An immune system for the body politic: Using social science to control COVID-19
COVID-19 attacks the human body, but it is largely the body politic that defends us against it. While we wait for vaccines and treatments, we depend on health systems, governments, and the actions of others to detect the virus, control its spread, and break the chain of infection.
But our “social immune system” is compromised. In far too many cases, governments and individuals have been unable, unwilling, or too slow to learn from epidemiological evidence. As a result, hundreds of thousands are already dead, and the virus continues its spread. The social, political, and economic systems that should keep us safe are not just weak; in some cases they are actively harming us. Society needs an urgent “immunity boost.”
Social scientists must step up. If we target our theoretical and empirical powers on two critical research questions—what effect do policies have, and why do governments act differently—we can inform better social controls on COVID-19, buying the medical community time to develop vaccines and treatments.
What effects do government policies have?
As the pandemic spreads, governments have responded with an extraordinary range of measures to prevent human contact, including school and workplace closures, bans on travel, and orders to stay at home. Because these measures are so costly—we likely face an economic crisis greater than any in living memory—we need to know if they work.
The short answer is yes, on average. Early studies show that that “lockdowns” have led, a few weeks later, to a fall in infections and, a few weeks after that, to fewer deaths. Acting early and decisively seems to have been key. Countries that waited longer, or that took only half-hearted measures, saw both higher peaks in cases and deaths and slower declines from that peak. In other words, the harder and faster the blow, the flatter the curve. Moreover, those that re-open too quickly can see second waves.
But locking down a modern society is like amputating a limb to treat an infection. It may be necessary if you have no other treatment, but is best avoided. Moreover, it can’t be repeated too often without causing lasting damage. We therefore need to find less draconian methods.
Testing and contact tracing systems are key. No country has yet brought infections under control without these methods, which even poorer countries can deploy effectively, as we’ve seen in Vietnam. When infection levels are low, testing and tracing may be enough to keep things under control, as we see in Taiwan’s experience. For countries that have successfully used lockdowns to stop general transmission, like New Zealand, testing and tracing safeguard those hard-won gains.
But when testing and tracing fail—and there are blind spots even in places like Singapore, where clusters went undetected amongst migrant workers—and transmission spreads, stronger medicine is needed. The key question going forward is therefore: how do we maximize the health benefits of containment and closure policies with the least impact on the economy and society?
This is a hard question for two reasons. One, in the first months of the pandemic most governments adopted similar measures in a similar sequence. We therefore still lack much variation in the use of individual policy responses. For example, we do not have a number of countries that had school closures but not workplace closures, allowing us to compare the effectiveness of the two. As lockdowns ease and become more targeted, greater variation gives us more analytic leverage.
Two, social scientific theory tells us the effect of government policies on human behaviour, and therefore on the spread of the disease, will be mediated by a wide range of social, political, and economic factors. We already can see some empirical examples of such effects. For example, lockdown measures did less to reduce people’s mobility in low income countries, where work outside the home is commonly needed for subsistence, than in middle or high income countries. These confounders appear both at the societal and the individual levels, and likely interact with each other and with government policies in complex ways, creating devilish difficulties for our ability to make inferences.
Devilish, but not impossible. The social science toolkit has an array of research designs for exactly these kinds of complexities. Our goal should be to understand which measures provide the maximum public health benefit with the least “side effects,” and how both benefits and side effects vary across different populations, groups, and countries.
Why do governments act differently?
Social science can suggest ways to tailor and improve government responses, but will policymakers listen? As social scientists would expect, government behaviour is not only driven by information on what most effectively controls the disease, but also a wide range of economic, political, and social factors. Some of these factors can lead to pathological outcomes, like denying or downplaying the dangerousness of the disease. Understanding why governments act, or fail to act, is critical for effective pandemic management.
The first months of the pandemic already provide an empirical record to examine. While there has been some variation in the stringency of lockdowns, most variation has actually been in timing. Some governments acted quickly vis-à-vis the spread of the disease, and some slowly. We also observe a lot bandwagoning, with most governments acting around the middle of March, when the WHO declared global pandemic, as opposed to when the disease reached them (as the WHO recommended). Subsequently, some kept restrictive policies in place for extended periods, while others eased them quickly. Can we explain these differences?
Here, social scientists have come charging out of the gate. Every day new studies appear online examining how government behaviour or the spread of the disease is associated with different political regimes, demographic characteristics, social beliefs, political ideology, economic conditions, the imminence of elections, or other factors. Alongside this analysis, popular commentary is full of armchair explanations about autocracies versus democracies, the role of female leaders, populism, and other factors salient in the public imagination.
This work is critically important, but faces two barriers. First, the early wave of government responses shows more noise than signal. While some early studies have been able to show statistically significant correlations, teasing apart causality is more difficult. For example, there are democracies that have performed well, and autocracies that have performed poorly, and vice-versa. Some populists have denied the seriousness of the crisis, others have used it to advance their political agendas. For every correlation, exceptions and counterexamples abound, limiting our ability to generalize.
When the data are muddled, theory can help. It is plausible that in the early months of the pandemic, when political leaders were making decisions under crisis conditions, the structural and institutional factors that social scientists emphasise were simply less influential than the idiosyncratic characteristics of individual decision-makers or the unique set of conjunctural factors that happened to apply at that moment. In the fullness of time, qualitative process-tracing studies will likely be key.
The second, related difficulty is that it is likely too soon to tell how social, economic, and political factors will shape government outcomes. As the pandemic, the responses to it, and their subsequent effects continue to develop, they will both shape and be shaped by a wide range of factors social scientists emphasise. For example, we already see attitudes toward the pandemic response mapping onto existing political cleavages in countries like the United States and Brazil, which are likely to further shape future government responses in those two countries. As social and political contestation around the pandemic and its effects play out, we can expect government responses to become further differentiated over time.
Social scientists will need to study these future dynamics carefully. If we can understand what factors shape government decision-making, we can help public-minded decision-makers mobilise support for effective policy, while also helping publics hold leaders accountable.
Finally, how governments interact also matters. A pandemic is a classic “weakest link” collective action problem. Given interconnectedness, we are only safe if others in our community, in our country, and globally are also able to control the disease. We’ll therefore need more research into how governments can cooperate more effectively
An immune system for the body politic
We each hope our own immune system will be strong enough to fight off the virus. But we are perhaps even more dependent on the robustness of our societies and governance systems to control the disease. This social immune system needs rigorous, applied social science insights to grow stronger. As our medical colleagues do in developing treatments and vaccines, social scientists can, and must, play an essential role in keeping us all healthy.
This article was originally commissioned and published by the Campaign for Social Science as part of its COVID-19 programme.
Thomas Hale is Associate Professor of Global Public Policy and Director for China Engagement at the Blavatnik School of Government, University of Oxford.