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States must implement a coordinated response to contain COVID-19

States must implement a coordinated response to contain COVID-19
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Several states around the country have eased or are preparing to ease their stay-at-home restrictions that were imposed to combat the COVID-19 pandemic. This is happening despite reports and model predictions that the number of coronavirus cases in the U.S. is still climbing and will continue to rise for several more weeks — if not months.

Not surprisingly, whether individual states should reopen their economy now or keep hunkering down has generated heated debates.

The issue of how different states should respond to the pandemic is a prime example of what social scientists call a “social dilemma,” which is a situation in which individuals’ interests and the wellbeing of the collective group are in conflict. When this occurs — and when individuals act selfishly without coordination — the result is a suboptimal outcome that ends up hurting everyone. Right now, with governors — who are under pressure to revive their states’ economy — around the country acting independently with regard to reopening their states, we are hurtling towards that dark fate of likely prolonging and even deepening the current crisis.

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To prevent this from happening, we need to first understand why coordination matters at the national — and indeed the international — level. In a world with highly mobile populations, how one state responds to a pandemic in terms of policy choices affects all other states. If a state reacts too late and experiences a large surge in cases, that effect will spill over to other states through interstate commerce and travels and likely drive up the disease prevalence elsewhere. 

If one state invests resources in increasing its capacity for testing and contact-tracing so as to better identify and isolate infected people, that state may end up incurring a disproportionately large cost for its policy if other states do not adopt similar containment measures and end up exporting many virus-carriers to the state with the enhanced testing capability.

With regard to the lifting of stay-at-home orders, a major concern is that states acting independently without some sort of coordination would lead to several waves of shutdowns and reopenings, thereby lengthening the pandemic. North Carolina, for instance, will enter its initial phase of reopening given signs that its curve is flattening. However, with the number of cases still increasing in other parts of the country, there is a real possibility that this reopening, even if done gradually, would lead to a surge of new infections in the Tar Heel state. If that occurs and Gov. Roy Cooper (D) decides to shut down the state again, who is to say in a few weeks’ time we will not be right back here in the same position, contemplating a reopening of the state after managing to flatten the curve again? This situation is not unique to North Carolina and is a scenario that other states are facing or will have to face.

The way to solve a social dilemma is through coordination and cooperation of the parties involved. In the context of the COVID-19 pandemic, what we need is a national pandemic management team to coordinate and orchestrate government responses at the regional, state and local levels. Put differently, the current approach of having individual governors, who serve the interests of their own states and not those of other states, decide on their own about how to respond and proceed is precisely what social science research tells us we should not do when presented with a social dilemma.

To avoid or minimize partisanship, this management team should be free of elected officials and be informed by science — including findings from the social sciences — and data. Because pandemics pose a multi-dimensional problem that touches on medical, economic and ethical issues, among many others, this management team should consist of experts from several disciplines and spheres, not just from public health and medicine.

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Just as importantly, we need a leader who is willing to listen to this management team and to implement its recommendations. Perhaps it is no coincidence that the countries Taiwan and South Korea — being lauded for their organized handling of the pandemic — have seen their coronavirus infection curves “flatten,” while Italy, with its fragmented and patchwork approach, has fared poorly.

For better or for worse, we are all in this together. We will have to work together to get out of it.

Frederick Chen is a professor of economics at Wake Forest University who studies bioeconomics and economic epidemiology.