Staying at home during the COVID-19 pandemic actually increased the spread of infection, according to new study published by the University of Chicago and, soon, by the National Bureau of Economic Research.
Staying at home during the COVID-19 pandemic actually increased the spread of infection, according to new study published by the University of Chicago and, soon, by the National Bureau of Economic Research.
“Within a month, employers implemented prevention protocols – screening, masks, better airflow, etc. – much more than households did,” explained University of Chicago Economics Professor Casey Mulligan, who served as the Chief Economic Adviser to the White House Council of Economic Advisers from 2018-19.
In the paper, Mulligan pointed out, “Public health policy recommendations often presume that the workplace is less safe.” Yet data shows they are safer, if protections are in place.
Mulligan analyzed data collected from schools, hospitals, nursing homes, food processing plants, hair stylists and airlines during the pandemic. Once those organizations adopted mitigation protocols, “infections rates in workplaces typically dropped from well-above household rates to well-below.” When that happens, going to work and school becomes safer than remaining at home.
Mulligan explained the issue as a function of scale. As an example, he cited China’s Great Leap Forward, when Chairman Mao required villagers to manufacture steel in their backyards to accelerate China’s transition to an industrialized nation. The resulting steel was worthless and the production of other goods suffered. “The efficient scale for steel production, reflecting advantages of specialized physical and human capital, is too large for the backyard,” he pointed out.
And so it is, too, with personal protection during pandemics. Large organizations have the capital to invest in more effective air filtration and other sanitizing devices and have the ability to enforce compliance with other procedures, such as social distancing and masking.
“Schools, businesses and other organizations implemented a range of prevention protocol – from adjusting airflow to installing physical barriers, to monitoring compliance, to administering their own testing services – that households did not and perhaps could not,” he wrote. Therefore, rather than being “places of solitary confinement and zero transmission,” households show the highest transmission rates.
For example, infections of pupils and staff at in-person primary and secondary schools were 20-times more likely to be traced to the community than to the school. Likewise, infections among university students and airline pilots were notably lower than those of the general population.
Infection rates among Duke University healthcare workers, for example were 167% higher than those in the general community before mitigations were put in place. Afterward, the infection rate fell to 31%. The infection rate among in-person students and staff in North Carolina schools was 23% of that of the general population. In Wisconsin in-person schools, it was 18% of the general population.
Clearly, shifting time spent in an area with higher infectivity rates to an environment in which infections rarely occur helps reduce infections.
However, “Reallocating some of a person’s time from a group with a high average infection rate… such as a household, to a large group with a low rate does not necessarily confer a (benefit) on the broader community,” he wrote.
For example, if someone could be infected at home with one hour of exposure, reducing time there from 16 to 15 hours per day probably won’t matter even though longer exposure does increase risk of contracting the infection. If no one there is infected, however, spending time in a more protected environment helps reduce the risks of contracting COVID-19.
Stay-at-home orders, Mulligan argued in 2020 and reiterated today, prevent innovative, effective transmission control strategies from being developed and implemented.
Duke’s healthcare network “swears by the efficacy of universal masking for all patients and staff,” Mulligan told BioSpace. The hospitals in the study also closed lunch rooms, prohibited handshakes, mandated eye protection, and installed physical barriers. Organizations of all types generally screened or quarantined potentially ill people and limited interdepartmental contact. Some (especially airlines and hospitals) also installed air filtration systems designed to eradicate or at least reduce the presence of the virus.
With such precautions not prevalent in homes, he wrote, “Remote learning and skipping healthcare appointments are not slowing the spread. In fact, it’s probably the opposite when those organizations take some precautions, as they have.”
Therefore, Mulligan told BioSpace, “Students should be in their normal school buildings and healthcare patients should go to their normal appointments. For schools and the health sector, we have the best data that they have very low infection rates…and COVID-19 infections are not a big deal for the students (because of their young age).
“Outside of education and healthcare sectors, no employer should be forced to close when their workforce is healthy,” Mulligan continued. “Employers are better situated to slow the spread than households are, which policymakers should acknowledge as – at least – a strong possibility. This is especially true when the prevalence of disease is high, because that is when employers’ preventative actions – which few households take on their own – make the most difference.
“The practice of shutting schools and businesses when (disease) prevalence is high is backwards,” Mulligan stressed.
