Alex Tabarrok on Covid Failures and Successes, Part I
Alex Tabarrok has posted a talk he gave at Bowling Green State University in February. The title is “U.S. Pandemic Policy: Failures, Successes, and Lessons.”
Alex does a good job of presenting his case. I’ll hit the main highlights on which he does well. At the same time, there are yawning gaps that leave me wondering whether he has no view on the issue (for example, he mentions zero about lockdowns) or whether he just is not familiar with what I thought were pretty well-known failures (e.g., nursing homes in New York, New Jersey, and Pennsylvania.)
I’ll go through the talk seriatim. Because my comments are extensive, Part I is today and goes to about the 41:00 point of the 60-minute talk. Part II will be tomorrow.
Alex starts off by pointing out the huge number of U.S. deaths due to Covid-19, now in excess of 900,000. He notes that this is greater than the total number of U.S. deaths in all foreign wars the U.S. has fought in. That’s correct.
For completeness, though, it would have been good to point out that the median age of military members’ deaths in all U.S. foreign wars was almost certainly below 40 and probably below 35, whereas the median age of Americans who died of Covid was about 80. That means that the number of life years lost to Covid was substantially below the number of life years lost to all those wars combined. (I’m focusing on Americans here. Comparing worldwide deaths from Covid to worldwide deaths from World War II alone shows Covid to be a fraction of WWII, even putting aside life years.)
Am I callous about people close to age 80 who die? No. For one thing, I’m only 9 years away from that age. I’m simply pointing out what Alex’s George Mason economist colleague Don Boudreaux has pointed out well here, namely, that we sensibly react differently to the death of an elderly person than to the death of a teenager.
Next, Alex discusses the economic costs and shows that they are huge. Here’s where I first started wondering: are these the costs of the pandemic alone or are they the costs of the pandemic and of the lockdowns that governors of states with over 98 percent of U.S. residents imposed on those residents? Alex doesn’t address that. The losses in the first few months from early March 2020 to about June 2020 are likely due mainly to people’s voluntary reactions to the pandemic. But after that, the losses were probably mainly due to lockdowns.
His next major point is that Covid-19 was not a “Black Swan” event but, rather, was a predictable and predicted event. Alex says that we were not ready for this pandemic. I’m not sure that’s true. I think we were somewhat ready. As Phillip W. Magness and Peter C. Earle pointed out in “The Fickle ‘Science’ of Lockdowns,” Wall Street Journal, December 19, 2021, in 2019, both the World Health Organization (WHO) and Johns Hopkins University’s Center for Health Security had concluded that large-scale quarantines were not a good way to deal with the pandemic. So it wasn’t so much that “we weren’t ready” as that we were somewhat ready but Donald Trump’s task force and a whole lot of similar organizations in other countries threw out the playbook, ignored tough tradeoffs, and went with widespread lockdowns even of people for whom there was no evidence of disease and people (children) for whom the risk of death was tiny. Alex mentions none of that. Regarding tradeoffs, Scott Atlas, one of my Hoover colleagues and an adviser to President Trump on Covid (too late in the game, given the disastrous decisions Trump made in the first few months) points out in his 2021 book, A Plague Upon Our House, that he (Atlas) tried unsuccessfully to get his colleagues who were advising Trump to look at tradeoffs. I talk about that in my forthcoming review of Atlas’s book in Regulation.
Instead, Trump’s government and governments around the world were influenced by a model created by Neil Ferguson and his colleagues at Imperial College London. The model turned out to be way off-base. One fact that Magness and Earle cite:
Imperial predicted up to 42,473 Covid deaths in Sweden under mitigation and 84,777 under uncontrolled spread. The country, which famously refused to lock down, had some 13,400 deaths in the first year.
More on the Ferguson model later, in Part II.
Here’s one recommendation from the Johns Hopkins study that caught my eye (p. 13):
WHO and national authorities will need to provide strong evidenced-backed reasoning for the necessity of NPIs in order to effectively implement them and to communicate their role and necessity to the public, especially for NPIs such as social distancing that inherently limit civil liberties. Therefore, they should under- take directly or support research on NPIs and disseminate their findings on these analyses.
NPIs are “non-pharmaceutical interventions.”
Next Alex goes over a timeline showing some huge mess-ups by the CDC and the FDA. Alex does such a good job of this, and with a beautiful righteous anger. It goes from about 6:30 to about 14:30. I highly recommend this segment. It covers Helen Chu, whom I wrote about here on April 8, 2020, among others.
A minute or two later Alex, justifiably goes after the FDA for slowing down tests and compares our experience to that of other countries like South Korea. That goes to about 24:00. His story about South Korea (from about 22:00 to about 24:00) is really powerful.
Like Alex, I think these were huge mistakes. Because of these mistakes that slowed testing, we in the United States were flying blind.
Well, almost. Stanford medical professor Jay Bhattacharya, who has a Ph.D. in economics and earned an M.D., was skeptical from the beginning about two things: (1) that the reported fatality rates of about 3 percent were real; and (2) that the virus had not already spread widely as, in his reading of the literature, had happened with previous viruses.
On (1), his reasoning was that what was being measured was the case fatality rate and this was likely to be much higher than the infection fatality rate. Why? The people who went to get tested were disproportionately people who had symptoms, and not just symptoms, but bad symptoms.
To test (2), he and some colleagues, in early April 2020, tested 3,328 residents of Santa Clara county (California) to see how widely the virus had spread. What they did is called a seroprevalence study. They concluded that 1.1 to 2.0 percent of Santa Clara county residents had antibodies. This implied about 53,000 people, which was a large multiple of the 1,200 confirmed cases at the time.
In private conversation, Jay told me that that percent was just too high for a society-wide lockdown to be effective.
Alex doesn’t mention Bhattacharya’s seroprevalence studies or those of many others who were conducting such studies at the same time who found numbers broadly consistent with Jay’s.
In Alex’s view, the big success was something he had a large role in: persuading the Trump administration to give drug companies many billions of dollars so that they could build capacity and be ready to quickly scale up production once a vaccine was found. This was Operation Warp Speed. OWS also guaranteed that the government would buy the vaccine once it had been produced, even if the virus went away. His story about how they went about that is very interesting and I recommend listening to it. It goes from about 24:30 to about 41:00. The best part, in my view, is getting the FDA to back off from business as usual (at about 25:50.)
Also, Alex says (26:10) that OWS paid firms to start building factories now. I think he leaves out a major, and successful, exception. While Moderna, the company that vaccinated me 3 times, did take that money, I think I recall that Pfizer refused. (I can’t find the link: I remember reading it in the Wall Street Journal in the spring or summer of 2020. Please correct me if I’m wrong.)
I’m a fan of the vaccines. I think they accomplished a lot. The big unknown is whether we would have had the vaccine without the subsidy elements of OWS. Alex clearly thinks we wouldn’t have. He emphasizes the importance of building capacity even before the drug is proven effective. Co-author Charley Hooper, who makes his living consulting to pharmaceutical companies, and I wrote an article in December 2020 titled “The FDA’s Deadly Caution.” We lay out a timeline where, without FDA regulation, we might have had the vaccine months earlier than we had it. As Alex agrees, a few months difference is huge.
That’s it for Part I.