Rapid Antigen Tests in Europe

Image‘If rapid antigen tests are so good how come other countries aren’t using them’? is a question I get asked a lot. In fact, India authorized these tests months ago. Slovakia tested most of their population using antigen tests. Germany is using them to protect nursing home residents. Lufthansa is trialing rapid antigen tests on special flights. Rapid antigen tests are now beginning to be available more widely in Europe. Here from a twitter thread is a picture of what they look like, it’s just a paper strip inside. You swab your nose (no need for deep cleaning), swirl the swab in a tube with some liquid and then squeeze a few drops of the liquid onto the end of the tester. Results in 15 minutes. They cost about $8 a test.

Why are these tests important? The CDC now says that asymptomatic or pre-symptomatic people account for a majority of infections. Do you get it? How many people without symptoms will get a COVID PCR test, which can be time consuming and expensive? (And how many PCR tests can we run in a timely fashion if people without symptoms get many more tests?) Not that many. But many people without symptoms would get a $8 or less, at-home, 15 minute test. And if some of those people discover that they are infectious and self-isolate for a few days we can drive infection rates down.

We should have had an Operation Warp Speed for tests. We still need funding for a mass rollout and, of course, the FDA needs to approve these tests! (Here is Michael Mina in Time fulminating at the FDA holdup.)

By the way, more than 2800 Americans have died of COVID since Pfizer requested an Emergency Use Authorization for their vaccine. The FDA meets Dec. 10.

Addendum: Here’s me explaining why Frequent, Fast, and Cheap is Better than Sensitive and the difference between infected and infectious.

Externalities and Covid

I am getting a little ornery with all of the people citing Covid externalities, and then not going a step deeper.  To be clear, I agree we should subsidize preventive measures (most of all vaccines and testing, but more too), and close down high-risk indoor gatherings in many locales.  No more Democratic Party fundraisers in New York State, not indoors at least.

What is being neglected is that many of the American people are voting with their feet when it comes to externalities, and we may not always like the answers we are seeing.  Take all of the pending Thanksgiving travel — the biggest risk is to parents and grandparents, but mostly they are receiving their children voluntarily.  Now I get that there is a higher-order risk to friends of the parents and grandparents, and that externality is not internalized, but still…much of the externality is in fact internalized.

I haven’t seen many (any?) jurisdictions in this country where the median voter wants to shut down Thanksgiving travel.  Do please note it is in fact my personal preference that no one travel for Thanksgiving, but I’m not going to confuse that preference with the Coasean outcome or for that matter the democratic outcome.  It might be the Coasean outcome in northern Jutland, it does not seem to be here.

Or consider mobility.  The people of means I know have been moving to Austin and Miami, two locales that are both quite open in the sense of having relatively few Covid-related restrictions on commerce.  These individuals do not have to work as a cashier in the Safeway, and so they can enjoy the openness while avoiding most of the corresponding risk.  They can work at home and socialize outside.  Maybe the weather, the time zone, the “coolness” of the locale, and other factors are more important than the stores being open.  Still, the “loose” Covid policies have not scared them away.

One might expect that front-line workers would be less keen to move to Austin and Miami, but I have not seen data to that effect and I am not convinced that is true on net.  I genuinely would like to know, and in the meantime am agnostic on the question.

I don’t see many people moving into Vermont or San Francisco, two locales that have done a good job minimizing Covid risk.

Analytically, you might put it this way.  There always have been positive externalities from human contact through commerce, and at the margin, even with Covid risk, for many people those externalities still are positive.  Thus if you limit or tax those interactions, the policies will be unpopular.

I genuinely do think many of our failings are those of prudence rather than externalities.  That is one reason why I am reluctant to recommend large-scale coercive lockdowns, while still regarding the positive fight against Covid with extreme urgency.  Three of our prudence failings are the following:

1. We are not good at intertemporal substitution in this context, and

2. The risks of Covid are sufficiently stressful that many people instead prefer to self-deceive and minimize the risks, rather than deal with the stress (NB: this is one instance where higher stakes and decisive choice lead to a worse rather than a better outcome, contra Caplan).

3. Many individuals are bad at grasping the multi-week reporting lags and also the “Blitzkrieg” nature of the struggle.

I am reluctant to smush together the externalities argument and the paternalism argument for policy activism, and instead prefer to unpack the two, even though that weakens the case for major restrictions.  It disturbs me that few public health commentators or for that matter commenting economists are willing to consider even this simple analytic division.  Talking about all the deaths does not in fact settle the matter, as it remains necessary to ask what Americans really want, and how much we ought to be willing to respect those preferences.

Vaccination economic resumption sentences to ponder

If you think of state governments as basically being as permissive as possible consistent with not overwhelming their hospital systems then even vaccinating 20% of the population has a huge economic impact as long as it’s targeted in a halfway plausible way.

That is from Matt Yglesias.  I would stress also the bad news that in the meantime many Americans (other citizens too!) are becoming infected.  I haven’t seen recent serological results, but quite some time ago the range already was 10-15% of America infected.  It seems entirely plausible to think that many parts of the country (not SF, not Vermont) will be at 30% or higher infected by February.  Plus 20% getting vaccinated, and still likely a residue of the population with above average protective immune response, and by that I mean relative to age group.

So overalI I am more optimistic about the spring than are many of the people I am talking to.  And the United States may well be the first country to arrive at a semblance of herd immunity, albeit not the way we might have preferred.

Favorite books by female authors

Elena Ferrante named her top forty, and I am not sure I approve of the exercise at all.  Still, here are my top twenty, in no particular order, fiction only, not counting poetry:

1.Lady Murasaki, Tale of Genji.

2. Emily Brontë, Wuthering Heights.

3. Alice Munro, any and all.

4. Elena Ferrante, the Neapolitan quadrology.

5. Doris Lessing, The Golden Notebook.

6. Octavia Butler, Xenogenesis trilogy.

7. Zora Neale Hurston, Their Eyes Were Watching God.

8. Mary Shelley, Frankenstein.

9. Sigrid Undset, Kristin Lavransdatter.

10. Susanna Clarke, Jonathan Strange and Mr. Norrell.

11. Virginia Woolf, many.

12. Willa Cather, My Antonia.

13. Harriet Beecher Stowe, Uncle Tom’s Cabin.

14. Jane Austen, Persuasion.

15. Anne Rice, The Witching Hour, and #2 in the vampire series.

16. Anaïs Nin? P.D.James? A general award to the mystery genre?

17. Christa Wolf, Cassandra.

18. Marguerite Yourcenar, Memoirs of Hadrian.

19. Irene Nemirovsky, Suite Francaise.

20. Ursula LeGuin, The Left Hand of Darkness.

Comments: No, I didn’t forget George Eliot, these are “my favorites,” not “the best.”  Maybe Edith Wharton would have made #21?  Or Byatt’s Possession?  The other marginal picks mostly would have come from the Anglosphere.  I learned my favorite Latin American writers are all male.

Radio and riots

Although the 1960s race riots have gone down in history as America’s most violent and destructive ethnic civil disturbances, a single common factor able to explain their insurgence is yet to be found. Using a novel data set on the universe of radio stations airing black-appeal programming, the effect of media on riots is found to be sizable and statistically significant. A marginal increase in the signal reception from these stations is estimated to lead to a 7% and 15% rise in the mean levels of the likelihood and intensity of riots, respectively. Several mechanisms behind this result are considered, with the quantity, quality, and the length of exposure to radio programming all being decisive factors.

That is from a recent paper by Andrea Bernini, a job market candidate from Oxford University.  We forget sometimes that arguably the internet is a more peace-inducing institution than was radio.

The political economy of Swine flu vaccine allocation

Previous research has isolated the effect of “congressional dominance” in explaining bureaucracy-related outcomes. This analysis extends the concept of congressional dominance to the allocation of H1N1, or swine flu, vaccine doses. States with Democratic United States Representatives on the relevant House oversight committee received roughly 60,000 additional doses per legislator during the initial allocation period, though this political advantage dissipated after the first 3 weeks of vaccine distribution. As a result political factors played a role in determining vaccine allocation only when the vaccine was in particularly short supply. At-risk groups identified by the Centers for Disease Control (CDC), such as younger age groups and first responders, do not receive more vaccine doses, and in fact receive slightly fewer units of vaccine.

That is from an Economic Inquiry paper by Matt E. Ryan.  Via Henry Thompson.

Mental health and Covid — correction

Earlier I had reported incorrectly that one in five Covid patients developed subsequently mental health problems.  Here is the original paper, and a more accurate rendering of the result is this:

“In the period between 14 and 90 days after COVID-19 diagnosis, 5.8% COVID-19 survivors had their first recorded diagnosis of psychiatric illness (F20–F48), compared with 2.5–3.4% of patients in the comparison cohorts. Thus, adults have an approximately doubled risk of being newly diagnosed with a psychiatric disorder after COVID-19 diagnosis.”

That is still a lot of mental health problems, but much smaller than the original claim.

For a pointer on the econometrics I thank Patrick Collison.

And here is a new paper Discussion of Mental Illness and Mental Health by NBA Players on Twitter.

Progress against HIV-AIDS hasn’t been reported enough

While an effective vaccine against HIV may still be a long way off, a new HIV prevention technique has proven remarkably effective at protecting women against the virus.

A single injection of a drug called cabotegravir every two months was so successful in preventing HIV in a clinical trial among women in sub-Saharan Africa that the study was wrapped up ahead of schedule.

The study, run by the HIV Prevention Trials Network, was looking at two forms of pre-exposure prophylaxis or (PrEP) aimed at women. PrEP is a technique of administering low doses of anti-AIDS drugs to people who are HIV negative as a way to protect them from infection. The study compared the effectiveness of the new long-acting injectable against the current form of PrEP, a daily pill of Truvada.

The findings were announced by the study’s researchers on Monday.

“This is a major, major advance,” said Dr. Anthony Fauci in a briefing. The director of the National Institute of Allergy and Infectious Diseases, which was involved in the study, Fauci has spent much of his career working on HIV/AIDS.

Here is the full NPR report, here is NYT coverage. Yes, it still needs to be easier to deliver.  But how many Americans, right now, could identify what cabotegravir is?  As I said earlier this morning, the great stagnation may be ending.

Covid travel markets in everything

EVA Airways, one of the largest carriers in Taiwan, is partnering with travel experience company Mobius on a campaign called “Fly! Love is in the Air.” These are flights for singles on Christmas Day, New Year’s Eve and New Year Day.

“Because of Covid-19, EVA Air has been organizing “faux travel” experiences to fulfill people’s desire for travel. When single men and women travel, apart from enjoying the fun in travel, they may wish to meet someone — like a scene in a romantic movie,” Chiang Tsung-Wei, the spokesperson for You and Me, the speed dating arm of Mobius, tells CNN Travel.

Each of the dating experiences includes a three-hour flight that departs from Taipei’s Taoyuan International Airport and circles the airspace above Taiwan, plus another two hours of a romantic date back on land.

Participants are encouraged to have in-depth conversations with each other on board while sampling meals prepared by Michelin-starred chef Motoke Nakamura. They are also encouraged to keep masks on when they’re not eating or drinking.

Here is the full story, via Air Genius Gary Leff.