People often find it easier to focus on one issue at a time. I’m no different in this regard, which is why I try to force myself to think of problems from a “multivariate” perspective.
I would encourage people to be skeptical of reports that “solution X” won’t work. Tyler Cowen linked to a recent example today, which evaluates Paul Romer’s proposal for mass testing. It’s not that these studies are wrong; indeed I believe the skepticism is usually justified. Rather they must be understood in context.
In my view, there are at least three very useful policies for addressing Covid-19:
1. Test-trace-isolate
2. Wear masks in crowded public areas
3. Voluntary social distancing
I don’t believe any of those three policies would be sufficient, considered in isolation. But we have more and more evidence from countries all over the world that major gains can be achieved by utilizing all three in combination.
The goal in many countries (not Sweden!) is to get the “R0” reproduction rate below 1.0. Every effective practice that reduces R0 can push us closer to that goal, even if that individual step not enough. So I’m not persuaded when a skeptic tells me that masks alone won’t do the job, or testing alone won’t do the job. There are now some pretty populous countries that have essentially zero community transmission and where restaurants and stores are open for business. Of course, even in those countries things are far from perfect. But there are much worse outcomes that South Korea, and we have one of those much worse outcomes in the US.
PS. All of the countries I considered in my April “Islands” post continue to make great progress. Furthermore, an ever-growing number of countries are making substantial progress, despite not reducing community transmission to zero. Thus active caseloads are falling very rapidly in places like Austria, Germany and Switzerland (and perhaps Norway, although their active caseload data is not updated.) I’m not as confident of the continued success of those places because they still have very caseloads, and also closer links with other countries than the island success stories. But they are worth watching.
The US continues to see its active caseload skyrocket (today it reached 1 million). In early April, we had 5 times as many active cases as Germany. Now we have nearly 50 times as many. We seem unsure as to whether to try to control the disease or to go for herd immunity, and thus are ending up with the worst of both worlds—lots of new cases and deaths, and a crashing economy.
READER COMMENTS
P Burgos
May 8 2020 at 2:14pm
Isn’t the seven day rolling average for deaths in the US in a gradual decline? As for the number of US cases, I thought that part of that is a large increase in testing starting during the last seven days in April.
Scott Sumner
May 8 2020 at 2:36pm
Very gradual. The US is not doing well right now. I expect things will gradually improve, but the combination of death and depression is probably not optimal.
Stanley Greer
May 8 2020 at 5:02pm
Testing has actually skyrocketed in the U.S., and the share of tests that result in positives has been plummeting for weeks. That means in all likelihood that the number of people in the U.S. with active COVID-19 is falling, not rising, contrary to the inference you are drawing.
I know you look at National Review frequently, but perhaps you missed this item today by A.G. Hamilton. I don’t know who he or she is, but NR overall has hardly been a hotbed of COVID-19 skepticism throughout most of the pandemic.
Media Outlets Mislead Readers about COVID-19 Data
By A. G. HAMILTON
The public overwhelmingly relies on the press to provide them with accurate information and proper context. When it comes to COVID-19, many press outlets are consistently failing to do that. In fact, the reporting on data related to the epidemic has increasingly led to conclusions that aren’t accurate and an … Read More
Thomas Hutcheson
May 9 2020 at 12:21pm
“Plateauing/gradually falling” is probably a more cautious conclusion.
The main problem with media coverage is the confusion between measures aimed at permanent suppression and those that aim to “bend the curve” enough not to exceed the capacity of the health care system to deliver life-saving interventions.
Scott Sumner
May 9 2020 at 2:29pm
Yes, increased testing has an effect, but that’s also true in many other countries. It’s difficult to argue that there’s a lot of improvement given the persistently high mortality rates. But there’s certainly some truth in what you say.
Rebes
May 8 2020 at 6:43pm
Scott, your last paragraph nailed it.
Lorenzo from Oz
May 9 2020 at 12:24am
Possibly due to the inherent information problems, health policy in Western democracies seems to be very much a case of you get what you pay for. Not pay for in terms of alleged intention, but pay for in terms of operative incentives.
We pay for health departments to encourage good treatment of acute illnesses (as dead folk do not generate continuing health expenditure and the taxpayers what obvious risks reduced) but steadily worsening chronic health (as an increasingly chronically, sick–specifically metabolically unhealthy–population continually boosts health budgets).
We clearly have not being paying for good management of health risks, including such things as possible pandemics. Civil engineering and mass technology seems to have done far more to reduce health risks over the last century or so than health departments.
Whether there will be serious attention to our ‘presiding over budget-enhancing ill-Health’ departments is a big question from this pandemic. This, by the way, includes nutrition guidelines that never made good scientific sense, because health departments had remarkably little incentive to ground their recommendations in good science, or resist the obvious regulatory capture of agricultural departments, but have tended to worsen the pandemic by raising death rates from comorbidities.
The US clearly suffers from the problems of coordinating such a big and diverse country, probably not assisted by personalist Executives. Has collective-executive-in-legislature Westminister tended to do better than Montesquieu separation-of-executive-around-single-individual Presidential/Gubatorialism? The Anglo settler states that kept the Crown long enough not to go down that path (hence figurehead rather than administering Governors and Governor-Generals) do seem to have done better.
Brian
May 9 2020 at 4:14pm
Scott,
I agree with much of what you say here. I would note only that testing by itself would appear to accomplish nothing, and testing with contact tracing is largely impossible once the pandemic has spread widely. Medical experts and the media have been pushing for greatly increased testing, but I’m at a loss to see what it will accomplish. 80% of our COVID-19 tests already come back negative, so it’s hard to argue we’re under-testing. Does increased testing cause more people to social distance? Seems unlikely.
Mark
May 12 2020 at 2:24pm
20% of tested positive does sound like far-too-little-testing to my ears.
1. Tested positve obviously must mean, the Covid-carrier stays in strict quarantine (and get specific tratment). Which is very useful.
2. Testing many more might allow for Romer’s plan, which would have so many nice consequences. The US and Germany seem pretty far from that quantity of testing.
3. Main thing about testing for me seems nowadays: Testing allows to get some idea about the (changing) prevalence of the virus. My German home town (not depicted in Scott’s postcard shot of a tourist trap) had near zero new positives this month, so the easing of the lockdown (not a very strict or ridiculous one here in Germany anyway) we do now feels good and the right thing to do. Sat in a cafe with my oldest daughter yesterday. To the playground with the youngest. Took the tram, went to town. If there were only tests of near-certain-cases, I would feel less good about it. – As you wrote, we still know so little. So in mortality rates and tests I trust. In what else?
btw. Who gets infected now? – Herds of infection after weeks of lockdowns are here the few places where groups live together, sharing the showers and kitchen plus often the bed-room: Romanian meat-factory workers in rooms of 4. Refugee shelters (Also in my town. Had 90% of the new infections in the last 4 weeks. – I shared the same ALDI with them.)
Mark Bahner
May 15 2020 at 10:06am
No, Scott, you’re wrong. There is a magic bullet. If everyone wore:
#1 = properly designed and well-fitting washable masks, covering nose and mouth,
#2 = properly designed balaclavas on top of the masks, with proper eye protection for the balaclava eye holes, and
#3 = washable gloves,
…in essentially every potential situation outside of their homes (and even when possible inside homes wouldn’t hurt) the COVID-19 pandemic would likely be ended in every country in the world within a month. The cost would almost certainly be less than $100 per person (even including multiple masks, balaclavas, and washable gloves), and probably less than $50 per person.
So the price to “end” the COVID-19 pandemic in the U.S. in about a month would almost certainly be less than $33 billion, and probably less than $15 billion. (I put “end” in parentheses because any small pocket of infection could be dealt with by everyone near the infection re-donning their masks, balaclavas with eye protection, and washable gloves.
And why do I think this “magic bullet” exists? I understand aerosol filtration and aerosol movement in air. Any virus or bacterium that is transmitted by aerosol and respiratory means can be filtered to prevent transmission:
How COVID-19 is spread
P.S. And this is not what I’m talking about. These are two inexcusably ignorant men:
Our inexcusably ignorant U.S. senators. No wonder the country is such a mess.
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