The macroeconomics of pandemics

By Eichenbaum, Rebelo, and Trabandt:

We extend the canonical epidemiology model to study the interaction between economic decisions and epidemics. Our model implies that people’s decision to cut back on consumption and work reduces the severity of the epidemic, as measured by total deaths. These decisions exacerbate the size of the recession caused by the epidemic. The competitive equilibrium is not socially optimal because infected people do not fully internalize the e§ect of their economic decisions on the spread of the virus. In our benchmark scenario, the optimal containment policy increases the severity of the recession but saves roughly 0.6 million lives in the U.S.

I would add this: if you hold the timing and uncertainty of deaths constant, death and output tend to move together. That is, curing people and developing remedies and a vaccine will do wonders for gdp, through the usual channels.  The tricky trade-off is between output and the timing of deaths.  Whatever number of people are going to die, it is better to “get that over with” and clear up the uncertainty.  Policy is thus in the tricky position of wishing to both minimize the number of deaths and yet also to speed them along.  Good luck with that!  In terms of an optimum, might it be possible that some of the victims do not…get infected and die quickly enough?  Might that be the more significant market failure?

Via Harold Uhlig.  In any case, kudos to the authors for focusing their energies on this critical problem.

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I know for a fact that the optimal solution is not to shut down the country for an indefinite period of time just to save the elderly and infirm.

Mmm... for a fact, you say? Such certainty!

We shut down the global economy because a *BOOMER* might get sick from the flu! Who's the real snowflake generation now?

Troll much? Or is this your first time out the gate?

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I struggled to follow the logic. How can you determine optimum without doing a cost benefit analysis? The benefit is 600k lives saved. But what is the cost? How does that translate into cost per life?

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Yes, knowing for a fact something based on an indefinite period of time seems devoid of information on an optimal solution. Steven Hawking was quite infirm for decades (and close to elderly at the end) but no one familiar with his work would say that keeping him alive was not optimal (for example).

Is he representative of the long-term infirm?

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Since last week, he’s been running ventilators for the sickest COVID-19 patients. Many are relatively young, in their 40s and 50s, and have minimal, if any, preexisting conditions in their charts. He is overwhelmed, stunned by the manifestation of the infection, both its speed and intensity. The ICU where he works has essentially become a coronavirus unit. He estimates that his hospital has admitted dozens of confirmed or presumptive coronavirus patients. About a third have ended up on ventilators. .... "I have patients in their early 40s and, yeah, I was kind of shocked. I’m seeing people who look relatively healthy with a minimal health history, and they are completely wiped out, like they’ve been hit by a truck. This is knocking out what should be perfectly fit, healthy people. Patients will be on minimal support, on a little bit of oxygen, and then all of a sudden, they go into complete respiratory arrest, shut down and can’t breathe at all.”

That seems to be from Pro Publica - https://www.propublica.org/article/a-medical-worker-describes--terrifying-lung-failure-from-covid19-even-in-his-young-patients

It would be helpful if people included links more often, though this is pretty detailed information that might not be pleasant to read.

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Broader statistics are much more helpful for making decisions than the narrative of one doctor's experience. https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6912e2-H.pdf

You are right, of course. But it seems as if many people are resolute in not recognizing two things - the U.S. has no useful broader statistics at this point, and what is going on in Italy and Spain is not somehow exceptional, especially when a country has not adequately prepared itself.

But maybe what will happen in Switzerland or Germany will be useful, in a certain sense, though far too late to actually help the American medicine system from being equally overwhelmed.

Do I detect some ... glee, in what you write?

Glee over the deaths of thousands and thousands people? What a bizarre question.

This is a gross tragedy, and there is no humor to be found in the reality of the richest part of Italy needing to use the army to haul bodies away to be cremated in other regions. It is quite likely that the total will be 1000 dead today or tomorrow or the day after. That is tragedy, as the number is not 1000 total, it is 1000 in one day.

And it is tragedy that is also happening and still growing in Spain and France, and will happen to Germany and Switzerland next.

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Isn't that a characteristic of the specific disease? One that infects and kills quickly will fizzle out in short order. Diseases that have a long latent period and then take a long time to kill will spread much more.

Excellent point. Years ago I emailed TC and told him the watch the Ebola virus, as I said it would become a pandemic. He dismissed it with a contemptuous wave of the hand and he was right. Now I get revenge, but from unexpected places.

TC's point of your point is still valid, as reframed in his OP (and only a chess player could make such a brilliant and heartless post, good stuff), in that Covid-19 is not killing us fast enough. "Car crash or cancer" is the internet meme from 2008 that comes to mind. Cancer is much more expensive and awful than a car crash, most of the time.

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When it comes to timing of death, we all seem to be treating death today as equal to death one month from now, in moral terms. But given enough time we will all die. Shouldn't the relevant metric on saving lives really be human-life days? If we can push someone's death today to next year, then, whether or not there are other benefits that accrue, we've saved that person a year of life.

That year has value.

This seems to be the right way to value life and is I think how it is done in outcome based healthcare.

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Even if it is a year without seeing your children or grandchildren, or going out to restaurants? Oh Methuselah lived 900 years, Methuselah lived 900 years, but who calls that livin' when no woman's givin' to a man who's lived 900 years?

That's a valid point. We should probably be multiplying quantity of life saved by the quality of life during that period. That seems like a difficult calculation to make, but we could probably come up with a crude estimate that's close enough to be of value. The simplest model is one where quality of life doesn't vary, and thus we just end up with quantity.

Regardless, whatever that calculation is, and however low quality of life may go during this period, I'd expect it to remain above zero.

In that case another year of life has positive value. As such, putting off deaths to a later date is a good thing.

Your points are valid and very central to the field of Health Economics.
That is Health Economics outside of America... In the USA it seems the focus is on financing and insurance. In single payer and national insurance systems that focus on reimbursement rates and allocating budgets then the cost-effectiveness of treatment needs to consider the benefits and quality of life with and without various treatment is key.
You may want to check out QALYs (quality-adjusted life years).

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A new Osterholm interview that covers economics, likelihood, duration, pandemic choices:

http://www.startribune.com/coronavirus-pandemic-what-s-normal-now-what-s-next-an-interview-with-michael-osterholm/568978932/

I like to follow this guy. An epidemiologist. Has a website as well. Google works. Talks about advice he gave to White House.

"And so one of the things I’m trying to drive … is saying we need to think about what we might see when we loosen up society again, knowing that transmission will occur.

[At that point], we make every effort to … protect those most vulnerable. And we continue to emphasize social distancing, all the things that happen there. We don’t want people to be isolated … [but we have to] keep the hospitals from being overrun. We keep doing that until we get a vaccine."

We are proud of Dr. Osterholm here in Minnesota.

"Hope is not a strategy." That's true.

Dr. M. Osterholm was effective on Joe Rogan's podcast also. Joe also stood out by telling it like it is a calling anti-vaxers "whackos."

Dr. M. Osterholm's comment about rebuilding the US Pacific fleet after Pearl Harbor was inaccurate however. Although it doesn't change his message that you can't turn a mousetrap into a cathedral overnight.

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@Bill, @Brian Anderson - I also read Osterholm and I pray that he's wrong, he points out that pandemics come in waves and even quarantine does not kill viruses, is predicting new cases will start again in China once it goes back to work, even though China's internal population is nearly Covid-19 free.

@Glaucon - I like your nym, named after one of Socrates followers, believed to be a brother, who typically asked dim witted questions, lol.

Ray Gomez, You may be thinking of Thrasymachus.
Socrates made everyone seem dim-witted, if you can believe Plato. Glaucon by the way was politely reasonable, a good example to follow in these troubled times.

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"In terms of an optimum, might it be possible that some of the victims do not…get infected and die quickly enough?"

This is a fairly common situation. Uncertainty is reduced if people drop dead suddenly vs lingering for weeks or months. And obviously health care costs too. But unless you know that you're going to die a slow agonizing death, or are ready to die now, as a patient you're going to expect to receive those fancy expensive medical treatments and are not going to prefer a fast-acting infection that kills you quickly.

Other analogous situations: in military combat, it can be worse if one of our soldiers gets wounded instead of killed. Because a wounded soldier requires treatment from a corpsman, and distracts his comrades, and either slows down the squad's movements or calls for a helicopter evacuation. Whereas a dead soldier is a sunk cost (except for the recovery of the body).

And people who pay into social security, i.e. most of us, create a positive externality by dying early. We collect less in social security payments, and thus there's more for everyone else. So in that sense we have an incentive to encourage each other to start smoking cigarettes and to stop exercising (while we privately do the opposite).

The utilitarian reasoning here seems quite convincing and rational. But to fully embrace this logic seems to jettison much of our humanity...

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> The reason is that fewer people die in
the epidemic so the population falls by less in the SIR-macro model than in the SIR model

Except that the virus preferentially kills people that aren't typically in the workforce (or whom consume much). Would it not be better to scale consumption and work hours lost by the age-based mortality rates? I assume this would manifest in a more laissez faire approach than the SIR-macro.

'preferential' does not mean 'exclusive'... as the death of younger health care workers shows.

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Let's not forget one major reason to 'delay' some deaths is the time we are taking today quarantined. Local medical services all over the country need time to gear and man up, and this time is helping. We do not want to see little 'Italy's' popping up here and there. Eventually we will all get exposed, and hopefully over time we will have treatments, vaccines and such to help protect us all.

Yes, the world as a whole dithered and did not anticipate more widespread global spread of this virus. During the antebellum period of Jan-Feb, countries could have been gearing up PPE manufacturing.

Right now, the local hospital systems I interact with are burning through disaster stockpiles of PPE at 100x originally projected pandemic burn rate. Everyone has had to move to strict conservation.

Individual provider groups (nurses, anesthesia, respiratory therapy) have talked about refusing to see patients if they do not have PPE.

This variable will ultimately greatly influence each country's CFR. Do not conflate the pooled global number and apply that to the country as a whole. Circumstances of hotspots and hospital capacity vary between countries and regions.

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I think we need to include in an economic model some way we can extract benefits from this pandemic.

For example,

1. Road construction during this period. No people are on the roads. Get out and fix the potholes, do projects on what would otherwise be bottlenecks in the system, but are now not carrying much traffic.

2. Have a "make work" program that increases resiliency. For example, give aid to restaurant workers and restaurants that take classes on reducing food poisoning or transmission of pathogens.

Train restaurants and employees how to monitor their health. Pay them to have installed better sanitation equipment.

3. Workers, in the past, went to meetings; n ow the participate in zoom conferences. Well, this gives the firm an opportunity to integrate field offices and different parts of the corporation into a meeting. In other words, as people get more comfortable with videoconferencing we might have more information, not less, being shared in the corporation across the silos. Maybe we should be looking at how we can use this forced opportunity to knock down barriers.

4. Have you noticed that there are fewer talking heads on TV and more remote interviews of experts. In the past, you might not have accepted a person talking to their computer appearing on TV; now it is normal.

This may pave the way for more experts appearing on TV rather than opinionated talking heads.

Here's another example of where if we solve one problem we make ourselves more resilient: obesity, untreated hypertension, asthma, etc. are factors that increase the risk of dying from covid....how about ramping up public health programs or your own program to address these risks during the period you are in your house. Here are the risk factors: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2763184

I've been practicing social isolation for the last two weeks except for one grocery trip and one unexpected benefit is that I've lost weight even though I wasn't trying to and even though I'm certainly exercising/walking less than before. The most likely explanation for this is that eating by yourself at home is much healthier than eating out or with friends, which I'd normally do on average one meal a day or more. You naturally eat smaller portions and you know exactly what you are eating. After this is all done, it will be interesting to see what impacts this all had on people's health. I imagine we will see a lot of mental health problems, especially if this goes on for more than a few weeks, but I could also plausibly see physical health improvements in things like obesity, hypertension, etc., as all people eat healthier and many people potentially also exercise more now that they have more time on their hands.

It's been interesting here as well. With respect to mental health, we have a men's group that meets every week early in the morning for breakfast--a number of the group members are academics so I pick their brains. Several are retired. So, when we stopped meeting, I and another member started teaching others how to use zoom. Our next meeting is next week.

I've used it also to participate in discussion with folks on topics where I would not have traveled to a conference to hear them, but they are more than willing to join a group discussion with other academics in their field that I organized at a graduate school of business. That has been very interesting. What is also interesting is that it is easier to discuss matters collaboratively than to write papers or memos with others. Also, Instead of emailing a friend, we're doing more video streaming. Both sides like it, particularly if the person you are dealing with has never used the software.

I hope this becomes the new normal. For now, it is an excuse for me to pester someone to download software and get together. The downside is that a neighbor instead of calling you on the phone is setting up a video conference. They act like teenagers.

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Australia's just upped their fiscal stimulus from 0.9% of GDP to 9.7%. Fortunately, they can increase that if necessary. Doubling pensions and payments to poor people, low interest loans, etc. etc.

Finally, some action. Now if they'd just do something about the actual disease. Quite literally, the only response I've seen by my government is one sign. Well, technically two identical signs near each other.

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I would say that the main problem with that paper, and what will make the world a worse place with the paper existing vs. the paper not existing, is that the disease assumptions are divorced from reality.

For reference, Finnish Covid-19 disaster planning assumptions computed for the Finnish environment from the global data available so far: 0.4-1.0% hospitalization rate of infections, 25% of hospitalizations requiring ICU care, and 0.05-0.1% infection fatality rates. These were estimated by epidemiologists, not celebrities or politicians. I trust these people and numbers they produce over, say, Neil Ferguson group, WHO, or the CCP.

Wherever the chips may fall, I hope that the people who are loud and wrong will be held accountable in terms of their reduced credibility.

The problem we have is that if they are successful, you will claim it was unnecessary or overdone. Realistic modeling of what could have happened is what you may want to look at, or different countries which had different results, ala , Italy.

Luckily we do have a sterling example of worst possible outcome in Lombardy. If you extrapolate their numbers to the US (or even a single state in the US), you can use that as a starting point for a model of worst possible outcome.

It's amazing to me that there are still so many people who downplay potential catastrophic outcomes when there's one happening in front of our eyes.

Italy's overall infection numbers haven't peaked yet. We're not even past the inflection point.

The Chinese aid workers sent there say if anything their quarantine has been too loose and too many people are slipping through the cracks.

Respectfully, your response is insane.

“ Italy's overall infection numbers haven't peaked yet. We're not even past the inflection point.”

How could you know that, given that you have no idea whether 1%, 5%, or 20% of Italians have been infected?

A semi random sample of seemingly healthy Icelanders are showing up 1.1% positive for Coronavirus without any noticeable symptoms. It’s not a hot spot. Based on that result, I’d put my estimate of infected Italians way, way above 7 million.

Ptuomov,

Just as a challenge to yourself, why don't you post below the total number of dead persons from Covid you expect to see in your model by the end of the year.

Post below and let's check back in December.

In the US population, I’d expect 25% cumulative infection rate and 0.25% infection lethality rate cumulatively by the end of the year 2020. These are my point estimates, and given the negative subjective correlation between the two, the expected deaths are less than the product of the two and the population.

I assume the challenger has to offer their prediction, too, to maintain any credibility?

No the challenger does not, because we do not have a plan. The challenger does point you to the range of projections that epidemiologist you referred to. I would use Osterholm's, Johns Hopkins and the Oxford site for the do nothing baseline of what would happen if we did nothing.

Is your baseline "no action by government" or is it "action by government" for the US. You can't use what we have done and are likely to do be your baseline. So, what are the assumptions of your baseline if we had done nothing since you seem to object to doing anything.

Per a request by you, I gave an unconditional projection. You chose not to give one in response. Did I get this right?

Nobody owes you nothin.

Don't be a cuck, Wally.

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Ptuomov,
I asked you if your unconditional projection is (1) the baseline of do nothing or (2) the baseline of taking actions to reduce or mitigate the spread. Obviously, if it is (2) what you are saying is that mitigation efforts will reduce spread over and above what you did not disclose as (1).

I am challenging your assertions.

I will give you a prize. But I don't know what it is yet. It might involve me asking Tyler to give you a prize.

It is your assertion. Either stand by it and clarify or continue to obfuscate, which tells me and others something. If you are sincere, you will clarify.

Both. Whether there is social distancing or lockdowns matters for whether the disease peaks in April or May, but it doesn’t in my opinion matter much to the 2020 totals. So my forecasts for (1) and (2) are approximately the same, other than the couple trillion of lost GDP.

And my forecasts are reasonably well in line with the average expert: https://fivethirtyeight.com/features/infectious-disease-experts-dont-know-how-bad-the-coronavirus-is-going-to-get-either/

By the way, the “Cuck” comment wasn’t by me, apparently anyone can spoof these comments.

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At the link it says Iceland tested a representative sample of the population (n 5490) and 86 bp (0.86%) of the pop was infected. This means of the 7.7B people there are 66M infections.

https://cleantechnica.com/2020/03/21/iceland-is-doing-science-50-of-people-with-covid-19-not-showing-symptoms-50-have-very-moderate-cold-symptoms/

yes,interesting, I look forward to more results. There could be natural immunity in the population which is what the Israeli Chemistry nobel prize winner claimed 3 weeks ago, i think
https://www.calcalistech.com/ctech/articles/0,7340,L-3800632,00.html

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The key point about Italy is not how many are, or will be ultimately infected. The key point is to delay things here today in an effort forestall any local outbreak that overwhelms local HC capabilities. That is where the SHT show starts!

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Historically, the more likely problem is the opposite. Who remembers the Simpsons episode on the bear brigade?

Ptuomov, challenge from Bill not accepted?

I did but since this site seems to allow others to impersonate you with the same nic, this will be my last comment here. I have enjoyed it, thank you!

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Agree on " In terms of an optimum, might it be possible that some of the victims do not…get infected and die quickly enough?"

Covid patients do not get infected and then die according to cohort-based CFR odds or get better right away. They need time, monitoring, and supportive care to determine their outcome. Each person's fatality rate is hugely dependent on the local circumstances. In the meantime they clog up a bed and consume medical staff time and equipment.

Economists may think of this as "crowding out" other medical issues.

If you want to achieve an optimal equilibrium for the economy, you can assign QALY to each particular patient vs cost of treatment + externalities of treatment. In other words, perform triage up front. Have a points based system of age + comorbidities where if you're over a certain line you don't get treatment but rather are automatically channeled into end of life care. This will speed up dying and allocated scarce medical resources more optimally.

The only question is, can you be the politician who successfully sells this message, or will you be accused of death panels? Will you turn into a softie in the face of massive outcry among the elderly+losers?

Times of scarcity means picking winners and losers. Have you thought about the possibility of you being a loser?

Impending death tends to make people irrational. As a front line health worker, I've seen plenty of people who were DNR change their mind when the sensation of shortness of breath forces them to come to terms with mortality.

Maybe you should put compliance as a factor as well. If the person did not engage in activities that protected the herd, perhaps they should go to the back of the line for getting a ventilator. It would improve compliance. What you are really doing is attaching a weight to activities which cause externalities in your decision to put one person ahead of another.

Like with organ donations or vaccines?

The problem is in times like these is that a lot of traditionally libertarian preferences are easily thrown out the window in the name of expedience and rapid action. How many people with skin in the game can remain true to their beliefs in the foxhole?

Those non-complaints
Will have to take
My ventilator
Out of my dead hands.

To the back of the line, buddy, don't come crying to me if you whined about compliance, decided not to comply, and made yourself and others sick.

If there is a scarcity of vaccines, they get it last.

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I've been reading about historical pandemics, and it really seems like the economic impact of this pandemic is unprecedented. No past pandemic in the modern age going back to at least the Spanish Flu (which is almost certainly worse than this virus) seem to have created even a recession. In fact, stock prices continued going up during the Spanish Flu and the most recent large pandemic, the 2009 swine flu, too.

This all tells me that the pandemic itself does not inherently create major economic problems. The economic problems come from our decision to shut down the economy, which has never been done in any past pandemic.

Furthermore, the risk to the economy seems to be dependent more on the duration of the social isolation measures rather than their severity. China put in very severe measures, but now seems to have things under control and although their economy took a hit, it is now rebounding (and its stock markets are holding up better than most other large countries). Thus, if we are going to force social isolation on people, we should do it immediately, go all-out, and be done in a month or two. That would be far preferable to having some restrictions in place for many months (for instance, my state has ordered many businesses to close--tanking the economy--yet I saw lots of people milling about without maintaining six feet of personal space outside from my window today--reducing the effectiveness of the measures). If we can't do a big-bang approach that's over in a month or two, the second-best alternative is just to let this run while protecting the most vulnerable populations. Even a million lives saved is not worth another Great Depression, especially when considering that the original Great Depression spawned all kinds of reactions and political movements that ended up killing tens of millions and visiting horrors upon people worse than any plague.

Yes, if you do it early and do it well, you can minimize the duration of isolation and let your economy recover ASAP. 4-6 weeks is enough time where with a bit of support your small businesses won't crumple.

However, in reality it's not easy to do. As a politician you face a competing pressures to keep businesses open because overall infections identified are not that low. Do it too early and you're accused of strangling businesses. Even now southern states haven't gone on nearly as strict lockdown efforts as coastal ones.

The other issue is selective piecemeal quarantine. We're seeing states dither and then gradually ramp up on social distancing over time only to become more draconian as they observe many people slipping through the cracks and not complying with distancing.

We're also making the mistake of Italy where there was selective quarantine of the north followed by a massive exodus of people trying to escape the quarantine area. That likely served as the vector for infecting the rest of the country. China showed that you need to combine harsh lockdown with a blockade. Each geographic unit (whether city, state, or country) needs to prevent movement in/out and quarantine everyone within that area. What use is it if California goes on lockdown only to be re-infected by Texans escaping to the state in 4 weeks after California has lifted lockdown but Texas is starting to impose theirs?

At the rate things are going, governors need to seal state borders which may not be legal.

As Fauci said, you're always behind the curve on where you think you are. As in it's always worse in reality than what you're seeing on the ground because of a 5 day incubation time during which people feel well and are actively spreading. Even after that there's a period of mild symptoms where they can still spread.

The long lead up, easy transmissibility, and high fatality rate (relative to other resp infections) of this virus is what makes it unique.

Borders don’t need to be sealed, you could just order everyone traveling from outside to quarantine for 14 days. The governor of Hawaii did just that. I understand many cities in China such as Beijing did that as well.

No, what I mean is you need checkpoints at all crossings in and out. No one from inside can leave. Anyone from outside going in (why would you want to?) must be on observed quarantine for 14 days.

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I guess it is non-PC to even ask:

"What fraction of the deaths from the novel cold virus represent elderly smokers, and the elderly with multiple co-morbidities?"

Did we just collapse the global economy to save people who have one leg in the grave?

Is listening to public-heath officials like listening to the national-security guys about how much defense spending is needed and what are the global threats emerging? That is, worst-case scenarios rule.

Is the time to commit to a national policy the day after 9/11? When hysteria is ascendant, take advantage of the public mood.

Did you know that, in fact, 150,000 Americans have died since COVID-19 invaded America? Well, they died of cancer, and cancer is often triggered by artificial carcinogens. Another 450,000 will die the rest of the year. Oh, and next year too, and after that...and so on. In other words, cancer deaths dwarf COVID-19 deaths. And will next year and thereafter.

But 600,000 elderly smokers and old people with co-morbidities...we will suffocate the economy in their behalf!

Korea found the death rate for the under-30 crowd is....zero.

Yes, implementing a gated triage approach prior to the saturation of hospital beds is one way of arriving at an equilibrium better for the economy as measured by GDP. You can restart the economy the next day if you lift shelter in place restrictions, allow everyone to go outside and engage in normal activities at their own risk, and announce the parameters of the triage in advance.

Something like:
You do not get ICU level care (e.g. a ventilator) if you are one of:
Over 65
Have COPD
Have coronary artery disease or heart failure
Have 2 of diabetes, hypertension, or obesity

You do not even get admitted to the hospital for basic oxygen therapy if you are one of:
Over 55
Have end stage conditions (kidney failure on dialysis, incurable cancer)

Then let everyone determine using their own risk appetite whether to go out or not.

Good luck selling that politically. That is really the limiting factor to a more Malthusian or Benthamian reponse.

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I must say, I am a huge fan of Tyler Cowen, and I believe I understand about 99.9% of his posts, and am usually sympathetic to the thesis of each of them. But I am confused by the meaning of this post. For example, I don't know what "holding the timing and uncertainty of deaths constant" means in this context. Also, why would one assume that the number of deaths would be fixed, but the timing variable? It seems to me that one of the givens in this situation is that the number of deaths is not estimable with much precision and therefor should not assumed to be fixed. Is it just me, or are there other readers who don't quite understand what Tyler is driving at with this post?

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Assume that isolation is 100% effective in country A, and new cases goes to zero. People go back to work, the borders reopen.

Absent a vaccine, and given the worldwide infected pool that has been established now, is there a reason to think that there will not be (potentially repeated) re-infection from some source external to country A, starting the cycle all over again?

Mandatory 14 day quarantines or rapid testing (once we get to that point) for ALL arrivals into the country, as is what East Asia (the first region to recover and clear community transmission) is doing now.

If that’s your plan, you are going to need a bigger (and better) wall.

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China and some other countries are requiring mandatory quarantine for all arrivals without banning any travel. This seems like an effective strategy so far, indeed more effective than banning travel from certain other places because it also prevents infection from unbanned places. (It is also much less disruptive because it still allows people whose reason for travel is important enough for them to endure a 14-day quarantine to travel).

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You’ve reached the repugnant solution but do not recognize it as such?

Stop your virtue signalling, real economists have no problems with pruning worthless dead wood.

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"Whatever number of people are going to die, it is better to “get that over with” and clear up the uncertainty."

This is a frighteningly idiotic. The CFR is heavily correlated with number of infected individuals at any given time. At overall (known) infection rates of well less than 1%, we are seeing advanced medical systems being overwhelmed. In those circumstances, not only are there not enough ICU beds and ventilators, but HCPs get infected and taken out of the system at alarming rates.

There is no way to "get that over with" quickly without the "that" increasing five fold, or ten fold, or worse. And writing "that" as a euphemism for a "mass die-off of citizens, many of whom are vital and productive members of society" is a bit glib, eh?

Bringing up the reality of having all ventilators occupied while the need for them continues to increase leads to the deaths of all those needing ventilators is not the sort of real world math many people perform. Though in Italy and Spain, it has become tragically unavoidable.

For example, anyone who gets in a car wreck and requires a ventilator for a couple of days as part of their recovery is unlikely to be given access to one in Lombardy right now. Or they are given access, with the facility accepting the death of the person taken off a ventilator.

This leads to the further reality that the accident victim is then much more likely to be infected with covid-19, as the Lombardy health care system is completely overloaded, and that the accident victim will then be taken off a ventilator after two weeks to make space for the next accident victim.

There are many differences between a war and a pandemic. The differences between weeks of intense combat and a pandemic are much smaller. Which is why the Army in Italy is equipped to help deal with hundreds of bodies a day, day after day after day.

There will also be many fewer accidents if people stay home though. Maybe this is why China banned private car travel in Wuhan, a policy that didn’t seem to make sense from a stopping infection perspective.

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