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Sunday assorted links
1. Barry Lopez has passed away. Arctic Dreams is one good book by him.
2. Higher ed is issuing a lot more debt (WSJ).
3. Is Covid-19 getting much worse in Africa now? (NYT)
4. A new Google?, or at least how to top the old one.
5. Ted Gioia’s favorite albums of the year list, always interesting for the number and variety of sonic worlds under consideration.
Vaccinate, 24/7
On Christmas I tweeted:
Operation Warp Speed makes me think that America isn’t finished. We have now vaccinated more people than any other country in the world.
I hope Biden awards Slaoui, Perna, Marks and Bourla the Presidential Medal of Freedom.
and a bit later “Today we celebrate. Tomorrow back to demanding more, faster.” Well, it’s tomorrow and we do need to do more, faster. Israel, for example, is doing better than the United States on vaccinations per capita and they are rolling out 24/7 vaccination clinics.
Health Minister Yuli Edelstein called Thursday to keep the vaccine operation going 24 hours a day, 7 days a week, including on Shabbat.
Regarding the push to carry out vaccinations on Shabbat, Edelstein, who is Orthodox, cited the Jewish legal principle of saving a life, or “pikuah nefesh,” which trumps nearly all other religious requirements.
According to a Channel 12 report Saturday, Clalit, Israel’s largest health maintenance organization, will open 24/7 vaccination centers in Tel Aviv, Haifa and Herzliya in the coming days to help ramp up the pace of the vaccine drive. Additional centers are expected to be opened at a later date.
Israeli hospitals are also to join the vaccination effort next week, and hundreds of IDF medics will also participate, to help expedite the process.
Also, if Britain approves the AZ vaccine this week, as I think they will, it should be immediately approved in the United States, if not as part of Operation Warp Speed then on a right to try basis until fully FDA approved.
How to improve and speed up vaccine allocation, from my email
One issue I haven’t seen discussed is slow throughput of the Vaccine administration, due to a combination of inefficient binning/allocation of distributed vaccines, hesitation to take the vaccine, lack of a central database of available appointments for vaccination, and those time slots potentially going empty if a front line worker misses their appointment, and when there’s no standby/waitlist for people to receive it.
These seems like a use case for a priority queue/heap, which would allow high priority folks to join the queue late but be bumped up to their appropriate priority if they wanted the vaccine, while also allowing those who want the vaccine but are not currently prioritized to get it if there are unallocated supplies.
If prioritization is done (cdc guidelines or not) by restricting who can get it during a particular time period, then it’s guaranteed that throughout won’t be maximized, as all appointment slots won’t be necessarily filled (given the hesitance I’ve heard from people across different levels of education and socioeconomic status) by the allowed demographics at each office where vaccines are available. Meanwhile, there will be those who would gladly take it in an instant who aren’t allowed.
I worry that slow throughput and bad prioritization vaccine administration will keep hospitals indefinitely full, hemorrhaging money, and will thus require a bailout, which I expect will come with medicare4all-style strings attached.
That is from Abhi C., a loyal MR reader.
What should I ask John Cochrane?
I will be doing a Conversation with him. Just in case you don’t know him, here is basic information about his work. So what should I ask?
Saturday assorted links
That was then, this is now — Pakistan edition
Ayub Khan ended the political turmoil to become the country’s first military ruler in 1958. He revived the economy, carried out agrarian reforms, provided stimulus to the industry and encouraged foreign investment. State-backed capitalism and alliance with the US powered a ‘golden age’ of high growth rates under Ayub Khan’s reign. The growth was significant enough for the international media to take a note of it. In January of 1965, New York Times went on to predict that Pakistan might be on its way towards an economic milestone reached ‘by only one other populous country, the United States’. A year later, The Times, London, called Pakistan’s survival and development ‘one of the most remarkable examples of state and nation-building in the post-war period’. Pakistan was ‘considered to be one of the few countries at the time that would achieve developed-country status’.
That is from Sameer Arshad Khatlani’s recent and really quite good The Other Side of the Divide: A Journey into the Heart of Pakistan.
Neil Tambe on Courage Studies (from my email)
Most importantly, happy holidays to you and your family. Thank you (and Alex) for another year of MR and CWT.
I wanted to suggest that you involve the theme of courage into your various projects. For the purpose of this message, my working definition of courage is the capability to do the right or needed thing, even though one knows it will be difficult.
Several recent posts in MR have a question of courage at their foundation. For example, reasonable people could agree that accelerating vaccine approvals by eliminating conventional but unnecessary bureaucracy, crossing the fault lines of polarized political issues, taking a risk to start a business, implementing provocative new ideas for democracy and liberalism, or launching a project within a corporation that improves productivity might all be “right” to do.
And yet they don’t happen. Why?
To be sure, there are many explanations. That said, I’ve spent my career operating in large organizations and I’ve come to observe a common thread – courage.
Teams and individuals often have motivation, skill, and even the power to do the “hard but important stuff” like the ones I’ve listed. But we pass. We aren’t willing to go out on a limb. We follow conventional courses of action even though they don’t live up to our ideals. If we only had the courage to act.
Again, there are many other reasons why hard stuff doesn’t get done. Courage, in my observation, is a fundamental one but not an idea that is well understood.
Much like you’ve suggested “Progress Studies” as a discipline in its own right, I’d suggest “Courage Studies” (the study of what courage is and how to cultivate it) as a relevant sub-discipline within the domain of Progress.
I’m particularly interested in this area, and doing my own writing here, so I acknowledge that this point of view is biased by my own interests. I won’t be shy about submitting my work to Emergent Ventures once a manuscript is transcribed from my handwritten notebook!
In the meantime, I’m happy to share more detailed ideas on “Courage Studies” if they’d be helpful to you or your team.
Vaccine incentives matter (from my email)
I am a physician in private practice in [redacted]. We have just been approved to order and administer the vaccine to tier-appropriate patients. Medicare has approved a payment of 18$ for the first shot and 28$ for the second. As far as we can determine we will not be allowed to bill for an office visit so that is the entire amount we will receive for registering the patients, screening then for covid outside of the office, taking their vital signs, taking a history to see if there are any contraindications to the vaccine, administering the vaccine, observing them in the clinic for a minimum of 15 minutes up to 30 minutes depending on their history, and recalling them in 28 days and going through most of the same procedure again, minus the registration and history. There is also an extensive regime of recording and reporting all vaccination data daily to the state government. We had anticipated hiring someone to manage this new service due to the amount of new work that is required. At this rate we might be able to give 10 shots an hour in each of our 3 clinics if we see no other patients for illness, injury, or covid testing.
Do I need to say that we cannot possibly afford to do this for the reimbursement offered. The alternative is for patients to receive the vaccine in some state funded site or clinic. That may take a very long time to roll out.
We need many more economists complaining about this, right? Other than John Cochrane, where will we find them? Why do we not find them?
Christmas assorted links
1. Black-footed ferrets are getting their own Covid-19 vaccine.
3. David Brooks’s Sidney awards (NYT).
4. In memory of Richard Cooper, Harvard economist.
5. When Larry Summers is trending on Twitter, he is usually correct.
6. My Bloomberg column on all the scientific developments of 2020. Hail computation!
7. Vaccine envy (NYT). And “NBA memo warns teams about obtaining, administering COVID-19 vaccine early.”
8. One Texas health district received 900 doses of the COVID-19 vaccine. Then, it closed for Christmas.
10. Turkey Finds Chinese Vaccine Efficacy Rate of 91.25% in Trial.
Happy Holidays!
Gerard ter Borch (Dutch, 1617 – 1681) been thinking a lot about this lately.
Dr. Fauci, Straussian
Recently, a figure to whom millions of Americans look for guidance — Dr. Anthony S. Fauci, an adviser to both the Trump administration and the incoming Biden administration — has begun incrementally raising his herd-immunity estimate.
In the pandemic’s early days, Dr. Fauci tended to cite the same 60 to 70 percent estimate that most experts did. About a month ago, he began saying “70, 75 percent” in television interviews. And last week, in an interview with CNBC News, he said “75, 80, 85 percent” and “75 to 80-plus percent.”
In a telephone interview the next day, Dr. Fauci acknowledged that he had slowly but deliberately been moving the goal posts. He is doing so, he said, partly based on new science, and partly on his gut feeling that the country is finally ready to hear what he really thinks.
Hard as it may be to hear, he said, he believes that it may take close to 90 percent immunity to bring the virus to a halt — almost as much as is needed to stop a measles outbreak.
Asked about Dr. Fauci’s conclusions, prominent epidemiologists said that he might be proven right…
Dr. Fauci said that weeks ago, he had hesitated to publicly raise his estimate because many Americans seemed hesitant about vaccines, which they would need to accept almost universally in order for the country to achieve herd immunity.
Here is the full NYT story. A few points:
1. Surely Straussianism by now should be persuasive as a general theory.
2. Fauci is idolized by many as a kind of anti-Trump, but he is a terrible risk communicator, as evidenced also by his recent attacks on some of the “lesser” vaccines (which still would work if applied collectively). Not to mention his earlier remarks on masks, and also the mid-March safety of cruises. How a person understands Fauci is in fact a pretty good litmus test.
3. Should you be trusting everything the insiders are telling you about FDA processes?
4. I genuinely do not know what the herd immunity threshold is, but I assure you I am trying to tell you the truth on this one (and other matters). My Straussianism is not a normative theory of my own communication, but rather a positive theory of how the world works, and it has been vindicated once again.
This is us, that is them, China antitrust suit of the day
Chinese regulators said Thursday they have launched an antitrust investigation into Chinese e-commerce giant Alibaba Group Holding Ltd. BABA 0.14% and separately said they would summon affiliate Ant Group for discussions on competition and consumer rights.
Taken together, the two actions mark the strongest enforcement action by Beijing against the country’s biggest technology giant and Jack Ma, its billionaire founder.
The Alibaba investigation was revealed Thursday by China’s antimonopoly regulator, the State Administration for Market Regulation, which said in a brief statement that it was acting on reports that Alibaba was pressuring merchants who sell goods on its platforms to commit to not selling on its competitors. Alibaba’s e-commerce platforms, Taobao and Tmall, compete with domestic rivals JD.com Inc. and Pinduoduo Inc.
Here is the full story, via the excellent Kevin Lewis.
The Tony Blair “one dose” idea
Here is the source, of course Alex Tabarrok was there first. For now give everyone one dose rather than two, and enjoy the partial but more broadly spread protection. Here are the reactions from two epidemiologists:
Professor Wendy Barclay, from the department of infectious disease at Imperial College London, said Mr Blair’s idea was interesting but agreed it was “too risky” to try without further evidence.
And Professor Neil Ferguson, also from Imperial, added that the UK regulator had authorised the vaccine on the basis that people would receive two doses.
Administering one dose only would require “an entirely different regulatory submission”, he told a Commons committee.
A Department of Health and Social Care spokesperson said: “Over the coming weeks and months, the rate of vaccinations will increase as more doses become available and the programme continues to expand.”
Where are their cost-benefit analyses? Letting people get infected at current and indeed accelerating rates is also “too risky,” yes? Is there an epidemiologist or public health expert out there willing to show his or her work, either for or against this idea? A genuine query, and of course comments are open. How about one dose for Moderna only? If we are to defer to their expertise, they do actually have to step up and be the experts, right?
The age of polarization ended some while ago
The coronavirus-relief bill racing through Congress contains a fair amount of economic relief as well as a wide array of unrelated measures that were thrown into the bill with little or no public debate. Included in the latter category is something shocking: a huge package of energy reforms that will result in major greenhouse-gas reductions.
How big a deal are the climate provisions? The World Resources Institute has called the bill “one of the most significant pieces of climate legislation that Congress has passed in its history.” Grant Carlisle, a senior policy adviser at the Natural Resources Defense Council, says, “This is perhaps the most significant climate legislation Congress has ever passed.”
To be sure, the “most significant climate legislation Congress has ever passed” designation is a little bit misleading. Congress hasn’t passed much climate legislation. The climate provisions in the coronavirus-relief bill might add up to more than President Obama’s 2009 stimulus bill, which included $90 billion in green-energy subsidies and helped seed the boom in wind, solar, batteries, and other tech over the past decade. They likely won’t be as significant as the 1970 Clean Air Act, which created the regulatory authority that does most of the heavy lifting in reducing carbon pollution.
But the amount of good climate policy in this bill is shocking, especially given the fact that it is about to be signed by Donald J. Trump. The major provisions include: a $35 billion investment in new zero-emission energy technology (including solar, wind, nuclear, and carbon-capture storage); an extension of tax credits for wind and solar energy, which were set to expire; and, most significantly, a plan for phasing out hydrofluorocarbons, a small but extremely potent greenhouse gas used as a coolant.
The rhetoric, however, will continue. That article is from Jonathan Chait. And here is my March 2019 Bloomberg column on polarization:
If I had to describe 2019 so far, I would characterize it as The Year Political Polarization Started to Erode. I know that sounds counterintuitive — aren’t partisans at each other’s throats on social media all the time? — but bear with me.
There is some data to support my point. A recent poll about regulating the tech industry, an issue which could prove to be one of the most important of our time, asked: “Do you agree or disagree that tech companies have too much power and should be more regulated?” Some 16 percent of Republicans said they “strongly agree,” while 13 percent of Democrats did. And combining those who “strongly agree” and “somewhat agree” gives an identical figure for both parties — 46 percent. This is the near-opposite of polarization.
More generally, both parties also seem to have converged in thinking that fiscal deficits are fine and more government spending is a good thing.
Ahem.