Covid Catastrophe is a seven part series examining the history of the COVID-19 pandemic, its impact on Maine and what data policymakers used to lock down society and centrally-plan our economy. This is the seventh and final part of the series.

Understanding the state’s comparative advantages in relation to other institutions of society is crucial to determining the proper scope and course of public action. Government action tends to favor one-size solutions, especially in crisis. In the throes of a public health crisis of pandemic scale, the state can play an important role, but true solutions are more likely to emerge within business, academia, and the nonprofit sector. When information is rapidly changing, mustering the greatest amount of knowledge possible—while maintaining societal balance—must be the goal for policymakers.

Secure Credible Information

People will voluntarily alter their behavior based on the risks of living in a world with an unknown, potentially very contagious and deadly virus. Through the fast-paced nature of media within our increasingly connected world, information reaches people at lightning speed. Whether understood or not, people constantly reevaluate their situation and respond to changes in their condition. 

In a true emergency situation, the state could aid in the spread of credible information by encouraging accurate, disinterested accumulation of peer-reviewed scientific information and issuing guidelines—not mandates—to apprise citizens of recent developments. Of course, this scenario would rely on the bureaucracy to be honest about its findings and principled in its approach, lest it overstep the boundaries of its own power. In this way, the government could have avoided the loss of legitimacy and trust among the populace that has inevitably occurred today.

So-called “caution fatigue” among the people can limit the effectiveness of large-scale public health interventions, making it difficult for governments to maintain legitimacy. This should not be seen as an indictment of common sense safety measures like voluntary face coverings, hand-washing, and stricter respiratory etiquette, but public officials must ensure they have the support of their constituents in order to be effective. Counterintuitively, broad mandates are likely to diminish overall effectiveness.

While regulating information flow could be a useful tool of the state, a danger still exists—based on the economic and political incentives inherent in state action—to make known information that would only support compliance by furthering a preferred narrative. This is likely what the people of Maine and many other states experienced during the course of the public response to COVID-19. To remedy this problem, this report recommends the separation of science and state. The potential for corruption and conflict of interest is too great when the state selects, hires, and finances its own experts for guidance on public health. 

Seek Balance & Flexibility

Despite the large-scale economic disruption that resulted from one-size-fits-all shelter-in-place orders from state governors, data shows us that the previously determined strategy of physical isolation to avoid infection was also harmful on an epidemiological level.

A recent study of data from the early months of the pandemic in South Korea showed that people are five times more likely to contract COVID-19 from household contacts than from non-household contacts. Data released by the State of New York in early May showed a similar trend, with two-thirds of new hospitalizations coming from people who were staying at home. New York Governor Andrew Cuomo called this revelation “shocking” during his May 6 briefing on the report, but this should not have been shocking. It was never expected that COVID-19 would simply disappear or be eradicated, it could only be managed. 

The wholesale shutdown of a vast majority of business and the order to “shelter in place” from the powers-that-be likely exacerbated not only the economic damage from the virus itself, but also the length and severity of the pandemic. Admonishing citizens for leaving their homes and interacting with others outside the household may have limited the short-term rate of infection, but it also inhibited the accumulation of useful antibodies in the healthy population, unintentionally extending the duration of the outbreak. Taking into account the many ways people respond to their environment necessitates a more holistic, balanced approach. 

Understand Comparative Advantage

Regrettably, state action in response to COVID-19 meant that it would take on almost sole responsibility of planning the economy and society. By designating which businesses and workers were “essential” and which were “nonessential,” the government flipped the script on the people. Instead of outlining what action is prohibited by law, state officials attempted to construct society from the ground up, dictating what is expressly permitted.

During a new public health crisis, the comparative advantage of the state will likely be securing a standard testing regime across the healthcare system. Private-public partnerships, like the one made with IDEXX, can make up a lot of ground in the pursuit of adequate and actionable data with which to guide future decisions. The state can also promote innovation by simply removing regulatory limitations on the private sector, encouraging the development of new products and occupations. The fewer barriers to innovation, the quicker possible solutions can be tried, tested, and eventually adopted.

The state may also have a comparative advantage in monitoring health care capacity on a statewide level. Reviewing the sub-par record on protecting vulnerable nursing home populations, it is clear that this should have been a priority of state leaders in the early stages of the pandemic. State CDC officials should target congregate care facilities most susceptible to severe outbreaks and prioritize the direction of protective equipment and testing capacity to those centers.

With the benefit of hindsight, the answer is clear: early on, limited resources should have been focused on securing the most vulnerable populations, like the elderly living in nursing homes. The state should have prioritized providing those residents and staff with COVID-19 tests and PPE as soon as possible in order to understand and better control the situation within group homes and long-term care facilities.

It is important for policymakers to understand the extent of their own comparative advantages in order to utilize the best that other institutions of society can provide. In the realm of public health, as well as economics, when the state tries to do too much outside of its comparative advantage, it can crowd out more efficient private-sector solutions.