Sunday, May 10, 2020

Burning Down the World to Save It

Is the total lockdown of society during the Covid-19 pandemic necessary?  What if the same public health benefits could be achieved with more limited lockdown?  The National Bureau of Economic Research asked and answered that very question in a working paper published last week.  The Bureau determined sheltering only the elderly would jump-start the economy while saving almost as many lives as the total lockdown models currently used.

The paper studied the effects of various levels of lockdowns on three groups: young (20-44), middle-aged (45-65), and old (>65).  The 39-page paper is posted below.  Some highlights of the paper are:

* "optimal uniform policies involve long lockdowns in order to keep the infection rate low. Despite these aggressive lockdowns, total fatalities reach 1.83% of the population and economic losses amount to 23.4% of one year’s GDP.  In contrast, targeted policies can significantly improve both on public health and economic outcomes. Interestingly, we find that semi-targeted policies that simply apply a strict lockdown on the oldest group can achieve the majority of the gains from fully-targeted policies. For example, a semi-targeted policy that involves the lockdown of those above 65 until a vaccine arrives can release the young and middle-aged groups back into the economy much more quickly, and still achieve a much lower fatality rate in the population (just above 1% of the population instead of 1.83% with the optimal uniform policy). This policy also reduces the economic damage from 24.3% to 12.8% of one year’s GDP. The reason is that, once the most vulnerable group is protected, the other groups can be reincorporated into the economy more quickly."  (KF: This is the paper's main conclusion.)

* The paper suggests that targeting could be done by area or industry.

* "our results consistently highlight that targeted policies can improve both public health and economic outcomes with social distancing between groups and testing and isolation of the infected, targeted policies can significantly improve the trade-offs faced by policy-makers."

* The main message from our baseline results in the next subsection is that targeting has a major benefit in terms of both lives saved and reduced economic damage relative to optimal uniform policies, and interestingly, most of this benefit can be achieved with the semi-targeted policies. (KF: Translation: We don't have to lock everyone down.  Targeted lockdowns perform much better than throwing everyone overboard into a lockdown sea, thus saving businesses and jobs.)

* We showed that these conclusions are robust to a range of changes in parameters and the gains from targeted policies can be substantially increased if we also combine them with additional measures to reduce interactions between groups. For example, increasing the “social distance” between the oldest group and the rest of the population—by norms that temporarily reduce visits to older relatives or regulations that segregate the times when different demographic groups can go to grocery stores and pharmacies—can reduce fatalities to as little as 0.6% of the population (as compared to 1.83% in the baseline with uniform policies). Semi-targeted policies combined with identification and isolation of infected individuals can lead to even larger gains.." (p.35)

* P.19-20 are probably the most important pages to read.

* "there are substantial gains from semi-targeting (because we are locking down the most vulnerable subpopulation) and considerably smaller gains from full targeting"

53% of Covid-19 deaths have been nursing home patients.  Such patients comprise 44% of the nursing home deaths in Mississippi.  Mississippians over the age of 70 are two-thirds of all Covid-19 deaths in the state while those over the age of 60 are 88%.  However, those over the age of 60 make up only 30% of Covid-19 cases in Mississippi.

Kingfish note:   Four MIT Economists produced the working paper.  MIT.  That means they are really smart people; smarter than everyone you and I know put together.  The paper uses all sorts of groovy terms such as coefficient, exponent, SIR model, quadratic, and parameterization. It even has pretty graphs.  It is posted below so have at it.   


Anonymous said...

Ben Shapiro recently discussed the same topic on his radio show. Questioning how many people are going to die, regardless of shutting down the economy. He also pointed out that anyone who considers the cost benefit analysis of any policy regarding the coronavirus is vilified. And by cost benefit analysis, he means value of jobs and the economy vs value of human life, relative to a particular policy. Cuomo says that every life is priceless. But with that policy stance, the economy will never reopen. X number of people are going to die. X number of people are going to die from the coronavirus. But does it make sense to destroy our economy to possibly not save many or any lives?

Anonymous said...

So a targeted lockdown with effective contact tracing is the best solution. Good plan. Now how far from contact tracing are we? And what’s the plan when a particular area gets out of control?

Anonymous said...

And of course, the flip side from the same place- the cost of ending measures too soon exacerbates the economic pain.

"From Panel A, we see that abandoning containment initially generates a large recovery with consumption surging by roughly 17 percent. Unfortunately, this surge results in a large rise in infection rates. The latter rise plunges the economy into a second, persistent recession.

So, prematurely abandoning containment brings about a temporary rise in consumption but no long-lasting economic benefits. Tragically, abandonment leads to a substantial rise in the total number of deaths caused by the epidemic.

Panel B shows that the longer policy makers pursue optimal containment policy, the better. Both the temporary gains and the losses of abandoning optimal policy in Panel B are smaller than those in Panel A."

Which is EXACTLY what Tea Party greedsters urge: Hurry UP and let COVID work; gotta try to re elect Trump with SHORT TERM GAIN and LONG TERM PAIN. Making the economy worse long term.

Kingfish said...

There is a different between infection and death or symptoms requiring hospitalization

Anonymous said...

The shelter in place was initially sold to us as "flattening the curve." The curve flattened, but the total numbers of infections were expected to be the same, just spread out over a longer time so as not to overwhelm the hospitals. Those who are vulnerable to Covid will likely die from it now or later, assuming the death isn't due to lack of available care. Keeping the lockdowns in place in most areas will not affect the total death rate.

KaptKangaroo said...

This is the last conversation I really want to engage because of the amount of literature that is being suppressed.

Folks, if you think the "China Way" is the only way to deal with a pandemic, then you are willing to subjugate the best minds of the US.

There are targeted approaches outlined in this paper and also, previous "expert" approaches to dealing with a virus we are better prepared to model.

The initial models were based on prior viruses. The prior models used and R0 that fit a perfect curve. The models did not factor specific populations. The prior models quickly failed in predictive analysis globally.

The fact is, we overestimated the impact based on history. History does not apply to this virus. History simply gave us a solution to deal with "a virus". China Virus, interestingly enough, targets populations; most folks affected had severe underlying conditions or were in an environment where late addressing of symptoms led quickly to drastic measures.

Fear is a powerful thing. Politics is a dangerous game. Combining the two with a pandemic does not allow for cooler heads to prevail. It results in stupid panic.

Don't panic.

KaptKangaroo said...

Contact tracing is unconstitutional. It should never be an alternative to being smart when you are sick and staying home.

KaptKangaroo said...

May 10, 2020 at 4:57 PM

There is data emerging on the "herd mentality" of immunity. Don't go politicizing and waste a good idea with your hate of Trump.

KaptKangaroo said...

I'm hearing out of DC the pandemic is crashing into summer. Stop the fear folks.

KaptKangaroo said...

Don't get me started with the #s. The fact is, influenza and influenza pneumonia, ONLY counts these two conditions. NO OTHER UNDERLYING CONDITIONS like heart failure, kidney failure, cancer, yada, yada, yada... goes into the calculation of the efficacy of this virus in terms of death.

Stop the panic and stop the politics of this. The fact is the virus is deadly, just like plague, flu, the common cold (Coronavirus), hanta-virus...

KaptKangaroo said...

Bring it.

Anonymous said...

"Four MIT Economists produced the working paper. MIT. That means they are really smart people; smarter than everyone you and I know put together."

I can hardly wait until the Trumpsters among JJ's readers find out a little about Daron Acemoglu's politics and feelings about their hero. Acemoglu is a very well-educated, often-quoted guy and while he's intelligent, he is far from the smartest person I know (but since I try not to associate with idiots, I know a fair number of pretty smart people). That aside, I wonder if any of the four go to other economists or just mere mortal doctors when they or their families need medical attention?

Phillip Ley MD FACS said...

The Kaptain is correct. Many employers have experienced and described "desired unemployment" among the workforce, and the devastation of small businesses, has been my biggest concern with an absolutely IDIOTIC (or, on the other hand, cold and calculated) response to this problem. The political realm has been largely cold and calculated at higher levels, and, in most places, a complete fiasco at state, local, and personal ones. The masks have all come down and we have seen all the petty tyrants, informants, enforcers AND all of those who are noncompliant with basic measures used in other nations that did not lock down, and whose behavior enabled those first described. I have come away from this affirming my wholly negative opinion of government in general as overbearing and ineffectual, and of people as a divided group of mostly good, kind and rational and a larger cadre that's selfish, narcissistic, functionally illiterate, envious and spineless.

There's not enough medication to relieve my nausea and revulsion of the entire situation.


Anonymous said...

"they are really smart people; smarter than everyone you and I know put together."

Clearly Kingfish and I do not know the same people, and clearly he doesn't know about those people I know.

Anonymous said...

" Fear is a powerful thing. Politics is a dangerous game. Combining the two with a pandemic does not allow for cooler heads to prevail. It results in stupid panic:" .

Very well said.

After going on three months now, panic buying contines at an unprecedented rate.
This virus is damn sure for real. Hell, I've had three friends die as a result of Covid.

None of them were in a high risk category to my knowledge.
God help their familes !

At the same time, I can't keep up with the number of friends that have lost their jobs.
I don't know what the answer may be.

( Die of the Chinese Flu . . . or by starvation from our Government shutting down the Economy).

KaptKangaroo said...

May 10, 2020 at 6:20 PM

Given the fact most family medical practices are hit as hard as the rest of your thoughtfulness around hourly wage workers; and your holier than thou, but I order takeout, and support wearing a mask, and I'm washing my hands while touching everything in sight...

You bore reality.

The fact is, this is a problem with a solution. Wearing masks, social distancing, sitting in your house, doing nothing... It is not a solution. Why don't you just advocate Mrs. Mary to weld locks on all the doors of Madison? Maybe Chokwe Jr. can give you assurances with no one showing a gun while it is absolutely legal to conceal one without a license.

It amazes me the foolishness of the left. There is nothing rooted in reality. It is simply an attempt at superiority EVERY SINGLE TIME. And it is always wrong.

KaptKangaroo said...

Dr. Ley,

I am a fan. Thank you.


KaptKangaroo said...

I'm going to delve into a OT thread on the fact we are facing Socialism as an experiment...

Not by design, but by necessity. The reality in DC is the USG is being turned upside down. The best laid plans are now unravelling, they are being destroyed. Allowing the USG to head down the path of convenience for those who are in power assisted by a media with access and gratitude ($), leaves the People with no response, no recourse.

Today, it does not matter if you are a lawyer, a doctor, a warehouse worker, a burger flipper, a field hand...

We are all facing a stark choice.

We are either for the freedom to associate with those who are smart enough to avoid a plague or we are willing to accept what we are told without true questioning.

When are we, as the silent majority, going to speak? When are we going to do the right thing?

It is right in front of every single one of us. We are The People. We are those who raise families in our communities, school our children, assist and support our neighbors; rich, poor, left, right, independent, (I take issue with socialists and communists)... it does not matter. This is a philosophical issue we all face as Americans.

We have a larger choice to make at this point in history.

I'm going to take the road less travelled.

Anonymous said...

Roses are red
Violets are blue
Coronavirus is a conspiracy by the CCP to crash the world’s economy

Anonymous said...

The Kaptain has apparently ran out of tin foil hats.

Anonymous said...

KF: I think all these layer of GOVT. have really learned their lesson. Don't shut down the hand that feeds you.

Anonymous said...

👍👍 for Dr. Ley

KaptKangaroo said...

May 10, 2020 at 9:20 PM
May 10, 2020 at 9:23 PM

Is that all you have? I wish only the best for you. If you believe sitting at home, doing nothing, collecting a check is best for you, please stay at home. I do not want you harming or coming into contact with harm outside your safe space.

Oh, please wear a fucking mask while you do it, eh? Never sacrifice safety.

Anonymous said...

Dr. Ley - post more, please.

I'd love to see an op-ed in the Clarion-Ledger or the Northside Sun.

Let's get the conversation started, so we will know more when the Virus takes off again in October-November.

Anonymous said...

In regards to a cost/benefit analysis based on the value of human lives, I recall that post-Katrina the levees in New Orleans were being designed to withstand a Category 3 hurricane as the cost/benefit of human lives didn't justify anything above that. Also, watch Michael Moore's latest film-"The Planet of the Humans", as it showcases the real cause of many of today's situations-too many damned people. And I'm a staunch Ronald Reagan Republican, which, sadly, is another endangered species.

Anonymous said...

@5:52 That depends on the development of a vaccine or effective treatment. Both are showing promise with multiple vaccines progressing to initial human trials and drugs like Remdesivir reducing the seriousness of cases. The death rate will drop dramatically once those measures are implemented, but only for those that survive until then. It isn’t an all-or-nothing choice. We need to find the balance where the economy is as productive as possible while still containing the spread as much as possible.

Anonymous said...

This is one of the many reasons why there should be class action lawsuits against Bill Gates for this. It was his flawed model, it was his expertise, he stands to benefit financially, he has caused harm, and people deserve to be made whole.

Anonymous said...

Not a doctor, lawyer or politician- just someone who employs 235 workers from salaried, hourly, commissioned and part time.
I estimate that these employs ( many are younger) have around 300 dependents. To date I have heard of 4 that exhibit symptoms and two of these required medical attention. 40 or so are still being paid at any rate. No one is being paid fully. I likely will close 3-4 locations that were not producing at a high margin, the has a landlord that is inflexible or that local govts have proven tyrannical. Those are the facts on the ground.

Typically during flu season we would have anywhere from 5-10% of employs infected. The average days off from illness only averages to 1.62 days. However, during these illnesses others fill in and total loss of work hours per employ doesn’t even avg a half day. During the wuhan flu paid hours are down between 85-90%. This is hard to justify when only 2/435 have received medical attention.

Anonymous said...

Some more easy bathroom reading:
1976: President Gerald Ford orders a nationwide vaccination program to prevent a swine-flu epidemic.

Ford was acting on the advice of medical experts, who believed they were dealing with a virus potentially as deadly as the one that caused the 1918 Spanish influenza pandemic.

The virus surfaced in February at Fort Dix, New Jersey, where 19-year-old Pvt. David Lewis told his drill instructor that he felt tired and weak, although not sick enough to skip a training hike. Lewis was dead with 24 hours.

The autopsy revealed that Lewis had been killed by "swine flu," an influenza virus originating in pigs. By then several other soldiers had been hospitalized with symptoms. Government doctors became alarmed when they discovered that at least 500 soldiers on the base were infected without becoming ill.

It recalled 1918, when infected soldiers returning from the trenches of World War I triggered a contagion that spread quickly around the world, killing at least 20 million people. Fearing another plague, the nation's health officials urged Ford to authorize a mass inoculation program aimed at reaching every man, woman and child. He did, to the tune of $135 million ($500 million in today's money).

I remember getting paid relatively good money for administering the swine-flu injection with an injector gun in an assembly line type manner. Was at the George Washington University School of Medicine and Health Sciences at the time.

Anonymous said...

OR, government could have done NOTHING. We would have been far better-off, had government done absolutely NOTHING (about the supposed "crisis" under discussion). We would be better-off, if government, in the future, would do NOTHING about Coronavirus.

I doubt that anyone will have made it to this post. Between Captain Kangaroo's flurry of largely-inane posts, and posts by the Medical Industry's paid trolls attempting to silence and ridicule him, most people probably have given up, by now, and stopped reading.

Rational and competent analyses of the current pandemic, reveal that the current pandemic is not substantially worse than the average pandemic. In fact, most such analyses reveal that 'Covid-19' is LESS deadly than run-of-the-mill Influenza.

I would point to Dr. Simon Thornley's analysis (he's a respected epidemiologist in New Zealand), in which he states that one's risk of death from Covid-19, equals one's USUAL risk of death during the year under consideration. The risk is simply COMPRESSED, due to the virus, into a period of a few weeks. Statistically, your risk of dying, in your 85th year (or in your 25th year), has not been changed by Covid-19, though.

There IS a crisis, however. The crisis is not due to the characteristics of the actual virus, as much as it is due to the various machinations surrounding its PROMOTION, and the various official interventions and intrusions resulting from the PROMOTION of the virus (as the centerpiece for an exercise in deliberately-created mass hysteria).

Anonymous said...

Targeted lockdown, symptomatic testing, antibody testing, contact tracing, and support for the vulnerable; would all be elements of a PLAN.

The entire country has been on lockdown for 2 months, and yet, there is no plan. This isn't just on Trump either.  He's a buffoon and is a laughing stock as he suggests ingesting sunlight and disinfectants, but Congress is happy to write blank checks instead of devise solutions. Chalk it up to a bunch of empty suits who got elected by giving good speeches and pandering to the right lobbyists instead of actually governing.

Right now, this country's entire plan is to let the virus run its course, give people a false choice between fully opened or fully closed, and spend money we don't have to keep the economy on life support.

Every politician in DC, Democrat or Republican, should be ashamed and know that they have blood on their hands. They can't endlessly pass the buck onto Trump, though Trump should be held accountable too. We had 3 months warning that this was coming to our shores and did nothing. Then we had 2 months of lockdown and did nothing.

This article makes some great points. You're dealing with a virus that largely DOES NOT affect the work force, and yet, we're not using that information. And good luck finding anyone in Washington that cares to understand this or make plans accordingly.

We've lost our way as a country and are devoid of real leadership.

Could be said...

@8:57, good luck with getting anywhere near pinning something on Gates. He is one of the chosen ones, protected from every angle.

Anonymous said...

KF I believe the MIT folks are "smarter than almost everyone else " when it comes to areas of study offered at MIT. I would remind you that there are folks who were accepted at MIT and chose to go elsewhere or follow other career paths.

I agree with everything in this but what isn't there is glaring.

They did not account for the fact that while Alaska got over $3 million and change per CV19 patient help, New York got $23000 and change. And, we are killing more doctors and nurses and first responders. Those are glaring examples of the implications of what this group failed take into account.

They seemed not to have felt the need to consult with experts in our cultural and political behaviors. We are not cohesive and cooperative. We have never in our history been as culturally incohesive save for the Civil War.

They did not account for those economic peculiarities we have acquired , like our health care system, and farm to table system and increasingly monopolistic approach.
It's those changes that cause our systems break down more quickly when other capitalistic systems did not fare as badly . We can't rely on past herd models nor can we contrast our economy with other capitalistic countries.

And, then there's just the " how does life actually work " for most the population " gap".

As an elderly person with high risk, I have been sheltering in place since mid-February. Unfortunately, I learned very quickly that even at "elderly hours" or in deliveries, others did not follow the social distancing or sanitizing practices needed to protect me or anyone over 60 with or without an underlying condition. They were vehicles of spreading to everyone else.

Some suppliers of food and services did not have the means to sanitize or protect me adequately then or now. Some have been able to make sure their employees have what is needed and are trained and supervised adequately in being safe themselves and protecting others.

You cannot safely shelter the elderly with people like those commenting here, that don't care whether we survive or not. We can't even protect the elderly in nursing homes that were in lock down early.

So the attitude still seems to be to " let them die", money is more important.

And, while it may be that we are not counted in GDP in large numbers, I don't think that overlooks how our money works on the local and State levels. If you look only nationally, the impact is only our estimated value. But, if you look at States like Mississippi and Florida with higher populations and don't look at the elderly in terms of consumption in goods and services or personal wealth, it's a different picture.

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