In his latest opinion piece George Friedman paints a pretty bleak portrait of the medical establishment:

t is the medical system that was charged with protecting us from this disease. No institution can possibly be infallible, and each is limited by its knowledge and culture. The medical research establishment did not understand the nature of the disease. It still is uncertain whether catching the disease provides immunity or whether we will spend our lives in endless recurrence. It has at the moment no treatment that might mitigate the disease nor any that might prevent it. The culture that medical research has presented and projected to the world is that it is intensely at work, but that its work cannot be time-sensitive. It cannot be hurried, but its process must take its course.

This is not an unreasonable standpoint, but it has consequences. The only solution the medical system had was to prevent the spread of the disease by sequestration, the separation of individuals from each other. This may have had some mitigating effect on the disease, but it is having a disastrous effect on society. It is not hyperbolic to say that we are heading for a depression. The best available medical solution reduced the available labor force, reduced consumption and in many countries forced extravagant government infusions of money, infusions for which we will pay later. A depression is a disease in its own right. Poverty and despair cause their own deaths, but it is the loss of expectations and hopes that is the highest cost. I say we seem to be heading toward depression, not that we are there. Still, the danger is there and it is not trivial.

The mitigation of the spread of the disease has, apart from the social pressures of sequestration, generated a significant economic crisis. The response has been myriad decisions based not on certainty but on calculated risk. The government does not know that the trillions of dollars to stabilize the economy will abort a depression, but it does know that the cost of a depression justifies taking a risk and racking up debt. Each of us, in some small or large way, has engaged in calculated risk.

The moral foundation of medicine is that it must, first of all, do no harm. By “harm” it means that no action of the physician or the researcher should harm the patient. This imposes a meticulous discipline on medicine. No drug is released until it is certain that it will do no harm. This requires meticulous testing and evaluation, and that takes time. Part of the medical research process is imposed by the complexity and mystery of the subject. Part of it is due to the moral aversion to risk. And that aversion to risk can turn a virtue into a vice.

The medical profession cannot eliminate risk, but doing no harm makes it a moral imperative. Other systems operate not on a zero-risk principle but on the principle of calculated risk.

That’s an interesting point and explains why physicians should not be making public policy. The focus of the physician is properly on his or her patient. Would it be unethical for a physician to advocate a course of action that would benefit society at large or humanity at the expense of her or his patients? I think it would be. Conversely, it would not be unethical for a physician to advocate a course of action good for her or his patients but deleterious for the society at large. Different callings properly have different ethical obligations.

Illinois’s Gov. J. B. Pritzker has said that Illinois will not reopen until a vaccine for COVID-19 is available. The editors of the Sun-Times are apparently in agreement with him:

Central to the argument of many proponents for an immediate reopening of the country is that doing so would lead to the quick building of herd immunity among Americans, slamming the brakes on the spread of the virus. As Americans came down with COVID-19 and recovered — if they did not die — they would become immune to catching the bug again or passing it on.

But an array of medical experts have poured cold water on that notion in recent weeks, including Fauci on Tuesday. While it is “very likely” that people who have recovered from COVID-19 enjoy “a degree of protection,” Fauci said, nobody yet knows how intense or prolonged an exposure to the virus is necessary to gain immunity or how long it lasts.

Nor, he said, do we yet understand the full and long-term effects of the virus. He noted, for example, that doctors have just recently discovered the virus can cause “a very strange inflammatory syndrome” in children.

In order for Americans to develop herd immunity, experts say, an effective vaccination against the coronavirus must be developed, and the earliest that might happen is late fall or early winter.

In the meantime, what are we to make of supposed expert medical advice from the likes of radio talker Rush Limbaugh, who’s all for throwing open the country and pursuing herd immunity right now?

To take them seriously is to risk running out of coffins.

“Without a vaccine, over 200 million Americans would have to get infected before we reach this [immunity] threshold,” Johns Hopkins University epidemiologists David Dowdy and Gypsyamber D’Souza wrote recently. “If current daily death rates continue, over half a million Americans would be dead from COVID-19 by that time.”

Worldwide, 40 to 50 million people would likely die if countries decided to try and achieve herd immunity without a vaccine, University of Chicago associate professor Luis Barreiro, author of a recent study on herd immunity, told us.

“It’s completely irrational to consider that as an option,” Barreiro said.

Gov. J. B. Pritzker last week called it “an invitation for us to just let people die.”

There is presently no vaccine available for any coronavirus and it is quite possible that an effective vaccine will never be developed to protect against SARS-CoV-2. IMO the greatest likelihood is that, like many other related infections, SARS-CoV-2 will become endemic in the population and the best case scenario is that a vaccine will be developed that needs to be reformulated every year and protects a percentage of the population from 19% to 60% from the virus.

There is an alternative other than letting the entire United States or, indeed, the State of Illinois remain shut down until a vaccine that may never materialie is developed and that is what I support. There should be limited, systematic, and targeted reopenings rather than a radical reopening and this process should be informed by the best and most current information available.

The governor and the Sun-Times need to get their minds around the idea that remaining shut down forever is not a viable option. We will need to learn to live with some level of risk.

In his latest Wall Street Journal column Walter Russell Mead urges Germany to become a great power again:

Thirty years after unification, history is knocking at Germany’s door. To answer the call, Germany will have to break some of its deepest taboos, and begin to think and act like a great power again.

Power politics has a bad reputation in Germany, and it is not hard to see why. Otto von Bismarck and his successors made Germany a great power, but the effort ended in the shipwreck of World War I. Adolf Hitler’s fever dreams of empire led to an even worse outcome. Divided and impoverished, Germany lost millions of citizens, saw centuries of cultural treasures annihilated by Allied bombs, and was saddled with a burden of shame and guilt that still haunts its conscience.

Postwar German leaders took another path, integrating themselves into the West. The North Atlantic Treaty Organization, which protected Western Europe from the Soviet Union, also reassured Europeans who feared another German bid for supremacy by creating large American bases in Germany. NATO made the European Union possible and still underwrites its security.

Throughout the Cold War, a strong West Germany worked with allies to strengthen both the trans-Atlantic relationship and its European partnerships. When the Cold War ended and Germany reunited, the rewards were enormous. Central and Eastern Europe wanted nothing more than to join NATO while integrating economically with Germany and the EU. A weak Russia looked hopefully to Germany for the investment that would launch its recovery and a growing China eagerly welcomed German companies and imported German capital goods. With the whole world apparently moving toward the Western values to which Bonn (and later Berlin) had passionately committed itself, Germany was richer, safer and better liked than ever before in its history.

Today’s world is very different. U.S.-German relations haven’t been this troubled since West Germany recovered sovereignty in 1955. A revanchist Russia probes for weakness across the EU. China seeks to challenge Germany’s place atop the value-added manufacturing chain. Bitter Italians and Spaniards blame Berlin for their countries’ difficulties and threaten to disrupt the EU if their considerable financial demands are not met. Countries like Poland and Hungary are flouting democratic norms that Germans believed were solidly implanted.

The last time Germany was a great power it laid waste to large swathes of Europe three times in 75 years. As its economic might has grown over the last half century, fueled especially by German reunification, it has used that might, the European Union, and the euro to expand its foreign markets under its mercantilist trade policy and impose harsh sanctions on its southern neighbors. Every ill that Dr. Mead catalogs and wants a great power Germany to remedy was fomented by Germany. And more: the Balkan wars were in part fomented by Germany. Europe’s present inability to defend itself is largely a product of Germany’s failure to fund its own military.

The risks presented by a great power Germany are too grave to ignore. Rather than encouraging Germany to reassume its great power status, I propose something radically different: divide Germany permanently into at least four separate countries and possibly as many as six. Let the Germans compete with each other. Those Germanies might be less willing to triangulate between the U. S. and Russia as the united Germany is presently doing. And they’d be less threats to their neighbors.

With a tone of injured innocence Xie Feng, commissioner of the Chinese Foreign Ministry in Hong Kong, takes to the pages of the Wall Street Journal to announce China’s readiness to help during the COVID-19 crisis:

China was the first to spot and report the outbreak, identify the pathogen, and share its genome sequence with the World Health Organization and the rest of the world. Yet China has been accused of coverups and delays and put in the dock. At the same time, those who failed to test, report and act in a timely fashion are passing judgment on others. Isn’t it a bit ironic?

As the timeline changes and possible cases are discovered in other countries that predate those found in China, some are anxious to shift the blame instead of reflecting on their own failures in the virus’s early days. Was it because they lacked the techniques, or perhaps a sense of responsibility? Could there have been any undercounting or even coverup? Should a country be labeled as the origin of the virus, held accountable and made to pay for others’ inept responses simply because it was the first to report what it found? If so, what country will be willing to test people and honestly report the findings in the future?

Some are taking things further, trying to make a fortune out of the pandemic. They have demanded reparations from China, a chilling reminder of the Boxer Indemnity foreign powers coerced China into paying more than a century ago. As a Chinese proverb goes, “A gentleman pursues wealth in a righteous way.” Blackmail and plunder are surely not the correct response to a pandemic.

Some others have seen the crisis as an opportunity to cut off trade and decouple economically from China. This has caused bottlenecks in global industrial supply chains and will only set back the recovery of frail economies.

Fighting Covid-19 should be everyone’s first concern. The enemy is the virus. Scapegoating China will neither make up for the time that has been lost, nor save the lives that are at risk. We are teammates in this battle, not rivals. Countries need not compete with or envy each other, still less point the finger at or turn against one another. In fact, quite the opposite is necessary. We need to show sportsmanship and team spirit, give teammates who perform well a pat on the back, and lend a helping hand to those in need. After all, this is a fight nobody can afford to lose, one we must win together.

When disaster struck, people in Eyam and Wuhan made their heroic choices. They are the epitome of responsibility, self-sacrifice and solidarity. Such spirit defies time and space, transcends national, ethnic, religious and ideological boundaries, and inspires the international community to set aside prejudice and differences and unite as one. Not only has it kindled our hope of prevailing over the ongoing pandemic; but it will also light our way to a better future.

If the Chinese government genuinely wanted to be of assistance during the crisis, it should allow an outside task force unrestricted access to China and its records to determine what actually happened from October 2019 through March 2020 in China. Not sending defective tests and PPE to other countries would be nice gestures as well.

I’ll reserve my own views on how China can help other than to ask how can the world trust anything from a China that falsifies its own conduct? If they want to help, they should leave the rest of the world the heck alone.

The editors of the Washington Post are shocked, shocked to learn that politics is influencing the actions of the U. S. Congress:

“Additional fiscal support could be costly but worth it if it helps avoid long-term economic damage and leaves us with a stronger recovery,” Mr. Powell said.

That’s correct. Unfortunately, Mr. Powell spoke as Congress has begun to divide along partisan lines about how much more to spend, when and for what purposes. House Speaker Nancy Pelosi (D-Calif.) has unveiled a $3 trillion measure, key provisions of which are $895 billion in cash for state, local, tribal and territorial governments and another round of direct payments to households potentially larger than the first, which cost an estimated $290 billion. The bill also includes $3.6 billion in new aid to meet a crucial non-economic need: helping as many voters as possible participate securely in the November elections.

The huge measure has no chance of passing the Republican Senate and is therefore part political statement, part opening bid in inevitable negotiations with the GOP. Republicans are balking, both because they insist on their own policy priorities, such as lawsuit protection for reopening businesses, and because they believe there’s “no rush” (President Trump’s phrase) to tee up more spending before the money already approved has had a chance to work.

Indeed, only about $1.4 trillion of Congress’s total $3.6 trillion in covid-19-related spending and tax relief had actually hit the economy as of May 8, according to the Committee for a Responsible Federal Budget. (Notably, Mr. Powell has yet to activate a $600 billion business lending program backed by capital Congress gave to the Treasury Department.) It’s also true that states have received significant federal help already and that the next installment must be based on carefully assessed needs — especially given the inevitable difficulties of asking taxpayers everywhere to help states, sometimes wealthy ones, where they don’t live.

I can’t distinguish how much of the WaPo’s concern is sincere and how much crocodile tears. If you genuinely want the members of Congress to act like statesmen we’ll need to start electing statesmen to Congress. Our present system does not encourage that. We should also face reality. Congress will not reform itself.

Let’s not let this crisis go to waste. Repeal the 17th Amendment or even abolish the Senate entirely. We need a single subject amendment to the Constitution. Something along the lines of

Every law shall embrace but one subject and matter properly connected therewith, and the subject shall be briefly expressed in the title.

The list of urgently needed reforms is huge: civil service reform, abolishing seniority rules in the Congress, the House should be enlarged and there should be a limit on how many people a single Congressman may represent, lobbying reform, and so on and not a one is something the Congress would do on its own steam.

And, yes, a crisis is exactly the right time for this long overdue housekeeping to take place.

Tyler Cowen takes a stand on quarantine in his latest piece for Bloomberg:

There has been surprisingly little debate in America about one strategy often cited as crucial for preventing and controlling the spread of Covid-19: coercive isolation and quarantine, even for mild cases. China, Singapore and South Korea separate people from their families if they test positive, typically sending them to dorms, makeshift hospitals or hotels. Vietnam and Hong Kong have gone further, sometimes isolating the close contacts of patients.

I am here to tell you that those practices are wrong, at least for the U.S. They are a form of detainment without due process, contrary to the spirit of the Constitution and, more important, to American notions of individual rights. Yes, those who test positive should have greater options for self-isolation than they currently do. But if a family wishes to stick together and care for each other, it is not the province of the government to tell them otherwise.

My view is that a voluntary quarantine cannot be effective in achieving any goal that has been mentioned for the lockdowns, at least not in the absence of more social cohesion than we possess. Take Illinois’s example. After two months of “stay at home” directives and businesses being shuttered, wouldn’t you think that the number of new cases would start declining? Not only are they not, they’re accelerating.

I think that from that you can only draw the conclusions that the tactics were doomed from the start, that something a lot more strenuous than a voluntary quarantine was necessary, and that the primary goal being served by the present tactics is political.

The most likely outcomes are either lifting the directives by gubernatorial edict (the same way in which they were imposed), soft rebellion, or hard rebellion. The governor appears to be backing himself into a corner rendering the first alternative less likely. I’m hoping for a soft rebellion, i.e. enough people start ignoring the directives that they become untenable.

Meanwhile, in his Washington Post column Josh Rogin finds an urgent need to do something about Chinese cybercrime:

The mere fact the Chinese government is attempting to steal coronavirus information should make clear that the blame for the lack of U.S.-China cooperation on the pandemic lies primarily on the Chinese side. China has restricted its own researchers from sharing coronavirus research and has refused to hand over early virus samples. Chinese research institutions have even tried to copy and patent leading U.S. drugs sent to China for trials.

Now, China is trying to steal coronavirus data from inside U.S. institutions through hacking and “nontraditional actors,” according to a draft notice prepared by the FBI and the Department of Homeland Security (and seen by the New York Times). Assistant Attorney General for National Security John C. Demers didn’t confirm the report, but he talked about the threat Monday on CNBC.

“It would be crazy to think that right now the Chinese were not behind some of the cyber activity that we’re seeing targeting U.S. pharmaceutical companies and targeting research institutes around the country that are doing coronavirus research, treatments and vaccines,” he said. “This is the holy grail of biomedical research right now, [and has] tremendous value both commercially and geopolitically.”

He suggests imposing the same sort of sanctions we have imposed on Russia on China.

I’ve seen the logs for a number of web sites, not just this one but some high traffic sites as well. Nearly all of the unwanted malicious traffic emanated from China. I find it hard to believe that activity is not state sanctioned.

I’m not sure that sanctions will actually do much to stop Chinese hacking. It would probably be better to use China’s own strategies against them. An embarrassing publicity campaign, for example. Or, as the State of Missouri has done, take them to court.

Failing those I’d suggest harnessing a major untapped resource: privateers. Put a bounty on taking major Chinese sites down. That might take the whimsy out of cybercrime.

David Ignatius expresses concern in his latest Washington Post column over the U. S. ability to wage war against China:

Brose explains a terrible truth about war with China: Our spy and communications satellites would immediately be disabled; our forward bases in Guam and Japan would be “inundated” by precise missiles; our aircraft carriers would have to sail away from China to escape attack; our F-35 fighter jets couldn’t reach their targets because the refueling tankers they need would be shot down.

“Many U.S. forces would be rendered deaf, dumb and blind,” writes Brose. We have become so vulnerable, he argues because we’ve lost sight of the essential requirement of military power — the “kill chain” of his title — which means seeing threats and taking quick, decisive action to stop them.

How did this happen? It wasn’t an intelligence failure, or a malign Pentagon and Congress, or lack of money, or insufficient technological prowess. No, it was simply bureaucratic inertia compounded by entrenched interests. The Pentagon is good at doing what it did yesterday, and Congress insists on precisely that. We have been so busy buffing our legacy systems that, as Brose writes, “the United States got ambushed by the future.”

Even if we had unquestioned military “primacy” over China, I would favor avoiding war with China to the greatest degree possible. Present U. S. doctrine favors limited war and IMO the notion of a limited war against China is nonsensical on its face. The only practical tactic against China would be to eliminate its command and control at the outset without concern about collateral damage rather than the sort of maneuver warfare that is being discussed here.

I’d also like more details about the war games mentioned in the column. The assumptions and constraints in these games frequently dictate their outcomes.

Also, I can’t distinguish between a genuine practical concern and someone promoting his own pet project.

Finally, although I have little doubt that China is a formidable military foe, I think that both Mssrs. Brose and Ignatius are discounting China’s lack of a seasoned officer corps too strongly. What would happen when China’s battle plans did not survive contact with the enemy? Technology is important but war is likely to remain a human activity for the foreseeable future.

In his latest Wall Street Journal column Walter Russell Mead speculates about what the foreign policy of a Biden Administration might seek:

There will certainly be changes. One will be on climate policy. While moderate liberals may not embrace the entire “Green New Deal” agenda that featured prominently in the Democratic presidential primary, a strong climate program is central to Democratic thinking these days. Mr. Biden’s America would not only return to the Paris agreement; it would put U.S. diplomatic weight behind a stronger, faster push to reduce global emissions.

There will also be surprises. Those looking for a Biden administration to return to the free-trade agenda that presidents from George H.W. Bush through Mr. Obama prioritized should brace for a shock. It isn’t only Republicans like Mr. Trump and Sens. Marco Rubio and Josh Hawley who have broken with the free-trade orthodoxy of past decades. Jake Sullivan, a former top aide to Secretary of State Hillary Clinton and national security adviser to Mr. Biden in the Obama White House, published an article this February calling for significant changes.

He and co-author Jennifer Harris (another Obama veteran) argue for a fundamental shift away from what they call the “neoliberal” agenda of recent presidents. “Policymakers must move beyond the received wisdom that every trade deal is a good trade deal and that more trade is always the answer,” they write. A “postneoliberal” agenda would promote industrial policy (large public investments in green energy and other climate-friendly technologies as well as funding to match China’s support for tech). It would include the reshoring of strategic manufacturing capabilities, “a laser focus on what improves wages and creates high-paying jobs in the United States,” and aggressive campaigns against firms taking advantage of low-corporate-tax havens like Switzerland and Ireland.

A Biden administration would likely share Mr. Trump’s position that China is America’s major geopolitical competitor, but it will pursue that competition in a different way. While the current president views existing international architecture with suspicion, Mr. Biden would likely see it as an indispensable element in building an effective international approach to Beijing. A Biden administration would not share Mr. Trump’s willingness to disrupt relations with both European and Asian allies, and it would attempt to smooth relations with important U.S. allies like Japan, South Korea and Germany. But Mr. Biden’s White House would likely combine any friendliness with a new emphasis on human rights and a skepticism about the value of trade—which could lead to some interesting conversations with regional powers including Vietnam, Myanmar, Thailand and even India.

On Iran, most Democratic foreign-policy experts regret Mr. Trump’s withdrawal from the JCPOA, but there is less consensus on what to do going forward. So many things have changed since 2017 in Iran and the region that simply returning to the status quo ante Trump is unrealistic. The unilateral sanctions the Trump administration imposed on Iran may not have brought Tehran back to the bargaining table on the president’s terms, but a Biden administration might not want to give up the leverage those sanctions provide without receiving something from Iran in return.

much of which sounds pretty good to me which makes me suspicious of it. How much is based on VP Biden’s published statements and how much on wishful thinking? Is it mostly the latter?

A President Biden would need to protect his left flank so I have little doubt that climate change will figure in his foreign policy as it has not in President Trump’s. In the face of a global depression which is exactly what will happen if the U. S. doesn’t come back online quickly, pursuing U. S. carbon emissions as a major focus of foreign policy will look increasingly surreal.

Indeed, unless the U. S. economy recovers more quickly than seems likely at the present, I doubt that President Biden will have the time to take much of an interest in it at all.

But all of this is getting far ahead of ourselves. At this point we can’t be sure that Joe Biden will be the Democratic nominee let alone whether he will be elected.