Racial Gaps and Data Gaps

Are there racial gaps in the distribution of the COVID-19 vaccine? This is an important and interesting question in its own right. But I’ll talk about this question today because it’s an interesting example of how confusing and sometimes misleading data can be.

How do we answer this question? One is by surveying people. There are a number of surveys that ask this question, but a recent one by the Kaiser Family Foundation finds that among adults 70% of Blacks and 71% of Whites report being vaccinated. And given the sampling error possible with surveys, we would say that these are virtually identical. No racial gap! (Note: there was a racial gap when they did the same survey back in April, with 66% of Whites and 59% of Blacks vaccinated.)

But, surveys are just a sample, and perhaps people are lying. Maybe we shouldn’t trust surveys! And shouldn’t there be hard data on vaccines? Indeed, the CDC does publish data on vaccinations by race. That data shows a fairly large gap: 42.3% of Whites and only 36.6% of Blacks vaccinated. This is for at least one dose, and the percentages are of the total population (which is why it’s lower than the survey data). So maybe there is a racial gap after all!

But wait, if you look closely at the footnotes (always read the footnotes!), you’ll see something curious: the CDC admits that the race data are only available for 65.8% of the data. We don’t have the race information for over one-third of those in this data. Yikes! And given the exist disparities we know about in terms of income and access to healthcare, we might suspect that the errors are not randomly distributed. In other words, if there is probably good reason to suspect that Blacks are disproportionately reflected in the “unknown” category. But we just don’t know.

So what can we do? Since this data comes from US states, we can look at the individual state data and see if perhaps some of it is better (fewer unknowns). What does that data show us?

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Delta: Danger is Rising, but 2021 is not 2020

Covid cases are rising rapidly in the US thanks to the more contagious delta variant.

Based on the experience of 2020, this has many states, cities, and organizations considering a return to mask mandates and shutdowns. But our situation in the US has changed substantially since 2020 as we now have better knowledge, better masks, and above all abundant vaccines.

We can see this difference clearly when looking at countries hit by the Delta wave before us. It first devastated India, where less than 10% of the population was fully vaccinated, officially killing 400,000 people and unofficially perhaps 10 times that. In constrast the UK, where more than half the population was fully vaccinated, saw a major spike in cases that did not translate into a major spike in deaths:

The delta waves seem to come and go quickly, with cases rising more rapidly than previous waves, but also falling rapidly 6-8 weeks after they began to rise in India, the UK, and the Netherlands. Cases began rising in the US at the beginning of July, so if this pattern holds we have about 2-4 more weeks of rising cases before a rapid drop.

My worry is that a spike in cases just before the school year will lead schools to shut down just as the danger begins to recede, and when vaccines mean the danger was never as great as in previous waves. Externality-based arguments for shutdowns and mask mandates are now substantially less valid than in 2020 but I don’t know that policymakers have internalized this. The Biden admin actually does seem to get it, calling this a “pandemic of the unvaccinated“- i.e., if you’re worried, get vaccinated, and if other people don’t, that’s their problem. Even with delta the vaccines reduce covid’s danger to you by ~10x, and so also reduce the protection you gain from controlling others by ~10x.

The situation with masks has also changed. Cloth masks have limited effectiveness in protecting you from others, but decent effectiveness in protecting others from you, which meant there was a strong externality-based case for mask mandates. But now in 2021 high-quality KN-95 and even N-95 masks are easily available, and unlike cloth masks they offer excellent protection FROM others, as well as FOR others. Anyone who is vaccinated and wearing an N-95 really has nothing to worry about anymore, and little reason to force masks onto others.

The main externality-based arguments that could still work are for vaccine mandates and for restrictions in areas where hospitals are overwhelmed by unvaccinated Covid patients in a way that substantially worsens care for non-Covid patients. But outside of areas with low vaccination rates leading to overwhelmed hospitals, I no longer see a good case to impose mask requirements or restrictions on movement or events.

According to one set of projections, by the end of August adult ICUs (though not hospitals overall) will be over capacity in most low-vaccination states:

If you want to wear a mask and avoid crowds, you can, and in fact probably should do at least one of those during the Delta wave of the next month. But the externality-based case for restrictions is mostly gone, and governments would do better to focus on continuing vaccine rollout in the US and ensuring vaccines are available worldwide to help other countries and to prevent more variants from emerging and finding their way here. Personally I’m glad that my employer has a vaccine mandate but, at least currently, no mask mandate. For those who do still want Covid restrictions I ask- what are you waiting for? What event or number would make you say “ok, now we can go back to normal”? When do you expect that to happen? For me, what I was waiting for was vaccines available for everyone and now, at least in the US, we are lucky to have that.

Vaccine Innovation: A Marvel of Modern Science and Modern Markets

We’ve already talked about different methods for distributing the vaccine in the face of limited supply on this blog (see my post and Doug Norton’s post). But today I want to talk about something different: the speed at which this vaccine was developed. It is truly amazing.

Timeline showing a comparison of vaccine development timescales from Typhoid fever in 1880 to SARS-CoV2 in 2020.

This chart from Nature (adapted from the fantastic Our World in Data) dramatically shows just how quickly the COVID-19 vaccine was developed compared with past vaccines. What used to take decades or even a century was done in mere months (yes, even with all the regulatory barriers today).

Exactly how we developed this vaccine so quickly is a complex story that involves the advanced state of modern science, incentives offered by concerned governments, and the harnessing of the profit motive to advance the public good. We don’t know all the details yet, and likely won’t for a long time since, like a pencil, no one person knows how to make and distribute a vaccine.

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Allocating the vaccines: central planning or the free market?

In the short term, there are only a few million doses of the COVID vaccines available, but well over 100 million adults in the US that want to take the vaccine if offered for free to the consumer. There are also billions worldwide that would like the vaccine.

So who should get it first? In practice in the US, the allocation method has already been determined politically: the federal government will allocate vaccines to the states, and states will allocate them to individuals based on a priority list: health workers and the most vulnerable first, then teachers, etc. The NY Times has a tool that shows you your probable place in line.

But essentially the allocation method being used is central planning.

John Cochrane has proposed a “free market” solution: sell the vaccine to the highest bidder. Or at least, sell some doses to the highest bidder.

As an economist, there is always some appeal in thinking about a free market solution. But there is a problem in this case: there are positive externalities from taking the vaccine. It not only benefits me, but it also benefits others. My willingness to pay only reflects the benefit to me, the private benefit. The social benefit is mostly ignored by a simple auction, and in the aggregate for a vaccine most of the benefits are likely to be social benefits. But positive externalities don’t imply we need to use central planning!

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