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Behavioural errors

If only Jeremy Corbyn had won the December 2019 general election, the Covid-19 crisis would have been entirely different.  At least, that is what the Facebook sages on the left of the political spectrum are currently claiming.  This, though is just the usual political theatre in which the red team blame the blue team for everything that goes wrong and vice versa.  The reality, though – borne out in part by the actions and errors of the Labour administrations in London and Cardiff Bay – is that a Labour government would have done more or less the same as Johnson’s Tories have done.

One reason for this is that it now appears that the SARS-CoV-2 virus was circulating in Britain during or just after the General election last December.  Last week, the BBC reported on the “strange case” of a Yorkshire choir which became infected at an early stage in the pandemic:

“Dr John Wright of Bradford Royal Infirmary is intrigued by a group of amateur singers who experienced a viral illness with familiar symptoms long before the first recorded case in the UK…

“Among the first singers to get ill was the partner of a man who returned from a business trip to Wuhan on 17 or 18 December and developed a hacking cough…”

Had this been an isolated case, it would be easy to dismiss it as being similar, but not related, to Covid-19.  Except that confirmed cases in December have also been found in France and in California; suggesting that the outbreak began in Wuhan as early as October or early November.

While critics have slated the Johnson government for not following the science, the real problem seems to be that he did.  As a special report by Stephen Grey and Andrew MacAskill at Reuters explains:

“Interviews with more than 20 British scientists, key officials and senior sources in Johnson’s Conservative Party, and a study of minutes of advisory committee meetings and public testimony and documents, show how these scientific advisers concluded early the virus could be devastating.

“But the interviews and documents also reveal that for more than two months, the scientists whose advice guided Downing Street did not clearly signal their worsening fears to the public or the government. Until March 12, the risk level, set by the government’s top medical advisers on the recommendation of the scientists, remained at ‘moderate,’ suggesting only the possibility of a wider outbreak.”

In December and January, of course, the Johnson government was focused entirely on “getting Brexit done.”  Little attention was given to a virus in China that, at that time, the World Health Organisation was not even sure could be transmitted in the human population.  Had Corbyn won the 2019 election, he would have been embroiled in an equally time-consuming Brexit negotiation – in this case to renegotiate a deal and then to prepare the ground for a new referendum.  It is unlikely that he or his new front bench would have been any more cognisant of the threat coming from Wuhan than Johnson’s Tories were.  Nor, in any case, would a clear out of the various public health scientific advisory committees have been high on an incoming Labour government’s priority list.

The truth is that an incoming Labour government would have responded in more or less the same way to the same advice from the same advisory bodies.  Nor least because the cynicism of politics is that it is better to follow the official advice and be wrong than it is to risk going against the advice even if you are right to do so.  It would have been a brave Labour Health Secretary who would have contradicted the SAGE committee and all of its feed-in groups just weeks after being appointed to the job.

The problem is, as we now know, there is no such thing as The Science; and that the original modelling used by government proved to be wildly inaccurate.  The fact that former government science advisor David King was moved to set up an alternative science committee is evidence enough that there are several scientific perspectives on the best approach to tackling the pandemic.  In particular, scientists have raised concern with the slow pace of the government response, the failure to vigorously track and trace cases, and the failure to protect the most vulnerable; for example, by discharging infected patients into care homes or failing to provide adequate protection to front line black and minority ethnic workers.

While this has all of the hallmarks of a spat between scientists, though, there may be another academic profession that has seriously muddied the waters.  Could it be that our old friends the economists have been using models which bear little resemblance to the real world to shape the government’s response?  It could indeed; although in this instance it is a branch of economics that has tended to be more realistic than the mainstream neoclassicals which is at fault.

The great strength of behavioural economics, which drew on social psychology to inform its understanding of human behaviour, is that it introduced the scientific method to a discipline that is ordinarily about as scientific as homeopathy.  Its most useful insight was the discovery of the “Cobra Effect” – the way in which government policies all too often have unintended consequences.  Its solution – which would be science 101 in any other field – was to run controlled trials to determine whether a policy would work before introducing it.  Its greatest failure, however, was its discovery of “social proof” – people’s tendency to fit in with what everybody else is doing – and its tendency to assume that social proof approaches to policy will always work.

This is why the use of controlled trials is essential.  As the Financial Times “undercover economist” Tim Harford explained in a 2014 article:

“A recent experiment designed by BIT [Behavioural Insights Team] highlights both the opportunity and the limitations of the new discipline. The trial was designed to encourage people to sign up for the Organ Donor Register. It was huge; more than a million people using the Driver and Vehicle Licensing Agency website were shown a webpage inviting them to become an organ donor. One of eight different messages was displayed at random. One was minimalist, another spoke of the number of people who die while awaiting donations, yet another appealed to the idea of reciprocity – if you needed an organ, wouldn’t you want someone to donate an organ to you?…

“Expecting social proof to be effective, the BIT trial used three different variants of a social proof message, one with a logo, one with a photo of smiling people, and one unadorned. None of these approaches was as successful as the best alternatives at persuading people to sign up as donors. The message with the photograph – for which the teams had high hopes – was a flop, proving worse than no attempt at persuasion at all.”

Harford takes three lessons from this.  First, it demonstrates the value of controlled trials – the fact that a different message was revealed to be better than the ones assumed by the policy makers is proof that the experiment was far less expensive than the roll out of the wrong message would have been.  Second, the fact that previous insights cannot predict future public behaviour demonstrates the limits to this branch of economics/social psychology.  Third, behavioural economists have strayed away from economics and into politics.

The problem is that behavioural economics – at least as practiced in the political arena – has less to do with science than with letting politicians off the hook for unpopular and often simply wrong-headed policy:

“For example, in May 2010, just before David Cameron came to power, he sang the praises of behavioural economics in a TED talk. ‘The best way to get someone to cut their electricity bill,’ he said, ‘is to show them their own spending, to show them what their neighbours are spending, and then show what an energy-conscious neighbour is spending.’

“But Cameron was mistaken. The single best way to promote energy efficiency is, almost certainly, to raise the price of energy. A carbon tax would be even better, because it not only encourages people to save energy but to switch to lower-carbon sources of energy. The appeal of a behavioural approach is not that it is more effective but that it is less unpopular.”

The Behavioural Insights Team that Cameron inherited from New Labour had already helped then Energy Minister Ed Miliband sell costly climate change-related energy policies to a public that was already beginning to complain about energy bills.  It has had a chequered record in the years since; often advocating the least unpopular rather than the most effective policy to politicians seeking cover from the electorate.  But its biggest (pre-Covid-19) failure came, when it recommended that the Cameron government take a social proof approach to the rollout of smart meters:

“How we feel we compare with others has long been known to be a key determinant of our feelings and actions.  In the context of domestic energy use, providing consumers with feedback on how their energy use compares with similar households in their neighbourhood has been shown to reduce energy consumption in higher-than-average users. For example, the US company Opower provides consumers with a Home Energy Reporting Program, which includes comparative consumption information (see overleaf) showing how your energy use compares with similar neighbours. This neighbourhood comparison is accompanied by personalised feedback on how the household uses energy and tailored suggestions on how to waste less energy and save money.”

The stupidity of this approach had already been highlighted by Alex Henney (Former director of London Electricity) and Ross Anderson (Professor of Security Engineering, University of Cambridge, Computing Laboratory):

“Based on a study of smart metering in 11 countries, we find that Britain has taken longer to devise a more complex and expensive system than any other country… we recommend that Britain stop trying to invent the wheel and just use one that already works. The three models that immediately suggest themselves are the Dutch, Spanish and New Zealand; any would be much cheaper than the current proposals and would largely remove the technological risk of a systems disaster that would become apparent just in time for the next election in 2015. DCC is not necessary; no other country is attempting to build such a system; and there are good reasons for expecting a very poor outcome if we try…”

We now know how this worked out.  The Behavioural Insights Team provided government with the ammunition for a social proof-based programme to deploy smart meters to households via the supply companies.  Correctly smelling several rats – the original meters locked household into a single supplier, the financial benefits went to the supplier, and the meters contain an nasty little kill switch that allows a supplier to remotely disconnect a user – a large number of us chose to have nothing to do with smart meters.  As a result, the date by which we were all supposed to be connected was pushed back to 2020. Then, in 2017 when it became obvious that even this date was going to be missed, the government moved the goalposts so that we would all merely have been offered the chance to install a smart meter by 2020.

The models recommended by Henney and Anderson had none of these issues because they began with the obvious point that the metre is an integral part of the energy infrastructure.  Thus, if the Distribution Network Operators had been given responsibility for the rollout, there would have been no need to persuade anyone else of the benefits; they could have simply installed new smart meters in every household.

Discovering that the Behavioural Insights Team has played a central role in shaping the UK government response to the spread of SARS-CoV-2 explains a good deal about why the response has been so disjointed.  From the beginning, the assumption has been that the British people would not stand for restrictions on their freedoms and that they would have to be “nudged” toward “social (i.e., physical) distancing.”  This was compounded by a manifestation of “Maslow’s Hammer” – if the only tool you have is a hammer, every problem starts to look like a nail.  In this case, the tool at hand was the influenza pandemic strategy originally developed in the wake of the 2009 Swine Flu pandemic.  As the Reuters report explains:

“As they watched China impose its lockdown, the British scientists assumed that such drastic actions would never be acceptable in a democracy like the UK. Among those modelling the outbreak, such stringent counter-measures were not, at first, examined…

“That limited approach mirrored the UK’s longstanding pandemic flu strategy [which]… stated the ‘working presumption will be that Government will not impose any such restrictions. The emphasis will instead be on encouraging all those who have symptoms to follow the advice to stay at home and avoid spreading their illness.’

“According to one senior Conservative Party politician, who was officially briefed as the crisis unfolded, the close involvement in the response to the coronavirus of the same scientific advisers and civil servants who drew up the flu plan may have created a ‘cognitive bias.’”

The result was that Britain made two enormous errors at the very beginning which were to propel us down the road of a lockdown that has caused the biggest economic depression since the dawn of the Industrial Revolution.  As the Reuters report explains:

“While the UK was prepared to fight the flu, Asian states like China, Hong Kong, Singapore and South Korea had built their pandemic plans with lessons learned from fighting the more lethal SARS outbreak that began in 2002… SARS had a fatality rate of up to 14%. As a result, these countries… were more ready to resort to widespread testing, lockdowns and other draconian measures to keep their citizens from spreading the virus.”

Crucially, these states closed their borders as soon as news of the virus emerged.  China was slow to ban flights out of Wuhan, but eventually did so on 23 January.  By this time, however:

“… 17 passenger flights had flown directly from Wuhan to Britain since the start of 2020, and 614 flights from the whole of China, according to FlightRadar24, a flight-tracking service. That meant thousands of Chinese, some of them potential carriers, had come to Britain. On April 5, scientific adviser Ferguson said he estimated only one-third of infected people reaching Britain had been detected.”

Indeed, Britain is only now considering restricting travel into the country, and even this only on a voluntary rather than compulsory isolation basis.  It is no accident that the Asian states which closed their borders at the outset have significantly lower per-capita death rates than the UK. Which is now fourth behind Belgium, Spain and Italy.

The second failure was not to instruct everyone to wear a face covering when out in public.  Although government scientists have refused to endorse this policy, the reasons are very different to the purpose employed in those same Asian countries and, indeed, in states like Slovakia which have also maintained a low per-capita death toll.  In most cases, scientists have been responding to the wrong question: will wearing a mask prevent me from being infected? (it won’t). There is also a concern that wearing masks may give people a false sense of security; for example, making them less inclined to wash hands or to avoid touching their faces.  The shortage of medical-grade face masks is clearly a concern too.  Recommending that people wear masks could cause a run on PPE just at a time when frontline health workers are struggling to access it.

Wearing face masks is, though, merely an extension of the earlier advice to sneeze of cough into a handkerchief, tissue or your elbow – a means of lowering the chance of you infecting someone else.  As David Ewing Duncan at Vanity Fair reports:

“It sounds too good to be true. But a compelling new study and computer model provide fresh evidence for a simple solution to help us emerge from this nightmarish lockdown. The formula? Always social distance in public and, most importantly, wear a mask…

Duncan points to modelling by De Kai, an American computer scientist with joint appointments at UC Berkeley’s International Computer Science Institute and at the Hong Kong University of Science and Technology which suggests that if 80 percent or more of us were to wear face masks, the curve of infections could be flattened far more effectively than the UK’s lockdown policy has managed.

This raises a more mercenary reason why government scientists might be reluctant to suggest the compulsory wearing of face coverings in public.  Having crashed the economy – first by failing to take the pandemic seriously enough and then by u-turning and ordering an economically devastating lockdown – it would be difficult to admit that the same outcome might have been bought by spending a couple of million pounds to issue everyone with two or three reusable cotton masks.

One reason the economy was already beginning to crash before the lockdown was ordered was that a large part of the UK population was taking the pandemic far more seriously than the government appeared to be.  Bars, restaurants and cinemas saw their customer numbers crash from mid-February.  Large numbers avoided public transport while air travel ground to a halt.  At the same time, so-called “panic buying” – in reality just large number of people adding a few extra items each – was an indication that people were prepared to lock themselves down if government didn’t order them to. We can only wonder whether people might have behaved differently if everyone had been ordered to wear a mask in order to make public spaces safer.  However, from the beginning it seems that government advisors believed that even this would be considered too draconian.

Claims that a Labour government would have done things differently are the predictable first step in a movement which will result in the inevitable public inquiry into the government’s handling of the emergency.  In truth, though, if a Labour government had been returned last December, they would have inherited exactly the same advisory bodies and influenza-based emergency plans.  Like Johnson’s Tories, they would also have been largely preoccupied with their own approach to Brexit.  It is doubtful that they would have deviated from the scientific advice to any significant degree.  Nor – evidenced by their actual electoral failure in December – are they likely to have been any more in touch with public sentiments than the government turned out to be.

As human activities – especially our globalised industrial agriculture – encroach into the last remaining wild habitats on the planet, we can expect pandemics to become yet another of the crises that we have to deal with.  Covid-19 – the illness that results from the SARS-CoV-2 virus – is relatively benign when compared to the death toll from diseases like Ebola or Malaria – the response to which will likely be underfunded for a decade or more because of the resources channelled into dealing with Covid-19.  Its unpleasant sting is in the long asymptomatic infectious stage at the beginning of the illness; which made it far harder to control than a strain of influenza would have been.  But mercifully, it is far less fatal than SARS and MERS.  In terms of the number of excess deaths, it will probably fall within the range of previous pandemics simply because of the age and ill-health of the majority of those who die – half of British care home residents, for example, die within 15 months of moving in; suggesting that many of those who died of Covid-19 would have died of something else later in the year or early next year.  And while every death is a tragedy for someone, statistically, this suggests that if and when Covid-19 passes, we will experience several months in which there are far fewer deaths than average.  Only then will we be able to judge the full impact of Covid-19.

None of this is to condone the failures of the government response.  It is merely to point out that even with the high death toll from Covid-19; we might be witnessing a relatively mild version of the pandemics which lie ahead of us.  And with this in mind, it is essential that we learn all of the lessons from this – not just the ones that we can use to attack the opposing political team or to defend our side from criticism.  The question is not whether a Labour government would have done things differently – it wouldn’t – but whether a different – and far more transparent – approach to the science –  and the assumptions behind it – might have resulted in very different advice being given to whichever government happened to be in office from the outset.

As you made it to the end…

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