How to Make Decisions

After pointing out in her Washington Post op-ed that media outlets have incentives to exaggerate dangers and underreport successes, economist Emily Oster provides what may be the best advice I’ve seen on making strategic decisions about SARS-CoV-2:

In the absence of complete information on risks, our overreactions can have serious consequences. One example is the Three Mile Island nuclear event, which has not been conclusively linked to any long-term negative health outcomes but did terrify Americans about nuclear power. People simply didn’t have enough baseline information about the number of nuclear plants operating safely on a given day to realize that the probability of a nuclear disaster was vanishingly small. The result was that nuclear power — a plentiful, carbon-free energy source — never reached its potential in the United States, leading to needless overreliance on dangerous fossil fuels.

We risk making similar mistakes with the coronavirus. Keeping children out of school harms their development. Shuttering businesses destroys livelihoods. These downsides may be offset by the benefits of limiting covid-19. But we cannot rationally assess the trade-offs when we have only partial information.

What we really need to know is not the anecdotes that news reports provide, but the full picture. What share of schools have cases? Moreover, what differentiates places with cases from those without? Is it differences in prevention measures? Demographic and economic characteristics? The prevalence of community-spread events?

To answer these questions, we need systematic data collection and reporting — the sort that lets us evaluate risks in all kinds of situations, from driving cars to flying on planes to, yes, ocean swimming. It should be possible to do this. As schools open, districts will have counts of at least detected covid-19 cases, as well as information on the overall enrolled population. This data could be combined in public databases with user-friendly dashboards and maps. Since this type of data collection has not been spearheaded by central authorities, I’ve partnered with a set of national educational organizations and a data team to try to put it together.

I would fault President Trump for not providing that kind of leadership but not only President Trump. Few governors have emphasized “systematic data collection and reporting” sufficiently—Indiana appears to be an exception. Our own governor seems to be collecting the data and ignoring it quite assiduously.

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Not Watching Again

I’m not watching the Republican National Convention, either. Based on the captions of the reaction pieces I’m seeing (you can hardly miss them), they might as well have been written six months or a year ago, dusted off, and filed this morning.

It must be easy to be a columnist for the New York Times or the Washington Post these days. All you need is a thesaurus.

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Will Immigrants Save New York?

This quote of James Hacker in a piece at Axios caught my attention:

While lots of New Yorkers are leaving, “out there in Bangalore and Ukraine and Natal, there are people who want to be New Yorkers” who will gladly take their place, bringing their ambition and brainpower.

Leaving aside for a moment that Bangalore is a city, Ukraine arguably a country, and Natal a territory, I’m curious about the selection process that would be used. About 70% of the people in the province that contains Bangalore are literate (mostly not in English), most Ukrainians are literate (probably not in English), and in KwaZulu-Natal hard to estimate but probably no greater than 50% (again mostly not in English). I’m a bit curious as to what Dr. Hacker thinks this very diverse population will do.

Anyway, I wish the resettled speakers of Kannada, Ukrainian, and Zulu the best of luck. They’re going to need it.

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The Second Time Around

A man in Hong Kong has just been confirmed to have been re-infected by SARS-CoV-2. From STAT:

Researchers in Hong Kong on Monday reported what appears to be the first confirmed case of Covid-19 reinfection, a 33-year-old man who was first infected by SARS-CoV-2 in late March and then, four and a half months later, seemingly contracted the virus again while traveling in Europe.

The case raises questions about the durability of immune protection from the coronavirus. But it was also met with caution by other scientists, who questioned the extent to which the case pointed to broader concerns about reinfection.

There have been scattered reports of cases of Covid-19 reinfection. Those reports, though, have been based on anecdotal evidence and largely attributed to flaws in testing.

But in this case, researchers at the University of Hong Kong sequenced the virus from the patient’s two infections and found that they did not match, indicating the second infection was not tied to the first. There was a difference of 24 nucleotides — the “letters” that make up the virus’ RNA — between the two infections.

That’s not particularly good news. If recovery does not convey persistent immunity, it’s not particularly likely that a vaccine will, either. However, this is good news of a sort:

During his second infection, the man did not have any symptoms. Some patients go through their course of Covid-19 without showing symptoms, but researchers have also hypothesized that secondary cases of the coronavirus will generally be milder than the first. Even if immune systems can’t stop the virus from infecting cells, they might still rally some level of response that keeps us from getting sicker. During his first case, the patient had classic Covid-19 symptoms of cough, fever, sore throat, and headache.

We really need to know a lot more about asymptomatic COVID-19. Was this reinfection milder because it was the second time or was it milder because of the strain of the virus that was contracted or because of the way in which it was contracted? There’s an enormous amount that we just don’t know.

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Setback for Small Nuclear

This is bad news. NuScale’s Utah project will be delayed by three years at their customer’s request. Josh Siegel reports at the Washington Examiner:

This month, NuScale Power, an Oregon-based nuclear company, learned its first customer needed to push back the timeline for when it plans to operate the first reactor from 2026 to 2029. The entire plant of 12 individual 60-megawatt reactors won’t be completed until 2030, a slip from an expected 2027 time frame.

Utah Associated Municipal Power Systems, a group of small community-owned utilities in six Western states, cited a rise in expected costs for the NuScale reactors. The group is counting on the nuclear power to provide around-the-clock, zero-carbon electricity to replace a coal plant it plans to close, but its members say they won’t need the new cleaner electricity source until later than expected.

“The setbacks are not fatal,” said Erik Olson, a climate and energy analyst at the Breakthrough Institute. “But if this project falls through, that would be an enormous blow to the promised next wave of nuclear power.”

The only practical approach for genuinely carbon-free energy production is using nuclear baseload generation and IMO small nuclear sidesteps most of the problems in nuclear power generation.

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Visualizing a Second Trump Term

At Politico Nancy Cook and Meridith McGraw ponder what President Trump would do in a second term:

As a reality TV star, Donald Trump seized the White House with an unusual slate of Republican pledges: take on China, tear up trade deals, restrict immigration. But as president, Trump has faced warnings from a long line of GOP stalwarts that he can’t win in 2020 by offering more of the same.

So, as the Republican National Convention looms, Trump and his team have scrambled to find new twists on old favorites to quell concerns about the question that has bedeviled him for months: What would he do with four more years?

Basically, they don’t come up with much. They’re stumped.

I think they’re looking at Mr. Trump in the wrong way. He’s completely transactional in his approach. He’s looking for the best deal. The question and the mystery is what the decision function is for “best”. As far as I can tell he’s the sole arbiter of that. Don’t look to him for ideology or sweeping plans. He just doesn’t operate that way.

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The Backside of the Curve?

UPI reports that the number of cases of COVID-19 diagnosed has fallen below 35,000 per day:

Aug. 24 (UPI) — There were fewer than 35,000 new cases of COVID-19 in the United States on Sunday, according to data Monday from researchers at Johns Hopkins University — the lowest number in two months.

The university’s Center for Systems Science and Engineering showed about 34,500 cases, nationally. That’s the fewest number of new cases since 30,500 on June 22.

The U.S. average over the previous six days was 44,000. There were about 450 coronavirus deaths on Sunday, the lowest figure in a week.

I prefer using deaths due to COVID-19 per day over time and ICU or hospital bed utilization by COVID-19 patients as metrics. Just cases diagnosed is too subject to vagaries in reporting or testing to be particularly useful. It could be explained by hurricanes rather than by an actual decline in the number of new cases of the disease. Without epidemiological testing there’s no way to know.

Here in Illinois the number of cases diagnosed per day has been rising steadily as the volume of testing has increased while the number of deaths due to COVID-19 has been flat for six weeks at around 20 per day. ICU and hospital bed utilization by COVID-19 patients has been flat here for months. That’s why I keep whining about the policy response here. It’s not based on anything I can identify other than a futile wish to reduce the number of cases of COVID-19 to zero.

But the decline in cases diagnosed is good news nonetheless.

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Other Than That, Mrs. Lincoln

Somewhere around here I have a tattered copy of a paperback book, Through History with J. Wesley Smith, a collection of the 20th century cartoonist Burr Shafer’s cartoons, most of which originally appeared in the New Yorker. J. Wesley Smith was a nebbishy sort of character who pops up at all points of history, always saying something outrageous or in poor taste—the precisely wrong thing to say. In one of the cartoons the indomitable Mr. Smith is interviewing Mary Todd Lincoln. The caption is “Other than that, Mrs. Lincoln, how did you enjoy the play?” I believe that may be the origin of that particular remark.

It was what I thought of when I saw this headline at CBS News: “Republicans see U.S. as better off now than 4 years ago ahead of convention”. With the increase in unemployment occasioned by the U. S. economy’s having been put on hiatus for months, 180,000 people dead of COVID-19, many of whom might otherwise have been alive today, the sharp decrease in U. S. GDP of 2Q20 even if temporary, and American cities set ablaze, I don’t see how anyone regardless of political party could possibly think we were better off today than in August 2016.

Before assigning blame or providing a strategic answer, just look around you. By what empirical measure are we better off than four years ago? It beggars credulity.

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View From the South

At Outside the Beltway Steven Taylor points out the increasing impact that COVID-19 is having on the countries of Central and South America:

If we look at the Worldometers stats and sort by cases per 1 million, French Guiana is #2, Chile #5, Panama #6, Peru, #8, Brazil #10, Aruba #14, Colombia #20, Turks and Caicos #22, and Bolivia #24 (half of the top ten, and nine out of the top 25).

In raw numbers, Brazil is #2 in the world in cases behind the USA as well as #2 in deaths, again behind the USA (which ought to be tired of all the wining, I have to add), with Mexico in third place.

In terms of death per million residents, Peru is third on the list and Chile ninth. With Brazil (11), Mexico (12), Panama (14), Sint Maarten (15), Bolivia (16), Ecuador (19), Colombia (20) occupying space in the top 25. (The US is 10th by this metric).

Despite the toll that COVID-19 has taken on the U. S. at this point it has not overwhelmed our health care system but the same may not be true of the countries of Central and South America and the Caribbean. They don’t have our capacity or our deep pockets. They are going to need assistance and lots of it.

I have been warning about this since the earliest days of the pandemic. With our highly porous border control the disease has unquestionably spread from the U. S. to Mexico but for the same reasons it is unlikely to remain that way forever. The U. S.’s outbreak and in particular our policy responses to it are a triple whammy for our neighbors in this hemisphere. Not only have we spread SARS-CoV-2 to them, putting our economy into a tailspin or, at the best, into a dormant state has reduced remittances to people living in those neighbors and rendered the U. S. a poor safety valve for people there who are out of work or just afraid.

South America is only now entering its winter and, if you recall, the worst days of the pandemic here were in the late winter and early spring. I see little reason that will not be the case to the south of us as well.

Even were a vaccine to become available or even if we were to achieve “herd immunity” here, to escape the pandemic we will need to take the outbreaks in the countries of South and Central America as seriously as we do our own at least.

I fear that’s politically untenable, for different reasons on different sides of the aisle. What we’ll be left with is a vicious cycle of our infecting them which circles around to infect us which circles around to infect them again and so on and so on.

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What the Future Will Bring

Morgan Housel is very optimistic about the future for what strikes me as a rather perverse reason: necessity is the mother of invention. He thinks the present panic will give rise to splendid innovations:

But think of what’s happening in biotech right now. Many have pessimistically noted that the fastest a vaccine has ever been created is four years. But we’ve also never had a new virus genome sequenced and published online within days of discovering it, like we did with Covid-19. We’ve never built seven vaccine manufacturing plants when we know six of them won’t be needed, because we want to make sure one of them can be operational as soon as possible for whatever kind of vaccine we happen to discover. We’ve never had so many biotech companies drop everything to find a solution to one virus. It’s as close to a Manhattan Project as we’ve seen since the 1940s.

And what could come from that besides a Covid vaccine?

New medical discoveries? New manufacturing and distribution methods? Newfound respect for science and medicine?

I don’t want to be a crêpe hanger but I think he’s misinterpreting recent events. A half century of enormous subsidization of health care has resulted in a lot of capacity in biotechnology. We’d have even more if we hadn’t been outsourcing our productive capacity to China for the last three decades.

The great technological developments of the 19th and early 20th century happened because there was space in which they could happen. That space doesn’t exist any more either in knowledge or in industry. We’ve picked the low-hanging fruit. Basic innovations were happening regularly a century ago. But those days have been gone for decades. What look like innovations today are actually just elaborations on old technology made possible by cheaper hardware. But Moore’s Law has run out of steam. The elaborations powered by cheap hardware will become much fewer and farther between.

AT&T, General Electric, Ford, General Motors. U. S. Steel, and the other massive industrial companies grew in the empty economic space of the late 19th and early 20th centuries. That space has long been filled. We aren’t seeing small companies sprout up to make use of the opportunities (such as they are) provided by COVID-19. We’re seeing the existing giants stepping up to fill the new needs.

I don’t know what the future will bring. But I don’t believe we’re on the cusp of a technological or economic renaissance.

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