Category: Current Affairs

Our Virginia regulatory state is failing us

As of tomorrow, hospitals in Virginia will no longer be able to administer COVID-19 vaccines. Thousands of elderly people are having their vaccine appointments canceled. From now on, all COVID-19 vaccines will go to the local health departments and none directly to hospitals.

Virginia Hospital Center had been running clinics all day every day to give people the vaccine. Appointments there for all 1st dose vaccines have been canceled because the hospital will no longer be able to get the vaccines.

Northam’s health department has also forbidden people from crossing county lines to get the vaccine. If the county next to you has an abundance of the vaccine, you can’t get it. Only residents of that county may get their vaccine.

These new rules will result in many people either having their vaccination appointment canceled or delayed for months. Currently, 7.5 million people in Virginia, Maryland, and DC qualify to get the vaccine, if only they had access to it. The new rules limit the options citizens have for getting the shot. Everyone MUST go through their local health department to be vaccinated. That means in a county such as Loudoun, with a population of over 420,000, and two health department locations to receive the vaccine, will continue to inoculate 400 to 900 people a day. There are no other options. The Loudoun health department has said they are trying to open a third location for vaccinations (possibly at Dulles Town Center) but that could take months. If Loudoun continues at its current pace it will take well over a year for the local health department to inoculate all those who want vaccines. If Loudoun hospitals were allowed to open clinics for vaccines, many more people could be inoculated every day but the Northam administration will not permit it.

Here is the link, via Hans.  In general, Virginia is a fairly well-run state, but as of late it has not been cracking the top 40 for vaccine distribution.

Is Germany still our ally?

Armin Laschet, the newly elected leader of Germany’s Christian Democrats, is coming under mounting scrutiny over statements he has made in the past defending Russian president Vladimir Putin and the Assad regime in Syria. Mr Laschet, prime minister of North Rhine-Westphalia, beat rival Friedrich Merz in a digital leadership election on Saturday. He is seen as representing continuity with Angela Merkel’s moderate policies. But in the past Mr Laschet, who has strong chances of succeeding Ms Merkel as chancellor after September’s Bundestag elections, has expressed views on Russia and Syria that put him outside the CDU mainstream and which have now come back to haunt him…

Mr Laschet in a Twitter message [had] said there was a lack of evidence to prove that Russia was behind the novichok attack on Sergei Skripal and his daughter Yulia in Salisbury in 2018.

Here is more from the FTAnd:

CDU Baden-Württemberg lists Huawei as top sponsor of this weekend’s party congress

This will be a tough one for Biden.

What was it that Stanley Fischer said?

Voters in the North would like to see a referendum on a United Ireland sometime in the next five years, while voters in the UK believe Scotland is likely to become independent within the next decade, according to a series of polls.

The Sunday Times commissioned a series of surveys across the UK gauge attitudes towards the Union.

The findings highlight some of the difficulties facing Boris Johnson and the UK government as he struggles to keep the country together following its departure from the European Union.

In Northern Ireland, 47% still want to remain in the UK, with 42% in favour of a United Ireland and a significant proportion – 11% – undecided.

However, asked if they supported a referendum on a United Ireland within the next five years, 51% said yes compared to 44% who were against.

In Scotland, the poll found 49% backed independence compared to 44% against – a margin of 52% to 48% if the undecideds are excluded.

The Irish result seems to be a more rapid shift than the Scottish one.  Here is the full article.

How Slowly ‘First Doses First’ Came to America

Yesterday I pointed out How Rapidly ‘First Doses First’ Came to Britain. The United States is also moving in that direction but more slowly. First we ended holding second doses in reserves. Now the CDC has new policies:

CNBC: The Centers for Disease Control and Prevention quietly changed its guidance on Covid-19 vaccine shots, saying it’s now OK to mix Pfizer’s and Moderna’s shots in “exceptional situations” and that it’s also fine to wait up to six weeks to get the second shot of either company’s two-dose immunization.

We will see what happens if new variants start to takeoff in the US, as seems likely, and as the number of people immunized starts to slow as we move from first does to having to vaccinate people for the second dose. More second doses means fewer resources for first timers. Biden’s 100 million in 100 days, for example, was already under-ambitious but it’s not even 100 million people it’s 100 million doses or only about 67 million people given that some will be in line twice.

It is a marathon, not a sprint

For all of its achievements, we still do not know if New Zealand will have ended up doing a good job against Covid-19:

New Zealand’s “go hard, go early” strategy to combat Covid-19 attracted global praise and eliminated local transmission of the virus. But the country’s slow rollout of vaccines is putting people at unnecessary risk and threatens to delay its economic recovery, critics warned.

Wellington plans to start vaccinating frontline workers in April and the general public from July under a cautious strategy that avoids the emergency authorisation of vaccines pursued by crisis-stricken nations such as the US and UK.

And note this:

There are at least 19 cases of the coronavirus variants first identified in the UK or South Africa in managed quarantine facilities in New Zealand for overseas arrivals, according to government data.

And this:

Mr Hipkins said there was “absolutely no complacency” in the government’s response.

Here is the full FT story.

We Will Get to Herd Immunity in 2021…One Way or Another

By July it will all be over. The only question is how many people have to die between now and then?

Youyang Gu, whose projections have been among the most accurate, projects that the United States will have reached herd immunity by July, with about half of the immunity coming from vaccinations and half from infections. Long before we reach herd immunity, however, the infection and death rates will fall. Gu is projecting that by March infections will be half what they are now and by May about one-tenth the current rate. The drop will catch people by surprise just like the increase. We are not good at exponentials. The economy will boom in Q2 as infections decline.

If that sounds good bear in mind that 400,000 people are dead already and the CDC expects another 100,000 dead by February. We have a very limited window in the United States to make a big push on vaccines and we are failing. We are failing phenomenally badly.

To understand how bad we are failing compare with flu vaccinations. Every year the US gives out about 150 million flu vaccinations within the space of about 3 months or 1.6 million shots a day. Thus, we vaccinate for flu at more than twice the speed we are vaccinating for COVID! Yes, COVID vaccination has its own difficulties but this is an emergency with tens of thousands of lives at stake.

I would love it if we mobilized serious resources and vaccinated at Israel’s rate–30% of the population in a month. But if we simply vaccinated for COVID at the same rate as we do for flu we would save thousands of lives and hundreds of billions of dollars in GDP. The comparison with flu vaccinations also reminds us that we don’t necessarily need the National Guard or mass clinics in stadiums. Use the HMOs and the pharmacies!

And let’s make it easier for the pharmacies. It’s beyond ridiculous that we are allowing counties to set their own guidelines for who should be vaccinated first. We need one, or at most 50, set of guidelines and lets not worry so much at people jumping the queue. (The ones jumping the queue are probably the ones who want to get back to the bars and social life the most so vaccinating them first has some side benefits.)

Of course, the faster we vaccinate the more vaccine quantities will become the binding constraint which is why we also need to approve more vaccines, move to First Doses First (delay second doses like the British), and use Moderna half-doses. Fire on all cylinders!

Time is of the essence.

Hat tip: Kevin Bryan and Witold Wiecek.

U.S.A. fact of the day

The U.S. also experienced its most violent year in decades with an unprecedented rise in homicides. The Gun Violence Archive reported that more than 19,000 people died in shootings or firearm-related incidents in 2020, the highest figure in over two decades.

New Orleans-based crime analyst Jeff Asher took a closer look at the number of murders in 57 major American cities and he found that the number of offenses grew in 51 of them. He only focused on agencies where data was available and most of them had figures through November or December of 2020. Growth in violent crime varied by city with Seattle seeing a 74 percent spike in homicides between 2019 and 2020 while Chicago and Boston saw their offenses grow 55.5 percent and 54 percent, respectively. Elsewhere, Washington D.C. and Las Vegas saw growth in their murder offences, albeit at a slower pace of less than 20 percent.

New York’s homicide count went up by nearly 40 percent with Mayor Bill de Blasio stating that the figures should worry all New Yorkers and it has to stop.

Here is the full link.  Via Noah.

Let us not again forget knowledge of exponentials

New variants may change everything. They’ll be 1% of all cases by end of next week, with hot spots in Florida and Southern California. But doubling every week, they’ll be about 30% of all cases in 5 or 6 weeks. It’ll be harder to hide from them, schools will be more vulnerable.

That is from Scott Gottlieb.  And much of what you thought you knew about this pandemic may soon be obsolete.

Praise the British

Britain has fully vaccinated more people against #COVID19 than every other nation on earth combined.

Link and picture here.  That is as of January 13, at least.  You may recall my previous and much-attacked July Bloomberg column suggesting that along a number of dimensions the UK pandemic response actually was quite good.

Addendum: Numerical correction from Alex on America, though you still can praise the British.

Our aggregate demand shortfall?

From Ben Casselman: “…unlike with most measures of the economy, retail sales are actually ABOVE their prepandemic level. Up 2.6% from February, and 2.9% over the past year. So not a clean story like with jobs.”

And from Larry Summers: ” Total household income is 8% above what anybody thought it would be before Covid.”

There are very real macroeconomic problems right now, but please keep the following in mind while drawing up a “demand-based” stimulus plan.  Focus on public health!

Vaccines Are Not Like Emergency Rations!

According to the Guardian the First Minister of Wales explained their policy of doling out the Pfizer vaccine evenly over the next six weeks:

the Pfizer vaccine has to last us until into the first week of February.

…We won’t get another delivery of the Pfizer vaccine until the very end of January or maybe the beginning of February, so that 250,000 doses has got to last us six weeks.

That’s why you haven’t seen it all used in week one, because we’ve got to space it out over the weeks that it’s got to cover.

Bonkers! A vaccine isn’t like a limited supply of water that needs to be rationed until you arrive at the next oasis. The sooner you get the vaccine out the better! Start lowering R now! If you run out of vaccine, well scarcity is bad but running out means that at least one part of your system is working well! It’s a bad idea to kill people to make it look like you are following some sort of numerically neat plan.

One year into the pandemic and people still don’t understand vaccines or viral growth.

Hat tip: Arthur Baker.

Insurrections are contagious

That is the topic of my current Bloomberg column, here is one bit:

Put aside U.S. politics for a moment and view the events of the last week from a global perspective. Without backing from the military, a crowd entered the Capitol building and disabled the U.S. Congress, and almost succeeded in achieving more violent goals yet.

The question is not what people should infer, or what most people will think. It’s what the people at the extremes will think and do. Even if many foreign citizens conclude that the events of last week were not a big deal, the most determined and rebellious observers might give them a different and more radical gloss. (Besides which, it actually was a big deal.) As the

Now imagine you live in Hungary, Uganda, Myanmar or any country that is experiencing political turmoil. If you had a violent plan against your own government, do you now rate your chances of success as lower or higher? Organizing a storming mob may have just become more appealing, especially since your adversary is almost certainly less formidable than the U.S. government.

And what if you express your surprise over recent events?:

Yet this very surprise, while justified, may itself induce a dangerous contagion effect. The surprise carries an implicit message: “It may not seem like you have many allies, but in fact you do, including in some powerful places.” So you can imagine how a supporter of say QAnon might come to believe that there are secret allies everywhere. And those beliefs may in turn encourage political violence.

And this:

One implication is that the media needs to be very careful about how they portray the perpetrators of the Jan. 6 events. Most media organizations have been publicizing the identities and deeds of these criminals, as they should. A lot of Americans need to be shocked out of their complacency about what happened, or at least nudged out of various theories of false equivalence. The more information becomes public, the more it becomes clear that at least part of the Capitol-storming group was conspiring and intent on violence and mayhem — and for very bad political ends: in essence, the destruction of American democracy.

Yet there is such a thing as too much information. In other contexts, the news media withhold the names, images and causes of many terrorists and criminals. To the extent those individuals are doing it for recognition, denying them that recognition may discourage future wrongdoers.

There are further arguments at the link.

The Magical Extra Doses and Supply Chain Optimization

1-ml syringe design yields 2 micro literes and standard syringe and needle hub yield 84 micro liters on average.
Image from Wikipedia, Low dead space syringe.

As pharmacists began vaccinations using the Pfizer vaccine some of them discovered that it was possible to extract a 6th or even 7th dose from a standard 5-dose vial. Where were the extra doses coming from? The fortuitous discovery was not due to over-filling. The vials contained just 5 doses when using standard syringes. But some of the vaccine distribution sites had access to low dead-volume syringes, syringes that leave less vaccine trapped between the plunger and needle — the “dead volume” — after a shot is given. Thus, less vaccine was wasted in the syringe and more available for putting into arms using the low dead-volume syringes.

This is quite remarkable. Increasing vaccine supply by 20% by building more factories could cost billions. We should do that, it would be worth it. But in this case, we managed to increase supply by at least 20% use a relatively inexpensive redesign of the syringe. What this indicates is the importance of thinking along the entire supply chain for opportunities for optimization.

The catch? Not all syringes provided by Operation Warp Speed and Pfizer are low dead-volume syringes so not every vaccine distribution site is getting the extra doses. We do need to invest more in the syringe supply chain.

The volatility of events is correlated (and not always in a good way)

That is the topic of my latest Bloomberg column, here is one excerpt:

Consider bad economic news, which is relatively unambiguous. With stock market returns, volatility is correlated over time, and it is higher in bear markets. To some extent the bad mood is contagious, and the bad events behind the volatility may be interlinked as well.

To be clear, the stock market has done fine lately. The latest bad news is about politics and public health, not corporate earnings. Still, the stock market is readily measurable and can offer clues about how broader social processes are connected over time — and one obvious conclusion is that volatility tends to feed upon itself, not usually in positive ways.

And:

Another problem is what my colleague Bryan Caplan has labeled “the idea trap.” Social science research indicates that in troubled times people are more likely to turn to bad ideas. The distressed German economy of the 1920s and early 1930s, for example, helped to breed support for the Nazis.

More recently, the global economy has been very much a mixed bag since the financial crisis of 2008. So people might begin to embrace worse ideas, which in turn will breed subsequent volatility. Such a cycle can worsen over time, and a ragged recovery from the Covid-19 deep recession could exacerbate this dynamic. It simply isn’t good for decision-making if everyone is feeling frazzled and stressed.

Recommended.