Results for “Tests” 772 found
FDA Approves American Rapid Antigen Test
What makes the FDAs failure to approve more rapid antigen tests even more galling is that the test being sold cheaply in the Amsterdam supermarket is the Flowflex, an American test made by Acon Labs in San Diego.
Well the FDA has finally approved the Acon test! Apparently it is good enough for the Germans and for US citizens. Hoorah! USA Today notes:
ACON expects to make 100 million tests per month by the end of this year. Production could double to 200 million monthly tests by February, according to the FDA.
…The United Kingdom and Germany have made significant purchases of home tests and widely distributed them to their residents to slow the spread of coronavirus. Such large government purchases allowed manufacturers to continue making tests even when demand softened as cases dropped.
The Biden administration will spend nearly $1.2 billion to purchase up to 187 million home tests from Abbott Laboratories and Celltrion Inc., company officials confirmed. The Department of Defense announced additional contracts totaling $647 million to buy 60 million kits from Abbott and three other testing vendors: OraSure Technologies, Quidel and Intrivio Holdings.
The FDA has authorized seven antigen-based tests that can be used at home without a prescription. The EU has authorized 21 tests beginning with the letter A (I am not sure all of these are authorized for home use but you get the idea.) Turtle slow. Still this is a big improvement.
Frankly, I think all the pressure from people like Michael Mina amplified by myself and others over 18 months and culminating in David Leonhartd’s NYTimes article Where Are the Tests? finally pushed them over the edge.
Saloons of Invention
I was taken aback by the bottom line of Mike Andrews new working paper Bar Talk: closing the saloons during prohibition reduced patenting by ~15%. At first, I thought that seemed like a very large decline but bear in mind that saloons were the coffeehouses of the day devoted not just to drinking but to meeting, talking and learning. Indeed, they were much more common than coffeehouses today:
Saloons were once everywhere in America, from urban alleys to rural crossroads. They were about more than drinking; from the 1860s through 1920, they dominated social life for the laboring majority building a new industrial nation. By 1897 there were roughly a quarter of a million saloons, or 23 for every Starbucks franchise today.
…Saloons became salons, where survivors of the Industrial Revolution could drink and debate, politick and speechify.
The saloons also often combined social aspects with a mailbox depot, telegraph or telephone, and a payday lender so they were good places to talk shop.
Andrew’s compares countries that were forced dry by state prohibition laws with previously dry counties, so the estimates are local and from across the country. He has significant patent data including the location of inventors and a variety of important robustness tests. Women, for example, didn’t typically patronize the saloons but also continued to patent at similar rates in wet and dry counties. After taking it all in the results are large but plausible! Here’s the abstract to the paper:
To understand the importance of informal social interactions for invention, I examine a massive and involuntary disruption of informal social networks from U.S. history: alcohol prohibition. The enactment of state-level prohibition laws differentially treated counties depending on whether those counties were wet or dry prior to prohibition. After the imposition of state-level prohibition, previously wet counties had 8-18% fewer patents per year relative to consistently dry counties. The effect was largest in the first three years after the imposition of prohibition and rebounds thereafter. The effect was smaller for groups that were less likely to frequent saloons, namely women and particular ethnic groups. Next, I use the imposition of prohibition to document the sensitivity of collaboration patterns to shocks to the informal social network. As individuals rebuilt their networks following prohibition, they connected with new individuals and patented in new technology classes. Thus, while prohibition had only a temporary effect on the rate of invention, it had a lasting effect on the direction of inventive activity. Finally, I exploit the imposition of prohibition to show that informal and formal interactions are complements in the invention production function.
Scott Gottlieb’s Uncontrolled Spread
Scott Gottlieb’s Uncontrolled Spread is superb. I reviewed it for the WSJ. Here’s one bit:
If there’s one overarching theme of “Uncontrolled Spread,” it’s that the Centers for Disease Control and Prevention failed utterly. It’s now well known that the CDC didn’t follow standard operating procedures in its own labs, resulting in contamination and a complete botch of its original SARS-CoV-2 test. The agency’s failure put us weeks behind and took the South Korea option of suppressing the virus off the table. But the blunder was much deeper and more systematic than a botched test. The CDC never had a plan for widespread testing, which in any scenario could only be achieved by bringing in the big, private labs.
Instead of working with the commercial labs, the CDC went out of its way to impede them from developing and deploying their own tests. The CDC wouldn’t share its virus samples with commercial labs, slowing down test development. “The agency didn’t view it as a part of its mission to assist these labs.” Dr. Gottlieb writes. As a result, “It would be weeks before commercial manufacturers could get access to the samples they needed, and they’d mostly have to go around the CDC. One large commercial lab would obtain samples from a subsidiary in South Korea.”
At times the CDC seemed more interested in its own “intellectual property” than in saving lives. In a jaw-dropping section, Dr. Gottlieb writes that “companies seeking to make the test kits described extended negotiations with the CDC that stretched for weeks as the agency made sure that the contracts protected its inventions.” When every day of delay could mean thousands of lives lost down the line, the CDC was dickering over test royalties.
In the early months of the pandemic the CDC impeded private firms from developing their own tests and demanded that all testing be run through its labs even as its own test failed miserably and its own labs had no hope of scaling up to deal with the levels of testing needed. Moreover, the author notes, because its own labs couldn’t scale, the CDC played down the necessity of widespread testing and took “deliberate steps to enforce guidelines that would make sure it didn’t receive more samples than its single lab could handle.”
Read the whole thing.
Addendum: My previous reviews of Michael Lewis’s The Premonition, Slavitt’s Preventable and Abutaleb and Paletta’s Nightmare Scenario.
Why the defenses of Australia do not persuade me
Alex laid out some complaints about Covid policy down under, I have been receiving emails and tweets arguing the following:
1. Australia is choosing a perfectly acceptable point on the liberty vs. safety frontier.
2. The Australian decision to do extreme lockdowns is democratic, and most Australians support it.
And sometimes I see a third point, which as far as I can tell is true:
3. Australia doesn’t have much in the way of ICU excess capacity, so a Covid surge would hit the country especially hard.
I think those responses, however, are missing the point of the critique. I would stress that if Covid risk has you with your back against the wall and the government is forcing extremely restrictive measures on your citizenry, you should be implementing the following in an urgent manner:
a. Twice a week rapid antigen tests for everyone. (Plenty of time to prep for this one.)
b. Much stronger incentives to vaccinate people more rapidly, including with the large stock (six million or so?) of AstraZeneca vaccines. Demand side incentives, supply side incentives, whatever can be done. Let’s throw the kitchen sink at this one. But as it stands, I just don’t see the urgency.
c. Mobile monoclonal antibody units, as they are used in Florida (modest progress here).
d. Maybe other emergency measures too? I’ve been hearing for decades that Australia has such a great health care system so surely they can make lots of progress on these and other fronts?
As far as I can tell from this great distance, Australia is doing none of these. And, while there is some disquiet about lockdowns, few of its citizens are demanding that they do any of those positive measures. Not many of its well-known politicians are proposing those ideas either. (Please feel free to correct me if that is wrong!…but I just don’t see word of it on-line.)
If Australia implemented all of those policies, or even just one of them, they could attain a much better “liberty vs. lives” frontier, no matter where you think the government should end up on that frontier. They could save lives, and enjoy more liberty.
And that is the great shame and indeed I would say crime. There seems to be an incredible complacency that people in some parts of the country will put up with the current measures and not demand the government look for more practical measures to boost both liberty and security.
So when you write me and suggest “this is democratic and the people approve,” yes that is exactly the problem.
My Conversation with Zeynep Tufekci
Here is the audio and transcript. Here is part of the summary:
Zeynep joined Tyler to discuss problems with the media and the scientific establishment, what made the lab-leak hypothesis unacceptable to talk about, how her background in sociology was key to getting so many things right about the pandemic, the pitfalls of academic contrarianism, what Max Weber understood about public health crises, the underrated aspects of Kemel Mustapha’s regime, how Game of Thrones interested her as a sociologist (until the final season), what Americans get wrong about Turkey, why internet-fueled movements like the Gezi protests fizzle out, whether Islamic fundamentalism is on the rise in Turkey, how she’d try to persuade a COVID-19 vaccine skeptic, whether public health authorities should ever lie for the greater good, why she thinks America is actually less racist than Europe, how her background as a programmer affects her work as a sociologist, the subject of her next book, and more.
Here is one excerpt:
COWEN: Max Weber — overrated or underrated as a sociologist?
TUFEKCI: Underrated.
COWEN: Why?
TUFEKCI: Part of the reason he’s underrated is because he writes in that very hard-to-read early 19th-century writing, but if you read Max Weber, 90 percent of what you want to understand about the current public health crisis is there in his sociology. Not just him, but sociology organizations and how that works. He’s good at that. I would say underrated, partly because it’s very hard to read. It’s like Shakespeare. You need the modern English version, conceptually, for more people to read it.
I would say almost all of sociology is underrated in how dramatically useful it is. Just ask me any time. Early on, I knew we were going to have a pandemic, completely based on sociology of the moment in early January, before I knew anything about the virus because they weren’t telling us, but you could just use sociological concepts to put things together. Max Weber is great at most of them and underrated.
COWEN: Kemal Mustafa — overrated or underrated?
TUFEKCI: Underrated.
COWEN: Why?
TUFEKCI: Why? My grandmother — she was 12 or 13 when she was in the Mediterranean region — Central Asia, but Mediterranean region, very close to the Mediterranean. She was born the year the Turkish Republic had been founded, 1923, and she was 13 or so. She was just about to be married off, but the republic was a little over a decade — same age as her. They created a national exam to pick talented girls like her. The ones that won the exam got taken to Istanbul to this elite, one of the very few boarding high schools for girls.
The underrated part isn’t just that such a mechanism existed. The underrated part is that the country changed so much in 13 years that her teacher was able to prevail upon the family to let her go. To have a 13-year-old be sent off to Istanbul, completely opposite side of the country, to a boarding school for education — that kind of flourishing of liberation.
I’m not going to deny it was an authoritarian period, and minorities, like Kurds, during that period were brutally suppressed. I can’t make it sound like there was nothing else going on, but in terms of creating a republic out of the ashes of a crumbling empire — I think it’s one of the very striking stories of national transformation, globally, within one generation, so underrated.
There are numerous interesting segments, on varied topics, to be found throughout the dialog.
Why Doesn’t the United States Have Test Abundance?!
We have vaccine abundance in the United States but not test abundance. Germany has test abundance. Tests are easily available at the supermarket or the corner store and they are cheap, five tests for 3.75 euro or less than a dollar each. Billiger! In Great Britain you can get a 14 pack for free. The Canadians are also distributing packs of tests to small businesses for free to test their employees.
In the United States, the FDA has approved less than a handful of true at-home tests and, partially as a result, they are expensive at $10 to $20 per test, i.e. more than ten times as expensive as in Germany. Germany has approved over 50 of these tests including tests from American firms not approved in the United States. The rapid tests are excellent for identifying infectiousness and they are an important weapon, alongside vaccines, for controlling viral spread and making gatherings safe but you can’t expect people to use them more than a handful of times at $10 per use.
We ought to have testing abundance in the US and not lag behind Germany, the UK and Canada. As usual, I say if it’s good enough for the Germans it’s good enough for me.
Addendum: The excellent Michael Mina continues to bang the drum.
Saturday assorted links
1. Private insurers are now picking up less of the tab for Covid-related hospital stays.
2. Claims about vaccine efficacy, useful. And further claims about boosters. The correct final picture here still is not clear to me.
4. Progress in the use of monoclonal antibodies. Sadly: “For the administration, mum’s the word on monoclonal antibodies, rapid home tests, high quality masks . . . anything except vaccines,” Eric Topol, founder and director of the Scripps Research Translational Institute, said in an email. “Which is wrong, since we need every tool in the kit to effectively take on delta; we’re not doing that well at all.”
5. What academia used to be like. Before the internet, that is.
6. Jerry Brito on the coming regulatory challenge for crypto.
They had better hurry up and distribute those AstraZeneca doses
Movement data from last weekend show Melburnians engaging in what experts have called thousands of small transgressions with the potential to drive COVID-19 infections higher, as the effect of 200 days of lockdown takes an emotional toll.
Google mobility data compiled by The Age reveals that across the state last Friday and Saturday, people were moving more than at any time since mid-July last year when complacency prompted Premier Daniel Andrews to plunge the state into stage-four lockdown and mandatory mask-wearing.
Last weekend saw a spate of breaches including an organised takeaway pub crawl in Richmond and an engagement party in Caulfield North attended by 69 guests. The couple involved in the illegal party have received $5400 fines. Two of their parents were also fined and other guests are being interviewed.
Some metropolitan municipalities including Glen Eira and Bayside recorded their highest lockdown movement levels last week, ahead of a number of mystery cases appearing in St Kilda.
Professor Mike Toole from Melbourne’s Burnet Institute, who lives in a mobility hotspot in the inner south, said he was shocked to witness large groups of people gathering in parks at the weekend.
Here is the full article, via Rich Dewey. And the Sydney lockdown is now extended until the end of September, with masks mandated for outside as well. Elsewhere:
Walmart, Target and Lowe’s, by contrast, all lifted sales forecasts this week after beating expectations for the three months to the end of July. While demand for toilet paper and cleaning supplies has cooled after 2020s pantry hoarding, the appetite for other products was broad-based. Party supplies, apparel and travel gear flew off Walmart’s shelves. At Home Depot, an early cache of Halloween decorations sold out almost immediately. Swimsuits and children’s clothing were similarly popular at Target and, in another sign of confidence, more customers returned to Walmart and Target store aisles after a year of browsing online.
Here is the associated FT article. Which set of values do you prefer? Which do most people prefer?
The TGA is Worse than the FDA, and the Australian Lockdown
I have been highly critical of the FDA but in Australia the FDA is almost a model to be emulated. Steven Hamilton and Richard Holden do not mince words:
At the end of 2020, as vaccines were rolling out en masse in the Northern Hemisphere, the TGA [Therapeutic Goods Administration, AT] flatly refused to issue the emergency authorisations other regulators did. As a result, the TGA didn’t approve the Pfizer vaccine until January 25, more than six weeks after the US Food and Drug Administration (FDA), itself not exactly the poster child of expeditiousness.
Similarly, the TGA didn’t approve the AstraZeneca vaccine until February 16, almost seven weeks after the UK.
In case you’re wondering “what difference does six weeks make?“, think again. Were our rollout six weeks faster, the current Sydney outbreak would likely never have exploded, saving many lives and livelihoods. In the face of an exponentially spreading virus that has become twice as infectious, six weeks is an eternity. And, indeed, nothing has changed. The TGA approved the Moderna vaccine this week, eight months after the FDA.
It approved looser cold storage requirements for the Pfizer vaccine, which would allow the vaccine to be more widely distributed and reduce wastage, on April 8, six weeks after the FDA. And it approved the Pfizer vaccine for use by 12 to 15-year-olds on July 23, more than 10 weeks after the FDA.
And then there’s the TGA’s staggering decision not to approve in-home rapid tests over reliability concerns despite their widespread approval and use overseas.
Where’s the approval of the mix-and-match vaccine regimen, used to great effect in Canada, where AstraZeneca is combined with Pfizer to expand supply and increase efficacy? Where’s the guidance for those who’ve received two doses of AstraZeneca that they’ll be able to receive a Pfizer booster later?
In the aftermath of the pandemic, when almost all of us should be fully vaccinated,there will be ample opportunity to figure out exactly who is to blame for what.
But the slow, insular, and excessively cautious advice of our medical regulatory complex, which comprehensively failed to grasp the massive consequences of delay and inaction, must be right at the top of that list.
You might be tempted to argued that the TGA can afford to take its time since COVID hasn’t been as bad in Australia as in the United States but that would be to ignore the costs of the Australian lockdown.
Article 13 of the Universal Declaration of Human Rights states that
- Everyone has the right to freedom of movement and residence within the borders of each state.
- Everyone has the right to leave any country, including his own, and to return to his country.
Australia has now violated each and every clause of this universal human right and seemingly without much debate or objection. It is deeply troubling to see people prevented from leaving or entering their own country and soldiers in the street making sure people do not travel beyond a perimeter surrounding their homes. The costs of lockdown are very high and thus so is any delay in ending these unprecedented infringements on liberty.
My Conversation with Andrew Sullivan
Here is the audio, video, and transcript. Here is part of the overview:
Andrew joined Tyler to discuss the role of the AIDs epidemic in achieving marriage equality, the difficulty of devoutness in everyday life, why public intellectuals often lack courage, how being a gay man helps him access perspectives he otherwise wouldn’t, how drugs influence his ideas, the reasons why he’s a passionate defender of SATs and IQ tests, what Niall Ferguson and Boris Johnson were like as fellow undergraduates, what Americans get wrong about British politics, why so few people share his admiration for Margaret Thatcher, why Bowie was so special, why Airplane! is his favorite movie, what Oakeshottian conservatism offers us today, whether wokeism has a positive influence globally, why he someday hopes to glower at the sea from in the west of Ireland, and more.
And here is one excerpt:
SULLIVAN: Well, and so you get used to real conversations about people, and you don’t mistake credentials for intelligence. You realize that people outside of the system may be more perceptive about what’s going wrong with it than people buried within it. I honestly find life more interesting the more variety of people you get to know and meet. And that means from all sorts of different ways of life.
The good thing about being gay, I will tell you, is that that happens more often than if you’re straight — because it’s a great equalizer. You are more likely to come across someone who really is from a totally different socioeconomic group than you are through sexual and romantic attraction, and indeed the existence of this subterranean world that is taken from every other particular class and structure, than you would if you just grew up in a straight world where you didn’t have to question these things and where your social life was bound up with your work or with your professional peers.
The idea for me of dating someone in my office would be absolutely bizarre, for example. I can’t believe all these straight people that just look around them and say, “Oh, let’s get married.” Whereas gay people have this immense social system that can throw up anybody from any way of life into your social circle.
Interesting throughout. And again, here is Andrew’s new book Out on a Limb: Selected Writing, 1989-2021.
Our Regulatory State Isn’t Learning
Delta is the fourth wave of covid, and amazingly the US policy response is even more irresolute than the first time around. Our government is like a child, sent next door to get a cup of sugar, who gets as far as the front stoop and then wanders off following a puppy.
The policy response is now focused on the most medically ineffective but most politically symbolic step, mask mandates. An all-night disco in Provincetown turns in to a superspreader event so… we make school kids wear masks in outdoor summer camps? Masks are several decimal places less effective than vaccines, and less effective than “social distance” in the first place.* Go to that all night disco, unvaccinated, but wear a mask? Please.
If we’re going to do NPI (non pharmaceutical interventions), policy other than vaccines, the level of policy and public discussion has tragically regressed since last summer. Last summer, remember, we were all talking about testing. Alex Tabarrok and Paul Romer were superb on how fast tests can reduce the reproduction rate, even with just voluntary isolation following tests. Other countries had competent test and tracing regimes. Have we built that in a year? No. (Are we ready to test and trace the next bug? Double no.)
What happened to the paper-strip tests you could buy for $2.00 at Walgreen’s, get instant results, and maybe decide it’s a bad idea to go to the all night dance party? Interest faded in November. (Last I looked, the sellers and FDA were still insisting on prescriptions and an app sign up, so it cost $50 and insurance “paid for” it.) What happened to detailed local data? Did anyone ever get it through the FDA’s and CDCs thick skulls that even imperfect but cheap and fast tests can be used to slow spread of disease?
…And then we indulge another round of America’s favorite pastime, answers in search of a question. Delta is spreading, so… extend the renter eviction moratorium. People who haven’t paid rent in a year can stay, landlords be damned.
All true. I got dispirited on testing. It’s insane that we don’t have cheap, rapid testing and good ventilation ready for a new school year. As I wrote about earlier, even the American Academy of Pediatrics is shouting from the rooftops that the FDA is deadly slow. The eviction moratorium is a sick joke. Just a backhanded way to redistribute wealth without a shred of justice or reason. Disgusting.
Here’s one more bit (but read the whole thing there is more.)
To learn from the mistakes, and institutionalize better responses would mean to admit there were mistakes. One would think the grand blame-Trump-for-everything narrative would allow us to do that, but the mistakes are deeply embedded in the bureacracies of the administrative state. Unlike bad admirals in WWII, nobody less than Trump himself has lost their job over incompetent covid response. The institutions have an enormous investment in ratifying that they did the best possible job last time. So, as in so many things (financial bailouts!) we institutionalize last time’s mistakes to keep those who made them in power in power — which means we do not learn from mistakes.
The incentives for Mexican hotel Covid testing
Yes you need a negative result on the test to return to the United States, but you never know the sensitivity of the test you are taking. It should be from an “approved provider,” but what does that mean? No authority from the United States can readily verify how good the test is.
Let us say you are a hotel owner, which kind of testing service do you wish to commission to send around to your rooms to test your American guests? A highly sensitive test that will yield periodic false positives, or a not very sensitive test that won’t generate false positives and might even result in some false negatives? And say some of your guests truly will be Covid-positive — do you wish to keep them in their rooms for another week or two, with all the attendant risks, or do you wish to send them along their way?
You don’t even have to imagine that the hotel owners are entirely cynical. They themselves can’t judge the accuracy of the tests, so a service that yielded a fair number of Covid positives could be seen as “they make too many mistakes and won’t let our guests leave, we don’t want them.” If the Delta variant is outracing publicity about the Delta variant, as was the case for a while in Tulum, such a hotelier reaction might be all the more likely.
I did in fact test negative. And the testers were very nice to me.
Is Haiti Governable Right Now? (at all)
More generally, might there be some countries that simply are not viable nation-states any more, no matter what we do? That is the topic of my latest Bloomberg column, here is one excerpt:
In other words, at the moment there doesn’t seem to be any way to govern Haiti. One problem is that foreign flows of money, whether from the drug trade or from Venezuelan foreign aid, have overwhelmed the domestic incentives to play by the rules. Haiti’s political institutions are mostly consumed by bribes and rents, with no stable center. The news, so to speak, is that such problems do not always have solutions. At all.
It is fine to suggest that Haiti invest in building up its political institutions — but those institutions have been unraveling for decades. I was a frequent visitor to the country in the 1990s, and although the poverty was severe, it was possible to travel with only a modest risk of encountering trouble. Government was largely ineffective, but it did exist.
These days the risk of kidnapping is so high that a visit is unthinkable.
And:
The buildup and rise of nation-states has become so ordinary that the opposite possibility is now neglected: their enduring collapse. It’s not history running in reverse. It’s that modernity has created new forces and incentives — drug money, kidnapping ransoms, payments from foreign powers, and so on — that can be stronger and more alluring than the usual reasons for supporting an internal national political order. If the rest of the world gets rich more quickly than you do, it might have the resources to effectively neutralize your incentives for peace and good government.
So where else might the political order soon unravel? In parts of Afghanistan, external forces (Pakistan, China, Russia, the U.S.) have so much at stake that the conditions there may never settle down. Other risks might be found in small, not yet fully orderly nations such as Guyana, Equatorial Guinea, and Eswatini (formerly Swaziland). El Salvador and Nicaragua seem to be consolidating their political orders, but at the cost of losing fair democratic political competition. The nation-state as we know it might not survive in every part of Nigeria, where the recent surge in kidnappings is striking.
In the Baltics and Taiwan, dangers from larger, aggressive neighbors lurk. In spite of generally good governance in these places, the pressures from outside powers might be too much to bear, reflecting broadly similar destabilizing mechanisms — namely, that the internal rewards for coordinating support for a status quo might not be high enough.
Recommended.
Alternative Dosing
Alternative dosing is finally getting some attention. This story in Nature recounts some of the recent arguments and evidence:
Two jabs that each contained only one-quarter of the standard dose of the Moderna COVID vaccine gave rise to long-lasting protective antibodies and virus-fighting T cells, according to tests in nearly three dozen people1. The results hint at the possibility of administering fractional doses to stretch limited vaccine supplies and accelerate the global immunization effort.
Since 2016, such a dose-reduction strategy has successfully vaccinated millions of people in Africa and South America against yellow fever2. But no similar approach has been tried in response to COVID-19, despite vaccine shortages in much of the global south.
“There’s a huge status quo bias, and it’s killing people,” says Alex Tabarrok, an economist at George Mason University in Fairfax, Virginia. “Had we done this starting in January, we could have vaccinated tens, perhaps hundreds, of millions more people.”
…Sarah Cobey, an infectious-disease researcher at the University of Chicago in Illinois and a co-author of a 5 July Nature Medicine commentary supporting dose ‘fractionation’, disagrees about the need for time-consuming data collection.
“We shouldn’t wait that long,” she says. “People are dying, and we have historical precedent for making very well-reasoned guesses that we think are going to save lives.”
…According to a modelling study published by Tabarrok and other economists, such an approach would reduce infections and COVID-linked deaths more than current policies.
Addendum: The reason for doing the modeling study is precisely to take into account variants like Delta. Our modeling suggests that even with efficacy significantly lower than that suggested by Figure 1 in our paper, alternative doses of more effective vaccines would still provide significant reductions in mortality, even when new variants dominate. The benefits derive from vaccinating more quickly.
Abolishing tenure is the least of my proposals
In my latest Bloomberg column I attempt to design an ideal university from scratch. The point is not that all schools should be this way, rather this is the experiment I would like to see at the margin:
I would start with what I expect students to know. They should be able to write very well, have a basic understanding of economics and public policy, and a decent working knowledge of statistical reasoning. I would give a degree to students who demonstrated “B-grade” competence in all of these areas; what now goes for passing C-minus work wouldn’t cut it.
Most important, the people who write and grade the students’ tests would not be their instructors. So students would have to acquire a genuine general knowledge base, not just memorize what is supposed to be on the exam.
Next, each student would have the equivalent of a GitHub certification page. If you learned three programming languages, for example, or won a prize in a science fair, that would go on your page as a credential. But it would not count as a credit toward graduation. Some students could finish their degrees in a year or two even if their pages were not adorned with many accomplishments, while others might fill their pages but get no degree.
My imaginary school would not have many assistant deans, student affairs staff or sports teams. The focus would be on paying more money to the better instructors.
And:
Instructors would not have tenure, but would have to compete for students — by offering them classes and services that would help them graduate and improve the quality of their certification pages. Teachers would be compensated on the basis of how many students they could attract, in a manner suggested long ago by Adam Smith, who himself lived under such a system in 18th-century Scotland.
The very best instructors could earn $300,000 to $400,000 a year…
The school would hire online instructors too, many of them from poorer countries and working at lower wages. So you might take French from a tutor in Senegal, or have a high school teacher from Tamil Nadu read your essays and offer writing tips. I am a big believer in face-to-face instruction, but in my school it would have to compete with online instruction. For this reason, I think my school would have a much more diverse faculty and instructional base than any other institution of higher education. None of the instructors would be required to have any undergraduate or advanced degrees.
The goal is to introduce competition across as many different margins as possible. There would be an “all on-line” option as well, offered to anyone in the world, though of course the on-line degree might be worth less as judged in the market place.
One issue I did not have time to get into is how the school would “shadow price” its different services to students. Access to different services has to be priced somehow, so should the school hand out total vouchers to each student for use within the school? Should the on-line and also face-to-face classes be priced at marginal cost (plus mark-up)? Or do positive externalities from class cohesion mean that the face-to-face classes should be priced at some additional discount? To what extent should factors other than this shadow price system be used to allocate access to classes?