Chill-Out Advisory: Pandemic to Endemic Means Live Again

13 Sunday Feb 2022

Posted by in Pandemic, Public Health, Uncategorized

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We might be just be done with the coronavirus pandemic. That is, it appears to be transitioning to a more permanent endemic phase. What follows are a few details about the Omicron wave and its current status, an attempt to put the risks of Covid in perspective, and a few public policy lessons that are now gaining broad currency but should have been obvious long ago.

What’s The Status?

The Omicron variant became the dominant U.S. strain of the coronavirus in December. Omicron outcompeted Delta, which was very good news because Omicron is far less severe. The chart below (from the CDC Data Tracker site) shows Omicron’s rapid ascendance and displacement of the Delta variant. The orange bar segments represent the proportion of cases of the Delta strain, while the purple and pink segments are Omicron sub-variants known as BA.1 and BA.2, respectively. BA.2 is even more transmissible than BA.1 and is likely to become dominant over the next month or so. However, the BA.2 sub-variant appears to be far less virulent than Delta, like BA.1.

Despite a record number of infections over a period of a month or so, the Omicron wave is tapering just as rapidly as it ramped up, as the next chart demonstrates. In fact, covidestim.org shows that cases are now receding in all states, DC, and Puerto Rico. Here are new cases per million people from Our World in Data:

Whether BA.2 causes cases to plateau for a while, or even a secondary Omicron “wavelet”, is yet to be seen. That would be consistent with the normal Hope-Simpson seasonal pattern of viral prevalence in the northern hemisphere (hat tip: HOLD2):

Data problems make the Omicron wave difficult to assess, however. We don’t know the share of incidental infections for the U.S. as a whole, but more than half of hospitalized Covid patients in Massachusetts and Rhode Island are classified with incidental infections. The proportion in the UK is estimated to be rising and approaching 30% of total cases, with much higher percentages in many regions of England, as shown below.

As I’ve emphasized in the past, case numbers should not be the primary gauge of the state of the pandemic, especially with a more highly contagious but relatively mild variant like Omicron. Hospitalizations are a better measure, but only if “incidental” infections are removed from the counts. That’s been acknowledged only recently by the public health establishment, and even the Biden Administration is emphasizing it as a matter of sheer political expediency. Another measure that might be more reliable for assessing the pandemic in the community as a whole is the number of emergency room patients presenting Covid-like symptoms. From the CDC Data Tracker:

There is no doubt that incidental infections create complications in caring for patients with other ailments. That has a bearing on the utilization of hospital capacity. Generally, however, strains on hospital capacity during the pandemic have been greatly exaggerated. This is not to diminish the hard work and risks faced by health care workers, and there have been spot shortages of capacity in certain localities. However, in general, staffed beds have been more than adequate to meet needs. This chart, like a few others below, is courtesy of Phil Kerpen:

With the more highly transmissible variants we have now, it’s not at all surprising to see a high proportion of incidental cases among inpatients. Incidental infections are likely to inflate counts of Covid deaths as well, given the exceptional and odd way in which Covid deaths are being recorded. It will be some time until we see full U.S. data on cases and deaths net of incidental infections. Moreover, many of the Covid deaths in December and January were from lingering Delta infections, which might still be a factor in the February counts.

How Are Your Odds?

The mild or asymptomatic nature of most Omicron cases, the large proportion of incidental hospitalizations, and the knowledge that Omicron is not a deep respiratory threat should offer strong reassurance to healthy individuals that the variant does not pose a great risk. According to a recent CDC report, in a sample of almost 700,000 vaccinated individuals aged 65 or less without co-morbidities, there were no Covid fatalities or ICU admissions during the 10 months from December 2020 through October 2021. There was only one fatality in the sample of healthy individuals older than 65. There were just 36 fatalities across the full sample of over 1.2 million vaccinated individuals, so COVID’s fatality risk was only about 0.3%. Of those deaths, 28 were among those with four or more risk factors (including co-morbidities and > 65 years). And this was before the advent of Omicron!

I have a few doubts about the CDC’s sample selection and vagaries around certain definitions used. Nevertheless, the results are striking. However, the study did not address risks to unvaccinated adults. Another more limited CDC study found that vaccinated patients were still less likely than the unvaccinated to require critical care during the Omicron wave.

A separate CDC study found a 91% reduction in the likelihood of death for Omicron relative to Delta. A study from the UK (see summary here) found that Omicron cases were 59% less likely than Delta cases to require hospitalization and 69% less likely to result in death within 28 days of a positive test. Omicron was far less deadly among both the vaccinated and the unvaccinated, and the latter had a larger reduction in the likelihood of death. The study was stratified by age as well, with less severe outcomes for Omicron among older cohorts except in the case of death, for which there was no apparent age gradient.

Another unnecessarily contentious issue has been the risk to children during the pandemic. Based on the data, there should never have been much doubt that these risks are quite low. Apparently, however, it was advantageous for teachers’ unions to insist otherwise. Phil Kerpen soundly debunks that claim with the following chart:

Covid has been less deadly to children from infancy through 17 years than the pre-pandemic flu going back to 2012! Oh yes, but teachers FEAR transmission from the children! That claim is just as silly, since children are known to be inefficient transmitters of the virus (and see here).

Now that Omicron has relegated the Delta variant to the history books, the risks going forward seem much more manageable. Omicron is less severe, especially for the vaccinated. Levels of acquired (natural) immunity from earlier infections are now much higher against older strains, and Omicron infections seem to be protective against Delta.

In commentary about the first CDC study discussed above, John Tierney lends perspective to the odds of death from pre-Omicron Covid:

“Those are roughly the same odds that in the course of a year you will die in a fire, or that you’ll perish by falling down stairs. Going anywhere near automobiles is a bigger risk: you’re three times more likely during a given year to be killed while riding in a car, and also three times more likely to be a pedestrian casualty. The 150,000-to-1 odds of a Covid death are even longer than the odds over your lifetime of dying in an earthquake or being killed by lightning.”

Yet with all this research confirming the low odds of death induced by Omicron, why have we seen recent deaths at levels approaching previous waves? First, many of those deaths are carried over from Delta infections. That means deaths should begin to taper rapidly as February reports roll in. And remember that daily reports do not show deaths by date of death. Deaths usually occur weeks or even months before they are reported. That also means some of the deaths reported might be “harvested” from much earlier fatalities. Second, given the high levels of incidental Omicron infections, some of those deaths are misattributed to Covid, an issue that is not new by any means. Finally, while Omicron is relatively mild for most people, the high rate of transmission means that a high number of especially vulnerable individuals may be infected with severe outcomes. We have seen much more severe consequences for the unvaccinated, of course, and for those with co-morbidities.

Things We Should Have Known

I’ll try to keep this last section brief, but as an introduction I’ll just say that it’s almost as if we’ve been allowing the lunatics to run the asylum. To paraphrase one comment I saw recently, if you wonder why there is so much dissent, you ought to consider the fact the much of what our governments have done (along with many private organizations) was to prohibit things that were demonstrably safe (e.g., going outside, using swing sets, or attending schools) and to encourage things that were demonstrably harmful (e.g., deferring medical care, or masking small children).

The following facts are only now coming into focus among those who’ve been “following the politics” rather than “the science”, despite pretensions to the latter.

Grow Up and Chill Out!

Life is full of risks, and nothing has changed to alter wisdom gained in earlier pandemics. For example, this pearl from a 2006 publication on disease mitigation measures should be heeded (hat tip: Phil Kerpen):

If there is one simple message everyone needs to hear, it is to stop allowing the virus bogeyman to rule your life. It will never go away completely, and it is likely to present risks that is are comparable to the flu going forward. In fact, it might well compete with the flu, which means we won’t be dealing with endemic Covid plus historical flu averages, but some smaller union of the two case loads.

So get out, go back to work, or go have some fun! Get back truckin’ on!

Feel the Nutzenfreude: Joy In Success of Others

06 Sunday Feb 2022

Posted by in Free markets, Human Welfare

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Michael Munger is a professor of economics at Duke University who has coined a term for the distaste we observe, in some quarters, for the success of others. He calls it Nutzenschmerz, a conjunction of the German words “nutzen” (benefit) and “schmerz” (pain).

According to Munger, nutzenschmertz is an impulse of “indignant outrage over someone getting” … “an undeserved benefit”. Of course, “undeserved” is a key word here. I suspect those inflicted with nutzenschmerz apply definitions as flexible and arbitrary as the envy from which they suffer. Nutzenschmerz is a special kind of envy, however, because it doesn’t necessarily imply a personal want of the benefit. It’s simply a condemnation of another’s good fortune. Munger applies an additional twist to the definition, which I discuss below. As a mnemonic device, it might be helpful to think of nutzenschmerz as a hatred for anyone who “gets their nut”!

People of good spirit believe success in others is something to admire, at least if it doesn’t come at someone else’s expense. Perhaps success is more admirable as the fruit of hard work and talent, as opposed to dumb luck. But good luck is nothing to be ashamed of, and it’s often said we make our own luck. Well, maybe only lucky people say that! “Luck” doesn’t necessarily come at the expense of others, however, and no one “loses” things they have no right to expect.

Furthermore, one’s success, lucky or otherwise, often inures to the benefit of others in the form of better products, new jobs, and higher income. For example, if I were to find a deposit of some rare earth mineral on my property while digging a well, I’d consider myself quite lucky. I would then hire people to mine it. The new supplies of the mineral would be used in industry, bringing more plentiful supplies of certain products to consumers. New jobs! Cheaper products!

Economists have a particular framework for discussing “successes” of this kind. If a change occurs from which everyone benefits and no one loses, economists say the change is a Pareto improvement. If only only a few benefit and no one is made worse off, it is a weak Pareto improvement. When all such opportunities have been exhausted, we have reached a state of Pareto optimality. Free markets generally move society toward that state, externalities aside. This is an aspect of what’s meant when we say markets promote economic efficiency. And when technology, tastes, or resource availability change, as they do constantly, new opportunities arise for Pareto improvements.

The Left is selectively intolerant of success and even Pareto improvements from luck or effort. The attitude is usually couched in terms of undeserved “privilege” or some form of “exploitation”. They exempt their own gains, of course, especially when they find themselves in a position to pick winners (and that enterprise almost always involves picking losers as well). In fact, they are probably inclined to celebrate success that owes to subsidies for politically favored activities, which clearly come at the expense of others and are not Paretian in any sense. Social justice warriors demand a free pass on coveting what belongs to others, and they are often just as contemptible of successful effort as they are of dumb luck. Whatever it is you have, or have achieved, don’t expect them to respect it … or your right to have it.

The word Nutzenschmerz amuses me partly because the original German form of my name begins with the letters “Nütz“. Also, like Munger, I’ve always been charmed by the German linguistic practice of stringing words together, like the more familiar Schadenfreude, which means to take pleasure in the misfortunes of others. Or Freundschaftsbeziehungen (friendship demonstrations). Mark Twain said some German words are so long they have perspective! David Sedalis once commented that he heard lots of long words in Germany, but one of the few that stuck was Lebensabschnittspartner:

“This doesn’t translate to ‘lover’ or ‘life partner’ but, rather, to ‘the person I am with today,’ the implication being that things change, and you are keeping yourself open.”

Then, of course, take Gleichschaltung (the standardization of political, economic, and social institutions in authoritarian states). Er … no, please, not that!

In addition to nutzenschmirz, Munger has coined the term Tradenfreude, meaning “joy … at observing the ‘well-contrived machine’ of commercial society, with everyone trading with everyone else for conveniences and necessities.” By extension, he adds Tradenschmerz, meaning the hatred reserved for free markets by many leftists.

Nutzenschmerz is an emotive force that shapes the Marxist psyche. It could be dismissed as incidental to a shallow grasp of the mutually beneficial nature of voluntary trade. However, it also demonstrates a fundamental disrespect for property rights. It’s a rejection of the very things that motivate human action, and which enable cooperation on a scale unprecedented over nearly all of human history preceding the Scottish Enlightenment.

I propose that we should all practice a philosophy of Nutzenfreude, by which I mean taking pleasure in the Paretian successes of others. It might be vicarious, or it might signal the genesis of new opportunities for the rest of us! The thing is, those successes all represent human progress to one degree or another, from which we all derive incremental benefits. That doesn’t mean we shouldn’t be watchful for harms or externalities, but neither should we regard every success with suspicion, or worse, nutzenschmerz!

Do as Munger says: fight nutzenschmerz! And revel in nutzenfreude!

Fiscal Inflation Is Simple With This One Weird Trick

03 Thursday Feb 2022

Posted by in Fiscal policy, Inflation

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I’ll get to the weird trick right off the bat. Then you can read on if you want. The trick really is perverse if you believe in principles of sound credit and financial stability. To levy a fiscal inflation tax, all the government need do is spend like a drunken sailor and undermine its own credibility as a trustworthy borrower. One way to do that: adopt the policy prescriptions of Modern Monetary Theory (MMT).

A Theory of Deadbeat Government

That’s right! Run budget deficits and convince investors the debt you float will never be repaid with future real surpluses. That doesn’t mean the government would literally default (though that is never outside the realm of possibility). However, given such a loss of faith, something else must give, because the real value government debt outstanding will exceed the real value of expected future surpluses from which to pay that debt. The debt might be in the form of interest-bearing government bonds or printed money: it’s all government debt. Ultimately, under these circumstances, there will be a revised expectation that the value of that debt (bonds and dollars) will be eroded by an inflation tax.

This is a sketch of “The Fiscal Theory of the Price Level” (FTPL). The link goes to a draft of a paper by John Cochrane, which he intends as an introduction and summary of the theory. He has been discussing and refining this theory for many years. In fairness to him, it’s a draft. There are a few passages that could be written more clearly, but on the whole, FTPL is a useful way of thinking about fiscal issues that may give rise to inflation.

Fiscal Helicopters

Cochrane discusses the old allegory about how an economy responds to dollar bills dropped from a helicopter — free money floating into everyone’s yard! The result is the classic “too much money chasing too few goods” problem, so dollar prices of goods must rise. We tend to think of the helicopter drop as a monetary policy experiment, but as Cochrane asserts, it is fiscal policy.

We have experienced something very much like the classic helicopter drop in the past two years. The federal government has effectively given money away in a variety of pandemic relief efforts. Our central bank, the Federal Reserve, has monetized much of the debt the Treasury issued as it “loaded the helicopter”.

In effect, this wasn’t an act of monetary policy at all, because the Fed does not have the authority to simply issue new government debt. The Fed can buy other assets (like government bonds) by issuing dollars (as bank reserves). That’s how it engineers increases in the money supply. It can also “lend” to the U.S. Treasury, crediting the Treasury’s checking account. Presto! Stimulus payments are in the mail!

This is classic monetary seigniorage, or in more familiar language, an inflation tax. Here is Cochrane description of the recent helicopter drop:

“The Fed and Treasury together sent people about $6 trillion, financed by new Treasury debt and new reserves. This cumulative expansion was about 30% of GDP ($21,481) or 38% of outstanding debt ($16,924). If people do not expect that any of that new debt will be repaid, it suggests a 38% price-level rise. If people expect Treasury debt to be repaid by surpluses but not reserves, then we still expect $2,506 / $16,924 = 15% cumulative inflation.”

FTPL, May I Introduce You To MMT

Another trend in thought seems to have dovetailed with the helicopter drop , and it may have influenced investor sentiment regarding the government’s ever-weakening commitment to future surpluses: that would be the growing interest in MMT. This “theory” says, sure, go ahead! Print the money government “must” spend. The state simply fesses-up, right off the bat, that it has no intention of running future surpluses.

To be clear, and perhaps more fair, economists who subscribe to MMT believe that deficits financed with money printing are acceptable when inflation and interest rates are very low. However, expecting stability under those circumstances requires a certain level of investor confidence in the government fisc. Read this for Cochrane’s view of MMT.

Statists like Bernie Sanders, Alexandria Ocasio-Cortez, and seemingly Joe Biden are delighted to adopt a more general application of MMT as intellectual cover for their grandiose plans to remake the economy, fix the climate, and expand the welfare state. But generalizing MMT is a dangerous flirtation with inflation denialism and invites economic disaster.

If This Goes On…

Amid this lunacy we have Joe Biden and his party hoping to find avenues for “Build Back Better”. Fortunately, it’s looking dead at this point. The bill considered in the fall would have amounted to an additional $2 trillion of “infrastructure” spending, mostly not for physical infrastructure. Moreover, according to the Congressional Budget Office, that bill’s cost would have far exceeded $2 trillion by the time all was said and done. There are ongoing hopes for separate passage of free community college, an extended child tax credit for all families, a higher cap for state and local income tax deductions, and a host of other social and climate initiatives. The latter, relegated to a separate bill, is said to carry a price tag of over $550 billion. In addition, the Left would still love to see complete forgiveness of all student debt and institute some form of universal basic income. Hey, just print the money, right? Warm up the chopper! But rest easy, cause all this appears less likely by the day.

Are there possible non-inflationary outcomes from ongoing helicopter drops that are contingent on behavior? What if people save the fresh cash because it’s viewed as a one-time windfall (i.e., not a permanent increase in income)? If you sit on such a windfall it will erode as prices rise, and the change in expectations about government finance won’t be too comforting on that score.

There are many aspects of FTPL worth pondering, such as whether bond investors would be very troubled by yawning deficits with MMT noisemakers in Congress IF the Fed refused to go along with it. That is, no money printing or debt monetization. The burgeoning supply of debt would weigh heavily on the market, forcing rates up. Government keeps spending and interest costs balloon. It is here where Cochrane and critics of FTPL have a sharp disagreement. Does this engender inflation in the absence of debt monetization? Cochrane says yes if investors have faith in the unfaithfulness of fiscal policymakers. Excessive debt is then every bit as inflationary as printing money.

Real Shocks and FTPL

It’s natural to think supply disruptions are primarily responsible for the recent acceleration of inflation, rather than the helicopter drop. There’s no question about those price pressures in certain markets, much of it inflected by wayward policymakers, and some of those markets involve key inputs like energy and labor. Even the median component of the CPI has escalated sharply, though it has lagged broader measures a bit.

Broad price pressures cannot be sustained indefinitely without accommodating changes in the supply of money, which is the so-called “numeraire” in which all goods are priced. What does this have to do with FTPL or the government’s long-term budget constraint? The helicopter drop certainly led to additional money growth and spending, but again, FTPL would say that inflation follows from the expectation that government will not produce future surpluses needed for long-term budget balance. The creation of either new money or government debt, loaded the chopper as it were, is sufficient to accommodate broad price pressures over some duration.

Conclusion

Whether or not FTPL is a fully accurate description of fiscal and monetary phenomena, few would argue that a truly deadbeat government is a prescription for hyperinflation. That’s an extreme, but the motivation for FTPL is the potential abandonment of good and honest governing principles. Pledging an inflation tax is not exactly what anyone means by the full faith and credit of the U.S. government.

The Great Unmasking: Take Back Your Stolen Face!

28 Friday Jan 2022

Posted by in Masks, Pandemic

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Right at the start of the pandemic, Dr. Anthony Fauci insisted that masks were unnecessary, which was in line with the preponderance of earlier evidence. Later, he sowed confusion — and distrust — by claiming he said that to discourage a run on masks, thus preserving supplies for the medical community. That mix-up put a stain on his credibility among those who were paying attention, and the reversal was simply bad policy given what is well established by the evidence on mask efficacy.

No Mas, No Mask!

Despite my own doubts about the efficacy of masks, I went along with masking for a while. It gave me a chuckle to see people wearing them outside, especially runners, or solo drivers. We knew by then that contracting Covid outside was highly unlikely. I was also amused by the idiotic protocols in place at many restaurants, where it was just fine to remove them once you walked a few feet to sit at your table, as if aerosols indoors were bound within narrow bands of altitude. Finally, I had reservations about the health consequences of frequent masking, which have certainly been borne out. Restricting air flow is generally not good for human health! Neither is trapping bits of sputum and hot, exhaled moisture rich in microbes right up against one’s muzzle. Still, I thought it polite to wear a mask in places of business, and I did so for a number of months.

In time it became apparent that the cloth and paper masks we were all wearing were a waste of effort. Covid is spread via fine aerosols and generally not droplets. That’s important because the masks in common use cannot block a sufficient level of Covid particles from escaping nor from penetrating through gaps and through the fiber itself. Neither can N95s if not fitted properly, as so many are not. And none of these masks can protect your eyeballs! When tens of thousands of tiny beads of aerosol are released with each cough or exhalation, a mask that stops 70% of them will not accomplish much.

The evidence began to accumulate that mask mandates were completely ineffective at “stopping the spread” of Covid. I then became an ardent anti-masker. I generally don’t wear them anywhere except medical buildings, and then only because I refuse to defer normal medical care, the consequences of which have been tragic during the pandemic. I have told clerks “I don’t need a mask”, which is true, and they have backed off. I have turned on my heal at stores that refuse to give on the issue, but like masks themselves, the signs on the doors are usually more for show than anything else. So I walk right past them.

Now, the Biden Administration has decided to provide to the public 400 million N95 masks — on the taxpayer! It’s a waste of time and money. But the timing is incredible, just as the Omicron wave crashes on it’s own. It will be one more worthless act of theatre. But don’t doubt for a moment that Joe Biden, when no one remembers the timing, will claim that this action helped defeat Omicron.

Mask Varieties

What is the real efficacy of masks in stopping the spread of Covid aerosol emissions? Cloth masks, including bandanas and scarves, are still the most popular masks. Based on casual observation, I suspect most of those masks aren’t washed as frequently as they should be. People hang them from their rear view mirrors for God knows how long. Beyond that, cloth masks tend to fit loosely and protect from aerosols about as well as the disposable medical or surgical masks that are now so common. Which is to say they don’t provide much protection at all.

But can that be? Don’t surgeons think they help? Well yes, because operating rooms can be very splattery places. Besides, it’s rude to sneeze into your patient’s chest cavity. Protection against fine aerosols? Not so much. “Oh, but should I double mask?”, you might ask? Gross! Just Shut*Up!

Face shields are “transparently” useless, offering no barrier against floating aerosols whatsoever except a fleeting moment’s protection against those blown directly into the wearer’s face. Then there are respirator masks: N95 and KN95, which are essentially the same thing. The difference is that KN95s must meet Chinese performance standards rather than U.S. standards. Both must filter and capture 95% of airborne particles as small as 0.3 microns. Covid particles are smaller than that, but the aerosol “beadlets” in which they are swathed may be larger, so the respirators would appear to be a big step up from cloth or surgical masks. R95 and P95 masks are made for protection against oil-based particles. They seem to be better overall due to thicker material and tighter fit with an overhead strap and extra padding.

Measuring Mask Efficacy

A thorough assessment of these mask types is documented in a 2021 paper published in The Physics of Fluids. Here are the baseline filtration efficiencies measured by the authors with an ideal mask fit relative to exhalation of 1 micron aerosols:

  • Cloth_______40%
  • Surgical____47%
  • KN95_______95%
  • R95_________96%

These are simply the filtration efficiencies of the respective barrier materials used in each type of mask, as measured by the researcher’s tests. Obviously, cloth and surgical masks don’t do too well. Unfortunately, even the N95 and KN95 masks never fit perfectly:

“It is important to note that, while masks … decrease the forward momentum of the respiratory jet, a significant fraction of aerosol escapes the masks, particularly at the bridge of the nose.”

Next, the authors assess the “apparent” filtration efficiencies of masks measured by relative aerosol concentrations in an enclosed space, measured two meters away from the source, after an extended period. This is a tough test for a mask, but it amounts to what people hope masks can accomplish: trapping aerosols containing bits of crap on material surrounding the nose and mouth, and for many hours. Here are the results:

  • Cloth___________9.8%
  • Surgical_______12.4%
  • KN95__________46.3%
  • R95____________60.2%
  • KN95-Gap______3.4%
  • KN95-Valve____20.3%

Cloth and surgical masks don’t do much to reduce the aerosol concentrations. Both the KN95 and R95 masks capture a meaningful share of the aerosols, but the R95 is a bit more effective. Remember, however, that the uncaptured share is a stand-in for the many thousands of virus particles that would remain suspended within the indoor space, so the filtration efficiency of the R95, while far superior to cloth or surgical masks, would do little to mitigate the spread of the virus. The KN95-Gap case is a test of a more “loosely fitted” mask with 3 mm gaps, which the authors say is realistic. Under those circumstances, the KN95 is about as good as nothing. Finally, the authors tested a well-fitted KN95 equipped with a one-way discharge valve. While its efficiency was better than cloth or surgical masks, it still performed poorly. The authors also found that various degrees of air filtration were far more effective in reducing aerosol concentrations than masks.

On the subject of mask fit, I quote Dr. Robert Lending, who has regularly chronicled pandemic developments for patients in his practice since the start of the pandemic:

“N95 type masks cannot be worn by men with beards. They must be so tightly fitted that they leave deep creases in your face. Prior to Covid-19, when hospital employees had to wear them for TB exposure prevention, they were told not to wear them for more than 3 hours at a time. They had to be fit-tested and gas leak-tested. … The N95 knockoffs such as the KN95s are not as good. N95 with valves do not protect others from you. There are now many counterfeit N95s for sale. … Obviously, N95s were never meant to be worn for 8-12 hours; and certainly not by youth and school children. If you are wearing an N95 and you can smell anything, such as aroma in a restaurant when you walk in, perfume, cologne, coffee, citrus, foul odors, etc.; then your fit is not correct and that N95 is worthless.”

Other Evidence

Another kind of evidence on mask efficacy is offered by randomized control trials (RCTs) in mitigating transmission of the influenza virus across a variety of settings, including hospital wards, schools, and neighborhoods of varying characteristics. A meta-analysis of 44 such RCTs published in the Cochran Library in late 2020 found that surgical masks make little or no difference to the spread of the virus. In a small set of RCTs from health care settings, the authors found that N95 and P95 masks perform about as well as surgical masks in limiting transmission.

An excellent review of research on mask efficacy appeared in City Journal last August. The author, Jeffrey H. Anderson, was fairly awestruck at the uniformity of RCT evidence that masks are ineffective. One well-publicized RCT purporting to show the opposite relied on effects that were negligible. Meanwhile, other research has shown that state-level mask mandates are ineffective at reducing the spread of the virus. Finally, here is a nice “cheat sheet” containing links to a number of mask studies.

Children

Children in many parts of the country are forced to wear masks at school. It’s well-established, however, despite wailing from teachers’ unions, that Covid poses extremely low risks to children. And there is no shortage of evidence that constant masking has extremely negative effects on children. The stupidity has reached grotesque proportions. Now, some school districts are proposing that children wear N95 masks! This is unnecessary and cruel, and it is ineffective precisely because children will be even less likely to use them properly than adults, who are generally not very good at it. From the last link:

“If N95s filter so well, why are respirators an ineffective intervention? Because masking is a behavioral intervention as much as a physical one. For respirators to work, they must be well fitting, must be tested by OSHA, and must be used for only short time windows as their effectiveness diminishes as they get wet from breathing.

“Fit requirements and comfort issues are untenable in children who have small faces and are required to wear masks for six or more hours each day. For these reasons, NIOSH specifically states that children should not use respirators, and there are no respirators that are approved for children. These views are shared by the California Department of public health. Concerns about impaired breathing and improper use outweigh potential benefits. There are no studies on the effectiveness of respirators on children because they are not approved for pediatric use.”

Rip It Off

At this point in the Omicron wave, which appears to have crested, we’re basically dealing with a virus that is less lethal than the flu and, for most people, comparable to the common cold. It’s a good time for the timid to shed their masks, which don’t help contain the spread of the virus to begin with. And masks do more harm than has generally been acknowledged, especially to children. So stop the bullshit. Take off your mask, and leave it off!

Vagaries of Vaccine Efficacy

23 Sunday Jan 2022

Posted by in Coronavirus, Vaccinations

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There should never have been any doubt that vaccines would not stop you from “catching” the coronavirus. Vaccines cannot stop virus particles from lodging in your nose or your eyeballs. The vaccines act to prime the immune system against the virus, but no immune response is instantaneous. In other words, if you aren’t first “infected”, antibodies don’t do anything! A virus may replicate for at least a brief time, and it is therefore possible for a vaccinated individual to carry the virus and even pass it along to others. The Omicron variant has proven that beyond a shadow of a doubt, though the wave appears to be peaking in most of the U.S. and has peaked already in a few states, mostly in the northeast.

I grant that the confusion over “catching” the virus stems from an imprecision in our way of speaking about contracting “bugs”. Usually we don’t say we “caught” one unless it actually makes us feel a bit off. We come into intimate contact with many more bugs than that. The effects are often so mild that we either don’t notice or brush it off without mention. But when it comes to pathogens like Covid and discussions of vaccine efficacy (VE), it’s obviously useful to remember the distinction between infections, on the one hand, and symptomatic infections on the other.

Cases Are the Wrong Focus

Unless calibrated by seroprevalence data, these studies are not based on proper estimates of infections in the population. Asymptomatic people are much less likely to get tested, and vaccinated individuals who are infected are either much more likely to be asymptomatic or the test might not detect the weak presence of a virus at all. VE based on detected infections is essentially meaningless unless testing is universal.

We are bombarded by studies (and analyses like the one here) alleging that VE should be judged on the reduction in infections among the vaccinated. The likelihood of a detected infection by vaccination status is simply the wrong way to measure of VE. It’s not so much the direction of bias in measured VE, however. The mere presence of cases among the vaccinated has been sufficient to inflame anti-vax sentiment, especially cases detected in mandatory tests at hospitals, where the infections are often incidental to the primary cause of admission.

The typical evolution of a novel virus is further reason to dismiss case numbers as a basis for measuring VE. Mutations create new variants in ways that usually promote the continuing survival of the lineage. Subsequent variants tend to be more transmissible and less deadly to their hosts. Thus, given a certain “true” degree of VE, so-called breakthrough infections among the vaccinated are even more likely to be asymptomatic and less likely to be tested and/or detected.

There is the matter of immune escape or evasion, however, which means that sometimes a virus mutates in ways that get around natural or vaccine-induced immune responses. While such a variant is likely to be less dangerous to unvaccinated hosts, more cases among the vaccinated will turn up. That should not be interpreted as a deterioration in VE, however, because detected infections are still the wrong measure. Instead, the fundamental meaning of VE is a lower virulence or severity of a variant in vaccinated individuals than in unvaccinated individuals.

Interestingly, to digress briefly, while immune escape has been discussed in connection with Omicron, that variant’s viral ancestors may have predated even the original Covid strain released from the Wuhan lab! It is a fascinating mystery.

Virulence

In fact, vaccines have reduced the virulence of Covid infections, and the evidence is overwhelming. See here for a CDC report. The chart below is Swiss data, followed by a “handy” report from Wisconsin:

From the standpoint of virulence, there are other kinds of misguided comparisons to watch out for: these involve vaxed and unvaxed patients with specific outcomes, like the left side of the graphic at the top of this post (credit to Twitter poster aparachick). This thread has an excellent discussion of the misconception inherent in the claim that vaccines haven’t reduced severity: the focus is on the wrong conditional probability (again, like the left side of the graphic). Getting that wrong can lead to highly inaccurate conclusions when the sizes of the two key groups, hospitalizations and vaccinated individuals in this case, are greatly different.

Bumbled Messaging

The misunderstandings about VE are just one of many terrible failures of public health authorities over the course of the pandemic. There seems to have been fundamental miscommunication by the vaccine manufacturers and many others in the epidemiological community about what vaccines can and cannot do.

Another example is the apparent effort to downplay the importance of natural immunity, which is far more protective than vaccines. This looks suspiciously like a willful effort to push the narrative that universal vaccination as the only valid course for ending the pandemic. Even worse, the omission was helpful to those attempting to justify the tyranny of vaccine mandates.

Waning Efficacy

It should be noted that the efficacy of vaccines will wane over time. This phenomenon has been measured by the presence of antibodies, which is a valid measure of one aspect of VE over time. However, immune responses are more deeply embedded in the human body: so-called T-cells carry messages alerting so-called B-cells to the presence of viral “invaders”. The B-cells then produce new antibodies specific to characteristics of the interloping pathogen. Thus, these cells can function as a kind of “memory” allowing the immune system to mount a fresh antibody defense to a repeat or similar infection. The reports on waning antibodies primarily in vaccinated but uninfected individuals do not and cannot account for this deeper process.

Conclusion

Vaccines don’t necessarily reduce the likelihood of infection or even the spread of the virus, but they absolutely limit virulence. That’s why Jay Bhattacharya, one of the authors of The Great Barrington Declaration, says the vaccines provide a private benefit, but only a limited public benefit. Yet too often we see VE measured by the number of infections detected, and vaccine mandates are still motivated in part by the idea that vaccines offer protection to others. They might do that only to the extent that infections are less severe and clear-up more quickly.

Voting Rights Doublespeak

18 Tuesday Jan 2022

Posted by in Voter Fraud, Voting Rights

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The so-called insurrection that took place on January 6, 2021 (J6) has obsessed Democrats seeking to ram through a “voting rights” bill that they hope will advantage them in future elections. Oh, and to legitimize proposed new powers for agencies in the fight against “domestic terror”, and to somehow disqualify Donald Trump from holding the presidency again. We can thank a couple of moderate Democrats for shutting down the election bill, at least for the time being, by refusing to eliminate the filibuster.

The Real Threat to Voting Rights

If your real aim is to undermine ballot security and make it easier to cheat, you’d have to work hard to beat the election bill pushed by the Biden Administration: the Freedom To Vote Act (FVA). In their fashion, however, the Left prefers to stake-out phony rhetorical high-ground, replete with spurious charges against the opposition alleging racism and subversive, anti-democratic intent. Joe Biden demonstrated this vividly during his ill-advised speech in Georgia last week.

Here is a fairly thorough summary of the FVA, including an earlier version passed by the House last March. The overarching thrust of the bill is to substitute federal for state authority over the election process. States would not be permitted to demand that voters produce photo IDs. The bill would also require automatic voter registration at the department of motor vehicles and other government agencies, on-line registration, same-day registration, more days of early voting, excuse-free, notary-free, and witness-free absentee ballots, and extended counting of late-arriving ballots.

Democrats in the House of Representatives have now used a NASA funding bill as a shell for all these federally-prescribed protocols. Reportedly, this bill would legalize ballot harvesting nationwide, but that does not appear to be the case. Nevertheless, it includes all of the other provisions cited above, and many others.

While Congress certainly has the power to regulate elections, states were given the primary authority for conducting elections under the Constitution:

“The Times, Places and Manner of holding Elections for Senators and Representatives, shall be prescribed in each State by the Legislature thereof; but the Congress may at any time by Law make or alter such Regulations, except as to the Places of chusing Senators.”

The Voting Rights Act of 1965 helped secure minority voting rights that plainly exist under the Constitution, and it prescribed federal review of certain changes in state voting procedures (some aspects of which were struck down by the Supreme Court). However, never before has such sweeping federal authority been proposed as to the range of mechanics involved in casting and counting ballots. Ballot security would be compromised by several provisions of the legislation.

While voter registration should be relatively painless, it should not be so painless that non-citizens find it easy to register. That is likely to be the case under automatic voter registration. Surely many non-citizens have much to recommend them, but they have not yet demonstrated their commitment to the nation through earned citizenship. The right to vote is a benefit of citizenship; it serves as an inducement to learn about our system of government through the naturalization process. These individuals might not be interested in going to the trouble, however, or they might be loyal to a foreign power. Do we really want such individuals to have a vote? And to the extent that their interest is focused on public benefits, they surely do not have an equal claim to natural-born but similarly-situated Americans.

Voter ID is a safeguard against voter fraud, and a huge majority of Americans support it, including majorities of minorities. The very idea that a photo ID requirement would “suppress” the legitimate votes of minorities is based on the presumption that those voters might have difficulty obtaining identification such as a drivers license or other government ID. Oh really? We can safely file that contention under “the bigotry of low expectations”.

Extensive use of absentee ballots was intended to facilitate voting during pandemic restrictions that were expected to reduce the safety and efficiency of polling places. However, most developed countries ban “mail-in voting”, regarding it as a prescription for voter fraud. That threat seems all too real given the lax standards proposed in the FVA.

The Threat to Political Opposition

The House investigative committee looking into the January 6th melee may recommend new intelligence powers for the federal government. Those powers aren’t needed to investigate the Capitol riot: the FBI has been in possession of teams of video evidence, and it has broad powers under the PATRIOT Act and other measures. Here’s Patrick Eddington from the link above:

“… the FBI already has unbelievably sweeping authority to surveil individual Americans or domestic groups without ever having to go before a judge to get a warrant.

Under an investigative category known as an assessment, FBI agents can search commercial and government databases (including databases containing classified information), run confidential informants, and conduct physical surveillance, all without a court order.”

The simple truth is that certain congressional Democrats and the Biden Administration are attempting to use the Capitol riot as an excuse to turn federal law enforcement against their political enemies. The claim by Biden, the guy who bragged of being mentored by Klansman Robert Byrd, and the same man who praised George Wallace on several occasions, is that his opponents are “domestic terrorists” and/or “white supremacists”. We’ve seen quite enough of this chicanery already. Having suffered through a lengthy “Russian collision” charade, a willingness to completely ignore massive riots and property destruction by BLM and Antifa activists in 2020, and an orchestrated attempt to treat concerned parents of schoolchildren as “domestic terrorists”, we’re expected to believe that these stooges need more power?

The J6 Fiasco

And that brings us back to the Capitol riot. It was, as Glenn Reynolds has said, a clownshow and a mess. But speaking of insurrection, let’s hope the FBI is keeping its eye on violent leftists as well, who perpetrated some unquestionably treasonous escapades in the not very distant past. From Legal Insurrection:

“…leftist rioters … attempted to stop the peaceful transition of power during President Trump’s inauguration. … did anti-Trump leftists riot, attack and injure police, set cars and buildings on fire… …

… the multi-day May, 2020 assault on the White House that left at least 60 Secret Service agents wounded and forced President Trump to be whisked away to a bunker for his personal safety.”

Even more dangerous leftist attacks on the Capitol building have been perpetrated, such as bombings by the Weather Underground in 1971 and the Armed Resistance in 1983.

Many people were hurt in the J6 riot through no real fault of their own, including Ashli Babbitt, who was shot and killed by a Capitol police officer shortly after she attempted to stop attackers from smashing windows. Nevertheless, those who breached the Capitol building were mostly a bunch of hapless goofballs encouraged to run amuck by certain instigators. Among those were the Oathkeepers, a gang who marched around in stack formation wearing gear that looked vaguely militaristic. They brought no weapons to the Capitol (though they had some stashed in the VA suburbs). Apparently, one of them did assist a crowd in barging through a door to the Capitol. Their activities on J6 have been described by one pundit as LARP — live action role playing. Nevertheless, there was much talk among them of interfering with the transfer of power to “the usurper”, as they called Joe Biden. And now, eleven of them have been charged with insurrection and sedition. Members of the Proud Boys were also at the Capitol, some of whom fought with police.

But what really happened to make things go off the rails on January 6th? This article by Joseph M. Hanneman offers an excellent discussion of the events of that afternoon, and the subsequent investigation. He notes the mysterious absence of a number of individuals involved in the breach of the Capitol and grounds from the FBI’s “Seeking Information” list of over 1,500 photos. That includes one Ray Epps, whose incitement was otherwise fairly well-documented. Some suspect certain parties with no interest in seeing Donald Trump remain in office actually encouraged the rioters, up to and including the FBI. Would that surprise anyone after the Whitmer kidnapping operation or the Russian collusion hoax?

The vast majority of the crowd on J6 came to the Capitol grounds to conduct a peaceful protest in the vain hope for congressional action to put a hold on the counting of electors pending state election audits, investigations, and court challenges. Many of those arrested were denied due process, and were held for months with no charges filed.

As for the “threat to the nation” posed by the crowd on J6, I found this Marco Rubio quote to be apropos:

“I don’t care how many candlelight vigils and musical performances you have from the cast of Hamilton, you’re not going to convince most normal and sane people that our government last year was almost overthrown by a guy wearing a Viking hat and speedos.”

Conclusion

Democrats still hope to vote to eliminate the Senate filibuster and then pass the FVA. That is a pipe dream at this point, but they would come to regret eliminating the filibuster in due course. They have used it themselves to defeat legislation hundreds of times in the recent past. The filibuster has its shortcomings, particularly its inability to restrain executive power. Nevertheless, it has never been more critical as protection against a tyrannical (and slim) majority in Congress.

The Freedom To Vote Act is doomed to failure. Still, no one should forget the mendacious rhetoric employed by Joe Biden and the leftist Democrat leadership in Congress on the issue of election integrity. Nor should anyone forget their dishonorable, anti-democratic intent to devalue legitimate voting rights.

Three Justices Reveal Astonishing Covid Ignorance

10 Monday Jan 2022

Posted by in Coronavirus, Supreme Court, Vaccinations

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Good God! What a remarkable display of ignorance we witnessed on Friday from three different Supreme Court justices. This trio dumped buckets-full of erroneous information about the current state of the COVID pandemic, all points that are easily falsifiable. The three are Sonia Satamayor, Stephen Breyer, and Elena Kagan. The flub-fest occurred during a proceeding on challenges to OSHA’s attempt to impose a nationwide vaccine mandate on private employers having more than 100 employees. I’m sorely tempted to say these jurists must know better, but perhaps they were simply parroting what they’ve heard from “reliable” media sources.

Here’s a list of the false assertions made by the three justices at the hearing, as compiled by Michael P. Sanger, along with my own brief comments:

  • 100,000 children in critical care and on ventilators (Sotomayor) — Not even close!
  • Vaccine mandate would prevent 100% of US cases (Breyer) — Lol!
  • 750 million people tested positive last Thursday (Breyer) — That’s more than twice the U.S. population… in one day! Haha! See here.
  • COVID deaths are at an all-time high (Sotomayor) — No, they are well under half of the all-time high, and many of those “announced” deaths are Delta deaths and deaths that occurred weeks to months ago.
  • It’s “beyond settled” that vaccines and masks are the best way to stop the spread (Kagan) — Say what?
  • COVID vaccines stop transmission (Kagan) — Is that why two fully vaccinated attorneys arguing the government’s case just tested positive?
  • Federal agencies can mandate vaccines using the police powers of the federal government (Sotomayor) — Incorrect, not at their fancy. Police powers with respect to health, safety and morals are generally reserved to the states by the Tenth Amendment. The Commerce Clause allows Congress to regulate these powers through federal agencies on “major questions”. Congress, however, has never acted on the question of vaccine mandates.
  • Hospitals are nearing capacity (Sotomayor) — Again, no! And see here.
  • Omicron is deadlier than Delta (Sotomayor) — Omicron may be more severe than the common cold in some cases, but all indications are that it has much lower severity than the Delta variant.
  • Hospitals are full of unvaccinated people (Breyer) — No, on two counts: 1) hospitals are not full, and 2) there are COVID hospitalizations among the vaccinated as well. Also see here.

I’ve covered most of these points on this blog at various times in the past, a few links to which are provided in the bullets above. As one wag said, it’s almost as if these justices read nothing but the New York Times, the paper that once assured the world that Joseph Stalin was actually a pretty decent fellow. With tongue firmly in cheek, Ed Morrissey asked whether Twitter would suspend Justice Sotomayor for spreading COVID misinformation.

There also followed a desperate attempt by left-wing journalists to convince themselves and their followers that Justice Neil Gorsuch had incorrectly claimed hundreds of thousands of people die from the flu every year. The actual Gorsuch quote in the transcript reads:

“Flu kills—I believe—hundreds, thousands of people every year.”

And that indeed is what can be heard clearly on the audio (short clip here). But in the fertile imaginations of the lefty commentariat, Gorsuch uttered an extra “of”. Gorsuch was clearly correcting himself mid-sentence. As noted by Phil Kerpen, the line of questioning had to do with the establishment of a limiting principle under which OSHA could conceivably have authority to impose a vaccine mandate. Naturally, Gorsuch intended to quote a number smaller than the count of COVID deaths.

Most of the justices appeared to lean against the OSHA mandate. We’ll probably get a ruling this week. However, the episode vividly illustrates the power of the leftist mainstream media and social media to manipulate beliefs, even beliefs held by individuals of formidable intellect. It also shows how fiercely people cling to falsehoods supporting their ideological mood affiliations.

Price Controls: Political Gut Reaction, Gut Punch To Public

06 Thursday Jan 2022

Posted by in Price Controls, Shortage

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In a gross failure of education or perhaps memory, politicians, policymakers, and certain academics seem blithely ignorant of things we’ve learned repeatedly. And of all the dumb ideas floated regarding our current bout with inflation, the notion of invoking price controls is near the top. But watch out, because the Biden Administration has already shifted from “inflation is transitory” to “it only hurts the rich” to “it’s fine because people just want to buy things”, and now “greedy businessmen are the culprits”. The latter falsehood is indeed the rationale for price controls put forward by a very confused economist at the University of Massachusetts-Amherst named Isabella Weber. (See this for an excerpt and a few immediate reactions.) She makes me grieve for my profession… even the frequently ditzy Paul Krugman called her out, though he softened his words after realizing he might have offended some of his partisan allies. Of course, the idea of price controls is just bad enough to gain favor with the lefty goofballs pulling Biden’s strings.

To understand the inflation process, it’s helpful to distinguish between two different dynamics:

1. When prices change we usually look for explanations in supply and demand conditions. We have supply constraints across a range of markets at the moment. There’s also a great deal to say about the ways in which government policy is hampering supplies of labor and energy, which are key inputs for just about everything. It’s fair to note here that, rather than price controls, we just might do better to ask government to get out of the way! In addition, however, consumer demand rebounded as the pandemic waned and waxed, and the federal government has been spending hand over fist, with generous distributions of cash with no strings attached. Thus, supply shortfalls and strong demand have combined to create price pressures across many markets.

2. Economy-wide, all dollar prices cannot rise continuously without an excess supply of a monetary asset. The Federal Reserve has discussed tapering its bond purchases in 2022 and its intention to raise overnight interest rates starting in the spring. It’s about time! The U.S. money supply ballooned during 2020 and its growth remains at a gallop. This has enabled the inflation we are experiencing today, and only recently have the markets begun to react as if the Fed means business.

Weber, our would-be price controller, exhibits a marked ignorance with respect to both aspects of price pressure: how markets work in the first instance, and how monetary profligacy lies at the root of broader inflation. Instead, she insists that prices are rising today because industrialists have simply decided to extract more profit! Poof! It’s as simple as that! Well what was holding those greedy bastards back all this time?

Everyone competes for scarce resources, so prices are bid upward when supplies are short, inputs more costly, or demand is outpacing supply for other reasons. Sure, sellers may earn a greater margin on sales under these circumstances. But the higher price accomplishes two important social objectives: efficient rationing of available quantities, and greater incentives to bring additional supplies to market.

So consider the outcome when government takes the advice of a Weber: producers are prohibited from adjusting price in response to excess demand. Shortages develop. Consumers might want more, but that’s either impossible or it simply costs more. Yet producers are prohibited from pricing commensurate with that cost. Other adjustments soon follow, such as changes in discounts, seller credit arrangements, and product quality. Furthermore, absent price adjustment, transaction costs become much more significant. Other resources are consumed in the mere process of allocating available quantities: time spent in queues, administering quotas, lotteries or other schemes, costly barter, and ultimately unsatisfied needs and wants, not to mention lots of anger and frustration. Lest anyone think this process is “fair”, keep in mind that it’s natural for these allocations to take a character that is worse than arbitrary. “Important people” will always have an advantage under these circumstances.

Regulatory and financial burdens are imposed on those who play by the rules, but not everyone does. Black market mechanisms come into play, including opportunities for illegal side payments, rewards for underworld activity, along with a general degradation in the rule of law.

Price controls also impose rigidity in relative prices that can be very costly for society. “Freezing” the value of one good in terms of others distorts the signals upon which efficient resource allocation depends. Tastes, circumstances, and production technology change, and flexible relative prices enable a smoother transitions between these states. And even while demand and/or input scarcity might increase in all markets, these dynamics are never uniform. Over time, imbalances always become much larger in some markets than others. Frozen relative prices allow these imbalances to persist.

For example, the true value of good A at the imposition of price controls might be two units of good B. Over time, the true value of A might grow to four units of good B, but the government insists that A must be traded for no more than the original two units of B. Good B thus becomes overvalued on account of government intervention. The market for good A, which should attract disproportionate investment and jobs, will instead languish under a freeze of relative prices. Good B will continue to absorb resources under the artificial tradeoff imposed by price controls. Society must then sacrifice the gains otherwise afforded by market dynamism.

The history of price controls is dismal (also see here). They artificially suppress measured inflation and impose great efficiency costs on the public. Meanwhile, price controls fail to address the underlying monetary excess.

Price controls are destructive when applied economy-wide, but also when governments attempt to apply them to markets selectively. Posturing about “strategic” use of price controls reveals the naïveté of those who believe government planners can resolve market dislocations better than market participants themselves. Indeed, the planners would do better to discover, and undo, the damage caused by so many ongoing regulatory interventions.

So beware Joe Biden’s bluster about “greedy producers” in certain markets, whether they be in “Big Meat”, or “Big Oil”. Price interventions in these markets are sure to bring you less meat, less oil, and quite possibly less of everything else. The unintended consequences of such government interventions aren’t difficult to foresee unless one is blinded with the scientism of central planning.

Reformed Covid Reporting Might Quell the Omicron Panic

31 Friday Dec 2021

Posted by in Coronavirus, Data Integrity

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That’s our Commander and Chief this week, posing in a mask on the beach in what is a phenomenal display of stupidity. More importantly, that kind of messaging contributes to the wholly unwarranted panic surrounding the Omicron variant of Covid-19. Panic, you say? Take a look at this admission from a New York health official. She says a recent alert on pediatric hospitalizations was driven by a desire to “motivate” parents to vaccinate their children. Yet Covid has never posed a significant risk to children. And take a look at what this insane physician posted. It’s fair to say he’s “catastrophizing”, an all too common psychological coping mechanism for alarmists.

The Omicrommon Cold

Given Omicron’s low apparent severity, it might be the variant that allows a return to normalcy. It’s perhaps the forefront of a more benign but endemic Covid, as it seems to be out-competing and displacing the far more dangerous Delta variant. In fact, Omicron infections are protective against Delta, probably for much longer than vaccines. The mild severity we’ve seen thus far is due in part to protection from vaccines and acquired immunity against breakthrough infections, but there’s more: there are plenty of non-breakthrough cases of Omicron, and most hospitalizations are among the unvaccinated. Yet we see this drastic decline in Florida’s ratio of ICU to hospital admissions (as well as a reduction in length of stay — not shown on chart). Similar patterns appear elsewhere. Omicron’s more rapid onset and course make it less likely that these patterns are caused by lags in the data.

Panic Begets Lockdowns

The frantic Omicron lunacy is driven partly by data on the number of new cases, which can be highly misleading as a guide to the real state of affairs. Testing is obviously necessary for diagnosis, but case totals as an emphasis of reporting have a way of feeding back to panic and destructive public policy: every wave brings surges in cases and the positivity rate prompting authoritarian measures with dubious benefits and significant harms (see here and here).

Flawed Case Data

In many respects, the data on Covid case totals have been flawed from the beginning, owing largely to regulators. At the outset in early 2020, there was a severe shortage in testing capacity due to the CDC’s delays in approving tests, as well as restrictions on testing by private labs. Many cases went undiagnosed, including a great many asymptomatic cases. The undercount of cases inflated the early case fatality rate (CFR). Subsequently, the FDA dithered in its reviews of low-cost, rapid, at-home tests. The latest revelation was the Administration’s decision in October to nix a large rollout of at-home tests. While the results of those tests are often unreported, they would have been helpful to individual decisions about seeking care and quarantining.

The PCR test finally distributed in March 2020 was often too sensitive, which the CDC has finally acknowledged, This is a flaw I’ve noted several times in the past. It led to false positives. Hospitals began testing all admitted patients, which was practical, and the hospitals were happy to do so given the financial rewards attendant to treating Covid patients under the CARES Act. However, it resulted in the counting of “incidental” Covid-positives: patients admitted with Covid, but not for Covid. That inflates apparent severity gleaned through measures like hospitalized cases, and it can distort counts of Covid fatalities and the CFR.

On balance, the bias caused by the test shortage at the start of the pandemic likely constrained total case counts, but the subsequent impact of testing practices is uncertain except for incidental hospitalized cases and the impact on counts of deaths.

Omicron Enlightenment

Omicron spreads rapidly, so the clamoring for tests by panicked consumers has resulted in another testing shortage, both for PCR tests and at-home tests at pharmacies. The shortage might not be relieved until the Omicron wave has crested, which could occur within a matter of a few weeks if the experience of South Africa and London are guides. In the meantime, another deleterious effect of the “case panic” is the crush of nervous individuals at emergency rooms presenting with relatively minor symptoms. Now more than ever, many of the cases identified at hospitals are incidental, particularly pediatric cases.

A thread by Monica Gandhi, and her recent article in the New York Times, makes the case that hospitalizations should be the primary focus of Covid reporting, rather than new cases. Quite apart from the inaccuracies of case counting and the mild symptoms experienced by most of those infected, Gandhi reasons that breakthrough infections so common with Omicron render case counts less relevant. That’s because high rates of vaccination (not to mention natural immunity from prior infections) reduce severity. Even Jennifer Rubin has taken this position, a complete reversal of her earlier case-count sanctimony.

Incidental Infections

Phil Kerpen’s reaction to Gandhi’s article was on point, however:

“Unless HHS Protect adds a primary [diagnosis] column, hospital census isn’t much more useful than cases.”

HHS Protect refers to the Health and Human Services public data hub. Without knowing whether Covid is the primary diagnosis at admission, we have no way of knowing whether the case is incidental. If Covid is the primary reason for admission, the infection is likely to be fairly severe. It is more useful to know both the number of patients hospitalized for Covid and tge number hospitalized for other conditions (incidentally with Covid). The distinction has been extremely important to those interpreting data from South Africa, where a high proportion of incidental admissions was a tip-off that Omicron is less severe than earlier variants.

The absence of such coding is similar to the confusion caused by the CDC’s decision early in pandemic to issue new guidance on the completion of death certificates when Covid is present or even suspected. A special exception was created at that time requiring all deaths involving primary or incidental Covid infections to be ruled as Covid deaths. This represented another terrible corruption of the data.

Summary

Earlier variants of Covid were extremely dangerous to the elderly, obese, and the immune-compromised. Yet public health authorities seemed to take every opportunity to mismanage the pandemic, including contradictory messaging and decisions that compromised the usefulness of data on the pandemic. But here we are with Omicron, which might well be the variant that spells the end of the deadly Covid waves, and the focus is still squarely on case counts, vaccine mandates, useless masking requirements, and President Brandon wearing a mask on the beach!

Case counts should certainly be available, as Gandhi goes to great lengths to emphasize. However, other metrics like hospitalizations are more reliable indicators of the current wave’s severity, especially if paired with information on primary diagnoses. Fortunately, there has been a very recent shift of interest to that kind of focus because the superior information content of reports from countries like South Africa and Denmark is too obvious. As Don Wolt marvels:

“Behold the sudden interest by the public health establishment in the “With/From” COVID distinction. While long an important & troubling issue for many who sought to understand the true impact of the virus, it was, until very recently, actively ignored by Fauci & crew.”

That change in emphasis would reduce the current sense of panic, partly by making it more difficult for the media to purvey scare stories and for authorities to justify draconian non-pharmaceutical interventions. It’s no exaggeration to say that anything that might keep the authoritarians at bay should be a public health priority.

May All Your Christmas Parleys Be Bright and Well-Officiated!

22 Wednesday Dec 2021

Posted by in Christmas, Debate

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The Christmas holidays are upon us, with many joyful gatherings of family and friends, lots of tempting treats and libations, and of course, plenty of college football bowl games… all barring cancellation due to Covid psychosis. Just as discipline and good sportsmanship is maintained on the football field via sound officiating, it might be helpful to designate at least one friend or family member to serve as an impartial referee for the many political and philosophical discussions that are bound to crop up around the Yule log.

In the spirit of giving, I present you with an illustrated guide to officiating these deliberations. A complete set of hand signals for philosophy referees is shown below, with credit to the Leiter Reports blog. However, you better give your designated ref(s) a day or so to prepare. And remember to appoint a videographer for replay review!