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Cognitive Bias and Public Health Policy During the COVID-19 Pandemic

Educational Objective
To understand how cognitive bias affects public health policy during COVID-19
1 Credit CME

As the coronavirus disease 2019 (COVID-19) pandemic abates in many countries worldwide, and a new normal phase arrives, critically assessing policy responses to this public health crisis may promote better preparedness for the next wave or the next pandemic. A key lesson is revealed by one of the earliest and most sizeable US federal responses to the pandemic: the investment of $3 billion to build more ventilators. These extra ventilators, even had they been needed, would likely have done little to improve population survival because of the high mortality among patients with COVID-19 who require mechanical ventilation and diversion of clinicians away from more health-promoting endeavors.1 Yet most US residents supported this response because the belief that enough ventilators would be available averted their having to contemplate potentially preventable deaths due to insufficient supply of these devices.

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Article Information

Corresponding Author: Scott D. Halpern, MD, PhD, Perelman School of Medicine, University of Pennsylvania, 423 Guardian Dr, 301 Blockley Hall, Philadelphia, PA 19104 (shalpern@upenn.edu).

Published Online: June 29, 2020. doi:10.1001/jama.2020.11623

Conflict of Interest Disclosures: Dr Truog reported serving as a paid member of data and safety monitoring boards for Sanofi, Gilead, and Covance. No other disclosures were reported.

References
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Sen  S , Karaca-Mandic  P , Georgiou  A .  Association of stay-at-home orders with COVID-19 hospitalizations in 4 states.   JAMA. 2020;323(24):2522-2524. doi:10.1001/jama.2020.9176PubMedGoogle ScholarCrossref
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Sharot  T , Riccardi  AM , Raio  CM , Phelps  EA .  Neural mechanisms mediating optimism bias.   Nature. 2007;450(7166):102-105. doi:10.1038/nature06280PubMedGoogle ScholarCrossref
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Weissman  GE , Crane-Droesch  A , Chivers  C ,  et al.  Locally informed simulation to predict hospital capacity needs during the COVID-19 pandemic.   Ann Intern Med. Published online April 7, 2020. doi:10.7326/M20-1260PubMedGoogle Scholar
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Laibson  D .  Golden eggs and hyperbolic discounting.   Q J Econ. 1997;112:443-77. doi:10.1162/003355397555253Google ScholarCrossref
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Centers for Medicare & Medicaid Services. National health expenditure data—historical. December 17, 2019. Accessed May 27, 2020. https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsHistorical.html
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Ritov  I , Baron  J .  Protected values and omission bias.   Organ Behav Hum Decis Process. 1999;79(2):79-94. doi:10.1006/obhd.1999.2839PubMedGoogle ScholarCrossref
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Greenfield  J . No, the Covid fight isn’t like WWII—and that’s bad news. Politico. Published May 9, 2020. Accessed June 8, 2020. https://www.politico.com/news/magazine/2020/05/09/covid-world-war-ii-245252
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AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

  • 1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
  • 1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
  • 1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
  • 1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
  • 1.00 CME points in the American Board of Surgery’s (ABS) Continuing Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.

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