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Saving lives saves livelihoods

At the beginning of January of this year, in the middle of a global pandemic, I stood maskless at the stern of a diving boat off the coast of a Caribbean island and talked to a member of the environmental department about her pandemic and lockdown experiences on the island. "It's been a terrible month," she said, "but life has been pretty good since then." She dived to spear lionfish, an invasive species native to the South Pacific that threatens coral reef ecosystems in the Caribbean.

We were two strangers chatting without worrying about the virus passing on because the island we were on completely destroyed local transmission of COVID-19 by adopting a set of sensible guidelines. The lionfish, on the other hand, proved to be an elusive and more tenacious enemy. Lionfish arrived in Caribbean waters thanks to irresponsible Floridians who released their exotic pet fish into the waterways in the 1980s. COVID-19 also took a similar route to the Caribbean via a visiting passenger cruise ship. But this time the island was prepared.

As reported by the locals, the lockdown was very strict and a bit painful. After a passenger fell ill and spread COVID-19 to local residents in March 2020, the island's tourism-dependent economy made the bold decision to close the airport and all ports immediately. Only citizens were allowed to return on special return flights provided they were strictly quarantined for 14 days in a government-approved and monitored facility regardless of their test results.

My family, who have roots on the island, saw this quarantine procedure when we moved my elderly father to get him out of the coronavirus-hit United States. The public health personnel stationed at the airport greeted us in protective suits upon our arrival. We were asked to sanitize our hands four to five times before we were even given a pen to fill out immigration forms. After quick COVID-19 tests, we were taken to our government-inspected quarantine apartment in a government sanitary vehicle. We were provided with tracking wristbands that monitored us continuously for two weeks, with the risk of hefty fines and jail sentences for violations.

These rigorous procedures worked. The average daily cases almost never exceeded five, and with local transmission virtually eliminated, life was fully normalized by June 2020. This normality meant no masking requirements and no social distancing. It meant going to work, going to restaurants as often as possible, and having get-togethers with friends and family. The 14-day strict quarantine requirements still apply to outsiders. The island has created its own bubble, as families and friends in the US and UK have tried. But its bubble spans the whole country.

While tackling the pandemic on a tiny Caribbean island might be easier, the successful coronavirus response strategy is a symbol of the success seen by much larger countries: New Zealand, Australia and China among them. The key component of this strategy is easy to design but difficult to implement. First, enforce a hard lock and prevent the virus from being transmitted locally. Once the virus is destroyed, residents can enjoy maximum freedom as long as they are vigilant to outsiders who could bring the virus back. Australia and New Zealand could even merge into a larger super-bubble, as long as the countries can trust each other to function with strict entry restrictions.

Under these conditions, even the Beijing Marathon or the Australian Open tennis tournament can take place at a time when US and British citizens are not even comfortable visiting the neighborhood restaurant. Life can go back to normal, but you need to stay away from other irresponsible nations. The embargo requires some steep sacrifices and the basic needs of all residents need to be taken into account. In poorer countries, where there are no social safety nets and a family's daily food security depends on the income of a worker in the informal sector, this hard lockdown may not be implemented. However, this approach is feasible for high income nations.

This strategy of fighting the virus also avoids the need for a confused “reopening the economy” debate that has shaped politics elsewhere. U.S. states like Texas and Florida, which were among the earliest states to reopen, had to withdraw in late June 2020 due to rising infection rates and busy intensive care units. Bars and restaurants opened early had to be closed. And this cycle continues to this day. Texas recently lifted a mask mandate and declared itself open. The US President Joe Biden has raised allegations of "Neanderthal thinking".

The success of countries that have broken the curve shows that the “life versus livelihood” debate that dominated many countries at the start of the pandemic is a false dichotomy. The best way to protect livelihoods in the long run is to first wipe out the virus and only then reopen the economy.

Countries that have the systems in place to attend to basic citizens' needs for a few weeks would minimize the damage to livelihoods by taking the hard lockdown approach, destroying the virus and saving lives in the process. Indeed, New Zealand's V-shaped economic recovery is an affirmation of the COVID-19 elimination strategy that the country has been pursuing.

By December 2020, New Zealand's economy had already grown 0.4 percent year-on-year, contradicting forecasts of a 1.8 percent decline at the start of the pandemic. In contrast, the International Monetary Fund's October 2020 projections suggest that the UK economy contracted 9.8 percent in 2020 while the US economy contracted 4.3 percent. China behaved irresponsibly at the start of the pandemic by minimizing the threat, but its tough blockade that followed allowed the economy to recover quickly. It was the only major economy to see positive growth (of 2.3 percent) in 2020.

Beyond the macroeconomic indicators, the rationale behind this strategy is backed by detailed micro-data on consumer behavior during the pandemic, analyzed by economists. Rich people don't feel comfortable when the virus isn't under control, regardless of the lockdown policy in place. University of Chicago economists examined detailed data on consumer cellular traffic in more than 2 million US companies and found that the 60 percent decrease in visits was directly related to fear of infection.

Traffic decreased the most in countries where the COVID-19 death rate was high, not in countries where legal movement restrictions were in place. Harvard University's Opportunity Insights team found that when the rich don't come out and spend money in bars, restaurants, or hotels, the economy stagnates and poorer service workers suffer. The pandemic recession hit the poorest sections of the US population hardest.

A critical part of this strategy is early determination. This has to do with a simple principle that we have known since the beginning of this pandemic: if an infection has the potential to grow exponentially, it becomes exponentially more valuable to contain it early on. This means that it is worth investing too much in protective measures, overreacting to the threat, and making huge sacrifices, even if they seem silly given the low number of infections at this point. There is one important asymmetry: economic waste from overreaction pales in comparison to long term losses in life and livelihood if you are wrong about underreaction. Italy's early experience with the pandemic provided concrete evidence of this.

Countries that heeded these warning signs flourished while others that ignored the Italian experience and repeated the same mistakes faltered. Although the number of infections in the UK rose rapidly in mid-March 2020, the government hesitated over a lockdown. Early decisive action must be pursued with a consistent strategy that is clearly communicated to all citizens. Leaders need to inspire citizens to make sacrifices to protect one another. This is another area where many rich, powerful countries have failed.

Not all countries are equally capable of dealing with the sacrifices required to destroy the virus, especially if they miss the boat and fail to catch it early. In April 2020, in Foreign Policy, I argued that poor countries need to think twice about introducing social distancing in places where there are no adequate social safety nets and lockdowns have the potential to cause widespread hunger. Early data showed that the enforcement of social distancing in rural Nepal or Bangladesh resulted in day laborers being unable to support their families. We have now rigorously documented the economic hardship that has emerged in low and middle income countries in Africa, Asia and Latin America.

However, the optimal policy in countries with better resources is very different. The Cayman Islands government periodically sends checks to service workers whose jobs have been interrupted by the lockdown. With community support, a friend of mine who is the head chef in one of the oldest restaurants on the island repurposed his entire crew to prepare and deliver meals to low-income residents during the lockdown.

China – after recognizing the coronavirus – has extremely locked down Wuhan, but it's important to ensure that all residents who are forcibly kept indoors have adequate access to food and medical care. Like Australia and New Zealand, the United States theoretically has the wealth to temporarily assist all citizens when a strict lockdown has been imposed. However, implementing such a strategy requires much stronger political will than politicians have shown.

The economic costs incurred by society as a whole from disorganized, indecisive measures to combat pandemics can be clearly seen in the online data on Google Mobility. The data collects daily visits to retail stores using millions of smartphones with location tracking enabled. New Zealand saw a much larger drop in mobility for a month during its initial tough lockdown in April 2020 compared to the US.

Visits to retail establishments in New Zealand fell 90 percent this month compared to pre-pandemic levels (as opposed to just 40 percent in the U.S.), meaning New Zealanders followed lockdown policies more strictly than Americans. This allowed retail visits to New Zealand to return to normal in September 2020 while the United States continued to experience a prolonged slump. Visits to U.S. retail companies continued to be 25 percent below pre-pandemic normal in March this year.

While the prospect of livelihoods and livelihoods should be reason enough to make the sacrifices necessary to destroy the virus and remain vigilant, for the average person in Europe or North America concerned about their freedom, these benefits seem to to be too abstract about everyday life.

But for those complaining of lost freedom, countries that the virus wiped out can give a taste of what true freedom from a pandemic feels like. Back on the Caribbean island, people go out every day without worrying about whether they thought of bringing their masks. They exchange hugs and kisses with family members and regularly visit restaurants. People support dive operators and rent equipment to put in their mouths.

Locals go out and spend knowing that everyone around them has made some sensible choices in the interests of collective health. My family and I enjoy the freedoms of a virus-free existence that I no longer take for granted because I usually live in the United States.

While New Zealanders lived free and healthy lives for most of 2020, my fellow American citizens and I were forced not to live fully or to work freely. Our individual freedoms have been constrained by wavering politicians, late decisions, and the impatience of people who prioritized reopening in the short term but constrained us even more in the long run.

This is the main lesson from this pandemic that we need to remember when new variants emerge or the next time a novel virus threatens humanity: don't be shy if we overreact.

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