Risk-Driven Responses to COVID-19 Eliminate the Tradeoff between Lives and Livelihoods

Abstract

Responses to the COVID-19 pandemic have been conditioned by a perceived tradeoff between saving lives and the economic costs of contact-reduction measures. We develop a model of SARS-CoV-2 transmission where populations endogenously reduce contacts in response to the risk of death. We estimate the model for 118 countries and assess the existence of a tradeoff between death rates and changes in contacts. In this model communities go through three phases – rapid early outbreaks, control through initial response, and a longer period of quasi-equilibrium endemic infection with effective reproduction number (Re) fluctuating around one. Analytical characterization of this phase shows little tradeoff between contact reduction levels (underpinning economic costs) and death rates. Empirically estimating the model, we find no positive correlation between (log) death rates and (normalized) contact levels across nations, whether contacts are estimated based on epidemic curves or mobility data. While contact reduction levels are broadly similar across countries, expected death rates vary greatly, by two orders of magnitude (5-95 percentile: 0.03-17 deaths per million per day). Results suggest nations could significantly reduce the human toll of the pandemic without more disruption to normal social and economic activity than they have already faced.