My brother-in-law is suffering in pain 24-7 from an injury that could be treated with surgery, but that is now forbidden. I think it is pretty likely that other people are suffering and even dying because they are denied medical care. This is because health care is being rationed, reserved for Covid patients who
a) are not showing up in hospitals in the expected numbers; and
b) might not be treatable if they did show up
I am surprised there is not more outrage about this.
1.090 overall, 1.11 outside of New York state.
I am seeing a lot more stories featuring overall excess deaths, because of doubts about virus death counts. But I will stick with the 3DDRR indicator.
I saw a headline that said that the models think we are headed for an increase in deaths. I don’t see that. I see a downward trend. Not as steeply sloped as I would like, but still downward.
In order to forecast fatalities going forward, what you really need is an indicator that predicts infection rates in nursing homes. If you could promise me that nursing homes will do a better job of keeping out the virus going forward, then I would promise that the deaths per week from the virus will fall rather than rise.
Despite its smaller population, Iowa has half-again more COVID-19 cases than Minnesota. I’ve little doubt that this is due to Iowa still having no stay-at-home orders from the governor as well as the fact that Iowa hosts the country’s densest cluster of meatpacking facilities.
But despite Iowa’s much larger overall caseload, the state has also suffered fewer than half the deaths from COVID as Minnesota. Over ¾ of Iowa’s positive cases are in people aged 65 and younger, an age group that is highly likely to survive the virus. Minnesota’s cases are skewed into older age groups, making death more likely.
2. Tyler Cowen notes that people are turning toward comfort music and comfort food. I would add “comfort news” to the list. For the right, it’s news that supports the view that the virus is no worse than the flu. Right-wing sites are still all over the Santa Clara study as proof of that. For the left, comfort news includes analysis that blames the virus crisis on President Trump. The left also seems to want stories that show that remote learning and/or charter schools are really awful. There is a recent NYT story filled with such anecdotes. Meanwhile, I know a private school teacher who says that she is trying to make the best of it, noting that in this environment she has the ability to mute a student at the touch of a button.
3. WBUR reports,
After Brigham and Women’s Hospital in Boston began requiring that nearly everyone in the hospital wear masks, new coronavirus infections diagnosed in its staffers dropped by half — or more.
Brigham and Women’s epidemiologist Dr. Michael Klompas said the hospital mandated masks for all health care staffers on March 25, and extended the requirement to patients as well on April 6.
Pointer from Scott Sumner, who has other interesting items in his post.
4. Scott also points to a Vox story pooh-poohing the notion that the virus came from a Chinese lab. The story does not address the argument made by Weinstein/Heying that bats and pangolins do not ordinarily hang out together (I cannot explain why this makes the virus unnatural, but that is what they say).
5. Michael T. Olsterholm and Mark Olshaker write,
The F.D.A. must bring order to this chaos and determine which tests work well. It should stick to its normal review process but expedite it by giving it top priority with its clinical reviewers and bringing in more reviewers as necessary.
But they also write,
as long as testing for SARS-CoV-2 is too limited or unreliable, the United States must ramp up what public health professionals call “syndromic surveillance”: the practice by medical personnel of observing, recording and reporting telltale patterns of symptoms in patients
I also feel better about low-tech methods than I do about the technocrats’ favorites of models and tests.
6. Casey B. Mulligan, Kevin M. Murphy, and Robert H. Topel write,
If an extensive shutdown of economic activity costs $7 trillion, largely in terms of economic hardship, and a limited response would lead to a $6 trillion loss of life, then an intermediate solution could, in principle, achieve a great deal.
If you are salivating for a cost-benefit analysis, these may be your guys. I just skimmed it, then I did a search for the word “mask” which came up empty, and decided to dismiss it. Tyler Cowen says “They think like economists,” which would only be praise if we didn’t know that they are economists.
In the early innings of this crisis, the most resilient companies include blue-chip retailers like Amazon, Walmart, Dollar General, Costco, and Home Depot, all of whose stock prices are at or near record highs. Meanwhile, most small retailers—like hair salons, cafés, flower shops, and gyms—have less than one month’s cash on hand. One survey of several thousand small businesses, including hotels, theaters, and bars, found that just 30 percent of them expect to survive a lockdown that lasts four months.
Big companies have several advantages over smaller independents in a crisis. They have more cash reserves, better access to capital, and a general counsel’s office to furlough employees in an orderly fashion. Most important, their relationships with government and banks put them at the front of the line for bailouts.
Pointer from Tyler. That last sentence is the important one. The politicians talk about helping small business, but it’s the banks and the big companies that will wind up getting most of the newly-printed money.
Ironically, I think that ordinary people, as opposed to government officials, want to do the opposite. They want to support small businesses, and they don’t worry about the banks much. The contrast between the preferences of the people that earn money and the looting class that prints money could create some social tension in the months and years ahead.
1. The NYT has a hopeful story.
On April 14, Mr. Bello was disconnected from the ventilator and began breathing on his own for the first time in 32 days.
This time, when she received a FaceTime call from the hospital, his wife gathered the children around. On the screen, he whispered the first words he’d been able to say to his family in a month: “I love you.”
As he was wheeled out of the I.C.U. to a regular floor, the medical staff, previously despondent about his case, lined the hospital hallway, erupting in applause. He waved.
I know of another lawyer who was taken off a ventilator several days ago, to the joy of the hospital staff, who said he was the first Covid-19 patient that they had been able to take off a ventilator while alive.
His Zoom funeral was yesterday.
it could be years before a vaccine is produced at a scale sufficient to help the entire world. The first country to the finish line will be first to restore its economy and global influence. America risks being second.
China is making rapid progress, with three vaccines entering advanced development. Chinese officials say they could have a vaccine available for widespread use next year.
There certainly are worse priorities than trying to develop a vaccine. But the tone of the piece is that all it takes to succeed is sufficient national willpower.
We ran a simple one-variable correlation of deaths per million and days to shutdown, which ranged from minus-10 days (some states shut down before any sign of Covid-19) to 35 days for South Dakota, one of seven states with limited or no shutdown. The correlation coefficient was 5.5%
I don’t trust the method, but I suspect that with better methods one would get similar results. I don’t think that government restrictions save lives. But of course, Justin Wolfers would not agree.
4. Joshua R. Goldstein and Ronald D. Lee write,
We estimate 75% of all US Covid-19 deaths to be age 70 or above, somewhat above the 64% for normal mortality. In fact, the age-distribution of deaths attributed to Covid-19 so far is quite similar to that of all-cause mortality, which tends to increase by about ten percent every year of age after age 30.
The goal of the paper is to provide a way to think about the mortality risk that the virus provides. One measure is the amount by which the presence of the virus increases your effective age. They scale this by the severity of the overall outbreak, meaning whether it kills 125,000 people in total or 2 million people in total.
An impact of 1 million deaths in three months in the United States would have the effect of temporarily exposing a 60 year-old to the normal mortality of a 73 year old.
In other words, a fairly large outbreak makes age 60 the new 73 in terms of mortality risk. Pointer from John Alcorn.
5. Today’s email included a message from Democracy Journal promoting a new book by Gene Sperling based on his essay Economic Dignity.
An economic dignity compact must ensure that those who do their part are able to care and provide opportunity for family. . .
Each American must have true first and second chances to pursue his or her potential. As Martha Nussbaum writes, “The notion of dignity is closely related to the idea of active striving.”
. . .A definition of economic dignity must include the capacity to contribute economically with respect and without domination and humiliation.
As I see it, the virus is causing a lot of people to lose their economic dignity. The lockdowns are making that worse. I think that the best hope for recovering economic dignity is a very strong dose of capitalism–letting price signals and the profit-and-loss system guide people into meaningful economic roles.
We want to do work that other people appreciate. That gives us dignity. Sitting at home waiting for permission from the government does not.
6. A paper by Sumedha Gupta and others.
Using multiple proxy outcome measures, we find large declines in mobility in all states since the start of the epidemic. Even states that did not implement major policy changes have experienced large mobility declines, and other states experienced large changes before the policy actions.
The best part is the charts at the end. For example, a chart showing trends in “social mixing” shows a sharp decline from about March 5 through about March 23, and a slower decline thereafter.
The authors speculate that lifting restrictions could have a stronger effect in causing people to go out by giving the impression that everything is all right. That may be a valid concern. If I were the government official announcing that restrictions are lifted, I would say very emphatically “This is not an all clear. This is simply a policy that leaves the choice up to individuals and businesses how they wish to handle risk.” I also think that a mandatory masks-when-in-public policy would send the right signal.
7. Here is a new paper by Jason Abaluck and others on the case for wearing masks. I have not read it. Sounds like academics getting a Blinding Glimpse of the Obvious. (BGO is not my phrase, just so you know)
Sam Long and Alexander Synkov write,
Altogether the Fed will deploy more than $1.45 trillion in support of investors in leveraged assets—more than double the size of the 2008 Troubled Asset Relief Program, and over $7,000 for each working-age American. That includes $750 billion to purchase recently downgraded junk bonds and bond exchange-traded funds—an unprecedented intervention in the private credit markets.
I have said all along that the checks being written to households and small businesses were just a fig leaf to cover a massive bailout of large corporations and the financial industry.
If we saw mobs breaking into stores, pulling items from the shelves, and walking out, we would recognize this as looting. But if we define looting as taking property without giving anything of value in return, then it is now widespread.
Tenants are looting landlords by not paying rent and not getting evicted.
Borrowers are looting banks by not paying mortgages or credit card debt.
Shareholders of airlines are looting the rest of us by getting bailout money.
The financial industry is looting us by getting bailout money from the Fed.
The government does not produce food, electricity, medical care, or any of the stuff that you can order from Amazon. The government produces pieces of paper, which it uses for looting. Households and businesses who are prudent and try to save for the future will be looted the most, through taxes and inflation. I predict that sooner or later the people who do work to produce food, electricity, and so on also will be looted, as their pieces of paper that will depreciate in value before they can spend them.
We are becoming a culture that accepts looting. It’s not people’s fault that they cannot pay their bills, so let them loot. It’s not the airlines’ fault that hardly anyone is flying, so let them loot. We can’t afford to let the financial industry go under, so let it loot. The government can pay its bills by printing money, so let it loot.
The widespread looting is not criminal, in that it is taking place within the framework of our political and administrative system. So far, it is not accompanied by violence. For that, we can be thankful.
1. 3DDRR edged down to 1.12, and 1.14 outside of New York. I will comment on Tuesday.
those who carried the disease into Europe must have gone from Wuhan to Europe for reasons of leisure or work. And if for work related reasons, their behaviour (hand shaking, hugging long time colleagues, being together for long hours in closed environments) would be very different from what you would expect from tourists.
Pointer from Tyler Cowen. I wonder what the data for airline passenger traffic shows for each week from the end of February to the end of March. My guess is that if we see a sharp decline, that would be followed by a slowdown in the spread rate. Although this virus does have a formidable ability to spread once it is in a community.
3. That same Tyler Cowen post also points to Christopher Phelan.
The number of times humankind has created an effective vaccine against any coronavirus currently stands at zero. While some antiviral treatments have shown promise, hopes that a “magic bullet” treatment is soon forthcoming are exactly that — hopes.
I think that one of the reasons that Americans spend so much on health care is that we place a high value on hope. We always hope that another test will identify the cause of the pain, another type of treatment will solve the problem, and so on. We don’t admire a doctor who says, “You just have to accept your condition.”
The idea of letting the virus runs its course cuts against that culture of hope. Such a policy would be an admission of defeat. But some of us see the lockdown as a form of futile care. When I introduced Anti-fragile Arnold, I pointed out that those of us who seek to avoid getting the virus as long as we can should not be dictating the behavior of everyone else.
Check out the tenth podcast from Bret Weinstein and Heather Heying. Skip the first 4+minutes, which only have music.
I noted the following:
1. A different flaw in the Santa Clara study.
2. Scans can show severe lung damage in people who report no symptoms
3. Their subjective probability that the virus was engineered in a lab has increased (they do not quantify by how much, but I think it is a lot).
4. They cite instances in which odd corners of the Internet are outperforming mainstream science and mainstream journalism. This comes through most in the last few minutes of he podcast.
The epistemology of this virus is fascinating. Some experts believe that about 3 million Americans have been infected, and other experts believe it is more like 30 million. Some experts focus on what it does to lungs, while others believe that it attacks the body in other ways. There is controversy, particularly since yesterday, concerning whether having the virus confers immunity. There is disagreement over how accurate tests must be in order to be useful (although perhaps I am the only one arguing that the current level of accuracy is insufficient).
I approach epistemology as a logic puzzle. If I believe A, B, and C, does that mean I have to believe D? Or if I become convinced that D is false, what do I have to do with my beliefs in A, B, and C?
Sometimes, as in (3) above, I use subjective probability as a shorthand. But I think of myself as having a complex, interconnected set of beliefs, so that I am reluctant to express any one belief as a subjective probability. This notion of complex, interconnected beliefs sounds to me as though it relates to Quine, but I don’t feel sufficiently well acquainted with Quine’s ideas to implicate him.
In my epistemology, I have contempt for computer models. I will spell this out more below. Continue reading
1.Kieran F. Docherty and others write,
A substantial proportion of excess deaths observed during the current COVID-19 pandemic are not attributed to COVID-19 and may represent an excess of deaths due to other causes.
Pointer from John Alcorn. This raises the possibility that the panic over the virus is causing about as many deaths as the virus. That would be because we are conserving hospital resources in order to maintain capacity to treat Covid patients. But don’t absolutely bet on this research being correct. For one thing, if they use our CDC numbers, the CDC has a much lower estimate of virus deaths than other data sources. But the researchers are showing the same sorts of findings for other countries.
2. 3DDRR today was 1.14, and excluding New York it was 1.17, but I am waiting until Tuesday to comment.
The $100 billion Term Asset-Backed Loan Facility is a reprise of a program launched in 2009 that enabled investors to buy bonds linked to consumer and business debt using money borrowed from the Federal Reserve. The central bank and other supporters say the program, known as TALF, helped unfreeze credit markets vital to the workings of the economy.
If it works as intended, TALF will jolt the market into reviving the issuance of new bonds, which spreads risk to investors and allows lenders to continue making loans. On the other hand, the Fed could face criticism for helping to super-charge returns for some of the biggest investors at a time when millions of Americans are losing their jobs as a result of the coronavirus pandemic.
In short, at a time when ordinary individuals and small businesses are getting only partial relief, these Wall Street activities will get a complete bailout. Moreover, this rewards the kind of behavior that Anti-fragile Arnold hates: financial engineering that results in privatized profits and socialized risks. Continue reading