I don’t think that Illinois legislator Dan McConchie has the right end of the stick in his criticism of governors exceeding their powers this op-ed in the Wall Street Journal:

As governors across the country destroy their states’ economies in the name of public health, there is shockingly little oversight of their actions.

In my state of Illinois, Gov. J.B. Pritzker has locked down the state, closing swaths of commerce and limiting the movement of citizens in response to Covid-19. These actions have been challenged in court by my colleague, state Rep. Darren Bailey, and a judge initially agreed to a temporary restraining order on the governor’s emergency measure, but only as they apply to Mr. Bailey. The rest of the state remains under lockdown by the governor’s orders, which continue without oversight.

Normally, the three coequal branches of government impose checks and balances to ensure accountability. Power is divided to allow recourse if one branch grows too intrusive or authoritarian. And while many people have sued governors in recent weeks to demand judicial redress, the judicial branch is reactive in nature, usually declining to disrupt legally plausible actions during a crisis. The legislative branch is a far better source of timely restraint.

His problem is not with the governor but with the legislature and the judiciary. In Illinois the governor’s emergency powers are defined and restrained by 20 ILCS 3305/7:

Sec. 7. Emergency Powers of the Governor. In the event of a disaster, as defined in Section 4, the Governor may, by proclamation declare that a disaster exists. Upon such proclamation, the Governor shall have and may exercise for a period not to exceed 30 days the following emergency powers; provided, however, that the lapse of the emergency powers shall not, as regards any act or acts occurring or committed within the 30-day period, deprive any person, firm, corporation, political subdivision, or body politic of any right or rights to compensation or reimbursement which he, she, it, or they may have under the provisions of this Act…

I agree that the governor must conform with the provisions of the law but the issue doesn’t end there. The judiciary needs to articulate the law and the legislature needs to be willing to amend the law or to ensure that it is enforced. I see a mutual longing for despotism among all three branches.

I see it as largely a partisan issue. If Republican Bruce Rauner were still governor, he’d’ve already been shut down by the legislature.

However, I agree with this:

Here in Illinois, some of Gov. Pritzker’s limits on commerce can hardly be defended as “based in science.” Even under his latest Executive Order released Thursday, I can visit Target to buy furniture, Walmart to buy clothing or my grocery store to buy flowers. But I can’t go inside a furniture store, a clothing store or a florist, even though those stores could easily adopt the same safety measures required of the retail outlets permitted to stay open.

Oh, they’re based in science all right. Political science and sociology. Keeping Target and Walmart opened prevents people from rebelling against the lockdown and enabling those stores to continue business as usual is easier to administer than forcing them to close non-essential departments. They’re open for the same reasons that non-emergent city services continue.

Government at all levels is providing enormous subsidies to big businesses while putting small businesses out of business. Half of all Americans work for small businesses. Don’t be surprised if, when the lockdowns end, there’s nothing for people working for those businesses to return to.

More than five weeks ago I wrote a post taking note of an effort to test systematically a number of drugs that had already received FDA approval for other uses but that there was reason to believe might be effective in treating COVID-19. There has been been a follow-up report at The Conversation from that group of researchers:

Our multidisciplinary team of researchers at the University of California, San Francisco, called the QCRG, identified 69 existing drugs and compounds with potential to treat COVID-19. A month ago, we began shipping boxes of these drugs off to Institut Pasteur in Paris and Mount Sinai in New York to see if they do in fact fight the coronavirus.

In the last four weeks, we have tested 47 of these drugs and compounds in the lab against live coronavirus. I’m happy to report we’ve identified some strong treatment leads and identified two separate mechanisms for how these drugs affect SARS-CoV-2 infection. Our findings were published on April 30 in the journal Nature.

In summary their in vitro studies have shown some success. Two groups of drugs have been at least a little successful, one group that interfered with what’s called “translation”, the ability of the virus to make previously healthy cells start making viral RNA, the other that interfered with the virus’s ability to infect cells. They also found two other interesting results. The first result was that hydroxychloroquine does interfere with the virus’s ability to infect cells but does not do so very effectively. The second was that a common ingredient in cough syrup, dextromethorphan, actually facilitates the operation of the virus. They don’t have enough evidence to say that dextromethorphan should be avoided but it’s interesting.

Dr. Krogan concludes:

The next step is to test these drugs in human trials. We have already started this process and through these trials researchers will examine important factors such as dosage, toxicity and potential beneficial or harmful interactions within the context of COVID-19.

Their study is proceeding slowly and painstakingly which is, indeed, the way that science works. Under the circumstances it’s frustrating but it’s actually exciting that their approach to looking for a treatment for COVID-19 has worked at all.

I mentioned some of my assumptions in my last post. Here’s another one. The pandemics of 1918, 1957, and 1968 are still in progress, just at lowered intensity. My assumption is that the same will be true of COVID-19. In a column at Bloomberg Narayana Kocherlakota, formerly a member of the Federal Reserve Board of Governors, urges policymakers to plan for that possibility:

So far, the response to the coronavirus pandemic has operated on the assumption that the worst will be over within a year or so. But what if the malaise lasts much longer? It’s a scenario that policy makers must recognize and prepare for.

Breathless media constantly repeat that a vaccine might be widely available by next spring. But even spring of 2023 would be the fastest in medical history, and there’s no guarantee of that. Maybe antibodies will turn out to confer little or no protection from infection, as is true for some viruses. In that case, developing a vaccine would be a lot harder, and the concept of “herd immunity” would be meaningless. Almost everyone would remain susceptible, whether or not they’d had it in the past.

So a very long battle with Covid-19 seems entirely possible – while it seems nearly impossible that the U.S. and much of the world can follow New Zealand’s lead and almost eliminate the disease. A longer-term crisis would have very different implications for the economy. Sectors that are expected to bounce back – such as tourism – could be out for good. Sectors that have seen a boost – such as streaming services – could be permanent winners.

I guess I also assume that not everybody is equally susceptible to the virus and not simply because of differences in age or pre-existing conditions. Just because they’re less susceptible for one reason or another.

I think that even if COVID-19 is not seasonal and has a higher case mortality rate than the seasonal flu, it’s something we need to get used to. I don’t think that political leaders can get their minds around that. They’d better start doing so quickly.

I see that Holman Jenkins is thinking along lines similar to mine in his most recent Wall Street Journal column:

I joked the other day that the media doesn’t do multivariate, but it wasn’t a joke. Sometimes it imposes a hard cap on what we can achieve with public policy when the press can’t fulfill its necessary communication function.

This column isn’t about Sweden, but the press now claims Sweden’s Covid policy is “failing” because it has more deaths than its neighbors. Let me explain again: When you do more social distancing, you get less transmission. When you do less, you get more transmission. Almost all countries are pursuing a more-or-less goal, not a reduce-to-zero goal. Sweden expects a higher curve but in line with its hospital capacity. Sweden’s neighbors are not avoiding the same deaths with their stronger mandates, they are delaying them, to the detriment of other values.

The only clear failure for Sweden would come if a deus ex machina of some sort were to arrive to cure Covid-19 in the near future. Then all countries (not just Sweden) might wish in retrospect to have suppressed the virus more until their citizens could benefit from the miracle cure.

Please, if you are a journalist reporting on these matters and can’t understand “flatten the curve” as a multivariate proposition, leave the profession. You are what economists call a “negative marginal product” employee. Your nonparticipation would add value. Your participation subtracts it.

Let’s apply this to the U.S. Americans took steps to counter the 1957 and 1968 novel flu pandemics but nothing like indiscriminate lockdowns. Adjusted for today’s U.S. population (never mind our older average age), 1957’s killed the equivalent of 230,000 Americans today and 1968’s 165,000. So far, Covid has killed 57,000.

Before patting ourselves on the back, however, notice that we haven’t stopped the equivalent deaths, only delayed them while we destroy our economy and the livelihoods of millions of people.

That’s because public officials haven’t explained how to lift their unsustainable lockdowns while most of the public remains uninfected and there’s no vaccine.

An enormous amount depends on your objectives and even more on your assumptions. I have assumed that no vaccine will be available for the foreseeable future, that a lot of people will contract the disease, and a lot of people will die of it. I have also assumed that I am more susceptible to the virus than the average American due to my age but that may not be a good assumption. I think the biggest problem facing the health care system right now is lack of good treatment options for COVID-19. I hope those will become better but I don’t assume it.

Here in Illinois despite the “stay at home” directives we do not seem to be “bending the curve” meaningfully. Judging by their public statements, our political leadership seems to disagree with that. I’d like them to explain how increasing numbers of people in hospital on a daily basis, increasing number of people occupying ICU beds, with a flat number of those being COVID-19 patients is “bending the curve”.

Meanwhile the main prescription from policy makers is “double down”.

Yesterday we received a delivery of five pounds of fish. I don’t recall whether I’ve mentioned it before but there are a few luxuries my wife and I allow ourselves. Other than the dogs, of course. We have a subscription to Chicago Lyric Opera and we belong to Sitka Salmon. Sitka Salmon is a sort of co-op of Alaska fishermen who for ten months of the year send their catch directly to consumers in the lower 48. The fish are caught by independent fishermen operating small boats (rather than factory ships), processed and flash frozen and packaged right on board, shipped to us, and delivered by local deliverymen. At this point we have a couple of months of good fish dinners in our freezer. This month we received Pacific Cod.

As long as we have electricity, cooking oil, and a bag of rice, we won’t go hungry, at least not for a couple of months.

I do not envy the lot of journalists trying to write about very nearly any of the aspects of the situation that presently confronts us in the outbreak of COVID-19. Imagine you’re a copy writer for a major newspaper, assigned to write an article on how to shorten the time to produce a vaccine against the virus that causes it, SARS-CoV-2. Or imagine you’re a J-school graduate with no practical experience of anything including actual reporting. But I repeat myself.

It’s the biggest news story of the decade and we can say almost nothing about it with confidence. It’s a virus. People are dying of it. We don’t really know how to prevent it or treat it or how contagious it is or whether any of the measures that have been put in place to mitigate the risks are actually working. And yet we’re being deluged with millions of words, most of which are meaningless noise.

This post began in life as remarks about an NYT article on how the time to produce a vaccine against SARS-CoV-2. We don’t even know if an effective vaccine can be produced. How can you write an article on such a subject when you know nothing about medicine, public health, politics, chemical engineering, or business? You can write anything you care to as long as you ignore biology, politics, economics, and industrial practice. That’s the alternative that was chosen.

I am filing this post under three categories: COVID-19, journalism, and O tempora o mores, my category for laments about the sorry state of just about anything.

The Associated Press reports that the “field hospitals” that were set up in New York City largely went unused:

NEW YORK (AP) — Gleaming new tent hospitals sit empty on two suburban New York college campuses, never having treated a single coronavirus patient. Convention centers that were turned into temporary hospitals in other cities went mostly unused. And a Navy hospital ship that offered help in Manhattan is soon to depart.

When virus infections slowed down or fell short of worst-case predictions, the globe was left dotted with dozens of barely used or unused field hospitals. Some public officials say that’s a good problem to have — despite spending potentially billions of dollars to erect the care centers — because it’s a sign the deadly disease was not nearly as cataclysmic as it might have been.

When is it preparedness and when is it panic? The argument articulated above (“it’s a good problem to have…”) suggests that no cost is associated with allocating resources for facilities that are never used but that isn’t true.

I found this interview in Die Welt of two pathologists, one a specialist in lung pathology, very interesting. I’ll try to provide a few translations. They say that infection is via nose and throat and suggest that ventilator support may actually be causing the deaths of at least some of the patients receiving it.

Jonigk: Blood clotting occurs in the lung [capillaries], which are in the walls of the lung alveoli that serve to absorb oxygen and remove CO2. The damage causes protein to escape from the blood into the alveoli. Oxygen must somehow be transported from the air we breathe into the capillary network. That’s how we breathe. Anything that lengthens that route ensures that the patient can no longer supply himself with sufficient oxygen. It’s like playing soccer when you’ve skinned your knee: First a brown-red crust of protein and blood develops. We have a similar situation in the air bubbles. And breathing through them is massively difficult. The patient has a feeling of breathlessness, too little oxygen gets into the organism. It is more likely to be secondary to an inflammatory reaction. A downward spiral begins, which ends in a so-called shock lung. The lung and with it the patient fight for their lives.

In response to a question about which pre-existing conditions predispose a patient to worse outcomes:

Older people with previous damage to the lungs. Patients who are dependent on medication that diminishes the immune system. And smokers, for example. Or people who live in an area with high particulate matter pollution and therefore already have pre-damaged lungs. So they are already not well before that. If an acute infection such as SARS-CoV-2 is then added, this can be enough to put the already sick patient’s life in danger.

which makes me wonder if it’s not population density per se but air quality. That could be very bad news for India, for example, whose cities have some of the worst air quality in the world.

Classic pneumonia is a bacterial infection with purulent sputum. The pus is yellow because it is made up of fatty granulocytes. Their task is to fight the enemy, the pathogen, in the body. But SARS-CoV-2 is a virus. It attacks cells directly and reprograms them. After an initial unspecific reaction, the response to this infection consists of specific T-lymphocytes, a subtype of white blood cells. These can recognize and attack virus-infected cells. We now have a large number of lymphocytes in the basic structure of the lung, which collect in the walls of the alveoli and develop their inflammatory activity there.

I found these remarks about the dysregulation of clotting interesting:

Up to 25 percent of intensive care patients have disorders of liver and kidney functions. In addition, blood coagulation often appears to be permanently disturbed. Small, local blood clots form at many sites because the inflammatory cells beat around to destroy the virus-infected cells, which include vascular cells. No matter where this occurs, it always has considerable consequences for the organ — strokes occur and sometimes extremities have to be amputated. In many organs, the occlusion of a blood vessel can be compensated. But if you have many occlusions, the blood does not flow properly, organ damage occurs, inflammatory cells do not get where they actually want to go, and the heart is also put under strain.

There’s also a lengthy suggestion that the sudden deaths on the part of young people are being caused by over-exertion, as in working out. They also point to the peculiar demographic issues in Germany as I have and have this observation:

It’s not enough to say, “This patient had something.” Rather, the previous illnesses must be systematically uncovered in relation to the population.

About Italy:

As far as we know, in Italy a corona test was carried out on every person who died and everyone who was found to have the virus was considered to have died of corona. In the case of pre-existing conditions, a distinction must also be made between diseases that generally shorten life expectancy and diseases that specifically increase the risk of corona infection and possible complications. This is somewhat muddled in the public discussion.

which would increase the reported number of deaths due to SARS-CoV-2, wouldn’t it? I’ll try to find a version that isn’t firewalled and is translated in full for you.

The editors of the Wall Street Journal take note of Germany’s experiment in reopening the economy while simultaneously avoiding an increase in the introduction of new cases of COVID-19:

German officials are concerned that the disease’s reproduction rate, or R0, has drifted upward since smaller shops were allowed to reopen April 20. The Robert Koch Institute, the government’s disease-control agency, estimated Monday that the rate is 1. That means each infected person on average spreads the virus to one other person. A rate above one signifies exponential growth in infections.

That matters because Berlin is conducting an experiment in whether it’s possible to reopen an economy in a way that controls R0. Chancellor Angela Merkel, who holds a doctorate in chemistry, became an internet sensation this month for a press conference in which she soberly lectured Germans on why they must suppress the rate, and why R0 would be the benchmark for the government’s reopening policies. Two days before the lockdown started easing, RKI estimated the rate was 0.8.

That approach and Germany’s aggressive test-and-trace program earlier in the outbreak were presented as a triumph of science-based policy in contrast to a certain U.S. President. Yet it’s plagued by problems. One, as the RKI acknowledges in its daily briefings, is that no one can know in real time what the reproduction rate is. RKI’s figure is only an estimate. Any leader who picks R0 as a policy target will be flying half-blind.

I don’t think the editors appreciate just how fundamentally COVID-19 is challenging the foundations of German social thinking. Germany is striving to remain German, a futile struggle in my opinion. The ethnic German population is more at risk from the virus because it’s older. A high toll among older ethnic Germans will leave a much higher proportion of ethnic Turks and Arabs who are not only not ethnically German, they’re not culturally German, either.

Additionally, Germany is highly dependent on process and near 100% conformance with the processes in place for its prosperity and its entire way of life. The VW scandal has already revealed the holes in that. How could the scandal take place at all? Why didn’t the processes in place prevent it from happening? It’s being portrayed as just a few bad apples but, given the nature of German society, IMO it’s more likely that the processes in place are actually an elaborate fraud.

Now they’re relying on process and conformance with the process in a society much less socially cohesive and, yes, less German that it has been at any time in the postwar period and, consequently, less conformant. Will they succeed? Or will they just have excellent metrics for why they failed?