failed because America’s CMR is 827 while that of Vietnam, a much poorer country, is only 0.4.
The geographic pattern is so marked that there has to be an explanation in terms of past illnesses and immunities, viral strains, ecology, or some other factor that we are yet to identify. To see the effect of policy, we need to make within-region comparisons (as I recently argued in a co-authored paper for the Brookings Institution).
The experience of India also demonstrates the risks of lockdown semantics. On March 24, the Indian government announced a “lockdown” that supposedly was even more severe than those in Europe, often described as the strictest possible. The problem with this policy became evident after a week or two. The authorities had made no provision for the country’s poor migrant workers who, stranded in urban centers without work or pay, had no choice but to walk hundreds of miles back to their homes, mostly in the countryside. So, although India’s cities, towns, and economy were locked down, the opposite was true of 23 million to 40 million migrant workers. For them, this could be described as the “Great Unlocking.”
This misstep is now showing up in the statistics. India’s number of daily COVID-19 cases rose without interruption for six months, a trend seen in very few places. India’s CMR of 99 is now the highest among South and East Asian countries (and higher than in most of Africa), largely because the “lockdown” actually unlocked the coronavirus and scattered it nationwide.
But instead of lamenting the past, we need to move on. At least until a safe, effective COVID-19 vaccine becomes available, all countries need different forms of tailored, limited lockdowns and rules of behavior. And as far as possible, this should be implemented through persuasion and leadership rather than by police enforcement.
Here is one suggestion. We have to begin to rely on people who have already had COVID-19 and are now immune. Instead of resorting to compulsion, we should offer people with certified immunity attractive pay to take jobs that involve physical human interaction and contact. This will help to keep supply chains open and the overall economy running.
Once governments take the lead, market forces will kick in and do the job. As we discuss in the Brookings paper, this option is not risk-free. But it has huge potential, and economies that develop a functioning “immune labor market” can reap big benefits.
Now that the U.S. election is over, there seems to be more flexibility in the lockdown debate. Encouragingly, many on the left support tailored lockdowns and rules of behavior that can enable the bulk of the economy and society to remain open. Assuming that Trump, who has adamantly opposed any lockdown, does not lock himself down in the White House beyond January 20, 2021, the U.S. response to COVID-19 is likely to be overhauled accordingly.