Will we repeat the Christmas Covid wave?

EDIT at 7pm, same day as posting: You know you have good friends when someone quietly emails you and tells you that the news about Omicron just got much worse and you should probably edit your post. I’ve been trying to rationalized why this January will be better than last January. Of course if it were not for Omicron, I would expect very little from holiday gatherings among mostly-vaccinated Americans. However, having known Omicron was looming, I probably shouldn’t have even tried to speculate. Get your booster and be prepared to hunker down in January if the 2-3 week data indicates that infections are turning extra-lethal. </edit>

In keeping with the “dismal science” brand, let’s dwell on the horrible death toll of the January 2021 Covid wave in the US that followed the Christmas holiday. Here comes Christmas (and other winter holidays) again, a major public health event.

https://www.cnbc.com/2021/01/27/us-reports-record-number-of-covid-deaths-in-january.html

This graph I borrowed from CNBC shows how fast deaths spiked up after the winter holidays of 2020. See also https://data.cdc.gov/.

According to Google search auto-complete, the public is more interested in whether there will be another Christmas Prince movie than whether there will be another Christmas Covid death wave.

I think it’s unlikely that we will see a repeat of exactly what happened last year. I’ve been looking online for predictions and mostly I have found articles warning that Omicron will cause a some kind of wave. No one wants to commit to predicting how many people will die, because anyone who tries is sure to be wrong. The consensus is that breakthrough infections are likely but that vaccines protect against extreme illness.

Nearly a million Americans have died from Covid already (Jeremy argues for a million). Some of those deaths, in retrospect, can almost certainly be tied to family travel during the holidays in 2020. The January Covid wave has only happened once, so it’s impossible to predict what will happen this time. Unfortunately we may get an interaction from increased holiday travel plus a novel highly infectious variant.

The Omicron variant is spreading fast, but no one knows if it will be worse than we we are currently dealing with from Delta. It seems like triple-vaxxed people are not at high risk, from preliminary data. That is reassuring to me personally. Thank you South Africa for being fast and sharing data with the world. For communities with low vaccination rates, it seems certain that more deaths will result from fast-traveling Omicron. Yet, from my reading this week, it is hard to know if it’s really much worse than what they are currently experiencing from Delta.

I’m keeping a Twitter thread going of what other people are saying. Caleb Watney points out that we have two things going for us. Widely available vaccines keep people safer from infection and reduces the chance of needing medical treatment. Secondly, we have gotten better at treating the disease. Together, that should mean less deaths in January 2022, as long as people seek treatment quickly and hospital capacity does not become a limiting factor. Omicron could multiply cases so quickly that we can’t apply all our best treatments to everyone. That is the biggest reason to worry.

Even though people will be less cautious about winter holiday travel this year than they were last year, the country has been open for many months now, including the recent Thanksgiving holiday. The vulnerable population this time should be smaller, in terms of the people likely to die from Omicron.

To say that we won’t blindly exactly repeat the biggest mortality event of my lifetime is not “optimism”. It seems like this January will not be as bad as last January for the reason Watney states: better medical tech on hand, most importantly vaccines for prevention.

Continue reading

If Tyler is talking about a new variant…

For some Americans, this Thanksgiving was the first holiday that felt normal in a long time. Being re-united, without Covid restrictions, is something to celebrate.

On the other hand, a new coronavirus variant was just discovered in South Africa. It’s scary enough that travel bans might be imposed. We have all (just about) learned to live with the original strain from Wuhan, but scientists want time to figure out how dangerous and infectious this new strain is. Maybe at this point people are tired of being lectured about risks. No matter how much or little a person sacrificed for Covid-19, they might feel like that storyline has become too boring to deserve any more of our attention. We cannot stop looking out for new variants that might force us to put cherished traditions on hold again. Coronaviruses kill. My advice is to keep following news from Tyler Cowen, Alex Tabarrok, and Emily Oster.

Oster has been consistently reasonable about family and health risks. She argued to open schools and essentially said that you can see grandparents if the risk is small enough (even though the risks are never zero). As I said before, another trustworthy source of information throughout the pandemic has been Tyler and Alex, who put up almost all of their material in real time at Marginal Revolution.

I’ll share something a friend wrote to me today:

Although [his wife’s name]’s chemo treatment continues to show good long-term signs, this morning we discovered that [she] tested positive for COVID. That’s bad news, the good news is that [she] is already getting the antibody treatment and some extra fluids at the hospital as I write this.

“The antibody treatment” did not exist when the first Covid-19 waves swept through New York with such devastating consequences.

If the newest strain turns out to be a serious development, then in many ways we are better prepared to deal with it than we were before. We probably will blow through the red tape on at-home rapid tests faster the next time around (I’m such an optimist!). We already have contact tracing apps that protect privacy. Vaccine scheduling software is already in place. Everyone has masks at home.

The biggest difficulty I foresee is not coming up with scientific solutions but agreeing as a society about which tools to use. Some people might (will) not even believe the new strain is real.

EWED was started right at the moment when Marginal Revolution commentary on Covid seemed the most crucial. So, sometimes I will do little more here than keep up the echo. Do tweets, phone calls, letters, blogs, or talk about Covid around the Thanksgiving table. Don’t give up.

It’s now clear, whether or not the news out of South Africa turns out to be serious, that we are living with a new problem that will last a long time. It’s a marathon, not a sprint.

If you ever read much of the New Testament, you’ll see a theme in the letters of Paul to cities he has visited. The brand-new churches were doing well, while he was with them in person. Then time goes by and the community or doctrine starts to fray.

Paul wrote these words to the church in Galatia, more than a year after he had visited them:

Let us not become weary in doing good, for at the proper time we will reap a harvest if we do not give up. 

Galatians 6:9
Continue reading

Alex Madrigal’s Atlantic Article on Testing Positive for COVID, and Pushbacks

A friend just texted me a link to an article by Alex Madrigal that came out yesterday in The Atlantic. Madrigal described how he made a last-minute decision to attend a wedding and associated gatherings in New Orleans. He knew there would be non-zero risk of infection, of course, but he had been fully vaccinated and he had reason to believe that essentially everyone else at the festivities was likewise vaccinated.  Madrigal had helped to assemble and lead a consortium of journalists who gathered and published COVID data in the early months of the pandemic, before officialdom got its act together on reporting good numbers, so he is well-acquainted with the math of this disease.

He had been seeing maskless people laughing and chatting  in restaurants, and he really liked New Orleans, and he wanted to support his friend who was getting married, and he wanted to enjoy some return to good old normal good times. So, he went and he mingled. Liquor flowed and happy chatter filled the air. And then he flew home.

He has a wife and two children, so to be on the safe side, upon his return he took no less than three PCR antigen tests, a day or so apart. All came back negative, even the one four days after the wedding. He did develop some cold symptoms, and upon his wife’s request, did one more swab at home on the fifth day. That was unmistakably positive, as was a follow-up test.

What followed was a nontrivial amount of inconvenience – – he went and  lived in a rental apart from his family for at least ten days, his kids got pulled out of school, and he worried that if he had passed it to them, they in turn would need to quarantine. He is 39 and in top physical condition, and was vaccinated, so his course of illness was just that of a nasty cold, but that was still not fun. For him the most poignant aspect was the reaction of his two children:

My nonbinary 8-year-old was so mad and maybe so scared that they could barely look at me. My 5-year-old daughter proved her status as the ultimate ride-or-die kid. She brought a chair down the street so she could sit 20 feet away from me outside in her mask, as I sat on the porch in an N95. I’m not sure which reaction was more heartbreaking. It was as if one never wanted to see me again and the other didn’t want to let me out of her sight.

He wrote all this up in “ Getting Back to Normal Is Only Possible Until You Test Positive “. The concluding lines echo the title, “Right now most policies appear designed to make life seem normal. Masks are coming off. Restaurants are dining in. Planes are full. Offices are calling. But don’t be fooled: The world’s normal only until you test positive.”

My reaction, which I’d like to think would be a common reaction to this piece, is sympathy for the hassle that he and his family have been through, and appreciation for this reality check: the newer variants of COVID multiply so fast that you can get sick and spread the disease, even if you have been vaccinated. You probably won’t die, but getting infected could be very uncomfortable and inconvenient. At the macro level, some activities may never get fully back to pre-2020 levels, and on the personal level we should keep all this in mind before entering a room with lots of talking (or singing) unmasked people. In the U.S. there are still a thousand people dying every day from this communicable disease, and Europe is getting hit hard. I guess we all have pandemic fatigue, but a thousand deaths at a pop used to be considered a lot.

That would be a fine observation with which to end this blog post. But I will throw in one other observation: the internet is a pretty harsh place, and Madrigal’s article spawned at least two fairly ascerbic pushback articles.  Claire Carusillo at gawker.com (which I know nothing about), in Alexis Madrigal: I Can’t Believe I, a Really Good Person, Got Covid , takes multiple jabs:

Alexis C. Madrigal, a columnist for The Atlantic and a cofounder of the COVID tracking project, got a mild breakthrough COVID case at a destination wedding in New Orleans. Instead of just going to bed for two weeks like a normal person, he wrote an essay about it wherein the only thing he makes clearer than his dedication to his workout routine is how he believes his story is a horrifying parable for our time.

It isn’t. It’s an unremarkable story from a public health perspective, though Madrigal’s inclusion of specific details make this piece a fascinating study of what it’s like to be an American man with a certain level of privilege who also just so happens to have a huge platform and a deadline to meet. Social distancing, it seems, has inflamed his out-of-touchness with what most people have endured over the course of the last 20 months.

… You may be thinking, spending a few childcare-light days at an Airbnb on your own block with a mild throat “tickle” that does not prevent you from either doing Peloton workouts or writing an essay for The Atlantic does not sound that bad. In fact, you may think it sounds a lot better than the trips I have taken to the Bay Area, particularly the family vacation we took to Alcatraz when I was nine. Either way, how dare you?

Ouch.

Tiana Lowe at the Washington Examiner blames Madrigal’s fear-mongering for his kids’ reactions to his plight, in her article If your nonbinary 8-year-old gets mad at you for getting COVID, tell them to grow up :

Over at the Atlantic, Alexis Madrigal engages in some light sadism, dedicating thousands of words to flagellating himself for the great sin of contracting the coronavirus….. He got a mild breakthrough case of coronavirus. But because the vaccines work well, he made a full recovery shortly thereafter.

….Children these days have dramatically calmed down from the bad behavior of the ’80s. This has brought with it the blessing of far fewer pregnancies and underaged smokers. But helicopter parenting, even before the pandemic, produced a significant cohort of children far, far too cautious and not nearly socialized well enough for adulthood. The share of teenagers who have ever had a job, gotten their driver’s license, or gone on a date, all previously the major milestones of young adulthood, has plummeted, and now we’re adding COVIDiocy to that trend?

An 8-year-old capable of making a parent abide by their preferred gender identity is probably also capable of bullying said parent out of having a normal social life. But the real fault belongs to the parent who would let a child live in such fear and fall so deeply into coronavirus delusions.

A virus for which we now have three vaccines and several new, inexpensive treatments does not provide any reason to stop living life to the fullest. To fail to explain this to children is the kindness of cowardice — or even cruelty masquerading as kindness.

Again, ouch. I think the two pushback articles make some valid points, particularly Lowe’s observations on helicopter parenting in general, and it does seem like the Madrigals’ kids had been given overly inflated fears about their dad’s prospects. That said, we need more in the way of civil discourse. The abrasive tone of these reactionary articles says more about their authors’ attempts to garner clicks than about Madrigal’s original earnest cautionary tale. It is a jungle out there.

Forecasting that Job Growth Would Continue

The number of new jobs is being heralded (example in picture) as disappointing relative to the expectation that we would march steadily back to pre-Covid employment levels. (Ben Casselman is a good Twitter source for the data.)

One of the reasons for a slow recovery is that the Delta variant of Covid hit hard at the end of the summer and people are not getting vaccinated, so the health threat of going out to work and consume did not decline as much as we had expected. Covid was hard on family caregivers, often women. The disruptions to childcare from Covid still are not over. We are seeing a reversal of the massive influx of women into the formal workforce that started in the previous century.

Some people are saying that workers no longer want “dead end jobs,” and there has been a permanent shift in the labor supply, although it is hard to disentangle that from the effect of temporary Covid subsidies.

I am reminded of two very different sources who claimed, before 2019, that what we had in the early 21st century was not sustainable.

First, there were agitators for a $15/hr minimum wage. They marched in the streets while leading Democrats voiced approval. They were pointing out that families in America who depend on $8/hr jobs do not feel like they have a part of the American Dream.

Someone who, I am certain, would be against a federally mandated $15/hr minimum wage was also pointing this out. Tyler Cowen published Average is Over in 2013, when unemployment was still high following the Great Recession. Chapter 1 of Average is Over is called “Work and Wages”. Tyler was concerned that market forces were creating a world where some people have the best jobs that humanity has ever conceived of, by virtue of their compatibility with intelligent machines, while the rest of the workforce is left with jobs that are not so great. At the time, I don’t think people realized how many jobs could be done from the comfort of home or from a hip coffee shop. Covid exposed that. The “not so great” jobs feel especially crappy when you know that people in your city get paid 6 figures to sit at a laptop.

Tyler might have been surprised when unemployment dropped so low in 2019, right after he had written The Complacent Class, which warns us that America isn’t working well for a large group of people.

We are not great at predicting the future.* Some of Tyler’s predictions have come true already, but even he did not try to put a date on things. The point is that maybe the latest job numbers are not as surprising for the reason that the forecasts were more wrong than we thought. Covid has moved us far out of equilibrium, so it is still hard to tell where we are going to land.

Personally, I thought prices at the grocery store, one of the few places you could go in early 2020, would shoot up faster. It seemed to me like we would need to start paying cashiers more as hazard pay.

*In one of my experiments, I asked subjects in the role of employers to predict what their employees would do. They failed to predict how strongly employees would respond to wage cuts. We are not great at predicting.

The high cost of day care and demographics

When I moved half-way across the country to take a new job, I had no local support system for my 2-year-old. Putting him in a full-time day care was the plan. I wanted a day care center with a good reputation that is located near work and home. My story, like so many others, includes phone calls and long wait lists. At first, it was hard to understand how I could be willing to pay for a service and it could just not exist.

Opening a large daycare center is risky. Who wants to take that risk? I joked that I’d quit my professor gig and start a daycare in response to the huge demand. Of course, I did not. Fortunately, I don’t live in one of the American counties that lost population over the past ten years.

The WSJ on demographics describes this situation in a shrinking county:

In Lincoln County, Kan., pop. 2,986, about 40 miles west of Salina, Kan., economic development director Kelly Gourley set out to build the county’s first day-care center not run out of someone’s home. A child-care shortage was making it difficult to work and raise children, she saw. The town’s handful of in-home daycares were the only options, and they tended to come and go.

Ms. Gourley estimated it could cost as much as a half-million dollars to build the facility, and she didn’t think it could weather fluctuations in demand. “In a rural community, you lose one kid and you might be in the red all the sudden,” she said. She shelved the plan and instead is working to increase the supply of in-home caretakers.

Allison Johnson, a 32-year-old nursing home speech pathologist, grew up in Lincoln County and hoped one day to have three children. She no longer thinks that is feasible after she had to wait a year to get an in-home daycare spot when her first child was born. Now she and her husband, who owns a residential-construction business, are trying to figure out how they would juggle having a second child.

Her father, a farmer, watches her son, now 2, when her in-home daycare provider isn’t available. But he and her brother are in their busy season, and “they’re not going to be able to do anything but throw him in the tractor.”

There are attractive economies of scale for day-care centers. This economic fact is part of the reason that young people are leaving rural areas, which in turn makes it harder for rural areas to support services for young families.

There has always been a huge amount of value created at home within families that is not fully captured by GDP. As more childcare is moving to the formal market, we are starting to see just how valuable those services are that used to be provided in the family.

Whatever your views on the matter, it’s not surprising that politicians are talking about subsidized day care.

Allowing for flexibility through policy moves like vouchers and de-regulating in-home daycares is important. Some communities can’t support a day-care center facility, like the one in this article. I think the if you build it they will come philosophy, if applied too widely, would be hugely expensive and not efficient. On the other hand, there could be situations in which more day care would be provided if the local government would take on some of the risk currently faced by entrepreneurs.

Covid, Cars, China, Crypto, Corruption

We generally do long “effort posts” on specific topics here, but today I’m mixing things up with 5 quick updates.

  1. Covid My daughter got sent home with a cough Tuesday, which meant I cancelled classes Wednesday to hang out with her until we get a Covid-negative PCR. Last Thursday my son’s public school was closed for Yom Kippur, and I got so focused on hanging out with him I forgot to post here.
  2. Cars My wife bought a new used car last week. We’ve covered here how car prices have jumped up while inventories fell this summer, and the latest numbers show that used car prices are now falling slightly from very high levels while new car prices continue to rise. While actually buying a car, the low inventories stood out even more than the high prices. Several times we saw a promising car online, only to call or visit the dealer and find out it had sold the day before. The new Nissan Leaf sounds like an excellent value at its sticker price, but none were available in Rhode Island, and no blue ones anywhere in New England.
  3. China Scott covered the collapsing Chinese real estate market on Tuesday. I’ll just pass along the takes I’ve seen from Western economists and China-watchers Michael Pettis and Christopher Balding, which is that this is a big deal that will slow Chinese growth for years but is unlikely to precipitate a 2007-style financial crisis. I find Balding’s argument that financial contagion will be limited to be convincing partly because of his actual arguments about quasi-bailouts, and partly because he almost always argues that “things in China are worse than you think”, so if he says “Evergrande isn’t Lehman Brothers” I listen.
  4. Crypto Tuesday I met the co-founder of a new crypto-based prediction market, Melange, which sounds promising. The prediction market space is growing rapidly with PolyMarket and Kalshi joining the older PredictIt.
  5. Corruption Last week the World Bank announced it is discontinuing the Doing Business report/ranking due to apparent corruption; top Bank officials in the middle of raising money from countries including China pushed to raise the rankings of those countries beyond what the data justified. I hope another organization steps up do continue the good parts of the Doing Business report in a more trustworthy way.

The War of Ideas Isn’t Over

I have spent some of the last week educating myself about Afghanistan. You might ask where I was back when the US had a strategic advantage. I now regret the time spent at the paint store squinting at 200 different shades of white. Here’s an idea: America gets only 20 paint colors until we achieve our foreign policy objectives. 40? All I know is that we are past the optimal number of shades of white, considering what just happened.

A lot of the “takes” in the past week have been on the subject of blame. Despite the fact that American lives are still at risk in Afghanistan, this has not been a unifying event, like 9/11 was.

Are we picking our battles in such a way that helps vulnerable people? Any energy spent fighting your enemy B is a resource you cannot use to fight enemy C. Incidentally, that is one of the points that President Biden made in his speech on August 16th. There is an opportunity cost to mean tweets.

I reached out to a veteran friend of mine for insight last week. This is part of what he told me:

Biggest mistake is looking at Afghanistan as a single cohesive entity. It isn’t. There is no national identity. The Kyrgyz, Uzbeks, and Kazaks of the north … Karzai was a Pashtun and always ensured the main leadership roles were Pashtun.

He said that there are sub-units of Afghan people opposed to the Taliban who are upset by the advance we all witnessed to Kabul. Divided people lose, and then they don’t have the capacity to help others.

There was a time when the Taliban were few in numbers and hanging on the fringes. One advantage they had is that they went with the “legalize it, tax it” drug policy. Farmers under their jurisdiction can grow opium poppy and pay the Taliban a fee. In the American sphere of influence, we were fighting against the laws of supply and demand. The American public is not the only destination market for illicit opioids, but it’s a big one. It’s pretty self-defeating to ask our security forces to fight against drugs when most Americans can’t be bothered about them.

Consider the movie Little Miss Sunshine, a beloved American comedy. Consider the grandpa. He’s not a perfect man. He has his little vices, like dropping F-bombs in front of his young granddaughter. And, he snorts heroin. It’s easy to imagine what a great rapport he has with his dealer. No one would report his behavior to the police.* The drug habit is not portrayed as a virtuous thing, but overall he’s a sympathetic figure.

There is a lot of muddled thinking in our society when it comes to drugs. The bill comes due.

Humans are very creative. The good news is that we could have more discussions about drugs and experiment with new policies. It’s not inevitable that laws regarding drugs will be the same next year, but there is a lot of inertia that needs to be overcome. A society where celebrities joke openly about doing illegal drugs is not going to also be a society that can effectively “reshape the world in its image”, to quote Tyler.  

Tyler’s point is that this unfavorable outcome was not inevitable. From responses I read, many people offering opinions on Tyler’s article did not read past the headline. Nuance can’t be conveyed in a headline or a tweet. Tweet culture is a handicap right now, at a time when good complete ideas are badly needed. What happened in Afghanistan was complex. A tweet might be long enough to say what you would like to see happen, but it’s not long enough to help anyone.

The same Americans who tweet that they want refugees to live somewhere safe won’t go to a city council meeting and argue in favor of building high-density housing in their neighborhood. The same Americans who have tweeted that they hope the Taliban will build an “inclusive” society…

If you take the view that the failure in Afghanistan was inevitable, then Matt Y ’s explainer is ungated and helpful. There is also a lone voice saying that 20 years of “jail” had value.

If indeed this is a major crisis, then we are showing a lack of awareness when it comes to media. Some Americans alive today might not know about the role of media in fighting Nazis. Here is a fun read about that. In addition to WWII-era Brits, the Taliban are also strategic with media.

Considering that this is partly a war of ideas, I don’t know if taking Kabul so fast will look strategic in hindsight. There is much still to be determined. Had the Taliban consolidated power more incrementally, they would have been able to control the images that got out.

Here’s one image I won’t forget:

On the assumption that 20 times more people saw the image than liked it, this picture has been seen by well over 2 million people. Imagine how those girls’ lives have changed. “they are now with the Marines.” The entire world is breathlessly watching the airlift, and any abuses by the Taliban are headline news.

The media you choose to consume shapes the world around you. Every click is a vote for the kind of world you want. The war of ideas continues.

James Bailey here on information consumption (not on Afghanistan)

*It’s nothing glamorous or entertaining, but this is one approach to opioid use. As more parents lose children to fentanyl overdoses, more civic action is happening which generates publicity. Deaths from opioids increased rapidly after 2010. Little Miss Sunshine came out in 2006, so perhaps if it were made today they wouldn’t have taken such a cavalier approach to heroin.

Self interest and self care

“Self care” is all the rage. It’s heralded as a novel and progressive notion.

The stance one takes on Simone Biles is largely colored by one’s theory of self care.

So, as Biles occupies the headlines for days, why isn’t more credit going to Adam Smith and his intellectual descendants? “Self interest” was condemned, yet here we are in 2021 with “self care”!

James had a similar post yesterday! He went back in history much further than Adam Smith.

The Question of When to Act

The collapsed condo building in Florida has been in the headlines for days. Two recent reports come from USA Today and the WSJ.

This is a tragedy that will be associated with many deaths. A steady decay in the concrete structure appears to the be the cause, although there is no professional consensus on the reason for the sudden collapse (see WSJ).

In 2018, an engineering firm recommended repairs in a report. Every 40 years, a building like that needs to be re-certified, and the tower happened to be 40 years old when it collapsed. The recommended repairs had not started.

According to USA Today, a letter circulated in April 2021 (two months before the collapse) warned condo residents that expensive repairs were necessary. Meetings were being held. The condo board was gathering information from engineers and lawyers.

A line from the letter is chilling (see USA Today):

We have discussed, debated, and argued for years now, and will continue to do so for years to come as different items come into play.

Continue reading