Post #871: Age-adjusted trend in COVID-19 mortality rate in Virginia

After mistakenly focusing on short-term trends in Virginia COVID-19 cases (Post #867), I decided to do a proper analysis of changes in COVID-19 mortality rates in Virginia.

The question is:  Has there been any reduction in COVID-19 case mortality since the start of the pandemic, in Virginia, once you account for changes in the age of the newly-infected population over time?

I got a lot of surprises.  The biggest is that there appears to have been no material improvement in hospital care over the pandemic period, in Virginia.  The fraction of individuals dying, compared to the fraction hospitalized, is no different now than it was back in May.

And yet, the fraction of cases hospitalized, and fraction who died, both fell roughly in half during the pandemic period.  And that occurred despite testing levels remaining roughly constant since early July.  My conclusion is that the average severity of illness of diagnosed cases has fallen quite a bit over time.  It’s not clear what’s causing that.


Continue reading Post #871: Age-adjusted trend in COVID-19 mortality rate in Virginia

Post #870: Herd immunity and theater of the absurd

Source:  Clipart-Library.com.

Today’s rant is brought to you by the “Great Barrington Declaration”.

The gist of the Libertarian “Great Barrington Declaration”  is that the current government-imposed lockdown is harmful.  And so we should remove that lockdown and instead just let coronavirus run free among “low risk populations” until we achieve herd immunity instead.

This apparently is getting a lot of interest in the Administration.  I’d just like to take the opportunity to point out two tiny little flaws in the argument.

1  Hasn’t anyone noticed that we’re not in lockdown any more?

The whole gist of this Libertarian “Great Barrington Declaration” is that the harm caused by the current government-mandated shutdowns exceeds the harm that would occur under some (purely hypthetical) spread of COVID-19 limited t low-risk populations.

That’s an interesting concept.  Might have even been worth debating back when we actually had some such shutdowns.  But, apparently, nobody signing onto this “Declaration” has noticed one tiny little flaw in the argument:  We’re not in lockdown any more.

As a society, we might have had cause to debate this back in April.  But now?  

I don’t know about you, but I’m free to go eat in a restaurant, fly in a plane, work out in a gym, see a movie, and so on.  There’s no rule or regulation against doing that.

And yet, certain business segments related to people crowding together continue to do poorly.  Airplanes travel.  Travel in general.  Indoor restaurant seating.  Gyms.  I don’t need to belabor it.

The idea that government policy is somehow the limiting factor, right now, isn’t just wrong, it’s absurdly wrong.  It requires you to ignore the fact that we’re all free to engage in these activities now.  But few choose to.  Government policy may set some capacity limits, in some areas.  But that’s it.

So, what’s the problem for these segments of the economy?  Its free choice.  For example,  surveys show that only about 10% of the US population is comfortable going back to indoor restaurant meals.  It’s not government regs that are keeping people out of restaurants.  It’s common sense.

And that’s what makes this pure theater-of-the-absurd.  We have the Libertarians coming out for this policy, to “save the economy”, when the problem isn’t government regulation, it’s that people are freely and rationally making individual choices to avoid higher-risk situations.

School opening is different.  That’s a government (not private-sector) function, it’s a local decision, and presumably reflects the will of the people.  As in, I’ll bet if we’d taken a vote on it, FCPS wouldn’t be doing in-person classes.  Which is exactly what they’re (not) doing.

In any event, the whole discussion requires you to ignore everything that has happened since April, and pretend that we’re still in lockdown Which we are not.

2:  Can anybody out there do long division?

I’m not talking paper-and-pencil.  Feel free to use a calculator as you follow along with this ultra-sophisticated argument.  Ready?

100,000 / 80 = 1250.

How long will it take to achieve herd immunity?  I’ve addressed this in prior posts.  Let me do the math again.

The highest rate of infection ever observed in a U.S. state is what we’re seeing right now in ND.  That’s 80 cases per 100,000 per day.  And, at that rate, they are perilously close to running out of staffed ICU beds.

Can anybody out there calculate that 100,000/ 80 = 1250 days, or three-and-a-half years to get 100% infected, at the highest rate of disease spread ever observed in the US.

We’ll have vaccines in hand and distributed long before we’d achieve herd immunity by a strategy of “let ‘er rip”.

Feel free to reduce that to just 70% infected.  Feel free to cut it down by some reasonable factor (say, 3) to account for infected cases not officially diagnosed.  I don’t really much care how you play with it, the lesson is the same.

Even ignoring the mortality and morbidity, the proposed policy is inferior because it would take more time to get us back to “normal” than just staying the course on vaccine development and administration.

3 Conclusion

It has often been said that generals always fight the last war.  But at least they fight the last war with the best tactics that could have applied in that war.

Here, we’re being asked to fight the last war (lockdowns that are no longer in place) using tools that aren’t even the best available.  This proposal isn’t quite the stupidest thing ever to come out of academia.  But I’d say it’s in the running.

Post #867: RESCINDED. Why is the COVID-19 death rate declining in Virginia?

Rescinded.  The recent decline in the COVID-19 mortality rate in Virginia falls within the bounds of normal variation.  I never would have guessed that, as the number of persons involved should have yielded a stable mortality rate.  Not so.  Here’s the “concurrent” mortality rate (each day’s deaths over each day’s newly diagnosed cases), shown as a seven-day moving average.  The recent “decline” is that last bit on the end, and is clearly within normal variation.

Original short-sighted post follows.

Source:  Calculation from counts obtained from the Virginia Department of Health COVID-19 dashboard, 10-15-2020.  Black line is deaths, blue and orange are cases and hospitalizations, respectively.  These three different data series are normed so that they have the same average value of the time period shown.  Hence, there is no label on the Y-axis. Continue reading Post #867: RESCINDED. Why is the COVID-19 death rate declining in Virginia?

Post #866: Externality theory of government and private enterprise behavior with respect to COVID-19

This was going to be a long, boring post about economics.  So let me see if I can cut to the chase.

There’s a huge and obvious difference between what (some) private enterprises are doing in response to COVID-19, and what most governments are doing.

Look at how strict most successful colleges are being, with respect to students.  And here, I’ll use my daughter’s college as the example.  Mask use is rigidly enforced, no exceptions.  Social distancing, ditto.  Testing and repeat testing are mandatory, not optional.  Quarantine upon infection is mandatory and closely monitored.  Large gatherings are banned, with a system in place to catch violators.  Risky behavior is banned, and authorities actively seek to identify rule breakers and isolate them from the rest of (college) society.

In terms of COVID-19 regulation and enforcement, Red China has nothing on William and Mary.  Maybe they wear a nicer velvet glove at the Ancient and Honorable College.  But make no mistake about the iron fist.

Contrast this with our government rules, even in a well-governed state such as Virginia.  Sure, we have a mask mandate, of sorts, but nobody enforces it.  Have you heard of even a single person being fined for failure to wear a mask?  (Enforcement is via local public health departments, not via police.)  Laws against mass gatherings are simply not enforced, for the most part.  Ditto for laws regarding quarantine.  Occasionally, a venue that egregiously violates the social-distancing rules will be temporarily shut down.  But compared to private enterprise, our rules boil down to “let’s all try to play nice together”.

I think that difference in behavior is due to what economists call “externalities”.  Or, more to the point, our universal tendency to undervalue externalities. You can see a brief definition of externality here, but it boils down to: You cause something that end up being somebody else’s problem.  And you don’t have to pay for it.

Places that fully internalize the harm from COVID-19 — where spread of disease within an organization directly and profoundly impacts the bottom line — those are places that are laser-focused on preventing spread of disease.  So, where the harm from disease spread is internalized, you find people taking this seriously.  If a college messes this up badly enough, that’s the end of in-person college for that semester.  By contrast, places where the fallout from spread of disease is somebody else’s problem — where there is no direct link between an entity spreading disease and that same entity suffering significant economic harm — those tend to be entities with weak to nonexistent mandatory practices to prevent disease spread.

That is my theory, it is mine, and belongs to me and I own it, and what it is too.

A key point here is that, in general, Republicans don’t believe in externalities.  Or, at least, modern Republicans don’t.  Or don’t believe that they matter much.  Or something.  The idea that transactions other than market transactions matter just does not seem to impinge upon their thinking. Or, equivalently, that if money didn’t change hands, the value of the transaction is given a default value of zero.  (The sole exception is a legal setting, such as a tort case, where a judge or jury determines the monetary value to assign to an injurious-but-otherwise-uncompensated transaction.)

And, of course, the heart and soul of public health is externalities.  That’s the difference between Infectious Disease as a specialty, and Public Health as a specialty.  Public health is largely about trying to prevent the involuntary risk and harm that result when individuals expose others to infectious diseases.  It’s about putting a value on the harm that you do to others, by spreading disease, and then taking steps to minimize that harm.

And so, under this theory, Republicans as a party really and truly are clueless when it comes to public health.   They literally don’t understand it, because, by and large, they don’t recognize the concept of externalities as a central tenet of their ideology.  In fact, I’d say that as a whole, they work to reject any notion of it (e.g., pollution, global warming, and so on).

To a public health official, a pandemic is about people harming other people by spreading disease.  And so the goal for rational public health policy is to value that harm, and take steps up to the point where the cost of prevention exceeds the cost of harm prevented.  And so, dealing that that rationally requires acknowledging that an epidemic is all about externalities. 

Republicans, by contrast, are not allowed to think in terms of externalities.  That leaves them with far more primitive notions of what a pandemic is.  To them, at root, a pandemic is an act of God.  Or an act of Nature.  It’s just something that happens. The (default) dollar value assigned to it is therefore zero.

And, more to the point, to the Republicans of today, a pandemic is not something to which the standard economic cost-benefit calculus can be applied.  Because they are ideologically blind to the value of externalities, they can’t assign a dollar value to them, even roughly.  Even in theory.

The result is that they behave in a way that is the complete opposite of a well-run business organization that internalizes those costs.  Such as a well-run college.  Or nursing home.  Or, to a degree, meat-packing plant.  All of which have adopted vastly more stringent approaches to infection control than has any state or local government.

To the point where they backed, and apparently continue to back, approaches to this pandemic that are hugely economically inefficient.  And here, I’ll refer you back to Post #571, and my crude characterization of “herd immunity with no shutdown” as a proposed strategy for dealing with the pandemic, as follows:

So let me make you an offer.

If you let your child (or, possibly, grandchild) die a slow painful death, in the next couple of months, I’ll give you a brand new luxury SUV.   

Do we have a deal? 

No?  Well, suppose I make it a nice new house instead?  Do we have a deal yet?

If not, you’re beginning to understand what’s missing in a strategy that focuses solely on lost GDP  ...

Economists have a word for that:  Inefficient.  That would be an economically inefficient decision. 

And yet, apparently, herd immunity is still in play, in parts of the current Administration.  Despite the fact that it is an economically inefficient strategy (as defined in that posting).  Because Republicans are trained to think that a pandemic, and dying from a pandemic, is somehow an Act of God.

Well, that, plus the fact that none of them appears to be capable of doing even basic arithmetic.  And so none of them seems to realize just how many years it would take to achieve herd immunity by spreading infection (Post #799).

 

 

Which brings me back to South Dakota.  They’re now above 70 new cases per day per 100,000, and together with North Dakota, seem to be setting new records for rate of infection just about every day.

And yet, there’s no mandatory mask ordinance.  And clearly no sort of shut-down or stay-at-home orders.  And probably never will be.  Because if a pandemic is an Act of God, and you can’t place a value on the fact that person A infects person B, then you have no ideological basis for taking action.

To put this bluntly — for the handful who have bothered to skim to this point — failure of national and state Republican leadership in dealing with the pandemic is truly a failure of their ideology, in this context.  Their blindness to the value of externalities means that they really, truly don’t understand what public health is all about.  They don’t correctly value the involuntary harm caused by public transmission of disease, but instead, conceive of it as more-or-less an Act of God.  (My point is, they assign zero earthly dollars to it.)  That leads to economically inefficient decision-making.  And, unsurprisingly, based on that ideology, they’ve managed to fumble just about every public health aspect of this pandemic.

And once you get to that conclusion, the constant denial of reality by die-hard Republicans snaps into focus.  Who could possibly fail to be impressed when the Governor of South Dakota, when faced with the current very high rates of COVID-19 infection, blamed it on increased testing (Post #864).  Pulled a page out of the standard Republican playbook, even though the last Republican governor to try that line of baloney in the context of a surge in cases had to eat his words just nine days later (again, Post #864).  And when the state next door — with a virtually identical rise in cases — was down to its last handful of ICU beds.

(That is, in addition to insisting that stay-at-home orders and such are “useless”, rejecting the notion that a week-long 500,000 person party during a pandemic could possibly have any negative public health consequences, and, of course, insisting that there’s no evidence that wearing masks reduces transmission of disease.)

That is her theory, it is hers, and belongs to her and she owns it, and she’s  damned proud if it, too.

I wonder how the South Dakota governor’s campaign to lure new businesses to that state (referenced just above) based on their lack of COVID-19 controls is going?  I wonder if she’ll learn anything from that market test?  Odds are, I would bet not.  As an economist, it always amazes me how people will ignore the judgment of the market when it pleases them to.

The bottom line is that because Republicans don’t value externalities, they are incapable of grasping solutions that make sense and that fit within the limits of their ideology.  But they can’t say, our ideology is the problem here.  They can’t say, here’s a problem that our ideology prevents us from addressing.  So, instead, they say, well, see, there is no problem. 

It’s all perfectly logical.  In its own way.

Post #865: Getting ready for a hard winter, 5: Grocery story deja vu

As you (almost certainly don’t) recall, I tracked the progress of pandemic panic shopping in the Vienna, VA area.  That started with with the disappearance of all dust masks from the local Home Depot before Virginia had even one COVID-19 case.  Progressed to “genteel panic shopping“, where only the good stuff was gone.  Passed through the Soviet-style hundreds-of-people-lining-up-at-the-rumor-of-toilet-paper phase.  And finally seemed to settle down into the occasional shortage of the odd item or two.  (Yeast? Apple cider vinegar??)  This was summarized, with dates and references to original posts, in Post #816.

Along with slow internet, I thought that the poorly-stocked grocery store was now a thing of the past.  Been there, done that. Got the merit badge.

But from what I’m seeing and hearing, that’s just not so.  And so, both by the evidence of my own eyes, and by a few credible reports, I’d say that grocery store shelves seem to be thinning out once again.

And so, if your life didn’t seem quite enough like Groundhog Day,* you can now look forward to modest repeats of the same shortages you dealt with earlier this year.

* ” … doomed to spend the rest of eternity in the same place, seeing the same people do the same thing EVERY day.”  Rob Harthill, IMDB.com

For the life of me, I can’t quite figure out why.

Continue reading Post #865: Getting ready for a hard winter, 5: Grocery story deja vu

Post #864: COVID-19 reruns. At least this proves the South does not have a monopoly on goobers.

Source:  Calculation from NY Times COVID-19 data repository on Github.   Case counts maintained by Johns Hopkins University.  Data reported through 10/12/2020.  Note that I’ve had to expand the vertical scale since the last time I published this graph, just a few days ago.


Definition of goober

By goobers, I’m not talking about peanuts.  I’m talking about a slang term for individuals who are naively stupid.  A name, per folklore and tradition, typically associated with residents of the rural South.  (I must note here that I am a southerner).

Here’s an example of how the Governor of Florida permanently established his goober cred (Post #825).  The spread of COVID-19 among college students is a serious issue that universities across the country are addressing.  Student parties have been repeatedly identified as the single largest source of spread of infection.  Colleges acted to restrict those parties.  In response, the governor of Florida proposed a legal “Right to Party” for college students.  What a goober.


The Dakotas are proving that the South has no monopoly on goober governors.

Continue reading Post #864: COVID-19 reruns. At least this proves the South does not have a monopoly on goobers.

Post #863: Getting ready for a hard winter, part 4: Maple Avenue businesses

More than a year ago, I estimated the retail vacancy rate along Maple Avenue here in Vienna VA.  It was, as far as I could tell, no different from the rest of Fairfax County.  I also catalogued the variety of retail establishments along Maple (Post #208).

Last Sunday morning, I took a slow drive down Maple to see what had closed since that last survey.  And then to determine, as best I could, what has closed along Maple Avenue since the start of the pandemic. Continue reading Post #863: Getting ready for a hard winter, part 4: Maple Avenue businesses

Post #862: Will we finally get some bodies in reefers? The Dakotas test the limits of stubbornness.

Source:  Isaacs and Isaacs . com

Reefer being the common term for refrigerated trailer or truck of any sort.

I bet not.  I bet they’ll act before it comes to that. Based on history.

 

And so, here’s how things look.  This is more-or-less the history of the US pandemic, in one big, sloppy graph.   Continue reading Post #862: Will we finally get some bodies in reefers? The Dakotas test the limits of stubbornness.