3DDRR and general update, April 20

1. A University of Texas Modeling Consortium says that there is an 89 percent chance that we passed the peak in daily deaths. That seems right to me.

Also, that model predicts a sharper decline in New Jersey than in California, which is consistent with the heavy in, heavy out model.

Pointer embedded in a post from Tyler Cowen.

2. The 3DDRR was at 1.15 and excluding New York it was 1.18 The tendency has been for Tuesday to be a peak day for reporting deaths (the Texas people are betting that last Tuesday was the peak), so I am curious to see what tomorrow brings.

General update, April 17

1. Commenter John Alcorn watched the entire Swedish health minister video. John points out that the Swedish experiment definitely differs from ours in that they kept schools open. Some more of John’s take-aways.

School closures would de facto pull 20% of medical personnel away from hospitals because parents (including medical personnel) would have to stay home with children.

Sweden is halfway thru major wave of pandemic. Now seeing slowdown of contagion in Stockholm. One third of populace “has been involved” (exposed?). Summer probably will diminish contagion. But this virus, unlike SARS and MERS, won’t go away. Key will be to achieve original goal of shield or isolating the vulnerable (esp. those in elder care) much more effectively.

Skeptical of face masks (except in hospitals and nursing homes) because they tempt people who are symptomatic to go out with a mask instead of properly staying at home.

conditional on infection, death risk isn’t much greater than the flu if the individual receives timely care.

So they are approaching it as just a rapid-spreading flu that you want to keep out of nursing homes. Maybe Swedes are healthier then we are. Physically–less obese? Or mentally–less easily frightened?

And what does the health minister make of the disparity in incidence between their immigrant population and natives?

2. While trying to understand how New York’s delayed reporting of 4000 deaths is affecting things, I came across the NY health department page. I had to go to my browser settings and shrink the type to be able to see it all, but it has some interesting information. The co-morbidities that matter the most seem to me to be generally associated with obesity. I wonder if this puts me in a low-risk category, in spite of my age. It depends a lot on the Unknown Denominator, which is how many people are infected. The higher that number, and the lower the number of deaths of people my age with my BMI, the better off I am.

Poking around the site further, I found data on deaths among nursing home residents in NY state. Does anybody know how to prevent outbreaks in nursing homes? What do the Asian countries do about it?

3. German virologist Hendrick Streeck claims to have debunked the doorknob effect.

“There is no significant risk of catching the disease when you go shopping. Severe outbreaks of the infection were always a result of people being closer together over a longer period of time, for example the après- ski parties in Ischgl, Austria.” He could also not find any evidence of ‘living’ viruses on surfaces. “When we took samples from door handles, phones or toilets it has not been possible to cultivate the virus in the laboratory on the basis of these swabs….”

“To actually ‘get’ the virus it would be necessary that someone coughs into their hand, immediately touches a door knob and then straight after that another person grasps the handle and goes on to touches their face.” Streeck therefore believes that there is little chance of transmission through contact with so-called contaminated surfaces.

He bases his view on the result of a “case cluster study.” I gather that the idea is to try to determine how the people with the virus in a particular region contracted the virus. If there are no doorknob cases in a sample of one thousand people, then you are inclined to downplay doorknob effects.

4. What will be the long-term economic effects of the virus crisis? I am going to try to put my thoughts together this weekend. Meanwhile, Joel Kotkin writes,

Growing corporate concentration in the technology sector, both in the United States and Europe, will enhance the power of these companies to dominate commerce and information flows. As we stare at our screens, we are evermore subject to manipulation by a handful of “platforms” that increasingly control the means of communication. Zoom, whose daily traffic has boomed 535% over the past month, has been caught sharing data from its users with its clients widely, and without approval. Not surprisingly these platforms are most widely deployed in tech centers like the Bay Area, Seattle, and Salt Lake City as opposed to areas like Las Vegas , Tucson, or Miami where more jobs require close physical proximity.

The modern-day clerisy consisting of academics, media, scientists, nonprofit activists, and other members of the country’s credentialed bureaucracy also stand to benefit from the pandemic.

Off hand, I don’t agree with the second paragraph. I think that there is now an “essential/non-essential” divide, and a lot of the clerisy fall on the wrong side of it. But I am still pondering.

5. The story about the findings of lots of asymptomatic carriers at a Boston homeless shelter is being framed as scary news about the way the virus gets transmitted. Personally, I would have headlined the story “Homeless people show the way in developing herd immunity.”

6. Eran Bendavid and many co-authors write

These prevalence estimates represent a range between 48,000 and 81,000 people infected in Santa Clara County by early April, 50-85-fold more than the number of confirmed cases.

Wow. Pointer from Tyler Cowen.

If you believe that this is true, and that it holds for the country as a whole, the implications are staggering. As of today in the United States, we are at about 700,000 confirmed cases. Multiply that by a number between 50 and 85. That would make the infection fatality rate 1 in a thousand, as opposed to the expert estimate of between 10 and 20 in a thousand. It also would say that voluntary social distancing and government-imposed lockdowns came too late to stop the spread of the virus, for better or worse (probably for worse–if the death rate is so low, we should have just let it keep spreading). It would make it seem probable that the virus was in the U.S. much sooner than we now believe.

That is too much revisionism for me to adopt, based on just the one study. But I am encouraged by an apparent trend toward more studies and more pushback against relying on computer simulations.

[UPDATE: Balaji S. Srinivasan pours some cold water on the study.]

General update, April 16

1. On the issue of enclosure vs. outdoors, a reader alerted me to an article from 2009, by Richard A. Hobday and Jown W. Cason about the Spanish Flu outbreak, which seems to support my idea of treating patients in the parking lot. Here is the abstract, with my emphasis provided.

The H1N1 “Spanish flu” outbreak of 1918–1919 was the most devastating pandemic on record, killing between 50 million and 100 million people. Should the next influenza pandemic prove equally virulent, there could be more than 300 million deaths globally. The conventional view is that little could have been done to prevent the H1N1 virus from spreading or to treat those infected; however, there is evidence to the contrary. Records from an “open-air” hospital in Boston, Massachusetts, suggest that some patients and staff were spared the worst of the outbreak. A combination of fresh air, sunlight, scrupulous standards of hygiene, and reusable face masks appears to have substantially reduced deaths among some patients and infections among medical staff. We argue that temporary hospitals should be a priority in emergency planning. Equally, other measures adopted during the 1918 pandemic merit more attention than they currently receive.

2. D.F. Linton made some charts that smooth the 3DDRR.

3. Sweden, which is relying primarily on private decisions for social distancing, as of this morning was at 132 deaths per million, more than all but 7 other European countries. I was forwarded information that points to immigrant populations in Sweden having a disproportionately large share of infections relative to their share of Sweden’s population.

4. Health economist Jeffrey E. Harris writes,

New York City’s multitentacled subway system was a major disseminator – if not the principal transmission vehicle – of coronavirus infection during the initial takeoff of the massive epidemic that became evident throughout the city during March 2020. The near shutoff of subway ridership in Manhattan – down by over 90 percent at the end of March – correlates strongly with the substantial increase in the doubling time of new cases in this borough. Maps of subway station turnstile entries, superimposed upon zip code-level maps of reported coronavirus incidence, are strongly consistent with subway-facilitated disease propagation. Local train lines appear to have a higher propensity to transmit infection than express lines.

From my timeline: March 4. New York Health Commissioner Oxiris Barbot: There’s no indication that being in a car, being in the subways with someone who’s potentially sick is a risk factor.

5. Speaking of New York, today is the day that about 4000 deaths showed up that had not been previously reported. As of yesterday, New York was showing only 11,586 and the number of “new death” reported to day was 606. But today the total for the state is 16,251

6. Olivier Blanchard and Jean Pisani-Ferry write,

The extraordinary operations that are under way in most countries in response to the COVID-19 shock have raised fears that large-scale monetisation will result in a major inflation episode. This column argues that so far, there is no evidence that central banks have given up, or are preparing to give up, on their price stability mandate. While there are obviously some reasons to worry, central banks are doing the right thing and the authors see no reason to panic.

Take anything Blanchard says, put a minus sign in front of it, and you have my view.

7. Pat Bayer looks at death rates in Italy and sees flat declines post-peak. Pointer from Tyler Cowen. I think I am seeing the same thing in the ex-NY data in the U.S., and I am not happy about it.

8. I listened to a bit of the Sweden update that Tyler linked to, around minutes 12 through 16. It seems that there was a lot of voluntary social distancing, including an enormous reduction in the use of mass transit. Also, many of the deaths were in nursing homes. So perhaps we are not learning as much from the “Sweden experiment” as one might hope.

General update, April 15

1. Robin Hanson writes,

to the extent pandemic policy is driven by biomed academics, don’t expect it to be very flexible or abstractly reasoned. And my personal observation is that, of the people I’ve seen who have had insightful things to say recently about this pandemic, most are relatively flexible and abstract polymaths and generalists, not lost-in-the-weeds biomed experts.

Read the whole post. He offers many interesting hypotheses, including an explanation for why you have to fire many of the generals who rose through the ranks during peacetime.

2. John Cochrane writes,

From the March 4 and April 8 Fed H.1 data, we learn that the Fed held $2,502 billion and $3,634 billion Treasury securities on those dates, an increase of $1,132 billion. From the Treasury debt to the minute page, we learn that debt held by the public (including the Fed) rose from $17,469 billionaires to $18,231 billion — a (huge) rise of $762 billion. $9 trillion at an annual rate. The Fed bought all the Treasury debt, printing new money to do it, and then some. On net, the government financed the entire $762 billion by printing new money and printed up another $370 billion to buy back that much existing treasury debt.

Later, he writes,

Inflation comes basically if the US hits a debt crisis.

I would say that we only get hyper-inflation if there is a debt crisis. But I believe that we can get at least a 1970s-style inflation without a debt crisis. We are keeping people home and getting them laid off, which means that they are not producing anything of value. Yet we are giving them funds as if they were still producing, which they will then spend on stuff that other people produced. Regardless of what games the Fed plays with interest on reserves, we have more money chasing fewer goods, and that means inflation.

As it stands now, inflation is being repressed by a form of price controls, in the form of laws and social norms against “price gouging.” If it weren’t for those laws and norms, prices would be soaring for the things that people want to hoard (masks, toilet paper), many grocery products, and stuff that we used to get easily from China.

3. Eric Boehm writes,

In the midst of the COVID-19 pandemic that has already prompted Congress to hike spending by $2.2 trillion (with more likely on the way), and with revenue collections likely to drop in a big way as a result of the coronavirus-induced economic shutdown, the federal government is facing the prospect of a budget deficit of nearly $4 trillion this year.

4. Concerning age and obesity as risk predictors, Christopher M. Petrilli and others write,

In the decision tree for [hospital] admission, the most important features were age >65 and obesity. . .Age and comorbidities are powerful predictors of hospitalization; however, admission oxygen impairment and markers of inflammation are most strongly associated with critical illness.

The most recent NYC data show only 133 deaths out of 6589 were among people who were deemed as having no underlying conditions. The footnote in the table lists only medical conditions such as cancer or heart disease, but it does not include obesity. Also, the table includes 1422 deceased individuals who are not classified as either having or not having underlying conditions but instead are deemed “underlying conditions unknown.”

Thanks to commenters for pointers.

5. The WSJ reports,

CVS—where Mr. Lackey heads up talent acquisition—is now taking on the most ambitious hiring drive in its history. To recruit the 50,000 staffers it needs to meet a coronavirus-fueled surge in business, it is partnering with Gap Inc., Hilton Worldwide Holdings Inc. . .Delta Air Lines Inc. . . . and dozens of other companies to employ their laid-off workers. More than 900,000 people have applied for CVS jobs in just the last few weeks, including roles stocking warehouses and stores, answering phones at call centers or stepping in for CVS staff who end up sick or quarantined.

As the government and many pundits try to figure out how to make the economy revert to what it used to be, the market tries to find patterns of sustainable specialization and trade.

6. Meanwhile, Olivier Coibion, Yuriy Gorodnichenko, and Michael Weber write,

the employment-to-population ratio has declined sharply. Using the adjusted metrics described above, we find that the employment ratio fell from 60% of the population down to 52.2%, a nearly eight percentage point decline. . . this decline in employment is enormous by historical standards and is larger than the entire decline in the employment-to-population ratio experienced during the Great Recession. Given that the US civilian non-institutional population is approximately 260 million, this drop in the employment-to-population ratio is equivalent to 20 million people losing their jobs. This drop is even larger than the 16.5 million new unemployment claims over this time period.

7. Tyler Cowen writes,

Any model of optimal policy should be “what should we do now, knowing the lockdown can’t last very long?” rather than “what is the optimal length of lockdown?”

But we are still flying blind. I am hopeful that asymptomatic spreaders are unlikely to kill people, other than those who are very old or very obese, but this is just a conjecture. As far as I know, we still don’t know the prevalence of the doorknob effect, or the importance of viral load. We have no idea whether there are 1 million people in this country with immunity, or 20 million. We don’t know about the effectiveness of masks and scarves.

We need to replace the peacetime public health leadership, which only knows how to scold and cower, with some actual scientists determined to answer these urgent questions.

8. Maybe we do know something about the effect of enclosed spaces. Hua Qian and others write,

Home outbreaks were the dominant category (254 of 318 outbreaks; 79.9%), followed by transport (108; 34.0%; note that many outbreaks involved more than one venue category). Most home outbreaks involved three to five cases. We identified only a single outbreak in an outdoor environment, which involved two cases. Conclusions: All identified outbreaks of three or more cases occurred in an indoor environment

Pointer from Tyler Cowen. Also from Tyler and possibly related: Travis P. Bagett and others write,

testing of an adult homeless shelter population in Boston shortly after the identification of a COVID-19 case cluster yielded an alarming 36% positivity rate. The vast majority of newly identified cases had no symptoms and no fever on a single point-in-time assessment

9. From the Hollywood Reporter,

California Gov. Gavin Newsom on Tuesday announced a broad six-point plan to reopen the state’s economy and relax strict Safer at Home guidelines.

The six points sound more like conditions that must be achieved before relaxing restrictions. For example,

the ability to monitor and protect communities through testing, tracking positive cases, properly isolate and support individuals who are positive and/or exposed to COVID-19.

A few weeks ago, the focus was on avoiding hospitals becoming overwhelmed. But that is only one of the Newsom’s conditions. Somewhere along the way, we went beyond the goal of reducing infection risk as a means to preserve scarce medical resources. The goal now seems to be reducing infection risk as an end in itself. Once we accept that as a vital government objective, the default becomes indefinite infringement on liberty.

Explaining the worst outbreaks

As you know, I am not a fan of models, such as the one that Tyler Cowen points to. I prefer an Ed Leamer “patterns and stories” approach.

One pattern, which Tyler agrees is significant, is that the virus is producing fatalities very unevenly across regions. For example, New York has 552 deaths per million, and Texas has 11. If you believe models, then you probably believe that Texas will catch up at some point. But I can imagine a story in which that does not happen.

Here are what I think are the causal factors for the differences.

1. Living conditions of the elderly. Consider Spain, which appears to have the highest per capita death rate of any major country (although Belgium might catch up). Wikipedia says,

Many nursing homes in Spain are understaffed because they are for-profit businesses and elderly Spaniards cannot necessarily afford sufficient care. In some nursing homes, elderly victims were found abandoned in their beds by Spanish soldiers mounting emergency response. Defense minister Margarita Robles said that anyone guilty of neglect will be prosecuted. By 23 March, a fifth of nursing homes in the Madrid area had reported cases of the virus. More than 65% of fatalities have occurred in those 80 or older, compared to 50% in Italy and only 15% in China. By 3 April, at least 3,500 Spaniards had died in nursing homes and another 6,500 contracted infections there. Thousands of elder care workers are also infected.

2. Concentrated poverty. Actually, it is not dire poverty. It is working conditions and living conditions that make it hard to socially distance.

Low income neighbourhoods in Barcelona have seven times the rate of infection of more affluent neighbourhoods. Part of the reason is that essential workers, who have kept going to work despite the epidemic, are likely to work in low-skill jobs such as supermarkets or elder care. Also, many care workers are immigrants, who lack access to unemployment benefits and live in some of the lowest category housing. Homeless people are also at risk and the charities that help them were forced to cease operations because of the disease.

3. Enclosed spaces where one might come into contact with someone with a high viral load.

I think that enclosure matters. I think some scientific papers suggest this, although I don’t have any links right now.

Actually, someone just sent me a link to Wendell Cox on exposure density which says

Exposure density, and thus infection, is likely to be less, all else equal, if common halls, elevators, crowded places and transportation facilities are avoided.

Cox says that exposure density is the likely explanation for why deaths have been much higher in New York City than elsewhere.

I am trying to come up with an explanation for why the virus has not killed thousands of homeless people in LA and SF. I think that the most plausible reason is that they live outdoors, and so do not inhale the large viral loads that you can inhale in a confined space. That is just a guess.

Note that if enclosure matters, then maybe health care workers would be safer treating patients in the parking lot than inside the hospital building.

So here are some hypotheses.

a) We will find that New York has some nursing homes that are run appallingly badly, and these will account for a significant share of the deaths there. Going forward, spikes in deaths in other locations will be tied to nursing homes that fail to maintain proper hygiene and to keep sick workers away.

b) The elderly and the very obese are vulnerable to fatal infection even from asymptomatic or mildly symptomatic spreaders. But the rest of us will have low infection fatality rates unless exposed to a highly symptomatic individual in a confined space.

c) Someone who is very symptomatic and gets into a crowded space, such as a bar or subway, can kill many people.

If these hypotheses are correct, then I believe that we can avoid a repeat of the New York fiasco with carefully targeted public health interventions and not require general lockdowns.

Keep in mind that I am not an expert and I have an aversion to lockdowns, so there are some obvious biases at work.

General update, April 12

1. Tyler Cowen offers some unsolicited advice from an economist to epidemiologists. More here.

I applaud epidemiologists for thinking exponentially rather than linearly. I boo them for going with computer models without seeming to appreciate how flawed data and parametric simplification make them unreliable.

I would add that the political process selects economists as advisers based on criteria that are uncorrelated, or perhaps negatively correlated, with wisdom. I could imagine the same thing happening when epidemiology mixes with politics.

2. Reader Aaron Lindsey has posted a 3DDRR spreadsheet that makes it easy to see how that indicator has behaved.

Do you want to understand how difficult it is to make epidemiological forecasts? Squint at the chart from April 1st on. Imagine a trend line from April 1 to April 6 extended to the present. The difference between that trend line and the actual behavior may seem small. But because of that difference, we may have twice as many deaths from the virus compared with what would have happened had the trend from April 1 through April 6 continued.

3. Another reader, John Alcorn, found this article.

We identified 103 possible work-related cases (14.9%) among a total of 690 local transmissions. The five occupation groups with the most cases were healthcare workers (HCWs) (22%), drivers and transport workers (18%), services and sales workers (18%), cleaning and domestic workers (9%) and public safety workers (7%). Possible work-related transmission played a substantial role in early outbreak (47.7% of early cases). Occupations at risk varied from early outbreak (predominantly services and sales workers, drivers, construction laborers, and religious professionals) to late outbreak (predominantly HCWs, drivers, cleaning and domestic workers, police officers, and religious professionals).

Their investigation looked at Asian countries other than China.

4. As economists start to think about how all this new government spending is going to be financed, you might want to re-read this post from 2010.

As of 1946, the ratio of debt to GDP was 108.67 percent. From 1947 to 1970, it fell to 27.96 percent. A substantial amount of the drop was due to the fact that the government ran a primary surplus in all but four of those years (the exceptions were 1953, 1959, 1962, and 1968), for a cumulative primary surplus of 43 percent of the 1946 debt.

I was surprised by this. I had not remembered these surpluses. One reason is that the primary surplus excludes interest payments. Including interest payments, the government mostly ran deficits, particularly in the 1960’s. Another reason may be that the U.S. only began to include Social Security surpluses in the overall Budget late in President Johnson’ second term. Had we used the “unified” budget from the beginning, the deficits would have seemed much smaller and we would have counted more surpluses.

Thanks in part to Social Security, which was running surpluses that were not included in the budgets as reported at the time, we were very fiscally responsible in the 1950s and 1960s, so we paid most of the World War II debt.

In contrast, today mainstream thinking is that “interest rates are low, so why bother worrying about the debt?” Olivier Blanchard, one of the leaders of the economics profession, takes this stance. I have never had much regard for him. Over the next decade, we’ll see who turns out to be right.

5. Tyler asks why Belgium is doing so poorly. I immediately looked for a sociological variable. It turns out that Antwerp and Brussels are two of the European cities with very high Muslim populations. The Netherlands, which has several cities that have large Muslim populations, also has a per capita death rate on the high side.

I am using Muslim population as a crude proxy for ghetto-ized living conditions, equivalent to Hispanics in New York City. I am not trying cast any ethnic aspersions on Muslims or Hispanics. What I picture is a lot of people who do not have the privilege of a social-distancing option. They cannot work in home offices or avoid living in crowded conditions. As the Wikipedia list says, “In Western Europe, Muslims generally live in major urban areas, often concentrated in poor neighborhoods of large cities.”

But Germany, which also has major cities with large Muslim populations, is doing relatively well. Berlin also has a high reliance on mass transit, which deepens the mystery of how Germany is containing the virus. This story credits early implementation of test, track and trace.

6. Some of you have expressed an interest in betting on the fate of colleges and universities. You will want to read this.

“Financially, many colleges have been struggling, facing a perfect storm which is going to be even more difficult now,” Robert Franek, editor-in-chief of the Princeton Review, told Campus Reform. “Their costs are up, but their tuition dollars are down as enrollments trend[s] down. The value of their endowments is also down, and with the economy in [a] downturn, alumni and corporate donations are likely to be less.”

The coronavirus relief bill signed by President Donald Trump on March 27 includes $14.3 billion for higher education, with $12.4 billion split between emergency grants to students and money to colleges “to address needs directly related to coronavirus” and to “defray expenses” from lost revenue, reimbursement, technology for distance learning, and payroll.

Tyler’s dire prediction for colleges is based on what he foresees as their inability to sustain the foreign enrollments that have been a crucial source of revenue. But note the huge bailout voted by Congress, even though it requires Republicans voting to give money to Democratic bastions. The higher education lobby has quietly become one of the most powerful and effective political operations in the United States.

Tyler Cowen at Princeton, annotated

Tyler Cowen talks about medium and long-term consequences of the virus crisis. I give it an A+.

For a couple of days I worked on a post on the economic outlook, which I scheduled to go up tomorrow. I think you will see a lot of similarity in our views. We differ in terms of tone. Tyler sounds detached and fatalistic. I sound cranky. Below are some more detailed comments of mine, sometimes amplifying his remarks and sometimes disputing them. Continue reading

General update, April 10

1. Ronald Bailey reports,

Over the last two weeks, German virologists tested nearly 80 percent of the population of Gangelt for antibodies that indicate whether they’d been infected by the coronavirus. Around 15 percent had been infected, allowing them to calculate a COVID-19 infection fatality rate of about 0.37 percent. The researchers also concluded that people who recover from the infection are immune to reinfection, at least for a while.

I cannot read German, and I am a little worried about how they calculated this. Suppose we find that as of today 10000 people have had the virus and 37 have died. I don’t think it would be correct to infer that the infection fatality rate is 3.7 percent. It could be that there are 50 people currently in the hospital, and if 40 of them subsequently die, then that would mean we should double our estimate of the infection fatality rate.

If we trust the 0.37 percent number (round it to 4 in 1000), we can work backwards from deaths to the number of people who have had the virus. So here is some speculative arithmetic. If 4 Germans have died for every 1000 who have had the virus, and the reported number of deaths is 2600, then the number of Germans who have the virus is 2600 * 1000/4 = 650,000.

We can play the same game for the U.S. Take 17,000 * 1000/4 and that gives 4.25 million people in the U.S. have had the virus.

2. Tim Skellet has some tweets about the German study. I noted this:

Overall in Germany: “So far, no transmission of the virus in supermarkets, restaurants or hairdressers has been proven”. #SARSCov2 was detected by PCR on “remote controls, washbasins, mobile phones, toilets or door handles” BUT NOT in infectious form.

. . .The entire #COVID19 outbreak in #Heinsberg district is traced back to a couple who attended a local Karneval festival. It all kicked off from there.

Pointer from Tyler Cowen.

3. I also liked another link from Tyler, the Dan Wang piece on life in Beijing during the lockdown there.

Where we stand as a society

[UPDATE: please also read My case against lockdowns, which spells out why I don’t think lockdowns are saving lives.]

Tyler Cowen writes,

R0 won’t stay [below] 1 for long, even if it gets there at all. We will then have to shut down again within two months, but will then reopen again a bit after that. At each step along the way, we will self-deceive rather than confront the level of pain involved with our choices.

There is some more at the link. Tyler is careful not to say how he feels about this scenario, but one is left with the impression that he believes that it is about the best one can hope for. I am going to protest more strongly.

My own thinking is focused on our economic and political system. I would prefer a much milder government response to the virus. In fact, the only response might be to require people to wear masks in crowded public areas, such as the sidewalks of Manhattan or riding mass transit.

I expect that on their own, without any legal coercion, many stores would require mask use as a condition of entry. “No shirt, no service” would become “No mask, no service.”

I expect that on their own, without any legal coercion, many businesses and individuals would increase teleworking and reduce travel. Large conferences and sporting events will hold little appeal.

Many schools and day care centers would take measures to keep sick children (or sick adults) from coming into their facilities. Parents who do not want to take time off to care for sick children would have to find commercial services that will do so.

Compared with the outcomes of these individual choices, the marginal effect of government-mandated closures and lockdowns on the rate of virus spread is small. It may not even be in the right direction.

Note that it is not certain that slowing the spread rate of the virus has benefits. Because medical treatment seems to make little difference in many cases, the solution to the problem of “overwhelming the hospital system” might be better triage.

Of course, triage is not the American way. Our cultural norms are that keeping someone alive an extra few weeks on a ventilator is better than giving up. There is something admirable about such norms, but perhaps in a crisis they ought to give way in order to conserve resources, especially the health of hospital workers.

The main benefit of delaying the spread of the virus is the likelihood that there will be more effective treatments down the road. But individuals who would like to try to avoid getting the virus until better treatments become available can make their own decisions to act especially cautiously. They do not need the state to impose their preferences on everyone else.

Whether the government response is mild or severe, there will be considerable economic dislocation. Much of the economic dislocation comes from the actions of private individuals and businesses. The idea that the government has the power to “reopen the economy” is as wrong-headed as believing that it is government’s responsibility to close businesses and shut people up indoors.

But I don’t think of the government as a rich uncle with an attic full of toys to give away. Instead, I think of government as an institution for forcibly collecting charity that can be used to help some of the people who suffer the most in this crisis.

I favor giving people and businesses access to credit lines, backed by taxpayer funds. Many individuals and businesses will not need credit to get through the next few months. At the other extreme, many will say that they can never recover financially, and they have to declare bankruptcy. In between will be individuals and businesses able to use credit lines to ride out the crisis and get back on their feet.

I also could support a relief program that gives money to those individuals who are particularly hard hit by the crisis, with the relief checks paid for by reducing government spending elsewhere and/or raising taxes for the next few years. I do not favor deficit spending, which strikes me as catering to the “rich uncle” illusion.

To me, it seems highly probable that in the last few weeks we have discarded American capitalism and individual rights for something that more closely resembles the Chinese model. Unlike China, we will have competitive elections, but both parties will now be more statist than Bernie Sanders.

The rights of the state now take precedence over the rights of individuals. The economy will now be a form of state-capitalism, in which government will direct funding and firms will expect protection from competition and innovation. Where it used to be the responsibility of government to enforce contracts, such as those between renters and landlords, it is now the responsibility of government to tear up these contracts.

Federal government spending as a share of GDP will permanently rise above the 18-20 percent norm of recent decades, to somewhere between 30 and 50 percent (getting to the latter would require crowding out some spending by state and local governments). I predict that inflation will soon be manifest, and price controls will be instituted, at least on some “necessities.”

When someone like me objects to all of this, I am afraid that the response from people under age 45 will be, “OK, Boomer!” Even before this crisis, there was little appreciation among well-educated young people for the liberal institutions of free markets, equality under the law, and civil liberties.

General update

1. John Cochrane writes,

Ask yourself, if you are lucky enough as I am to work from home and still have a paycheck, just when and under what conditions are you ready to go back to the office, to have people breathing the air in the seat next to you in the seminar room, to go touch the salad bar tongs, to go give a talk, shake a lot of hands and meet a lot of people, to get on a plane, to stand in a line? The virus may be contained, with aggressive testing and public health playing whack-a-mole, but authorities relenting and allowing business to open, in a highly regulated way. But will you just go back to normal? Likely not.

That assumes that the Expert Yet Idiots will continue to flail in the dark. Suppose that we ran experiments that let us know how spreading actually works. If doorknobs cause the virus to spread, what would we have to spray on doorknobs to make them safe? If breathing is the main source of spread, what sort of masks are needed?

Should people who have the antibodies for the disease be given “immunity badges” that allow them special privileges? I would not go to a dance session now, but if I can see someone’s immunity badge before I ask her to be my partner. . .

2. Mencius Moldbug, using a pseudonym, writes,

The strongest possible response will come from a new agency, built as a startup. This Coronavirus Authority will scale up faster than any existing organization can execute. It will use the old agencies only where it finds them useful. And it will dissolve itself once the virus is beaten.

Sounds like a typical Internet Engineering Task Force. Pointer from Tyler Cowen, who says he thinks some of the essay is off base.

I wish that this sentence were sourced:

On March 9, dear old Dr. Fauci said: “If you are a healthy young person, if you want to go on a cruise ship, go on a cruise ship.”

Can anyone find a link for this quote?

[UPDATE: Several commenters came through with links. Here is the transcript of the March 9 briefing.

Q Would you recommend that anybody, even a healthy person, get onboard a cruise ship?

DR. FAUCI: Yeah. Yeah. Yeah. I think if you’re a healthy, young person, that there is no reason, if you want to go on a cruise ship, to go on a cruise ship. Personally, I would never go on a cruise ship because I don’t like cruises — (laughter) — but that’s another story.

But the fact — the fact is that if you have — if you have the conditions that I’ve been speaking about over and over again to this group, namely an individual who has an underlying condition, particularly an elderly person that has an underlying condition, I would recommend strongly that they do not go on a cruise ship.

As Tyler would say, that was then, this is now.]

Moldbug’s idea amounts to putting a Silicon Valley CEO in charge of the hypothetical CVA. The authority of this person would supersede that of the President.

It turns out that everyone’s reaction to this crisis is to say that it proves the correctness of their political ideology. Economists did pretty much the same thing with the 2008 Financial Crisis. Moldbug has always disdained democracy in preference for a more corporation-like form of government. I find it easy to nod my head in agreement as he describes the current failure. But any untried alternative form of government looks better only because we have not had a chance to observe its unintended consequences.

The economic section of the essay struck me as sketchy and unconvincing. But I am not going to spend time writing a point-by-point critique.

3. A reader forwards an article from the South China Morning Post.

On Friday, both the US and Singapore switched to advising citizens to wear masks when they leave their homes. The WHO also made a U-turn itself, with Ryan saying: “We can certainly see circumstances on which the use of masks, both home-made and cloth masks, at the community level may help with an overall comprehensive response to this disease.”

Leading from behind. Another quote:

“Universal masking, as a package of anti-epidemic measures, including greater social distancing and hand hygiene, has been instrumental in keeping Covid-19 in check,” said infectious diseases expert Professor David Hui Shu-cheong of the Chinese University of Hong Kong.

4. Another reader forwarded this from the Israel Ministry of Health.

Masks covering the mouth and nose greatly reduce the chance of getting infected and infecting others. These masks prevent the emission of droplets that carry the disease from reaching the nose and mouth. The masks protect those who wear it, as well as others around them, therefore, when a carrier of the virus meets a non-carrier, if both are wearing a mask, the protection against infection is doubled.

Therefore, we are instructing everyone to wear a mask at all times in public to prevent exposing acquaintances, bystanders, and coworkers.