1. A reader writes, “epidemiology as GDP-factory-ism”
So many epidemiology models seem to use THE value for R, or THE case fatality rate (CFR) or THE infection fatality rate (IFR). But these rates differ for different people and different circumstances. It seems the same kind of simplification that treats output as a single something. The simplification can be useful some times but there is such a temptation to use it without asking that question.
If you want to know why I am so adamant and ornery about the models, that is it. They remind me of macroeconometric models, which I am confident are misguided.
The modelers are still at it. The NYT reports,
The daily death toll will reach about 3,000 on June 1, according to an internal document obtained by The New York Times, nearly double the current number of about 1,750.
I would like to make the following bet with these modelers. I bet that the daily death toll in the last two weeks of May averages less than 2500. Whoever loses the bet has to shut up. If I lose, I stop blogging about the virus. If the modelers lose, then they have to stop reporting results from their models.
Note that Daron Acemoglu and others have disaggregated the typical model into more than one risk bucket. Tyler Cowen enthuses, “I would say we are finally making progress.” I say it’s just more social-engineering drunks searching under the lamppost.
2. Another reader points to an essay by Sean Trende. Difficult to excerpt, the essay seems quite rational to me.
No states are on anything resembling an exponential growth trajectory, almost all states are past a peak, and most states are substantially so. This would suggest that in many states, the question really should be how to reopen while keeping hospitals from being overwhelmed again.
As Tyler Cowen once predicted, we went from insufficient fear to excess fear. With excess fear, it will be difficult to re-start the economy. Even if restrictions are lifted, people will not be confident as consumers or entrepreneurs.
3. Alberto M. Borobia and others look at a cohort of patients at a major teaching hospital in Madrid. It is worth poring over the tables at the end. As I read table 3, out of 665 patients under age 50, only 5 died. That is a mortality rate of less than 1 percent among those hospitalized. To compute the overall infection fatality rate for those in that age group, one would have to multiply by the probability that an infected person becomes hospitalized. If the latter is 0.1, for example, then the IFR would be less than 1 in a thousand. Pointer from John Alcorn.
He also points to a study by Zichen Wang and others of patients in three New York hospitals. As I read the tables, obesity does not seem to be associated with a greater likelihood of death, but hypertension does.
And he points to yet another study, in the LA area. They find that a big difference of male vs. female.
One thing I would like to see from these cohort studies is a really careful analysis of the relationship between the risk from age and the risk from comorbidities, given that the high correlation between the two.
We are starting to open, and will continue to open, as long as opening is the main well-supported alternative to the closed status quo, which we can all see isn’t working as fast as expected, and plausibly not fast enough to be a net gain. Hearing elites debate a dozen other alternatives, each supported by different theories and groups, will not be enough to resist that pressure to open.
Winning at politics requires more than just prestige, good ideas, and passion. It also requires compromise, to produce sufficient unity. At this game, elites are now failing, while the public is not.
I am not rooting for the elites to win. I don’t think any top-down solution is going to work well. Letting individuals decide which risks they are willing to take is probably the best approach. As someone who will be making risk-averse choices, I do not think others’ riskier choices pose a significant threat to me.
We shouldn’t be trying to conquer fear so we can go back to the old economy. We should be building the new economy that has an order of magnitude fewer casual human interactions.
Maybe this is overstating it. But I do think that we will see new patterns of specialization and trade, and we need a lot of capitalism to get there.
Polls indicate that the restrictions are still rather popular (e.g. well over . I don’t see evidence that people agree that they are not working. Fewer than 30% support re-opening dine-in restaurants now (see Washington Post- UMD Poll).
A bit tangential, but on another of your common topics, I thought this post by Jason Crawford stated very well a case similar to what you’ve made in the past, about why for-profit organizations are generally better drivers of progress (including anti-pandemic progress) than nonprofits:
https://rootsofprogress.org/organizational-metabolism-and-the-for-profit-advantage
From other sources (maybe the model builder?), I understood the 3,000 deaths/day on 6/1 to be a scenario for planning purposes, not a forecast. As in, ‘how do we prepare our ops for that time period if this turns out to be true?’ rather than ‘our best prediction is this.’
And the media, as is not uncommon, took it out of context. Of course, I could be wrong, because I think it’s dumb enough that I don’t feel like doing any extra work to find the links to that.
Casual human contact pretty much defines most peoples lives. That comment seems pretty anti-human to me.
+1
(No duh, right?)
Re: No. 1 — Modellers who can’t be trusted:
https://www.telegraph.co.uk/news/2020/05/05/exclusive-government-scientist-neil-ferguson-resigns-breaking/
“Government scientist Neil Ferguson resigns after breaking lockdown rules to meet his married lover
The scientist whose advice prompted Boris Johnson to lock down Britain resigned from his Government advisory position on Tuesday night as The Telegraph can reveal he broke social distancing rules to meet his married lover.
Professor Neil Ferguson allowed the woman to visit him at home during the lockdown while lecturing the public on the need for strict social distancing in order to reduce the spread of coronavirus. The woman lives with her husband and their children in another house.
The epidemiologist leads the team at Imperial College London that produced the computer-modelled research that led to the national lockdown, which claimed that more than 500,000 Britons would die without the measures….”
To his defense, it’s kinda awkward to carry on an affair over Zoom or FaceTime. I mean seriously, even I can model this one.
Thanks for a good chuckle — much needed!
Does social distancing require no visits from a friend?
I thought that distancing was aimed at group gatherings. Obviously I have missed part of the program.
Strict social distancing would require at least keeping six feet of distance with the face mask, I guess. I suppose we don’t know that the affair involved getting any closer than that… For comedic purposes I hope Ferguson does try to say “we met, but never touched. Strict 6 feet apart. Never even saw her face. Believe me.”
This guy is a jerk, obviously, and a terrible scientist to boot…
but it does raise an issue.
I did visit a friend a few weeks ago, and he was reluctant to get into my small car with me.
Again, I have felt that the chance of getting infected without saliva and body contact is tiny, and the chance of a healthy young person getting seriously ill from a contact with a friend who does not go to bars and football games is even tinier.
I am not paranoid enough for social distancing, apparently.
They remind me of macroeconometric models, which I am confident are misguided.
—
A major difference is that these models had to assume that N, the total number was reasonably constant. They attempted to close the loop, so to speak. Been a long time since I have seen a macro economist close the loop.
Re: No 1 — “Note that Daron Acemoglu and others have disaggregated the typical model into more than one risk bucket. Tyler Cowen enthuses, ‘I would say we are finally making progress.’ I say it’s just more social-engineering drunks searching under the lamppost.”
I share Arnold Kling’s position on pandemic policy. And askblog has been the surest reality check and compass throughout this crisis and disequilibrium. But Dr. Kling once wisely remarked, “Libertarians have no reliable friends.” A lapidary insight.
So the question arises: When should we endorse something 2nd or 3rd best? If some prestigious misguided modelers find their way to forsake broad lockdown in favor of narrowly targeted lockdown, why not meet them there?
By analogy, Bryan Caplan ardently advocates open borders in immigration policy, when the there is broad support to build The Wall. So he make overtures to unreliable friends, by seeking common ground in “keyhole solutions,” narrowly tailored immigration restrictions to address specific arguments against immigration.
Back to pandemic policy: The keyhole solution — which Sweden understood would be key from the outset — is to quarantine eldercare facilities (and to shield other especially vulnerable demographics), whilst relying voluntary social distancing, normative self-isolation of symptomatic persons, and private adaptation of workplaces and of commerce for the rest of society.
If prestigious misguided modelers belatedly have discovered a version of this approach, by sorting the populace into different risk buckets in their models, then why not strike a tactical (unreliable) friendship?
Practices and policies around nursing homes have been woefully inadequate, and deserve sharp focus, even from misguided modelers.
BTW, other modelers in academe got onto the idea of keyhole quarantine well before Daron Acemoglu. The most prestigious is not always the quickest! See, for example, Paul M. McKeigue and Helen M. Colhoun (U. of Edinburgh), “Evaluation of ‘stratify and shield’ as a policy option for ending the COVID-19 lockdown in the UK” (25 April 2020):
https://www.medrxiv.org/content/10.1101/2020.04.25.20079913v1.full.pdf
And Adriano A. Rampini (Duke U.), “Sequential Lifting of COVID-19 Interventions with Population Heterogeneity,” (22 April 2020):
https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3579183
Virus-schmirus, let’s go back to normal. The hospitals will not become flooded because we have flattened the curve, and the elderly are self isolating.
Let us rush to market at vaccine so that we can free the elderly.
Why did the elites do a good job in Taiwan or South Korea and not the West? Or are Asians just better at self-distancing in a pandemic due to previous experiences?
Yes to the second. It may also be true that the virus that hit Europe and the eastern USA is a mutated stronger form of the virus that hit east Asia.
https://www.sciencealert.com/yes-sars-cov-2-is-mutating-but-before-you-freak-out-read-this
I actually like some of the elements in the Cochrane models that struck me as missing from epidemiologists, and adding different risk groups in #1 make sense.
Cochrane models here:
https://johnhcochrane.blogspot.com/2020/05/an-sir-model-with-behavior.html
https://johnhcochrane.blogspot.com/2020/05/dumb-reopening-might-just-work.html
Still wouldn’t trust a quantitative prediction from any of these, but at least as a description of behavior and heterogeneity, I do feel they have some use in terms of framing the problem.