Some realistic thinking, including about 2024

It is urgent to understand the future of severe acute respiratory syndrome–coronavirus 2 (SARS-CoV-2) transmission. We used estimates of seasonality, immunity, and cross-immunity for betacoronaviruses OC43 and HKU1 from time series data from the USA to inform a model of SARS-CoV-2 transmission. We projected that recurrent wintertime outbreaks of SARS-CoV-2 will probably occur after the initial, most severe pandemic wave. Absent other interventions, a key metric for the success of social distancing is whether critical care capacities are exceeded. To avoid this, prolonged or intermittent social distancing may be necessary into 2022. Additional interventions, including expanded critical care capacity and an effective therapeutic, would improve the success of intermittent distancing and hasten the acquisition of herd immunity. Longitudinal serological studies are urgently needed to determine the extent and duration of immunity to SARS-CoV-2. Even in the event of apparent elimination, SARS-CoV-2 surveillance should be maintained since a resurgence in contagion could be possible as late as 2024.

That is the abstract of a new piece by Stephen M. Kissler, Christine Tedijanto, Edward Goldstein, Yonatan H. Grad, and Marc Lipsitch.

The implication of course is that changes to the structure of production will be far-reaching unlike say in 2008.  Ongoing social distancing will limit productivity and very drastically shape demand.  This to some extent militates against response measures that assume “the economy as we knew it” will be bouncing back in a few months’ time.


This is assuming no vaccine?

When all the policy responses never involve paying workers to work building capital, how can a vaccine come to exist?

That its realistic to hope for a vaccine in less than two years, is credit to the vaccine capital built over a dozen plus years over the objections of the right by Congress funding NIH, BARDA, and others, plus foundations like Gates decades of seed money and lobbying, plus efforts in Europe, that address some unique challenges of coronavirus. Flu evolves rapidly but the ability to produce vaccines have a century of history. Coronavirus and rhinovirus evolve rapidly but have proved hard to create vaccines. Of course, vaccines exist for the common viruses that evolve slowly like polio, measles, etc.

Create a couple of vaccines for coronavirus and a future SARS, MERS will only require preventing epidemic for 3-6 months.

But lots of workers must be paid for years to work on developing, producing, and testing vaccines for coronavirus. Those payments were slowed over the past 5 years by conservatives.

Whatever, mulp.

You are, as usual, long on opinionated rhetoric and short on actually linking to any data that would make your point.

Yes. The more complete quote from the body of their document:

"Intermittent distancing may be required into 2022 unless critical care capacity is increased substantially or a treatment or vaccine becomes available"

The no treatment / no vaccine qualifier is very important.

I've posted in the comments here before - when Tyler referenced his Bloomberg column predicting major long-term changes for NYC - that I'd love to make a friendly wager that he's wrong if he'd agree to it and we could agree on a set of metrics. I'll make that same offer regarding his prediction here.

He's already put his name and reputation into the kitty, "Dave". Why don't you do the same, for the record? It seems to me the essence of a "friendly wager" requires both parties to identify themselves. You should also be careful about definitions. I have no idea what "major (changes) or "long-term" means: long-term: 5 yrs? 10? 2? "major": change of 10% of NYC gdp? employment? population?

I'm not clear why critical care capacity (i.e. more beds and ventilators) is impossible by 2022? I mean I know supply lines are struggling with masks, gloves and hand sanitizer but we're talking two years here.

The paper's conclusion is conditioned on no vaccine. Tyler's conclusion is conditioned on people's willingness to tolerate that long a period of social distancing. I'm not sure which one is less likely. People who believe the pessimistic scenarios (i.e. those requiring longer periods of social distancing) should be more willing to let this thing run its course.

I am an optimistic concerning covid-19 (not concerning the effects of the lock-downs, which are already catastrophic). but I am not very long on the chances of an efficient vaccine soon (even by 2024). A more effective symptomatic treatment, an anti-viral, and natural, even if partial and temporary, herd immunity are our best chances, and we will live (or sometimes but rarely, die) with this virus for decades as we do with dozens of other ones.

It also seems incredibly unlikely to me that people will maintain social distancing into the summer months. Young people in my neighborhood are already out and about with the nicer weather, presumably visiting one-another as that is what they do.
However, this poll
seems to imply that it is still very popular among voters (after all, the young have no political voice). According to Politico, "More than eight in 10 voters, 81 percent, say Americans “should continue to social distance for as long as is needed to curb the spread of coronavirus, even if it means continued damage to the economy.”"

For fun I will add that I enjoy comparing people in different public venues to see what proportion are wearing masks. Sam's Club has the most, about 40%, the grocery store at about 10% and the hardware store almost 0%. This is in Indiana.

Interesting. I am in Texas (Austin).

As of this Monday (April 13), we had a city order that we are supposed to wear masks in most public places.

I was at the grocery store one day later, and I'd say that compliance was at least 2/3. Prior to that, I'd guess that people on the street were more like 40% to 50%.

Massachusetts here. My impression is also different from many on this blog. As far as I can tell, compliance is quite good.

Weirdly, and this is anecdotal so take it for what it’s worth, the risk-takers I see are generally old. People are having a hard time getting elderly parents to stay safe.

I suspect the reason we all picture young people not complying is because the beach and the basketball court are obvious photo spots. The coffee shop and visiting the grandkids, not so much.

You DO understand that the mask wearers are protecting OTHERS not (directly) themselves, right? That is: not wearing a mask isn't a risk to the one not wearing it, but to others. (If masks were a significant protection to the general public, the CDC wouldn't have not recommended them. To be clear, they reduce the wearer's risk by only a small amount (but not zero, either).

Is this supposed to be directed to me? I don't follow.

Maybe it is directed at me.

(1) The mask story is at best confused and debated.

(2) Most of my comment was about mobility and grouping, not masks.

With respect to (2), I should have made that more clear.

Oh. The mask story isn't being debated or confused except by the vast unwashed. They are good for spaces with high viral loads (like health care and nursing homes). Their impact on the general public is minor, but with asymptomatic spreaders, the CDC changed its tune on wearing masks in public. People (like check-out clerks) who contact a large number of people are the first who should be wearing them, the last would be old people living by themselves who minimize their shopping trips. They aren't likely as the working public to be spreaders (nursing homes are an exception).

Dude, chill out. You're attacking a straw man.

My complaint about old people is that they are out and about, not that they are not wearing masks. I hear it from neighbors and co-workers, so it's anecdotal. Take it for what it's worth. Sorry if I wasn't clear.

Sorry. I am often unclear. I'll try to use smaller words. Yes, Acton, to you. The old people do not benefit from wearing masks. I do not know how to make that statement easier to understand. Since they do not benefit, and since it is both uncomfortable and can obstruct breathing there is nothing weird about them not wearing them. And your statement implying that wearing masks keeps them safe is wrong. (Except for its relatively minor impact on R.)

I think it's my fault for my unclear comment. Sorry.

Our water heater went out and I had to get a new one on Saturday and (of course) make a trip on Easter Sunday for additional parts.

On Saturday I went to Lowes, and it looked like roughly a third the people had mask (30-40%). On Sunday I went to Home Depot (Lowes was closed) and it seemed like only 10-20% were wearing masks.

I suspect the Sunday crowd was a both a little more blue collar and a lot more in need and thus willing to work on Easter Sunday.

This was middle TN.

This of good stuff.

I hope they are wrong about 2024 though. But if you look closely at prior outbreaks of disease in the ancient world through the Middle Ages and into 19 century London... it seems to have merit.

As a student of history, you could say C-19 is nature's way of saying Malthus and the Club of Rome were right in the long run... I'm surprised nobody (except me of course) has thought about how C-19 will cause massive inflation due to vane fiat money creation by hapless governments trying to inflate NGDP. I'm also going long on agriculture, buying some still cheap Greek (and soon, PH) farmland, which is actually profitable under existing prices (I'm planting genetically engineered walnut trees now, growing honey, but for fun and profit). Rich get richer. For you non-1%-ers, try buying stock in ADM as a second best option.

"As a student of history, you could say C-19 is nature's way of saying Malthus and the Club of Rome were right in the long run."

Crazy talk, Ray.

"As a student of history, you could say C-19 is nature's way of saying Malthus and the Club of Rome were right in the long run"

And a successful vaccine will be humanity saying those guys were Luddites and pessimists.

History is never written by those who didn't survive.

What is the likelihood that a vaccine will *not* be developed by 2021 or 2022? It's a well-established technology to inject an attenuated virus to stimulate antibody production, right? (Understood that one needs to find the proper dosing.) Given that we seem likely to devote sufficient resources for development, testing, and manufacture, what are the factors that could prevent a vaccine from emerging?

If human challenge testing is implemented by at least one state we could potentially have a working vaccine within a few months, presuming attenuated virus works, plus whatever time it takes to manufacture a billion doses.

@BC - "It's a well-established technology to inject an attenuated virus to stimulate antibody production, right?' - no. Recall the adaage "there's no cure for the common cold'. C-19 virus is a coronavirus, and C-19 is a chimeric virus specifically designed as a attenuated bioweapon to vex humans. Did you read the WaPo story from yesterday? So as not to upset China and to placate the American people, perhaps wisely, the editors labeled it "opinion". But it was fact. C-19 will be around for a long time, constantly mutating, just like the common cold or flu, requiring constant new vaccines. And it's Made In China.

Am I good or am I good, MR readers? When Ray says something, you can bank on it. Sometimes literally (I've called DJ-30 to 10k, bank on it, even with nominal GDP expanding due to the March 15 Fed "QE Infinity" program and PPT pumping). My shorts are in place using SPDN.

Coronavirus Throws A Curveball: New Mutation Can Make Current Vaccine Research 'Futile': Study By Rachel Cruise 04/15/20 AT 2:04 AM -

Ray - my understanding is that "there's no cure [vaccine] for the common cold" because the common cold is caused any of about 200 viruses. ( ). Only a few of those viruses are coronaviruses, BTW.

So nobody has ever developed vaccines against the cold because an effective vaccine - or more likely vaccines, plural - would need to cover a meaningful number of these 200 viruses to do any good. And, even then, some people would obviously still get colds after being vaccinated. So it would be an enormously expensive and complicated project that might well end in commercial failure because "it's just a cold" (and this vaccine doesn't even fully protect against it).

As I understand it, quite a bit of progress was made in developing vaccines against the original SARS as well as MERS - both also caused by coronaviruses - though that work hasn't been fully completed due to the containment of both diseases. Some of that knowledge is being applied to the current situation.

Also, while there might be a need for periodic updates to a COVID-19 vaccine, coronaviruses don't mutate as rapidly as influenza viruses.

Seriously, I sometimes wonder when I read your comment: if you're really as wealthy person that you claim, why don't you hire a research assistant so that you're not wrong so often? If you won't bother to put in a couple of hours of reading to understand a subject better, at least pay someone to do it and then write a summary memo for you.

The wikipedia page is a little weird in that it groups influenza within the common cold category. My impression was common cold was about one third coronaviruses (I think there are only seven of those and among them MERS and SARS are rare) and two thirds rhinoviruses where there is more diversity.

So even absent the current pandemic, a broad-spectrum coronavirus vaccine would be immensely valuable. Reducing the incidence of the cold by one third would be no joke economically.

1/5 of colds not one third of colds from the other 4 coronaviruses the two alpha coronaviruses 229E and NL63 and the two beta coronaviruses: OC43 and HKU1.
HCoV-OC43 and HCoV-HKU1 viruses bind to a different receptor, the sialoglycan-based receptors with 9-O-acetylated sialic acid (9-O-Ac-Sia) as key component.
HCoV-229E binds to the human aminopeptidase N (hAPN, CD13) receptor
NL63 binds to ACE2 like Covid-19. It's not that common
A vaccine against Sars-Cov2 is unlikely to protect against the others.
Colds come from 4 groups: the myxo- and paramyxoviruses, the adenoviruses, the rhinoviruses and the coronaviruses

One fifth reduction in the cold would be immensely valuable. I didn't say a SARS-CoV-2 vaccine would likely be a broad spectrum coronavirus vaccine. I said a broad spectrum vaccine would be immensely valuable. There was always good economic reason to target these viruses, even if there are technical, business, and legal reasons why that's hard to do.

And yes, I agree that 229E, OC43, HKU1, NL63, SARS-CoV-1, MERS-CoV, and SARS-CoV-2 indeed add up to seven known coronaviruses that affect humans.

Thanks Catinthehat and Lord Action. Dave, you're fired. Please leave out the back door so as not to disturb my guests.

That's nonsense, Ray.
Firstly, while it's possible (though not probable) that the virus escaped from a lab, all the evidence and analysis of the viral RNA indicates that it is of natural origin, and there is none to suggest that it was 'designed'.
Secondly, we have considerable evidence that vaccines against particular coronaviruses can be effective (and evidence from the SARS outbreak that antibodies to the virus can persist in humans for over a decade).

The bioweapon theory is malarky, not least because it seems like a terrible bioweapon. Leaving aside the lack of evidence for genetic manipulation.

But the lab-escape theory is legit. For example, see The Bulletin of the Atomic Scientists article below. They aren't especially prone to tinfoil hat stuff. I mean, isn't it especially convenient that this outbreak starts steps from a bat coronavirus research facility?

SARS -appeared in 2002. Still no vaccine
MERS -appaeared in 2014. Still no vaccine.
oh, but this time it will be different!

SARS-CoV1and MERS-CoV came and went and the momentum behind finding a vaccine evaporated. It’s not that it couldn’t be done, it wouldn’t be done.

SARS-CoV1 -specific antibodies persist for about 2 years. see

@Nigel - nonsense. You rely too much on what "experts" tell you but your information is stale. You probably think that SARS-CoV-2 is not chimeric due to the article found here: ("the Nature Medicine paper") but...

(1) the Nature Medicine paper uses as evidence that SARS-CoV-2 in natural because it has an intermediate host that’s a pangolin, but, this was rebutted (i.e., found false) a week after the Nature Medicine paper was published, see here: March 26, 2020 paper: ("The pangolin viruses, however, lack a feature seen in SARS-CoV-2 that may have helped the virus make the leap to humans — a hint that the virus may have acquired an adaptation in another, not yet identified, animal before spreading around the globe.")

(2) the Nature Medicine paper assumes the chimeric virus that is SARS-CoV (invented in 2015 at the U of NC (Chapel Hill) by, inter alia, two Wuhan bioweapons experts, this is incontestable, i.e., nobody disputes this) cannot be SARS-CoV-2 since the latter is not as efficient at infecting humans. But this is speculation and off-topic, since a bioweapons lab may make a virus less efficient just to cover their tracks. Further, SARS-CoV-2 *has* been quite efficient at infecting humans, so this point is moot (i.e., off-topic, that is, irrelevant).

I've dumbed it down as much as I could so you could get it Nigel. Lern to think for yourself Nigel. It's not that hard to do.

Bonus trivia: in 2018 only two children born in all of the UK were named Nigel at birth, though it was once a more popular name (GM Nigel Short in chess comes to mind). I think it's a fine name.

Seriously? "We used estimates of seasonality, immunity, and cross-immunity" already means a deeply flawed model concerning an actual virus with still unknown properties. It has not even existed long enough to know what its seasonality is, making any estimate a guess. Nothing wrong when guessing when responding to the unknown, but seriously, exercises like this are basically a waste of time due to the lack of actual data.

Something especially relevant in regards to immunity, where there is at least some preliminary evidence that reinfection is quite possible. Evidence that needs to be rigorously collected and evaluated, which is the opposite of such modeling based on a lack of data.

Remember when it was assumed that asymptomatic spread was not happening, that it was unlikely, that it was happening, that it may represent half of all infections? That complete reversal in assumptions only took a couple of months to be demonstrated, and there is no model used today that assumes asymptomatic spread does not occur, as the data has proven that it does.

Strange that an economics blog is uninterested in the central importance of rigorous data collection during a novel pandemic.

So what do you do when you don't have the quality of data to make sophisticated models for forecasting?

Your answer is to fiddle while Rome burns (ie gather data). Isn't it better to make 'best guesses' using the data you have, knowing that those guesses will most certainly be wrong in detail but that they may offer some useful guidance for your actions.

I guess you work as a civil servant or in a large corporation.

'So what do you do when you don't have the quality of data to make sophisticated models for forecasting? '

The answer was already provided - Nothing wrong when guessing when responding to the unknown

'I guess you work as a civil servant or in a large corporation.'

And your guess is totally wrong, Which would also seem to make this wrong too - 'knowing that those guesses will most certainly be wrong in detail but that they may offer some useful guidance for your actions.' Though it does seem a good time to correct whatever model you used, now that some actual data is available. And to recognize that the guess was incorrect, as happens quite often when guessing when lacking data. Data is how one judges a guess. There is precisely zero empirical data about seasonality, and immunity is a still very open subject, with indications that infection provides imperfect immunity at least some of the time (possibly to the point that re-infection is rare, and thus not a significant factor when making projections).

The senior author of this paper is a noted coronavirus expert who did a lot of work on the original SARS virus. I would deeply doubt the ability to forecast out to 2024, but the concerns raised by the paper are quite concerning and real.

An informed guess is likely better than a coin flip, but in the absence of actual data, it is still a guess. Just after 6 months, we have a much better understanding of the differences between the two viruses. We know zero about seasonality, and will discover how it works in the next six months, independent of any guessing based on the original SARS virus.

To make not a too fine point on it, highlighting informed guesses as realistic thinking is the sort of thing economists are truly skilled at. Make a guess that in 2024 .................. Fill in the blank as you wish, it will undoubtedly be what you consider realistic.

Much of this silly model discussion has simply been an exercise in curve fitting affiliation, very often using significantly outdated data compared to the pace of data being collected.

Prior_approval is the uncle at Thanksgiving who gets drunk and rants to the children about how “Monte Carlo is bullshit!! Bullshit!!!” while he verbally recites links and everyone else exchanges nervous glances.

Hologram effect.
Continue to move the hospital channel to sustainability and the social process will find the proper distancing.

severe acute respiratory syndrome
Yes, and the mechanism is similar for a number of virus besides corona family. But this treatment sets the clinical path and tells us hospital capacity. Once we have hospital capacity then we know the granularity of isolation we need to keep hospital capacity within bounds.

Apologies, apologies: The end is nigh!

So, through lockdowns we might save an unknown number of lives, but we are deliberately implementing a deep economic depression.

There are debates whether lockdowns are working in terms of public health, and there are debates whether the US economy can recover from the depression.

You know, the cost and benefits do not seem to be lining up.

Completely agreed.

We have a framework for making life vs. resource tradeoffs. It's called Value of a Statistical Life (VSL). Under that regime the current policies are actually insane. Something has broken badly in our decision making process.

Researchers do know that reinfection is an issue with the four seasonal coronaviruses that cause about 10 to 30% of common colds. These coronaviruses seem to be able to sicken people again and again, even though people have been exposed to them since childhood.
This is the most probable outcome right now.

I strongly doubt the death and severe illness rates are enough to shift social and economic equilibria far from 2019's, and there will be no political support for repeated lockdowns outside thoroughly propagandised societies. Add this blog used to advise, think about what has actually changed in the marketplace, and solve for the equilibrium.

Winner countries will be those that acknowledge covid as another flu. Countries that see this as an end-of-world pest will have a very limited role in the economy.

Does that mean you're currently long Brazil and Turkmenistan, and short every other country in the world?

Predicting that CV will have a deadly second wave because the Spanish flu did in 1918 seems odd considering they didn’t know what DNA was at the time. They also barely understood antibodies and certainly couldn’t test for them.

So why would we need to expand critical hospital capacity now when we didn’t even use it all the first time around?

It’s like you don’t think innovation circa 2020 is dependable!? and can protect us from a coronavirus.

I would bet the Dow hits new all time highs this year.

Certainly, anyone saying, "my projections show that hospital capacity will be overwhelmed without strict social controls," ought to be viewed with severe suspicion at this point.

Tyler! Innovation alert:

Emirates is now testing all flight passengers for COVID-19, presumably with the Abbott kit.

Also this: Abbott launches COVID-19 antibody test, plans 20 million tests per month by June.

Sigh of relief...

Interesting headline.

“Study points to evidence of stray dogs as possible origin of SARS-CoV-2 pandemic” by Oxford University Press

You may have to lockdown cats and dogs too. The outlook is for COVID-19 to become endemic globally. Who knows about bats, squirrels, other mammals.

Is there a Plan B to lockdowns? And...what is Plan A, anyway?

It can last longer than that if the Fed continues to let inflation expectations remain below what is consistent with 4-5% growth in NGDP. As of yesterday, the 5 year TIPS rate was less than 1%.

The problem of infectious disease is an ancient one. It must go back all the way to the evolution of big animals. As soon as you had a jellyfish or whatever, you would have had things trying to live inside.

It's kind of amazing to me that the number of things that can threaten a human as infectious disease are so few. That billions of us can inhabit the same planet shoulder to shoulder. We must have really strong immune systems. We had to, to get this big in this long lived.

And now with modern science we have another edge, with advanced treatments and effective vaccines.

So I am an optimist. We have a natural edge. More than that we have modern tools to defeat 'the invisible enemy.'

And if that took a couple years, big deal. Especially in terms of the history of life on Earth.

There are lots of things that can infect humans, but most of them just make us miserable rather than kill us and, as you said, we've been very good at figuring out how to control them. If you include viruses, bacteria, fungi, and single- and multi-cell parasites, there must be thousands that can infect humans. The tropics in particular are home to all kinds of exotic parasites (you can google but not for the faint of heart), some of which are still not well-known among developed-country doctors outside of specialists.

But agree on the optimistic take. If nothing else, we will learn much more in the next few months about how best to control the spread and perhaps to treat it.

Still, we evolved in those tropical lands, and made it out.

Without soap, even.

As an over 65er, I am pleased and surprised that the government and society value us oldsters so highly - although it must be pointed out that a lot of the central decision makers and planners are oldsters too. I think that if we as a society can minimize the loss of the young alive thru this, that the concern for the fate of us oldsters shouldn't be allowed to cause (or lengthen) a Recession (let alone a Depression). Not that I'm anxious to try my luck with this.

Of course, if it did take a couple years, we might have to get outside our free market boxes and think about social action.

If it takes a few years, and some people suffer, why not help them?

If your only answer is that you can't, because it doesn't fit your preconceived ideas, that's not a good answer.

In the case of New York state, via WSJ: Statewide 202,208 people tested positive as of late Monday, a rise of 7,177 from the previous day. Total deaths have risen to 10,834 in New York.

The population of the state of New York is said to be 19.44 million. That means that 1% of the population has tested positive for the virus and .06% has succumbed to it. In fact, a crowd of 10,834 at a Yankee game would be considered almost as grave a calamity as the death toll. Fortunately, 19,429,166 Yankee fans are still available to attend the pinstripes' games, at least at this point, should in-person entertainment ever resume.

Shouldn't we be experimenting with what the optimal level of social distancing is and will be? I used to see (outside of my own immediate family) dozens, if not hundreds, of people every week; now, under the lockdown, I see very, very few. I find it hard to believe that that is the optimal level of reduction.

Considering the likelihood that the disease was already widely present before being detected, this may be consistent with why the USA states' with no, or limited lockdown, have better mortality statistics than those with severe lockdown:

-you did a bold claim unsupported by current evidence/data
"disease was already widely present before being detected"
-followed by causality pimping based on poor understanding of
how viruses spread
"why the USA states' with no, or limited lockdown, have better mortality
statistics than those with severe lockdown "

Most of the scenarios modeled in Fig 4 and Fig 5 show us reaching herd immunity this summer or early in the winter. The double-peak scenarios only hold in scenarios where social distancing is keeping R0 around 1.3 or lower.

Keep in mind that "social distancing" has little to do with physical distance and everything to do with "biological distance". If two people are in contact with each other when using personal protective equipment (PPE), the probability of a virus transfer is effectively zero.

The basic reproductive rate of the virus R (number of new cases per case) depends upon the number of contacts time the probability of virus transfer. It is a pure social factor and not a basic property of the virus. Good PPE utilization, like in hospitals, if used by everyone would take the basic reproductive rate (R) of this virus to < 1 where the virus goes to away without changing physical distances between people or completely shutting down the economy.

There are already at least three vaccines (Johnson & Johnson, Moderna, Inovio) with a good chance of working. Efficacy, approval and production are the big three questions. JnJ is producing 1 billion doses (prior to official testing and approval), Inovio is producing 1 million doses by years end, Moderna is scaling up to millions of doses.

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