Beyond borders: The benefits of proactive policies in a pandemic

The coronavirus clearly doesn’t care about borders. And as governments around the world continue their battles to contain it, new research suggests how pandemic-related policies could benefit more from the practice of thinking outside the jurisdictional box.

“You can think of it as a giant whack-a-mole game,” said Stanford economist Matthew Jackson. “The problem is everyone’s doing this in asynchronous ways. For instance, it’s just completely inefficient to try and lock one place down when another place right next door is open and the disease is growing there. Then when you open up, the disease comes right back and then they’re locking down.”

Overall infection rates could be substantially lower if governments are more outward-looking and more proactive — as opposed to reactive — when it comes to instituting policies to contain a disease, according to the new study by Jackson and his colleagues, published Tuesday in the Proceedings of the National Academy of Sciences. 

Jackson is the William D. Eberle Professor of Economics and a senior fellow at the Stanford Institute for Economic Policy Research (SIEPR). His co-authors are Arun Chandrasekhar, an associate professor of economics at Stanford, Paul Goldsmith-Pinkham of Yale, and Samuel Thau of Harvard.

In analyzing COVID-19 infection rates within a model of different types of decentralized policy approaches, the researchers found that overall infection rates are three to 10 times worse when government jurisdictions are being reactive, or imposing quarantine restrictions only after infection rates rise within their own borders. That’s compared to when they are being proactive, deciding on quarantine measures by tracking infections outside their jurisdictions and forecasting infections within their own borders.

Coordinated efforts and timely information-sharing among governments — specifically, taking heed of infection rates outside their jurisdictions — raises the effectiveness of a regional policy to curb infections over time, according to the researchers. What’s more, their analysis shows that the existence of a few “lax jurisdictions,” or those that wait for higher infection rates within its own borders before imposing shutdown restrictions, worsens the outcomes for all jurisdictions.

“Governments should realize that they are reacting to what's going on in other settings, and they have to be a little bit more proactive about it, by forecasting what's going to happen by looking at the rest of the world,” Jackson said. “Then they can be better prepared and have better policies than they would if they wait until crisis hits and then react to it on their own just based on what's going on in their own jurisdictions.”

In a way, some recent new surges in COVID-19 infections reflect the tradeoffs of the policy dynamics the researchers examined.

“A region can control the disease better if it does a little bit more mitigation now than waiting until it hits a big spike again,” Jackson said.

But the problem, he said, is that jurisdictions often put themselves first and react, rather than coordinate. And without coordinated organization, he said, “then we suffer.”

"Some countries, including the U.S., have been fortunate in getting portions of their populations vaccinated, which is starting to slow the spread,” he said. “However, other parts of the world are still experiencing rapid contagion and may face significant delays until much of their populations are vaccinated. That becomes everyone’s problem, especially as countries continue to act out of sync, which enables the disease to continue to survive, mutate, and resurge.’’

In the study, the researchers use an epidemiological model that accounts for patterns of exposure, latency in detection and rates of infection and mortality. They incorporate that model within a framework that compares the effect of different regional quarantine approaches — those that only react to infection rates within its region, and those that are outward-looking, considering infections both within and outside of its jurisdiction to forecast its infection rates.

“What we find is that it is problematic when you’re not in sync and you’re not forecasting what’s happening,” Jackson said. “Then you’re waiting until you see the cases and the surge before you start closing down, which just leads to continued large-scale contagion across different jurisdictions.”

Substantial improvements in curbing infections are possible if governments look beyond their own citizens and account for how their actions could impact other jurisdictions, the researchers say.

“The theoretical findings give us an idea of what kinds of policy network connections are going to be more problematic or effective when you’re dealing with a disease that could be difficult to detect and has a latency period before people start to show symptoms,” Jackson said. “And although the simulations are back-of-the-envelope calculations, they still show us that does it really matter — and how much does it matter — if everybody just does their own thing.”

Essentially, the study indicates the benefits of a broader governing mindset.  

“Any kind of mitigation procedure will have some cost to it, but if I’m a mayor or a governor, what they should be doing is thinking, what’s the benefit to the world of this thing? Those benefits are way beyond the local jurisdiction,” Jackson said. 

“In stopping one sickness, I shouldn’t be saying, ‘Oh, I’ve just saved one ICU bed here.’ What I should be thinking is, ‘I’ve saved an ICU bed here and in Florida and in New York and in Texas.’”

“And if you start looking at those benefits that way, then you should be putting more mitigating measures in place and trying to coordinate efforts on a more global scale than if you're just doing the me-first kind of calculations that people are doing.”

The policy coordination and proactive approach that the researchers find beneficial could be applicable to other global issues as well, and not just COVID-19. Problems like a financial collapse or carbon emissions in one region are everyone’s problem, the authors stated in the study. 

“The lack of coordination between governments on systemic problems, from climate change to financial contagions, has large costs that are well-exemplified by a pandemic,” the researchers wrote. “Our techniques should be useful in studying networked interactions across other domains.”