Diabolical dilemmas of COVID-19: An empirical study into Dutch society’s trade-offs between health impacts and other effects of the lockdown

Abstract

We report and interpret preferences of a sample of the Dutch adult population for different strategies to end the so-called ‘intelligent lockdown’ which their government had put in place in response to the COVID-19 pandemic. Using a discrete choice experiment, we invited participants to make a series of choices between policy scenarios aimed at relaxing the lockdown, which were specified not in terms of their nature (e.g. whether or not to allow schools to re-open) but in terms of their effects along seven dimensions. These included health-related effects, but also impacts on the economy, education, and personal income. From the observed choices, we were able to infer the implicit trade-offs made by the Dutch between these policy effects. For example, we find that the average citizen, in order to avoid one fatality directly or indirectly related to COVID-19, is willing to accept a lasting lag in the educational performance of 18 children, or a lasting (>3 years) and substantial (>15%) reduction in net income of 77 households. We explore heterogeneity across individuals in terms of these trade-offs by means of latent class analysis. Our results suggest that most citizens are willing to trade-off health-related and other effects of the lockdown, implying a consequentialist ethical perspective. Somewhat surprisingly, we find that the elderly, known to be at relatively high risk of being affected by the virus, are relatively reluctant to sacrifice economic pain and educational disadvantages for the younger generation, to avoid fatalities. We also identify a so-called taboo trade-off aversion amongst a substantial share of our sample, being an aversion to accept morally problematic policies that simultaneously imply higher fatality numbers and lower taxes. We explain various ways in which our results can be of value to policy makers in the context of the COVID-19 and future pandemics.

Exploring the Trade-Off Between Economic and Health Outcomes During a Pandemic: A Discrete Choice Experiment of Lockdown Policies in Australia

“…There are two DCEs that have been recently published [ 41 , 42 ] that examined preferences for the easing of restrictions used to manage the COVID-19 pandemic in the USA [ 42 ] and the Netherlands [ 41 ]. These are not directly comparable to our study as they differ in terms of the perspective and the attributes and levels used.…”

United States COVID-19 Vaccination Preferences (CVP): 2020 Hindsight

“…A similar study was conducted by Kreps and colleagues in July 2020, well before the first-generation vaccines were known to be efficacious and such plans were disseminated [5]. Between May and November 2020, many noteworthy health preference studies examined various aspects of COVID-19 in the United States [6] and in other countries [7][8][9][10][11][12][13]. Hopefully, many more studies will follow, building an evidentiary basis to inform the development of public health programs [14].…”

Social Study Resources and Social Wellbeing Before and During the Intelligent COVID-19 Lockdown in The Netherlands

“…Further, large-scale business-, school-, and university closures followed, and international travel was restricted (de Haas et al 2020 ; Fried, 2020 ). Despite these restrictions, citizens were still permitted to move around freely and meet with social contacts under the condition that they maintained a 1.5 m distance (Chorus et al 2020 ; de Haas et al 2020 ).…”