Month: September 2020

The game theory of SCOTUS nominations

Despite the conventional wisdom that Trump would surely nominate a judge to secure a conservative majority that would ultimately overturn Roe v. Wade, getting that judge successfully confirmed would diminish Trump’s reelection prospects (by energizing the Democratic base to vote for leaders who would pack the court or ratify PR and DC as states). But Trump doesn’t care a whit about abortion, much less ideology. He only cares about his power and his reelection. His incentive, it seems to me, is to choose a weak nominee who will surely fail confirmation or a nominee whose confirmation will be deferred post-election. If the nomination is rejected, the Democrats will be seen as obstructionists and the Republican base will be energized. A deferred confirmation, in contrast, will act as a carrot that Trump can dangle in front of congressional Republicans, who will more strongly campaign for him. In either case, an unsuccessful confirmation will work in Trump’s favor, while a confirmed conservative will act against his reelection interests. Such a maneuver by the Trump campaign can, of course, only happen surreptitiously, because it would anger both Democratic and Republican leadership to be manipulated this way.

That is from Shiran Pasternak in my email.

Wednesday assorted links

My Conversation with Alex Ross

And:

ROSS: …conducting is so mysterious in terms of what is actually happening between the conductor and the orchestra. There are explicit messages being sent. There’re instructions being given, but there’s also this slightly mystical side to it, where once you get to a figure like Klemperer, or today, Bernard Haitink, who just retired, or Herbert Blomstedt, who is incredibly vital and active in his 90s.

COWEN: Coming back at age 93 in Switzerland.

ROSS: Yeah. Even before they say anything, just the mere fact, when [they] arrive at the podium, there is a level of respect. There is a level of attentiveness and readiness in the orchestra. They don’t have to be won over when Herbert Blomstedt is in front of them. His reputation . . .

Blomstedt — someone like this can just skip all the preliminaries and just go for fine-tuning these points, and everyone plays better because they’re in the presence of this celebrated, legendary older musician. It’s almost as if they don’t even need to do anything anymore. They do, of course. They are working very hard, and Blomstedt is delivering very particular instructions to the orchestra.

But there’s that psychological dimension. The musicians are excited to be having this opportunity, and they think this might be the last time, so they give something more. So that’s the mystery of conducting.

I always think of that anecdote about Furtwängler — I think it was Walter Legge who told this story — watching the orchestra rehearse with a different conductor, and they were playing all right, nothing too inspired. He’s looking straight ahead and looking at the orchestra, and suddenly something changes. Suddenly the playing is electrified, transformed. The conductor seems to have done nothing different. And so, “What is going on? How did that change take place?”

Then he happens to look over his shoulder. Furtwängler is standing by the door, watching. In the few minutes that he’s entered the hall and has been standing at the back, the orchestra noticed him there, and their playing changed completely. So that’s the weird, the slightly occult power that the conductors can have. Just their mere presence transforms the playing.

And I start with this:

COWEN: I have so many questions about Wagner. Let me start with one. Why is it I have the perception that the truly great Wagner recordings come from the 1950s or the 1960s? If I think even of the talk you gave for the New Yorker — well, you talked about Keilberth and Solti and Furtwängler. Those are ancient recordings. Clemens Krauss, that was what, 1953? What has happened to the recording quality of Wagner?

Recommended.

The Great Forgetting: How to Stop Tooth Decay

What if I told you that a cheap, effective and painless method of stopping tooth decay had just been invented! You’d be pretty happy. What if I told you that a cheap, effective and painless method of stopping tooth decay was invented over 100 years ago and has been available in other countries for decades but only now is it starting to be used in the United States as a non-FDA approved, off-label treatment? I hope you would be angry. Well, I did tell you this in 2016 in The FDA Versus the Tooth and now the Washington Post has an update.

Studies show silver diamine fluoride stops decay in 60 to 70 percent of cases with one application. A second application six months later boosts the treatment’s long-term effectiveness to more than 90 percent.

In addition to killing cavity-causing bacteria, the treatment hardens tooth structure, desensitizes the tooth and even stops new cavities from forming. Applying the liquid on the exposed root surfaces of older adults once a year is “a simple, inexpensive, and effective way” to prevent cavities, a 2018 study concluded.

One of the most important benefits of the application on older patients is that the liquid can reach decay that forms under existing dental work such as crowns and bridges, said dental hygienist Michelle Vacha, founder of Community Dental Health, which runs clinics in Colorado Springs and Pueblo, Colo.

Previously, a dentist would have had to remove the crown, drill out the cavity and make a new crown — a traumatic, time-consuming procedure with a typical cost of $1,000 or more, Vacha said. Unable to afford the cost, many patients would instead have the tooth pulled.

The paint-on liquid is significantly cheaper than traditional treatment. Estimates vary, but a private dentist may charge $10 to $75 for one application, compared with $150 to $200 for a filling. Hygienists often have lower fees. At Vacha’s community clinics, the cost is $10 a tooth.

…Silver diamine fluoride has been used in other countries for decades, and studies have proved it safe. Its biggest downside is that it permanently turns the decayed area black — a turnoff, in particular, for people with decay on a front tooth. Dental providers say the black spots can be covered by tooth-colored material for an extra cost. For older adults, Geiselhofer said, a dark spot is a small price to pay for a treatment that stops cavities quickly, with no drilling, needle prick or trip to the dentist required.

The FDA deserves some of the blame but incredibly lost science is more common than you might think. You probably know that in 1797 the British Navy required lemon juice on all foreign service to prevent scurvy but did you know that by the early 20th century scurvy had returned because the cure had been forgotten or discounted?

Mental Floss: Yes, this really happened: scurvy was “cured” as early as 1497, when Vasco de Gama’s crew discovered the power of citrus…but this cure was repeatedly lost, forgotten, rediscovered, misconstrued, confused, and just generally messed around with for hundreds of years, despite being a leading killer of seafarers and other explorers. By the 1870s the “citrus cure” was discredited, and for nearly sixty years, scurvy — despite being cured, with scientific research to back it up — continued killing people, including men on Scott’s 1911 expedition to the South Pole. This went on until vitamin C was finally isolated in 1932 during research on guinea pigs.

It’s tempting to think that these forgettings are a product of the past but the more than 100 year loss of silver as a treatment for tooth decay is a painful modern example.

Hat tip: Ari Armstrong and M. Pettengill.

Cases vs. deaths in the Covid debates

Once upon a time, there were some herd immunity theorists.  They claimed that once a certain percentage of the population had been infected, the R for Covid would fall below one and the disease would become far less common and less significant.  Since these analysts were especially aware of heterogeneity issues (though common in the broader scholarly literature), these same herd immunity theorists tended to be less pessimistic than many of the mainstream forecasts.

To be clear, everyone knew that herd immunity was a general and universally accepted concept in the literature.  But these particular herd immunity theorists were the ones saying it really would matter, and they did so in the bold and fearless manner.  As I mentioned earlier, the NYT didn’t really start covering this issue until this August, a kind of unbelievable (and appalling) communications failure from public health experts who didn’t want to say anything that might be construed as minimizing expected risk.

Now, I don’t recall many of those theorists early on making a prediction about a specific number required for the herd immunity threshold to be reached.  Nonetheless, when deaths and hospitalizations collapsed in Sweden, London, and New York at about 20 percent seroprevalence, obviously it seemed that might be the critical level for herd immunity to kick in. (Higher measured levels of seroprevalence, such as for the slums of Mumbai might just come from the speed of ripping through a very dense and exposed community.)  And a lot of the observed later waves were in fact coming in other parts of these countries or regions, such as Barcelona following Madrid, or Arizona following New York.

These herd immunity theorists were correct in predicting an “earlier than the mainstream is telling you” collapse in deaths and hospitalizations in the hard hit regions.  And that is very much to their credit.

You will note that part of their prediction or implied prediction was that past the herd immunity point cases should fall, not just deaths.  Transmission just would not be very effective or speedy any more, so cases should be low whether or not people die in the hospitals or the hospitals can save them.  I’ll be coming back to this.

Then things started to go askew in the last few weeks.  First, it seems like a bad second wave came to an already fairly hard hit Madrid.  OK, you could say Madrid was never had 20% seroprevalence to begin with.  And then what appears to be a second wave has started coming to Israel, with rising hospitalizations.  Finally, it is believed that in Britian R equals about 1.7, and that a second wave of cases is on the verge of hitting London and Southeast England.  That hasn’t quite happened yet, but the informed authorities greatly fear it, and the numbers so far seem to indicate that as the trend.

Added all up, those data points are not decisive in rejecting the claims of these herd immunity theorists.  But they do make the herd immunity theorists look less correct than they did say three weeks ago.  Those “partial second waves,” or whatever they turn out to be, seem more active than one might have expected.  Again, though, the story is still unfolding and we should not rush to final conclusions.  But in the meantime we should update!

In response, many of the herd immunity theorists strike back and ask “where are the deaths“?  But that is not the right question for testing herd immunity claims.  Those claims were about transmission slowing down, and those claims should be true about Covid-19 cases whether or not more people are surviving in the hospital.  (Imagine for instance a perfect antiviral that saved everybody — would that mean herd immunity was true a priori?  Nope.)

Another claim from some of the less careful herd immunity theorists is that cases are rising again because testing is rising.  That doesn’t seem to explain observed patterns in Israel, Spain, or England, where in all instances actual Covid cases are rising above and beyond what is going on with testing policy, and by some considerable margin.  It probably does explain some parts of America, however.

It is very likely that death rates will be much lower this time around, because of better procedures, younger victims, lower doses, and possible (speculative!) variolation through mask use over time, exposing people to lower doses repeatedly and boosting their immune responses.

There is a temptation to say “few deaths, we don’t need lockdowns!”  Indeed, the more partisan of the herd immunity theorists are obsessed with the lockdown issue.  Lockdowns are important questions, but don’t let your lockdown views skew your interpretation of the numbers, and furthermore there are many other important Covid questions of interest, for instance:

1. How much more should we invest in better hospital procedures?  Better biomedical fixes?  And how much should we hurry?  If transmission is mostly over, you can relax much more, but ongoing cases both will bring some long-term damages (short of death) and also some ongoing panic, whether rational or not.

2. How do we deal with the fact that case numbers per se will scare people for a long time to come?  Again, if transmission is winding down, you don’t need as big a long-term plan here.

3. Should you let large swarms of tourists into your currently semi-protected region, say it is Venice, Italy or the less infested parts of Hawaii?

4. To the extent there is current herd immunity or semi-herd immunity as I call it, how fragile is that arrangement with respect to a possible rotation of potential super-spreaders?  And what might set off those fragilities?

For those questions, and indeed many others, it matters a great deal whether the original herd immunity prediction about “permanently low cases past the herd immunity threshold” is correct, or not.  Whether the death rate is high or low.  You really do need to understand about the cases in their own right, once you see this broader spectrum of issues at stake.

The more partisan herd immunity theorists wish to debate “how terrible will this be and will that justify a lockdown?”, and then they seek to talk you into a mood of not being so terrified, because frequently they are lockdown skeptics.  Again, that is a super-important question.  But don’t let it distract you from the other important questions at hand.

And for those other questions, as I’ve already stated above, the trajectory caseload predictions of the herd immunity theorists are looking worse than they did a few weeks ago.

Of course I will be giving you updates on this matter as time passes.  But this is the very latest, namely that some of the herd immunity theorists are on the precipice of being dogmatically wrong about matters of real import, just as were some of the most pessimistic mainstream predictions from March and April.

Gangs, Labor Mobility and Development

We study how two of the world’s largest gangs—MS-13 and 18th Street—affect economic development in El Salvador. We exploit the fact that the emergence of these gangs was the consequence of an exogenous shift in American immigration policy that led to the deportation of gang leaders from the United States to El Salvador. Using a spatial regression discontinuity design, we find that individuals living under gang control have significantly less education, material wellbeing, and income than individuals living only 50 meters away but outside of gang territory. None of these discontinuities existed before the emergence of the gangs. The results are confirmed by a difference-in-differences analysis: after the gangs’ arrival, locations under their control started experiencing lower growth in nighttime light density compared to areas without gang presence. A key mechanism behind the results is that, in order to maintain territorial control, gangs restrict individuals’ freedom of movement, affecting their labor market options. The results are not determined by exposure to violence or selective migration from gang locations. We also find no differences in public goods provision.

That is from a new NBER working paper by Nikita Melnikov, Carlos Schmidt-Padilla, and Maria Micaela Sviatschi.

The Distribution of Vaccines in the 19th Century

Distributing a COVID vaccine to billions of people will be challenging. We will require vials, needles, cold storage, air travel, trained health care professionals and much more. The challenge of distributing a smallpox vaccine in the 19th century was even greater because aside from fewer resources the vaccine, cowpox, was geographically rare and infected humans only with difficulty. Moreover, the best method of storing the vaccine was in a person but that worked only until the person’s immune system defeated the virus. Thus, a relay-race of vaccine couriers was created to distribute the vaccine around the world.

In 1803, the [Spanish] king, convinced of the benefits of the vaccine, ordered his personal physician Francis Xavier de Balmis, to deliver it to the Spanish dominions in North and South America. To maintain the vaccine in an available state during the voyage, the physician recruited 22 young boys who had never had cowpox or smallpox before, aged three to nine years, from the orphanages of Spain. During the trip across the Atlantic, de Balmis vaccinated the orphans in a living chain. Two children were vaccinated immediately before departure, and when cowpox pustules had appeared on their arms, material from these lesions was used to vaccinate two more children.

The British tried the same thing to get the vaccine to India but heat and shipwrecks led to many failures until, as Andrea Rusnock writes, Jean De Carro successfully delivered live cowpox to Bombay from Vienna via Baghdad.

De Carro, a Genevan who had received his M.D. from Edinburgh and who practiced medicine in Vienna, became one of the staunchest supporters of Jenner on the continent. It was through De Carro’s effort that vaccination was introduced in Austria, Poland, Greece, and the cities of Venice and Constantinople. In a letter to Jenner, De Carro carefully described his successful shipping technique. First he saturated lint with cowpox lymph and then placed the lint between two pieces of glass, one concave, one flat. He then sealed it with oil. “To prevent the access of light,” De Carro continued, “I commonly fold it in a black paper, and when I was desired to send to Baghdad, I took the precaution of going to a wax-chandler’s, and surrounded the sealed-up glasses with so much wax as to make balls. With this careful manner it arrived still fluid on the banks of the Tigris.

In the United States, Thomas Jefferson also wanted to be vaccinated but after several failures to deliver live cowpox from the Harvard Medical School, “Jefferson designed a new container: An inner chamber would hold the fluid lymph, while a surrounding chamber, filled with cool water, insulated the lymph.”

[Later] President Thomas Jefferson gave some cow lymph to Meriwether Lewis and William Clark to take on their explorations west of the Mississippi River. Antoine Saugrain, the only practicing physician in St. Louis when Louisiana was purchased by the United States from France in 1803, received some cowpox lymph from Lewis and Clark and began to vaccinate individuals free of charge, including Native Americans. Saugrain’s free vaccination program established cowpox in the Mississippi valley roughly a decade after Jenner published his inquiry.

Talk about Operation Warp Speed!

Even when delivered, the vaccine had to be kept alive so each cohort of vaccinators was incentivized to provide the vaccine for the next cohort:

In Glasgow, parents had to put down a deposit of 1 shilling (1801) and later 2 shillings (1806) to be refunded only when the child was returned to the clinic [and more cowpox could then be extracted from the children’s lesions]. In Boston, Waterhouse resorted to paying parents to vaccinate their children in order to keep a supply of cowpox.

Occasionally, herd immunity would be reached but that meant there was no way to store the vaccine for the next generation! Physicians, therefore, looked to newly created institutes that shipped the vaccine by one method or another around the world.

Returning to the British and India, after cowpox was delivered through De Carro’s efforts to Baghdad an Armenian child was infected and lymph from his arm was taken to Basra where an East India Company surgeon established a an arm-to-arm relay race that brought cowpox to Bombay:

On 14 June, 1802, Anna Dusthall became the first person in India to be successfully vaccinated against smallpox. Little else is known about her, except that she was “remarkably good tempered”, according to the notes of the doctor who vaccinated her…The following week, five other children in Bombay were vaccinated with pus from Dusthall’s arm. From there, the vaccine travelled, most often arm-to-arm, across India to various British bases – Hyderabad, Cochin, Tellicherry, Chingleput, Madras and eventually, to the royal court of Mysore.

As today, there was fear and opposition to the vaccine, especially in India, because it was foreign, threatened local healers who used variolation, and the use of vaccine couriers meant that “the vaccine was passing through bodies of all races, religions, castes and genders, and that ran counter to unyielding Hindu notions of purity.”

To counter the opposition, the British started an advertising campaign featuring Indian royalty. The picture above, for example, according to one compelling interpretation shows three Indian queens of Mysore with the queen on the right prominently portraying her arm where she has been inoculated with cowpox while the older queen on the left shows the discoloration around the mouth associated with smallpox. Thus, the younger queen on the right symbolizes health, vigor and the value of British science.

The challenges of delivering a vaccine in the 19th century–storage, transportation, fear, and incentives–are surprisingly similar to the challenges we face today. The 19th century effort to deliver the smallpox vaccine was impressive. Within years of Jenner’s pamphlet, the vaccine had made its way around the world. The 21st century effort will need to be much larger. Our civilization has many more resources than that of the 19th century. I hope we can match their will and ingenuity.

How should America regulate TikTok and other Chinese tech companies?

I say focus on data protection but let them keep the algorithm.  From my new Bloomberg column here is one excerpt:

A second principle for good policy is that the U.S. government should not cut off the U.S. — including of course Chinese Americans and visiting Chinese — from the Chinese internet. Let’s say TikTok and WeChat are banned altogether, along the lines of the (now court-halted) Trump executive order banning WeChat. Are all Chinese apps to be kept out of the country? How about clicking on Chinese links, which also could compromise security? Would Chinese newspapers (including from Hong Kong) be allowed?

The costs of these restrictions would be very high, most of all for Hong Kong, but for America too. Americans would become more ignorant about China, and China would fall out of touch with America. Chinese students and tourists would find it much more difficult to come to the U.S. and stay in touch with home, and as a result many of them would avoid the U.S. altogether. America’s world knowledge and soft power would decline. These too are major national security disadvantages, in addition to their economic costs.

More generally, China is America’s No. 1 trading partner. Can it really make sense to cut off the flow of so much information across the internet? For how long?

There is also a problem of enforcement. The rest of the world is unlikely to take a comparably harsh approach to Chinese technology. Will the U.S. also have to stop Americans from downloading an app from a privately owned joint Cambodian/Chinese company? Where exactly will these lines be drawn?

Regulating the algorithm won’t work, so the deal on the table, despite its ugly, politicized origins, is perhaps the best we can do at this point.  There is much more at the link, and here is more from Elaine Ou at Bloomberg.

Unintended Consequences of Criminalizing Sex Work

We examine the impact of criminalizing sex work, exploiting an event in which local officials unexpectedly criminalized sex work in one district in East Java, Indonesia, but not in neighboring districts. We collect data from female sex workers and their clients before and after the change. We find that criminalization increases sexually transmitted infections among female sex workers by 58 percent, measured by biological tests. This is driven by decreased condom access and use. We also find evidence that criminalization decreases earnings among women who left sex work due to criminalization, and decreases their ability to meet their children’s school expenses while increasing the likelihood that children begin working to supplement household income. While criminalization has the potential to improve population STI outcomes if the market shrinks permanently, we show that five years post-criminalization the market has rebounded and the probability of STI transmission within the general population is likely to have increased.

That is from a new NBER working paper by Lisa Cameron, Jennifer Seager, and Manisha Shah.

Monday assorted links

1. More detail on the Venus phosphine discovery.

2. Wes Pegden on herd immunity and transmission rates.

3. Ross Douthat on the Ginsburg seat (NYT).

4. “In short, academic institutions systemically promote exactly the sort of short-term optimization of which, ironically, the private sector is often accused. Is entrepreneurship a trap? No; right now, it’s one of the only ways to avoid being trapped.”  Link here.

5. Rethinking the roots of Chinese civilization we know so little about the ancient world.

6. Expanding the Measurement of Culture with a Sample of Two Billion Humans.

America, meet India

Tata group has received approval from the Drug Controller General of India (DCGI) for the commercial launch of the country’s first CRISPR (Clustered Regularly Interspaced Short Palindromic Repeats) coronavirus test ‘Feluda’, the Council of Scientific and Industrial Research (CSIR) said on Saturday. This test uses an indigenously developed, cutting-edge CRISPR technology for detection of the genomic sequence of SARS-CoV-2 virus, CSIR said in a statement.

The Tata CRISPR test achieves accuracy levels of traditional RT-PCR tests with quicker turnaround time, less expensive equipment and better ease of use.

Here is the full story, via Alex HR.

From my email, on QAnon

This is perhaps a bit whacky, but along similar-ish lines to the uniqueness theory, I have been wondering whether QAnon’s big differentiator is it’s comparative defensibility, powered by its complexity.

If you accept that social movements need their legitimacy-granting myths and “narratives” to hold up for at least as long as they are niche or otherwise unacceptable to the mainstream, and that one of the large effects of TV and the internet is to ease (and encourage) the voicing and wide dissemination of counter-narratives, then perhaps you should expect the best performing movements which do emerge to have key memes which cluster at either end of the “vague -> precise” axis.

Sitting at one of the two extremes is a great way to survive in an ideologically adversarial environment: vagueness gives converts a way to dismiss attacks out of hand (at the cost of rate of growth and cohesiveness, perhaps. Crypto might be an example), while highly detailed and well defined concepts (especially when hard to access) makes it too expensive for outsiders to build a case which will feel coherent and convincing to insiders.

QAnon is quite the cocktail, with its anonymous founder (can’t attack the credibility of an anonymous poster with no accessible history!), highly detailed yet easy to wield lore transmitted through word of mouth on semi-private Facebook groups or in person, no easy experiments which raise internal contradictions (the downfall of flatearthers), and the highly emotionally potent mix of corruption and child abuse.

Are there really any competing groups which offer anything remotely as attractive, all encompassing, and seemingly (to insiders) unassailable?

Will be interesting to see if it loses strength over time. I suspect there will be enough events which can be interpreted as confirming key points over the next 10 years for it to keep growing. Its rate of conversion is also pretty incredible, compared to previous cults/religions.

That is from Arnaud.

America fact of the day

…according to recent polls from Quinnipiac and Monmouth, 38 percent of registered Hispanic voters in 10 battleground states may be ambivalent about even voting

Progressives commonly categorize Latinos as people of color, no doubt partly because progressive Latinos see the group that way and encourage others to do so as well. Certainly, we both once took that perspective for granted. Yet in our survey, only one in four Hispanics saw the group as people of color.

Here is more from Ian Haney López and