Author Archives: Nuetzel

Some Cheery COVID Research Tidbits

16 Thursday Jul 2020

Posted by in Pandemic, Public Health, Uncategorized

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Here’s a short list of new or newish research developments, some related to the quest to find COVID treatments. Most of it is good news; some of it is very exciting!

Long-lasting T-cell immunity: this paper in Nature shows that prior exposure to coronaviruses like severe acute respiratory syndrome (SARS) and even the common cold prompt an immune reaction via so-called T-cells that have long memories and are reactive to certain proteins in COVID-19 (SARS-CoV-2). The T-cells were detected in both C19-infected and uninfected patients. This comes after discouraging reports that anti-body responses to C19 are short-lived, but T-cells are a different form of acquired immunity. Derek Lowe says the following:

“This makes one think, as many have been wondering, that T-cell driven immunity is perhaps the way to reconcile the apparent paradox between (1) antibody responses that seem to be dropping week by week in convalescent patients but (2) few (if any) reliable reports of actual re-infection. That would be good news indeed.”

The herd immunity threshold (HIT) is much lower than you think: I’ve written about the effect of heterogeneity on the HIT before, here and here. This new paper, by three Oxford zoologists, shows that the existence of a cohort having some form of prior immunity, innate or acquired, reduces the number of infections required to achieve the HIT. For example, if initial transmissibility (R0) is 2.5 and 40% of the population has prior immunity (both reasonable assumptions for many areas), the HIT is as low as 20%, according to the authors’ calculations. That’s when the contagion begins to recede, though the final infected share of the population would be higher. This might explain why new cases and deaths have already plunged in places like Italy, Sweden, and New York, and why protests in NYC did not lead to a new wave of infections, while those in the south appear to have done so.

Seasonal effects: viral loads might be decreasing. From the abstract:

“Severity of COVID-19 in Europe decreased significantly between March and May and the seasonality of COVID-19 is the most likely explanation. Mucosal barrier and mucociliary clearance can significantly decrease viral load and disease progression, and their inactivation by low relative humidity of indoor air might significantly contribute to severity of the disease.”

The BCG vaccine appears to be protective: this is the bacillus Calmette-Guérin tuberculosis vaccine administered in some countries, This finding is not based on clinical trials, so more work is needed.

Is there no margin in plasma? No subsidy? This is the only “bad news” item on my list. It’s widely agreed that blood plasma from recovered C19 patients can be incorporated into an immune globulin drug to inoculate people against the virus. It’s proven safe, but for various reasons no one seems interested. Not the government. Not private companies. Did Trump happen to mention it or something?

C19 doesn’t spread in schools: this German study demonstrates that there is little risk in reopening schools. One of the researchers says:

“Children act more as a brake on infection. Not every infection that reaches them is passed on…. This means that the degree of immunization in the group of study participants is well below 1 per cent and much lower then we expected. This suggests schools have not developed into hotspots.”

Also worth emphasis is that remote learning leaves much to be desired, as acknowledged by the National Academies of Science, Engineering and Medicine, which has recommended that schools reopen for younger children and those with special needs.

Can angiotensin drugs (ACE Inhibitors/ARBs) reduce mortality? This meta-analysis of nine studies finds that these drugs reduce C19 mortality among patients with hypertension. The drugs were also associated with a reduction in severity but not with statistical significance. These results run contrary to initial suspicions, because ACEI/ARB drugs actually “up-regulate” ACE-2 receptors, to which C19 binds. Researchers say the drugs might be working through some other protective channel. This is not a treatment per se, but this should be reassuring if you already take one of these medications.

Tricor appears to clear lung tissue of C19: this research focused on C19’s preference for an environment rich in cholesterol and other fatty acids:

“What they found is that the novel coronavirus prevents the routine burning of carbohydrates, which results in large amounts of fat accumulating inside lung cells – a condition the virus needs to reproduce.”

Tricor reduces those fats, and the researchers claim it is capable of clearing lung tissue of C19 in a matter of days. This was not a clinical trial, however, so more work is needed. Tricor is an FDA approved drug, so it is safe and could be administered “off label” immediately. Tricor is a fibrate; the news with respect to statins and C19 severity is pretty good too! These are not treatments per se, but this should be reassuring if you already take one of these medications.

Hydroxychloroquine works: despite months of carping from media and leftist know-it-all’s dismissing the mere possibility of HCQ as a potential C19 treatment, evidence is accumulating that it is effective in treating early-stage infections after all. The large study conducted by the Henry Ford Health System found that treatment with HCQ early after hospitalization, and with careful monitoring of heart function, cut the death rate in half relative to a control group. Here’s another: an Indian study found that four-plus maintenance doses of HCQ acted as a prophylactic against C19 infection among health care workers, reducing the odds of infection by more than half. An additional piece of evidence is provided by this analysis of a 14-day Swiss ban on the use of HCQ in late May and early June. The ban was associated with a huge leap in the C19 deaths after a lag of less than two weeks. Resumption of HCQ treatment brought C19 deaths down sharply after a similar lag.

Meanwhile, a study in Lancet purporting to show that HCQ was ineffective and posed significant risks to heart health was retracted based on the poor quality of the data.

Remdesivir also cuts death rate: by 62% in a smaller controlled study by the drug maker Gilead Sciences.

Pet ownership might confer some immunity: this one is a little off-beat, and perhaps the research is under-developed, but it is interesting nonetheless!

I owe Instapundit and Marginal Revolution hat tips for several of these items.

Case Fatality, Stale Ratios and Exaggerated Loss

14 Tuesday Jul 2020

Posted by in Analytics, Pandemic

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I hope someday I won’t feel compelled to write or worry about the coronavirus. However, as the pandemic wears on, it seems to take only a few days for issues to pile up, and I just can’t resist comment. Today I have a couple of beefs with uses of data and concomitant statements I’ve seen posted of late.

People are still quoting case fatality rates (CFRs) as if those cumulative numbers are relevant to the number of deaths we can expect going forward. They are not. Just as hair-brained are applications of cumulative hospitalization and ICU admittance rates to produce “rough and ready” estimates of what to expect going forward. Or, I’ve seen people express hospitalizations as ratios to CFR, as if those ratios will be the same going forward. Again, they are not. Let me try to explain.

The chart below shows the course of the U.S. CFR since the start of the pandemic. It’s taken from the interactive Covid Time Series site. My apologies if you have to click on the chart for decent viewing (or you can visit the site). The CFR at any date is the cumulative number of deaths to-date divided by the cumulative number of confirmed cases. It is a summary of past history, but it is not well-suited to making predictions about death rates in the future. The CFR began to taper a little before Memorial Day, and it is now at about 4% (as of July 13).

Out of curiosity, I also generated CFRs for AZ, CA, FL, GA, and TX, which now average about half of the national CFR. There’s an obvious lesson: if you must use CFRs, understand that they vary from place to place.

Again, CFRs are cumulative. Their changes over time can tell us something about recent trends, but even then they are flawed. For example, case counts have risen dramatically with more widespread testing. Those testing positive more recently are concentrated in younger age cohorts, for whom infections are much less severe. Treatment has improved dramatically as well, so there is little reason to expect the CFR’s of recently diagnosed cases to be as high as the latest CFRs shown above.

There is no easy way to calculate an unflawed “marginal” CFR for a recent period, though an effort to do so might improve the predictive value. Deaths lag behind case counts because the progression from early symptoms to death can take several weeks. Even more vexing for constructing a valid, recent fatality rate is that reporting of deaths is itself delayed, as I explained in my last post. Each day’s report of deaths captures deaths that may have occurred over a period of several weeks in the past, and sometimes many more.

Finally no CFR can capture the true mortality rate of the virus without ongoing, ubiquitous testing. As the state of testing stands, the true mortality rate must reflect undiagnosed cases in the denominator. The CDC’s latest “best” estimate of the true mortality rate is just 0.3%, and 0.05% for those aged 50 years or less. Those figures are based on serological tests for the presence of antibodies to C19 in more random samples of the population. Those findings reflect the extent of undiagnosed and/or asymptomatic cases.

The point is one shouldn’t be too blithe about throwing numbers around like 4% mortality based on the CFR, or even 1% mortality as a “nice, round number”, without heavy qualification. Those numbers are gross exaggerations of what we are likely to see going forward.

The same criticisms can be leveled at claims that hospitalizations will proceed at some fixed ratio relative to diagnosed cases, or some fixed ratio relative to deaths. Again, new cases tend to be less severe, so hospitalizations are likely to be a much lower ratio to cases than what is reflected in cumulative totals. Because of improved treatment, the ratio of deaths to hospitalizations will be much lower in the future as well.

CFRs are not a useful guide to future COVID deaths. The true mortality rate is a much better baseline, particularly for subsets of the population matching the current case load. Finally, and this is the only disclaimer I’ll bother to provide today, we all know that suffering is not confined to terminal cases, and it is not confined to the hospitalized subset. But don’t exaggerate the extent of your preferred interpretation of suffering by applying inappropriate cumulative calculations.

 

Reported and “Actual” COVID Deaths

13 Monday Jul 2020

Posted by in Pandemic, Political Bias

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I was updating my post from twelve days ago on the upward trend in new coronavirus cases when I came across a great tabular summary of a phenomenon that’s been underway since early April: significant delays in reporting deaths from COVID-19 (C19). Before I get to that, a quick word on what’s happened over the past 12 days. New coronavirus cases keep climbing in a number of states, and it’s been a grisly waiting game to see whether the severity and lethality of infections will follow the case counts upward. The following chart provides a very preliminary answer. It’s taken from Our World In Data, and it shows the seven-day moving average of C19 deaths in the U.S.

There has indeed been an upturn in reported deaths over the past week. Just prior to that, a temporary plateau in late June was caused by a set of “reclassifications” of earlier deaths in New Jersey (the “plateau effect is caused by seven-day averaging). These kinds of changes in reporting make it rather difficult to interpret trends accurately. Unfortunately, the reporting of deaths has been subject to continuing distortions that are even more difficult to discern than New Jersey’s spike.

Kyle Lamb provides the interesting table below, which might be difficult to read without either clicking on it or going to the link at Twitter. Here is another link to an annotated version of the table. The top row labeled “CTP Total” is the C19 death toll reported each week by the COVID Tracking Project. This is generally what the public sees. These reports show that deaths reached their highest levels during the weeks of April 11th through May 9th. However, the second column shows C19 deaths by their actual week of occurrence. This series shows a more distinct peak on April 18th with steady declines thereafter.

The weekly totals in the second column are not final, however. Take a look at the last reporting week in the far right column (July 11th). The CTP reported 4,286 deaths, an increase over the prior week consistent with the upturn in the first chart above. But the table shows that over half of that week’s reported deaths actually occurred in late April and early May! So the upturn in deaths is something of a mirage.

We won’t have a reasonable approximation of the death totals for the past several weeks (or how they compare) for at least several more weeks. In fact, one can argue that it might be a matter of months before we have a reasonable approximation of those deaths, but it’s worth noting that the vast bulk of “actual” C19 deaths tend to be reported within four weeks of the initial reporting week, and the additions or revisions to the two weeks in late April and early May in the last column were exceptionally large. Chances are we won’t see many more that big…. Or will we?

Aspects of this process hint at the ease with which the C19 death totals could be manipulated. The reported totals for all-cause mortality in the first column are incomplete; more recent weeks, especially, are not fully settled as to causes of death. Some of those fatalities are certain to be attributed to C19. Others might be reclassified as C19. And here is the scary part: the all-cause totals are certain to include a significant number of lockdown-related or COVID-phobic deaths: individuals who were unable or unwilling to seek medical care for urgent needs due to lockdowns or fears of rampant spread of C19 infections within hospital environments. To anyone with an interest in manipulating the C19 death toll, whether hospital officials seeking higher reimbursements, local or state officials seeking federal funds, or public officials at any level seeking to promote pandemic fears and/or political discord, these “extra” deaths might be tempting marks for reclassification.

I’m fairly confident that the uptrend of new cases will be far less severe than early in the pandemic. I believe much of the alarm I see on social and mainstream media is misplaced. More on that in a subsequent post, but for now I’ll simply note that those testing positive are concentrated in much lower ranges of the age distribution, and treatment has improved in a variety of ways. The table above shows that the downtrend in actual weekly C19 deaths is intact as of the admittedly incomplete July 11th reporting week. We won’t know the “actual” pattern of early-July C19 fatalities for another month or more. Even then, one might harbor suspicions that the totals are manipulated for economic or political reasons, but we can hope the reporting authorities are exercising the utmost objectivity in assigning cause of death.

Unfortunate COVID Follies

08 Wednesday Jul 2020

Posted by in Government Failure, Pandemic

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This post is devoted to a few coronavirus policies and positions that trouble me. 

Counting Deaths: People have the general impression that counting COVID-19 cases and deaths is straightforward. The facts are more reminiscent of the following exchange in the film Arsenic and Old Lace, when Jonathan Brewster angrily insists he has offed more souls than his sweet little aunties have poisoned with elderberry wine:

Dr. Einstein: You cannot count the one in South Bend. He died of pneumonia!
Jonathan Brewster: He wouldn’t have died of pneumonia if I hadn’t shot him! 

Here, Dr. Einstein wears the shoes of public health authorities who claim that C19 deaths are undercounted. But lives counted as lost from C19, in many cases, are individuals who also had the flu, pneumonia, stroke, kidney failure, and a variety of other co-morbidities. Yes, other causes of death might be induced by the coronavirus, but like Johnny’s victim in South Bend, many would not have died from C19 if they hadn’t had a prior health event. In addition, otherwise unexplained deaths are often attributed to C19 with little justification.

In fact, the C19 death toll has been distorted by a perverse federal hospital reimbursement policy that rewards hospitals for COVID patients. Death certificates seem to list C19 as the cause for almost anyone who dies in or out of a hospital during the pandemic, whether they’ve been tested or not. In fact, deaths have been attributed to C19 despite negative test results when officials decided, for one reason or another, that the test must have been unreliable!

Lockdowns: almost all of the “curve flattening” in late March and April was accomplished by voluntary action, which I’ve covered before here. The lockdowns imposed by state and local governments were highly arbitrary and tragic for many workers and business owners who could have continued to operate as safely as many so-called “essential” businesses. Lockdowns in certain areas were also blatant violations of religious rights. There is little to no evidence that lockdowns themselves led to any actual abatement of the virus. And of course, people are fed up! 

The Beach: Right now I’m at a wonderful beach condo in Florida for a week. There are other people on the beach, mostly families and a few groups of friends, but there is plenty of open space. You will not catch the coronavirus on a beach like this. And there is almost zero chance you’ll catch it on any beach. In fact, the chance you’ll catch it anywhere outside is minuscule unless you’re jammed so tightly among hundreds of protesters that you can’t even turn around. Yet government officials have closed beaches in many parts of the country while allowing the protests to go on. Oh sure, they think people will CROWD onto beaches as if they’re at a BLM protest… except they’re not. Ah, then it must be banned! That takes a special kind of dumbass.     

Waiting for Results: How could we have spent trillions of dollars as a nation on economic stimulus, much of it skimmed off by grifters, but we can’t seem to get sufficient resources to make calls to those awaiting test results? This is a case of misplaced priorities. Even now, people are waiting more than a week for their results, and many are wandering around in the community without knowing their status. Wouldn’t you think we’d get that done? We can conduct well over a half million tests a day, but can’t we find a few bucks to deliver results via phone, email, or text within 24 hours of processing results. This is truly absurd. 

Vaccine Candidates: A similar point can be made about vaccine development: We are spending $5 billion on Operation Warp Speed to build capacity in advance for five promising vaccine candidates. These will be identified over the next few months, and it looks as if all five will come from established pharmaceutical majors. There are many more vaccine candidates, however, some being developed by smaller players using inventive new techniques. The OWS expenditure looks pretty meager when you compare it to the trillions in funds the federal government is spending on economic stimulus, especially when finding an effective vaccine would obviate much of the stimulus. 

Treatment: Hydroxycloroquine has been found to lower the death rate from COVID-19 in a large controlled trial. Congratulations, morons, for trashing HCQ as a potential treatment, solely because Trump mentioned it. Way to go, dumbasses, for banning the use of a potential treatment that could have saved many thousands of lives. 

Air Conditioning: I’m shocked that public health experts haven’t been more vocal about the potentially dangerous effects of running air conditioners at high levels in public buildings. The virus is known to thrive in cool, dry environments, which is exactly what AC creates, yet this seems to have been almost completely ignored.   

Vitamin D: Likewise, I think public health experts have been far too reticent about the connection between Vitamin D deficiencies and the severity of C19 (also see here and here). The accumulating evidence about this association offers an explanation for the disturbingly high severity of cases among Black, Asian and Minority Ethnics (BAME), not to mention a possible role in C19 deaths among the generally D-deficient nursing home population. For the love of God, get the word out to the community that Vitamin D supplements might help, and they won’t hurt, and otherwise, tell people to get some sun!

Masks: I’m not in favor of strict mask mandates, but I have trouble understanding the aversion to masks among certain friends. Of course, there’s been way too much mixed messaging on the benefits of masks, and it didn’t all come from politicians! Scientists, the CDC, and the World Health Organization seemingly did everything possible to squander their credibility on this and other issues. However, a consensus now seems to have developed that masks protect others from the wearer and seem to protect the wearer from others as well. It should be obvious that masks offer a middle ground on which the economy can be restarted while mitigating the risks of further contagion. But even if you don’t believe masks protect the wearer, but only protect others from an infected wearer, donning a mask inside buildings, and when social distancing is impossible, still qualifies as a mannerly thing to do.  

 

Activists Prey On Corporate Pushovers

05 Sunday Jul 2020

Posted by in Corporatism, Identity Politics, Political Correctness

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I don’t think I’ve ever linked to anything on Captain Capitalism’s site. I know I’ve been tempted. The Captain is Aaron Clarey, a lively writer who is so politically incorrect he’s almost guaranteed to offend the faint of heart. His consulting company is known as Asshole Consulting because his gig, he says, is to be a truth-telling asshole so he can save you from yourself. I check his blog from time-to-time because he’s unabashedly pro-capitalist (not to be confused with corporatist!), he has interesting points of view, and well, he can be very entertaining.

Clarey wrote a piece a few days ago entitled “Corporate Donations to BLM vs. Government Spending on the Black Community“. Here are a few of his points:

    • Corporate gifts to Black Lives Matter and similar organizations dedicated to black causes are a mere pittance relative to the trillions of disproportionate benefits that have been paid by the government to aid blacks over the years. By “disproportionate” Clarey means the excess of those benefits above the black share of the population.
    • The disproportionate government benefits have been gloriously unproductive as a permanent solution to end black poverty. Clarey says, “… the multiple trillions of dollars [spent by government] has not closed the:

wage
health
income
savings
life expectancy

   gaps between black and white“

    • The comparatively tiny corporate donations “may enrich some black activists who sit on the boards of these non-profits, but it will not do one damn thing to tangibly improve the lives of black people in the US.”
    • Clarey then challenges “anybody of any political or racial stripe to be intellectually honest with themselves and acknowledge what this laughable joke of “corporate donations” are – Marketing. Placating. Danegeld. Virtue-signaling. These corporations do not care about black people, they care about themselves and are capitalizing off of a tragedy to profit.“

I’ve worked for some large corporations over the years and they all play these games: not only are shareholder resources dolled out to every special interest under the sun, who are now deemed “stakeholders”, but employees are constantly harangued because they just might have less than appropriate consciousness of these interests. Staff time is dedicated to training employees in “right-think”, and they are asked to bend and twist their objectives and job descriptions in order that they appear to revolve around those interests. It’s patently ridiculous. And now, some of these corporations have been cowed into withdrawing advertising dollars to sites that might offend those whom the corporations don’t wish to offend, or sites that might support the First Amendment rights of those whom their intimidators wish to silence. 

Clarey’s use of the term “Danegeld” is particularly interesting. He means that the primary interest of these corporations is in buying off potentially hostile forces. That‘s exactly what’s going on here! The cowardly upper management of these companies would be better off taking Rudyard Kipling’s advice on the matter (with apologies to my Danish friends):

“It is always a temptation to an armed and agile nation
To call upon a neighbour and to say: —
‘We invaded you last night–we are quite prepared to fight,
Unless you pay us cash to go away.‘

And that is called asking for Dane-geld,
And the people who ask it explain
That you’ve only to pay ’em the Dane-geld
And then you’ll get rid of the Dane!

It is always a temptation for a rich and lazy nation,
To puff and look important and to say: —
‘Though we know we should defeat you, we have not the time to meet you.
We will therefore pay you cash to go away.’

And that is called paying the Dane-geld;
But we’ve proved it again and again,
That if once you have paid him the Dane-geld
You never get rid of the Dane.

It is wrong to put temptation in the path of any nation,
For fear they should succumb and go astray;
So when you are requested to pay up or be molested,
You will find it better policy to say: —

‘We never pay any-one Dane-geld,
No matter how trifling the cost;
For the end of that game is oppression and shame,
And the nation that pays it is lost!'”

Equal *Mattering* Under Ethics, Law and Community

04 Saturday Jul 2020

Posted by in Identity Politics, racism, Uncategorized

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How many white lives is a single black life worth? It seems so easy to pin that down, but if you think it’s okay to say “black lives matter”, but not to say “all lives matter”, the implication is that one black life is worth more than one white life. Anyone who insists on that should take the following litmus test. 

A classic dilemma discussed by ethicists involves situations of mortal danger in which a life or lives might be sacrificed in order to save other lives. Variants of it come up again and again in the effort to tune software for autonomous vehicles. It’s also a simple tool for challenging assertions about the values of different lives, or whether different lives “matter”.

Suppose that two pedestrians step into the path of your vehicle. You can save them only by swerving, killing a single pedestrian standing at the curb. Most would agree the car should swerve, but the answer might change under certain circumstances. Forget about the argument that the two in your path weren’t careful, so they “deserve” die. We just don’t know what caused them to proceed, or what might have distracted them.

What if the two in your path are elderly, using walkers and dragging oxygen tanks, while the pedestrian at the curb is a healthy child. Does that matter? Do we weigh the sacrifice of many potential life-years as well as a higher quality of life? People might feel less certain about that choice.

Now let’s suppose that all three pedestrians are healthy, young adults. Does it matter that any of the pedestrians are black? The one on the the curb, or the two in your path? Of course not! The truly “colorblind” answer is to swerve regardless of race. You are an obvious racist if you think otherwise. The sacrifice of one white life is certainly worth saving two black lives; the sacrifice of one black life is certainly worth saving two white lives. Black lives and white lives matter equally. 

Our Constitution and ethical standards dictate that lives are equal, that we are equal before the law, that we that we have equal rights to speak, worship, and enjoy the fruits of our labors, including the unchallenged right to property we might acquire. Under the law, and in all of our social interactions, we must be accorded equal consideration regardless of extraneous characteristics such as race. All of us have the same promise of life and opportunities to pursue happiness, and to make of our lives what we can or will. However, none of this entitles us to equal happiness, romance, and material well being.

Now, detractors will say all that misses the point. The value of black lives has been discounted for centuries, they say, as evidenced in disparate treatment by police, prosecutors, juries, employers, neighbors, social clubs, and places of business. Of course it’s true that racism has a long history throughout the world, and at one time or other it has been turned against virtually every race or religion in existence. If you think in this day and age that racism doesn’t exist elsewhere, think again.

Slavery was a tragic reality in the U.S. until 155 years ago, but it was certainly not unique to the U.S. Jim Crow laws that prevented blacks from participating equally in many aspects of life were finally ended more than 50 years ago through a series of legislative actions and Supreme Court decisions. Slavery and Jim Crowism were the acts of long-dead ancestors of almost anyone living today. The presumption that all whites should assume guilt for some kind original sin against blacks is sheer nonsense, and one many of us will simply never accept.

Nevertheless, the legacy of degraded personhood under those long-defunct laws created a heavy burden for blacks in terms of upward mobility, and certainly vestiges of racism survive even today. However, we have adopted many standards and programs intended to rectify this unfortunate legacy, including the civil rights legislation of the 1960s and beyond, the Great Society programs of Lyndon Johnson, and many other enlargements of the social safety net since then. These programs have represented a massive redistribution of resources to the impoverished via education, housing, and direct transfers. One estimate put cumulative federal spending on anti-poverty programs alone at $13 trillion between 1963 and 2010. In addition, a variety of programs have been a source of preferential treatment for various minorities in an effort to ensure equal opportunities across many aspects of life.

The success of these programs is subject to great doubt (more on that below), and in fact the motives of Johnson and other proponents of this expansion in the role of government were perhaps less than pure. Nevertheless, the entirety of the package of civil rights and welfare state programs over the years was supported by most of the black community. In fact, one could say that these measures were hardly the actions of a racist society, at least in ostensible intent.

And yet we are told today that we do not sufficiently appreciate that black lives matter! There is no question that racism lives in the hearts and minds of certain individuals, but those individuals aren’t all white. More importantly, the blanket condemnation of whites as racist lacks any basis in reality.

When Black Lives Matter activists talk of “systemic racism”, you can translate as follows: blacks have not met with the ex post economic and social success to which these activists believe blacks are entitled. As it pertains to law enforcement, they mean that blacks are met with more violent police actions than blacks should suffer.

As to law enforcement, it is an awful thing that crime perpetrated by blacks, and particularly crime by blacks against blacks, is disproportionally heavy. As I argued recently, it is difficult to accept the hypothesis of systemic racism in law enforcement in the presence of rampant “systemic crime” in the black community. But crime, in turn, is tied closely to economic success, or the lack thereof.

Median black income has grown relative to median white income since 1970 (also see here). Unfortunately, many blacks have not shared in that growth and remain mired in poverty and on public aid. Sadly, many aid programs have pernicious effects because they impose extremely high marginal tax rates on earned income. The solution lays the groundwork for continued dependency. That qualifies as systemic racism, or at least classism.

Two well-known black economists, Thomas Sowell and Walter Williams, have both decried the welfare state’s destructive impact on the black family unit. That’s one reason why Williams calls white liberals the “worst enemy of black people“. (Also see what Williams has to say about expectations for black students, and about black crime.)

Ultimately, the uproar over racism alleged to be so widespread and “systemic” is divisive. It is an application of Marxist “conflict theory” lying at the very heart of identity politics. Such tribal philosophies creat huge obstacles to peaceful and productive coexistence among diverse peoples. Meanwhile, there’s a simple truth: a widespread consensus exists that all lives are of equal value, that all lives deserve respect and equal treatment under the law, that the goodwill of one’s fellows is a birthright, and that racism is fundamentally evil. If society is to provide fertile ground for the equal cultivation of all lives, it must reject the strictures and resentment bred by identity politics in favor of individual liberty, personal responsibility, and compassion for those unable to care for themselves.

Cases Climb, Most Patients Faring Better

30 Tuesday Jun 2020

Posted by in Pandemic, Public Health

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There’s been much speculation about whether recent increases in confirmed cases of COVID-19 (first chart above) will lead to a dramatic increase in fatalities (second chart). More generally, there is curiosity or perhaps hope as to whether the virus is not as dangerous to these new patients as it was early in the pandemic. I have discussed this point in several posts, most recently here. Based on the national data (above), we’re at the point at which an upturn in deaths might be expected. Based on the experience of many individual states, however, deaths should have trended upward by now, but they haven’t done so. Cases are generally less severe and are resolving more quickly.

Of course, more testing produces more cases (though there has been a mild uptick in test positivity over the past two weeks), but that doesn’t really explain the entire increase in cases over the past few weeks. In particular, why are so many new cases in the south? After all, there is evidence that the virus doesn’t survive well in warm, humid climates with more direct sunlight.

As I have mentioned several times, heavy use of air-conditioning in the south may have contributed to the increase. Nate Silver speculates that this is the case. The weather warmed up in late May and especially June, and many southerners retreated indoors where the air is cool, dry, and the virus thrives. Managers of public buildings should avoid blasting the AC, and you might do well to heed the same advice if you live with others in a busy household. In fact, nearly all transmission is likely occurring indoors, as has been the case throughout the pandemic. At the same time, however, with the early reopening of many southern states, younger people flocked to gyms, bars and other venues, largely abandoning any pretense of social distancing. So it’s possible that these effects have combined to produce the spike in new cases.

Some contend that the protests following George Floyd’s murder precipitated the jump in confirmed cases. Perhaps they played a role, but I’m somewhat skeptical. Yes, these could have become so-called super-spreader events; there are certain cities in which the jump in cases lagged the protests by a few weeks, such as Austin, Houston, and Miami, and where some cases were confirmed to be among those who protested. But if the protests contributed much to the jump, why hasn’t New York City seen a corresponding increase? Not only that, but the protests were outside, and the protests dissuaded many others from going out at all!

The trend in coronavirus fatalities remains more favorable, despite the increase in daily confirmed cases. One exception is New Jersey, which decided to reclassify 1,800 deaths as “probable” COVID deaths about six days ago. You can see the spike caused by that decision in the second chart above. Reclassifications like that arouse my suspicion, especially when federal hospital reimbursements are tied to COVID cases, and in view of this description from Bloomberg (my emphasis):

“… those whose negative test results were considered unreliable; who were linked to known outbreaks and showed symptoms; or whose death certificates strongly suggested a coronavirus link.”

Deaths necessarily lag new cases by anywhere from a few days to several weeks, depending on the stage at the time of diagnosis and delays in test results. The lag between diagnosis and death seems to center on about 12 – 14 days. Thus far, there doesn’t appear to be an upward shift in the trend of fatal cases, but the big updraft in cases nationally only started about two weeks ago. More on that below.

Importantly, a larger share of new cases is now among a younger age cohort, for whom the virus is much less threatening. The most vulnerable people are probably taking more precautions than early in the pandemic, and shocking as might seem, there is probably some buildup in immunity in the surviving nursing home population at this point. We are also better at treatment, and there is generally plenty of hospital capacity. And to the extent that the surge in new cases is concentrated in the south, fewer patients are likely to have Vitamin D deficiencies, which is increasingly mentioned as a contributor to the severity of coronavirus infections.

I decided to make some casual comparisons of new cases versus COVID deaths on a state-by-state basis, but I got a little carried away. Using the COVID Time Series web site, I started by checking some of the southern states with recent large increases in case counts. I ended up looking at 15 states in the south and west, and I added Missouri and Minnesota as well. I passed over a few others because their trends were basically flat. The 17 states all had upward trends in new cases over the past one to two months, or they had an increase in new cases more recently. However, only four of those states experienced any discernible increase in daily deaths over the corresponding time frames. These are Arizona, Arkansas, Tennessee, and Texas, and their increases are so modest they might be statistical noise.

Again, deaths tend to lag new cases by a couple of weeks, so the timing of the increase in case counts matters. Five of the states were trending upward beginning in May or even earlier, and 13 of the states saw an acceleration or a shift to an upward trend in new cases after Memorial Day, in late May or June. Of those 13, the changes in trend occurred between one and five weeks ago. Six states, including Texas, had a shift within the past two weeks. It’s probably too early to draw conclusions for those six states, but in general there is little to suggest that fatal cases will soar like they did early in the pandemic. Case fatality rates are likely to remain at much lower levels.

We’ll know much more within a week or two. It’s very encouraging that the upward trend in new cases hasn’t resulted in more deaths thus far, especially at the state level, as many states have had case counts drift upward for over a month. If it’s going to occur, it should be well underway within a week or so. Much also depends on whether new cases continue to climb in July, in which case we’ll be waiting in trepidation for whether more deaths transpire.

Brave Cops and Foolish Subversives

25 Thursday Jun 2020

Posted by in Police Bias, racism

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It’s difficult to put oneself in the shoes of a cop, but it seems clear that many partisans lack an appreciation for the intensity and danger of police work, which is fundamentally about protecting the public from threats to life and property. Confrontation is an unavoidable part of the job, whether it involves a domestic disturbance, drunk and disorderly conduct, property crime, or a shooting. Situations are adversarial and officers often face significant mortal risk. These are very brave people.

It would be impossible to do a cop’s job without legal authorization and occasional use force, but it can be very hard to judge when that’s necessary. A cop’s beat can feel like a war zone. There’s not much time to think. Things happen fast. Bad things happen really fast. Calm is restored in the best of circumstances, but arrests may be necessary, and sometimes a situation escalates or is already so fraught that it ends in tragedy. Sound procedures help police do their jobs better, but outcomes are capricious, and it is all too easy to make harsh judgements about split-second decisions in hindsight. Like any other accused, when a police matter ends badly, the cop is entitled to due process. Depending on circumstances and evidence, that means cops deserve a fair margin of error in the conduct of their duties.

To take a recent example, the police shooting of Rayshard Brooks in Atlanta occurred after Brooks wrestled with officers when they attempted to put him in handcuffs. Brooks broke free and snatched one of their tasers. As he ran, an officer pursued him at fairly close range. Brooks turned and fired the taser at the officer, shooting too high as it turned out. But the officer returned fire within an instant, three shots, striking Brooks in the back twice. Was that justified or reckless? The videos shown on the networks are in slow motion, but decisions like that can’t be made in slow-mo. The taser might have struck and disabled the officer, or in rare circumstances even killed him. And some tasers fire more than once; if one or both officers were disabled, their guns were potentially up for grabs. Either way, the use of his firearm seems to have been within Georgia law and Atlanta Police Department guidelines. No one should pretend there was time for careful deliberation. However, none of that dissuaded the Fulton County DA from filing immediate murder charges in a politically charged atmosphere. That’s hardly due process.

Of course there are bad cops and racist cops, but they comprise a distinct minority. Certain reforms might help to keep them from abusing their power, get them off the force, or convict them, depending on the nature of the offense. Qualified immunity gives excessive cover to bad cops and has protected far too many from prosecution. It’s regrettable that Senate Republicans have refused to consider modifications to qualified immunity, but perhaps they are holding it back as a negotiating ploy. Monitoring the conduct of officers is obviously important, and anonymous peer review within departments would be an excellent mechanism for identifying problem officers. Some reform proposals would certainly reduce the likelihood that police actions will be unjust, regardless of individual attitudes: ending no-knock raids and decriminalizing drugs would be major steps forward on that front.

The brutal murder of George Floyd has brought much more radical calls for changes in policing — even defunding or dismantling entire departments. These are based on widespread assertions that police are biased against blacks and that unjust police violence is directed at blacks. There is conflicting evidence on that point, however. Harvard Professor Roland Fryer concludes that while there is no evidence of racial bias in the use of lethal force by police, there is some evidence of bias in the use of non-lethal force. Other facts make the latter conclusion seem dubious, however. Consider the patterns of criminal activity described at the last link by Barry Latzer, CUNY Professor of Criminal Justice:

“The latest police data collected by the FBI indicates that blacks comprised 58 percent of all murder arrests and 40 percent of those apprehended for all violent crimes. This disproportional involvement of African Americans in violent crime turns out to be the most significant factor of all in explaining the use of force against blacks by police.

It will be no surprise that violent criminals in the United States are commonly armed and dangerous. For assaults, for instance, 71 percent of arrested persons carried firearms. Among suspected murderers, 58 percent had guns, as did 42 percent of apprehended robbery suspects. This tally doesn’t include the knives or blunt instruments recovered from violent offenders, including over 48,000 cutting instruments possessed by those arrested for assault alone.”

Latzer cites a number of studies of lethal force by police. One of these studies found:

“… after controlling for numerous factors, that blacks were 27.4 percent less likely than non-Hispanic whites to be fatally shot by police.”

Other researchers have noted:

“… the absence of any correlation between the race of the officer and that of the victim. That is, after controlling for other factors, white police officers were no more likely than black officers to fatally shoot black civilians. In fact, the more black officers on a police force, the more African Americans were fatally shot.” 

Another finding by the same study:

“[O]fficer race, sex, or experience did not predict the race of a person fatally shot beyond relationships explained by county demographics. On the other hand, race-specific violent crime strongly predicted the race of a civilian fatally shot by police, explaining over 40% of the variance in civilian race. These results bolster claims to take into account violent crime rates when examining fatal police shootings.”

The most tragic aspect of all this is that the vast majority of black crime victims are victimized by other blacks. Here are 2018 statistics for homicides. While blacks account for about 13.5% of the U.S. population, black offenders accounted for nearly 45% of homicides in 2018, and black-on-black homicide accounted for nearly 40% of all homicides.

Crime in the black community, and its economic costs, are inflicted almost exclusively on other blacks. If there was ever a need for good policing, this is it. The reasons for disproportionate crime and violence in the black community are complex. The notion that there is “systemic racism” at play here might be correct, but again, the evidence suggests it is not the fault of police. The welfare state plays a major role, as Walter Williams has long asserted. There are many more children living without fathers in the black community, a product of misdirected social policy that awards greater benefits to single-parents households. High rates of male incarceration obviously compound this problem. Blame can also be ascribed to a dysfunctional system of public education, and our nation’s continuing insistent on prosecuting the War on Drugs is highly destructive.

The campaign against police is promoted by a number of leftist organizations, the most prominent of which are Black Lives Matter and Antifa. Other well-meaning leftists do not question the rhetoric of police racism, and they also tend to fall for the illusion of collectivist virtue. Don’t accept this bullshit! It won’t help blacks as a class. We’ve known for some time that BLM is a Marxist organization, as is Antifa. Lawrence Person quotes BLM co-founder Patrice Cullors: “We are trained Marxists.”

According to Alexandra Phillips:

“BLM happily self-identifies as a neo-Marxist movement with various far left objectives, including defunding the police (an evolution of the [Black] Panther position of public open-carry to control the police), to dismantling capitalism and the patriarchal system, disrupting the Western-prescribed nuclear family structure, seeking reparations from slavery to redistribute wealth and via various offshoot appeals, to raise money to bail black prisoners awaiting trial. The notion of seizing control of the apportionment of capital, dismantling the frameworks of society and neutralising and undermining law enforcement are not just Marxist, but anarchic.”

Identity politics provides a rich trove of grievance, guilt projection, and intimidation. But it won’t end there. They will use any and all means to subvert civil society in order to gain power, and there will be a high cost in terms of freedom, lives and human well being. These people are ruthless morons. One doesn’t have to look far to learn that the histories of Marxist revolution and attempts at governance are uniform in their failure and bloody mayhem.

Too many “nice people”, media, businesses, and other institutions are all too willing to accept BLM and Antifa propaganda unquestioningly, including their stupefying lies about disproportionate police violence against blacks. Yes, there are black victims of police brutality, and there are many white victims as well — criminal justice and police reform is not to be dismissed. Unfortunately, there is a large disproportion of violent crime committed by blacks against blacks. Many in the black community know all too well that good policing is desperately needed. Quite simply: no cops, no peace, no justice.

Zero Cost Stimulus: Risky Business

21 Sunday Jun 2020

Posted by in Uncategorized

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When the federal government intervenes to stimulate the economy, it generally means a big spending program or tax reduction and an increase in the federal deficit. This year we’ve witnessed the largest single-year fiscal policy effort in U.S. history, an effort to aid individuals whose jobs were lost and to stimulate the suddenly depressed economy. The coronavirus lockdowns in most states brought federal legislation enhancing unemployment compensation, one-time support payments to most adults, emergency business “loans” that are largely to be forgiven, and many other elements. The cost of these packages is expected to be about $2.4 trillion. And there will be more legislation this summer intended to stimulate hiring, including a probable infrastructure bill. President Trump still supports what the Administration calls a “hiring subsidy”, which is in fact a payroll tax holiday. As described, it would not explicitly target new hires, but would grant the holiday to all workers regardless of employment status. All these programs will ultimately be quite costly to taxpayers.

But what if there is a way to stimulate hiring without adding a dime to the federal deficit? (And I’m not talking about monetary policy, which inflicts costs of its own.) One inventive idea would create hiring incentives on a contingent basis, but with the beautiful feature that the program itself eliminates the contingency. Alex Tabarrok recently devoted a post to this idea, for which credit goes to Robertas Zubrickas. Here’s how it works, in Zubrickas’ words:

“… we propose a policy that offers firms wage subsidies for new hires payable only if the total number of new hires made in the economy does not exceed a prespecified threshold. An example would be a promise to cover all new labor costs contingent on that less than, say, 100,000 new jobs are created in total. From a firm’s perspective two outcomes can occur from this policy. One outcome is when the number of new jobs is less than the threshold, in which case the firm has its additional labor costs covered while keeping all the additional revenue. The second outcome is when the threshold is met and no subsidies are paid.”

If enough firms hire in order to reap the subsidies, then aggregate hiring exceeds the threshold and no wage subsidies are paid, but the additional employment boosts demand sufficiently to justify the hiring. Fiscal stimulus without any budget impact! Incredible, right?

There are problems, of course. The simple program described would carry big risks for many businesses. Just because aggregate hiring exceeds the threshold doesn’t mean demand for your firm’s offerings will increase. To take an obvious example, can a rural employer count on an increase in demand? The program could be designed to hinge on different regional hiring thresholds, or different industry hiring thresholds, but that quickly gets complicated.

Moreover, firms will have an incentive to free ride on other businesses who hire up-front. The timing of cash flows would also be critical. Are the subsidies to be paid upon proof of hiring, with repayment later if the aggregate hiring threshold is reached? If not, I suspect many employers would rather scramble to hire workers upon the realization of any increase in demand as might occur, but unwilling to risk hiring given the possibility that the subsidy will be lost and that their own sales will remain weak. That might be especially true for small firms. And if the subsidy is paid up front, good luck getting it back on behalf of taxpayers! So there are substantial fiscal risks, whether or not the aggregate hiring threshold is met. But perhaps those risks could be minimized with some limited tests of such a program.

Finally, this sort of plan would be much less likely to succeed with repetition. Then again, a one-time contingent hiring subsidy might be well suited to the so-called “low-employment equilibrium” that many believe we face today. The contingent subsidy is certainly a market distortion, but one hopes it would be a temporary distortion.

Zubrickas’ contingent wage subsidies are fascinating. The pandemic and the social distancing imperative have increased the cost of doing business, and the infection risk perceived by consumers is a potential drag on demand. Wage subsidies would reduce hiring costs, but if enough firms hire, those costs would be restored while demand would be stronger. But additional sales might not materialize for your firm! Designing a program of this type so as to minimize the risks faced by individual firms and taxpayers is tough, but it is an idea worth exploring in more detail. In concept, it’s certainly preferable to fiscal programs that carry huge costs and usually end in permanently larger government.        

 

 

Coronavirus Framing #7: Second Wave Uncertainty

19 Friday Jun 2020

Posted by in Pandemic

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We’re now said to be on the cusp of a “second wave” of coronavirus infections. It’s become a new focus of media attention in the past week or so. Increased infections have been reported across a number of states, especially in the south, but I’m not especially alarmed at this point for reasons explained below. Either way, the public policy response will certainly be different this time, at least in most areas. We’ve learned that a more targeted approach to managing coronavirus risk is far less costly, which means eschewing general lockdowns in favor of focusing resources on protecting the most vulnerable. That approach is supported by research weighing the costs and benefits of the alternatives (also see here and here).

The targeted approach I’ve advocated does not call for any less caution on the part of individuals. That means avoiding prolonged, close contact with others, especially indoors. I don’t mind wearing a mask when inside stores or public buildings, but I believe it should be voluntary. I do my best to stay out of close proximity to most others in public places anyway, masked or otherwise. This is voluntary social distancing. I also believe public health authorities should be more active in disseminating information on known correlates of coronavirus severity, such as Vitamin D deficiency, high LDL cholesterol, and the “reverse seasonal effect” caused by low humidity in air-conditioned spaces. I would also strongly agree that the effort to identify and mass produce vaccine candidates, known as Operation Warp Speed, should be ramped up considerably, with heavier funding and more than five vaccine candidates.

We’ve seen a continuing increase in coronavirus testing since my last “framing” post about a month ago. Testing has increased to a daily average of almost 500,000 over the past two weeks. At present we appear to have an excess supply of testing capacity in many areas, as Rich Lowry notes:

“The problem with testing nationally is becoming less a shortfall of availability of the tests and more a shortfall of people showing up to get tested. An insider in the diagnostics industry says that laboratories are reporting that they are ‘sample starved’ — i.e., they aren’t getting enough specimens. He notes, ‘We have all seen stories about sample-collection sites in some regions not seeing that many patients.’

An HHS official says that in May there was the capacity to do twice as many tests as were actually performed, calling it a function of ‘allocation and efficiency, but more just demand.’ Says Giroir, ‘We really see areas in the country now that there’s more tests available than people who want to get tested or the need for testing.'”

Before turning to some charts, a word about the data in the charts I’ve been using throughout the pandemic. Some of the nationwide information was directly from the CDC or the Johns Hopkins dashboard. In other cases, I’ve reported state level data and some nationwide data published by The COVID Tracking Project (CTP) and the COVID Time Series (CTS) dashboard, which uses state data from CTP. I first noticed a few discrepancies in the national totals in April, which have become larger with growth in the counts of cases and deaths. Here is a key part of CTP’s explanation:

“For many states, the CDC publishes higher testing numbers than the states themselves report, which raises questions about the structure and integrity of both state and federal data reporting. … Another point of contrast between the CDC’s new reporting and the official state data compiled by The COVID Tracking Project is that the CDC has not released historical, state-level testing data for the first three months of the outbreak.”

Thus, the CDC currently reports almost 120,000 U.S. deaths, while CTP reports about 112,000. Nevertheless, I will continue to report numbers from both sources for the sake of continuity, and I will try to remember to note the source in each case.

The first chart below shows the number of daily tests from CTP; the second chart shows the number of daily confirmed cases (CTP). Since mid-May, daily testing has increased by more than 50%, calculated on a moving average basis, and is now approaching half a million per day or more than 3 million per week. Pooled testing is coming, which will ultimately increase testing capacity several-fold. Daily confirmed cases have been hovered just above 20,000 since around Memorial Day, with a recent turn upward to around 24,000.

Early in the pandemic, I made the mistake of focusing too heavily on case numbers. Yes, I adjusted for population size and was aware that the initial shortage of tests was restraining diagnoses. Still, I did not foresee the great expansion in testing we’ve witnessed, the great transmissibility of the virus in some regions, nor the large number of asymptomatic cases that would ultimately be diagnosed.

The daily percentage of positive tests (CTP), which is smoothed in the chart below using a seven-day moving average to eliminate within-week variability, has declined gradually since early April to about 4% before the uptick in the last few days. Still, that’s a drop of about 75% from the peak when tests were in very short supply. Those were days when even heavily symptomatic individuals were having trouble getting tested.

We’d hope to see a resumption in the decline of the positive percentage as testing continues to grow, but even with a relatively constant positivity rate, the number of daily confirmed cases must grow as testing expands. There may be several reasons the positivity rate has remained stubbornly near 5% over the past few weeks. One is the obvious reversal in social distancing as states have opened up. People became less fearful about the virus in general, and protesters jammed the streets after the George Floyd murder in Minneapolis. Another reason is that there are new areas of focus for testing that might be picking up cases. For example, hospitals in some states are now testing all admissions for COVID-19. This will tend to pick up more infections to the extent that individuals with co-morbidities are hospitalized at higher rates in general and are also more susceptible to the coronavirus. Finally, testing more broadly is likely to pick up a larger share of asymptomatic cases even as the “true rate” of infection declines.

The daily death toll (CTP) attributed to coronavirus has continued to decline. See below. It is now running at about a third of the peak level it reached in mid-April. There are several reasons for the decline. One is the lower number of active cases, changes in which lead deaths by a few weeks. Awareness and testing capacity have undoubtedly led to earlier diagnosis of the most severe cases. There is also the strong possibility that the virus, having felled some of the most susceptible individuals, is now up against more hosts with effective immune responses. An ongoing degree of social distancing, more humid weather, and more direct sunlight have probably reduced initial viral loads from those experienced early-on, when the case load was escalating. Finally, treatment has improved in multiple ways, and there are now a few medications that have shown promise in shortening the duration and severity of infection.

The course of the pandemic has varied greatly across countries and across regions of the U.S. The New York City area was especially hard hit along with several other large cities, as well as Louisiana. CTS shows that states with the highest cumulative number of coronavirus deaths (New York (blue line), New Jersey (green), Massachusetts, Illinois, and Pennsylvania in the charts below) have experienced downward trends in positive cases per day (the first chart below), leading daily deaths downward in May and early June (the second chart — NY’s downtrend began earlier). I apologize if the charts below are difficult to read, but they have resisted my efforts at resizing. Note: I’m mainly focused on trends here, and I have not shown these series on a per capita basis.

More recently, almost two dozen states have begun to see higher daily case diagnoses. Several of these had more favorable outcomes in the early months of the pandemic and were in more advanced stages of reopening. The charts below (CTS) show results for Arizona, Florida, Georgia, and Texas. The new “hot spots” in these states are mostly urban centers. It’s not clear that the reopenings are to blame, however. The protests after George Floyd’s murder may have contributed in cities like Houston, though no increase in New York is apparent as yet. The states in the chart are all in the south or southwest, so the increases have occurred despite sunny, warm conditions. It’s possible that hot weather has prompted more intensive use of air conditioning, which dries indoor environments and can promote the spread of the virus. These southern states have not yet experienced a corresponding increase in deaths, though that would occur with a lag. 

Missouri has seen an slow upward trend in its daily positive test count over the past four weeks, even though the state’s positive rate has trended down slowly since early May. I show MO’s confirmed cases per day below (in green) together with Illinois’ (because my hometown is on the border and the two states are a nice contrast). IL is much larger and has had a much higher case load, but the downward trend in new cases in IL is impressive. Coronavirus deaths per day are shown in the second chart below, with seven-day averages superimposed. Deaths have also trended down in both states, though MO has experienced a few bad days very recently, and MO’s case fatality rate is slightly higher than in IL.

We’ll know fairly soon whether we’re really headed for a second major wave. However, the case count, in and of itself, is not too informative. Testing has increased markedly, so we would expect to see more cases diagnosed. The percent of tests that are positive is a better indicator, and it has flattened at a still uncomfortable 5% for about a month, with a slight uptick in the past few days. Even more telling will be the future path of coronavirus deaths. My expectation is that more recent infections are likely to be less deadly, if only because of the lessons learned about protecting the care-bound elderly. I also believe we’re not too far from what I have called effective herd immunity. 

The pandemic has taken a heavy toll, especially among the aged. In fact, total deaths in the U.S. have now exceeded both the Hong Kong flu of the late 1960s and the Asian flu of the late 1950s. Unfortunately, risks will remain elevated for some time. However, any reasonable estimate of the life-years lost is considerably less than in those earlier pandemics due to the differing age profiles of the victims. In any case, the coronavirus pandemic has not been the kind of apocalyptic event that was originally feared and erroneously predicted by several prominent epidemiological models. It can be tackled effectively and at much lower cost by focusing resources on protecting vulnerable segments of the population. 

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