Fight the Virus!

I was asked by the LATimes to contribute to a panel on economic and pandemic policy. The other contributors are Joseph E. Stiglitz, Christina Romer, Alicia H. Munnell, Jason Furman, Anat R. Admati, James Doti, Simon Johnson, Ayse Imrohoroglu and Shanthi Nataraj. Here’s my contribution:

If an invader rained missiles down on cities across the United States killing thousands of people, we would fight back. Yet despite spending trillions on unemployment insurance and relief to deal with the economic consequences of COVID-19, we have spent comparatively little fighting the virus directly.

Testing capacity has slowly increased, but where is the national program to create a dozen labs each running 200,000 tests a day? It’s technologically feasible but months into the crisis, we have only just begun to spend serious money on testing.

We haven’t even fixed billing procedures so we can use the testing capacity that already exists. That’s right, labs that could be running tests are idle because of billing procedures. And while some parts of our government are slow, the Food and Drug Administration seems intent on reducing America’s ability to fight the virus by demanding business-as-usual paperwork.

Operation Warp Speed is one of the few bright spots. Potential vaccines often fail and so firms will typically not build manufacturing capacity, let alone produce doses until after a vaccine has been approved. But if we follow the usual procedure, getting shots in arms could be delayed by months or even years.

Under Operation Warp Speed, the government is paying for capacity to be built now so that the instant one of 14 vaccine candidates is proven safe and effective, production will be ready to go. That’s exactly what Nobel-prize winning economist Michael Kremer, Susan Athey, Chris Snyder and I have recommended. It might seem expensive to invest in capacity for a vaccine that is never approved, but it’s even more expensive to delay a vaccine that could end the pandemic.

Relief payments can go on forever, but money spent on testing and vaccines has the potential to more than pay for itself. It’s time to fight back.

Alex Tabarrok is a professor of economics at George Mason University and a member of the Accelerating Health Technologies With Incentive Design team.

My point about not fighting the virus directly was illustrated by many of the other panelists. Joseph Stiglitz, Christina Romer, Alicia Munnell, Jason Furman, James Doti, and Shanthi Nataraj say nothing or next to nothing about viruses. Only Anat Admati, Simon Johnson, Ayse Imrohoroglu get it.

Admati supports a Paul Romer-style testing program:

Until effective vaccines and therapies are available, which may be many months away, our best approach is to invest heavily in increasing the capacity for testing many more people and isolating those infected.

Simon Johnson argues, in addition, for antibody tests (not the usual PCR tests):

Policymakers should go all-in on ramping up antibody testing, to determine who has been exposed to COVID-19. Such tests are not yet accurate enough to determine precise immunity levels, but the work of Michael Mina, an immunologist and epidemiologist at Harvard, and others demonstrates that using such tests in the right way generates not just information about what has happened but, because of what can be inferred about underlying disease dynamics, also the information we need to understand where the disease will likely next impact various local communities.

Imrohoroglu advocates for targeted lockdown:

In addition to CDC recommendations about social distancing and public health strategies for all, I believe that as we reopen, we should keep a targeted lockdown policy in place for at-risk groups.

Comments

Record heat yesterday in Fresno, CA. No new covid cases reported. It will be over a hundred in two days. But it is also true people stay home in the heat.

Remember: Now that the virus is over, its Time To Fight Back.

There were 22,000 new COVID-19 cases in the US yesterday and 740 deaths. Clearly this is some new definition of the word "over" I was previously unfamiliar with.

America sending two million doses of hydroxychloroquine to Brazil, because why not?

Covid 19 will let up out of pity.

https://www.forbes.com/sites/isabeltogoh/2020/06/01/us-sends-two-million-doses-hydroxychloroquine-to-brazil-despite-little-evidence-it-can-treat-coronavirus/#52f7d33d75be

Although a nice gesture, it was not necessary. Brazil's produced and stockpiled enough chloroquine to last Brazil years of pandemics if it were necessary.

By any measure, drug companies have been experiencing record profit margins and record profits during the past five years. Why didn't they use part of those profits to build the capacity for the pandemic everyone expected would come? No, I'm not opposing what Tabarrok et al. are promoting (I've been consistently complimentary of Tabarrok in my comments), I'm just reminding readers that if drug companies are looking for someone to blame for our lack of capacity, they need only look in the mirror. Again, I'm not opposing Tabarrok, and when the house is on fire, it's not the time for casting about for someone to blame for building the house far from a fire hydrant: you just figure out the fastest way to get water to the fire.

Name the Covid drug currently in shortage due to lack of capacity.

...........?

How exactly did you expect the drug companies to build capacity for a virus that did not exist until a few months ago and a vaccine that has not yet been invented for that virus that did not exist.

Since January, Gilead has invested significant capital to establish a supply chain capable of large-scale production of remdesivir.

The production of remdesivir is a long, linear chemical synthesis process that must be completed sequentially and includes several specialized chemistry steps and novel substances with limited global availability. The process is both resource- and time-intensive, with some individual manufacturing steps taking weeks to complete. Because remdesivir is administered intravenously, production also requires sterile drug product manufacturing capabilities, which limits the number of organizations capable of manufacturing the medicine. This complex process impacts the ability to rapidly produce large quantities of drug supply in an emergency situation like the COVID-19 pandemic. In light of these realities, Gilead worked early on, before any clinical trials had started, to procure a steady flow of long-lead-time raw materials that will accelerate large-scale production of remdesivir by our current and future partners once these materials become available in significant quantities. www.gilead.com/purpose/advancing-global-health/covid-19/working-to-supply-remdesivir-for-covid-19

Great news. Now if Gates et al. can get the production capacity built, and if remdesivir turns out to be both safe and efficacious, Gilead will have the raw materials and the production capacity to be able to produce the vaccine in sufficient quantities to defeat the virus. But there will be other possible vaccines if remdesivir turns out not to be the right one. Gates et al. wants to build at least seven facilities, not putting all of the wager on one vaccine. Cooperation, coordination, and collaboration. Sort of like SpaceX.

Remdesivir isn't a vaccine. Why do you insist on posting childishly incorrect things on this blog in every thread?

https://www.washingtonpost.com/business/2020/04/12/drug-ventilator-shortage-coronavirus/

The capacity Tabarrok is referring to is the capacity to produce billions of vaccines that will be required to stop the pandemic. Developing the vaccine is only the first step, actually producing the vaccine in quantities that will stop the vaccine is actually the greater challenge. That's why Bill Gates, Tabarrok, and others are addressing it now, so that the capacity is being built now while the vaccines are in development. Drug companies don't have near the capacity to produce sufficient quantities of the vaccine.

Is there sound evidence that the tests are much good? Everyone seems to assume they are but what's the evidence? Indeed, how do you test a test?

Yes, there are both good viral and antibody tests. Validation procedures for assessing the quality of tests are straight forward and all good clinical laboratories do this prior to deciding what test/platform to use in their labs. I've read probably 100 different papers on validation studies of various COVID-19 tests.

There are also some good finger prick lateral flow antibody tests. I was quite impressed by the validation of one of these from the Finnish company BioHIT Healtcare that was validated at Yale.

As the Australians endlessly point out, it is basic public health measures that work, regardless of the quality of testing. Quarantining the infectious, and isolating the potentially infectious, is what works. Testing is a tool, but it in no way replaces basic public health measures.

And as Prime Minister Abe pointed out, there is the "Japan model" where a country does relatively little testing and doesn't declare a lockdown but does eventually ask people to kindly stay at home if possible - a cross between the U.S. and Sweden that has resulted in about the same number of deaths per capita as Australia. 0.000004 for Australia and 0.000007 for Japan.

The main reason for Nihon's low fatality rate is the extremely low rate of obesity there.

This is a fine post by Alex, but it too omits the single most important thing in addressing the pandemic: prevention.

43% of Yanks are obese, 60% are overweight. A public health message:

Lose weight [reduce extent of obesity, esp. abdominal fat]

Become active [get fit, reduce extent of hypertension, reduce extent of poor insulin response]

The co-morbidities above are subsumed under this moniker of metabolic dysfunction:

https://en.wikipedia.org/wiki/Metabolic_syndrome

90% of the fatalities in NYC involved some or all of the above!

Last, get outside [boost photo synthetic Vitamin D; its impossible to overdose on it via this synthetic pathway]

https://www.thelancet.com/journals/landia/article/PIIS2213-8587(20)30183-2/fulltext

"The main reason for Nihon's low fatality rate is the extremely low rate of obesity there."

South Korea also has a 3% obesity rate and almost no morbid obesity but this doesn't explain Australia. It also says testing that the Koreans are lauded for has almost nothing to do with the 50 fold less deaths since Japan tested less than the U.S.

Yeah, we're like way fat there in Australia. New Zealand is a little fatter, but not as much fatter as you might expect given the portion of the population that's Polynesian.

Thank you for missing the entire point of my post.

Apologies, Crikey

Meant for Todd K's non-sequitur above.

No, problem. I figured one of us was confused. Usually it's me.

There’s isn’t much point increasing testing capacity if tracing isn’t happening. Unless of course you increase it to the crazy number of daily tests advocated by Alex. But asking us to conduct that many tests a day is basically conceding, at least in my mind, that we’ve given up on contact tracing. But if you have given up on contract tracing, seems to me marginal increases to testing capacity just aren’t all that exciting.

Am I right about that? What progress is being made on contact tracing? With all the people out in the streets, difficult to not imagine a jump in numbers heading our way.

Contact tracing is a stone-cold dead issue after the last few days. Thousands of strangers just swirled together in the streets, shoulder to shoulder, many not masked. No one is going to unscramble that egg.

Besides, Tyler and Alex apparently aren't even allowed to *mention* the riots. No public-health official is going to torpedo his or her career by actually tracing the ways in which all this civil unrest contributed to sickening and killing people. Expect the coming spike in community transmission to be blamed instead on outside white supremacists.

Nah, it’s obvious that shoes looted from Nike stores provide excellent protection against the virus, works much better than the cheap stuff looted from Target.

The biggest looting happened when the Tax Cuts and Jobs Act was passed in 2017. Those lost trillions are so badly needed now and didn't even make any sense when it was passed at the time. It was a special interest giveaway to donors of both Dems and Repubs but mostly R's since they controlled the House, Senate, Presidency, and the Supreme Court (which ruled legal the capping of state deductions). A pair of Nike's is a literal rounding error to the real thievery going on in DC.

A tax cut is thievery? If anything, Trump actually took away a lot of the wealthy classes ability to game the system through write offs.

True the marginal top end rate came down a little bit but not much.

So wait, now the middle class is big R donors?

I'll grant you that the D party only really cares about the wealthy, but you're being ludicrous.

I just don’t see how you’ll get the number Alex wants unless you have the public health people requesting it. Are they? I haven’t really seen anything. I suspect they aren’t because the tests already undertaken overwhelm their capacity to trace.

I almost think you’d be better off spending money to increase testing capacity in countries were contract tracers are cheaper to hire. Not saying I agree with the lack of increased testing. Just trying to think of reasons why it hasn’t increased.

As for the riots, I don’t think we really need any public health people to risk their careers. I suspect it will be pretty obvious, sadly.

" Unless of course you increase it to the crazy number of daily tests advocated by Alex."

The US is already around 400K per day in tests. Alex mentions doing 1.2 million per day in tests. So, it's only 3x where we're currently at.

It's hardly crazy. Indeed it sounds like a minimum number. That being said, i do believe we are getting ahead on testing. There was free testing at the park in my area all day on Tuesday and Wednesday, so it can't be that rare at this point.

I’m probably being unfair on Alex. When I say crazy numbers I mean Romer’s 20 million tests a day. And maybe he’s shifted that. As I have been saying in comments, I haven’t really been tracking Covid very closely for maybe a month now.

> Contact tracing is a stone-cold dead issue after the last few days

Bullseye. Every plan that had existed is rendered moot. In two weeks, if there's not a huge uptick from riot mixing, then this thing is dead. Already all the huge upticks we'd expected have largely failed to materialize.

We're currently use 1/3 of our testing capacity. Building more is foolish.

Contact tracing, if you are dealing with a few dozen cases makes sense. But right now the gov isn't capable of contact tracing. Remember, this is the same gov that cannot reliably count votes: Here is a box of votes, we counted it three times. We got three wildly different answers. We'll count it again tomorrow after our 2 hour break. It's 3:30 now, I need to go home. Union rules say I'm in violation if I work a minute past 3:30.

TV government is competent. Movie government is competent. They have nice offices, everyone has a STEM degree and is whip smart sitting at a computer running a desktop machine with a GUI that has never existed. And drones high above that can zoom in on anything at the drop of a hat.

Real-life government can barely issue a driver's license, and they use 40 year old computers running COBOL to do so.

Do not confuse TV government with real-life government.

New York City is about to start contact tracing. They're going to pay people to stay home while in quarantine, so I think we can expect those who test positive to name as many of their friends and allies as they can.

https://twitter.com/MarkLevineNYC/status/1267478571565617153?s=19

>Am I right about that?

I guess I look at the two things as being complementary. A positive step would stop me from infecting someone tomorrow (a few "Neil Fergusons" notwithstanding). That's probably 50% of the game on average.

Yeah, I think they are complimentary, too. I sometimes feel like testing is being treated as a substitute to contact tracing, which I guess it sort of is at the moment.

>a targeted lockdown policy for at-risk groups.

Gee, if only you thought of that 12 weeks ago, maybe 20 million people would still have a job.

It seems to be that at every decision point to date doing nothing would have been better than what we did.

Why is that going to change now that the virus appears to be waning?

This lockdown really seems to favor big business. They have every excuse for slow and lousy service. There’s nowhere else to go. Meanwhile small and moderate size businesses are being devastated.

I guess academics remain silent about this so as to maintain lucrative contacts?

The response to Covid has created a massive transfer of wealth from poor and middle class workers and entrepreneurs to government employees and shareholders of large corporations.

So, the next step is to transfer even more.

Lessee...

- 9/11. Excuse to transfer wealth upwards.
- 2008 recession and crisis. Excuse to transfer wealth upwards.
- Covid. Excuse to transfer wealth upwards.

I think I'm seeing a trend here.

I have been meaning to pose the question:

What will they call the Covid version of the Patriot Act?

The weirdest thing about this covid from a political perspective has been Trump's response.

Sure, there's bipartisan agreement around stimulus to shower $100 on banks for every $1 on unemployed workers. No surprise there.

But Trump's abdication on federal leadership remains strange. I can only best explain it is a failure of competence which his apologizers try to explain as some sort of federalist experiment. Rubbish. Don't try and tell us he's reacting to any principle whatsoever.

Here's this tremendous opportunity to massively increase the Executive power etc. The GOP has never been shy about that.

Are we to believe that Trump squandered that chance in exchange for a few news cycles worth of making a couple Dem Governors look bad? That's actually plausible.

Sure, he's dabbled around with his nepotism and ad hoc panels, taking advantage of some crony opportunities and settle a few scores. But he has steadfastly refused to grab the mantle, for good or for ill.

I don't think he has it in him. All he can do is destroy.

Trump can do more than destroy. He can cower in a bunker.

Wait, you WANT a massive federal overreach?

Leadership does NOT always mean action, more often it can be seen as guiding and putting the experts up to get the message out, which is exactly what happened.

A hurricane in OBX doesn't mean you evacuate Montana.

No, I do not want massive expansion of the Executive authority and a new & improved Patriot Act. But the GOP has trained us to expect that. So the absence thereof is weird, particularly since it is not explainable by some widespread born-again love for Federalism by the GOP leadership.

What I do want is for the POTUS to act as designed and as in the past during times of national crisis - to marshal resources, activate his agencies, and provide leadership and coordination. Which has not happened at all.

The only messages Trump has put out are dysfunctional and counterproductive. And the idea of him guiding the nation in any way whatsover is laughable and a little pathetic of you to try and assert.

This is not a threat from outside our borders. The correct response for the feds to be provide all the supplies needed, and let each state do what is required to ensure they get back to work while mitigating (not eliminating) deaths.

States that are more bold and manage to keep deaths down should be rewarded byt he feds.

States that are less bold and manage to keep deaths down should NOT be rewarded by the feds.

> The only messages Trump has put out are dysfunctional and counterproductive.

You don't think these messages are helpful? For example, what is wrong with this message? "“That is not a protest. It is not a statement. It’s people, a handful of people, taking advantage of a situation for their own purposes — and they need to be treated as criminals,” said the commander in chief. “. . . A handful of criminals and thugs who tore up the place.”

That message correctly captures everything that is happening. Some people--good people-are protesting peacefully. Some people--bad people--are rioting. They are criminals.

I take it you don't like the word thug?

Fine. Allow me to revise my post.

Some of the messages distributed by the President - which might be reasonable or even helpful - are drowned out and nullified by his pattern of issuing reckless, cruel, deceitful, self-contradicting, and downright batshit messages.

Lessee.. for just two examples, "liberate Michigan" and "the shooting starts."

I just don't see how saying "liberate michigan" is bothersome. Even the governor's husband decided the rules were bullshit and wanted his boat in the water in violation of the govs orders.

I will agree that Trump isn't presidential. But that is why he was elected.

Would the dems love a guy like Trump that moved their agenda forward? Someone who punched republicans in the nose, was a savvy businessman, and didn't care about always being polite?

Hell yes they would.

The reason they detest Trump is because he's effective. Bush was nice and presidential and got streamrolled by the swamp. Obama was nice and presidential and got steamrolled by the swamp.

Trump is streamrolling the swamp.

See the difference?

And you didn't answer the question I'd ask directly: Did you think Trump's use of "thug" was offensive or cruel or inaccurate?

Between your characterizing goading armed protestors who stormed into the statehouse as no big deal, and claiming Trump is draining the swamp, I don't see much reason to follow this thread any further.

I have no problem calling thugs thugs. But I do note that usually the use of that language is coded dog whistles, and intent matters.

> stormed into the statehouse as no big deal,

Would you rather have the statehouse protesters where nothing was broken or the "unarmed" protester where the city was left in ashes?

> laiming Trump is draining the swamp

Not draining the swamp! Steamrolling! Big, big difference.

> hat language is coded dog whistles,

Well those were Obama's words during Ferguson, and if you hear the whistle in that then you are the dog.

Are you mandating people get these additional tests? Because at this point, pretty much anyone who wants a test can get one. Testing centers are closing for lack of demand. We're pretty close to the market equilibrium. This article might have been relevant two months ago, but at this point testing is increasing while case numbers are decreasing. Alex is talking about a program to scale up artillery production when Berlin has already fallen.

And as usual, the market has come up with a solution better than what men imagine they can design. Most places of business aren't doing clinical COVID testing but temperature checks. Temperature checks might have both more false positives and false negatives, but they have the advantage of being cheap, easy to implement, and something that people are willing to submit to. Once again an ostensibly libertarian organization leaps out of its seat when someone offers it the chance to play central planner. I guess we'll have to content ourselves with the annoyance at current government regulations and inefficiencies while ignoring the fact that Alex is proposing new ones. But naturally the new ones will work exactly as intended.

LA Times is obviously not interested in conservative opinion.

LA Times was up until recently owned by Sam Zell, a big Republican donor.

Those two categories do not overlap that much, regardless of what claims the party makes.

I wonder what the Stiglitz advice is? A UBI, college for all, health care for all, VAT for all, carbon taxation for all, a covid test and everything will be amazing?

He’s getting boringly repetitive in his old age....

It's not just that insufficient money isn't spent on fighting the virus. Completely cost-free actions that have a good chance of substantially reducing the risk of covid-19 are also not taken.

One of these are increasing indoor relative humidity to about 50% (just turn the dial in buildings that already have a humidifier, and it's still relatively low cost if a humidifier needs to be installed). This was more relevant a few months ago, in winter, since humidity tends to be higher in summer, but it will become highly relevant again in the fall. This is one intervention I discuss in a blog post at https://radfordneal.wordpress.com/2020/04/30/seasonality-of-covid-19-other-coronaviruses-and-influenza/. One article I link there is at https://www.esmagazine.com/articles/100256-a-coronavirus-conversation-with-dr-stephanie-taylor (look towards the bottom for the relevant part).

Here's a quote from that link: "...the transmission pathway that we haven't really wanted to think about is when an infected person sneezes, coughs, or simply breathes droplets into the air. If the air is dry, those droplets shrink and desiccate to reach a moisture equilibrium within the air around you. And we now know that the viruses in those very tiny desiccated particles can go up in the air, they can travel into an HVAC system, and re-infect people who are quite far away and have had no immediate contact."

A second low/zero cost intervention is to make sure that everyone has adequate levels of Vitamin D. Here are two links making the case for this:

https://berthub.eu/articles/posts/vitamin-d-the-new-covid-19-chloroquine/

http://agingbiotech.info/vitamindcovid19/

The health authorities are not just failing to promote this intervention, they are actively making things worse by scaring people away from ever getting any sunlight.

That’s why Rickets is also on the rise in some parts of the world.

Not getting skin cancer is a higher priority.

Kids aren’t getting enough Vit C either in some parts of the world and scurvy is making a comeback.

How do you square that with the rapid spread of the virus in Manaus?

Well, I don't claim that using Vitamin D supplements and keeping the humidity high will completely eliminate any chance of covid-19 spreading. There are other factors.

One factor that seems under-researched is the extent to which infection by one of the common-cold coronaviruses may confer at least partial immunity to covid-19. If so, that could be one explanation for geographic heterogeneity in covid-19 spread, depending on how recently such common cold infections have been common in an area.

Maybe we should infect everyone with those common cold variants

"One of these are increasing indoor relative humidity to about 50% "

We ran a de-humidifier all winter long to keep the humidity in the house down to 45%. It's over 60% without it running. If humidity were that large a factor there wouldn't have been any worry of a large outbreak in the SouthEast. Or conversely maybe that's why there wasn't a large outbreak in the SouthEast, but I'm not convinced humidity alone is the answer.

SouthEast of what?

Humidity is not the only factor, of course. But for influenza, the effect of humidity is the most widely-accepted theory for its seasonality in temperate regions - this is not some crazy fringe idea.

Sorry, I gave a short hand response. The SouthEast region of the US.

>We ran a de-humidifier all winter long to keep the humidity in the house down to 45%

YMMV. In cold weather cities, you normally actively humidify the air... in part because it's more comfortable at 25% than 5%, and in part because higher humidity helps you tolerate lower thermostat set-points.

"If an invader [might in ten years] rained [a single] missiles down on cities across the United States killing thousands of people..."

The GOP would demand spending one trillion dollars to build better modern nukes, plus trillions on military blockades, bases occupying neighboring nations against the will of those nations people.

The only way to get funding for fighting any health problem is to frame it as a military need.

Before WWII and until the 60s, food needs of families were critical to national defense as well as public health.

In the 30s, CCC camps were run like boot camps and army camps with food and health care high priority to make the men healthy workers who could serve in the Army. A portion of their wages were sent to their families to improve the health of fathers and brothers.

The Army was a major innovator in vaccine development because the Army brass knew what the public did not: the 1918 pandemic ended WWI prematurely without victory, and it's likely the flu then sabotaged the post war diplomacy. The 1918 pandemic originated in the US, the spread to Europe by all those moving from the US to Europe and related regions in support of the war. However, the Wilson administration silenced the press reporting of "bad news". Its likely President Willson was struck down by the flu while in Europe trying to influence the peace settlement, and then greatly hindered in making the case for the League of Nations. This US originated flu is known as the Spanish flu because only the Spanish press was free to report bad news, about the war, about the scale of deaths from the flu pandemic.

Even today, the primary agency behind fighting pandemics and other public health problems is the deference agency BARDA. However, the Bush restructuring of "homeland security" moved BARDA under the same umbrella as CDC which was a "purely civilian" agency. Obviously both had virtually identical objectives in fighting health problems, BARDA dealing with chemical weapons shares 99% of the goals of the CDC dealing with dangerous chemicals used in industry and households and farms. These two agencies and their more specialized peers shared information and work, eg OSHA, DARPA, FDA, NASA, USDA, etc.

But by putting so much under Homeland Security, the conservative opposition to civilian government spending conflicted with their support for defense government spending. Thus, Obama's appeal for more funding in 2014 to fight future future pandemics was seen as government spending for civilian benefit. However, Trump views the pandemic Obama warned of as an act of war by China, even tho he and his advisors removed health threat reporting from the daily security briefings.

BARDA is the agency that is tasked with enacting the national security production act when it comes to medical production needs. But BARDA has been sidelined in doing its historical jobs.

I'm what conservatives would call a radical leftist, being about 99% in agreement with Obama, making me a right-wing conservative in the view of Bernnie Bros and AOC (before she had to get things done in Congress), et al. I was a conscientious objector in 1969 when I notified my draft board I was no longer a student, but I needed my dad's advice (hhe was a WWII CO) and went to my draft physical. Even after 8 months of dieting and weight training with a dorm mate, I exceeded the military weight limit by 8 pounds. But I was willing to do two years of civilian service.

But I realized in the 70s, only when economic and social progress are framed in military terms does progress gain conservative support and support by "liberals" like me and Obama.

The right-wing does not support universal service because the 14th amendment requires it treat everyone equally. If everyone is subject to a large draft, then the health and education of everyone becomes important to the military draft. In the Bush years, the health and education of volunteers became a big concern, but that ceased under Obama because to improve the health and education of young adults became a leftist agenda to destroy America.

The Army Corps of Engineers was a military action to protect health and promote economic development. But when Congress tasked it with protecting civilians from environmental harms it lost support from conservatives. Draining swamps to eliminate malaria, dengue, cholera to profit businesses is aok "defense" but protecting individuals is an America hating leftist agenda.

Just as Bush et al had to declare 911 as totally unpredictable, Trump has declared the widely predicted SARS-Cov2 pandemic as both totally unpredictable but also an act of war by China.

Such is the success of John Birch, Newt Gingrich,... McConnell, Trump.

Note, in my youth, the 50s and 60s, it wasn't the "job" of the president to protect us, but that's the justification used by presidents for many actions today, especially those that at best inconvenience us. TSA security theater is to protect us. Police shooting people is to protect us. But not preventing diseases from harming annd killing us.

(If you don't support 1000 nukes to destroy the global economy, you aren't protecting us, thus you are disqualified for any Federal officce.)

If missiles rained down on us, the GOP would also lose it's interest in 'liberty' or its alleged fear of big government, and dream up some bigger worser Patriot Act to shove down our throats.

After this past weekend, it’s too late. Covid-1984 is so last week.

How does one make the leap from stay home we’re in this together to it’s ok to loot, burn and destroy as long as you wear a mask? Please try to maintain social distancing while storming the castle.

How? By tracing liberals. Liberals are at war and working on three fronts:

First, liberals are at war with themselves because they know they are a minority. Yes, in democracies, it's too difficult for a minority to access and maintain power. For a long time, liberals have been trying to become a “sustainable” majority by attempting to give voting rights to everything that moves within the U.S. —soon they will attempt to give rights to their pets. In democracies, it’s almost impossible to build “sustainable” majorities —you may keep the name and the slogan but not the essence (assuming there was one at the beginning).

Second, liberals are war with the majority. In democracies, one way to defeat a majority is by changing the rules. In the U.S., however, it’s hard to change them to accommodate and benefit the losers. It’s funny to see attempts to break rules by people that used to defend them when they thought that they would be able to keep power forever. The struggle to include "new" minorities in the system will continue forever because it’s the way to grant them “privileges”.

Third, liberals are war with the fake armies that they rely on to defeat the majority. Neither the Russians and their creepy sirens, nor the CCP and their malicious viruses, nor the Antifa gangs and their random nonsense violence is a good idea because you don’t control them. The past few days and nights some Americans have suffered the violence of Antifa gangs. They are attempting to force the federal government to use the military to repress them and then claim the government is violating their rights.

It's all there. You are saying liberals == protesters == agitators == antifa.

But it's not sane, or a rational path forward to peace or reconciliation.

Read again the question and then my answer. You may not like my speculation but it's just that. I'm not saying that liberals are equals to any of the other three categories you mention. I'm saying that liberals rely on groups that they don´t control so they are different. Liberals are inclined to think that they can take advantage of useful idiots, but often they are wrong and they end up serving the interests of those groups.

There are plenty of clips, not just the one below, of peaceful protesters trying to keep things under control.

https://www.tmz.com/2020/05/31/black-woman-confronts-two-white-protesters-tagging-starbucks-blm/

For anyone who hasn't seen clips like this, some of the protesters are trying to be self-policing:

https://twitter.com/FOXLA/status/1267222974655954944

Anybody sane does want everyone to go home, and does think that's more important than one side or the other "winning in the streets."

It's a good test of who actually is more partisan than sensible.

I like the interface at Syracuse.com for NYState info. NYS broke the 60K/day testing mark last week (though this doesn't break out antibodies vs. current infection). They kept it up for 2 day, then dropped back down into the 50s. That still doesn't seem like very many.

A vaccine will be great. But where are the N95 masks? If we had enough masks so that people could wear them in their own self-interest instead of the altruism motivating the wearing of less effective masks to protect others we could return to pretty close to normal. The payoff for building mask factories would be enormous. Of course, we should have started two months ago.

We will be bulldozing unused masks into landfills in 60 days (or storing them somewhere to avoids the embarrassment)

If the reproduction rate immediately falls from around 1 to 0.7 there will still be over 600 new daily cases of COVID-19 in the US per day in 60 days time.

Who will pay the most and for the longest the economic costs of the lockdown? The younger
Who are at most risk because of coronavirus/COVID19? The older
Is there’s an adequate balance between the younger and the older in current policies?
NO!
http://perkurowski.blogspot.com/2020/03/financial-escape-valves-in-times-of.html

Agree with Alex on testing. It is achievable and it is part of public health practice, along with contact tracing, which can both reduce the spread, reduce death, and open the economy safely. Alex's Harvard piece which he did with others fully supports his assertions.

"Who are at most risk because of coronavirus/COVID19? The older"

Not really. The young are at almost no risk, the older at just above almost no risk. I am older bit still at very, very, very low risk.

Those who are the highest risk are those within six months of natural death or with severe pre-existing conditions. Over 40% of deaths were in nursing homes.

I agree that there is an ongoing power imbalance, but it is not between those over 83 and those under.

The Econ editorial (analysis and solutions from various economists) in yesterday’s LATimes. No one economists had all the answers, but none of the solutions were mutually exclusive with the others. I’d say implement the advice of all the economists. As far as government debt, who cares. Stephanie Kelton is right. Tyler and the rest of the economics profession that counter Kelton are more wrong than wrong, inarguably so, on everything they use as a counterattack.

+1. I know this will tee off the detractors here but I see both Kelton's stock and MMT rising. All the economists invested in the old paradigms from across the spectrum know they are marked for extinction by this. Time to retire the Hubbards, Summers, Krugmans, and Mankiws to make room for the fresh out of the box thinking that lines up better with reality. To butcher some Keynes, let's no longer be slaves of defunct economists.

I do think that there should be public return on investment and risk mitigation perspectives in regard to spending, but this shouldn’t be a problem. Public underinvestment and latent and realized risks is through the roof.

Asking sincerely, because I stopped paying attention to the chaos emanating from the Trump administration: Where are we on preparedness for a future surge in severe cases?

- PPE supplies (and distribution/allocation)
- Medical equipment supplies (and distribution/allocation)
- Rapid reaction flex capacity to deploy for ICUs etc, including equipment, medicines, beds, and health care workers
- Coordinated protocols about dealing with upticks in infections, esp. in health care settings and among workers.
- Coordinated national/global system for information sharing, situational awareness, and best practices. Mediated to reduce the noise and garbage.
- Coordinated policy for dealing with cross-state differences, travel, etc.

And, also a single shared national understanding of the nature of the disease and the character of a optimal response.

Yeah, that last one is a doozy.

PPE supplies have been growing at a rate as fast as humanly possible. Outside of PPE, we didn't really run out of anything else--drugs, ventilators, beds were all fine. Hospitals (including floating hospitals) were set up and torn down throughout the country and most went largely unused.

The feds have published guidelines for the all of the "coordinated" bullets you've listed. But the states are the ones that tweak to their region. Some states have banded together to define cross-state travel. For example, CA, OR and WA work together.

The optimal response cannot be known at this point. Hindsight being 2020, the US should have shut borders on Jan23 when Taiwan did, and kept them completely closed through today. And we should have done our 2 months lock down beginning at that time.

Additionally, we should have made it illegal for anyone to leave NYC. That city turned out to be major source of disease for the entire country. They were very late to close down--they probably shoudl have closed 6 weeks earlier and closed the subway completely.

The US has roughly 1000 people per day that enter the country unauthorized from Mexico, so even with borders completely closed, the chances that infections in Mexico were brought across the border would have been sky high. That's pretty much how Canada was infected--from the US (again, NYC).

- Stop China from creating pandemics, then dangerously dissembling

We may not need the others

For the future, sure, but has nothing to do with solving current crisis, unless you have a time machine, and there are even problems with that.

You are right. I misread the opening sentence. And I don't have a time machine.

prohibits messing with the timeline unless it serves the plot-line.

Jack, we can be very confident Chinese food production will be brought up to late 20th century standards and probably beyond as a result of the Coronavirus. The the risk to the world of new epidemics has now shifted to Africa.

this is the human trial that will blunt the coronavirus... and many other RNA viruses as well:

https://clinicaltrials.gov/ct2/show/NCT04407390

I've been following this NR development for a few weeks. It looks promising but won't be published until 2024. Maybe preliminary results will be released next May.

Dominate it. If you don’t dominate, you’re wasting your time,

Actually, when it comes to natural phenomena, I am more of a jiu jitsu guy

Good ideas from Alex.

Operation Warp Speed seems to be an agreement with just one company? Better than nothing, but I wonder about the lack of scale, and the potential for undue favoritism.

I will believe the "powers that be" are serious about combating viruses when they start funding and rollout of Todd Rider's DRACO as well as method to increase host resistance by regenerating the thymus gland (Greg Fahy's TRIIM) and increasing physiological robustness in general: https://joshmitteldorf.scienceblog.com/2020/05/11/age-reduction-breakthrough/

I prefer all three of these methods over the "band aid" of a vaccine, which doesn't work most of the time anyways.

Yes, rebuilding the thymus is critical... the underlying problem is the self-destruct program in the cells we call "aging".

This trial in Copenhagen is actually applying anti-aging to the coronavirus:

https://clinicaltrials.gov/ct2/show/NCT04407390

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