Sunday, July 5, 2020

Seriously, Don't Shut Down Again!

(NOTE:  This post has been updated several times, see the updates at the end of the post.)

It looks like several states are seeing spikes in COVID-19 in recent weeks following reopening.  While probably most of it is due to increased testing, the very large spikes (and increases in positivity rates) in Texas, Arizona, Florida, California, and some other states also show increases in hospitalization rates, so at least some states are likely seeing real increases.  And those are generally the ones who reopened before even reaching their peaks, while California's early flattening of their curve seems to have merely delayed the bulk of their infection burden.  And interestingly, Georgia had not seen any real spikes until very recently, despite being the first state to reopen.  Meanwhile many states, most notably New York and New Jersey, have not seen any spikes at all despite increased testing and massive protest rallies in recent weeks.  Both were among the first states to have mandatory mask requirements, and were also the earliest and hardest-hit states.

Even the increase in hospitalization numbers may be less than meets the eye.  Given how now they tend to test every patient that darkens their doors regardless of what they initially went in for, that alone will push the numbers up, especially since many new patients are from the backlog of patients when non-urgent and elective procedures were restricted during the shutdown and many people had a fear of going to hospitals due to COVID-19.

Thus, it may not even be due to the timing and pace of reopening at all, but rather due to how many people are wearing masks, and simply that states that were hit harder earlier, the epidemic has largely run its course, while the states that started with milder outbreaks simply still have a ways to go yet.  And overcrowded bars and nightclubs seems to be the biggest culprits in the new hotspots lately.

It is notable that death rates are still dropping nationwide despite the apparent surge in daily cases to new record highs.  Even in the new hotspot states, deaths are generally low and flat or declining, and even Arizona's death rates are still following the same old slow-burn pattern they had before reopening despite being the fastest-growing state in terms of positive test results lately.  Most new cases are coming from younger people (under age 35), a possible reason for the apparent decoupling of infection rates from death rates, and suggesting herd immunity likely occurring sooner rather than later.  Or perhaps we have learned (often the hard way) better ways to treat the disease, thus saving more lives.  Or the virus itself could simply be getting tired and losing its "mojo" after circulating so much for so long.

So even if there is a surge in cases, resist the impulse to lock down ever again.  Doing so once is already one too many times.  Simply require masks to be worn in public, particularly indoors, and tighten limits on building occupancy and large gatherings.  That's it.  Add some temperature checks and you're golden.  Maintain such policies until case numbers drop to a statistically and practically negligible level, then repeat as necessary.  As for a vaccine or cure, don't hold your breath, since a vaccine is likely years away, while anything resembling a (belated) cure would most likely not be much of a game-changer compared to existing treatments (remdesivir, steroids, etc.).

And of course, there is already a certain alternative treatment protocol that has gotten such a bad rap in the mainstream due to grossly improper use (and its infamous guilt by association with certain politicians who promoted it) that some countries have even banned it despite its rather promising effectiveness in saving lives when used early, properly, and under the advice of a qualified physician.  Switzerland briefly banned it and subsequently lifted the ban, effectively creating a natural experiment, and the results speak for themselves in terms of death rates. (The TSAP cautions the reader to always consult a physician before beginning any sort of treatment or prophylactic regimen, especially this one.)

(Also, enter lab-created antibodies, which are of course certainly worth a try in the meantime.)

As for contact tracing, they really need to step it up.  And any supposed shortage of testing capacity (even after having many months to prepare!) is no excuse not to do it, as Japan was able to do retrospective contact tracing successfully with very little testing (2000 tests per day, equivalent to about 5000 per day in the USA), focusing on the larger clusters and thus the "superspreaders" that account for the vast, vast majority of virus transmission in the community.

And perhaps COVID-sniffing dogs will soon become a thing as well.  Apparently they exist. Regardless, all of these aforementioned alternatives are far better than a return to lockdown.  So what are we waiting for?

JULY UPDATE:  It looks like daily death rates finally did begin modestly rising again for the USA, driven by a handful of hotspot states, several weeks after apparent cases had begun rising.  That said, the death rates nevertheless still remain far lower than what they were in April and May, and the case-fatality rate continues to fall.  In other words, the curve has been flattened.  And apparently a good chunk of these supposedly "new" COVID deaths are a simply a result of delayed reporting of deaths that occured back in June, May, or even April, and/or were not even necessarily caused by the virus (e.g. motor vehicle fatalities in which the deceased happened to test positive).  Thus, our argument still stands.

AUGUST UPDATE:  As the ever-insightful J.B. Handley recently noted, there is yet another crucial nuance to this pandemic that has been overlooked.  That is, much like with other seasonal viruses, in the more southern latitudes, the epidemic burns slower and the peak simply arrives later and is smaller (at least in terms of deaths) compared with the more northern latitudes.  And since even in the north (Europe and the northern US states) it arrived about three months later than a typical flu season, it would be even more delayed still in the southern US states as well as Latin America and the rest of the global south, lockdown or no lockdown.  Divide the USA by the 35th parallel and in fact you see two distinct death curves.  This is exactly what the famous epidemiologist Dr. Edgar Hope Simpson would have predicted.  Combine that with Dr. William Farr's famous Farr's Law, and one can predict that the pandemic is almost over.  So yes, much of the surge in cases and deaths in the southern states is all too real,  but even there it will be largely over (that is, no longer at epidemic proportions) in a few weeks from now.  Based on excess weekly all-cause mortality, Handley notes that the predicted end date for the USA overall is August 25, 2020, when such figures return to baseline and there is no longer any signal in the noise (even if there are still some reported cases and deaths from or with COVID-19).

(Same thing happened with its cousin SARS back in 2003, by the way.  It simply arrived and peaked later in the lower latitudes, then eventually disappeared.)

And let's not forget the problem of false positives on the PCR tests as well, which will become increasingly salient as the actual epidemic/pandemic wanes.

SEPTEMBER UPDATE:  Looks like all-cause deaths in the USA by date of death are still elevated (significant excess deaths) as of late August and early September, but declining.   Thus, the prediction by Michael Levitt was simply off by a few weeks due to reporting lags.  The lag for designated COVID deaths specifically is even longer still, with a good chunk of the deaths reported today having occurred weeks or even months ago.  And given all of the increased testing and false positives for cases, what we have now seems to be more of a "casedemic", while the actual pandemic is waning if not already technically over in most places.  A true second wave is thus unlikely.

Saturday, June 27, 2020

Is America Headed For Civil War Or Collapse?

Perhaps we are, according to a mathematical model by Professor Jack Goldstone.  Based on trends in inequality, selfish elites, and political polarization that began since the 1980s, the conditions for civil violence are the worst they have been since the 19th century.  In fact, this same model accurately predicts the (first) American Civil War, and if it is correct this time around, we are dangerously close to the precipice of another one very soon.  If so, it will make the pandemic look like a walk in the park by comparison, and the past three months look quaint.

The powder keg has been building for decades now, and recent events have been both a consequence (our national failure to mount anything close to an effective response to COVID-19 before it was too late) and a spark (recent civil unrest from pent-up rage over both persistent racial injustice and increasing police-state authoritarianism, along with the toxic effects of the lockdowns).  Throw in record levels of unemployment and economic anxiety followed by the cliff that results from the impending and abrupt ending of the extra $600 per week in unemployment benefits come July 31 (unless extended further).

But the biggest flashpoint of all is yet to come in a few months from now:  the 2020 presidential election.  Whichever side wins, the other side loses, and plenty of people on the losing side will be very, very angry.

It is probably not too late to stop a full-blown civil war and/or collapse before the Rubicon is crossed, but that window is closing very, very fast indeed.

So what do we need to do to save the Republic (again) before it is too late?  I mean, we really don't want to give the reich-wing accelerationists like the Boogaloo movement the satisfaction, right?  For starters:
  • Immediately implement Universal Basic Income (UBI) for all, no strings attached, via federal or central bank money creation.  Start it at $2000 per month for everyone over 18 and $1000 for everyone under 18, for three months, then drop it to half that amount ($1000 and $500, respectively) indefinitely. 
  • Immediately implement single-payer Medicare For All.  Yesterday.  And along with that, increase much-needed funding for hospitals and healthcare providers across the board.
  • For both above items, include anyone with a SSN or ITIN, regardless of citizenship or immigration status.  No means test, no discrimination, no perverse incentives.  And no bank account required--use debit cards whenever needed.
  • Free college (and trade school) for all, thus improving stagnant economic mobility.
  • Implement the rest of Rodger Malcolm Mitchell's Ten Steps to Prosperity as well.  That includes, among other things, progressively taxing the very rich 0.1% very heavily to reduce inequality.
  • Implement the Green New Deal, including a federal job creation program. 
  • Implement much-needed and long-overdue reforms to police nationwide, rooting out structural racism and abuses of power.  Yesterday.  What are we waiting for? 
  • Extend any moratoriums on evictions and foreclosures for an additional 30 days or until the aforementioned UBI payments reach everyone, whichever is longer.
  • It should go without saying, but DO NOT LOCK DOWN EVER AGAIN!  Even in the worst COVID-19 hotspots, mandatory mask requirements and bans on very large gatherings are sufficient to prevent a worst case scenario at this point.
  • And of course, we must go back to actually being a Constitutional Republic rather than an unconstitutional empire.  No more over-bloated military and unnecessary wars of choice to make the rich richer.
As the saying goes, "all models are wrong, but some are useful".  The TSAP sure hopes that this model is very wrong, but there is no denying that this one is highly useful.  The evidence is all around us.

Wednesday, June 17, 2020

Lockdowns Don't Work. But Masks Do.

NOTE:  As of August 14, 2020, the TSAP's positions taken in this article are hereby superseded by those in a newer post.  Also, since the article was posted, the study that formed the primary basis for this article has apparently been recommended by over 40 scientists to be withdrawn due to its apparent flaws.

That is essentially the conclusion of a new study that looks at the (former) COVID-19 hotspots of Wuhan, NYC, and northern Italy.  Based on the relative timing of when social distancing measures, stay-home orders (i.e. lockdowns), and mandatory mask rules were first imposed, the researchers found a strong inverse correlation with COVID-19 cases and mask requirements, while barely any correlation with social distancing and stay-home orders.

(And not the only study either.  Though other studies do find some degree of effectiveness for social distancing as well.)

Unfortunately, the study authors kinda shoot themselves in the foot by effectively conflating as "airborne" both larger ballistic droplet as well as small aerosol droplet transmission.  The strong inverse correlation with mask wearing would if anything make even more sense for catching larger droplets than smaller ones.

Either way, while correlation does not prove causation, this is nonetheless a pretty strong correlation.  Thus, there is no good reason not to reopen the economy at this point, and quite frankly, yesterday is not soon enough.  During the reopening process, state governors (Ducey of Arizona, I'm looking at you!) really ought to require masks to be worn in public, particularly indoors (which is far riskier than outdoors) and during the most critical and riskier phases of the reopening process.

And of course, We the People really need to wear them, yesterday.  At least in indoor public spaces and public transit, or any other crowded area where sufficient physical distance is difficult or impossible.  Even if it is just for the next few weeks or so, it will still make a big difference, especially in reducing the overshoot beyond the herd immunity threshold in places that are at or approaching that threshold.  In fact, as source control, when a large enough percentage of the population wears masks, it can effectively simulate herd immunity, and the virus will thus quickly run out of momentum and die out.  And all without wrecking the economy and society at large, and with minimal effect on individual rights.

That said, the TSAP should clarify that we support mask mandates that are nuanced and temporary, not absolute or permanent.  Absolute (i.e. without nuance) ones should not last more than two weeks in any case, and the much lower risk of outdoor transmission should be taken into account by mandates lasting longer than that.

It is worth noting that the states with mandatory mask requirements have seen decreases in COVID-19 cases, while the states without (including California, who only very recently implemented such a requirement, thus the effects haven't kicked in yet), have seen significant increases.  And that is true even though all 50 states and DC have reopened to one degree or another at some point.  It is hard to find a correlation stronger than that.

So even if there is a surge in cases, resist the impulse to lock down again.  Simply require masks to be worn in public, particularly indoors, and tighten limits on building occupancy and large gatherings.  That's it.  Add some temperature checks and you're golden.  Maintain such policies until case numbers drop to a statistically and practicallly negligible level, then repeat as necessary.  As for a vaccine or cure, don't hold your breath, since a vaccine is likely years away, while anything resembling a (belated) cure would most likely not be much of a game-changer compared to existing treatments (remdesivir, steroids, etc.).

As for contact tracing, they really need to step it up.  And any supposed shortage of testing capacity (even after having many months to prepare!) is no excuse not to do it, as Japan was able to do retrospective contact tracing successfully with very little testing (2000 tests per day, equivalent to about 5000 per day in the USA), focusing on the larger clusters and thus the "superspreaders" that account for the vast, vast majority of virus transmission in the community.

And perhaps COVID-sniffing dogs will soon become a thing as well.  Apparently they exist.  Regardless, all of these aforementioned alternatives are far better than a return to lockdown.  So what are we waiting for?

Wednesday, June 10, 2020

Latest Pro-Lockdown Studies Are Far Less Than Meets The Eye

The latest two studies that claim that lockdowns somehow prevented millions of COVID-19 cases from occurring are getting a lot of attention right now.  But upon closer examination, we see that there is less here than meets the eye:
  • Only six countries are included in the first study:  China, South Korea, Iran, Italy, France, and the USA.  Conspicuously absent are the UK, Belgium, Spain, Germany, Sweden, Iceland, Taiwan, Japan, and Belarus, which clearly skewed the results.
  • The other study, done by the same Professor Neil Ferguson known for his buggy and discredited model back in March among others included 11 European countries (including many left out of the other study) and did a "simplistic counterfactual" compared to no intervention.
  • Teasing out the precise effects of each specific type of intervention is not easy.
  • The researchers in the second study assume an R value of 3.8 and a doubling time of two days at the beginning of the epidemic, before any intervention, and that it would have remained that high in the absence of such interventions.  In contrast, most other researchers put the basic R value at between 2 and 3, with a doubling time of 3 days--and that makes a very big difference.
  • Epidemics do not keep growing exponentially forever, rather, they famously follow a sigmoidal Gompertz curve even without intervention.
  • There is evidence that the R values in many countries plummeted well before any lockdowns went into effect (Germany's dropped below 1 just days before their lockdown, and Sweden's also did without ever doing a lockdown).  This was due to voluntary behavior changes as well as more modest policy measures.
  • Failing that, the R value will plummet and drop below 1 when the herd immunity threshold is reached regardless.
  • There is evidence that the herd immunity threshold is lower than the naive assumption would put it, and that it would be reached sooner than believed even in an unmitigated scenario.  Also, a LOT more people were infected than the number of confirmed cases, by at least a factor of 10 if not a factor of 80 or 100.
  • The first study only looked at confirmed cases, not hospitalization or death rates.  And confirmed cases are probably the most biased measure of true infection rates that there is.
  • And now the real kicker:  flattening the curve does not actually change the number of cases or deaths, only delays and staggers them.  Except to the extent that it prevents hospitals from being overwhelmed and collapsing, but that generally did not materialize anywhere outside of Lombardy, Italy and some localities of Spain, not even in Sweden.  Moderate social distancing appears to be sufficient to prevent such a collapse, while belated lockdowns utterly failed to prevent it in the very few rare and exceptional cases where it happened.  Thus, the case for lockdowns, well, collapses.
And the best empirical evidence does not pan out in favor of lockdowns:  non-lockdown countries are generally outperforming lockdown countries on average, and within the USA, non-lockdown states have also been outperforming lockdown states in terms of coronavirus case and death rates per capita.

The supposed effectiveness of lockdowns (compared to far less extreme restrictions) in terms of slowing or stopping the spread of coronavirus has been called into serious question lately by other recent studies.
Such studies have found there is at best no correlation, and perhaps a perverse effect between the two defining features of hard lockdowns (stay-home orders and closures of all non-essential businesses) and COVID-19 cases and deaths per capita after other factors such as less-extreme policies are accounted for.  The benefits are thus nothing more than a statistical mirage that does not stand up to scrutiny--much like the supposed benefits of the 21 drinking age vis-a-vis DUI deaths in the long run.

Meanwhile, the collateral damage (economic depression, inequality, poverty, alcohol and other drug abuse, domestic violence, child abuse, loneliness, poor mental health, delayed medical treatment, etc.), which also kills people too by the way, continues to mount with each passing week of lockdown, making an utter mockery of practically all progressive and even basic humanitarian priorities.  And that's to say nothing of the civil rights and liberties, as well as community cohesion, that progressives generally support.  It seems that the "cure" is quickly becoming far worse than the disease as time goes on.

(And that's just for the affluent countries.  For poorer countries, the collateral damage will most likely be at least an order of magnitude worse and deadlier.)

Furthermore, all may not be what it seems in terms of death rates.  In many countries, deaths with COVID and from COVID are conflated, and even non-COVID deaths saw increases during at least the first few weeks of lockdown.  Excess all-cause mortality in so many countries shows a rather suspicious pattern that is strongly suggestive that the government response of lockdowns (along with closely related policies such as artificial restrictions of healthcare and monumentally screwing up with nursing homes) likely caused far more deaths than the virus itself.  In fact, despite the fact that the virus was already circulating much earlier, excess all-cause mortality did not exceed statistical norms in any country until after such lockdowns were imposed.

If that is the case, then that is nothing short of mass murder!  And those are just the short-term effects, with longer-term effects coming down the pike.

Thus, the latest Nature studies should be taken with at least a grain of salt, if not a whole pound.

Monday, June 8, 2020

Just How Old Is COVID-19 Really?

Along with Zsa Zsa Gabor and the universe itself, there are several things whose real age have long been a mystery.   We can now add COVID-19 to this list as well.  The now-pandemic viral disease was first thought to have originated in December 2019 in a "wet market" (live animal market) in Wuhan, China.  Then, it was found that there were older cases not linked to that infamous "wet market" cluster, implying a different origin from that, and November 17 was then given as the date for the first known case.

But now there is increasing (albeit circumstantial) evidence that it may be even older still.  Satellite data from China, particularly Wuhan, suggest that hospitals saw unusually high traffic and unusually full parking lots in the fall of 2019, as far back as mid-September.  Internet search trends in Wuhan also show a spike for searches for "cough" and "diarrhea", two now-known key symptoms of COVID-19, the latter of which is generally not found in seasonal flu.  And those upward trends actually began in late summer.

Thus, it was very likely that travelers had brought it to the USA and Europe far earlier than originally believed.  Take this YouTube video from 10 months ago (August)--it discusses outbreaks of a mysterious respiratory illness in nursing homes in Fairfax County, Virginia.  While some antibody survey testing results were a bit underwhelming in several countries, we should keep in mind that, as Oxford Professor Sunetra Gupta notes, other facets of the immune system (such as T-cells) may have fought off the infection before the body had a chance to make antibodies to the virus, and indeed mild infections may not generate detectable levels of antibodies right away if at all.  There seems to be at least partial cross-immunity with exposure to related coronaviruses (i.e. common cold viruses).  So the percentage of positive antibody test results should really be seen as a lower bound for the percentage of the population that was already infected at some point. 

Thus, herd immunity is closer than you think, if we are not already there yet.  And it is that, and not the (belated) lockdowns, that is what really caused COVID-19 peak and then decline in so many places.

JULY UPDATE:  The plot thickens even more, it seems.  An analysis of old, frozen sewage samples from Spain finds that the virus was already circulating since at least as far back as January 15, 2020.  For the virus to be detectable in sewage, it must have been quite prevalent indeed!  That dovetails nicely with the positive test result of the reanalyzed old blood sample from a patient in France back in December 2019.  Moreover, the Spanish researchers subsequent analyzed old sewage samples from January 2018 through December 2019, finding all were negative except for March 12, 2019 (i.e. more than a year ago!), which was found to be weakly positive for the virus.  This means that either the test is more prone to false positives than we thought, or the virus is in fact a LOT older than anyone imagined, more than a full year old.  And just like its cousin SARS, it does not seem to be aging very well either in terms of its genetic material, and may very well be losing its "mojo".

AUGUST UPDATE:  There seems to be a growing scientific consensus lately that the COVID-19 virus likely originated in a lab (the Wuhan Institute of Virology) rather than in nature.  Basically, researchers would do reckless "gain of function" experiments (which is illegal on most countries) on various bat coronavirusues to make them more contagious, more deadly, and/or more likely to jump species barriers, in order to study such phenomena. And perhaps one of these novel genetically modified (GMO) viruses "accidentally" escaped the lab and got into the population, and the rest is history.  If so, the institute and the government of China (and also the Trump regime who lifted Obama's moratorium on such research) really have a LOT of blood on their hands!  And the very best way to avenge the deaths of COVID-19 victims is to permanently ban such reckless experiments worldwide, no exceptions.

The latest theory is that that the virus actually originated in 2012 (leading some to call it COVID-12 instead) when a group of six miners in southwest China contracted pneumonia from it, which they likely got from exposure to bat guano in the mine shaft.  The Wuhan Institute of Virology then kept samples of this virus, which they perhaps tweaked even further using their so-called "gain of function" research.  The virus then escaped from the lab sometime in 2019, and as they say, the rest is history.

Another possible route is a genetically modified bat coronavirus from 2015, one deliberately engineered to make use of the human ACE2 receptor to enter our cells, which we now know that SARS-CoV-2 (aka COVID-19) does as well.  This "gain-of-function" research was apparently done in a collaboration between the University of North Carolina at Chapel Hill and the Wuhan Institute of Virology.  Again, all it would taken was for it to "accidentally" escape from the lab in order to easily cause a pandemic.

And now the plot thickens even further as a Chinese virologist turned whistleblower finally gets the chance to tell her story....

JANUARY 2021 UPDATE:  A genetic investigation into the origins of COVID-19 in China apparently puts it at October 2019 (if not earlier), which means the virus had been spreading months before Chinese authorities belatedly alerted the world.  Also, a new Bayesian analysis finds that, statistically speaking, the probability that the virus originated in a lab is practically certain.

Maybe even earlier than that, who knows? 

And while it turns out that only some pockets of herd immunity prevailed after the first wave in Europe and the USA, hence the second wave in several countries and states, the fact that the virus is now in retreat despite it being the middle of winter strongly suggests that we are at or very close to full herd immunity nearly everywhere now.  This is evident even before the vaccine would have had any effect, by the way.  The first wave, even in Sweden, apparently produced just enough immunity for seasonality to naturally suppress the virus temporarily in the summer, only to be followed by a fall/winter wave.  But Sweden's second wave was still not as bad as either their own first wave or the second waves of most other European countries.  And future major surges are unlikely in nearly every county going forward, even with new strains of the virus emerging.

Thursday, June 4, 2020

How Japan Beat COVID-19

One country that the lockdown enthusiasts seem to conspicuously avoid talking about is Japan.  Sweden is their favorite punching bag, as is Florida, but Japan?  It's as if they don't even exist.  And yet, they managed to beat the COVID-19 virus by doing everything "wrong".  And by "wrong", we actually mean RIGHT for the most part.

Despite being in the original geographical danger zone for the pandemic, and being one of the earliest countries to be infected that was not named China, their per capita death rate (the most important indicator) remains so low that it barely even gets on the chart relative to the rest of the world.  So how did they do it?

They did not impose a compulsory lockdown, opting instead for what they called a "soft lockdown" that did not even have the force of law (as their constitution, that they actually take seriously, strictly forbids doing such a thing), and even that was fairly brief and quite belated.  Nor did they close their borders either, opting instead for health checks at ports of entry and fairly modest visa restrictions early on.

What they did do, rather famously, is habitually wear face masks in public, as they did even before the pandemic began during flu season as well as allergy season.  Not everyone, but apparently enough to make a difference. And they are generally very good about hygiene overall there as well.  But less famously, and yet likely contributed even more to their success, was their virtually unique strategy of contact tracing despite doing relatively few tests for the virus.  Instead of going high-volume, labor-intensive, and prospectively, they quietly went after the larger clusters and traced contacts retrospectively, working backwards.  And that strategy really seemed to out-ninja this rather stealthy virus, since the spread pattern is highly skewed and heterogeneous, overwhelmingly driven by a fairly small number of "superspreaders" (10-20% of infected people), while about 70% of infected people statistically don't pass the virus on at all to anyone.  So this pattern lends itself more to that kind of contact tracing paradigm.  And best of all, they did it with excellent timing, unlike so many other countries that squandered and missed their chances to do so before it was too late.

Some cynics may think that Japan deliberately did as few tests as possible so as to make their numbers look good to the outside world, in the hopes of hosting the 2020 Olympics in Tokyo (which nevertheless got postponed to July 2021), thus sweeping it under the rug.  While that may or may not have been part of the motivation for running a low number of tests, their death numbers don't lie, and they seemed to have outsmarted the virus in any case.

And last but not least, despite having the oldest population in the world, they apparently protected the elderly quite well, and apparently did NOT screw up with their nursing homes like so many other countries (especially the UK and New York) unfortunately did royally.  That alone is worth its weight in gold, and the proof is in the numbers.

Now THAT is a shining city on a hill!

(The Wall Street Journal has another great article about Japan's success story here.)

OCTOBER UPDATE: While Japan still seems to have quite a lot of "cases" (positive tests), their per capita death rates are still very low and barely even get on the chart. Another good article can be found here.

2021 UPDATE:  We now basically take back anything we said about Japan "beating" the virus, especially anything about masks which turned out to be largely a red herring all along.  Japan had lots and lots of cases, even with low testing, but very few deaths and essentially no excess deaths, most likely due to low obesity and prior immunity from related coronaviruses common in East Asia.  That is a far better explanation than masks or ingenuity.  Their two worst waves so far both occurred in 2021, and they also had quite the surge in RSV in 2021 as well, despite a whopping 98% mask compliance.  Otherwise though, we still praise Japan for avoiding a hard lockdown, or even any serious mandates prior to 2021.  The virus was always destined to become endemic, and on some level they seem to be accepting that despite their initial elimination strategy.

The Nuanced Truth About Sweden

Sweden is one of those countries that, in our polarized world, you either love them or hate them.  Being the most famous of the non-lockdown countries, the anti-lockdown side loves them while the pro-lockdown side just loves to hate them.

In truth, however, they are neither a shining city on a hill, nor are they an unmitigated disaster in terms of how they handled the COVID-19 pandemic.  They are in fact...about average by European standards, at least in terms of per capita death rates for now.  Worse than their Nordic neighbors and Germany and Austria, but better than the UK, Belgium, Spain and Italy.  Worse than the USA as a whole, but better than the seven worst US states, especially New York.  Which is nothing to brag about, of course, but hardly a ringing endorsement for lockdowns either.  Especially since they avoided completely annihilating their economy (albeit still suffering) and inflicting other collateral damage that the lockdowns in other countries (especially the UK) did, while still being able to "flatten the curve" and thus keep hospitals from being overwhelmed and collapsing Lombardy-style.

The architect of the Swedish mitigation strategy of moderate social distancing, Anders Tegnell, admits that Sweden could and should have done more.  And yes, they did screw up in several major ways, at least in the beginning.  But he still does not endorse a full lockdown.  So what could they have done differently, short of a lockdown?  Here are the things that come to mind that they should have done but didn't, or should have done earlier but did too late:
  • They kept their borders wide open with no hard restrictions on international travel or even any health screenings at ports of entry.  Even Japan and Belarus didn't make that mistake.  In hindsight, that was really quite foolish.
  • They did not declare a state of emergency.  Even the Donald did that, albeit belatedly.
  • Their gatherings limit of 500 people, first imposed on March 11, should have been cut down to 50 people or some other double-digit threshold much sooner, ideally on that same day or the very next day, rather than waiting until early April to finally do so.
  • They should have made virus testing available much sooner.  Instead, until very recently, you literally had to be sick enough to go to the hospital in order to get a test as per their test rationing policy that began in March.  Their testing is basically a national joke.
  • Contact tracing?  What's that?  (Though even with very little testing, they could still have done it the Japanese way.)
  • Like most countries, they should have done a better job protecting nursing homes. In Sweden's case, they should have banned or severely restricted visits to nursing homes much, much sooner, instead of being loosey-goosey about it until finally doing so on March 31.  And they should have made sure early on that the staff had (and used) adequate masks and PPE, which they failed to do.  Even Florida did better than they did, though New York was far worse.
  • Their triage protocols for nursing home patients being (not) sent to the hospital turned out to be wholly unnecessary and counterproductive.
  • And like most countries also failed at, they should have kept colleges open even if they canceled classes temporarily.  Sending students home to infect their parents and grandparents was probably not the wisest idea in the world.
  • And last but not least, they generally eschewed masks on the mistaken belief that they create a false sense of security.  Spoiler alert:  Um, NOPE!
Aside from those flaws, there is still much to admire about Sweden.  But ultimately they are paying a rather heavy price for their errors, even after belatedly correcting such mistakes.  They likely will reach the holy grail of "herd immunity" sooner or later, if they are not already there, but unfortunately due their missteps, the journey turned out to be much more dangerous than the destination.  Thus, we hereby give them a gentleman's C for effort.

In other words, we can certainly learn a lot from Sweden--both what to do as well as what not to do.

JULY UPDATE:   It looks like not only is Sweden's COVID epidemic all but oven now as per Worldometer death rates, and their death curve did turn out to be much more bell-shaped after all, but that Sweden is now quite vindicated indeed compared to even some of their neighbors in terms of cumulative all-cause mortality through the first 24 weeks (roughly the first half) of 2020.  Though worse than Norway, Sweden nevertheless fell very close to and just between Denmark and Finland, and fared far better than Scotland.  So it looks like the lockdown zealot vultures will need to find a new punching bag now.

Additionally, it looks like the Swedish city of Malmo is in fact doing a particularly good job overall.  They followed the Swedish strategy minus the screwups, basically, and as we can see now, it's really paying off. 

A Report Card For The Pandemic

It is June now, and we at the TSAP think it is time to issue tentative grades for each country on how they handled the pandemic.  These will be updated over time.  Grades are based on a mixture of per-capita death rates, economic damage, and policy measures.  All grades are on a curve, normalized with the European average set at C.  Here is the current list:

Taiwan:  A+
Hong Kong:  A
Iceland:  A
Belarus:  A
Norway:  A
Finland: A
Denmark: A
Japan:  A-
New Zealand:  A-
Germany:  A-
Austria: A-
Russian Federation:  B+
Portugal:  B+
Australia:  B+
Canada:  B
Singapore:  B-
Switzerland:  C+
Netherlands:  C
Sweden: C
USA: C (overall, varies by state)
Brazil:  D
France:  D
Italy:  F
Spain: F
UK:  F
Belgium:  F
China:  F (though they really deserve a Z, for infecting the whole world!)

Countries that avoided a full lockdown and still got good results automatically get higher grades than those who achieved the same results with a full lockdown.

For US states, a partial list of states' grades:

Washington State:  A
Iowa:  A
Wyoming:  A
Hawaii:  A-
South Dakota:  A-
Arkansas:  A-
North Dakota:  A-
Oregon:  A-
California:  B+
Florida:  B+
Georgia:  B+
South Carolina:  B
North Carolina:  B
Texas:  B-
Arizona:  C+
DC:  C
Maryland:  C
Virginia:  C
Wisconsin:  C
Connecticut:  C-
Massachusetts:  C-
Louisiana:  D
Illinois: D
Michigan:  D-
Pennsylvania:  D-
New Jersey:  F
New York:  F

If you remove the seven worst states, the USA has one of the mildest outbreaks in the world.  Only a very few states are worse than the European average as far as per capita death rates.  And non-lockdown states outperform most non-lockdown states.

All of these grades are of course subject to change in the coming weeks and months.

Tuesday, June 2, 2020

America Is Literally Burning. Stop Fighting Fire With Gasoline!

In the wake of the state-sanctioned murder of George Floyd by three cops while a fourth cowardly bystander did nothing, protests have fully understandably erupted across the nation.  Racism (especially structural racism) and widespread police brutality are nothing new in America, and remain persistent problems that are clearly not going away on their own, so the protestors' anger is fully justified.  The murderers and all of their accomplices must be brought to justice, and structural reforms absolutely must be made, yesterday.

(The problem is actually twofold, involving an intersection of both 1) institutional racism and the resulting gross racial disparities at all levels of the criminal "justice" system, as well as 2) a more general overcriminalization of people for victimless "crimes" and gross overmilitarization of police, along with a general lack of accountability for rogue cops.  And both need to be tackled simultaneously.  Yesterday.)

But when protestors foolishly play into the hands of outside agents provocateur (everyone from extremists to recreational troublemakers to false flags and even undercover cops) infiltrating the otherwise peaceful protests to turn them violent and destructive, then it becomes something far different and highly toxic, and counterproductive to the cause.  And by taking the bait of Trump and his buddies--the ultimate master baiters (pun intended)--who are also pouring gasoline on the fire, that is like cutting off one's nose to spite one's face.  So please don't fall for it.

The last thing America needs right now is a full-blown civil war.  Which is where we are unfortunately heading if this continues to escalate much longer.  And it is what the "alt-right", white supremacists, and other right-wing extremists like the Boogaloo movement seem to really want to happen, hence their sending outside agitators to infiltrate protests.

(Hear that?  That's the sound of Putin having a good belly laugh at America's expense.)

And while we really hate to be a wet blanket, please remember that while the right to peacefully protest is sacrosanct in what is supposed to be free society, the COVID-19 pandemic is still going on, and you still need to take precautions nonetheless since the virus doesn't care about your or anyone's politics.  Wear a mask, carry hand sanitizer, stick to smaller groups, and try to keep as much physical distance as possible out there.  Don't deliberately get in anyone's face either.  And if you have any sort of questionable symptoms at all in the least, please sit this one out and stay home protesting virtually.  In other words, please use common sense.  That advice applies to both the George Floyd / Black Lives Matter protestors as well as any anti-lockdown protestors, by the way.

To quote Rodney King himself during the 1992 LA riots:  "Can we all just get along?"

Friday, May 22, 2020

The Progressive Case For Reopening America (And Never Shutting Down Again)

Recently there was an article titled "The Left-Wing Case Against Lockdowns" that explains in detail why genuine leftists and progressives should oppose extending these coronavirus lockdown policies.  It basically echoes what we at the TSAP has been saying for weeks now, namely that these policies have not aged very well and are doing more harm than good in the long run. And the empirical evidence actually bears this out:  non-lockdown countries are generally outperforming lockdown countries on average, and within the USA, non-lockdown states have also been outperforming lockdown states in terms of coronavirus case and death rates per capita.

The supposed effectiveness of lockdowns (compared to far less extreme restrictions) in terms of slowing or stopping the spread of coronavirus has been called into serious question lately by more recent studies.
Such studies have found there is at best no correlation, and perhaps a perverse effect between the two defining features of hard lockdowns (stay-home orders and closures of all non-essential businesses) and COVID-19 cases and deaths per capita after other factors such as less-extreme policies are accounted for.  The benefits are thus nothing more than a statistical mirage that does not stand up to scrutiny--much like the supposed benefits of the 21 drinking age vis-a-vis DUI deaths in the long run.

Meanwhile, the collateral damage (economic depression, inequality, poverty, alcohol and other drug abuse, domestic violence, child abuse, loneliness, poor mental health, delayed medical treatment, etc.), which also kills people too by the way, continues to mount with each passing week of lockdown, making an utter mockery of practically all progressive and even basic humanitarian priorities.  And that's to say nothing of the civil rights and liberties, as well as community cohesion, that progressives generally support.  It seems that the "cure" is quickly becoming far worse than the disease as time goes on.

(And that's just for the affluent countries.  For poorer countries, the collateral damage will most likely be at least an order of magnitude worse and deadlier.)

As for the disease itself, here is what we already know:  The horse has already bolted long ago, the train has left the station, the genie is out of the bottle, and herd immunity is ultimately inevitable at some point (if we're not already there in some places).   That is the only way the pandemic will finally end for good, since any effective vaccine or miracle cure will most likely come far too late.  Fortunately though, the true infection fatality rate is revealed to be far lower than was originally believed, and most likely somewhere between seasonal flu and pandemic flu (though still nothing to, um, sneeze at of course).

Thus, whatever the original merits of these sweeping, medieval-style quarantines (unprecedented on such a large scale and for such an extended period of time), there is really nothing "woke" or progressive about extending them any further than yesterday.  It is no longer "merely" about lives versus livelihoods anymore, but increasingly about lives versus lives.

So what would a progressive reopening plan look like?  At the TSAP, we believe that the following schedule should be the case:

Phase 1:  End of stay-home orders and "bubbles", and gatherings of up to 10 people permitted.  Construction, manufacturing, and select retail reopened with restrictions, with priority given to small businesses. Masks required in all public places where six feet of distance cannot be maintained.  Parks and beaches reopened with restrictions.

Phase 2:  Gatherings of up to 20 people permitted.  All retail stores reopened with social distancing and 50% occupancy restrictions.  Restaurants, but not bars, reopened with 25% occupancy restrictions.  Masks required for all employees and customers of reopened businesses whenever practical.  Select places of amusement reopened with restrictions.

(Somewhere around this point, reduce the six-foot rule to three feet, in line with the World Health Organization's recommendation of one meter distance.)

Phase 3:  Gatherings of up to 50 people permitted.  All retail stores reopened with social distancing and some occupancy restrictions.  Salons, barber shops, and other "hands-on" businesses along with gyms and fitness centers reopened with strict hygiene standards and occupancy restrictions.  Restaurants reopened with 50% occupancy restrictions, select bars reopened with 50% occupancy restrictions and table service only.  Nightclubs and casinos remain closed.  Places of amusement reopened with restrictions.  All schools and educational facilities reopened, and all daycares and camps reopened as well regardless.  Some professional sports leagues at least partially resume, without the fans of course.

Phase Out:  Gatherings of up to 100, then 500 people permitted.  Everything including nightclubs and casinos reopened, albeit with some occupancy restrictions.  Bar service now permitted.  Mask wearing is now voluntary, except on public transit and for employees of higher-risk businesses, where it will remain mandatory at least at first.   Six-foot rule is now just a common-sense and non-absolute guideline rather than a hard and fast rule.   Hand and respiratory hygiene still taken as seriously as ever.  All schools and educational facilities reopened, period.  Professional sports leagues fully resume, without fans until at least Labor Day, then fans very gradually reintroduced to stadiums/arenas.

Each of the first three phases will last two weeks (or one week each for both Phases 1 and 2, if the onset of Phase 1 happens to be delayed until June 15 or later), while Phase Out is indeterminate but will likely last for 90 days or more.  Ideally, Phase 1 would not have begun until a state is at least two weeks post-peak, but after June 1st states may not have the luxury of waiting any longer to begin reopening (if they wish to avoid irreversible economic damage and a long-term depression).  If during any phase there is any resurgence in disease there should be a further pause between moving to the next phase, but otherwise full steam ahead with no backtracking after June 1st.

(Any reimposition of tighter restrictions after June 1st should be limited to the local level only, not statewide or nationally.)

Indoor gatherings, which are riskier than outdoor gatherings, should probably have a tighter limit.  For example, thet could have a cap of 10 people indoors vs. 50 people outdoors for Phase 3, or 50 people indoors vs. 500 people outdoors in Phase Out.

At all phases, mask and sanitizer kiosks should be available everywhere, and/or there should be a Taiwan-style free mask rationing app available for everyone.  And Taiwan-style temperature checks to enter most places should prevail through the first three phases and much of Phase Out as well.  (Hey, they must be doing something right over there, and with no lockdown or shutdown either.)

And while we clearly need to scale up testing and contact tracing, quite frankly the time to do that was weeks if not months ago, and we can no longer afford the luxury of time at this point.  We will simply need to make do with what capacity we have right now and in the immediate future, even if we have to do it the Japanese way of focusing mainly on the larger clusters instead of every single case out there, which is far less resource- and labor-intensive.

As for vulnerable populations (elderly, immunocompromised, and/or those with underlying health conditions), the lockdowns have utterly failed to protect them, so extending the lockdowns will not benefit them at all.  Rather, they should be encouraged (but not forced) to stay home as much as possible and avoid crowds during Phase 1 and 2 (and possibly 3), and nursing homes should continue to ban visitors or allow only one designated visitor per family during at least the first three phases of reopening.  And for the love of all that is good, immediately stop discharging still-contagious hospital patients into nursing homes!  Shame on any policymakers (New York, I'm looking mainly at you) who thought that was somehow a good idea!

The TSAP also supports a far more robust stimulus that includes Universal Basic Income and Medicare For All, and the rest of Rodger Malcolm Mitchell's Ten Steps to Prosperity.  We also support expanded unemployment benefits, expanded Social Security, and a Green New Deal.  And of course the HEROES Act.  It is not too late to prevent the greatest depression the world has ever seen--but only if we both reopen reasonably soon and implement such programs sooner.  It is NOT an either-or.

Also, it should really go without saying of course, but we at the TSAP do NOT support any sort of reckless behavior, rioting, violence, or death threats against Governor Gretchen Whitmer of Michigan or any other governor or government official regardless of how much we dislike their policies.  We hereby denounce and condemn such behavior, period.  Peaceful protests which follow proper health and safety precautions, fine, but anything else has no place in our movement or any other movement worth its salt.

UPDATE:  The TSAP does NOT support Trump's Fourth of July military parade or any other parade, campaign rally, or mass gathering of similar size at this time, as it is really far too soon and thus very, very ill-advised.  We believe that even the best-performing states and localities who appear to be almost out of the proverbial woods in terms of the pandemic should still do their darnedest to avoid gatherings of more than 50 people before July 4, and more than 500 people after that until at least Labor Day at the earliest.  The deadly lessons of the 1918 flu pandemic loom large.  But if we must have a second wave, which Dr. Fauci himself claims is somehow (but hopefully not) inevitable, frankly better it should happen in the summer when the virus is less virulent than in the fall or winter, and as a bonus, those Trump supporters who will be earning Darwin Awards will thus "thin the herd before" they can vote in November.  Unfortunately, these fools also put others at risk as well--they should at least be wearing masks to protect others even if they don't care one iota about themselves.  (At least it won't fall on the conscience of progressives this time.)

JUNE UPDATE:  It looks like several states are seeing spikes in COVID-19 in recent weeks following reopening.  While some of it is due to increased testing, the very large spikes in Texas, Arizona, Florida, California, and some other states also show increases in hospitalization rates*, so at least some states are seeing real increases.  And those are generally the ones who reopened before even reaching their peaks, while California's early flattening of their curve seems to have merely delayed the bulk of their infection burden.  And interestingly, Georgia had not seen any real spikes until very recently, despite being the first state to reopen.  Meanwhile many states, most notably New York and New Jersey, have not seen any spikes at all despite increased testing and massive protest rallies in recent weeks.  Both were among the first states to have mandatory mask requirements, and were also the earliest and hardest-hit states.

(*Even the increase in hospitalization numbers may be less than meets the eye.)

Thus, it may not even be due to the timing and pace of reopening at all, but rather due to how many people are wearing masks, and simply that states that were hit harder earlier, the epidemic has largely run its course, while the states that started with milder outbreaks simply still have a ways to go yet.  And overcrowded bars and nightclubs seems to be the biggest culprits in the new hotspots lately.

It is notable that death rates are still dropping nationwide despite the apparent surge in daily cases to new record highs.  Even in the new hotspot states, deaths are generally low and flat or declining, and even Arizona's death rates are still following the same old slow-burn pattern they had before reopening despite being the fastest-growing state in terms of positive test results lately.  Most new cases are coming from younger people (under age 35), a possible reason for the apparent decoupling of infection rates from death rates, and suggesting herd immunity likely occurring sooner rather than later.  Or perhaps we have learned (often the hard way) better ways to treat the disease, thus saving more lives.  Or the virus itself could simply be getting tired and losing its "mojo" after circulating so much for so long.

Also, here is another good article for any anti-lockdown leftist or progressive.  And another.

Wednesday, May 13, 2020

Reborn On The Fourth Of July? (Updated Part Deux)

A little gallows humor:  What do Julius Caesar and America as we knew it have in common?  Both died on the Ides of March (March 15).  That date was, indeed, roughly when America began to shut down to one degree or another.  But will America be reborn on (or before) the Fourth of July?

There is much debate lately about how and when to ease lockdown/shutdown restrictions and re-open the country for business.  Unfortunately, neither side seems to do nuance very well if at all.  Opening up everything or nearly everything all at once overnight would of course be reckless and cavalier, risking a resurgence of the virus (and associated deaths) and eroding much of the progress that has been made thus far.  But continuing the status quo indefinitely (or even simply taking too long to ease restrictions) is also not very wise either since that will do irreversible economic damage and likely will still not conquer the virus entirely.  Thus, if we wait too long, there may not be anything left to re-open by then, at least for small businesses.  And that's to say nothing of the adverse consequences to civil rights and liberties, mental health, and community cohesion as well.

(And you know, slopes are much, much slipperier than they appear, as Orwell spins in his grave.)

The supposed effectiveness of lockdowns (compared to far less extreme restrictions) in terms of slowing or stopping the spread of coronavirus has been called into serious question lately by more recent studies comparing those locations that had lockdowns and those that did not, or differed in the timing.  The results strongly imply that the observed declines in COVID-19 deaths (and thus the number of infections three weeks prior) was actually driven by the more moderate social distancing measures that were in place earlier, not the lockdowns, based on the timing.  And if there somehow was any extra effectiveness of the most extreme measures such as lockdowns, it is most likely only a short-term effect that eventually reaches a point of diminishing returns after which the "cure" really DOES become worse than the disease.

In other words, lockdowns early enough (and long enough) in the curve to successfully suppress the disease are unnecessary since more moderate measures apparently work just as well when done that early, while belated lockdowns are apparently worse than useless in terms of total excess deaths.

Perhaps the much-maligned Swedish mitigation strategy of moderate social distancing (not to be confused with the mythical "do nothing" strategy) really isn't so crazy after all?  The train has clearly left the station long ago for a suppression strategy to work at this point, and herd immunity is ultimately inevitable at some point in most countries (including the USA), if we're not already there in some places.

And support for reopening is clearly NOT just for right-wingers and fringe folks, by the way.   An even stronger left-wing and progressive case can also be made for ending the lockdowns sooner than later as well.  Keep in mind that Sweden is largely run by progressives, and even their self-proclaimed "conservatives" are still largely to the left of most American Democratic Party politicians today.

Thus, a careful and gradual but fairly speedy easing and re-opening is what is called for, in order to minimize the damage from both the pandemic itself as well as from the restrictions in place to suppress it.  The timing should vary by state and locality as well as exactly which types of restrictions to be eased and which types of businesses to re-open.  It would probably be best for all states to wait until at least two weeks post-peak (whichever is later) before making any major changes (though baby steps can and should be taken sooner).  Some states have already peaked in early to mid-April, others in latw April to early May, while others will not peak until well into May.  Hospitals would also have to not be overwhelmed as well (fortunately, very few are).  And testing would at least ideally be significantly ramped up along with contact tracing and individual quarantining--which should have been done weeks or even months ago--as well in order to move forward into the later stages of reopening.

(Though at this point, large-scale testing and contact tracing would probably best be put in the "wouldn't that be nice?" category rather than decisive.)

And of course we need a far more massive stimulus, and the Ten Steps to Prosperity that Rodger Malcolm Mitchell recommends.  Because even if we re-opened tomorrow, consumers will still be too cautious to come roaring back right away, and the damage is already done.  Especially a significant and permanent UBI, which would cure even the worst depression a lot sooner than not implementing a UBI.

Mitchell also recently wrote an article noting that reopening can be done a lot sooner, safer, and more cheaply simply by requiring everyone to wear masks in public (at least when practical to do so) and provide such masks for free to everyone via kiosks.  And with a little bit of nuance added to the mix, this seems to make the most sense of all for now.

Trump's latest guidelines for reopening are surprisingly reasonable now, likely because he finally consulted with experts rather than just going with his gut as usual.  But his administration is really lagging on providing coronavirus testing kits, which would clearly hinder any reopening strategy.  So they really need to speed that up.  It was, after all, due to the Trump administration's recklessness and negligence that this pandemic got so far out of control here in the first place, and it is estimated that up to 90% of the deaths could have been averted had they acted sooner and not screwed up so monumentally.

Thus the TSAP recommends that all states gradually lift lockdowns and partially reopen by Memorial Day (with many states doing so in early May) and fully lift all significant restrictions (except perhaps for restrictions on very large gatherings of, say, 500+ people) by the Fourth of July at the latest.  While some outlier states like Georgia rushed the reopening process (though interestingly, it still did not turn out to be the disaster that was predicted), most states are being cautious to a fault right now in terms of reopening, and you really can't blame them in the current climate of fear.

At the local (county and municipal) level, some hotspots may choose to still maintain tight restrictions or reimpose them in the event of a resurgence of the virus, but these restrictions should be exactly that--local.  In a similar vein, states may also impose modest, New Rochelle-style "containment zones" or "red zones" where local outbreaks or large clusters are observed.  As we move past the initial crude "sledgehammer" phase of suppression and into the more refined management phase, we need to be careful in how we calibrate such measures to avoid doing more harm than good in the long run.

As for school closures, that should really be decided locally for the most part.  While school closures are known to work very well in the short term in slowing the spread of infectious diseases in general, the longer-term effects are unknown, and children and teens seem to be at relatively low risk from this virus as well as not a particularly significant vector for spreading it to adults.  While some evidence strongly suggests that temporary school closures early in the epidemic curve have helped to flatten that curve (even if only indirectly to reduce the number of adults infecting each other), it remains unclear how long such benefits can last (likely not very long).  Some countries like Iceland, Denmark, and Taiwan have already reopened schools with no evidence of resurgence of the disease, and Sweden never closed them at all for children under 16.  Certainly they should at least plan on reopening in September at the very latest absent evidence of a large second wave of the disease.  And the usual summer school programs and even summer camps should be seriously considered as well.  At the very least, daycares (if not schools as well) should be opened yesterday, as it is really the only way to get the economy going since so many of American's workforce are parents of young children.

Regardless of the effectiveness (or lack thereof) of lockdowns, simply going straight from red to green overnight would be utterly foolish, since it's really still too soon to safely encourage a massive influx of tourists when the "all-clear" signal is given.  So we should thus go from red to orange, then yellow, then green, and we really only need a few weeks (not months) of orange and/or yellow in between.   And even green does not preclude very mild restrictions and common-sense precautions as well.

We have already flattened the curve.  Now let's keep it flat, without also flattening the economy as well.

UPDATE:  It should really go without saying, but we at the TSAP do NOT support any sort of reckless behavior, rioting, violence, or death threats against Governor Gretchen Whitmer of Michigan or any other governor or government official regardless of how much we dislike their policies.  We hereby denounce and condemn such behavior, period.  Peaceful protests which follow proper health and safety precautions, fine, but anything else has no place in our movement or any other movement worth its salt.

Thursday, April 23, 2020

Reborn On The Fourth of July?

A little gallows humor:  What do Julius Caesar and America as we knew it have in common?  Both died on the Ides of March (March 15).  That date was, indeed, roughly when America began to shut down to one degree or another.  But will America be reborn on (or before) the Fourth of July?

There is much debate lately about how and when to ease lockdown/shutdown restrictions and re-open the country for business.  Unfortunately, neither side seems to do nuance very well if at all.  Opening up everything or nearly everything all at once overnight would of course be reckless and cavalier, risking a resurgence of the virus (and associated deaths) and eroding much of the progress that has been made thus far.  But continuing the status quo indefinitely (or even simply taking too long to ease restrictions) is also not very wise either since that will do irreversible economic damage and likely will still not conquer the virus entirely.  Thus, if we wait too long, there may not be anything left to re-open by then, at least for small businesses.  And that's to say nothing of the adverse consequences to civil rights and liberties, mental health, and community cohesion as well.

(And you know, slopes are much, much slipperier than they appear, as Orwell spins in his grave.)

Even the supposed effectiveness of full lockdowns (compared to far less extreme restrictions) in terms of slowing or stopping the spread of coronavirus has been called into question by more recent studies comparing those locations that had lockdowns and those that did not, or differed in the timing.  The results strongly imply that the observed declines in COVID-19 deaths (and thus the number of infections three weeks prior) was actually driven by the more moderate social distancing measures that were in place earlier, not the lockdowns, based on the timing.  And if there somehow was any extra effectiveness of the most extreme measures such as lockdowns, it is most likely only a short-term effect that eventually reaches a point of diminishing returns after which the "cure" really DOES become worse than the disease.

Perhaps the much-maligned Swedish mitigation strategy of moderate social distancing (not to be confused with the mythical "do nothing" strategy) really isn't so crazy after all?

Thus, a careful and gradual but fairly speedy easing and re-opening is what is called for, in order to minimize the damage from both the pandemic itself as well as from the restrictions in place to suppress it.  The timing should vary by state and locality as well as exactly which types of restrictions to be eased and which types of businesses to re-open.  It would probably be best for all states to wait until at least May 1 or two weeks post-peak (whichever is later) before making any major changes (though baby steps can and should be taken sooner).  Some states have already peaked in early to mid-April, while others will not peak until early May or so.  Hospitals would also have to not be overwhelmed as well.  And testing will have to be signifcantly ramped up along with contact tracing and individual quarantining as well in order to move forward into the later stages of reopening.

And of course we need a far more massive stimulus, and the Ten Steps to Prosperity that Rodger Malcolm Mitchell recommends.  Because even if we re-opened tomorrow, consumers will still be too cautious to come roaring back right away, and the damage is already done.  Especially a significant and permanent UBI, which would cure even the worst depression a lot sooner than not implementing a UBI.

Trump's latest guidelines for reopening are surprisingly reasonable now, likely because he finally consulted with experts rather than just going with his gut as usual.  But his administration is really lagging on providing coronavirus testing kits, which would clearly hamper any reopening.  So they really need to speed that up.  It was, after all, due to the Trump administration's recklessness and negligence that this pandemic got so far out of control here in the first place, and it is estimated that up to 90% of the deaths could have been averted had they acted sooner and not screwed up so monumentally.

Thus the TSAP recommends that all states gradually lift lockdowns and partially reopen by Memorial Day (with many states doing so in early May) and fully lift all significant restrictions (except perhaps for restrictions on very large gatherings of, say, 500+ people) by the Fourth of July at the latest.  But states like Georgia that seek to re-open salons, barber shops, gyms, casinos, bars, and stuff like that while it is still April (and they haven"t even peaked yet) are really being foolish, as those riskier businesses should really be the very last ones to re-open after all the others do.  They should really wait another few weeks for those types of places and make sure they actually have a plan rather than flying blindly.

At the local (county and municipal) level, some hotspots may choose to still maintain tight restrictions or reimpose them in the event of a resurgence of the virus, but these restrictions should be exactly that--local.  In a similar vein, states may also impose modest, New Rochelle-style "containment zones" or "red zones" where local outbreaks or large clusters are observed.  As we move past the initial crude "sledgehammer" phase of suppression and into the more refined management phase, we need to be careful in how we calibrate such measures to avoid doing more harm than good in the long run.

As for school closures, that should really be decided locally for the most part.  While school closures are known to work very well in the short term in slowing the spread of infectious diseases in general, the longer-term effects are unknown, and children and teens seem to be at relatively low risk from this virus as well as not a particularly major vector for spreading it to adults.  Certainly they should at least plan on reopening in September at the latest absent evidence of a large second wave of the disease.

Regardless of the effectiveness (or lack thereof) of lockdowns, simply going straight from red to green overnight would be utterly foolish, since it's really still too soon to safely encourage a massive influx of tourists when the "all-clear" signal is given.  So we should thus go from red to orange, then yellow, then green, and we really only need a few weeks (not months) of orange and/or yellow in between.   And even green does not preclude very mild restrictions and common-sense precautions as well.

We have already flattened the curve.  Now let's keep it flat, without also flattening the economy as well.

Friday, April 3, 2020

Is The Cure Worse Than The Disease?

We know that the Trump administration clearly bungled its response to the coronavirus pandemic.  Scratch that, they failed miserably in practically every way possible to contain or suppress this virus, and now the proverbial genie is out of the bottle.  But what if the proverbial stopped clock can be right twice a day, particularly the claim that "the cure is worse than the disease" as far as shutdowns and lockdowns are concerned?
As is typical for Republicans, Democrats, and LOLbertarians alike, no one seems to do nuance, nor do they understand Monetary Sovereignty apparently. And the Donald is clearly no exception to the rule either.
That said, there are reasons to be concerned that longer-term shutdowns and lockdowns (some pundits even predict up to 18 months!) can cause a depression that NO amount of federal money can solve until well after such drastic measures are lifted. Because we didn’t quash it early on when we had the chance, there will likely be a long battle against COVID-19, to be sure, but the current “sledgehammer” phase of the battle cannot last indefinitely. Sooner or later we will have to ease or lift restrictions and pivot to case-based interventions rather than population-based ones once any of the following occur: A) the epidemic is largely under control, B) we reach the point of irreversible damage to the economy, or C) the epidemic exceeds 1% of the population and “flattening the curve” thus becomes impossible. Whichever comes first. And at least one of these three will happen within a few weeks from now at most, for better or worse.   Lockdowns and shutdowns are best thought of as a short-term tactic, not a long-term strategy. 
That’s to say nothing of the cost in terms of individual liberty, which is at *least* as priceless as life itself, as well as the cost in terms of mental health at least in the long run. Economic depression is not the only kind of depression to worry about, after all.
And even for hardcore communitarians who believe that individual liberty is worth absolutely zilch, one also can argue that the social consequences of long-term lockdowns and social distancing are ultimately corrosive to community as well.
And as of early April, option C likely already happened at least in parts of the USA, particularly the greater NYC metro area, plus several other hotspots around the nation.  Given how most people who catch the virus experience mild or no symptoms, it is very likely that the number of reported cases is off by a factor of ten or more.  Which, of course, makes the case fatality rate lower as well.  In any case, the peak will likely happen sometime in mid to late April in much of the country, with some areas in May.
Thus, there will come a point of diminishing returns where the cure really DOES become worse than the disease.  When exactly, no one knows for sure.  But a good ballpark estimate would be "weeks, not months".

Thus, the TSAP does NOT support the more extreme measures lasting more than a few weeks, nor even the less extreme ones lasting more than a few months at most.  And for NO length of time do we support arresting or jailing or shooting people for leaving their homes, suspending habeas corpus or the Constitution, or any form of martial law.  Period.
DISCLAIMER:  The TSAP are NOT doctors, epidemiologists, or otherwise experts on this matter, so please take our predictions with a grain of salt.