Can $683 Convince People to Self-Isolate?

If one of the main reasons coronavirus infection rates remain so high is that people refuse to self-isolate, paying them to stay home could make a difference. But doing so isn’t just expensive, it risks some unintended consequences.

It’s an idea politicians as far apart as the Republican governor of Vermont, Phil Scott, and Democratic Representative Alexandria Ocasio-Cortez of New York have supported. In November, Michael Osterholm, a coronavirus advisor to President Joe Biden, said that paying workers to stay home for four to six weeks could contain the virus.

Now the U.K. Department of Health is reportedly recommending a plan to pay workers 500 pounds ($683) to self-isolate, according to a leaked document detailed by the Guardian Friday. The government has downplayed the idea, but even the suggestion reflects how desperate it has become to control infections and relieve pressure on the hugely strained National Health Service.

While Britain’s inoculation program is going well, it’s still a long wait before herd immunity will be reached. And there are at least two hard months of winter to go.

There are a number of causes behind the current wave of infections, but poor compliance with self-isolation requirements among those with symptoms or who test positive seems to be a major contributor. The Guardian report cites government polling showing that only 17% of people with Covid-19 symptoms bother getting a test, largely because they fear they will lose income if they have to stay home. Another survey showed only one in four people self-isolate for the recommended full 10 days, while 15% continue to work.

These figures suggest that many people don’t feel they can afford to follow guidelines and self-isolation rules. Statutory sick pay in the U.K. is only 95.85 pounds per week, too low for many workers to get by on. Then there’s the country’s more than 5 million self-employed and gig economy workers who don’t benefit from that.

The problems with a blanket payment are apparent. One is enforceability. Just look at the U.K.’s patchy efforts to get people to comply with other guidelines such as mask-wearing. Administering a pay-to-stay policy — and keeping it from being abused — may require the sharing of health data with police and enforcement bodies. That’s not unreasonable in a public health emergency, but it may face some opposition on privacy grounds.

Inevitably, universal payments throw up objections on fairness grounds too. A one-size-fits-all welfare payment may be a nice top-up for some workers who would isolate anyhow or are not struggling, but it may be far too little for, say, a single mother who has to support her family on her income. And what about those who have endured hardship or lost income because they followed the self-quarantine rules in the period before the windfall?

It’s unlikely that those told to self-isolate after contact with someone who’s tested positive would be covered. The government currently offers a payment to those on low incomes who have been told to self-isolate, but the criteria are strict and the Labour Party has complained that three-quarters of applications are rejected. If testing was more widely available to those affected by contact-tracing, that could help move people more quickly back into work.

Handouts, of course, can result in perverse incentives. Would young people go out and try to catch the virus in order to claim a payment? They could then end up spreading the infection even more. A large household might be able to claim multiple payments — but at what risk to themselves and the community? Indeed, that is probably the key objection that must be overcome since the purpose of the payment is ultimately to save lives.

There is also the question of cost. Treasury estimates the program would cost 453 million pounds a week. Data published Friday showed that government borrowing climbed to 270.8 billion pounds in the first nine months of the fiscal year. With the national debt now above 2 trillion pounds, Chancellor of the Exchequer Rishi Sunak wants to show markets the government knows there are limits to the check-writing.

The problem for Johnson is that the U.K. already has one of the highest per capita death rates in the world. If a couple of months of added costs and restrictions would save lives while the vaccine is being rolled out, it’s hard to argue against it.

This column does not necessarily reflect the opinion of the editorial board or Bloomberg LP and its owners.

Therese Raphael is a columnist for Bloomberg Opinion. She was editorial page editor of the Wall Street Journal Europe.

©2021 Bloomberg L.P.

BQ Install

Bloomberg Quint

Add BloombergQuint App to Home screen.