The shift of prevalance toward the young

Half of new coronavirus infections in Washington [state] are now occurring in people under the age of 40, a marked shift from earlier in the epidemic when more than two-thirds of those testing positive were in older age groups.

A new analysis finds that by early May, 39% of confirmed cases statewide were among people age 20 to 39, while those 19 and younger accounted for 11%.

Here is the full article, via Anecdotal.  A number of points:

1. As people adjust, and the higher-risk individuals take greater precautions, and the lower risk people relax their vigilance, this is likely to happen.

2. The case for age segregation, as a remedy and protection, becomes stronger.  If your policy prescriptions never change over the course of a pandemic, you are not paying sufficient attention, or you are a dogmatist, or both.

3. Universities have to worry a bit less about their students and a bit more about their faculty, at the margin.

4. As more young people acquire immunity, the incentive for yet additional young people to invest in immunity, through stochastic deliberate exposure, rises.  That in turn strengthens #2 and #3.

5. Will markets play a further role in this trend?  The excellent Kevin Lewis sends me the following (WSJ):

…while surging demand has proven a boon for the traders known as blood brokers who source this commodity, diagnostic companies say high prices for the blood of recovered Covid-19 patients are posing a hurdle to developing tests. ‘We’ve had a terrible time trying to obtain positive specimens at a decent rate,’ said Stefanie Lenart-Dallezotte, manager of business operations for San Diego-based Epitope Diagnostics Inc., which sells an antibody test for Covid-19…She said one broker quoted $1,000 for a one-milliliter sample of convalescent plasma, a term for the antibody-containing part of the blood from recovered patients. Executives at other diagnostics companies say they have been quoted prices of several thousand dollars for one milliliter of plasma.

What is the market-clearing price here, and what is the elasticity of exposure with respect to that price?  Evolving…

Comments

Yes but the article makes this sound like a bad thing ("The trend is concerning") which doesn't really match with your comments. The whole Kawasaki link has not been proven and the confirmed cases are incredibly small percentage wise. So yeah, I agree with you but not with the linked article.

I suppose that "As More Young People Get Tested, More Young People Have Positive Test Results" would have been far too boring of headline.

COVID is over, Dems. Better count on police shootings from now on.

> The case for age segregation, as a remedy and protection, becomes stronger.

Well, the case for it might get stronger, but the challenges to actually doing it don't seem to change much. Perhaps the old people can just look after themselves in their own separate economy. So sure, let's update our policy prescriptions. But I can't see this one changing meaningfully

Australia or South Korea or Greece or Austria are doing an excellent job at protecting all ages.

Much like lockdowns, age segregation is the result of failing at controlling the spread of the virus. That requires constant hard work, something that most American policy prescriptions are designed to avoid, to make them more palatable.

The sad thing currently is that the massive ongoing protest wave in the U.S. will lead to more viral spread, and less ability of the government to exert the focused action necessary to control a disease that is still killing around 1,000 Americans a day.

What about Japan which never had a lockdown and has tested the least among OECD countries yet still has the same per capita Covid-19 deaths as South Korea and a third that of Greece?

Japan .000006
Korea .000005
Austria .00008
Greece .00002

It was warm in Australia and that may have played a major role but despite lockdowns they still had per capita Covid-19 deaths of .000004, similar to Japan.

What about them? You keep on hyping Japan but you never provide analysis on what lessons other countries can take from Japan.

Then add in the early experience with the Diamond Princess, so that the Japanese were fully familiar with how easily the virus spreads, and took measures to avoid it without requiring much in the way of heavy handed government decrees.

Certainly add Japan to the list. There seems to be a certain misunderstanding - lockdowns are what happens when the situation grows out of control. They are a desperate measure, the last one you can take before giving in to sheer fatalism. Which still may be a valid response, but is not the one practiced by the Japanese either.

Lockdowns are at one extreme - what Japan or South Korea or Sweden did does not represent the exact opposite extreme, however. Brazil comes much closer to the opposite of a lockdown than the other three mentioned countries.

And a note about Austria - look at its neighbors and their experience. The Austrian lockdown seems fully justified in the sense that Crikey has been pointing out for weeks.

Correct.
Correct.
Correct.

Lockdowns are almost always the result of panic, not a last resort. The Norwegian government recently said that its lockdown was not effective and should have used "safe social distancing" which is what Sweden did.

There is no evidence that Australia's lockdown was effective either and coronavirus entered there when it was warm, which may have significantly damped the spread.

Japan was essentially the opposite of lockdowns and a lot of testing - the lowest in the OECD, yet has had 50 times fewer Covid-19 deaths than in the U.S.

We have a different perspective. Italy and Spain used lockdowns as a last resort, after seeing what was happening. Call it fear, panic, or simply the natural reaction of a public health system to a new contagious disease that was spreading inexorably. Austria used a lockdown as a way to avoid what happened in Italy, and it was not a sign of panic - but if the lockdown had not worked, there was no other alternative. And of course in a countries like Austria or Germany, the lockdown was combined with all sorts of social distancing measures.

'Japan was essentially the opposite of lockdowns and a lot of testing' - if one squints and wishes to support a certain perspective. The other way of looking at it is that Japan responded appropriately at various times - for example, Australia's handling of corona virus infected cruise ship passengers was awful and led to wide spread infection, in two cases, not just one. However, Brazil remains a much better example of the true opposite of a response like Italy's or Finland's.

The NY Times had an article on Japan yesterday after completely ignoring its extremely low number of deaths for weeks. It says Abe declared a national emergency on April after cases started to spike even though the data do not show any spike. How was that the right response from Abe? Much of the public was against him closing down schools in late February, a strategy that is now known not to slow the spread of the virus by any notable degree. I don't see how I'm squinting and supporting some particular perspective when Japan didn't lockdown as the U.S. did with more extreme lockdowns in Spain and Italy while at the same time tested very little unlike South Korea.

As for Austria, it has not been shown that the lockdown was effective.

Is this meant to be a joke? - As for Austria, it has not been shown that the lockdown was effective.

Look at Austria's neighbors Switzerland, Italy, and Germany. We would all be interested if you have an alternate explanation of what Austria did that is not based on more than a century of experience in handling a contagious disease.

Nope, not a joke. Everyone was saying the exact same thing about Sweden and Norway with per capita deaths at .0004 and .00004 respectively, but no longer can after Norway's statistical analysis of the lockdown showed it wasn't effective.

I'm not sure why Austria's per capita death rate at .00008, is 20% lower than Germany's at .0001, which also had lockdowns. Maybe because Vienna at 1. 8 million people is Austria's only city of more than a million whereas Germany has Berlin, Hamburg, Munich and Cologne totaling to 7.6 million.

Why not compare Japan to an American state or two that did not have any lockdown at all? The following seven states do not seem to have had any lockdown - Arkansas, Iowa, Nebraska, North Dakota, South Dakota, Utah, and Wyoming. I will just pick the first and last to compare to Japan, mainly because I am not really that interested in this.

Cases/fatalities per million
Japan 132 / 7
Arkansas - 2,246 / 44
Wyoming - 1,540 / 26

Considering the Japanese experience with Hokkaido. it is likely that the Japanese authorities would have gone to further measures if they were looking at Arkansas's numbers. A reaction even harder to dispute if they were looking at Nebraska's numbers of 7,058 / 88.

I have lost track of what those comparisons mean and who is arguing what in this thread.

But what is clear, looking at the stats you provide, is that a full lock-down would have saved at most a fraction of 170 mostly very old people in Nebrsaka (88 per million, population 1.97M) , and that certainly it was not worth the cost. This is even more true for Arkansas, Wyoming, and of course Japan.

At least for those states and country, which didn't lock-down, It seems to me irrefragable that they did the right choice. (If you don't think so, I would like to know your arguments).

Can the pro-lock-downs persons give one single example of a state or country having done a strict lock-down with a clear evidence that it was worth the cost?

What's a lock down? Australia didn't have a lock down, but people keep saying it did, so it does not seem to be a useful term at the moment.

If you want to say Wuhan had a lockdown, as there were people actually locked in buildings fine, but no one locked me in anything here in Australia. I still went to work every day. Like 7 days a week because I'm really bad at my job. It takes me 70 hours to get 20 hours work done and I get paid for 37.5. Maybe if I stopped writing all these comments on the internet I'd be more efficient...

You are one of the few who say Australia didn't have a lockdown and nobody is using Wuhan as the definition of that even if there were different degrees. The Australian government's medical advisers said up to 150,000 Australians could die of Covid-19 unless stringent steps were taken and now with 100 deaths and 1,500 times lower than feared, *obviously* the lockdown was a smashing success.

New Zealand's Prime Minister recently made the laughable statement that "We have done what very few countries have been able to do. We have stopped a wave of devastation."

I'm one of the few people who's actually Australian.

Give us a definition so we know what you're talking about.

Is a lockdown a shutdown of most face to face interaction? Because we had that. But there are people who say a lockdown requires a shutdown of the economy and that never happened here.

Could it just be that they're testing more young people now?

Death rate compared to new hospitalizations should go down if new infections average younger.

It's a tendentious, fear-mongering way of saying that the state is doing better at protecting the elderly.

Germany, with a current death rate 1/50 of America's, has taken another approach. Which is using its current testing capability to basically test everyone involved in health care/nursing homes in a way to further reduce viral infections in such contexts.

2 months ago, age segregation in Germany was very strict, and plainly effective, as one would expect when using well established public health principles. Now that the spread of covid is under decent control, it is not age segregation that is required, it is segregating those who could infect others, and isolating those they have been in recent contact with.

That this is exactly the same process required at the beginning of the pandemic should be plain.

This prior_approval comment is one conspiracy theory laden snide reference to the Koch Brothers shy of a prior_approval Bingo game

The fatality rate comparison cited in this comment is spectacularly wrong.

Looking the Worldometer coronavirus site, as of May 31:

U.S. COVID-19 fatalities per million: 320
Germany COVID-19 fatalities per million: 103

So in fact the German death rate is about 1/3 that of the U.S.

What's the explanation for screwing up this comparison so badly other than deliberately lying in an attempt to misinform people? It takes all of two minutes to go to the Worldometer site and get the correct number.

If Washington recently increased testing of, for example, asymptomatic health care workers of all ages instead of only symptomatic people, the observed "young peoples' percentage of totals infections" would increase only because we didn't test asymptomatic young people in earlier time periods.

We'll never know, however, because Washington State's data collection and tabulation has been unreliable.

They claim at the end of the article:
“The purpose of this analysis is to alert the public and government officials and institutions that this is a higher risk group for transmission and infection,” she said, “despite the popular misconception that children, teenagers and young people are not at risk.”
TheIr data does not support this. The under 19 are 23% of the population in WA but only 11% of the infections. .
They’re under represented by a factor of 2.
Look up children and Covid-19 on MedArXiv. Many, many papers show that children are underrepresented in the C19 positives

Yup. Either they're stupid or they're not disclosing their actual agenda.

In the vast majority of samples we have, like those in WA, testing has focused on the symptomatic cases. Children, teenagers, and young people are less likely to show symptoms, and so less likely to be tested even when infected. Testing that has been randomized and is not symptom bases has shown that in fact young people are the major infected groups in lockdown situations, since they continue to engage in relatively riskier behaviors.

Yes, non random samples will have a bias towards older people due to a lot of asymptomatic cases in children but it's true in random samples anyway.
Vo Italy, random sample : No infections were detected in either survey in 234 tested children ranging from 0 to 10 years, despite some of them living in the
same household as infected people, much less than the general population.
https://www.medrxiv.org/content/10.1101/2020.04.17.20053157v1.full.pdf
Iceland random sample: all children negative:
https://www.medrxiv.org/content/10.1101/2020.03.26.20044446v2
Belgium daycare study:
https://www.medrxiv.org/content/10.1101/2020.05.13.20095190v1.full.pdf

here is a review article from the WSJ.
"antibody studies, including a recent one from Spain that found a sharp age gradient. Just 1.1% of infants under age one carried antibodies; 2.2% of those between one and four; 3% between five and nine; 3.9% between 10 and 19; and 4.4% between 20 and 39. Antibodies were most prevalent (about 6%) in Spaniards 60 and older.

There are also studies (e.g., one from Shenzhen, China) showing children in infected households equally likely to be infected. Infants and very young children have much less infection exposure than adults who are out and about, engaging in conversations with other adults who are out and about, etc. So of course very young children will have lower rates of infection. However, multiple studies have shown that, especially in social distancing setups, young adults and to a lesser extent teenagers are the big spreaders. And the article is not claiming that children are equally likely to get infected (they make the opposite point), but that contrary to the common misperception, young adults DO get infected, at high rates, and that even children get infected at higher rates than most people realize.

In any event, Tyler's post isn't focused on infection in babies and children, it's about the potential wisdom of segregating people by age. I assume in this he means segregate the elderly from everyone else, and let the infection run through that unsegregated population. I think that's a terrible idea.

"The case for age segregation, as a remedy and protection, becomes stronger."

Doesn't nursing homes empirically weaken this argument?

....If only they had been better segregated.

Older individuals are also wealthier, so restricting their consumption is still a catastrophe.

The United States should go hard or give up!

No, wait! Giving up wasn't meant to be a real option! It was just meant to be a psychological trick to snap you out of your learned helplessness. Or determined helplessness, or whatever it is.

Seriously, the US needs to drastically restrict the amount of droplets from people's mouths and noses that end up in other people's mouths and noses. This does not require stopping everyone from working, but it does require stopping droplets from people's mouths and noses ending up in other people's mouths and noses. The US needs to do this for six weeks. Then, provided a good job has been done, you can ease up. But you gotta be serious for six weeks. Pretend you're under attack by Al-Qaeda if that helps. If you think it would help, I'm sure Japan would be willing to drop a few fire crackers on Pearl Harbor.

'It was just meant to be a psychological trick to snap you out of your learned helplessness.' That hasn't worked for a couple of decades at this, particularly now that a lot of people 40 and under have never actually experienced a non-helpless U.S. Add in the horrible combination of U.S. number 1 mindlessness with a constant stream of how the U.S. is failing from all media sources (emphasizing different aspects of such failure), and you end up in the much better world that people like TC have devoted their professional careers to creating.

If you weren't Australian, it would be even easier to just point out how much you hate America, because ....... (fill in blank as desired).

The rates of infection are declining in 20-40 age group; the observation is that it is declining lest rapidly than in older age groups.

I just googled how much plasma you can recover from the average blood donation, and the answer seems to be at least 150 milliliter:
https://www.researchgate.net/post/How_much_plasma_can_be_removed_from_whole_blood.

If international trade is allowed, I can’t see how the equilibrium price could be higher than 10$ per milliliter.

Unless Trump slapped tariffs on plasma too.

A few thoughts:
1. is exactly to be expected, and 3. makes sense.

2. The question is not "is age segregation the right response" but "how can society meaningfully accomplish age segregation?" Also "Age is simply one risk factor - don't societies also need to segregate by the other major risk factors?"

4. Do you have evidence for the robustness of the immunity in young people who have mild or asymptomatic courses of COVID-19? It's entirely possible that people who get good and sick with COVID-19 have moderately strong immune responses for 2-3 years, while those with asymptomatic cases may have incomplete and/or short-lived immune responses. Further, we don't yet have clear documentation of the morbidity in young people, though we know that it's a leading cause of both hospitalization (and death) in this age group.

Perhaps my pessimism with this analysis comes from living in a densely populated country where the idea of "age segregation" is ludicrous, or perhaps it comes from knowing that there is no country has been able to selectively protect their elderly population, much less there non-elderly but high risk populations.

When you write posts like this, I would like to read some real-world ideas about how exactly age segregation would work on the ground. Better isolating nursing homes isn't a meaningful answer. That's low-hanging fruit, which no country seems to have actually accomplished despite how obvious and important it is. In fact, the existence of a substantial age-segregated populations in western countries is one reason the death toll has been so high, so increase age segregation could well lead to more death.

No, I'm asking how you segregate the tens of millions of people who have risk factors and are also in the 50-65 age range, and the millions of >65 who are embedded among us?

Singapore has the same number of cases as Ohio and 1/100 as many deaths. Even if you say Ohio is undercounting maybe 90% of their cases, that still gives them 10x the death rate. Either Singapore has some tough seniors, or they did a pretty good job making sure their 30,000 cases skewed very young.

I don’t know what they did or if we can copy it. But it does show that having half the deaths be over 85 isn’t a law with this disease. You can have a dense modern society and also keep elderly people from getting exposed.

Or maybe Ohio is undercounting not 90%, buy 99% of its cases. Sometimes the most obvious hypothesis is our blind spot.

But if we are good Bayesians, we should pay attention to all relevant information. Based on a randomized antibody study of Indiana residents, infection fatality rate may be 0.5%. There is no basis for the assertion that Ohio is undercounting covid-19 cases by a factor of 100 given deaths of about 2,000 and cases of 31,000.

https://news.iu.edu/stories/2020/05/iupui/releases/13-preliminary-findings-impact-covid-19-indiana-coronavirus.html

The study seems serious and in its own words, Indiana has been undercounting by a factor 11. Only it is Indiana, not Ohio. Obviously the undercounting factor, a quotient of the number of real cases (which varies a lot by states) by the number of positive tested case (which depends in large part on how the state tests) is a "bad random" number, which may vary a lot across states.

Singapore is probably catching and confirming cases much earlier than Ohio. Also, since many of these cases are among foreign workers living in dormitories, their infected population is probably relatively young.

I've seen this pattern play out with South Korea and Iceland, where someone points out how they have extremely low case fatality rates and therefore this proves that somehow the virus is not all that deadly. But, within a few weeks, this argument becomes obsolete because the low case fatality rates were simply an artifact of having large numbers of relatively newly infected people.

That hasn't really happened with Iceland.

Looking at the Worldometer site, Iceland has a reported 0.55% case fatality rate with almost all cases resolved as either recovered or fatal: 1,806 cases, 10 deaths, 1,794 recovered, and therefore only 2 active cases.

Singapore is an island city-state that engaged in extensive preparations after SARS-1, and responded early and aggressively with quarantine and extensive contact tracing. Until the virus got into worker housing (much as it easily could have gotten into elderly housing, if they go in for that sort of thing). No, the US cannot and clearly will not do what Singapore did. That ship has sailed, and the US in not only NOT building up it's pandemic responsiveness, it's devolving into political crabbing without clear goals and plans.

Even if the US were interesting in adopting the Singapore model, that model isn't/wasn't remotely based on segregating by age groups (whatever that means in actual practice).

I don't understand why this needs explanation. Earlier they were only testing severe cases. When the young are infected, their symptoms are generally mild, so they were under represented in the statistics. Now they're doing more testing, young people with the same mild symptoms are getting tested. There's no mention that the youth hospitalization or fatality rate is rising, so it's actually great news that we're targeting herd immunity spread in the low risk group, that's exactly what we should be going for.

It's not just faculty who are at risk being around young people. Young people have families, families of all ages, and they bring home to the family what they find while at school or at the clubs or at their favorite restaurants. I've commented that a large part of my family gathered together for Memorial Day weekend, from the mid-eighties matriarch to her youngest great grandchild. My pleas to the matriarch went unheeded because she both missed her grandchildren and great grandchildren and believed the risk to her and to each of them was so small as to be non-existent. As young people return to their pre-lockdown lives, their role as spreaders will only become more likely and more dangerous to others, including our hosts. I'm not sure readers appreciate what age segregation will mean, not only to the quality of life for every age group but the vitality of businesses of all kinds.

When Robin Hanson proposed his mass variolation solution, was it:

a) an instance of sincere policy advocacy on Robin's part, or

b) a clever Straussian prediction of what would actually end up happening in a chaotic, informal, can't-say-it-out-loud-in-public way?

“Percent of a total” numbers are mostly useless
when compared across time. The numbers always have to add up to 100%. So there were only three ways the data could look: 1) percent of cases among seniors rose; 2) percent of cases among young people rose; 3) all age groups changed behavior at the same exact rate and the percentage of all groups stayed the same.

The article is written as if there is an option 4 where all percentages drop. That of course can’t happen and given the extra danger to old people, #2 is clearly the best outcome. We’re getting what we want but we’re too innumerate to know it.

What is likely to follow the pandemic? Here are two opposing views, one by a historian who has written about the 1918 flu pandemic (https://www.washingtonpost.com/lifestyle/magazine/americas-response-to-coronavirus-pandemic-is-incomprehensibly-incoherent-says-historian-who-studied-the-1918-flu/2020/05/22/1906391a-7b53-11ea-b6ff-597f170df8f8_story.html) and the other by an economist who has written about the Great Depression (https://www.nytimes.com/2020/05/29/business/coronavirus-economic-forecast-shiller.html). The historian observed that Americans threw caution to the wind following the 1918 flu pandemic (the "roaring" twenties) while the economist observed that Americans hunkered down (avoiding risk-taking and consumption).

#4 also strengthens #1.

#5 This is a short run problem like the shortage of TP. When incentives for supplying blood, say by combining serological tests with collection of blood from those testing positive, the price will fall.

This has everything to do with massively increased testing. For example, at the peak of the crisis, 50% of people were testing positive in NYC. It's now down to 2%.

In early April, tests were being rationed to those with the very worst symptoms. Now anyone can get a test. So if you were a young person with a mild case, you weren't getting a test in April, either by personal choice (you weren't sick enough to care) or because you weren't sick enough to jump the line of people needing tests.

If the rate of death in young people suddenly spiked at this late stage, you'd have my attention.

I'm on my phone so at the moment I can't tell you what the positive test date is in WA, but I'm certain that it has fallen over time just like NY.

As a rule of thumb, any story about the number of new COVID cases is false, and that's almost always because it doesn't properly account for testing.

Historical data for WA is here - https://covidtracking.com/data/state/washington#historical

Seems that testing stopped dead on 5/21 and then went from 69 to 5431 from 5/22 to 5/23. Looks like around 40k tests after 5/22 with around 4% positive. If you increase the testing so sharply, you are going to pick up more cases. I’m not sure if there is a breakdown of tests by age.

Seems like they’re pushing a new line in the fear of reopening. The governor is the insane Inslee.

Washington has been so close to suppression since the beginning, that the implications for other places with "typical" rapid increases and then increases slowing to zero or decreases hardly applies.

The nature of the adjustments that Tyler posits is based on people having understood the social distancing recommendations as for their own protection. This is a flawed message as it does not attempt to lead people to internalize the externality of infection.

Social distancing fatigue can occur with behavior based on either message, but at least if people are acting out of a desire to protect others, observation of continued low prevalence rates, as in Washington, would not lead to reductions in behaviors that prevent the spread to others, like decreased mask wearing reported in the article

Why do so many forget the original purpose of our lockdowns? And that was done to give all the local acute HC facilities time to prep for any potential deluge of patients that might overwhelm their capacity. And yes it was effective in most cases, but of course at high social and economic cost. I guess you could call it 'medical panic', but it was first, not last resort.

That fact was not forgotten, strictly speaking. It has been pushed aside due to election year partisan re-framing.

From https://www.theguardian.com/world/2020/may/30/could-nearly-half-of-those-with-covid-19-have-no-idea-they-are-infected

----
“My husband ended up very sick,” she says. “He was in intensive care for a day, and in hospital for 10 days. But while I was also infected, I had no symptoms at all. I have no idea why we responded so differently.”

It took two months for Raje’s husband to recover. Repeated tests, done every five days, showed that Raje remained infected for the same length of time, all while remaining completely asymptomatic. In some ways it is unsurprising that the virus persisted in her body for so long, given that it appears her body did not even mount a detectable immune response against the infection.

When they both took an antibody test earlier this month, Raje’s husband showed a high level of antibodies to the virus, while Raje appeared to have no response at all, something she found hard to comprehend.
----

If an asymptomatic carrier expresses no antibodies, what does this imply about the use of seroprevalence testing to estimate population prevalence? And how did Raje's body clear the virus - native immune system?

lol, "markets."

Somewhere between a valuable commodity that altruistic individuals donate for free, and the putative socially-beneficial end-recipient, massive mark-ups by middlemen ensue.

That there is why I won't be donating my kidneys at death. Standing between my donation and the sick kid (or wealthy alcoholic) is a for profit machine that turns my donation into an $800,000 set of golden eggs.

And further - and this should be a concern that is widely agreed upon in Libertarian blogs - we just can't trust the incentives of a for profit medical system to work extra hard to extend my life, when my ailing corpus is potentially standing in the way of a million dollar windfall.

Those kidneys are worth a whole lot more than $800K X2!
Dialysis alone is on the order of $1000 a session. 3X a week...

And then there is the great value of any other parts or organs donated.

It is not so cheap and easy to harvest this stuff quickly after a death, preserve, protect, transport and then install into recipients. You can make great improvements in more than just a few lives.

As a doc in a small town we had a young worker die, and much to the chagrin of my hospital admin, I kept him alive with the OK of the family. And the next day specialists flew in and did their thing. As I recall benefiting 7 different patients.

The altruistic human benefits are undeniable.

However, we are on a libertarian blog. Altruism means nothing. Altruism is for suckers. People are foolish to donate such valuable organs without getting a piece of the action.

Bringing market discipline to the market for organ supply would inevitably, inherently, bring vast improvements to the system, and would lead to better outcomes for all by properly signalling the value of organs.

Donors should be able to shop their organs in advance on a clearing house auction, they could make agreements about thier lifestyle, submit to DNA testing, etc. Buyers would be able to obtain the characteristics they desire, and predict their supply pipeline with more (actuarial) predictability, and in fact this market would lead to more healthy behavior among potential donors.

Prices would be a sliding scale based on age and health factors.

Basically, I could sell my organs now, receive a NPV discounted price, and put my kid through college. I could even sell a promise to die or donate by a certain date, and receive a price premium for that guarantee.

This article is bad and misrepresents the situation. The reality of what's going on in Washington state doesn't support any of Tyler's conclusions.

In Seattle, the share of cases among people under 40 has not changed much since March. However, there are significantly fewer new cases in Seattle now than there were in March. Meanwhile, there's a separate outbreak among farmworkers (who're mostly 20-60) in the Yakima Valley. This outbreak now makes up a relatively large portion of total new cases in the state so it's bringing the statewide average age down even though the composition of the individual outbreaks hasn't really changed.

Comments for this post are closed