Month: January 2021
Instead of exploding relative to a baseline of 0 cases (like in March), the new strain will be exploding relative to a baseline of around 200,000 cases per day. As a result, day-to-day random noise will completely mask any increase in infections from the new strain until it becomes dominant — around day 40 in the above chart. This means that if people use the overall numbers to guide their levels of precaution, our reaction time could lag by two or three weeks compared to March — as if we had locked down in early April instead of mid-March.
Now, this isn’t entirely a correct comparison because the rate of exponential growth will be much below 1.36; a reasonable guess might be 1.12. (You can get this by assuming R = 1.6 and assuming a generation time of 4 days.) But the overall point is the same: because any increase in the prevalence of the new strain will be masked by noise in current COVID levels, the new strain won’t be evident in overall numbers until it starts contributing hundreds of thousands of daily infections.
That is from Eric Neyman, good points thought note we will have independent measures of the spread of the new strain, with shorter lags than is currently the case.
Asian spices such as turmeric and fruits like the banana had already reached the Mediterranean more than 3000 years ago, much earlier than previously thought. A team of researchers has shown that even in the Bronze Age, long-distance trade in food was already connecting distant societies…
Working with an international team to analyze food residues in tooth tartar, the LMU archaeologist has found evidence that people in the Levant were already eating turmeric, bananas and even soy in the Bronze and Early Iron Ages. “Exotic spices, fruits and oils from Asia had thus reached the Mediterranean several centuries, in some cases even millennia, earlier than had been previously thought,” says Stockhammer. “This is the earliest direct evidence to date of turmeric, banana and soy outside of South and East Asia.” It is also direct evidence that as early as the second millennium BCE there was already a flourishing long-distance trade in exotic fruits, spices and oils, which is believed to have connected South Asia and the Levant via Mesopotamia or Egypt.
2. Eli Dourado on the future course of innovation, recommended.
4. Even in hard-hit Manaus, hospitalizations are reaching a new record high. And more (speculative) worries about the South African strain.
6. A blind date.
Anton Howes, author of the excellent Arts and Minds: How the Royal Society of Arts Changed a Nation, asked on twitter about the best movies and televisions shows about invention. Here’s the collated list.
Anton started watching Pad Man, which is on Netflix and loved it. It’s based on the true story of a man who invented a cheap way of making sanitary pads for women in India which I was familiar with, from the TED talk, but I didn’t know about the movie. It is excellent! Great story, especially strong on the costs of innovating when the inventor must overcome social ostracism and ridicule as well as the difficulties with creating the invention itself. Also some great shots of Maheshwar India.
…researchers have just declared that there was a huge, hidden outbreak in the capital of Sudan. In the absence of a good death registration system, they used a molecular and serological survey and an online one distributed on Facebook, where people reported their symptoms and whether they’d had a test. The researchers calculated that Covid-19 killed 16,000 more people than the 477 deaths confirmed by mid-November in Khartoum, which has a population roughly the size of Wisconsin’s.
Here is the full NYT article by Ruth Maclean. The main theme of the piece is that Africa may not have escaped Covid by nearly as much as we had thought.
Total vaccine doses distributed: 388,100
Total vaccine doses administered: 75,288
Here is the link (which at some point will update), that is below 20 percent.
We need to do much better than this. As a nation, Israel is doing about 10x better than the United States. You might think for some intrinsic reasons Israel could do 2x or 3x better, but 10x? It is time to get our act together.
And here is (very poor) performance for the various German Bundesländer (in German).
1. “West Coast wellness elites think kambo, an Amazonian frog poison drug, is helping them purge “toxins” from their lives.” What kind of sentence is that? (NYT)
The British approved the Pfizer vaccine, they approved the AstraZeneca vaccine, they moved to first doses first and now they are allowing (not yet encouraging they are running a trial) mix and match. Under the present circumstances, the British focus on doing what it takes to save lives is smart, admirable, and impressive.
As I wrote on Dec. 10, in Herd Immunity is Herd Immunity:
Mix and matching has two potentially good properties. First, mix and matching could make the immune system response stronger than either vaccine alone because different vaccines stimulate the immune system in different ways. Second, it could help with distribution. It’s going to be easier to scale up the AZ vaccine than the mRNA vaccines, so if we can use both widely we can get more bang for our shot.
Addendum: The CDC is projecting 80,000 COVID deaths in the United States over the next three weeks.
Maybe it is different for you, but when I search Amazon for “D.M. Knight, Science and Spirituality”, D.M. being commonly used in citations to the book, I get this mess — no listing of the book!
If I pop the same into Google, the Amazon listing for the book comes up third.
So more and more I am using Google to search on Amazon (heaven forbid that your Amazon author’s name is “Glass,” you will be offered all sorts of glassworks for sale and if you are lucky the book listing is on p.3).
But what can I use for doing a Google search? Surely not Google…Daniel Gross must know!
We are seeing our state governments doing a poor job — yes a very poor job –distributing the vaccine. You can take this as evidence for various theories of bureaucratic dysfunctionality and it is. But still at the end of the day, always ask about the cross-sectional variation!
Virginia runs prisons, schools, maintains roads, has a Medicaid program, and various state-level functions, such as hiring staff for the governor, some of those in conjunction with other levels of government. Maybe those services are not productivity marvels, but they work OK — I’ve lived here for a long time. So why the differences? Here are a few hypotheses, not all of which need be true:
1. Learning curves are steep. Most of what governments do is just terrible at the beginning, but eventually there is learning and improvement. What is different here is simply the hurry.
2. Interest groups make everything run. It is clear who benefits from state-level Medicaid programs, and those constituencies keep the programs on track. In contrast, the beneficiaries from rapid Covid vaccination are quite diffuse and are not represented by strong, exclusive organizations.
3. Too many layers of government (and society) are involved. The states are waiting for the local public health authorities, who are waiting for the counties, who are waiting for the Feds, and so on. The private sector is involved too, through CVS and the like. No one is picking up the ball and running with it. No one was told who moves first. In contrast, the lines of responsbility for running roads, schools, and the like are fairly clear.
4. The real problem is the citizenry. The lines to get these vaccines for the 1A group are not long. Government made one mistake of assuming the first round of take-up would be rapid, but the real problem is the sluggishness of the demanders. And things will be OK once we get past the 1A group and open up distribution more broadly.
5. Logistics mentality is lacking. Our state governments have specialized in Medicaid, while contracting our schools to the localities and road construction and repair to the private sector. There is perhaps not a strong enough core of logistic expertise and logistics culture in most state governments.
What else? And what are the relative weights on the truth of these hypotheses? To what extent can we use these and other hypotheses to explain cross-sectional variation across the states? Why are West Virginia and the Dakotas doing relatively well in vaccine distribution so far, when those are not typically considered the most effective state governments?
Again, always ask about the cross-sectional variation!
2. “We find that [Chinese] police stations are more likely to be located within walking distance of foreign religious sites (churches) than other sites (temples), even after controlling for the estimated population within 1km of each site and a set of key site attributes.” Link here.
Most of it was about China, but here was my favorite part:
The key to reading Proust is not to pay too much attention to the plot. It’s of no great import, and one has to get used to abrupt shifts. In this way the novel is like Moby-Dick, which can shift from the politics of dining at Ahab’s table to a loving tour of the literal interior of a sperm whale’s head. Couldn’t find the transition? No matter, that detracts not at all from the wonderfulness of the scenes. Focus instead on the humor. There are many funny things that take place in the aristocratic set pieces, such as the constant misunderstandings of M. de Charlus at the dinner of the Verdurins, or his suspicion at the violinist who professes to enjoy solving algebra equations until late into the evenings, or his interactions with the Duc de Guermantes. Really anything with Charlus portends comedy.
Interesting throughout. And:
I may not not have accomplished much in life, but I’m proud at least to have eaten thalis in Chennai, pizza in Naples, and mie goreng in Singapore.
I know that Beijing is not the world’s best food city, but it might be the best food city for me. One can grab expensive sushi at the restaurant favored by the Japanese embassy or walk a few blocks and order five plates of dumplings for $20. One can find decent dosas, lots of Thai food, and even a bagel store whose breads would be out of place on the Upper West Side but would not be in San Francisco. Best of all, every region of China is represented in this city. To deal with the various challenges of a pandemic year, I found solace in stuffing my face.
I managed to sample dishes from all the provinces this year, including the relatively obscure cuisines from places like Anhui, Guangxi, and Jiangxi. My favorites are: Shanghai, Sichuan, and Yunnan…
Here is my four-step process for ordering success in China:
- Greens are usually the glories of the cuisine: order as many vegetables as there are people
- If you will have a meat, consider the juiciness that pairs well with the starch: something saucy if you will eat with rice, or less saucy if you will have soup noodles
- Order Yunnan mushrooms if they are on the menu
- Fill out the rest with cold appetizers, they are never a bad idea
Here is the full piece.
I was going to write a long blog post on the new strain but Zeynep Tufekci has written an excellent piece for The Atlantic. I will quote from it and add a few points.
One of the big virtues of mRNA vaccines is that much like switching a bottling plant from Sprite to 7-Up we could tweak the formula and produce a new vaccine using exactly the same manufacturing plants. Moreover, Marks and Hahn at the FDA have said that the FDA would not require new clinical trials for safety and efficacy just smaller, shorter trials for immune response (similarly we don’t do new large-scale clinical trials for every iteration of the flu vaccine.) Thus, if we needed it, we could modify mRNA vaccines (not other types) for a new variant in say 8-12 weeks. As Zeynep notes, however, the vaccines are very likely to work well for the new variant. It’s nice to know, however, that we do have some flexibility.
The real worry is not that the vaccines won’t work but that we won’t get them into arms fast enough. We were already going too slow but in a race against the new more transmissible variant we are looking like tortoises.
A more transmissible variant of COVID-19 is a potential catastrophe in and of itself. If anything, given the stage in the pandemic we are at, a more transmissible variant is in some ways much more dangerous than a more severe variant. That’s because higher transmissibility subjects us to a more contagious virus spreading with exponential growth, whereas the risk from increased severity would have increased in a linear manner, affecting only those infected.
Here’s a key example from epidemiologist Adam Kucharski:
As an example, suppose current R=1.1, infection fatality risk is 0.8%, generation time is 6 days, and 10k people infected (plausible for many European cities recently). So we’d expect 10000 x 1.1^5 x 0.8% = 129 eventual new fatalities after a month of spread. What happens if fatality risk increases by 50%? By above, we’d expect 10000 x 1.1^5 x (0.8% x 1.5) = 193 new fatalities.
Now suppose transmissibility increases by 50%. By above, we’d expect 10000 x (1.1 x 1.5)^5 x 0.8% = 978 eventual new fatalities after a month of spread.
…the key message: an increase in something that grows exponentially (i.e. transmission) can have far more effect than the same proportional increase in something that just scales an outcome (i.e. severity).
I argued that the FDA should have approved the Pfizer vaccine, on a revocable basis, as soon as the data on the safety and efficacy of its vaccine were made available around Nov. 20. But the FDA scheduled it’s meeting of experts for weeks later and didn’t approve until Dec. 11, even as thousands of people were dying daily. We could have been weeks ahead of where we are today. Now the epidemiologists are telling us that weeks are critical. As Zeynep notes holding back second doses looks like a clear mistake and the balance of the evidence also suggests we should move to first doses first:
All this means that the speed of the vaccine rollout is of enormous importance.
…Meanwhile, the United States was reportedly planning to hold back half the vaccine it has in freezers as a hedge against supply-chain issues, and some states may be slowed down by murky prioritization plans. Scott Gottlieb—the former FDA chief and a current board member of Pfizer—has argued that the U.S. should also go ahead with vaccinating as many people as possible right now and trust that the supply chain will be there for the booster. Researchers in Canada—where some provinces decided to vaccinate now as much as possible without holding half in reserve, and will administer the booster with future supplies—estimate that this type of front-loading can help “avert between 34 and 42 per cent more symptomatic coronavirus infections, compared with a strategy of keeping half the shipments in reserve.” (Note that this strategy, which is different from the one the United Kingdom just announced it will adopt in prioritizing the first dose, does not even necessarily involve explicitly changing booster timing protocols in order to maximize vaccination now; it just means not waiting to get shots into arms when the vaccines are currently available.) These were already important conversations to have, but given the threat posed by this new variant, they are even more urgent.
Perhaps most critically, the FDA should approve the AstraZeneca vaccine if not as part of Operation Warp Speed then on a right to try basis. We need every weapon in the arsenal. How many times must we learn not to play with exponential matches?
Addendum: See also this excellent Miles Kimball post, How Perfectionism Has Made the Pandemic Worse.
Complete constraint concern is the same as maximization. Selective rationality usually involves less than complete constraint concern. Also, there is a tradeoff between less constraint concern and more internalized pressure that an individual feels as a consequence of less concern. Thus an individual’s personality will determine the combination of degree of constraint concern and pressure he or she would like to choose — one that he feels most comfortable with. In general the individual strikes a compromise between the way he would like to behave (very low constraint concern) and the way he feels he ought to behave, which depends on internalized standards for performance and external pressures. This implies that individuals do not necessarily or usually pursue gains to be obtained from an opportunity to a maximum degree or marshal information to an optimal degree; also, maximizing behavior is a special case in this system.
…Thus personality and context select, so to speak, the degree of rationality that will control an individual’s decision-making (and performing) behavior.
A competitive environment may not eliminate X-inefficiency for at least two reasons. First, “There may be a lack of supply of the right kind of entrepreneurs.” Second, firms may engage in rent-sheltering activities instead.
Inertia and peer groups also were central ideas in Leibenstein’s theory, and you can see both factors at work today, or sometimes not at work, in our response to various emergencies. You will note this framework may help explain why the responses of our national, state, and local governments can vary so much in quality, depending on the issue.
Leibenstein was still at Harvard when I studied there, but word was that he himself had “gone X-inefficiency” and decided to stop producing. Here are Dean and Perlman with an appreciation of Leibenstein. As for Leibenstein’s key piece on x-inefficiency: “Between 1969 and 1980, the article was the third most frequently cited in the Social Science Citation Index.” Today it is virtually forgotten.
Welcome to another year of MR!