Comments Off on Woke Capital is not your friend

Woke Capital is not your friend

It is unconscionable that @StarWars has not yet tweeted the words #BlackLivesMatter — Chris Taylor

A Bugman is your typical big left leaning city dweller… Everything about his personality and life is not defined by who he is, but by what he buys and his consumerist tendencies — Urban Dictionary

Businesses don’t make money by setting themselves in opposition to their consumers, and the rise of the urban liberal both as market to be sold to and employee to retain has led to a corresponding shift in the values espoused by corporate PR. It is no longer sufficient for a company to simply sell you widgets; it must now sell you widgets while telling you about its grand social purpose, and this phenomenon is on full display in the current firestorm engulfing the US. Across that great country, legions of humanities graduates are composing sombre missives — white text, black background — to be posted on social media emphasising OmniGlobalHyperMegaCorp’s dedication to equality and support for social justice. The best that can be said for these posts is that they are usually no more than mildly grating in tone and content.

Occasionally, however, they’re pretty funny.

If it hadn’t been for the current conflagration, we might never have learned that The Dow Chemical Company believes strongly that when “we see injustice and inequity, we cannot be silent. We must stand up and speak out”. Strong words, and an admirable message, with a small caveat: the injustice and inequity can’t have anything to do with the Bhopal disaster. Then things are a little more complicated; Dow didn’t own Union Carbide at the time of the chemical leak, it didn’t take on its liabilities when it bought it, and standing up and speaking out is a mere moral obligation of very little weight compared to a dense mass of paperwork that shows it isn’t your problem anyway.

And while Nike has stood behind (and funded) activist Colin Kaepernick’s work on this issue for years, we wouldn’t have understood just how dedicated it is to grassroots activism; the company’s belief it’s time to be “part of the change” and that we can’t “pretend there’s not a problem” is a strong and welcome corrective to any confusion that might have arisen about its values. Confusion of the sort that might have been created last year, when Nike was busy removing Houston Rockets merchandise from its Chinese stores after the team’s general manager supported protesters in Hong Kong.

But maybe this was to be expected. We don’t look to clothing brands for moral leadership. Disney, though. Disney we can trust. Disney is devoted to ensuring “we are fostering a culture that acknowledges our people’s feelings and their pain”. Admittedly, this culture was fostered too late to prevent the posters for the Chinese release of The Force Awakens carefully minimising the presence of black actor John Boyega, or the editing out of a same-sex kiss in Singapore, but look, it’s something, right?

And anyway, Disney’s record is far better than that of Apple, where CEO Tim Cook can write to employees to say that while people “may want nothing more than a return to normalcy… [that] desire is itself a sign of privilege” without reflecting on his company pulling an app used by Hong Kong protesters to track Chinese police.

Or Activision Blizzard, that can simultaneously “support all those who stand against racism and inequality” and suspend players who support protests in Hong Kong. Or Gap, that tells us that “WE MUST STAND UNITED. Because together we are stronger. Together we create change”, while also making craven apologies for failing to respect “China’s sovereignty and territorial integrity” in not including Taiwan on a map of the country. Or Facebook, where staff “stand with the black community” in America and trained Rodrigo Duterte‘s campaign in the Philippines.

And, of course, they’re all better than Tik Tok, that’s “proud to provide a platform where #blacklivesmatter and #georgefloyd generate powerful and important content with over 1 billion views” and “committed to fostering a space where everyone is seen and heard”, just so long as they don’t bring up Tiananmen Square or Tibetan independence.

Broken. It’s all broken. America is broken. Isn’t time you drove a Ford? — Eddie Pepitone

I’m not suggesting that the people in America saying these things don’t believe them with every fibre of their beings. I’m just saying that if tomorrow it were more profitable to believe the opposite — and perhaps crucially more socially acceptable to do so — the corporations they work for would switch sides faster than you could say “hypocrite”.

And they’d do so with good reason. The responsibilities of a corporation — and the determinants of management pay — generally run to “promote the interests of shareholders” and end there. Any other obligations tacked on are pretty clearly viewed as secondary; constraints on the achievement of this objective.

It wouldn’t be hard to imagine a scenario where a company finds an immensely profitable asset which will, sadly, destroy the world in 100 years time, and then proceeds to quite rationally make use of it to please the shareholders. It wouldn’t be hard because it’s already happened. Exonn knew perfectly well that burning hydrocarbons was leading to changes in the climate. It did the coldly rational thing; it continued to drill, and funded climate denial. On a more human scale, the tobacco industry knew perfectly well that the cigarettes it sold caused cancer. The firms manufacturing leaded petrol knew that it damaged the brain. Oh. And, of course, a whole suite of American companies did highly lucrative business with the Third Reich.

My point is not that corporations are staffed with repugnant hypocrites who will surely be up against the wall come the revolution but that woke capital is not your friend. The point of a corporation, as an entity, is to remove legal responsibility from the owners. That’s fine and probably good. But what it also does is move people into a realm of systemic incentives. Corporations are value neutral by definition.

When they publish their statements on Black Lives Matter, or talk about their dedication to social justice, or how much they care about the environment, or how they’re working to improve diversity in their workforce, they’re doing this because they’re selling you what they think you want to see.

A corporation is never going to take a stand for values on the edge of social acceptability when it can just reflect wider society. At best, it’s going to back a cause that already has the press and politicians behind it. This isn’t virtue signalling because a corporation does not have virtue. It’s PR. It’s an identity a marketing team tries to create and project.

In turn, this sometimes throws activists who are used to using the language of the underdog. Finding out that you’re the cultural mainstream rather than the rebel alliance can be a hell of a shock to the system. But the fact that every time they demand statements they get them in sombre black and white text shows it.

A more interesting question is why they’re so desperate for the companies they buy from to write these meaningless statements. All I can think of is that people are so bound up in brands as part of their identity that they need them to reflect and validate their views, rather than simply provide them with goods and services.

In the end, of course, Star Wars released a suitably sad statement in plain white text on a black background.

Image courtesy of Sarah Corriher, used under a Creative Commons licence.

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Chen Sheng and the Twitter mob

Let’s say that one day you’re minding your own business, watching a film on Netflix or something similarly mundane, and because you haven’t learned the first lesson of 21st century living — never tell anyone what you think — you make the fatal mistake of writing down your thoughts and posting them online. Before you know it, you’re trending globally (#HasHeLoggedOnYet), the BBC want to interview you, the Daily Mail has people rooting through your bins, and some website called “4Chan” is torn between asking whether you’re “OurGuy” and trying to hack your social media accounts to post excerpts from Mein Kampf.

What, precisely, logging back on to Twitter, should you do when you see the dreaded 99+ sign in your notifications tab?

The one thing you absolutely should not do is back down and apologise.

Genuinely. By the time an outraged mob forms it’s far too late for that. They’re already too amped-up  to be placated, and now they want the ceremonial slaughter of your social life. Instead, given that the world as you know it is burning down around your ears, you should double down and at least earn that cancellation. This approach has the added benefit of providing onlookers with genuinely spicy takes as opposed to some milquetoast sentiment about how it would probably be bad to abolish the police, and also allows you to get a few things off your chest. Effectively, think Chen Sheng (1).

Chen Sheng was an officer under the Qin dynasty. One day, Chen and a man named Wu Guang received orders to bring soldiers to the north to assist with the defence of the realm, which they duly set about doing. After all, the punishment for disobedience was death. And just so that no canny soldiers attempt to weasel out of having to fight a pitched battle by dawdling along the way, the punishment for being late is also death.

The problem, as ever, was the weather. Halfway to the rendezvous, Chen and Wu found themselves halted by flooding. They couldn’t go forward. They certainly couldn’t get to the battlefield on time. This posed a number of interesting philosophical questions, the most prominent of which was this:

“If we follow our orders, we will be relieved of command and executed. If, on the other hand, we raise an army of ten thousand men and launch a rebellion to seize the throne for ourselves… then if we fail we will be relieved of command and executed. So why, precisely…”

And so it was that the problem of perverse incentives was discovered and made painfully clear to the men at the top, who proceeded to learn absolutely nothing and were eventually toppled by the founder of the Han dynasty in a startlingly similar revolt caused by precisely this problem.

Right. That’s the history covered. Now back to 21st century online norms. God willing, you’ll never be in the position of a Justine Sacco or any of the other people who the internet decided to destroy on the basis of a badly worded tweet. But if you’re online long enough and you do anything even vaguely political, there’s a pretty good chance that you’ll get the minor version of it at some point, when some 100k+ account decides to quote tweet you to the hard left or hard right, and your mentions flood with weird cartoon avatars. And when that happens, just remember: an apology won’t make it stop.

Like Chen Sheng, you may as well be hanged for a sheep as a lamb. The punishment for transgression is social and career death, and they’re determined that you’ve transgressed. So why not see where holding your ground gets you?

Image courtesy of Andreas Eldh, used under a Creative Commons licence.

Comments Off on The Tower and the Office Block

The Tower and the Office Block

1. A couple of years ago, during my postgraduate studies, I was doing some research into the theoretical properties of public housing allocation systems in the UK. British councils tend to use a type of programme known as a ‘choice based letting’ system, and I was interested in how close these would be to the algorithms we used in matching theory problem sets.

The answer turned out to be ‘not at all’, and while there were probably a number of reasons for that one of the starkest was the difference between the theoretical agents in an economic model — who knows what they want, and will choose their ‘strategy’ accordingly — and the people who actually went out to find public housing to live in.

One of the most interesting discoveries from that brief sojourn out of the ivory tower was that people often held totally erroneous beliefs about the way the matching process worked. These beliefs were not confined to more general myths (‘they all go to refugees’), or a reasonable lack of understanding of how an algorithm might work, but took in some truly bizarre misunderstandings of the relatively simple part the user played in operating the system.

While the allocation algorithm is simple — applicants nominate their most preferred houses in order, then the applicant highest on the list picks a house, and so on down — the interactions between bidders can make the end result hard to predict, and people often fail to follow instructions. In turn, this leads to a sort of mythology about the best way to get a council house. People would stay up to bid in the middle of the night, convinced that being ‘first in line’ would finally get them into a permanent house, or would bid on houses they didn’t want out of concern that failing to use all their bids would render them ineligible. Neither of these things were true.

Fast-forward to May 30th, 2020. Deputy Chief Medical Officer Jonathan Van Tam is being asked whether the UK’s new Coronavirus contract tracing system could lead to fraudsters calling people up to get access to their personal data. Apparently not: “I don’t think people are going to fall for this”.

Well, maybe we’ll be lucky. But anyone with a landline knows that the moment your number gets out there, you will be inundated with calls from ‘Microsoft technical support’, ‘HMRC’, ‘Apple’ and someone who knows you were in an accident that wasn’t your fault. Generally speaking, the people making these calls aren’t doing for the sheer joy of having people hang up on them. They’re making them because they work. And they work because the people who pick up the phone are generally less switched on than the people Van Tam usually associates with.

What we have, again, is a system that makes perfect sense from the point of view of the intelligent people that designed it, but that might not be quite so intuitive for those who will end up interacting with it.

The common factor between the cases as I see them is the failure of the designers to respect a hidden constraint on their plans: the ability of the end user to understand the system and their place in it.

I would guess broadly that this type of design failure becomes more frequent the greater the distance between the designer and the end user; an awful lot of information is filtered out as we move up the levels of an organisational hierarchy, and while the broad strokes of a problem may be presented the details are very unlikely to be.

Compounding this, I suspect that that the people towards the top of an organisation tend to be rather brighter than those at the bottom. Certainly, they are likely to be better educated and have more experience with the sort of task involved in building out a product, and for many purposes these things are pretty much equivalent. The tendency of talent to rise to the top — where it can be better put to use — leads to two further problems. The first is that the people who engage with customers day-to-day as people rather than points of data are unlikely to have the skills to build systems for themselves, or to identify how to meet user needs. The second is that the people at the top who build the system are surrounded by people of similar ability who are not at all representative of the general population.

At this point, I want to take a brief detour. It is all but certain that you, the person reading this, are also not representative of the population at large. It is also very likely that you don’t know how unrepresentative you are. Robin Hanson made this point well in a 2009 post; in a random sample of US adults, only 52% of respondents could look at a table in an almanac and correctly answer a question about whether US oil exports went up or down between 1976 and 1978.

Take a different example. Around the world, 15 year old students are asked questions to compare performance across countries. One item begins by telling students that when it is 1:00 AM in Berlin it is 10:00 AM in Sydney, then asks what the time in Berlin will be when it is 7:00 PM in Sydney. What proportion of American teenagers do you think got that question right? 90%? 80%?

Just under 46% of American students answered it correctly.

The thing is, these people aren’t stupid. That’s the point. They’re average, and you don’t really know what that looks like. And that’s a problem, because it’s going to be someone like you who designs the systems they rely on and work within in everyday life.

From this point of view, the biggest challenge in designing a system isn’t building in the capability to hand every possible case fed into it; it’s designing one that can be used and run by the less capable without totally falling apart.

What is particularly difficult about this is that the construction of the problem (the less capable operators serving the less capable users) rules out the obvious solution of staffing your structure with benevolent social planners who can carefully work out the optimal solution for their client (1). Instead, whatever you come up with has to be resilient to the normal on both ends.

I suspect this understanding is what results in some of the more frustrating rigidities in bureaucratic systems. A lot of time and work goes into defining the plausible use cases, and minimising the difficulty involved in handling them; call centre workers are given scripts, websites provide neat prompts, and the entire edifice is set up to funnel people into the best path to a solution with minimal fuss. The problem with this structure appears when something slightly out of the ordinary arises, because it really doesn’t offer much in the way of flexibility or independent decision making to the people operating it. It doesn’t do this because it can’t; the rules need to be simple and predictable, because discretion is likely to result in chaos.

From this angle, the primary problem of civilisation isn’t how to stop ourselves destroying one another. Humans might be selfish, grasping, greedy, venal, petty, tainted by original sin, and so on, but we are also members of a social species that generally manages to avoid the state of all against all. Instead, it’s how to harness people towards a common scheme; sure, preventing violence and theft is a part of this, but so are safety regulations and making sure we don’t build cities on top of active faults (looking at you, America). Less Hobbes’ Leviathan, and more Duns’s Leviathan (2).

So, back to Van Tam. In a plan’s transmission from the ivory tower to the concrete office block, quite a lot can go awry. Van Tam’s failure to understand the people who will be using his service — the elderly, the vulnerable, the scared, and the sick — is going to leave people open to scammers, who I expect will take full advantage of this golden opportunity.

And this really isn’t good enough. Highly capable people like Van Tam owe the less capable people who rely on them better than this. We can argue about how intelligence works until the cows come home, but I think we can probably broadly agree that (a) it exists and (b) people possess it in differing degrees. Why it does so is a different matter entirely, and perhaps with good schooling and tuition we could all operate on the level of Euler or Goethe. But for the most part people don’t have access to the time or resources to undertake that sort of schooling, and we have to take them as we find them.

This is, in some senses, the strongest case for redistribution and paternalism. We owe these people. We were lucky enough to be born with good genetics, or into a family that valued education, or in the catchment area for a good school, or with whatever your preferred explanation for differing ability is. As Scott Alexander has remarked, this debt is especially marked in a society which has carefully removed every outside source of support that they could once have relied on; they can’t hunt deer or gather berries or grow wheat because they have no land and have no right to it. And short of the long-overdue unwinding of the Norman conquest and the enclosure movement, they are’t going to get it. We are responsible for making the world we build one that they can navigate.

And when the government sets up a system that gives scammers a golden opportunity to fleece these people, then flings up its hands and says ‘well, I don’t think they’ll fall for it’, that is a total abnegation of that responsibility.

Comments Off on New paper: Fatalism and COVID-19

New paper: Fatalism and COVID-19

I appreciate this isn’t what the three regular readers of this site have come to expect, but I am going to briefly halt the flow of half-thought-out musings to direct your attention to some of my academic work, and one new paper in particular. The study is on the effect people’s beliefs about COVID-19 have on their behaviour, and it comes up with a few cool outcomes.

The starting point is that people think COVID-19 is way more infectious than it actually is. The mean participant in our project thought that a person with the virus will go on to infect 28 others on average. The actual figure, even at the ends of confidence intervals, seems to be between one and six.

Showing how beliefs affect behaviour can be really tricky, but because of the design of the project we were able to artificially create variation in people’s beliefs about infectiousness of the disease. We designed information treatments exploiting variation in expert estimates about the infectiousness of COVID-19, seen below, showing people upper-bound or lower-bound estimates of infectiousness.

We were able to show that this information did change beliefs, and that in turn beliefs generate changes in intended behaviour.

What we found shows that exaggerated beliefs really matter: when people thought COVID-19 was massively infectious, they were less likely to comply with social distancing measures. We call this the ‘fatalism’ effect, and it actually makes quite a bit of sense. If the disease is infectious enough, then social distancing won’t keep it at bay. And if you’re going to get it anyway, then there’s not much point in going through all the inconvenience and pain of locking yourself away for weeks on end. There’s a good bit of circumstantial evidence supporting this interpretation, perhaps the strongest of which is the fact that higher perceived infectiousness led people to be less optimistic about their future prospects.

The good news is that people responded to our treatments by updating their beliefs to be closer to the expert estimates. Giving people good information that causes them to revise exaggerated beliefs downwards is an effective way to encourage social distancing and other desirable behaviours. A very conservative (and very back-of-the-envelope) calculation shows that the benefit to revising down beliefs could be worth roughly $2.7 billion in reduced mortality loss in the US alone, simply through encouraging people to wash their hands more frequently.

The full paper goes into significantly more detail on what we found and how we found it, and can be read here. Perhaps most importantly, I’d like to thank my co-authors for all their work on this. Jesper in particular put in a magnificent late night shift to get it over the line for submission, and any praise for the article should be expressed in willingness to shout him a round if you run into him in London. Any blame for the paper should be directed at me, on the basis of the bountiful evidence of this website.

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Memento Mori

You are going to die, and so is everyone you love. Unless you are part of the extraordinarily lucky generation whose lives overlap with the time when cellular immortality is finally invented, “the price of life is death”. That does not mean that life is meaningless or short; when Beetham said those words he was mourning the loss of Mallory and Irvine on Everest. His subsequent conclusion that “so long as the payment is made promptly, it matters little to the individual when the payment is made” is by no means one that you must accept; a long and happy life lacking the peaks of a short and thrilling one may still be just as fulfilling, if not more so.

At the same time, almost everything worthwhile in life carries some risk with it. Love carries the possibility of rejection, sports of injury, eating of choking, travel of crashing. It is possible to go too far in seeking to avoid danger; as Jonathan Waterman puts it, “no journalist wrote about the banality of city life or how easy it is to become yet another automaton paying bills and working nine to five” so that “when death finally approaches in some antiseptic white room, just as you have been waiting for it, you sense that you have already been dead for years”. A life without any risk would consist of sitting in a carefully padded room, waiting for the last sands to run out of the hourglass.

This opening is not an attempt to grab the reader by the collar and force them to stare into the empty eye sockets of the reaper, but to draw attention to the point so clearly expressed by Aristotle; virtuous courage is somewhere between feelings of fear and confidence. We should not be heedless of cost, but equally we should not let the fear of those costs govern our lives entirely.

Mortality is frightening. It is particularly so in a culture that has relegated death to the status of something that happens to other people in carefully sterilised rooms, rather than something that walks with us. A virus that sweeps through a country killing tens of thousands is a potent and disquieting memento mori; each newspaper headline becomes a reminder that you came from dust and will return to dust in time.

Wanting to avoid this fate is entirely natural. Choosing to fight the disease is healthy. Entering lockdown to halt its controlled spread was a noble sacrifice; what it emphatically was not was a job done and the end of the matter. A national quarantine is a sensible step when you don’t have a plan; it lowers the number of cases and gives you time and space to increase the capacity of your health system to handle cases. It is not something that can last for a year or more, nor something that should.

We will need more courage now as we start to find the way out, because any feasible path will mean facing up to two harsh truths alongside our own mortality. The first is that anything short of total lockdown will result in ‘avoidable’ deaths. The second is that the cost of maintaining lockdown to avoid them would not be worth it.

Neither of these views are popular. Expressing them will not win you friends. But at the same time they underlie decisions that we make continually in everyday life. When the NHS decides which medicines and treatments to fund, it is making decisions about the value of life. When we decide to get into a car or a plane, to go climbing or swimming, we take on an increment of risk. The pandemic makes an additional demand of us; when we decide how much risk to bear, we must take into account the fact that we are also, to a degree, deciding for those around us. The presence of these external costs means that there is a role for common rules and policies to find an acceptable minimum risk of transmission; it does not mean that remaining locked in our homes until the uncertain advent of a vaccine is the answer.

Defining an exit strategy is about finding the degree of risk we’re willing to tolerate, and accepting that there are valid trade-offs to consider. Immunity passports will see some locked away longer than others, and could see younger people deliberately catching the disease in order to resume some semblance of normality. Testing, tracing, and quarantining would significantly reduce the caseload, but would present higher risks than a policy of locking everyone away until a vaccine is found. Staying in lockdown would tank the economy, rob the young of time, and leave us with uncertainty about when (if ever) any vaccine would be ready.

Dialogue around these trade-offs often focuses on money and deaths, partly because these are easy to measure when other costs are hidden. But lost hours and days being hard to measure does not mean they are without meaning; the psychological toll can be heavy, the strain on relationships severe, and the opportunity to be young does not, generally, come around twice. If we want to put these costs on an even footing with those more easily measured, it may be easier to think of each option as a series of transfers.

What incidence in the rate of depression are we willing to see in the young and healthy in order to reduce the risk to the vulnerable by 1%? What about to reduce it by 10%? How much should the middle-aged pay in lost earnings to avoid one infection in the healthy population? How much to avoid one hundred? How much time are we willing to take from the young to tack on to the lives of the elderly? Because that is, in one sense, what we are doing here. How many days in the prime of their lives locked inside their flats and bedrooms is worth another day of living to someone in their 90s? Is the ratio 1:1, 1:2, 1:10? How much economic harm are we willing to inflict on the working population? If this sounds callous, remember that we already make this calculation when we fund the NHS; in this case, the treatment and cost is simply that of locking the young away.

When the NHS makes these decisions it weighs them by quality-adjusted life years; the number of years in perfect health gained by funding a course of treatment. Implicitly, this suggests that not all deaths are equal. If a man of 91 passes when he might have seen 92, that is sad. If a mother of two dies in her thirties, that is tragic. We are all heading to the same place, but we have different distances left to travel. A policy which takes too much from those at the start of their journey to give to those almost at the end of theirs is morally flawed.

Image courtesy of Arallyn!, used under a Creative Commons licence

Comments Off on Just because there’s a law.

Just because there’s a law.

4,400 years ago Urukagina, ruler of the Mesopotamian city-state of Lagash, set down the first known code of law. The full text is lost to history, but cuneiform script on a clay cone tells us that, among other provisions, it made clear that the powerful could not force others to sell them their possessions. From that point onward, the very notion of such a compulsory purchase of land was unthinkable, particularly in the region of piece and prosperity that stretched from the Mediterranean to the Persian Gulf.

Of course, the development of legal systems did not halt there; a thousand years later, God himself took the pen and handed down to the Israelites ten commandments. Without wishing to give any one divinely ordained law greater attention than any other, it is useful for our purposes to note the strict rule against blasphemy. After all, it is thanks to this law that people swinging an unguarded foot out of bed and onto the waiting caltrop of a fallen plug curse the concept of random chance in a cruel and uncaring universe, rather than directing anger at an anthropomorphic personification of the forces of creation and destruction driving the whole show along.

While the laws set out by the almighty were clearly beyond criticism, they were also naturally somewhat limited in their scope. They have therefore left plenty of room for innovative legal thinkers to build upon them and so work ever harder for the attainment of utopia. Several promising initiatives have emerged in relatively recent years (1), including the simplification of mathematics by the Indiana General Assembly (which was set to rule that Pi equals 3.2 prior to the intervention of an unhelpful professor) and the prohibition of death in certain localities in Brazil — noble initiatives which will surely be adopted worldwide when the resistance of the medical profession is at last overcome.

Given this brief history of law and its effect, it is curious therefore that certain people — motivated one assumes by either simple ignorance or complex bad faith — insist on constructing arguments which fail to respect the straightforward fact that once a law declares something to be so, it is so. And yet to anyone accustomed to spending any time in political discussion, the following exchange will be familiar:

“But of course X can’t happen. The law says Y.”

“Ok, but what if X happens anyway?”

Readers who slogged through that opening, take heart: you are nearly at the end of this essay (2). While the arguments I made above are clearly ridiculous this does not seem to stop people from advancing variants upon them, claiming that because a law exists it will be obeyed. This does not quite qualify as an argument to authority, so for the sake of conciseness I’d like to refer to it as an ‘appeal to the rulebook’ (3); the tendency to argue by the rules as written, rather than the situation as it is.

This was on full display in the interminable Brexit wars (4) where proponents of EEA membership made much of the legal fiction of sovereignty built into the arrangement, it appeared throughout the austerity debates where activists and government went back and forth on what benefits assessments meant for the vulnerable, and it is back with a bang in the discussion around exit strategies for lockdown, where people have a tendency to treat behaviour as axiomatic.

While economists have many faults this is one of the few sins that they do not regularly commit. The misapprehension that making something illegal means it won’t happen (or conversely that creating a legal right means that it will be used) is not one that can survive in a discipline that cares only about the incentives that people face; you can write down what you like on paper, but what matters is the consequence assigned for breaking it, and the probability that that will be enforced.

This was neatly summarised by Sir Ivor Jennings, who pointed out that Parliament, being supreme, can outlaw smoking on the streets of Paris; the law simply would not have any effect; barring the odd case involving English tourists dobbed in by Public Health England’s legions of collaborators, no-one would have any incentive to follow it (5). Ultimately, the choice of whether or not to follow a law — and it is always a choice — is made by people weighing up the relative costs and benefits.

What brings this obvious point to mind is the discussion around the potential use of immunity passports. The UK is currently examining the available technological options for verifying the status and identity of those claiming to have had the coronavirus, with the eventual intent being an easing of lockdown restrictions for these people. The submission by Onfido to Parliamentary committee makes much of ensuring that immunity passports can’t be faked or traded, “allowing at-risk individuals to continue the proliferation of the virus”. For the lucky few, life could return almost to normal; they would be afforded significantly greater freedom to work, socialise, and travel. For everyone else, tough luck and lockdown continues.

How long do you think it would take the second group to work out that catching the virus would be the socially and economically sensible thing to do? How long would it take them to work out that the chances of being caught breaking the rules are significantly lower when they can blend in with the share of the population exempted from them? And would they, while doing this, continue to assume that others would follow the laws as written — removing any concern about spreading the disease to those not yet exposed?

Image courtesy of Steven Zucker, used under a Creative Commons licence

Comments Off on The strange rites of the deep country

The strange rites of the deep country

The following text is drawn from the papers of my late uncle Theophilus. Upon his passing in the soothing and pleasant grounds of his final residence it fell to my part to order his final words and documents, seeking among them debts to be paid or wrongs to be righted. In his prime, Theophilus had been an antiquarian of some status within the small academic community associated with Miskatonic University, and it was hoped that we could pull from his final ramblings some semblance of the clear-eyed thinker who had once contributed so much to the study of folklore. I found this task disquieting; in his last days, Theophilus had become increasingly deranged, warning of strange and blasphemous cults in the fenlands beyond the river, or of glyphs beyond the sight and comprehension of ordinary men left upon the interior of his locked room by the furtive agents of some hideous, nameless cult. It was among these brittle pages marked by his distinctive, wavering hand that I came upon the following chapter.

The inhabitants of this place had lived here long before the earliest records began, and from those antediluvian depths of time survived unchanged by the forces of modernity or evolution; the singular form of the local names borne both by the townsfolk and the long, unbroken chain of headstones in the local cemetery standing as witness to their physical and genetic isolation.

There were certain casts to their features that I did not like; something reptilian in their unblinking eyes. The town stood in a torpor of decay; unpainted houses and rotten, ruined piers, civic buildings left to the squalor and neglect of the populace. Above the bulk of the settlement on a small rise the remnants of some great ancestral home looked out over the bay, the shattered windows and crumbling roof a testament to the decadence that seen this great family fall into disrepute and nameless obscurity.

I had come to this remote place to study the local folk religion, expecting some twist upon the gaudy decoration and litanies that mark the papist church in this region. What I found was troubling. The pantheon worshipped at the altars and shrines that marked the edges of the street at six foot intervals bore little resemblance to the saints and theologians so honoured by our apostate friends, nor to the degenerate gods and daemons paid tribute by our distant ancestors, and examining the carvings it seemed to me that some madness lurked there, within the proportions and detailing of these nameless icons.

Very little of their beliefs was set down in writing, and it is likely that this isolated and ill-educated populace would be quite incapable of having explained in any significant detail the beliefs and practices that drove the hours of their days. Some small amount, however, was passed to me in the form of a brief and slanting set of hieroglyphs, curiously asymmetric and distinctive in their structure. There was nothing in this text to link the local faith to practitioners of the black arts in our wider continent, no fragment of the forbidden Eltdown Shards or the curious Pnakotic Manuscripts. The faith practiced in that unhallowed place was, for all of its abnormality, one that had taken root and festered there in the long dark beyond civilization without the influence of the world beyond the bay.

The days of the locals revolved around a series of peculiar rituals, the meaning and intent of which had long been lost to the ages, but whose observance was watched as closely as these strange beings could manage. Of these strange and abhorrent rites and litanies I will set nothing in ink and paper; it is better that the noisome chants and ululating shrieks that accompanied that bizarre and crude practice be committed to the abyss of memory with my passing. However, in the interest of furthering anthropological study I will make some brief note of the pinnacle of the ritual cycle.

At eight o’clock each Thursday the denizens of that benighted town emerged from the dark dwellings in which they spent their days to make obeisance to the greatest of their many gods; sweat sheened mounds of pallid flesh raising a clamour in praise, narrow eyes carefully noting those who failed to take part in the ritual tribute. When such a one was observed there emerged from their throats a most detestable and inhuman cry, gargling and rising from the back of the throat – the signal for this strange class to fall upon the unbeliever. The consequence of this cry ranged in my observations from simple shaming to fists and vicious beatings, all accompanied by ritual words demanding that their unnamed deity withdraw its protection from the outcast.

I did not last beyond a few days in that place. As I walked the tenebrous streets the blank faces of the worshippers raised the hairs upon my neck; there a hostility in those steady gazes that I have not felt before or since that day. Upon my my third morning, I awoke to find the door of my hostelry smeared with blood, with an unstated threat that should I not take my absence swiftly I would find myself dwelling for the rest of time at the bottom of the deep, black waters of the reef.

I found that village in the fourth month of 1900; I was glad to leave it. But it is troubling to me that the spread of the motor car and the curious decision to construct a railway line to that forsaken and insignificant place has lead to the spread of this people and their blasphemous cult through our fair land. I know now that they are watching me, and that my days run short. Soon their ages long machinations will reach their final, terrible fruition, and even now I lie awake at night dreading the first time that the alien and unknowable cry rises above the rooftops of my own town: Ia! Ia! EnnAitch’Ess fhtagn!

Photo courtesy of Tim Ellis, used under a creative commons licence

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How risky is commuting to work?

Officially, there are 1,950 coronavirus cases in the UK. Given the limits on testing, and the rapid growth in infections, the government’s own advisers believe the true number could be closer to 55,000.

These cases are not evenly distributed, and we know that London is a few weeks ahead of the rest of the country. Let’s say say London accounts for roughly half of these cases (25,000). The population of the city is roughly 8.9 million. Official advice is to avoid non-essential use of public transport and where possible avoid rush hour or work from home.

How risky is ignoring this advice? If you’re in a crowd of 100 people, what’s the probability that someone in that crowd is infected? How many people fit into a tube carriage with you? How many would you actually be exposed to?

Assume for the sake of argument your commute involves one train journey, that your fellow commuters are drawn at random from the population of the city, and that you all get on and off at the same station. Standing capacity on the most recent vintage of tube trains is about six people per square meter. A cough travels about six metres, and a sneeze about eight metres 1.

The diameter of the circle we’re thinking about is roughly sixteen metres. A tube train is about 2.68 metres wide and 16.5 metres long, so if you stand in the middle of the carriage you’re roughly within range of every other commuter.

At this scale, a rectangle will serve for an approximate area. This gives 44.22 square metres – or at peak travel times 265 people.

The probability that any one of them is infected is (naively) \frac{25,000}{8,900,000}, or 0.28%.

The probability that none of them are infected is 47%.

Surprising, right?

Now think about how many people you’d actually come into contact with on a commute – walking through stations, switching trains, coming into the office. How many people might you ‘meet’ in a day? Even if you travel when our example train is at half capacity – 133 people – there’s a 31% chance one of them will be sick.

You can play with the maths yourself if you want: the formula is (1-(25,000/8,900,000))^x, where x is the number of people you meet 2. At about 246 people, the probability hits 50%.

Obviously you may only be exposed to some of these people for a short time, and just because someone is infected doesn’t mean they will pass the disease on to you. This is just the probability of passing someone with coronavirus.

Still, probably best to follow the official advice. And if you can, work from home.

Header image courtesy of Clement127 on Flickr, used under a creative commons license. 

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Coronavirus and behaviour, part 2

This follow-up to my previous blog post goes into more detail on the UK approach to tackling the coronavirus outbreak, the assumptions driving it, and the alternative policy measures available. The usual disclaimer applies; I am trying to pull together information so I can get the shape of this in my head. Any errors are my own responsibility.

(1) The UK government’s plan

(a) The plan does appear to be developing herd immunity. 

Three days ago we had Peston telling us the strategy is “to allow the virus to pass through the entire population so we acquire herd immunity, but at a much delayed speed… such that the health service is not overwhelmed and crushed”.

This was in line with junior minister Lord Bethell’s statement in the House of Lords, where he noted that “creating some kind of herd immunity… is clearly the objective — well, not the objective; rather, it is one of the results of the virus passing through… so herd immunity will actually provide resistance to future visits by the virus.”

It was also in line with the chief scientific officer, who told the world that “our aim is to try to reduce the peak, broaden the peak, not suppress it completely; also, because the vast majority of people get a mild illness, to build up some kind of herd immunity”.

Following the somewhat heated reaction to the revelation that the government intends to allow at least 60% of the population to be infected with a potentially deadly disease with unknown long-term health outcomes, there has been a degree of walking back from such blunt statements, with Matt Hancock wheeled out to tell the public that herd immunity is not the plan.

Adam Kucharski presents a reasonable case for the defence on Twitter, explaining that herd immunity “has never been the outright aim” so much as “a tragic consequence” of a virus that will not be fully controllable; if you can’t control it, you’ll get it, so it’s about managing the timing with which it arrives.

This is probably fair; whether or not herd immunity is ‘the aim’ is a matter of splitting hairs. It is more the case that the government does not believe the virus can be stopped, so that herd immunity is how this will end. The major differences between the government and its critics are on how, given the assumptions underlying this view, we might best manage the flow of cases, and on whether the assumptions hold.

(b) The initial policy measures announced were very slim, and did not appear to reflect mechanisms for spread.

The early British response effectively consisted of asking people to wash their hands to avoid falling ill. If that fails, people developing a persistent cough or temperature were encouraged to remain at home for a period of seven days.

This was — as with much of the British strategy — out of step with the rest of the world, where an isolation period of two weeks is recommended. While patients may only be contagious for ten days or so, a two week period is simple and sure.

The virus appears to have an incubation period of approximately 5 days before symptoms appear. Patients are still contagious during this period, with a study finding that roughly 50% of patients in one studied group and 60% of another transmitted the virus to another person before showing symptoms. A pre-review paper suggests that up to a quarter of infections generated by a person may result from this phase. Moreover, a substantial share of infected individuals may remain asymptomatic throughout their experience.

This suggests that those living with self-isolating individuals are likely to catch the disease and transmit it in the period before they themselves develop symptoms sufficiently worrying to cause them to enter isolation.

Focusing purely on patients who are currently symptomatic will therefore miss a large number of carriers, and will be of limited efficacy in slowing the growth of the virus. It is not clear whether the modelling assumptions that generated the government’s understanding of the efficacy of different measures accounted for this.

It is worth noting that there is research suggesting that self-isolation may fail to have the anticipated effect when asymptomatic transmission is possible.

(c) Delaying delay.

Beyond this initial response, the government anticipated installing sterner measures over the following month. Concerns about ‘social fatigue’ led the government to choose this timetable; people would comply with social measures for a time, before changing their behaviour — potentially raising infection rates again at the peak of the disease.

From the government’s point of view, this reduces the policy response to a matter of timing; you get to introduce restrictions once, and then their effect decays. The game is to introduce them at the point where they will have the largest possible impact on the peak NHS caseload. Hence Robert Peston’s “senior government source” stating that the government is “waiting for the optimal time to force restrictions on our way of life that will be very painful”.

This is a very different perspective from that given if you believe that restrictions can be made to work long term, as Hong Kong, Singapore, and China appear to. In that framework, once the disease arrives you commit to rooting it out as early as possible; the nature of exponential growth means that a reduction in the rate of growth has a correspondingly larger effect the earlier it is introduced.

This raises an interesting possibility; if containment elsewhere does prove successful, and the UK approach results in the disease becoming endemic — or at the least, uncontained — then we may find ourselves facing travel restrictions when looking to leave these islands.

(d) Not met with universal acclaim.

As I’ve said before the UK response is very much out of line with that of other countries, and there is hardly a solid consensus behind it here. As Birmingham’s Professor Alan McNally says, “social distancing has worked in China, Singapore, and other countries”, while the Lancet’s editor-in-chief describes the British approach as “playing roulette with the public”. As covered later, the assumptions underlying it have also been questioned.

Others not specifically responding to the UK policy approach have made comments that clarify just how unusual it is, with the WHO director general telling the world that the requisite policy mix was “Not testing alone. Not contact tracing alone. Not quarantine alone. Not social distancing alone. Do it all.”

In the American context, Susan Rice — in addition to noting the time a containment strategy focused on keeping out certain groups of travellers might have bought — called “aggressive social distancing” the “last key tool for slowing the spread of the coronavirus in the United States”. Without it, there was very little hope of flattening the curve sufficiently.

(e) High Risk

This last comment points to one of the biggest flaws in the government approach. If it works, fantastic. But if it fails, it will all but ensure that no plan b is viable; infection will be widespread and growing fast, and hospitals will be ensured of a period of intolerable strain.

In order to pull it off, the government will need every assumption to hold. And it will need to time its interventions all but perfectly (or at least err on the side of moving too soon rather than too late) — something that could prove challenging without sufficient testing capacity to monitor the spread of the virus through the country.

From this perspective, it is worth noting that even a perfect application of the strategy could see the hospital caseload peak well above capacity.

(f) This plan has changed, partly because the government has been caught off-guard by assumptions failing to hold.

Since the initial steps outlined above, the government has begun to backtrack. There is now a wealth of contradictory information available.

Robert Peston, the closest to thing to a government spokesman currently available, has set out a list of potential measures in The Spectator. These include asking the over 70s to remain in strict isolation for a period of four months (likely to be enforced within the next 20 days), banning mass gatherings (over the next weekend), and temporarily closing pubs, bars, and restaurants some time after that. The option of temporarily closing schools to the children of those who are not “key workers in the NHS and police” is also being considered.

Matt Hancock, meanwhile, is telling the world that “We have a plan” and that “Herd immunity is not a part of it”. Except, as covered above, it very clearly is. His description of the government’s approach as possessing “maximum transparency” could itself be somewhat more transparent.

There are three possible explanations for this shift in tone and rhetoric. The first is that the government more clearly wants to communicate the policy set out in (1a). The second is that there has been a genuine shift generated by a desire to be seen to be acting in-line with the public mood; retaining confidence is essential in generating behavioural change. Even if policies are not being introduced earlier than planned, greater transparency could set minds at ease and win over approval, as well as emphasising how seriously the government is taking matters.

The third and least optimistic is that the assumptions underlying the policy are already being shown not to hold, and on this note it is probably relevant that the Times has been reporting that the virus has been spreading faster than government models predicted.


i) The plan, such as it is, is to try and control the spread of the virus through the population rather than attempt to contain it
ii) The measures adopted to do so (so far) may not achieve this, as they could potentially allow for significant spread
iii) More effective measures may be put in place down the line. It is unclear whether they will be timed correctly.
iv) Other countries are still attempting containment, or are attempting a similar controlled spread using dramatically more stringent tools.
v) It is not clear that this strategy will allow for an effective plan b. It is very reliant on assumptions holding.
vi) It is possible that the plan is already changing, reflecting either a need to retain the confidence of the public, or the early warning signs that needed assumptions will not hold.

(2) What assumptions underlie the government’s approach?

(a) The virus will continue to be a threat for the foreseeable future.

Public Health England believes the coronavirus outbreak could last until spring 2021. There will be no vaccine within a year, with a less than 50% chance of one being developed in this period. Containment within the UK — to the point where the disease dies out — will not be possible, and even if it were it is very likely that the disease would be reintroduced from overseas.

(b) The virus is likely to display multiple peaks when we would prefer one

The prospect of a double peaked outbreak underlies much of the UK’s planning. There are, as far as I can tell, three components to this logic. The first is the lower slack NHS capacity in the winter under usual circumstances; as seasonal influenza hospitalises the elderly, fewer beds will be available to treat coronavirus patients, and comorbidities are likely to occur which will reduce patients chances of surviving.

The second is that a number of viruses find winter conditions considerably more suitable for reproduction. It is possible that the coronavirus will spread more rapidly in the latter part of the year. Moving patients from the ‘unexposed’ to ‘immune’ shares of the population over the summer is vital in preventing a dramatic rise in cases in the winter.

The third is the expectation that behavioural changes might naturally drive a multiple peaked pattern of infections, as with the 1918 flu pandemic.

Of these, the second and third points are most questionable. Behaviour depends on beliefs and incentives, which may be very different in the more connected world we live in, while the reason why some diseases display seasonal patterns is unclear making it hard to infer whether the coronavirus will do so.

There are some suggestions that an environment with greater absolute humidity provides certain viruses with greater viability. It is possible that coronavirus will be one of the viruses which benefits, but there does not appear to be sufficient information to say with any certainty whether it is. It is worth noting that the virus has sustained transmission in supposedly hostile environments. As Harvard epidemiologist William Hanage notes, flu rules might not apply. Exposing people to the disease now to avoid a hypothetical second peak is risky.

(c) Social fatigue/Isolation fatigue/reduced compliance/disobedience

The assumption underlying the delay in harsher messages was simple: people would only change their behaviour for so long, went the logic. When instituting a new plan, you would therefore have a window of obedience before people began to change again — potentially just a few weeks, with any change in behaviour arriving at the peak of the crisis. Ask less now, get more later. Avoid “self-isolation fatigue”. But what precisely was this based on?

Over the last few days the Guardian managed to get a member of the advisory group on record pointing towards two relevant bits of evidence. The first was “a rapid review published in the Lancet last month on the psychological impact of quarantine”, which listed some potential negative psychological effects upon those undergoing it, emphasised the limitations of the papers reviewed, and recommended keeping such measures in place for as short a period as possible. The second was “a paper by the Economic and Social Research Institute in Dublin on how to harness behavioural science to fight the coronavirus”, which found that “extending isolation periods beyond initial suggestions risked demoralising people and increasing noncompliance”. The same paper also noted the danger of highlighting the potential negatives of isolation in advance, as people might understandably try to avoid such measures.

Spot the problem? Neither of them make the case for delaying the introduction of measures; they say to keep them to shorter periods if possible, and to be clear about how long they will last. The evidence base for the fatigue effects is not clearly visible in the literature.

This is all the more confusing when we consider the November 2018 update on pandemic modelling, which noted that “all social distance measures depend on compliance by the population which, in turn, depends on the social acceptability of the measures. Without good behavioural research on these it is difficult to predict the impact of such measures being deployed in a future pandemic”. Quite how we moved from a situation where fatigue was a total unknown to an agenda-setting fact is something of a mystery.

Perhaps more importantly, the research the government does have emphasises the need for transparency and good information in alleviating concern — something we are sorely lacking.

Other research has, for example, found that believing an outbreak has been exaggerated or having lower information understandably reduced engagement with social distancing in previous outbreaks. What message does the government believe ‘business as usual’ will send?

Similarly, while a UCL review of behaviour in previous outbreaks found that at-risk groups were more likely to comply with protective behaviours, a high level of trust in authorities was also important. Given the very conspicuous doubts over the government’s approach, could it be possible that attempting to over-optimise the timing of interventions may be reducing their efficacy through other channels?

A relatively recent paper examining willingness to self-isolate found ‘attitude’ (towards self-isolation) and ‘social norms’ (public perception of actions) played the largest role in regulating behaviour; what effect do we think telling people they are expected to break quarantine, can’t be trusted to behave sensibly, and indeed don’t need to take significant actions might have on agent beliefs and actions?

Research in an Australian context suggests that creating credible concern over personal or familial wellbeing would be associated with improved adherence to public health measures. Telling the public that everyone will get it, and all will be well, seems likely to work against this effect.

It is worth noting that questioning the efficacy of measures is consistently found to be an effective way to undermine cooperation. Legitimate, competent authority, normalising desirable behaviours (and creating strong norms against what we might term ‘selfish’ behaviour), and effective communication are all tools through which we can increase compliance with measures.

On which note, there is research suggesting that one major factor causing people to end self-isolation early is not fatigue or boredom, but simply money. The best way to improve the efficacy of social-distancing measures is to ensure people can afford them.

I have thrown a lot of papers at you here. As you can probably guess, I can’t vouch for the design and statistical power of each one. My point is that the government has placed a great deal of weight on a single assumption that may not hold.

It is unclear, for instance, why people would become bored with quarantine and leave home at the peak of the crisis, or continue to do so if their actions caused the rate of infections and deaths to spike upwards once more. It is also unclear whether the concern of non-compliance with voluntary measures is significantly reduced when such actions are imposed in top-down fashion.

It is also unclear whether the current behaviour of the British public lends support to one side of the argument or the other. On the one hand, you have people like Michael Head, an academic at Southampton, who suggests that “People already can’t be trusted to buy toilet roll properly, so how about long-term compliance when significant levels of freedom are removed and there’s a need to stay indoors for long periods of time? The evidence, as we have it right now, suggests it will decline.”

On the other, editor-in-chief of the Lancet Richard Horton notes “the public acted to socially distance, avoid mass gatherings, and work remotely ahead of govt advice”.

The distinction between the two is partly based in a misunderstanding of incentives; while only one is socially desirable, both reflect a strong perceived incentive to take actions to preserve personal and familial welfare — a perception that could potentially be harnessed for the better.

That the assumption of fatigue is at best questionable has been borne out by the response of the behavioural science community at large; an open letter signed by 481 individuals (at the time of writing) in the field of behavioural science expresses concerns that the assumption of “behavioural fatigue” is insufficiently based in evidence, ignores the possibility of radical behaviour change of the sort seen in South Korea, and that the approach of “carrying on as normal” may undercut the required urgency of action when government advice changes.

(d) Building up long term immunity to the virus is possible

In order for “herd immunity” to build up in a population, it must be possible for exposed individuals to develop immunity in the first place. There have been some suggestions that individuals have been reinfected after recovering from the virus, but it is not clear at all that this is common or even anything other than an artefact of inaccurate testing.

The larger question is how long such immunity would last. As the British Society for Immunology has said, “Because [the virus] is so new, we do not yet know how long any protection generated through infection will last. Some other viruses in the Coronavirus family, such as those that cause common colds, tend to induce immunity that is relatively short lived, at around three months.”

(e) Timing interventions is possible

Note that given our low testing capacity this may be difficult.

(f) We have enough capacity to manage the peak caseload generated by this approach, and can get away with an attempt to “flatten the curve” short of the measures imposed elsewhere. 

Fair warning, this one is dark.

The core assumption used by the government is that without measures the NHS will collapse, as we have seen elsewhere. Every measure taken by the government is taken with the aim of avoiding that.

The problem with this is that the government’s intended strategy still implies a considerable peak caseload relative to the number of beds available. Up to 7.9 million people may require hospitalisation according to Public Health England, with an extant supply of 170,000 hospital beds (~4,500 critical care beds). There are already “growing reports of problems on the ground”, with bits of the NHS “already falling over”, and staff exposed to the disease. As I said in my previous post, the mathematics is not optimistic.

A team of American public health specialists have gone somewhat further. Even among the seemingly healthy, there will be deaths as a consequence of the herd immunity strategy; immunisation by infection is considerably less safe than immunisation by vaccine.

The real risk however is the potential explosion of cases under the light touch measures envisaged by the government. The Americans note that even using more conservative (favourable) estimates than those adopted by the UK government, 20-40 year olds alone will require up to twice as many intensive care beds than are available. With older groups even more exposed, it’s not hard to see why they chose the paper’s optimistic title: “The direction of the UK Government strategy on the COVID-19 pandemic must change immediately to prevent catastrophe”.

One of the authors of the paper, Professor William Hanage, believes that “strong social distancing” will be required to do so, with measures (discussed below) including encouraging working from home and providing financial support for those doing so.

(g) An alternative framework is available.

As Anthony Costello notes, other countries have adopted a very different strategy. The approach in China, in particular, has been to crack down on pockets of infection: people are tested, contacts are traced, family clusters are identified, and individuals are isolated. Other countries, such as South Korea, Singapore, and Taiwan, have adopted less extreme versions of this strategy.

They will all face, as the UK has been keen to point out, the issue of how to unwind infected areas. But relative to a disease spreading freely through the population this seems like a good problem to have. If people are likely to vary their behaviour to become more risky as cases drop, and then less risky as they rise, then the caseload will oscillate in a manageable fashion.

Ultimately, taking strong measures gives a government far greater control over the speed of infection than those indicated by the UK approach. By varying social distancing it would be possible to pursue a policy of herd immunity over a more extended period, or to hold the disease in check for the twelve to eighteen months that a vaccine might take. The approach will place more strain on social organisation, but less on healthcare. It seems worth considering.


i) The coronavirus outbreak is likely to last for an extended period, and total containment in the sense of ‘eradication’ is not possible.
ii) It is possible that the virus could display multiple peaks in cases. This is however uncertain, and basing a strategy around the hypothetical poses its own risks.
iii) The evidence for social fatigue is threadbare at best, and we could likely implement longer term measures as used elsewhere. It certainly does not suggest delaying action.
iv) It is not clear whether building up long term immunity is possible
v) It is not clear that we will be able to time measures correctly.
vi) It is not clear that the measures proposed by the government would ‘flatten the peak’ sufficiently when implemented.
vii) Alternative frameworks for action are available.

(4) Things we can do

(a) Communicate better.

I don’t think it’s too strong an ask for the public to learn about massive changes to their way of living from official, named government sources with context, information, evidence, and offers of assistance, rather than through Robert Peston’s blog.

This is really, really basic stuff. The section above covered the importance of credible and authoritative messengers in generating desired changes in behaviour, and the section above that demonstrated the confusion the government’s current stance has left us in. Secrecy and spin might be the substance of politics, but it’s poorly suited to the task of gearing a nation up for the task of fighting a pandemic.

If I were to lay out the principles for an alternative system, I would choose the following:

(i) Being open and transparent;
(ii) Using clear and simple communications;
(iii) Acknowledging the existence of uncertainty;
(iv) Using absolute, as well as relative, risk;
(v) Framing ambiguous messages negatively [e.g., 1 in 100 will be ill, rather than 99 in 100 will not]*;
(vi) Using visual aids wherever possible.
*This principle recently broken by Chris Whitty

These principles seem sensible to me, but more importantly they’re the ones the government set out in its scientific summary of evidence for pandemic response planning. It should consider following them.

(b) Make it easy to follow the rules, including providing fiscal support to individuals and firms.

The best way to ensure compliance with the rules is to make them easy to follow. Even medical workers will find multiple rules tricky to follow, reducing the probability of compliance as the work required increases. Fewer large rules may be more effective than an array of smaller ones, and stating the rules simply is likely to help.

As noted above, fiscal ability is a major constraint on people’s ability to stick to regimes requiring them to withdraw from economic activity. As Greg Mankiw says, “Fiscal policymakers should focus not on aggregate demand but on social insurance. Financial planners tell people to have six months of living expenses in an emergency fund. Sadly, many people do not. Considering the difficulty of identifying the truly needy and the problems inherent in trying to do so, sending every American a $1000 check asap would be a good start. A payroll tax cut makes little sense in this circumstance, because it does nothing for those who can’t work.”

These are pretty much the textbook circumstances under which running a fiscal deficit is acceptable.

As Steven Hamilton writes over at The Bulwark (and if you have any interest in economics you should read this piece), any package should not only target vulnerable households. If we want to emerge on the other side with the minimum possible damage, businesses which would otherwise have been viable should be given support to bridge the gap in revenues. The alternative would be “a surefire recipe for a long and painful recession”.

Providing support to businesses can come alongside measures such as mandating sick leave and subsidising home working; there is no need for an unconditional transfer of money. By combining the two we will hopefully be able to improve compliance with measures taken to reduce the spread of the virus, while ensuring that we don’t set ourselves up for a painful recovery.

(c) Test widely.

As the 2018 Scientific Pandemic Influenza Group on Modelling said, “It is important to ensure mechanisms are in place to measure rates of infection in the community at different stages of the pandemic”.

This is not influenza, but it is a pandemic. Perhaps due to limited capacity the government appears to be giving up on community testing, reserving such capacity as is available for the most vulnerable.

Given the stated desire to time interventions for maximum impact, the aim of acquiring mass immunity, and the potential demand for localised measures to prevent regional health system collapses, it seems unwise to measure the flow of cases by the number arriving in hospital — particularly given the potential lag between infection and hospitalisation.

(d) Consider carefully the evidence on behaviour.

Rather than using the somewhat nebulous notion of fatigue as a reason to avoid action, the government could consider looking at the research on the interaction of behaviour and policies. Creating social norms that encourage social distancing (such as emphasising taking sick leave or working from home as the right and unselfish thing to do), maintaining public trust in the efficacy of measures and the strategy adopted by government to ensure continuity of supply and public safety (ensuring they understand what is required, and reducing less desired behaviour such as hoarding), and ensuring that people understand the level of threat posed to themselves and their families could all work to improve compliance.

If nothing else, switching messages while doing nothing may not maintain confidence in plans.

(e) Implement marginal social distancing policies. 

There are easy marginal gains on the table. For many people, working from home — at a reduced level of productivity — is an option. As Hanage says, anyone who can do so should. For a disease which is contagious in asymptomatic people, this additional space could help limit spread. While the broad evidence is that the effect is limited, where this is already possible it seems likely that the cost will be outweighed by the gain. Perhaps more importantly, it would create room to consider policies on school closures.

For a disease with no background immunity, the government’s pandemic flu research suggests school closures could reduce the peak by up to 50%, and the total number of cases by 10-20%. The latest modelling figures for the coronavirus suggest a 14 week closure would reduce the peak caseload by 10-15%. Given the role of young children in this epidemic as largely asymptomatic spreaders, this seems like a useful potential outcome. If mitigation is the aim — as is currently the case — then reactive closures upon a case arriving for a period of three weeks would produce roughly the same effect.

Closing schools changes behaviour. It is possible that it will do so in ways that will work against the effect we hope to achieve; as David Halpern says, “The models rest heavily on what people will do. Will people comply with instructions, and to what extent? If kids don’t go to school, what will happen?”

With that in mind, it is still worth noting that many of the alternatives are preferable. If children end up in a daycare — undesirable — it is still likely to bring together fewer than a school of several hundred, with associated limits on the spread of infection. If they are likely to be looked after by grandparents, efforts should be made to dissuade this and explain why it is to be viewed as undesirable.

If key workers — not just in healthcare, but in energy, transport, security, and so on — are unable to find childcare, then the option of limiting access to schools to only the children of those parents who cannot work from home or find alternative arrangements is open to us. It should not be impossible for a state that hopes to manage the peak of an epidemic to sort out a rough and ready solution to the childcare needs of NHS workers.

For limiting large scale events, evidence is limited, although the government estimates a direct reduction in cases of 5%. However, it is worth noting that from a psychological standpoint alone it would emphasise the need to change patterns of behaviour in order to limit exposure to the virus.

(f) Back up policies with enforcement.

This should go without saying, but relying on voluntary cooperation for all measures is a non-starter. The government should be willing to add some stick to the incentives for compliance.

(g) Cut the red-tape.

The American response has been hamstrung in part by CDC restrictions on testing, and a refusal to use the German-made kits supplied by the WHO. In Britain, we are eyeing the possibility of drafting in final year medical school students to help provide necessary manpower.

Where otherwise sensible restrictions can be removed in a way that will not endanger patient safety to a greater degree than inaction, governments (including ours) should be looking to clear the way. Providing care worse than that provided by a fully trained doctor is better than providing no care at all.

(h) Desynchronise if possible

This penultimate thought is my own, so I suspect it will make less sense than the rest. As I understand it, the USA is currently making a hash of its response to the virus, while the UK is attempting to deliberately target a peak of cases in the summer.

This strikes me as suboptimal for the following reason: if we experience our peak outbreak at the same time as somewhere else, we are likely to be competing for resources produced by stretched global supply chains. If we can desynchronise our pattern of infections from that of our American and continental cousins, then we may be in a better position to fight the disease.

Over the longer term, this suggests that countries might wish to coordinate when loosening restrictions on behaviour in order to avoid simultaneous flare-ups.

(i) Remember healthcare workers are human.

We are likely to be asking an awful lot of NHS staff in the coming year. It is possible that alongside sickness absences, some healthcare workers may be unwilling to come in at all. Arranging childcare, paying for hours actually worked, ensuring the supply of personal protective equipment, and taking steps to reduce stress should help to limit lost hours.


i) The government needs a clear and unambiguous message on strategy and measures taken.
ii) The government should make it easy for households to follow its requests both in what it asks of them, and through financial support.
iii) If your policy is dependent on timing, widespread testing seems important.
iv) Rather than pointing to ‘fatigue’ as a catch-all excuse for delaying action, the government should consider the behavioural consequences of action and inaction carefully.
v) Implementing marginal social distancing policies should be on the table. These may be necessary to enact the government’s current strategy.
vi) Relying on voluntary compliance with measures may be unwise.
vii) If policies designed to ensure safe treatment in normal circumstances are preventing treatment at all, the government should consider temporarily loosening them. The range of outcomes is sufficiently changed that they may do more harm than good.
viii) If possible, when timing the peak of infections the government should probably avoid coinciding with other nations, or at least staggering regions across the UK.
ix) Healthcare workers are human and will require additional support. 

(5) Summary

God, that was long.

It is not at all clear that the assumptions behind the government’s plan are holding. Given that, more aggressive social distancing measures will probably be needed, among other policy measures. Accounting for the speed with which this virus spreads, putting these into operation sooner rather than later would be desirable.

Header image courtesy of Sanofi Pasteur on Flickr, taken by CDC/ F. A. Murphy, used under a creative commons license. 

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