Comparing pandemic intervention strategies

As we navigate the greatest health crisis of our lifetimes, it turns out that many aspects of our experiences in 2020 aren’t as “unprecedented” as we may think. The widely varied pandemic responses by local and state officials (and resulting political polarization) occurring today also transpired over 100 years ago during the Spanish Flu. 

Lessons from a century ago may be worth revisiting: the left side of the graphic above details the health and economic case for public health mitigation strategies. Cities that enacted “longer interventions” (including mask mandates, closures, business capacity restrictions, and social distancing measures) in 1918 experienced fewer deaths per capita, as well as higher employment gains through 1919, compared to “similar” cities that enacted “shorter interventions.” For example, Los Angeles, which declared a state of emergency and banned all public gatherings early in the pandemic, had 25 percent fewer deaths per capita, and a 27 percentage-point greater gain in subsequent employment than San Francisco, which mainly focused on urging residents to wear masks in public.
Fast forward to today, when we’re also seeing significant differences between COVID containment policies at the state level. The right side of the graphic shows that states with the weakest overall pandemic containment policies are currently experiencing the worst outbreaks, measured here by hospitalizations per capita. States like Hawaii and New York, which maintained many of the strict mitigation strategies first put into place in the spring, are seeing those restrictions pay off with fewer hospitalizations during the latest spike.

Conversely, Iowa and the Dakotas have fewer, and less stringent, public health measures, and are now seeing the highest surges in the country today. (New Mexico shows that state-level policy decisions don’t explain everything—it’s currently battling a serious outbreak despite maintaining some of the strongest containment measures over the course of the pandemic.) 

As we head into the worst COVID wave so far, the debate over whether saving “lives” or “livelihoods” should dominate the pandemic response rages on. History shows that higher levels of public health intervention can both save lives and result in stronger economic recovery.

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