Category: Current Affairs

Vaccine access toolkit

In order to break down the information barrier, I partnered with my local faith community to set up a vaccine outreach program. We have a dedicated vaccine information email address and a website consolidating information about vaccine eligibility, sites, and benefits. We call community members who don’t have email, offer personal assistance making appointments and connecting to ride services, and provide information about best practices for riding safely in a car with masks and open windows. After vaccine appointments, we check in to see how they are feeling, make sure their second dose is scheduled, and offer to drop off comfort foods. One recipient replied, “It makes this daunting time just a little easier knowing there is someone out there to guide one through this process. My technology skills are minimal!”

By Margaret Scharle, for Oregon.  We need much more of this.

Osterholm on First Doses First

Here from a podcast is Michael Osterholm, Regents Professor, McKnight Presidential Endowed Chair in Public Health, the director of the Center for Infectious Disease Research and Policy (CIDRAP) and state epidemiologist for the Minnesota Department of Health.

…Imagine you are setting across the table from two people both of whom are 65 or older, both with underlying health conditions. You have two doses of vaccine, one in each hand. And you say to them I can give two doses to you or to you but then the other person gets nothing. Or I can give one dose to both of you. And this is what I know. At the very least, one dose is likely to prevent serious illness, hospitalization and death. Two doses will probably even prevent clinical disease with B.1.1.7. But the other one of you; if you get infected with this virus, which I think substantial numbers of Americans will, things are not looking good for you. What do you want me to do?

If that is your Mom or Dad. Your Grandpa or Grandma. What would you do?

This is where the rubber meets the road. I think if the data bears it out we can save so many lives in the upcoming weeks and we are missing that opportunity.

I have already made my choice. I am postponing my second dose. I want my second dose. But I am confident that I can wait. And I can only hope that my second dose, which I have just deferred, will go to someone who it will save their life. It will make a totally different world for that family.

You know some could argue that this could be the end of my career. But I could not sleep with myself at night if I didn’t do this. I just know in my heart of hearts that this is something we must do if we are going to save lives.

The entire podcast is worthwhile, this is from around minute 44:30 (my imperfect transcription).

Hat tip: Anon.

Addendum: Many other countries should be looking very closely at dose-stretching policies.

In other news, South Korea approves the AstraZeneca vaccine. It’s not like we have anything to learn from South Korea about managing a pandemic, right? Right?

How much do we value Covid safety?

The grand experiment of blocking the middle seat on airplanes has proved what we have known all along about air travel: More people care about a cheap fare than comfort, or even pandemic safety.

Delta announced on Monday that it was extending its middle-seat block for one more month, to the end of April. Delta, the last U.S. airline to block all middle seats in coach, will consider further extensions based on Covid-19 transmission and vaccination rates.

So far, Delta thinks it’s earning goodwill and confidence with customers, particularly business travelers, who aren’t traveling now but will come back. Some who’ve flown during the pandemic have been willing to pay Delta more for more space onboard. Most have been price-sensitive leisure travelers willing to sit shoulder-to-shoulder for cheap fares—on airlines not blocking middle seats…

The bottom line for Delta during the pandemic has been bigger losses than rival airlines selling all their seats. Delta was the most profitable U.S. airline in the final six months of 2019. That flipped during the pandemic. In the last six months of 2020, Delta had the biggest losses, with a net loss of more than $6 billion, greater than United and Southwest combined.

Mr. Lentsch says Delta can’t keep blocking middle seats forever.

Here is more from the WSJ.  I do get there is an externality here, so people are not paying enough for those more spacious Delta seats, as they do not take their higher risk to others into sufficient account.  Still, a lot of the risk here is private, and I feel the public health community in the United States has not been willing to look such data in the face squarely enough.  Is the public policy problem about minimizing “lives lost,” or maximizing “welfare,” or giving people “what they want”?  Or some combination of those?  Who exactly has been good at thinking through those trade-offs?

Have the pandemic population flows been into the relatively strict Vermont and California, or to the relatively open Florida and Texas?

To what extent is the real externality a kind of degradation of the public sphere, and the spread of stress and mental health problems, rather than the health of others per se?

Worth a ponder.

Sentences to ponder

Nearly 60 percent of the people facing charges related to the Capitol riot showed signs of prior money troubles, including bankruptcies, notices of eviction or foreclosure, bad debts, or unpaid taxes over the past two decades, according to a Washington Post analysis of public records for 125 defendants with sufficient information to detail their financial histories.

The group’s bankruptcy rate — 18 percent — was nearly twice as high as that of the American public, The Post found. A quarter of them had been sued for money owed to a creditor. And 1 in 5 of them faced losing their home at one point, according to court filings.

Here is more from The Washington Post.  You will notice that the very poorest people don’t have a lot of those problems.

Canada Needs a New Vaccination Strategy

The US vaccination rollout has been deadly slow, inefficient, and chaotic. It has also been one of the best in the world. Canada, for example, is far behind the US on vaccination.

The Canadian deficit is mostly because they don’t have enough vaccine. Canada bought doses but they didn’t invest in capacity and a deal with China fell through. As a result, Canada won’t be getting lots of vaccine until March or April. Operation Warp Speed invested billions in the Modern vaccine and in early purchases of the Pfizer vaccine and thus got first dibs. The Americans are also not allowing vaccine to be exported to Canada. (We could at least give them access to our AstraZeneca factory!).

Regardless of blame, this puts Canada in a precarious situation. Death rates aren’t as high as in the United States but with new variants exploding, Canada is running a big risk. To get Canadians vaccinated more quickly–including my mother–Canada needs to find ways to stretch their vaccine supply–that means First Doses First, half dosing, intradermal delivery and other dose stretching strategies should be considered.

Many other countries are in a much more worse position than either the United States or Canada.

The Rot is Deep

It’s not just the FDA, or the CDC, or Trump. The rot is deep.

Defense News: Imagine that, for years, the U.S. intelligence community warns about a specific national security threat that could come to pass. One day, it finally does. International observers sound the alarm. The press picks up the scent. Within two weeks, the threat breaches U.S. defenses, and two weeks after that, Americans begin to die. But it takes six months for the U.S. Army to agree to fill the capability gap with a counter-weapon of its own design, and more than a year after the first American casualties, the Army rolls it out.

This, in fact, just happened. It’s the timeline of the Army’s response to the COVID-19 pandemic, an unambiguous threat to life and livelihoods.

It took a full year for the service to design, approve and distribute a face mask — called a Combat Cloth Face Covering, or CCFC — for its soldiers, an effort that required an additional $43.5 million in contracts to provide temporary solutions. That comes out to about $45 per mask, if you assume every active-duty, National Guard and Reserve soldier received one. A pack of 20 N95 masks at Home Depot costs about $20.

And yet, the Army congratulated itself on the “expedited” timeline, compared to the 18- to 24-month procurement cycle such an effort would normally take.

“The system worked as designed,” tweeted a former Marine.

And that is precisely the problem.

One Shot if You Have Been Infected

Here’s noted microbiologist Florian Krammer:

This is now the third paper to find a very very good immune response after one shot of mRNA vaccine in people who had a previous SARS-CoV-2 infection. Time to discuss policy changes, @DrNancyM_CDC@CDCDirector

Paper here.

In other words, as I wrote earlier, “for the 25 million to 100 million Americans who have already been infected by COVID it may be better for them personally to delay the second dose….[thus] a significant fraction of second doses have little to no value.”

It’s good that people like Krammer are signaling that it’s time for policy change. Still, I am frustrated. None of this is unexpected or surprising. It’s just that some people (n.b. I am not referring to Krammer in particular) do not have the training or the mindset to make cost-benefit decisions under uncertainty. That’s ok in ordinary times but during a war, pandemic or takeover fight it’s deadly.

Investment, investment, investment — how to think about the Biden stimulus proposal

Here is my Bloomberg column on the stimulus, excerpt for those who are arguing for aid rather than stimulus:

Leave aside the political question of how aggressively to pursue an agenda of a larger, more activist government (and keep in mind that I am more libertarian than many of the participants in this debate). Take a Big Government as a given. History shows that consumption still ought not be the priority.

First, wise public-sector investments are better for the poor than one-time wealth transfers. The U.S. is still reaping the benefits of the great public-health and public-works achievements of the 20th century. Second, the most enduring and beneficial government-transfer programs, such as Social Security, have been built on sustainable majorities.

Progressive societies are fundamentally based on a valorization of investment — in physical structures, in software, in sustainable policies. This argues against a “Let’s grab this policy win while we can” attitude, no matter how popular that stance may currently be on social media. It’s foolish to think that no other policy combination is politically feasible, and if the president’s advisers and supporters really believe that, they are in for a long and unsatisfying four years.

It’s not as if there aren’t obvious candidates for alternative investment: green energy, broadband and public-health infrastructure for the next pandemic, to name a few. Yes, I am familiar with the argument that spending the extra trillion or so now will make it possible to spend more trillions later, including on such policies. But whatever kind of complicated political story you might tell, the basic laws of economics have not been repealed. Increasing current expenditures does, in fact, involve foregone future opportunities.

Another possible direction would be to rework Senator Mitt Romney’s proposed child support plan and turn it into an enduring policy. It is an expensive idea, but at least it would represent a greater investment in America’s future than mere one-off cash transfers.

The defenders of the president’s plan argue that inflation and an overheated economy are not major risks. Maybe so, maybe not — but that is not the crucial issue. Instead, ask yourself this question: Does this program, or this rhetoric, recognize the paramount importance of investment, whether public or private? If not, you needn’t look much further.

I say you can divide the commenters here into two groups.  Those who produce complicated arguments about why opportunity cost reasoning does not apply here, and those who stress the relevance of the opportunity cost of allocating another trillion dollars or two.  I believe that once you recognize that distinction, you know what to do with it next.

From the comments, on the stimulus

The people were grumpy yesterday!

I’m pretty sure that the “stimulus” package isn’t really about stimulus. I think it’s more to do with trying to compensate or mollify a citizenry that is rightly angry about the incompetent pandemic response. The government can’t come out and openly say “hey we screwed up so here’s $2,000”, so they call it stimulus instead.

I also think the Democrats are keen to refight the global financial crisis of 2008. It’s embarrassing to them that Trump was able to inject such massive stimulus into the economy.

Economists are quite right to object to all this as being way too much, way too late. But, well, here we are. Maybe we’ll see inflation after all.

That is from Brad F., and from B.B.:

Let’s bring James Buchanan into this.

Politicians have figured how to get away with handing out checks to get votes. It has nothing to do with stimulus. Biden would have done it without a pandemic if he could get away with it. But he couldn’t, so he used the pandemic. Never let a crisis go to waste.

He added the largest percent rise in the minimum wage in history to the “stimulus.” Is that going to boost employment? Of course not. Economists express frustration that politicians don’t under economics. They do, they don’t care.

Unions don’t want competition from lower-wage workers. So they want both minimum wage hikes and protectionism along with legislation to promote unionization. The unions understand their self-interest. Biden understands his self-interest; he gets union support.

Economists are supposed to understand self-interest. Why won’t we apply it to politicians?

And from Moral Panic:

I think he’s partly complaining that one can argue Biden’s proposal is way, way off, and yet we can barely discuss it. And the autopilot is not because there are minor differences, so come on, let’s get on with it. No, the alleged bill of goods has major issues.

I appreciate what Summers and a few others are saying. This seems similar to Obamacare’s passage. No debate allowed, and we’ll figure out what it means eventually. I find the straight-up endorsement by elite media especially disappointing, with the only notable dissent in true progressive form being about not giving stimulus $ to affluent people.

To be clear, no one is arguing for doing nothing, or questioning the value of automatic stabilizers.  Most of all, it is to the credit of Summers that we are debating this at all.

Stimulus sentences to ponder

Estimates by Harvard economics professor Raj Chetty and his colleagues suggest that consumer spending by low-income consumers is up more than 13 percent from January 2020 to January 2021, before any new stimulus. Researchers working with data from the JPMorgan Chase Institute find household cash balances have risen across the income distribution during the pandemic. At the proposed level of unemployment benefits, more than half of laid-off workers will see their incomes rise. Proposed expenditure levels for school support exceed $2,000 per student.

That is from Lawrence H. Summers, answering further questions about his stimulus stance.  Do read the whole thing.  Again people, you are being sold a bill of goods on this one…

Larry Summers, Right Again

No surprise but in can case you were wondering, retail investors trade mostly on noise. A little bit more surprising is that the effect is to make markets less liquid since some models suggest that noise traders make markets more liquid and accurate by bringing in the sharks.

Contrasting with recent evidence that retail traders are informed, we find that Robinhood ownership changes are unrelated with future returns, suggesting that zero-commission investors behave as noise traders. We exploit Robinhood platform outages to identify the causal effects of commission-free traders on financial markets. Exogenous negative shocks to Robinhood participation are associated with increased market liquidity and lower return volatility among stocks favored by Robinhood investors, as proxied by WallStreetBets mentions. Platform outages are also associated with reduced high frequency trader (HFT) activity, indicative of payments for order flow. However, outages have the strongest effect on stocks neglected by HFTs, suggesting that zerocommission traders have direct negative effects on market quality.

Here is the paper by Eaton, Green, Roseman and Wu.

Will tech companies be allowed to secede from Nevada?

I don’t pretend to know what this really means, but here is the report:

Planned legislation to establish new business areas in Nevada would allow technology companies to effectively form separate local governments.

Democratic Gov. Steve Sisolak announced a plan to launch so-called Innovation Zones in Nevada to jumpstart the state’s economy by attracting technology firms, Las Vegas Review-Journal reported Wednesday.

The zones would permit companies with large areas of land to form governments carrying the same authority as counties, including the ability to impose taxes, form school districts and courts and provide government services.

The measure to further economic development with the “alternative form of local government” has not yet been introduced in the Legislature.

Sisolak pitched the concept in his State of the State address delivered Jan. 19. The plan would bring in new businesses at the forefront of “groundbreaking technologies” without the use of tax abatements or other publicly funded incentive packages that previously helped Nevada attract companies like Tesla Inc.

Sisolak named Blockchains, LLC as a company that had committed to developing a “smart city” in an area east of Reno after the legislation has passed…

The Governor’s Office of Economic Development would oversee applications for the zones, which would be limited to companies working in specific business areas including blockchain, autonomous technology, the Internet of Things, robotics, artificial intelligence, wireless, biometrics and renewable resource technology.

Zone requirements would include applicants owning at least 78 square miles (202 square kilometers) of undeveloped, uninhabited land within a single county but separate from any city, town or tax increment area. Companies would have at least $250 million and plans to invest an additional $1 billion in their zones over 10 years.

The zones would initially operate with the oversight of their location counties, but would eventually take over county duties and become independent governmental bodies.

The zones would have three-member supervisor boards with the same powers as county commissioners. The businesses would maintain significant control over board membership.

Here is the full article.  I will keep you posted if anything comes of this.  Addendum: Here is a legislative analysis of the bill, at some point these zones simply become counties?  The underlying reality still is not clear to me.

And here is a different article: Joe Lonsdale Wants to Build a new Tech City Near Austin and a Tunnel Transportation System to Develop an Even Bigger Tech Hub.

How to Double the Number of Moderna and Pfizer Factories

Theory and data both suggest that a much smaller dose–perhaps as low as 1/4 the current dose—of both the Moderna and Pfizer vaccines are as effective as a larger dose. Half doses of Moderna and Pfizer would be equivalent to instantly doubling the number of Moderna and Pfizer factories and would save hundreds of thousands of lives and be worth hundreds of billions of dollars in world GDP. Clinical data from adults 18-55 from the Moderna Phase II trial already suggest that quarter-doses are effective, which is why Operation Warp Speed chief, Moncef Slaoui has advocated for half-doses (leaving plenty of margin).

“We know that, for the Moderna vaccine, giving half of the dose to people between the ages of 18 and 55, two doses [at] half the dose … we know it induces identical immune response” to the currently authorized dose, Slaoui added.

Another way of putting this is that new clinical trials on dosing would be tremendously valuable. Ideally, we could use correlates of protection and do a bridging trial to infer the effectiveness of half-doses. The FDA has already said they will accept a bridging trial for new mRNA vaccines for variants, which is the right decision. The FDA should also accept a bridging trial for new dosing.

If new clinical trials are deemed necessary, dosing trials could be run as challenge trials but instead of comparing half-doses to placebo we would compare full-doses to half-doses. Thus, everyone in the challenge trial would be vaccinated, massively lowering risks. If we can’t do challenge trials even with vaccinated volunteers (!) then let’s get started on clinical trials. The NIH created the ACTIV program to speed clinical trials. Use it.

New clinical trials are valuable not just for dosing but also for approving new vaccines. Equivalence trials on the Sputnik and Sinopharm vaccines, for example, could be very valuable. In other words, we would trial Sputnik and Sinopharm against Pfizer and Moderna. A lot of people would be quite willing to join a trial in which the worst outcome is most likely getting a somewhat less effective vaccine–that’s much better than no vaccine!

The value of experiments, or let’s call them pilot studies, right now is immense. We can do pilot studies on half dosing for Moderna and Pfizer vaccines much faster and cheaper than we can build twice as many factories. So let’s do it!

Why don’t Americans take the law seriously any more?

Why do so many Americans today have such an unusual relationship with the law? Has the relative isolation of the pandemic made people more susceptible to crowd enthusiasms, and thus less respectful of authority? Or is it that their daily interactions with the internet are so frequent and intense that their emotions are governed by some new set of principles, and the law feels like a distant memory? Might some recent leaders have been setting bad examples when it comes to respecting the law?

2020 was also a year in which the U.S. murder rate rose significantly — by more than 50% in many cities — and reckless driving was much more common.

If the U.S. is ever going to get back to normal, we need to understand this problem. It’s not just about breaking the law. It’s that so many Americans don’t even seem to notice that the law applies to them, too.

Yes the column has riffs on various recent episodes of brazen, poorly thought out law-breaking — did you have to put that Capitol selfie on-line?  That was then, this is now:

During the era of civil disobedience, Americans marched for civil rights or to protest the Vietnam War. Sometimes they broke the law deliberately, but there was a finely honed sense of the various lines. If your goal was to be arrested, you knew how to achieve it without being locked away for years. There were guides for how to behave and get arrested, and many arrests were orchestrated.

Martin Luther King Jr. was not shocked when he ended up in Birmingham jail, where he composed his famous letter. Getting arrested was a sign of status with other members of the movement, and multiple arrests meant that you understood the lines well enough to be spending most of your time out in the world, ready to get arrested yet again.

So what happened?

The anti-science presidency?

…recent Congressional Budget Office estimates suggest that with the already enacted $900 billion package — but without any new stimulus — the gap between actual and potential output will decline from about $50 billion a month at the beginning of the year to $20 billion a month at its end. The proposed stimulus will total in the neighborhood of $150 billion a month, even before consideration of any follow-on measures. That is at least three times the size of the output shortfall.

In other words, whereas the Obama stimulus was about half as large as the output shortfall, the proposed Biden stimulus is three times as large as the projected shortfall…

Looking at incremental deficits relative to GDP gaps is only one way of assessing the scale of a fiscal program. Another is to look at family income losses and compare them to benefit increases and tax credits. Wage and salary incomes are now running about $30 billion a month below pre-covid-19 forecasts, and this gap will likely decline during 2021. Yet increased benefit payments and tax credits in 2021 with proposed stimulus measures would total about $150 billion — a ratio of 5 to 1. The ratio is likely even greater for low-income individuals and families, given the targeting of stimulus measures…

If the stimulus proposal is enacted, Congress will have committed 15 percent of GDP with essentially no increase in public investment to address these challenges. After resolving the coronavirus crisis, how will political and economic space be found for the public investments that should be the nation’s highest priority?

Here is more from L. Summers.  And just wondering — what is it you all think the multiplier is these days?  Asking for a friend.