Did we lockdown some parts of America too early?

No, I am not referring to the preventive measures taken in California, Washington state, and parts of the Tri-state area.  Those made good sense to me at the time and in retrospect all the more.

I mean when the whole country started to shut down, including the South, Midwest, and other parts of the West.  And yes I know the legal lockdowns were not always the biggest factors, arguably it was when governments started scaring people.

Let’s say you have a simple model of political sustainability where Americans will tolerate [???] months of lockdown — shall we say two? — but not much more. (Maybe three months if we had Merkel as president.)  Then, if you scare/lock down in parts of the country where the virus is not yet evident, you create economic misery but not many public health gains.  Who after all thinks that Seattle should have been locked down last September?  Right?

Many parts of America now hate the lockdown, as they see the economic devastation, are not witnessing overloaded hospital systems, and just don’t quite “get it.”  And they are now taking off the lockdown, through both legal and informal means, before it is optimal to do so.  One loyal MR reader emailed me this:

The smaller town I am in was never hit hard, and therefore most people are somewhere on the spectrum between COVID is a bad flu and you should wash your hands to pick whatever conspiracy theory (plandemic).  People do not believe in the severity of the virus.  Not one family we know is social distancing. The ICU never got overrun, the only apocalypse to arrive is an economic one.  This is the fundamental point.  Most people’s only pain and sadness stems from loss of job, security, future NOT from sickness and death.  People here don’t work for big companies or the government.

Oddly, Trump’s big speech when he found “pandemic religion” may have been one of his biggest mistakes.  I fully understand that Denmark and Austria did well because they locked down early (and took other measures).  There is good evidence that NYC should have locked down earlier yet, but maybe (and I do mean maybe) other parts of the country — most of all rural America — should have locked down later, so they would have their lockdown active “when it really matters.”

In the meantime, we could have restricted or somehow taxed travel out of NYC, which seems to have been a major national spreader.

This is one reason why I am skeptical about models of epidemiology (and economics!) that do not consider political sustainability.  I am by no means sure that the claims in this post are correct, but they could be correct.  And a model that does not consider political sustainability and time consistency won’t even pick up these factors as concerns.  It will simply indicate that a lockdown should happen as quickly as possible.  But that was perhaps one of our big mistakes, namely to shut down many of the less dense parts of America before their problems were sufficiently acute, thereby rendering the whole program less sustainable.

And moralizing and blaming our current predicament on “Trump,” or “the yahoos who watch Fox News” is — even if correct — washing one’s hands of the responsibility to incorporate political sustainability into the model.

I fully admit, by the way, that I did not myself appreciate the import of this factor at the time.  This is all a sign of how backward our science is in this entire area.

By the way, here is a 55 pp. Powerpoint-like survey of lockdown models.  Many references, not much public choice or political economy to be seen.

Comments

"Men, it has been well said, think in herds; it will be seen that they go mad in herds, while they only recover their senses slowly, one by one.”

Charles Mackay.

Tyler slowly coming to his senses, about 2 months too late. This is going to be a painful process to watch.

@Yancey Ward - OMG no. TC didn't read the excellent Scott Sumner the other day? He had a Twitter thread that's entitled "Government Orders Alone Didn't Close the Economy" that shows in all states, from 7-14 days before the lockdowns, people were avoiding stores and shopping. See screenshot of thread here: https://www.themoneyillusion.com/wp-content/uploads/2020/05/Screen-Shot-2020-05-08-at-1.41.12-PM.png

A true libertarian response: educate and let the people decide (here the people were ahead of the government, at least most of them). What's the value then of a government order? It stops those minority of people too stupid to voluntarily shelter-in-place.

Bonus trivia: I will use my influence by email to get TC to update the post with one of those "UPDATE" addendums, thanking Ray Lopez (not the excellent Ray Lopez, just Ray Lopez, I'm modest). In fact, I'm so confident this will happen I will voluntarily social distance myself from this forum for one month if it doesn't happen.

In addition the large illness among those working in the meatpacking industry which are largely in rural areas points to a counter-factual. The economists might spend their time more productively looking at the impact of rolling business closures because of illness rather than pretending to be epidemiologists. The might arrive at a more sober conclusion.

No chance that will happen! Gutsy move betting the one month hiatus.

How do you constitutionally restrict or tax travel out of NY City? Or do you throw the constitution out?

Coming to his senses? He’s still wandering around in an intellectual fog of his own making.

And he still has no clue that “the yahoos who watch Fox News” are the large majority of the country - its viewership outnumbers CNN and MSNBC and the networks combined.

This, he will never accept.

This is why it is a joke when people on the right complain about "the media". Most Americans get their information from Fox News and Sinclair Media.

No, it is still right and proper to point out that NYT, WaPo, CNN, MSNBC, ABC, NBC, CBS, NPR and dozens of websites are hyper-partisan Dem-mouthpiece useless piles of crap. Believe it or not, there are still gullible people (like Tyler) who believe that if something is written in the NYT, it must be true. If you see someone doing this, you should mock them. Relentlessly.

I remember the first time a friend told me to “stop watching Fox News”, when he objected to some view of mine. No argument was offered, just an ad hominem attack. If these people were really informed, they would know that this Fox News exists mostly in their minds. Outside of the opinion shows, Fox News, especially the radio outlet, is just as bad as any of our feeble, biased sources.

The gold standard is Rush Limbaugh. Besides being a top notch radio guy, he’s probably the most insightful political/cultural commenter, by a mile. Of course, his critics don’t usually listen to him, but they know.

My wife and I used to listen to Air America, just to see what was going on. It was depressing - the left is humorless - and it failed miserably. The only left wing radio, NPR, has to be propped up with government aid.

I read the Times for years. It was always on the left, but there was enough good reporting and information to make it worthwhile. The Sunday Times was a treat. But it has descended into madness. The WaPo is even worse; it was a lot better when the Graham family owned it.

By the way, Marshall McLuhan was exactly right about TV versus radio. Radio is a “hot” engaging medium that involves the listener and stimulates thought. TV makes the viewer a passive receptacle.

I have relatives who watch fox 24 hours a day. It's hard for me to visit because I can't stop laughing after about 10 minutes.

I've listened to Rush for years and I think he is a genius. I have a formula I use when I listen to him. When he's busy criticizing Democrats, it means that the Republicunts have already done whatever he is criticizing the Dems for. He is a master at projection. He also takes great joy in attacking the media. Does he not know he is one of the stars of the media? Does he not know that the media is who pays him his hundreds of millions...

NPR is not left wing. It is only left wing if you think Fox is middle of the road.

No, they’re both very biased and if you can’t see that you are oblivious and beyond hope.

Nice name calling!

Got any facts?

No?

Why am I not surprised.

Yes

https://www.washingtonpost.com/news/the-fix/wp/2014/10/21/lets-rank-the-media-from-liberal-to-conservative-based-on-their-audiences/

You'll note that Fox News comes out at just under 2 (out of 10) to the Right and NPR shows up as over 4 to the Left of the Median American.

That Wash Post article is about who watches these shows, not their political biases. It says, "Fox News's viewership is pretty moderate compared to the Hannitys, Limbaughs, Becks and Breitbarts. This is probably because Fox's audience is just so large that it couldn't be relegated to an extreme end of the chart. But even liberals watch Fox."

So it has nothing to say about the actual political bias of the networks.

Please learn how to read.

It's not a joke. The right wing media is a mile wide and an inch deep. Right wing talking heads bloviate all the time , but right wing reporting -- right wing information creation -- doesn't exist.

-1

What an odd comment, can you state why you believe this?

Fox is not good, but the others are awful too, and I don't see how Fox is responsible for the fact that 63% of US deaths have come in a little area between DC and Boston which is not Fox's sweet spot.

If you want good journalism, you'll never get it on 10pm cable TV.

If you want conservative journalism, National Review is a good place to start. They aren't as good at journalism as the NYT or WaPo, but between the various sources you can often get the contours of reality.

He is quoting other people. Tyler isn't criticizing (at that moment) people who watch Fox. He is criticizing people who think that the only people getting sick of lockdown are yahoos.

Mitigation fatigue was always going to be a thing.

It's surprising no one is mentioning the protests over the lock down in Germany.

"(Maybe three months if we had Merkel as president.) "

Tyler makes this point, apparently oblivious to the fact that Germans are chaffing under the lock down also.

The major news networks evening news beat Fox News in audience despite their steep decline. So Fox News isn’t the majority

Are you implying that our intrepid blogger is not, in fact, A Very Smart And Serious Person™?

I wonder when the cargo cult here will come to their senses. My bet is around twenty-never.

Duh

Even shutting down all counties in a given state was stupid

The logic of the whole post is suspect to me. The point of the lockdown was to sow the spread, saying we should have staggered lockdowns implies the initial lockdowns implies we are trying to conserve hospital capacity in future outbreak areas where the disease has not spread. But this must necessarily mean that the initial lockdowns will fail, so why do them to begin with?

This is another Straussian hit piece despite the attempt to appear otherwise. Trump is at fault now for locking down too early, before he was too late. You NeverTrumpers never liked the guy, just say so already.

LOL. I thought this is TC trying to resurrect Trump for Nov. Hey, you know what, Science let Trump down because Science didn't take people into consideration; should have gone with Trump's understanding of people pulse and given him leeway to message (er, manage I mean) as appropriate

FWIW, my 2 cents is TC wants Trump for 4 more years.

TC prefers Trump to any sort of liberal alternative that’s clear. It is telling that TC ignores how much of the disaffection in rural America has been purposefully and consciously stirred up by the donor class to prevent any examination of the many failures of American crony capitalism the crisis keeps exposing.

What we really need is a better explanation of why America‘s 1 % lean so much more strongly libertarian and anti-government than elites in Asia and Europe. The Federalist/Koch/Buchanan wing seems far stronger than it was even two or three decades ago, and refuses to learn from crisis after crisis.

That was definitely a thing for a while. A certain kind of conservative hoped they could whistle past the graveyard with Trump.

But we didn't make it past the graveyard.

Meanwhile, all of the principled #NeverTrump conservatives get to choose between 1) a senile rapist who hands the presidency to whichever Obama-on-steroids the party forces him to pick one month in or 2) literal joke Justin Amash.

So what's one more?

I don't think Bill Clinton was senile, his occasional forgetting of who he had sex with in the Oval Office and the definition of "is" notwithstanding.

Pretending not to understand present tense verbs isn't a good look for you.

Ridiculously transparent double standards isn't a good look for the cargo cult either, yet here we are.

It's never going to happen.

Probably the main reason is the U.S. economy has substantially outperformed European economies, and most Asian economies, over the past 40 years. Furthermore, those economies seem to have all the same crises, plus a few extras. It's been one of my amusements during my adult lifetime to observe intellectuals, pundits, and the herd of independent minds who follow them blathering about U.S. decline, all in complete disregard of facts. Every once in a while they wake up for a few minutes, notice that there is one hyperpower in the world, and that it is getting richer, act puzzled, and then go back to sleepwalking.

Wait, so we don't need to MAGA?

The whole F'ing election was about a claim of decline. It was T's whole thing.

A decline compared to our former selves, not compared to the EU.

Who are these "former selves" we have declined from?

I don't read the 2016 election as having been particularly distinctive in that regard. Most elections involve the out party claiming that America is on the wrong track, and that the challenger will bring America home, or bring morning in America, or restore integrity to the presidency, or bring Hope, or whatever.

It's all so much bullshit. Both sides.

No, we should have locked down earlier. This would have enabled the virus to be contained or at least reduced to the point where test-and-trace would have been feasible. That is how Asian countries were able to control the virus. When China had 800 reported cases in Wuhan, it didn't just stop travel from Wuhan, but also locked down other cities around the country to prevent local spread from the cases that were already in those cities. If the US had locked down on March 10th when we had 800 reported cases, there's a good chance that we would have contained the disease by now and everything would be getting back to normal.

Of course, continued lockdowns at this point are futile and should be ended.

This was really a case of go big or go home and our half-measures resulted in the worst of both worlds.

That's true in a vacuum. Theres no cultural or political mechanism which could have reasonably done this in most western countries.

The US in particular is poorly positioned to deal with highly contagious diseases. It's federal system is great with most other things, but top down autocratic action to suffocate a city is one thing it does not do well.

I for one am ok with that. Even if it does mean a pandemic every 100 years.

I agree, this is better. But does the calculus change if it's a pandemic every 10 years?

I do not think test, trace, and isolate to the extent of suppressing the disease until a vaccine can establish heard immunity was ever possible in a continental size economy and society like the US, not even if CDC/FDA had in place regulations to permit a rapid increase in testing capacity and a Churchillian President to inspire a London blitz citizen response.

An increase in such capacity can still decrease the costs of a "bend the curve" strategy and is worth perusing.

We have been fed perhaps the greatest bait-and-switch in history. Bait: flatten the surge to prevent overwhelming hospitals. Switch: Even though hospitals are emptying out, many are laying people off, some are closing, we must stay closed until there are no new cases.

The hammer and the dance was published in February or early March IIRC.

Test trace and isolate could have done to it what we did to SARS, and obviated the need for a vaccine. The CDC should have been on top of it from early January, as soon as we heard about it. But again, the Trump administrations response was to ignore it and hope it went away. Now, it very well could have gone away if people behind the scenes were doing their jobs - but that's the sort of thing that yes, the President needs to be involved in. Instead of wishing it away, Trump should have been "suppress this shit NOW" and ordering the CDC to take the actions necessary to MAKE it go away. And he clearly wasn't.

The fact that zero other developed countries were able to do this other than the island of Taiwan and South Korea with its single infection vector tags this as politically-motivated magical thinking.

China also did it though after the lockdown in Wuhan. They started late because they tried to suppress information about the epidemic in the beginning. If they had done it earlier on, this would have been another SARS. The fact that SK and Taiwan did it proves that if you catch the first cases early enough it can be contained.

South Korea and Taiwan are both small countries, one surrounded by water the other a peninsula with a single seldom-crossed land border with a hostile neighbor. Both experience only a small number of initial infection events . The number of infection events in the US was likely in the hundreds. especially since it now appears the virus was introduced into the country well before the word was taking alarm over it. The horse was already out galloping away in through the next county by the time anyone thought about locking the barn door.

"China also did it though after the lockdown in Wuhan. T"

True, but are you seriously advocating that the US should have followed in Chinese foot prints.

Welding people into apartment building with only one guarded access left open? Patrolling the streets arresting anyone outside without government permission? Blocking all personal transportation outside of your "designated" town? Dumping the infected into massive wards, with minimal protections?

An authoritarian government can get away with treating people like cattle, and I will agree, in this case more of the "cattle" survived than would have otherwise. But those tactics would not have worked in the US. I don't think they would have worked nearly as well in any country without a decades long history of shooting anyone who pushes back against the government.

No, we should have done test-trace-and-isolate much sooner.
like in January, when Helen Chu was asking for permission to test ofr COVID-19 and being denied. If we had been able to isolate, and trace the contacts f the earliest cases, we would not have needed a lockdown at all.

This was never going to happen. Our ruling class was clueless. Presidential candidates were filling 20,000 seat halls into the middle of March.

"But that was perhaps one of our big mistakes, namely to shut down many of the less dense parts of America before their problems were sufficiently acute, thereby rendering the whole program less sustainable."

Isn't that what you are supposed to do? If you shut them down after the problem becomes "sufficiently acute," you've basically close the barn doors after the horses bolt.

I don't think it would have been easy to force people into an early lockdown against their will. It seems that populations must choose to do so on their own.

You go to war with the population you have.

Asian countries that had dealt with previous epidemics had a people that were ready to fight this, with some minority who wore masks in public even before the virus became a thing.

I have many complaints about Western government response, but without the people having had a brutal lesson delivered in recent memory, there was only so much they could have done.

In an ideal world: yes, prevention is better than cure.

Here in this rock where Homo sapiens sometimes-sensibilius roam, letting something to reach crisis stage and managing that gets one kudos as 'effective crisis manager'

The key to be a shrewed politician is to know just the right time to step in; not a moment late (f**ked for sure) not a moment earlier (no crisis). That's how it is in corporate world too

In between "lockdown" (what does that even mean anymore?) and laissez-faire, there is a whole spectrum of responses available. I keep hearing claims that the U.S. can't do tracing and testing but something seems off about that claim. Rural and suburban counties that have not been hard-hit are perfect candidates for this approach. Leave parks open and even experiment with allowing bars, restaurants and entertainment venues open subject to social distancing guidelines. No concerts or in-person church services, though.

You might need a different approach with metropolitan areas that have been hard-hit until things cool off there and restricting travel makes sense.

You're right to question why test&trace hasn't yet been rolled out. I suspect that it doesn't make much sense to roll out test&trace until the case load is at a very low level. Not yet but hopefully soon..

Why must churches remain closed when bars and restaurants may be opened? If you think people who attend church are too stupid to socially distance, are you aware that they also go to bars and restaurants?

Religious services routinely show up as one of the biggest sources of infection in contact tracing studies. The availability of less risky alternatives -- streaming, for instance -- and relatively low economic impact of suspending in-person services make it a plausible way forward. I suppose you could also have health authorities micromanage the conduct of religious services -- making sure only a certain number of people are in the church at the time, banning the shaking of hands, no communion, etc. -- but that somehow seems more onerous and big government-ish than just asking people to enjoy their favorite church service through live streaming while we figure all this out over the next few months.

But, hey, maybe I'm wrong and we need to continue lockdowns even in rural areas.

People doing vigorous lung activity -- including singing -- in a closed room seems to be a significant spreader.

Churches in my region are "open" in the sense that they are performing services. But they are limited to 10 people in personal attendance, and then livestreamed. Like you said earlier, there's a lot of room between "nothing" and "cancelled." In fact, with that "10" number, you have something you can tune a lot.

You don't build and maintain a nation full of unorganized aimless degenerates to lord over by allowing them to go to church.

If you can get the churches on your side religion is an ideal means of social control. See: most of history, pretty much everywhere.

Of course, economists having failed to adequately address the ECONOMICS of the inevitable pandemic deserve a pass as a profession. What does it say, TC, about economics as a profession and economists as both professionals and members of their wider society? Trump, I hope, tried his damnedest to be upbeat. Unfortunately narcissism, pathological lying, and ignorance (as well as willful misrepresentation and lashing out at critics) didn't inspire the broad population to sucking it up and staying the course - what course he described was just as delusional as the public health officials not understanding where the gd money they're paid comes from (hint: it's the economy, stupid). Please describe your solution, TC, for building a wall around NYC to keep all those infected masses from fleeing. Would it be at the city limits? the county? the state? And how would we intercept the boats, planes, etc.? Put it another way, putting forward impossible cures may be something that is respected in the White Towers and Halls of Academia, but here in the real world isn't likely to be productive. If I had to grade economics as a profession today, it'd get a F, but as long as zero public money is going to support the profession, I'm ok with them existing. I'd give epidemiological modelers an F also - not for their god-awful models, but for their failure to *effectively* demand that the government supply them with the data they need on an emergency basis. I'd also give media their share of the blame. This seems to be the Age of Media, and they deserve a lion's share of the failure of these others (politicians, economists, modelers) to get their points across to the public. Of course, that assumes there are effective means to get "the public" engaged on a long-term basis, and I'm not convinced there is. The unwashed massed have that (ironic) name for a reason.

Trump wants to build walls. Why didn't he build a wall around NYC and staff it with ICE, armed border patrol guards, and 24/7 drone surveillance? We can put those who try to flee in concentration camps and separate them from their children. Trump didn't need a pandemic to be a fascist but he has a good excuse to become an even better one.

I don't think a president can really shut a state down except from the standpoint of trade. Everything else is up to the governor. Remember, Trump told all the govs that HE was boss, and they all quickly stated he had zero control over them and that THEY were boss.

Correct. He did threaten to shut down NY but he was , rightly, told it wasn't within his power.

I'm not in the least surprised that foreigners often have little grasp of how limited the powers of a US Prez are. But I cannot shake off my amazement that so many Americans don't seem to grasp the point. That is, they may pay it lip service but I don't think they've fully absorbed it.

The American president is not that powerful, and yet people go insane every four years fighting over who it should be. Like it matters.

Ironic, isn't it? We can't isolate New York from the rest of the country, but we've let New York shut the entire country down for nearly two months now. It's time to decouple.

When bubonic plague first reached the US in 1900 it spread through California for several years while the CA governor flatly denied it existed in his state. The Feds ultimately threatened to quarantine the whole state-- easier to do back then since it would have mainly involved shutting down rail links and closing ports. Did Teddy Roosevelt not have that power? I'm not sure anyone told him he didn't. CA sat up and took notice and got serious about its plague problem-- but entirely too late as the disease had naturalized in the rodent population and has spread all over the Rocky Mountain states.

Well, it obvious now Australia put it's level 3 restrictions in place far too late. If we'd put them in place one week earlier we would have cut infections transmitted within Australia more than half, had fewer deaths and be more than one week closer to eliminating it. It took a medical rebellion (see Australia's rum rebellion) to get the government to act appropriately, although to be fair work was being done and the government wasn't asleep at helm even though the Cabinet appeared to be.

I'm sad to learn the Rum Rebellion wasn't about rum. In early America, the Whiskey Rebellion really was about whiskey, specifically taxes on it. I wonder if the anti-tax libertarians think of George Washington as some kind of tyrant or a worse to them, a socialist, for killing those who opposed his brand new policy of, get this, taxation with representation! It turns out a government with a national debt trying to behave responsibly must pay it off by raising taxes. Who knew?

The rum rebellion was about Governor Bligh attempting to stop corrupt officials from illegally lining their own pockets, so make of that what you will.

An indirect plot mechanism in "Desolation Island"!

What a piece of luck that I found the first couple chapters of "Master and Commander" a bit dull twenty years ago! A 20-volume series to pass the pandemic - how many adults have that?

I saw the first volume second hand years ago and bought it for a dollar. It was a good read. I might bother finding some of the others at some point.

One of the (many) dispiriting aspects of our pandemic response has been a total inability to acknowledge heterogeneity. Not only should the timing of responses have been different in different states (after imposing much more stringent limitations on travel than we did), but responses should have been fine-grained at the level of counties or even smaller.
Similarly, the stunning localization of ~1/3 of all deaths to nursing homes should have meant that we direct resources towards places of concentrated elderly people, and not treat nursing homes and bakeries equally.
Similarly, the obvious higher transmission rates of a respiratory virus in indoor, enclosed spaces compared to outdoors should have meant that we don't treat gyms and state parks the same way.
The deeper question to ask is: why is the US response so dully homogeneous? I have thoughts on the answer, but I'll leave this as-is.

At every level of the pandemic response, there is intense blue tribe and red tribe bitching.

Go back to late March and the blue tribe Miami Herald is just ASSAULTING DeSantis for not closing North Florida-while central and south Florida we’re already on total lockdown.

They get their wish. Total state lockdown and now the rural red tribe is leading the charge to end lockdown. Now Central and North Florida are relatively open. Nobody wears masks, gives a rats ass about social distancing and Outdoor eateries are packed on the sidewalks.

So we have the worst of all kinds of worlds. And to be honest, as much as I agree with Romer, we still don’t have reliable testing results. At least anywhere near what is needed to make test and trace in a federalist, freedom oriented, democratic republic functional.

The only play at this point is to pray there isn’t a second wave, get enough economic growth back to limit the carnage somewhat and hope for a vaccine by September.....

Agree on point about state parks. Regarding "the stunning localization of ~1/3 of all deaths to nursing homes should have meant that we direct resources towards places of concentrated elderly people, and not treat nursing homes and bakeries equally," what resources can you direct toward nursing homes other than a strict regime of test, trace and isolate for all staff, patients and workers? Maybe the U.S. has the resources to do that now but it certainly did not in March.

I have seen this discussed ad nauseum but no one can come up with a solid plan for how to keep staff from getting infected and bringing the virus into the nursing home environment. Do the staff live on site and have food, supplies and essentials delivered to them? What if there is no space or facilities at the nursing home to accommodate staff? What if they have kids to take care of at home? What if one of them is already infected unknowingly? Etc.

One you have staff out in their private time going to church, hitting the gym, going to parties, or merely living in the same house as family members who do these things, the chance that covid-19 is introduced into the work environment becomes extremely high over time. And there is nothing anyone can do about it absent wider social distancing measures in the community. Again, until testing and tracing really ramp up.

A couple things early on.

Self isolation after travel, especially for workers in care homes. That applies to families as well. That was the source of infections in the care home near where I live.

Second is no staff movement between facilities. This is another obvious one.

Third, and Cuomo was blitheringly stupid in this respect, is not sending infected people discharged from hospital back to the care home.

Fourth, no visitors.

Fifth, and this is where government earns their keep, someone setting up a team that communicates every day with every care home in their jurisdiction, giving out information, helping them set up their protocols, and getting information quickly and first hand to deal with outbreaks.

Sixth, this is implemented in my jurisdiction, if a resident leaves a care home to do something outside, they go into isolation for two weeks when returning.

what resources can you direct toward nursing homes

Do the staff live on site and have food, supplies and essentials delivered to them?

Yes.

What if there is no space or facilities at the nursing home to accommodate staff?

Put in as many as you can. The others you put in a hotel room, as close to the facility as possible. Yes, they might sneak out, or sneak someone in, and break quarantine. You can use bonus pay to keep them from doing that.

What if they have kids to take care of at home

You give them a vacation, or hire them to do the things that don't involve interacting with the people inside the facility.

What if one of them is already infected unknowingly?

You start by fixing the risks you can fix. If we stop 90% of the inbound transmission vectors, we can dedicate tests to the people we are concerned about.

If you start this process early -- like in late February -- you probably don't have sick staff workers at all unless you live in Washington or New York.

I know what I described is expensive. But it takes advantage of resources that we currently have a surplus of (unoccupied labor and hotel rooms) and is a bargain compared to some of the other things we've done.

"The deeper question to ask is: why is the US response so dully homogeneous?" That is a good question. One could take it a further and ask, what does the response to C19 tell us about the current state American society and its institutions? Maybe such a question is best answered by historians by comparing the C19 response to the response to the many previous pandemics. I don't know. In any event, it is a more important and interesting question than the endless hypothesis-contrary-to-fact arguments I keep reading.

Also, isn't this an economics blog? With so many economics questions to be explored I don't understand why the bulk of the posts are speculation about the virus and hand-wavy op-eds. Where is the analysis of the economics impact of the C19 response?

Economics is hard.

The statewide blanket lockdowns were bad policy from the start. Even in New York, where New York City has been the epicenter for both COVID-19 cases and the spread of the coronavirus to other parts of the U.S., there are several counties that have had exceptionally low numbers of cases (some in single digits with little to no change for weeks), where the state government's policy provides precious little benefit compared to the economic damage it is causing within them.

The blanket lockdowns in the state is a failure of the state government, which appears to lack both the competence and the capacity to manage the diverse needs and situation within the state. Multiply that times 50 states and 6 territories spread over thousands of square miles, and a one-size-fits-all national lockdown policy would be completely nonsensical. It would be better for any quarantine lockdown policy to be implemented at the county or city level.

On quarantining New York City - President Trump actually proposed doing just that in late March, but was opposed by Governor Cuomo. It was never implemented, which is partly why Washington D.C. and the area surrounding it is now dealing with an adverse trend for coronavirus infections compared to most other states that have improving trends.

If you want an example of a state whose lockdown policy is totally mismatched with the evidence of its coronavirus infection risk, take a look at Oregon. It's Governor extended the state lockdown to 6 July. Something other than the risk of spreading COVID-19 infections is behind that policy.

LOL. The parts of America that wanted to enforce the borders hate it when borders are enforced on them. You get what you deserve you fascist dumfuqqs.

Don't most people in rural areas prefer to be left alone? This lockdown should be dream not something to whine on about.

At first you don't know what you are dealing with. The prudent response at that time would have been to shut the borders down the instant Wuhan was closed. After all, if a country is closing a city the size of NYC or larger, how often does that happen? Once in 20 years? If that happens, it immediately means all international airtravel must stop immediately. Yes, people will tell you how sad it is they are missing their daughter's dance recital. But the chance of quarantine is something all international travels must budget for (time and $) anymore.

But ideally, you'd have a month earlier warning that we did with Wuhan. The DNA was sequenced in December, and docs in China knew it was moving among people. China's outflow should have been stopped by China in December. And then you can trace those that arrived to the US in the days prior while the rest of the world continues to go about its business and the world-wide doctors all work on sharing information. It's far better to trace new arrivals (where there's already a ton of paperwork) than it is to try and trace person to person transmissions in country.

The greatest mistake in all this was the world science community (the same community that has constantly told everyone there'd be a pandemic) collapsed, and that collapse happened LONG BEFORE the first person showed up at an ICU. Scientist in country A couldn't even share info with country B. The WHO idea was nice before the internet as a global clearinghouse of information. But anymore, why aren't scientists all communicating with each other directly on forums and working groups? Why isn't a doctor in a remote village in China taking samples to the city for sequencing, and those sequences are then uploaded for researchers in Nebraska or Cambridge to look at?

New tech like 4G, 5G, USB, Bluetooth are all done by massive global groups of engineers refining specs and IP collectively and mostly NOT face to face.

Trump wasn't perfect. But that's kind of like having an arsonist (China) light your house on fire, and then complaining that the fireman (Trump) scratched your car when he was trying to get the fire truck in the right place.

1. The virus was sequenced on January 9.

2. The better analogy to Trump is that a house on the other side of the neighborhood caught on fire. Then a house across the street. And then the fire started to spread to our own house. And instead of calling the fire department, Trump poured a cup of coffee, sat down in the kitchen and said "this is fine" while telling people to drink bleach, complaining about his ratings and encouraging people to breath deep the fumes.

3. Is Trump's car scratch the 80,000 dead in this analogy?

4. Outside of an ineffectual travel ban on China that wasn't really a ban, Trump did jack squat in the 7 weeks leading up until Mid March. And then he did even jack squattier. This is on him.

"This is on him."

This strikes me as a bizarre take. Trump did not impose lock-down policies at all -- he left that to the states. Trump did not fail to close NYC's schools. That power was in the hands of de Blasio and Cuomo and they are the ones responsible for the delays.

Here's the list of 10 states with Covid death rates above the national average:

New York, New Jersey, Connecticut, Massachusetts, Louisiana, Michigan, Rhode Island, Pennsylvania, Maryland, Illinois

All but two have Democratic governors. The other two are lead by Republicans who have contentious relations with Trump.

Blaming Trump for the disasters in blue states when he left those governors with full authority to manage their lock-down rules makes little sense. Is it Trump's fault that he did not send in the National Guard, take control of New York, and overrule their disastrous, inexcusable Covid nursing-home regulations that appear to have resulted in such carnage?

1. Wrong. China news sources have reported that "several" genomic companies had sequenced the virus by Dec 27. See Times of London report http://archive.is/ALkgA

2. Not really. The government moved much, much faster on Covid than H1N1. We hit 1M tests in 6 weeks after first death, instead of the 4 months H1N1 took. Emergencies were declared much faster, money was appropriated much faster. Everything moved much, much faster under Trump than Obama. And all the while, the left said it wasn't needed.

3. No, the 80K dead is 85% old people, most in nursing homes. These homes are highly regulated by the states--not the feds. And in the case of NY, the state sent people with covid BACK TO THE NURSING HOME.

4. Rather than print the list, I'll just note that Trump in Feb did far more than Cuomo in Feb to protect people. NYC put their first order for additional supplies--hand sanitizer and masks--in on March 6. And then they lost the order because they didnt' pay in 72 hours.

Nobody died because of a lack of care, ventilators, or because of a hospital bed. Increases in testing are growing faster than bullets production during WWII.

Plenty died because govs told their state this was nothing to worry about--a message delivered purely because they wanted Trump to look like an idiot.

Jan 31: Trump applies travel restrictions to flights arriving from parts of China and declares a health emergency, blocking some 7000 Chinese from arriving each day. The WHO later said these early closures brought 2-3 weeks of planning time.

The left went insane over these closures, calling them unnecessary, unneeded, racists, etc.

Feb 9: Chair of NYC Council of Health Relations urged a "powerful show of defiance of #coronavirus scare" and celebrated the "huge crowds" gather for the Lunar New Year parade.

Feb 9: Chuck Schumer marveled at the LNY crowds. NYC health commissioner Barbot urged everyone NOT to change plans due to "misinformation" about Coronavirus"

Feb 26: Cuomo proclaims NYC the "front door" the united states and welcomes all

March 1: NYC first case

March 5: DeBlasio says fear should not keep NY'ers off the subway

March 6: NY places first order for hand sanitizer and masks

March 16: NYC closes schools

March 26: NYC confirms 38K cases

Between March 5 and March 27, this was growing at 47% per day in NYC thanks to the the countless idiotic pronouncements and actions from the state leaders.

Consider it was just LAST WEEK that the city decided to finally close the subway at night for cleaning and sterilization. Prior to that? It never got a good spray down at night--it was filled with sick homeless people that spent the night riding through the tunnels and coughing.

You seriously think Trump is the problem here?

Re: No, the 80K dead is 85% old people

"Unlebenswertiges Leben" really does sound better in the original German.

"Scientist in country A couldn't even share info with country B."

I'm sure there is room for improvement in information sharing and collaboration but this doesn't strike me as true at all. Taiwan implemented enhanced screening and thermal scanning of all passengers arriving from Wuhan right after New Year. Why did they do this? According to Wikipedia, "Taiwan's Central News Agency reported that Luo Yi-jun, deputy director for Taiwan's Centers for Disease Control, had been reading on PTT in the early hours of New Year's Eve when a thread about an unknown disease causing pneumonia in Wuhan caught his attention. He saw a post including screenshots from a group chat with Li Wenliang. He immediately emailed colleagues and put the country on alert."

Right. The information was out there Jan 9-10. Any doubt should have been removed on Jan 23 - it was not too late then for all countries to band together and eradicate this with forthright action. But no.,.. we all lose the prisoner’s dilemma

But again, as I posted the source above, China's genomic companies had this sequenced in December. THEY KNEW IT WAS SARS, THEY KNEW IT WAS SPREADING HUMAN TO HUMAN. At that point, China should have closed their border to international outgoing flights.

Had that happened on December 15, none of this would have happened.

If a disease like SARS if found in your borders, you have an obligation to tell the world ASAP and close your borders until the situation is understood.

I lock my doors after I get robbed. But not before. That would be too early.

That's a poor analogy because locking your door is effortless and costless.

There are many very cheap mitigation strategies that people are refusing to do.

Tyler, the whole point of locking down early is to get to the point where you don't have to lock down later to avoid thousands of deaths.

Actually, estimates show that 90% of US COVID deaths (about 70k deaths) would have been prevented if lockdowns happened just 2 weeks earlier.

that's a very bold claim/estimate!

Lockdowns were crude, ignorant steps because we didn't know what to do. A lot of businesses that were shut, such as golf courses, weren't very risky at all. Others, such as ski resorts, were highly risky.

But I doubt if there was anyway possible for government policy to avoid a sizable economic downturn. Too many businesses are dependent upon "consumer confidence" and "animals spirits." An epidemic that makes face-to-face contact unappealing reduces consumer demand for all sorts of spending that exists mostly to make people look good to other people, such as new clothes, haircuts, car washes, and the like. Because I am not inclined to socialize, I am not inclined to spend money on all the things I usually spent money on to make my socializing more successful.

You seem obsessed with your misguided notion that skiing is risky. No, crowded bars at a few ski areas were risky. For the most part skiing itself is no more risky than golf.

Your basic point is correct though. The lockdowns seemed random and that naturally makes people angry and distrustful. It is apparently ok to fly but not sit outside on the terrace of a restaurant? Young people can’t gather in small groups outside? But we can force people to work in meat processing plants?

And one activity we know for a certainty is bad - religious services - are the one thing Republicans are scared to stop. It is, in short, a mess.

The essentialness of international travel: we discussed this in the comments, oh ... two months ago now, on March 12th.

International travel, I was told, was an activity apart. It makes people better and more "well-rounded". It is not "a waste of time" in the way other activities are.

Because of this mystical association of travel with enlightenment, which you have probably noticed borne out among your acquaintance - how they all return home Ibn Battutas - it is important that we continue to make a distinction between going out for a walk in your own corner of the world, an indefensible indulgence that curdles the mind; or sitting and enjoying the sun on your back - move along, this beach is for exercise only ... and boarding a plane. The latter must not be curtailed, now or ever, or the virus will have won.

What about ski lifts and gondolas aren’t they also risky (I have no idea...)?
You might be right that skiing is by itself not more risky than golf... but you shouldn’t look at it by itself. If I go golfing in Europe I take the car and then golf for a few hours (I hardly come in contact with anyone). Meanwhile for skiing I would take the car or public transport to a ski resort, where I would be at a hotel for a week, eat every day in restaurants and go almost every second day to have a drink somewhere. Obviously this is way more risky than golf.

Ski resorts, even small ones without hotels serving mostly local skiers, tend to have not st bars but cafeterias, changing rooms, restrooms, ski shops and equipment rental facilities, and maybe even swimming pools and hot tubs in which people get crowded together. How many golf courses have any of that beyond restrooms and maybe a pro-shop?

The Fed's job is to offset "animal dispirits" by providing enough liquidity to keep NGDP expectations on track.

What about acknowledging the heterogeneity of vital strains? According to a piece in the South China Morning Post, dated April 20, a strain with 270 times more virality landed in Italy and NYC. A much less transmissible strain set up on the West Coast and became dominant in the USA.
https://www.scmp.com/news/china/science/article/3080771/coronavirus-mutations-affect-deadliness-strains-chinese-study

Trump, like everyone else, was simply taking guesses with great ignorance about the true characteristics of this invisible enemy. Therefore, taking a stab and then adapting is the best possible course.

Pareto optimality of epidemics? Why...yes.

It has 270 time more virality? Wow, that's really viral. So if each person with the original version spread it to three other people, each person with this version would spread it to an average of 740 people? And here I was thinking measles was bad, but this is 50 times worse than that. Amazing.

Something along these lines was how the British government's advisors explained their intitial reluctance to lock everything down. My understanding listening to the left is that this was an excuse for Tory genocide.

The lockdowns didn't result from governments scaring people. They were precipitated by the explosion of carnage in Milan.

No one got to "choose" the timing. The virus dictated the timing.

Taiwan chose. Vietnam chose. Australia/NZ dragged their heels and responded adequately as the evidence they were heading to disaster mounted up. The US dragged its heels and then, rather than responding adequately, failed to reduce the spread of the virus enough to contain it. It's still not contained and is continuing to work its way through the population at about 1,000 people per hour.

In this instance, the US really acted as the united STATES. There was (and is) no national lock-down. This, I think, is something that Trump got right (and perhaps surprisingly so) If Trump had tried to directly manage NYC's lock-down policies, micromanaging the rules under which the region's residents (people who mostly hate his guts) had to live their daily lives it would have been a disaster. A more useful level of comparison is between states and countries of comparable population. Compare Australia to California, Texas, Florida, and New York. Compare New Zealand to Minnesota or Colorado (while keeping in mind the fundamental difference that U.S. states are not islands nor are they permitted to control their borders or impose quarantines on new arrivals).

States most certainly have the right to control their borders - at least for everyone not in the federal government. The first covid case in VGa Beach was military, and there is no way that the governor can stop the military from coming and going as they please to federal facilities (a lesson that Virginia was certainly taught a century and a half ago).

It's not clear that states could refuse entry to other Americans, and most certainly not to their own residents. At best they could quarantine such travelers.

We’d be early if we actually had a testing program. If we actually had a legitimate track and trace policy in place. If we had a healthcare system that didn’t discourage wide swaths of the public from seeking help when sick. If we had an employment system that didn’t encourage people to work sick because they don’t get paid.

Since we did not, we were left with only lockdowns. The crudest, most primitive, most blunt instrument of all in a country that should have had many more modern solutions at its disposal.

Yes, but lucky for us, since H1N1 the CDC and FDA have spent 250,000 staff years of labor and $150B in funds. In other words, not much. So, what do you expect?

I mean, coloring books teaching people not to bully aren't free.The CDC was also instrumental in teaching people that vaping was bad. And being fat was bad. And to respect pronouns!

So, look at what we for $150B and 250,000 year of effort:

1. People know being too fat is bad
2. People know not to bully
3. People know vaping probably isn't good for you
4. People know it's polite to use the pronouns people want you to use.

Things like testing and tracking? Sorry, those will cost a lot more. If a coloring book costs $150B, I'm thinking something basic like test and trace will required doubling or tripling the size of the CDC.

Face it: Our govs are clowns. Every org should be refocused on a few core missions, everything else jettisoned, and the budgets and headcounts cut in half.

Political sustainability...

I don't think anybody believed from the start that lockdowns were sustainable for more than a couple of months. The lockdowns were designed to buy time to set up a testing-and-tracing system.

That didn't happen.

Has the popular will turned against lockdowns? Not obviously. Concerns about too rapid a re-opening are still more common than concerns about too slow a re-opening.

The awful truth is the following: Until stock prices were affected, Trump's attitude towards COVID-19 was to ignore it and hope it went away. Once the stock market recovered, he lost interest in the pandemic as anything but a stick to beat over the heads of insufficiently deferential state governors. The "popular will" only matters when the "people" agree with Donald Trump.

I suppose I dont really know the true measure of peoples desire for the continuation of lockdown, but the stores that were reopening that I went to seemed quite full. There has also been a steady increase in traffic. I am planning on going to a dine in restaurant tomorrow, it will be interesting to see how full it is.

Never the less, my reaction to lockdown would have been much different if I was told that the purpose wasn't to spare the millions of ventilators that would be needed, but instead to setup pervasive electronic monitoring, mandatory DNA collection, and prison camps.

The political economy problem cuts the other way too, of course:

'Interviews and records published so far suggest that the scientific committees that advised Johnson didn’t study, until mid-March, the option of the kind of stringent lockdown adopted early on in China, where the disease arose in December, and then followed by much of Europe and finally by Britain itself. The scientists’ reasoning: Britons, many of them assumed, simply wouldn’t accept such restrictions.' https://www.reuters.com/article/us-health-coronavirus-britain-path-speci-idUSKBN21P1VF

Yet he government eventually imposed a lockdown in late March *in response to public/media pressure*. And 2 months on, people are starting to ignore the rules even more than before: https://news.sky.com/story/coronavirus-police-chief-warning-over-uk-lockdown-split-as-britain-bakes-11985648

Many people dismissed the behavioural psychologists/experts who warned that the measures weren't sustainable, but those experts now appear to be right. An equilibrium must, as always, be reached…

"Let’s say you have a simple model of political sustainability where Americans will tolerate [???] months of lockdown — shall we say two?"

Imperial Japan thought something similar about the United States having no stomach for war, but America surprised them. Now will the US surprise me by turning its current situation around and, after a bad start, eliminate the Coronavirus as other countries that got off to a bad start such as Germany, Austria, and Switzerland are doing? The United States is fully capable of doing it. All that's required is for enough people in positions of influence to articulate it to either convince the US leadership or bypass it.

We still don’t have a test that gives less than a 15 percent false negative rate.

Let’s start with that before we even think about test and trace.

What a government wants to do and what it’s people will deal with are two totally different things.

Test and trace requires non symptomatic people to seek testing. Almost nobody is doing that.

And it requires people quarantining away from their homes. Nobody wants to do that.

China, a nation with a per capita nominal GDP one sixth that of the United States contained the virus using thermometers as their main testing tool.

We had a lot of unknowns and still do.

It makes sense now that many rural counties across America would get few cases but we did not know that 6 weeks ago. It is getting to be time now to loosen things up in many places. But it is also true that cases are continuing to go up in some places. It is going to continue to be hard to strike the right balance between caution and reasonable risk.

We don't know what the virus will do here or overseas. I find the impulse to just ignore local authorities and to assume we overreacted disturbing. We may experience a second wave and another stay at home period may be wise. It could be that the second wave is worse. It would be a terrible thing if people just decided they knew better and refused to go along with public health warnings. It would be terrible if the government didn't issue valid warnings and orders because they thought people wouldn't follow them.

Can the states with low numbers not suppress to a point that they can open up and manage by contact tracing and border controls? Ie why isn't one lockdown enough, the earlier the better?

Likely counter productive to roll out test & trace before the large population centers are ready for it, as there will be much pressure to jump the gun. Patience.

You should start test-and-trace while still in lockdown, because that's when it's easiest to do and you can work out the, er, bugs in your process.

The point is fundamentally correct, though I'm not sure about any suggestion of "Lock-down only those that have confirmed cases", when we have early testing bottlenecks.

The right policy IMO would have been to progressively shutdown, first by very hard defacto travel bans and social distancing, then actual lockdown if necessary, all those areas that are a combination of:

- Dense.
- Frequently travelled to and from.
- Inhabitants tend to have many more face-to-face social connections and use public transport more.
- High burden of very old people and people with high morbidity relative to both the above.

Make an index of these features, then recommend different thresholds for high scorers vs low scorers. Get the urbanists and epis talking about this now, to plan for the next epidemic. We need a relative risk of outbreak index that works on a subnational level (it can hardly be blamed too hard for Cuomo to have been behind the curve on that one, if no one whose job it actually is has actually given them the tools to be ahead of the curve.)

New York should've shut down earlier than they did, while rural places which no one travels to shouldn't have shut down at all, just distanced.
Yes, this means that exactly the places that can least afford to shut down need to shut down earliest, and with the biggest impact on their economies. But that's life.

On the positive side, it probably provides them with a good incentive to mildly reduce their cosmopolitanism, dependence on tourism and social openness, which is probably good and which we want to happen anyway. (Seems to me a modest decline back away from rootless hipsterism to slightly more locally rooted, closest and "nativist" urban cultures would be beneficial. Not saying completely crushing all benefits of cosmpolitanism, just a bit).

This sane and measured perspective has no hope of influencing policy, not even "next time." Such a shame about your nation..

Rural areas probably didn't need extreme shutdowns, but they did need to close whatever their large gatherings were. Like churches.

I would guess that, yes, shutting down churches and synagogues and mosques and clubs and bars does make sense from the perspective of avoiding any superspreading events that can overstress small, local, rural healthcare, even if the effect on overall prevalence is small.

Still would want to try and find the best timing to do it, and some sort of risk:probability index would make sense to manage that.

Not religious at all myself, but I suspect most religious folk of a "cultural struggle" sort might take closing down churches temporarily as a reasonable "trade" for bars and clubs and other "temples of sin" shutting down; churches are maybe a bit more robust to short term disruption of this sort. So it might not be that tricky to sell, as long as it was reciprocally applied broadly enough.

The churches I know stopped sharing of the cup and shaking of hands several weeks before the schools closed. They were taking what were, given the information at the time, the reasonable mitigation steps. But they didn't stop the singing, which we now suspect is a key spreader.

This was one of the biggest gains from the shutdown: we could find out all the things we didn't know. There's probably lots of thing we can open up now, since we know the risks better.

I'm not sure how much more is really known about conditions that would make a large contribution to R0. There are a lot of *hypotheses* now...

You're right that there are lots of theories, some with good evidence, but we don't *know*.

We will never have perfect information. We can't do double-blind random analyses.

But there are very important decisions to be made here. Just in America, trillions of dollars and hundreds of thousands of lives hang in the balance. And there is no possible strategy in which we do not take a serious hit. All options are bad, but some are much less bad.

Different states will try different opening-up strategies. Some will work better than others and we can learn from that.

In some hard hit rural areas (like Sussex County, Delaware) the culprit has been meat packing plants where working conditions jam people together with minimal distancing or hygienic provisions.

Tyler you wrote:
"Let’s say you have a simple model of political sustainability where Americans will tolerate [???] months of lockdown — shall we say two? — but not much more. (Maybe three months if we had Merkel as president.) "
BUT in Germany they are having big protests this weekend (and on the 1st of May), while lockdowns were introduced at the end of March. Please correct this sentence about Merkel.

Which is the entire point - from a viral perspective. Our science in this entire area is not backwards, as can be seen in South Korea where spread is contained fairly well, or Germany, where the growth of confirmed cases is about half rate of the day after day fatalities rate. At least the term yo-yo effect was not brought up, since the U.S. is the only country that did not achieve at least some reduction in viral spread before deciding to re-open.

"In the meantime, we could have restricted or somehow taxed travel out of NYC, which seems to have been a major national spreader."
I agree with this - not putting NYC under quarantine was a big mistake by Trump. But then I read in the German media that Trump wanted to put NYC under quarantine but decided not to as his advisors, the media and Cuomo were against it.
I also think that Trump did a big mistake in playing down the risk of the virus in February. But at first Trump saw a big risk as he issued the Chinese travel ban on the 31st of January (this was before any Europeans, including Merkel, reacted). But he then got a big backlash from the media and democrats. So maybe he thought because of the reaction of this reaction that the virus is not a big deal?

At the end Trump is responsible for his decisions. Though Tyler it would be really interesting if you write a piece about how the media and democrats (or "polarization") leads to Trump making such bad decisions. Are you brave enough to do this?

Italy issued a real travel ban on China on January 31st, before Trump’s symbolic and ineffectual ban. Trump’s real failure was to not ban travel from Europe, and the pressure there was less from the left and the media and more from European politicians who didn’t want to be embarrassed.

Do you have any valid source for the travel ban from Italy? First time I’m hearing this.
Trump actually issued a EU travel ban on the 12th of March. I think that fine in terms of speed but unfortunately late. European politicians didn’t even have a travel ban for Italy at that time (an exception is Austria which issued it on the 10th of March). I remember that Trump got criticized for the European travel ban not only by European politicians but also by American politicians and the media. Finally, I don’t think the Chinese travel ban was ineffectual - at the end the pandemic hit the United States later than Europe (which in my knowledge did not have such a ban).

There is a link to Forbes.

Any official government reports? I only trust primary sources.

In any case, the Italian travel ban might have been less effective than the American one due to the Schengen area. It’s like New York issuing a travel ban... this won’t be as effective as the United States issuing one.

If so, this link would probably be adequate for getting to a primary source of something widely reported in the German press back at then end of January, along with the reporting of Germany's first confirmed case. www.viaggiaresicuri.it/approfondimenti-insights/saluteinviaggio

And honestly, if you only trust primary sources, why are you wasting time here?

I dont understand your question... I like Tyler as he provides an interesting "opinion". Newspapers also provide opinion (though unfortunately, not only do they provide a bad opinion, they act like they just provide "facts" and not opinion). The statement "Italy issued a real travel ban on China on January 31st" is not an opinion. Hence, I would like some proof for this. Linking to forbes (or Tyler), which provides opinion, is not a proof.

Unfortunately, I cannot speak Italian, so I cannot verify it...

I'm sure if you dig around on the Ministry of Foreign Affairs website or the website of whichever police agency is in charge of border inspection, you will find something. But it might be in Italian.

As for the effectiveness of bans, there are documented cases in both Italy and the U.S. of citizens of these countries contracting covid-19 while abroad and infecting people upon their return home. Banning foreigners while not at least quarantining your own citizens upon return is literally a half-measure. These bans at best may have slowed things down by a week or two but since that extra time was not used to solve the testing problem or stock up on PPE, it probably did not make a difference.

"Banning foreigners while not at least quarantining your own citizens upon return is literally a half-measure" I fully agree with this. I do not think it will "eliminate" Coronavirus. But it think that it definitely helps - like masks, like banning big events, like testing... Thats why I think it is a good policy choice to issue travel bans.

The US travel ban on China was also on January 31st

They were all responding to the major airlines cutting off routes to/from China: https://www.usatoday.com/story/travel/2020/01/31/coronavirus-china-flight-ban-delta-cuts-all-flights-white-house/4620989002/

It's pretty low-cost to say "you're not allowed to travel directly to/from the place where there is now no carrier going directly to/from."

From your link:"The U.S. State Department late Thursday elevated its China travel advisory to level 4, recommending that Americans do not travel there. That change followed the World Health Organization's declaration of a global health emergency over coronavirus."

So reaction was the other way, but either way, travel was halted

Couldn’t agree more. This crowd has probably observed the same thing I have which is everyone in NYC who had the ability to get out did so. Truly quarantining the whole city was always politically infeasible so no point working about the counter factual.

TC: This is one reason why I am skeptical about models of epidemiology (and economics!) that do not consider political sustainability. I am by no means sure that the claims in this post are correct, but they could be correct. And a model that does not consider political sustainability and time consistency won’t even pick up these factors as concerns. It will simply indicate that a lockdown should happen as quickly as possible.

Of course, this is an issue. But I'm skeptical we will ever be able to really resolve it.

You can gather as much social network data from this one as you want. But say next time, we then present it as evidence that lockdown should be imposed more slowly in order in some places to manage lockdown fatigue. What will happen?

You will immediately be griefed by statist trolls who loudly proclaim effectively that the state manufactures its own perception of reality, and faces no constraints other than its "will" and willingness to dictate reality. Then they'd play populism to the masses with claims that any non-zero excess death is avoidable excess death.

This is exactly what happened when our British modelers tried to build a calculation of lockdown compliance fatigue into their models, and it is probably inevitably what would happen again.

So any workable strategy cannot depend on building this sort of "fatigue" into the model, even though its real, because it will be politically impossible to use.

The Italians put their China travel restrictions into operation four days before the U.S. did.

'Speaking to the nation last night, U.S. President Donald Trump said a ban on Europeans entering the United States is necessary because Europe hadn’t banned flights from China early as the U.S. had done.

“The European Union failed to take the same precautions and restrict travel from China and other hot spots as a result a large number of new clusters were seeded by travellers from Europe,” he said.

But virtually every part of this statement is untrue.

Italy imposed a ban on flights from China on 31 January, immediately after a Chinese couple in Rome tested positive for the virus. The U.S. began to restrict flights from China four days later. But while Italy enacted a full ban, the U.S. policy was only a restriction, with wide exemptions.' forbes.com/sites/davekeating/2020/03/12/italy-banned-flights-from-china-before-americait-didnt-work/

Even science is political. We are doomed. What's next, an interview of Judy Mikovitz? https://www.nytimes.com/2020/05/09/technology/plandemic-judy-mikovitz-coronavirus-disinformation.html

The question of when to go into lock down is intimately related to the purpose of the lock down. As far as I can tell, there’s 3 different reasons to do some kind of lock down:
* you want to eradicate the virus altogether
* you want to prevent the healthcare system being overwhelmed (or at least signal to those who’s lives are on the line that you have their back)
* you want to protect the essential industries from arbitrary collapse

Each of these means different entry and exit conditions. (Or, of course you can ignore all conditions and act randomly).

Btw, the last reason is much under-appreciated, and the source of much confusion when compared to 1918 - our supply chains were much shorter and more resilient then, as compared to now, so protecting them is much more important, and protecting them is actually at least as important as the healthcare system

It's the movement of people (travel) that spreads the virus. And not only people who have traveled from or through New York. According to the "loyal MR reader" Cowen quotes, the lock-down worked to prevent the loyal reader's hometown from being hit hard by the coronavirus. Is the loyal MR reader grateful? Hell no! What this nonsense will do is convince millions not to take the vaccine once it's developed, leaving herd immunity to infection and death instead. I doubt this blog post by Cowen is Straussian as some suggest. Instead, I suggest that it's consistent with Cowen's ideology, an ideology that in the first order is anti-government (or, more accurately, the welfare aspect of the government). To go along with a lock-down, much less come across as supporting it, is beyond the pale. Loyal MR readers should have noticed that for every blog post that might be interpreted as supporting the reason for and goal of the lock-down, there's a blog post attacking the government agencies attempting to make the lock-down effective and to prevent fraud. On the other hand, maybe Cowen is upset that his favorite restaurants will fail because of the lock-down. That I can understand and appreciate. Lift the lock-down, save the restaurants!

Cowen: " I fully understand that Denmark and Austria did well because they locked down early (and took other measures)."

I'm still not sure why Tyler doesn't mention Japan as a success story even though it never locked down and people didn't start to socially distance much until a week before a state of emergency was declared on April 16.

Denmark has 15 times as many Covid-19 deaths as Japan on a per capita basis after a strict lockdown: Denmark 526; Japan 613.

You need to go back a few weeks and read the now classic posts on Japan, unless they have been deleted already. A local bedwetter sent this blog a super secret assessment that Japan was going to be hit really hard by this thing and faced their “greatest crisis since the war” —Which they leaked- we kept waiting for it and it never happened. It’s as if it never even got there in the first place— they didn’t do much testing, they did shut down schools (which now makes zero sense), and a recent antibody study showed an incredible level of people that already had it, almost as if they already had a vaccine applied to the population based on their casualties.

Here's the excellent Eric Posner on the asymmetry between government action and inaction: "When the government issues orders that restrict liberties, our constitutional tradition allows affected people to ask judges to block those orders. But when the government fails to issue orders, when it underreaches rather than overreaches, citizens have no right to judicial review. Courts do not recognize a constitutional right to health or safety; they do not allow people to sue for orders compelling the government to act." https://www.washingtonpost.com/outlook/lockdown-legal-challenges-constitution/2020/05/03/389af052-8aff-11ea-9dfd-990f9dcc71fc_story.html

Do read Posner's essay. It presents both sides of the argument, the libertarian as well as the non-libertarian.

In Britain Boris made lots of public statements to the effect that he wanted the timing of the lockdown to be just right. If it was done too early people would tire of it too early. Etc, etc.

As far as I can see he gets no credit at all for this argument. If the electorate gives a politician no credit for trying to be rational it's no wonder most politicians don't bother. That's democracy for you.

Yes, this.

Tyler, it wasn't unknown that there would be problems keeping up with compliance. The UK announced their plan that's been commonly (and incorrectly) called "go for herd immunity" they said up front that there would be mitigation fatigue. I don't have to go back through the video of it because in my own comment on this very blog about the topic, I apparently quoted them as saying that mitigation only works for 11-13 weeks:
https://marginalrevolution.com/marginalrevolution/2020/03/the-british-approach-to-coronavirus.html#blog-comment-160048842

Given we are around week 8 of most mitigation efforts and they are starting to break, it looks like the UK had a crystal ball. Someone ask them what the lotto numbers will be.

There are irresponsible vandals out there ruining the ability of mitigation to happen. Those vandals have agency and own their antisocial behavior and we should not forget the damage they are causing. But a policy that only works in the face of zero antisocial behavior isn't workable policy.

(Also, Tyler, your blog software doesn't redirect people back to the comment they just made. I get bounced to a url of #comment-12345678 when I should get bounced to #blog-comment-12345678.)

Yes, one size fits all policy doesn't fit very well. NYC is a poor, some might say toxic, template for national policy. Now do gun control / rights.

"In 2014, the most recent year that a county-level breakdown is available, 54% of counties (with 11% of the population) have no murders. 69% of counties have no more than one murder, and about 20% of the population. These counties account for only 4% of all murders in the country.

The worst 1% of counties have 19% of the population and 37% of the murders."

The problem is even more concentrated than that. In the high crime counties, a handful of neighborhoods account for almost all of the crimes.

https://crimeresearch.org/2017/04/number-murders-county-54-us-counties-2014-zero-murders-69-1-murder/

I am not sure how useful "if I only had a time machine" articles ever are.

If I only had a time machine, I would tell all Americans to keep 3 months food and 3 months masks on hand it all times!

And then we could have gone to Hong Kong route of just shutting down high-risk venues.

Of course, I sure as hell hope that if we have time machines we would not elect Donald Trump.

https://twitter.com/14Truth14/status/1259094470269775873?s=19

I wonder if Hong Kong's success was accidental..

They all bought masks, but for the protests. And so they had them on hand for the pandemic.

No, HKers regularly keep surgical masks.

Thanks for taking that joke both too literally and not seriously.

Were mask purchases constant through the uprising? I really doubt it.

The proximate error was not making the lock-downs entirely local and geared to local hospital capacity. Governors erred in applying similar policies throughout their states and the President erred in trying to "reopen" the whole nation. Too many public health professionals erred in speaking as if a strategy of suppression were the goal after explaining the need for lock downs as necessary to "bend the curve" so as to preserve the capacity of hospitals to provide health-restoring services.
Subsidiarily, mandatory business closures, SAHO's, and other measures even mask wearing were explained as paternalistic measures to protect the persons bearing the costs of the measures rather than as sacrifices, they are asked to bear to protect others.
Finally, except as an extremely short-term measure, it was a mistake to close firms on the basis of "essentially" rather than on the basis of the ability to operate in a manner consistent with mitigating contagion among customers and employees.
And in the background, although of possibly even greater quantitative importance for the amount of economic damage, was the need for the Fed to maintain expectations of steady/rapid recovery in NGDP growth. Instead the Fed has not even provided enough monetary stimulus to maintain 2% inflation expectations!
The same principles need to apply in reverse as localities (not states!) “open up.” Unfortunately, because of locally premature application of strict anti-spread measures some places will be relaxing those measures before they should go into effect.

Elephant in the room - why does not every man, woman, child, business, and institution not have 3 months of 'absolute end of the world' liquid savings and six months of quick-liquid assets? Do we have to do individual/ family financial stress testing at each tax season and do an idi*t-fund withholding?
Partial closing - never work - mass panic migrations and city-mouse / country-bumpkin conflicts will never be greater. Cases up in Canada of town council blockades/ address checks of major roads of tourist/ country towns against the second-house and second-family influx of city slickers.
There was no crime in the way things went only the inevitable pain of justifiable over-reaction followed by tremendous policy developments going forward.

Seriously? Our whole system is predicated on people living beyond their means. One thing both the right and left seem to agree on is that we MUST encourage consumption! In essence the lock down is encouraging people to move from spending to saving - and you can see the massive economic destruction that has caused.

Couldn't disagree more. My experience is that people of similar incomes, but greater 'rainy day' savings, will spend a greater portion of their disposable income. Purely psychological. Now that I have a no-touch $10k bank balance (at least, until last month), but a similar annual income from 3 years ago, I go out and online buy way more 'discretionary items'. With a covid-19 stress reducing back-up fund, I am hobbying, collecting, and binge/newby-purchasing way more with my free time. Plus I give more to charity when I am not worried. Plus some benefit schemes measure your income not your savings when they give you pay-outs. Don't be the can't -wait-marshmallow kid. Have a rainy day fund right out of college.

It is quite interesting to me to watch the change in political tribe's view about sustaining difficult behavioral changes to combat infection.

After all, back in the days of exponential HIV/AIDS it was conservatives who had a simple behavioral approach that would have eliminated around 99% of transmission (i.e. sexual monogamy and chastity in marriage with no anal intercourse). And it was the left reminding everyone that we had to be realistic about which behaviors were sustainable. It was the right who was fine with using legal coercion to stop transmission behaviors and the left who wrote into law protections for people to do things that were demonstrated to have resulted in infection and death for others.

Similarly, it was the left who argued for a less effective behavior changes as their solution (condoms with perfect use had around 3% failure rate and overall would cut HIV transmission by around only 85%), but ones that required less sacrifice. Now the right is arguing that some sort of personal responsibility/voluntary social distancing will be effective even though it assuredly will have higher rates of transmission than full lock downs.

Frankly, if we are going to buy the all lock down, all the time until the virus passes option, we are going to have to burn pretty much all of the HIV behavioral research. I mean seriously, at what point do we think a population that would not maintain sexual abstinence until marriage to avoid HIV is going to be able to manage sexual abstinence due to not sheltering with their partner(s)? Did not one of the IMHE authors himself break lockdown rules to have a tryst?

If we cannot expect people to maintain chastity, I see no hope of them maintaining the worst unemployment since the Great Depression, forgo all the social pleasures that might mitigate that, and placing large burdens on their children.

What really bewilders me are all the commentators who have taken opposing positions. If you think that asking for chastity is a bridge too far for the population to tolerate, one that if was successful would have saved millions of lives, then how on earth to do you expect to enforce lockdown which includes a lot of chastity for groups like teenagers, the divorced, and college students? If you thought that the government could somehow police who has receptive anal intercourse through some sort of monitoring and coercion, why exactly could the government not enforce social distancing through similar methods?

Sadly, it looks like Covid is becoming another "Who, whom?".

As I recall (and I may be wrong, its been a while), in the earlier days of the HIV problem, the left was vehemently against medical reporting of HIV positive test results (as I believe was standard for other STDs), and contact tracing, citing the potential discrimination against the infected.

I am old enough to remember when Malcolm Forbes, speaking for the conservatives, wrote an essay called "the myth of heterosexual AIDS."

Or was it his son? Regardless, the next stage of the story was that Elizabeth Taylor of all people called Malcolm and chewed his ass. A retraction followed.

But in a true telling the conservatives were actually slow to recognize this as a national health threat.

"After all, back in the days of exponential HIV/AIDS it was conservatives who had a simple behavioral approach that would have eliminated around 99% of transmission (i.e. sexual monogamy and chastity in marriage with no anal intercourse)."

99% of transmission could have been cut if just receptive anal sex was avoided (along with sharing needles). A U of San Francisco study around 1997 showed the odds of contracting HIV through penile-vaginal intercourse was 1 in 8,000. The odds aren't actually that high since people also lie on surveys. The CDC doesn't even list HIV among white heterosexual men since the numbers are so low.

Don't get me wrong. I think you target resources to where there are most infections, or highest risk of spread.

But I believe that essay was essentially saying don't worry, and don't spend that money.

The left was way off base in the 90s with its mantra told to high school and college students that "everyone is at risk from HIV" for political reasons. Had the truth been told instead about the extremely low risk of penile-vaginal sex and the high risk of receptive anal sex, many lives would have not been lost and unfounded anxiety would have disappeared.

By the 90s the horse had left the barn. As I say, Rock Hudson died in '85.

No, HIV is not at all a virus spreader like coronavirus. There is no such thing as "the horse already left the barn."

It very much was an epidemic, it just didn't rise to pandemic, if that is suddenly your bar.

No, the point is that HIV isn't nearly as contagious as the common flu to say nothing of coronavirus. The fact that early cases developed in the early 1980s is irrelevant. Behavior changes could have drastically reduced HIV transmission whereas it can't with coronavirus as we are seeing around the world. Well except in East Asia.

By the way, how many "sharps" infections happened to doctors and nurses in the 90's, because this wasn't shut down in the 80s?

This is also an age when there were a lot more closeted gays bridging the communities. Rock Hudson died in '85.

Those numbers only hold even in general in the developed world. A substantial amount of transmission in Africa and Asia has been through heterosexual contact and vertically from mother to child.

1/8,000 does not sound bad until you realize that the world population have 50 acts in a year is well north of a billion.

The big thing that saves heterosexual couples is not so much the odds as a median of one bought of intercourse per week for say 40 years still gives you around a 1/3 - 1/4 chance of catching HIV. Rather it is that the prevalence in the partner pool for heterosexual has historically been exceedingly low. First because a huge number of people (e.g. something like 1/5) are exclusively monogamous for life or at least substantially monogamous (e.g. fewer than 4 lifetime partners) without relatively closed sexual sets (e.g. all from the same town) and because the MSM population, historically, did not have a huge crossover into the general heterosexual population. Where this was not the case (e.g. Southern Africa) we watched HIV explode.

A substantial amount of transmission in Africa and Asia has been through heterosexual contact and vertically from mother to child.
--------------
But not penile-vaginal sex where anal sex is more prevalent. It is also very likely that most of HIV transmissions have been through reusing contaminated needles at local clinics, which essentially never happens in richer countries.

1/8,000 does not sound bad until you realize that the world population have 50 acts in a year is well north of a billion.
-----
It is closer to 1 in 80,000 once analyzed for lying through a risk analysis method.

Your numbers are the not the ones most commonly cited in the literature.

Insertive penile vaginal intercourse is per the most recent meta-analysis as having a 1/2,500 risk of transmission per act. Receptive penile vaginal intercourse is cited at 1/1,250.

Even if we halve the risks shown from us across multiple studies in multiple times, we still are not getting anywhere near 1/80,000.

And lest we forget the risk insertive penile anal sex is only 11/10,000 and that for receptive penile anal sex is 138/10,000.

If we have to drop our estimates of risks by a factor of 20, then there is no way for HIV to have spread as efficiently in the 80s among the MSM population as we saw. You physically cannot have enough sex to get the incidence and prevalence rates we saw back then. It also makes it incredibly hard to explain the seroconversion rates of Muslim women in Subharan Africa in serodiscordant marriages.

If we buy your numbers, we need Africa to be having an order of magnitude more anal sex.

Which does not fit with the observed rates of HPV infection and resulting anal cancer seen in African women.

Were the risks to heterosexuals not engaging in receptive anal intercourse inflated in the 90s? Yes. Traditional sex is an order of magnitude or two safer than receptive anal intercourse. Will serodiscordant spouses eventually convert if they fail to use either HAART or barriers? Yes. And once the incidence of HIV gets high enough, each generation will face increasing numbers of positive people in the next marriage cohort. And this exactly what we see in Africa. Afterall we have managed to trace cases where a single man has managed to infect multiple virgin females during ritual first sex sessions.

HIV largely spares heterosexuals because the transmission rate is low outside of highly repeated encounters and because the base prevalence is just that low.

SARS-CoV-2 spreads even if you aren't in contact, through air (sneezes, coughs etc.) that requires one to cover the mouth and nose; whereas HIV required one to have intimate contact (S of the STD) requiring covering of some other part that males sometimes think with and diff set of holes to cover.

What does that inconvenient fact do to this opinion? Re-evaluate?

Todd K: a shout out to your comment above!

Technically, under a strict interpretation of Australia's level 3 restrictions, orgies are legal under the right conditions. Getting the virus under control while still having the occasional subdued orgy seems like a pretty good deal. Not my cup of tea considering the fine print, but it should be enough to keep the physically gregarious happy.

Ha, orgies might include high-risk individuals by both the Old and New definition.

well, the right conditions being if you all live in the same residence. I can't think of any other circumstances where it would be ok

Same residence, plus one other. (Note, there is no particular reason why I've put the effort into working out the details.)

Looks like Australia's R is climbing steadily and has crept up above 1 again. Maybe best dial down the smug self-congratulation, and the orgies.

As of May 9, it's 1.07, which is precisely equal to the value for... Brazil.

(See the graph in the middle of this article: https://www.abc.net.au/news/2020-04-10/coronavirus-data-australia-growth-factor-covid-19/12132478?nw=0 )

Sure it is. We're down to one known person with the Coronavirus here in South Australia and the number of new cases yesterday was 15 for the country as a whole, down from a peak of around 400. We're not about to do a Hokkaido. Of course, that doesn't mean there isn't the potential for things to go worse than we expect. That's why we're being careful.

It's a new day in Australia and yesterday there were 12 new cases. Let's hope we soon get it down to zero for good.

Crap! A whole 16 new cases yesterday! This is going to take forever to get rid of!

For what it's worth I think keeping a core group of contacts is fine even in "shutdown."

And it's definitely related to that old HIV caution that when you have sex with someone you're having sex with everyone they ever had sex with.

So sure, booty calls are fine, but keep it monogamous.

You have forgotten about IV drug addicts that quickly?

No, they are just a small part of new cases. In 2010 there were 2,700 new cases from IVDU. That year there were around 36,000 new HIV cases in total. So after a large number of MSM had adopted condoms, but before PrEP was a big thing, IVDU consisted of around 7% of new infections. Note this is after a more than doubling of the IVDU rate since the 1980s.

I could be wrong, by my off the cuff estimate is that HIV back in the 80s, world wide, was transmitted 99% of the time by sexual acts rather than via the blood banks or shared needles.

In more affluent areas of the world I might amend my off the cuff guess to 95% but sex always has been the major cause of HIV transmission. I might, however, also be able to amend my statement to limit the behavioral strategy to just eliminating MSM contact (which I also recall being opposed by liberals).

For world wide prevention, it was liberals saying we had to make concessions on infection control for sustainability and it was conservatives toeing a harder line on what actually had the best possible outcome.

While you have a point about the reversal, the intended time frame is wholly pertinent here - in the HIV time, abstinence had to be relatively permanent, not temporary, and I don't believe anyone is claiming that the lock downs now are for more than a few weeks/months. We can indeed think that a population would observe such restrictions for a few months but not longer (we may be right, or not, but it's clearly different)

Back in the day it was the same. Google tells me that HHS was giving a two year timeline for getting an HIV vaccine up and running. That is not all that different from Covid (which was 12-18 months when I first heard a timeline).

I am much more hopeful that a Covid vaccine will be practical and come quickly. But people were hopeful back then too.

And lest we forget the conservatives were not saying you could never have sex. They just said you had to wait until you were monogamously married. The 1950s showed us that the average member of the population could manage and sustain that by around age 22. So again, this was not "forever abstinent", this was just asking people to delay sex, typically for a couple of years.

It really is pretty striking how little liberals were willing to sacrifice in terms of sexual liberty to curtail AIDS and how much they will sacrifice for Covid.

" After all, back in the days of exponential HIV/AIDS it was conservatives who had a simple behavioral approach that would have eliminated around 99% of transmission (i.e. sexual monogamy and chastity in marriage with no anal intercourse). And it was the left reminding everyone that we had to be realistic about which behaviors were sustainable. It was the right who was fine with using legal coercion to stop transmission behaviors and the left who wrote into law protections for people to do things that were demonstrated to have resulted in infection and death for others.
...
Now the right is arguing that some sort of personal responsibility/voluntary social distancing will be effective even though it assuredly will have higher rates of transmission than full lock downs."

Perhaps I don't recall the discussion about HIV/AIDS policy correctly; however, I do not recall any right wing inspired "legal coercion" against unsafe sexual behaviours. Encouraging voluntary safe behaviors (rather than legally imposing restrictions) is consistent with encouraging voluntary measures to prevent the spread of the Covid virus rather than legally-mandated lockdowns, etc.

On the other hand, I do recall a controversy in LA County regarding the mandatory use of condoms in the porn industry. A friend of my was then in charge of the HIV public health program there and was instrumental in the push to pass a regulation/law requiring condoms. The LA Public Health Dept was (and presumably still is) hardly a bastion of right wing activists.

https://www.bbc.com/news/world-us-canada-30489942

Criminal Transmission of HIV is a crime in over the half the states for a reason. Iowa, for instance, required that all HIV+ individuals disclose their HIV status to any and all sexual partners. Failure to disclose, irrespective of transmission was a felony. There is rough correspondence between conservatism and where these laws ended up on the books.

Then there were the anti-sodomy laws that were, at least pre-textually, about public health. Certainly a few people wanted much more vigorous anti-sodomy enforcement to combat HIV transmission.

"There is rough correspondence between conservatism and where these laws ended up on the books."

I don't see any "rough correspondence" with respect to laws on the books between red and blue states. If anything, it appears to be the opposite. Failure to inform a sexual partner of your HIV positive status and having unprotected sex with that person is likely a common law tort in any event.

https://www.cdc.gov/hiv/policies/law/states/exposure.html

These are not the same set of laws. CA, WI, CO and MA, for example only provide sentence enhancement. That is if you rape someone or otherwise commit a crime and are HIV positive, you get hit harder.

Of states that criminalize non-disclosure in otherwise consensual encounters the vast majority are conservative or swing. The exceptions are WA (which was not as liberal back then), IL, NJ (also not as liberal), RI, NY, and MD (arguably not as liberal).

Those with nothing on the books that are conservative. Well there is TX, AR, and WY. NM is not all that conservative but you could argue that it is a swing state and NH is much more libertarian than conservative and regardless is not a liberal bastion. Everywhere else that has no laws is pretty liberal compared to the average state.

As I said this is broadly true. If you just binned states by congressional delegations you would get (I think) wrong by going with the party in control.

So pick whatever language you want that notes a reasonable correlation for Criminal Transmission of HIV as a distinct crime as a correlate of conservative leaning politics back in the 80s/90s. It is reasonably true.

I think I'll award at least two Pinnochio's on this one.

For example, http://www.hivjustice.net/storify/us-wisconsin-man-charged-with-recklessly-endangering-safety-for-alleged-hiv-non-disclosure/.

California did, however, change their law as of 2017.

Whatever you like. What I know is that when it comes to patients refusing testing in order to not run afoul of Criminal Transmission, it is vastly more common in conservative areas than in liberal legal areas per my own experience and those of my colleagues at the national meetings.

My you have a different understanding of what constitutes the sort of law I have in mind. Whatever. What I have seen is patients being more worried about actual charges in more conservative areas. And yes this is pretty much the definition of legal coercion. Adopt the sexual practices we demand or get hit with criminal charges. Certainly when we move to the actual legal cases it is pretty much exclusively liberal organizations challenging these laws (wherever they originate) and it is rare for liberal jurisdictions to defend them through to appeals.

End of the day, in terms of real behavior there was a push to make Criminal Transmission stick and use legal coercion to blunt the epidemic. It was not the same bloc of people currently backing some version of arresting the anti-lockdown protestors or fining those who fail to social distance in public.

So if public opinion + some public intellectual opinion is that the lockdowns were a bad policy that made the recession much worse than it would otherwise have been and that not only was the lockdown a bad policy, the lockdown time was not used to do anything to make the situation better such as scaled up testing capacity but was rather spent on distributing ventilators that will never be used, what next?

We call for the heads of our our political leaders like Trump, Cuomo, Pelosi, Newsome and demand that their replacements come up with a rational pandemic strategy for next time?

It seems more likely to me that we just limp along to the next national crises, recession, massively inept government response that leaves us trillions more in debt until the US is a de facto welfare state with a comfortable and stable upper middle and upper class with the handful of innovators slowly squeezed into complacency as existing interests secure their place through government capture (we’re currently at Banking, airlines, medical, auto, tech, and soon to be pharma).

It seems like what we need to help those most impacted economically is total revolution in thinking and government but I just don’t see that ever happening.

If you unpack the unemployment data, you find zero correlation between lockdown rules and job loss. Some of the worst states for increased unemployment had no shelter-in-place rules at all.

Meanwhile, there is a growing class hostility between those who can work from home and those who cannot. That is why rural residents are mad at sheltered techies and academics and bureaucrats who make harsh rules but suffer no ill effects themselves.

But if you were talking about Progressive sheltered techies, they tend to be in favor of transfers.

And anger might come from people who are ideologically trapped, where they can't endorse transfers and so they must support opening up.

One thing not in control of the state governments is how generous the unemployment benefits and other cash transfers are. If Montana wants to pay people to stay home, they have to come up with the dollars from somewhere. Meanwhile, the Federal government can go brrrr and make dollars to make a shutdown more tolerable.

"Meanwhile, there is a growing class hostility between those who can work from home and those who cannot."

That's completely understandable and all the more reason to support a functioning safety net that can get money out to people who need it as quickly and efficiently as possible. A lot of state unemployment offices seem to be failing their citizens and there is the whole fiasco with the IRS taking its time getting checks out to people.

It’s not just about money. People like to work. It provides an identity, it gets people out of the house away from their kids, and it provides social interaction. These people don’t just want work either, they want to go to church, to grab a beer at a bar, they want to get their kids back to youth sports. For a lot of people, Netflix doesn’t offer much but a bunch of leftist propaganda parading as entertainment. They watch sports, and MLB and NBA are not on; we’re still months away from football season.

They aren’t “hostile” towards those who can WFH, they are envious because they feel worthless.

Sure, some younger or culturally bankrupt urban poor would be content with a government check, some weed, and a Pornhub subscription, but there are still large parts of the country that hold work ethic, independence, and community as values.

And that is why they have taken on a cult, and non-scientific, faith in "herd immunity."

Understand that your comment can just as easily be written as follows. "...Sure, some younger or culturally bankrupt WHITE TRASH would be content with a government check, some weed, and a Pornhub subscription, but there are still large parts of the country that hold work ethic, independence, and community as values..." It is a myopic to single out "urban poor" in this way despite the many dysfunctions apparent in the community.

Urban poor includes whites...

I believe this was exactly the reason why the UK didn't originally lock down faster. They calculated that the public would tolerate only a certain length of lockdown, and intended to time that locking-down for when it would prevent the most deaths. Then the more pessimistic model came out and they switched from mitigation to suppression.

The argument is basically that the polity will get exhausted at the policy - costs exceed benefits after X number of days. But that depends on leadership. I am thinking of the home front during WW2. Did gasoline rationing come too early? Should the oil producing states get more coupons? How long will the country put up with conscription?

Don't forget all the people claiming the war was a hoax.

Can't spell pandemic without Dem panic.

I'm now hearing that the government leaders in NYC and Boston are looking to extend the lockdowns til election day. Their plan is to create so much local misery that Trump has no chance of winning NY or MA in November. It's brilliant, really.

Ditto with Oregon. They have 100 or so deaths, and they have already decided they will be closed until July 6. Just like that. No checking every two weeks.

The safety valve in all this is states like Florida and Georgia. Two weeks ago GA started opening up and their deaths have continued to drop. A week ago restaurants opened. If trends hold for GA, then state govs like Oregon have a lot of explaining to do to voters.

Additionally, these state govs that are staying closed are destroying their revenues. Everything the left loves: Sustained care for homeless, safe injection sites, K12 for people here illegally, preschools, green....it's all going away. Because they wouldn't permit the revenue to be generated.

Trump needs a single proof point: Maybe it's GA maybe it's FL, that he can use to say "See, your governor should have done it like GA. I'm sorry, but I cannot ask people in GA that have been working for the last 4 months to pay for a green boondoggle in NY. It's not fair" and then let each state live with their choices.

I mean, I get it, Democrats are evil and stuff. But, buddy, you don't need to do anything to ensure Trump ain't winning NY and MA. Or any other Republican for the foreseeable future.

You just typed out something so stupid, and you can't erase it. Sad.

if we'd been testing people like we should have been this would have been possible, so yes, i agree, and it is 100 percent this administration's failure that this didn't happen

>>And they are now taking off the lockdown, through both legal and informal means, before it is optimal to do so.

Who's to say what's optimal and not optimal? Do we have even a halfway decent model that takes into account the economical and epidemiological effects of this particular virus? No, we do not.

The academics keep looking for a better model so that the experts can order society better. You'd think that an allegedly libertarian blog might at least give some thought to the possibility that Hayek had the best model—spontaneous order arises through no particular design as you let individuals make decisions that take their own circumstances into account.

Surely it doesn't come as a surprise to Tyler that a massive, across-the-board government intervention was clumsy, ineffectual, and had negative second- and third-order impacts? And yet the impulse seems to be to tinker around the margins. I get it; for a certain type of person it's fun to build spreadsheets and write code. But let's not pretend like that's doing anybody any good.

Generals are always criticized for planning to re-fight the last war. Academics are currently re-fighting the last battle while the war is still raging. But that's just fine so long as no one takes their masturbatory recommendations as holy writ. It turns out that inherently political decisions are better made by politicians, not by technical experts. The opinion of the electorate is crucial, and that isn't something that can be modeled on a spreadsheet. What's more, decisions about individual behavior are better made by individuals, not politicians. It'd be nice if there was some set of experts with a reasonably large platform who would make that argument. But when it comes down to it, I guess it's more fun to play with models and make hindsightful pronouncements about what the central planners should have done.

+1
I was also going to ask: "Wait? How do we know when optimal is?"

Okay, say we don't know the optimal path. Now what? Surely not just close our eyes and decide it's impossible to know anything.

Perfect is the enemy of good. Ease the restrictions and let the 'wisdom of the crowds' to work so a Hayekian spontaneous local optima for each geographical location will emerge.

I'm vaguely in favor of that, except that the people screaming (literally) loudest for re-opening also seem determined not to do the simple and low-cost steps like wearing a mask when inside a store.

Interesting indeed: So others exercise their freedom to not favor shops and businesses if they don't practice basic preventive measures; exercise the business owners right to not allow in if no masks (remniscent of no shirts no shoes no service) or hand sanitizing.

I mean if one can refuse to officiate homosexual marriages or bake cakes, others can refuse to serve where basic hygiene isn't present.

Yes. Good observation and well stated.

If the issue is spread, there is "spread from" and "spread to." The "spread to" that is most critical is those over 65 who make up over half of the deaths. So what about targeting protections at those folks rather than at everyone?

EXCEPT THAT: This morning we learn of a cluster of around 50 infant and toddler deaths of a rare illness. What they have in common is that they all test for COVID-19.

Is it too much to ask that Americans adjust their habits while we figure out this fatal mystery? Are we that weak that we can't change? It seems the American character was stronger when Pearl Harbor was bombed.

We are always ready to adjust other people's habits, by force if necessary, but never our own.

For instance, shutting down Sunday church services is an obvious step if you yourself never attend. But what about other things that the blue tribe holds dear?

How about no sex or even shared beds with new partners for the duration of the COVID emergency? Only marriage and pre-existing long-term relationships. After all, prolonged close contact with heavy breathing and exchange of fluids is a surefire way to spread the virus. But even back when AIDS was 100% fatal, there was enormous opposition to shutting down bathhouses, and legal requirements to disclose HIV+ status to sexual partners were challenged on constitutional grounds. Back then the authorities also insisted that everyone was vulnerable even though the risk was overwhelmingly concentrated to certain demographics... the same messaging as today.

How about drastically reduced meat consumption? After all, animal agriculture is the main way that new pandemics start, when a virus crosses into a new species. And meat processing plants are known to be superspreader hotspots. If we invoke the spirit of WWII, then remember that they had meat rationing back then and accepted it. But nope, even the "progressive" left mostly concurs that meat is an essential industry, since their “intersectionality" doesn't extend to animals.

How about shutting down subways in New York, or at least sharply limiting ridership during peak periods? But no, the people who advocate the hardest for total shutdown are the same blue-tribe folks who ardently support mass transit. So they vehemently push back against any suggestion that social distancing might apply to subways even though it's absolutely essential everywhere else. We could provide scooters, remember those? and encourage people to use them instead. But urban nimbys killed them because they came from evil big tech instead of benevolent government.

How about stopping all international airline travel that isn't long-term? No trips that last less than a month. But again, blue-tribe urban cosmopolitans are far more attached to their jet-setting ways than rubes in flyover country. And even the greenest Hollywood liberals never gave up their private jets, and sympathetic mainstream media rarely called them out for it.

So asking people to adjust their habits doesn't have a track record of success. And in any case, a cold shutdown of the entire economy is much more than merely adjusting "habits", it's a guarantee of economic collapse that will kill more people in the long term than the pandemic.

And we can't even foresee how high the upper bound might be. After all, Pearl Harbor and WWII happened because a great depression brought warmongering right-wing dictatorships to power. In the present context, we might easily imagine a conflict sparking between ascendant and emboldened China and a badly wounded and resentful America.

How about prohibiting more than one member of a household from working outside the home? That would prevent people who get infected by a family member from transmitting the virus to a different set of co-workers. But it would also probably mean a lot of women would have to quit their jobs. Nobody's advocating that either.

You kind of had something interesting going here, but when you claim it's progressives trying to keep the meat industry open?

Vegetarians lean way left. And the orders to force open the plants were coming from the right.

OK, you have a point. This is more like a case of "the dog that didn't bark." But it does speak to a certain hypocrisy, since the left is broadly pro-shutdown for everything else.

Vegetarians may lean left, but the left as a whole doesn't lean vegetarian in any significant way. Which seems odd on their part since they generally jump on every other bandwagon.

Trump's designation of meat processing as an essential industry was greeted largely with silence on the left. I take that as a sign that they are no more willing than the right to change their habits in any way that involves personal inconvenience. Just like an epidemiologist telling others to lockdown but then having booty calls with his mistress.

It is bizarre - Tyler seems to actually have internalized the kayfabe - the very real hatred of the lockdown felt by rich people upset that the proles aren't working led them to gin up fake demos and whatnot, and Tyler not only acts like it is real, but he seems to actually believe it.

You might call it self-regulatory capture.

"(Maybe three months if we had Merkel as president.)"

She goes have that 'I'll round you up into containment camps' vibe to her.

Great post Tyler.

I think this may also make the UK's relatively late lockdown look better in retrospect. It gave more time for people to feel its necessity and increased public support of social distancing measures/business closures.

The British people are now one of the most reluctant to end lockdown, and this increased caution once measures are relaxed may be useful in curbing future spikes of virus cases.

Dominic Cummings (Johnson's chief adviser) is a big proponent of Cialdini-style psychology of influence so I do wonder if this was factored into the initial decision to start lockdown later as well.

That all may be an over-estimation of the UK government's competence, but, intentional or not, it could make their decision to start late look smart in retrospect.

Re: Political Sustainability and Network Economy

1. Re political sustainability.

Political sustainability does not require that we must take a poll everyday to decide whether or not to sustain a practice, because we know that we will have a weak moment in the future.

The reason we have laws is the same reason that Odysseus asked his crew to tie him to the mast: he knew he would be weak later when he needed to be strong.

So, to be politically sustainable, in the sense of future action, you need to put in the rules (along with enforcement resources) now before you become weak later. That also sustains the practices better: see Germany, South Korea, Taiwan.

2. Re: Network economy.

There is a great piece on network economics and a covid outbreak that hits a large center and spreads throughout, and also, where parts of the US are connected to other parts so that when one part is down, the other parts suffer as well. This applies to connections between countries as well: https://news.stanford.edu/2020/03/26/coordinated-response-needed-fight-coronavirus-pandemic/

By the way, if you want to look at the network effect, look at Sweden whose economy is declining because it is interconnected with other countries. They have experienced more deaths per thousand than their neighbors, and will suffer the same economic costs: From the Financial Times https://www.ft.com/content/93105160-dcb4-4721-9e58-a7b262cd4b6e

Did this thought really just come to you, Tyler? Or did you think this 2 months ago? Either you made the same mistake or you were scared to make this point. Therein lies your answer. We looked at New York and saw our future in Kalispell, MT?

Amen on recognizing the political, human nature aspect. Models don’t do this well. It’s called common sense.

Perhaps shutting down every where made some sense if we didn’t know the extent of potential damage to a decent probability? If an outbreak starts in Iowa in 2103, then shutting down everywhere may make sense. This time, we had some sense because it didn’t start here.

We also need to understand the leadership aspects, getting elected, being responsible for death. What do I mean? Once they lock down to flatten the curve, the politicians and other leaders themselves won’t unlock unless they can outsource decision making and blame to others/policy. FEMA has to go national?

Yeah, no shit?
Montana still has a whopping total of 468 cases. They saw zero cases yesterday. All of 16 deaths. Clearly their ICUs are not being overloaded.
They were locked down from March 27th to May 4th. What the hell was that for? Massive overreaction.

Here's a hypothesis:
I strongly suspect that the existing chains of transmission in the shutdown world are not coming from random encounters between maskless people in grocery stores. Recent science supports the hypothesis that most transmission requires sustained close contact with an infected person.

Thus what probably happening is that a chain of transmission starts with someone like a hospital or nursing home worker, who then goes home and infects family members who in turn then go to work at some other "essential" business, infect their co-workers, who go home, and infect their family members, and so on.
So you have a chain of trnamission that looks like:
Hospital worker->family->co-workers->family->coworkers->family co-workers.

Thus, if you really want to cut down R0, what you want to do is prohibit more than one household member to work outside the home.
How many people are going to go out on a limb to support this policy over universal lockdowns?

Your hypothesis is not supported, as you say, and setting up a response that is not measured against other alternatives is likely also unlikely.

I have seen firms though rotate their workers in shifting patterns which reduce or could reduce transmission. My son is an investment banker in NYC. Before the lockdown, they were having half the workforce work two weeks in the office, and the other half two weeks at home, reducing the number of total exposures. You might see schools do a mix of off for one group and on for another--in and out of school--or having all kids as a group staying together throughout the school day.

Confused by your first scentance.
https://thehill.com/policy/healthcare/494348-new-study-finds-few-cases-of-outdoor-transmission-of-coronavirus-in-china

"A new study of the more than 300 outbreak clusters of COVID-19 in China reveals that the majority of the outbreaks were fueled by indoor transmission of the disease, while outdoor transmission was scarce."

Your quote does not support your claim, which was:

" existing chains of transmission in the shutdown world are not coming from random encounters between maskless people in grocery stores. Recent science supports the hypothesis that most transmission requires sustained close contact with an infected person."

If you actually read the link, you will find that they are talking about transmission among family members who live together, not casual encounters in grocery stores. Also public transit, which generally involves lots of people packed together for a sustained period

I did read the link, which said that most is indoor and not outdoor. As to family transmission, there has to be a vector into the family, which would come from a family member's contact with a person outside.

Unless you believe the family unit spontaneously generates a virus, there has to be a transmission path into it.

There isn't anything about grocery store contacts.

Everyone should read the article and see if Hazel's initial claim is supported from it.

Also, there is zero reason why investment bankers should not be able to work from home 100% of the time.

Third point: we're probably reopening in a stupid way too.
It's always been scientifically possible to target restrictions at the highest risks. We didn't do that - it was "shut everything". Now that we sort of know that transmission is mostly happening indoors where people are indoors in sustained close contact, we're opening restaurants and hair salons - where people are indoors, in sustained close contact. Brilliant!

Huh...doesn't the neoliberal creed say thou shalt unconditionally trust technocrats? Monday morning quarterbacking is par for the course though.

The problem with the argument about "should we lock down later?" is that it almost always fundamentally misunderstands exponential growth.

If algae doubles every day, and it covers the lake in 40 days, how many days does it take to cover half the lake? How about a hundredth of the lake?

It's not about locking down when we feel problems are sufficiently acute (which are felt in linear terms - i.e. we have 900 beds and >900 beds are now needed, or 50 of the 2,000 people in a town are sick), it's about when problems are acute in exponential growth terms (i.e. when we are X days away from massive problems without intervention but today are absolutely fine)

I think that a political capital argument can be made using the fact that maybe 5% of Americans understand exponential growth, but if you wait until your hospitals are showing pain, you are too late.

It should be obvious that you lock down BEFORE you get infected, not after, but denial is one of the uglier faces of "American Exceptionalism".
Quite a number of small towns and low-population counties here in Iowa, Minnesota and the Dakota have learned this the hard way... and it isn't just packing plants that have gotten rampant spread then shut down... other industries have, too.

"And moralizing and blaming our current predicament on “Trump,” or “the yahoos who watch Fox News” is — even if correct — washing one’s hands of the responsibility to incorporate political sustainability into the model."

And in that sentence we see, defined by absence, the phrase 'political leadership'. Leadership means leading, not following yahoos just because they are out there... and the same applies to many, many issues other than just this pandemic. Man up, show some guts, lead... 'taint the way of the current administration.

Suppose this is correct.

Who is to blame? Who is this "we" you talk about? Are you referring to Trump? Fauci? Governors who made lockdown decisions? Scott Gottlieb? Twitter epidemiologists? Twitter economists?

The lockdowns aren't something "we" did. Individuals made decisions. You say they were wrong decisions. But who made them?

This is a great post, lots of replies, and rich convos with key phrases, to run the Python NLP analysis toys and some custom dataviz apps we have for behavioral insights on this crowd. Should be fascinating... perhaps it will result in a pseudo-Tyler construct which can always create blog posts that result in 200+ comments.

What reasonable people find baffling are the over-the-top shutdowns. If we have a problem in nursing homes, why are we closing basketball courts? If a few 17-year old athletes get infected, so what? Infection itself is not a death sentence, or at least it is incredibly rare.

There is a great performance by George Carlin from about 2003 where he complains about germophobes. He describes swimming in raw sewage on the Hudson River as a kid, and how he now has "a super strong immune system, and I give it plenty of practice." He tells the super-health conscious to "take a friggin' chance."

Of course the virus is not this simple, but I think that Carlin had a general point.

There never should have been any shut-down anywhere. All anyone needed to do was help to isolate the vulnerable while otherwise living their normal lives.

For the small percentage who get acutely afflicted we have a very effective cure that keeps almost all of even the most vulnerable infectees from ever needing hospitalization. That our medical bureaucracy is trying to keep Hydroxychloroquine from ChiCom16 patients until they are hospitalized will go down as one of the great scandals in medical history.

HCQ can also be used prophylactically. It is one of the most widely prescribed drugs in the world, is very well tolerated, and virtually no one who is on it has gotten the XiCom lung pox. Virtually 100% prophylactic efficacy and our Fauci-led CDC-FDA-NIAID are all LYING about it.

NIAID-head Fauci is in bed with Bill Gates. They want to be the vaccine saviors of the world and to achieve this personal glory are striving to keep our economy shut down for the 1-5 years it will take to develop and test a vaccine, even though economic shut-down will kill all of us long before that and even though it isn't needed.

If ChiCom19 is more than a cold for you, get the cure. If you are afraid of getting it, take the cure prophylactically.

Bill Gates will be remembered as one of the great villains of history along with his many Newsom-Cuomo-Inslee-like puppets.

Leftist governors are glad to destroy the livelihoods of their own constituents because they think our leftist press will be able to blame the destruction on Trump. That is the real sickness afflicting us.

We are sentencing the population of Montana to endless house arrest while most of the transmissions occurs in the NYC subway. We are told we can't shut down the latter because it would be too difficult for the people in NYC.

And that right there is where you see *none* of the lock down policies have, or ever had, anything to do with Covid19.

Arguably Trump should have sent the army to forcibly close the NYC subways* and the wants of the NY elite be damned....but they had just impeached him and would have immediately impeached him again for doing so.

*I'm not sure what legal pretext you could use outside of the Obama-eque I have a pen and a phone.

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