General update, April 7

1. Roman Frydman and Edmund Phelps write,

The government’s approach is ill-suited to the crisis. The stimulus isn’t merely the wrong dose, but the wrong medicine altogether.

Instead of boosting public employment or seeking to stimulate demand, lawmakers should focus on mobilizing the private sector to combat the public-health crisis. We don’t dispute the need to improve America’s highways, airports and other infrastructure. But that would do nothing to address the specific causes of today’s crisis: self-imposed lockdowns to stop the spread of disease.

The CARES Act will live in infamy as one of the worst pieces of legislation every enacted. The portions of it that were supposed to address short-term liquidity needs have been nullified by complexity and bureaucratic snarls. But you can bet that the portions that reflect rent-seeking and irrelevant agendas will be implemented much more effectively.

And the politicians in Washington think that this is only the appetizer. They are preparing the next course.

2. Gary Cohn and Glen Hutchins write,

The Fed will be operating at an unprecedented scale, reportedly lending as much as $5 trillion, which is more than its entire balance sheet before the crisis. It will also be engaging in a practice in which it has little experience: targeting capital to individual companies in commercial industries. This is an important and complex task that requires great care and speed.

The Fed’s ability to identify and implement appropriate tools will be critical to its success in this new role. It is vital that the central bank succeeds in mitigating the pandemic’s damage to the economy. It is also important the Fed avoids the stigma that followed the 2008 “bailouts.” This will require a thoughtful approach to staffing, process and disclosure that ideally would be implemented at the outset.

They are cheerleading for the Fed, which I am sure is what you have to do if you want to stay in mainstream journalism or economics. We have become more Chinese than China, in that the centralization of capital allocation is more rigorous here and the Distributed Information Suppression Complex is more effective than China’s much cruder control over news.

3. A reader forwards a pointer to paper by Ke, et al.

Here, we argue that because death and the cause of death are usually recorded reliably and are less affected by surveillance intensity changes or delay in confirmation than case counts, the time series of death counts reflects the growth of an epidemic reliably, with a delay in onset determined by the time between infection to death. Based on this idea, we designed a simple 88 methodology to disentangle the epidemic growth from confounding factors, such as underreporting, delays in case confirmation and changes in surveillance intensity. We fit models to both case incidence data and death count data collected from eight European countries and the US in March 2020. We show that in most countries, the detection rate of infected individuals is in general low, and COVID-19 spreads very fast in these countries

In other words, they agree with me that the death rate gives you a way of looking at the spread rate through a rear-view mirror. I don’t know why they even bother to look at confirmed-case data at all.

4. Another reader sent me a link to an article behind an FT paywall (https://www.ft.com/content/9ee6f251-f3ee-4d42-8cac-e372f8564088) that says that Iran has adopted a credit-line approach similar to what I have suggested. Who says I have no influence?

The Avalon Hill metaphor

Note to commenters: feel free to correct me on any of this, preferably with links to definitive sources. I will post corrections here.

There are two stages to the virus disease. In the first stage, one gets flu-like symptoms. In the second stage, if it occurs, an immune response coats the lungs, reducing oxygen flow do the blood. I believe this is called ARDS, although sometimes I see it referred to as pneumonia. The second stage is by far the most deadly.

UPDATE: This article makes me think perhaps in three stages: flu-like; pneumonia; ARDS. But it doesn’t change the main point.

On the defensive side, we know that risk of death goes up with both age and obesity. As I understand it, obesity is a big risk for the second stage. I do not know whether being young is protective for the first stage, the second stage, or both. Perhaps it does not matter which.

On the offensive side, it seems intuitively reasonable that a more aggressive virus attack, meaning you inhale more of the virus, is more likely to cause worse symptoms at the first stage. It seems intuitively reasonable that having worse symptoms at the first stage is more likely to trigger the second stage.

This reminds me of an Avalon Hill war game, in which you move counters, and when a battle occurs, the winner is determined by the attacker’s attack factor, the defender’s defense factor, and a roll of the dice.

I view Robin Hanson’ variolation idea through the lens of that metaphor. Our current approach is either to have a mass retreat or a mass advance, not bothering to look at attack factors or defense factors. It seems to make more sense to choose our battles where we can be confident of low attack factors and high defense factors.

Cash or health coverage?

[Note: askblog had an existence prior to the virus crisis. I still schedule occasional posts like this one.]
David A. Hyman and Charles Silver write,

Since Medicaid and Medicare were enacted in the mid-1960s, the United States has spent trillions paying for defined benefits on terms dictated by the health care sector. The results have been decidedly unimpressive. Our proposal to convert Medicaid and Medicare into defined-contribution/cash-transfer programs modeled on Social Security recognizes that people generally know how to help themselves better than health care providers do. We should be giving money to Medicaid and Medicare beneficiaries and let them decide how to spend it.

While we are at it, we could take away the tax advantage of employer-provided health insurance, so that workers receive larger paychecks instead.

The challenges with doing this sort of thing, which the authors recognize, include:

1. Some people have very expensive medical conditions, so that they benefit more from health coverage than from an average cash benefit.

2. There is a major public choice problem, in that health care providers benefit from the current system.

These are the problems that present themselves when one tries to substitute a UBI or existing transfer programs. For the first problem, I recommend turning the problem of special circumstances over to local governments and charities that are closer to the people in need. For the second problem, I do not have a brilliant solution.

The worst is behind us

[UPDATE, April 16. This post was a bad call. Sorry.]

I am posting this at 11 AM eastern time, and I am about to go on a bike ride. By the time I come back, I may regret saying this. But I think that the worst is over on the virus crisis. The trend of the 3DDRR is going to be down, perhaps even faster than my optimistic scenario.

If I am correct, then many questions remain. The big one is whether things would turn bad again if we opened up more sectors of the economy. I wish we had a better way to test that other than experimentally lifting lockdowns.

UPDATE, 2:20 PM. a commenter suggests that New York might be distorting the figures. I took totals for the U.S. and subtracted the numbers from New York. Then I calculated the 3DDRRxNY, that is, the rate for the U.S. excluding New York. It is lower than NY. And also declining. I’ll keep my eye on 3DDRRxNY, but so far I stick with my call.

What explains differences in severity?

One of the unknowns in the virus crisis is what explains differences in severity. Of the people who have been infected, it seems that more than 95 percent experience low severity. Also, we see wide differences in severity across countries. Is Taiwan doing better than Spain because fewer people have been infected in Taiwan, or the infections are less severe in Taiwan, or both?

It seems to me that the possible explanations for variations in severity include:

1. How you are attacked–how much of the virus you get and how far it goes initially into your respiratory system.
2. How well your individual body defends.
3. How you are treated by the health care system.

The conventional wisdom, as I understand it, is that (2) matters, and I believe this conventional wisdom. That is, we think that young people without underlying conditions defend better once infected than do old people or people with underlying conditions. Of course, it would be better to have knowledge of which underlying conditions affect the ability to defend.

The conventional wisdom, as I understand it, is that (3) matters, but I am skeptical about it. The conventional wisdom is that we need to keep the number of hospital beds and ventilators ahead of the spread of the virus, or otherwise people will die unnecessarily. The conventional wisdom seems consistent with the high death rates in Northern Italy, Spain, and New York City. But there could be other explanations. Perhaps the rate of infection was higher in those areas. Perhaps how you are attacked matters, and people in these areas were more likely to be attacked more severely.

Suppose that more ventilators and hospital beds had been available in these dire regions. Would that have produced more cures, or merely kept some people alive a few more weeks? I am getting the impression that a shortage of ventilators means that victims who are beyond hope might have to be denied a ventilator, but it is less clear that people who could survive if given a ventilator must be denied one. I am by no means committed to this point of view. It is just a guess. Any evidence to the contrary would be sufficient to get me to change my mind.

The conventional wisdom is relatively silent about (1). But I wish we knew more. For example, suppose that strong attacks only come from symptomatic spreaders, while getting the virus from an asymptomatic spreader means that you face a weak attack. That would imply that fears of asymptomatic spreaders are exaggerated, which would have some significant policy implications. It would imply that a focus on identifying and isolating the symptomatic individuals is the key to preventing deaths. It might mean that universal masks and scarves, while not preventing all infections, might do well at preventing severe infections, particularly if symptomatic individuals are identified and isolated.

How we lose the culture war

[Note: askblog had an existence prior to the virus crisis. I still schedule occasional posts like this one.]
Titus Techera writes,

Monopoly over the sources of shame makes our elites superior to the rest of us, and Caldwell analyzes it in terms of the courts, administrative agencies, and business. This monopoly is why they can do anything and get away with it. No one will ask the Clintons or anyone around them or like them about their relationship to Harvey Weinstein or Jeffrey Epstein; it’s perfectly okay—because they are elite liberals who demonstrate their virtue by regularly calling the rest of us racist. In doing so, they remind us that it’s their privilege to slap us, the necessary punishment for our lack of enlightenment.

…The Republican Party is not without its victories—remember 2016, when the people gave them victory in all elections throughout the land? But Republicans almost never follow through by using their electoral victories to practice politics. They refuse to cripple the power of Progressives to ruin decent citizens’ private lives. Every year, conservatives become more scared about even voicing their opinions on college campuses or at work or on social media, living in fear of Progressives and ashamed of themselves for being so afraid—and you may imagine how they feel about the elites who don’t even seem to want to protect them. We will get Progressives to stop when more citizens act to stop them with support from their own institutions and their own elites. We will get citizens to act when we make them angry at the humiliations Progressives inflict on them, and we will generate that anger only if we force our own elites to act on our behalf

The essay reacts to Christopher Caldwell’s controversial new book, The Age of Entitlement.

The working backwards algorithm, explained a bit.

As Nate Silver says, case counts are meaningless. He goes into the weeds of how testing protocols affect reported cases. I say don’t bother.

I want to try to infer the number of people who have been infected from the number of deaths. I assume that death reports in the U.S. are a more reliable indicator of what is going on here. Call the number of deaths D. The problem is that we don’t know three things:

–the number of deaths per 1000 people that have been infected. r. So if the death rate (relative to the true number of people that have been infected, which is not at all the same as the number of reported cases) is 2 percent, then r = 20.
–the typical number of days between infection and death. Call this n.
–the growth rate of the number of infections from n days ago until now. Call this g(n). Because the 3DDRR stayed at 2 for a long time, I was estimating g(n) as 2^(n/3).

The algorithm to estimate the number of people who have been infected today is D*g(n)*1000/r. If the number of days between infection and death is 9, then n = 9. If g(n) = 2^(n/3), then g(n) = 8. So if r = 20, then the estimate of the number of people who have been infected today is 400 times the number of deaths as of today. For New York state, that would mean about 1.64 million people infected. If instead we assume that n=15 and r = 2 (o.2 percent of infected people die), that says that 64 million New Yorkers have been infected–clearly an over-estimate. Either r is greater than 2 or g(n) is less than 32, or both. g(n) could be less than 32 even though n is 15, provided that the the growth rate of infections per day started to drop in recent days, which would mean that the 3DDRR is going to drop soon. In fact, I’m inclined to expect a pretty dramatic drop in 3DDRR for New York in the coming days.