Thursday, April 30, 2020

Ready to reopen?

I've been on the "reopen fast but smart" bandwagon for weeks. The reopening is coming. Are we ready? I'm afraid not. I remain on the "plan ahead" bandwagon, which means not lots of ideas from bloggers but lots of implemented plans of action for local public health bureacracies. Two items in today's news.

Coronavirus Testing Capacity Is Going Unused
Many commercial and academic laboratories in the U.S. are processing coronavirus diagnostic tests far below their capacity, leaving tools crucial to slowing the virus’s spread unused.
Lab executives and public-health officials say that in some cases, the labs are getting far fewer orders for tests than they could conduct. 
For weeks, everyone has been saying "test test test," and bemoaning the lack of testing capacity. Well, now we have testing capacity. What's going wrong? Well, our public health officials don't have (and did not, in the last month, develop) concrete ready to implement testing protocols in place. You still get a test if you ask for one, which mainly is if you think you have symptoms and can get through the guidelines that still restrict testing. These guidelines are not developed with public health in mind.

Testing meant, for example, widespread random testing, or at least testing of volunteers, so we could find out where the virus is. Just how many people  in Palo Alto have the virus, right now? With 1000 roughly random tests we could find out. Nobody is doing that.

We remain, I think, sorely lacking in the public health infrastructure that must take over from blanket shutdowns. California just issued a revised list of what businesses can open. Apparently that's all we know how to do.

Food plants turned out to be a super spreader. ( Kris Maher, Jacob Bunge and Alexandra Berzon in WSJ)  The larger point here: About 40% of the economy is still open as "essential." Well, as we get ready to reopen safely the rest of the economy, one would think that the "essential" parts would be rapidly implementing the open with distance protocols that the rest will follow. No. It's pretty much business as usual. The same cropped up in the Amazon and Instacard delivery strikes.

If the "essential" businesses are still not operating with reasonable protocols, just how can the rest reopen?

It's not zero. I read with pleasure the quite sensible list of actions that our county required of the local hardware store, including posting said list on the front window where I could see compliance. (Waiting with the dog while my wife bought TP.) But one would expect the essential part of the economy to be really zooming along with safety protocols if the 'inessential' part is ready to reopen.

That does not mean reopen. The economic carnage is everywhere, and people will not stand to watch their livelihoods disappear, while virus trackers in many counties remain with stable small numbers. But watch out for the second wave.

We Still Don’t Know How the Coronavirus Is Killing Us is a great essay by David Wallace-Wells. While we're spending $2 trillion or more, and printing $5 trillion or more, it is really striking that our government is  not spending massive amounts on research, including just collecting data. Sure, bottlenecks and waste abound here too, but the amount just not known is striking.

For example, I attended a great presentation by Stanford's Jay Bhattachrya on his random sample testing in Santa Clara County, which found a surprisingly large number of asymptomatic cases. Yes, I've read the controversy. Some other day. But, in a $2 trillion dollar budget why are lonely heroes like Jay doing random testing on a shoestring?

10 comments:

  1. Thanks for the thoughtful post.

    Your comment about poor safety precautions in the food industry, Amazon, and Instacart was (to use an old word) a little 'jejune.' These employers are all notorious for always paying the lowest possible wages, and ignoring the needs of their workers. It is hardly surprising to see them doing the same during this crisis.

    As far as testing goes, I have one quick comment. The latest test that I read about required a swab to be inserted into the nostril and poked as far up as it would go. I had a test like that after lung surgery a few years ago, and I would rum from the room if I was required to have it again today. Not to mention having it over and over agsin, which might be required. Screw the public good.

    I have no problem with saliva or blood tests, incidentally.

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  2. "These employers are all notorious for always paying the lowest possible wages"

    At the end of March Amazon, Amazon raised its minimum wage for warehouse workers to $17/hr. and made OT hours double time instead of time and a half.

    I assume that they did this out of business necessity and not out of the goodness of their hearts. I also assume that it is probably the lowest possible wage for hiring the amounts of labor that they need.

    Around here (there are 3 warehouses in my metro area) the statutory minimum is about half of what Amazon is paying and statutory OT is time and half. So, the Amazon deal is not bad.

    Does this make Amazon "notorious"?

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  3. I agree that the research needs to be done to understand what is this virus. I've heard too many scientists say that they don't even understand what this virus is and how it works and how to treat / cure it. It will take a lot of brain pain to write the correct texts that describe this virus. Hopefully, the cure can be found soon.

    "into the nostril and poked as far up as it would go" - that seems weird. Isn't that just like test of saliva or something. Don't get why it has to go up as far as possible, but maybe later I will understand it. Thanks for the interesting reading.

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  4. Here in Indiana, as I understand it, it's perfectly legal for someone with covid-19 and uncontrollable coughing to go to his essential job, or the grocery store, or the pharmacy. But nobody, healthy or sick, can go to a campground, or a plant nursery, or a dress store. States like Alaska and Tennessee are being smarter, letting restaurants open up, but with things like masks for waiters and tracing logbooks for customers.

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  5. This blog post implicitly raises a fundamental question which has yet to properly answered, from an economic trade analysis point of view, namely, what is the net benefit of resuming ("re-opening") the economy (local or national) versus not doing so?

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  6. It has been around, most people have seen it, the image of dinosaurs with a meteor passing overhead and one of them saying "Oh shit! The economy!".
    There is no shortage of basic necessities. We can all get what we need at the grocery store and so forth.
    Production of luxuries, however, is at a standstill. No nail jobs. No haircuts.
    There is no more of a housing problem than there already was.
    For those of us fortunate enough to be able to do our regular job from home there is no employment hiatus like there is for many workers such as restaurant staff.
    So, on average, we should only have to give up some luxuries for a while.
    Failing to spread out the pain of missing luxuries will be our downfall. Need I say "rent-seeking"?
    How great is that?
    --E5

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    Replies
    1. OK, so here is someone with no skin in the game -- "fortunate enough to work from home" -- who equates the risks (costs) of the spread of a pathogen with a likely infection fatality rate of in the vicinity of 0.2% to 0.5% (I bet the low end) of (largely) those 65 and older with those of the KT extinction event. The problem is that a good deal of America is educated, "informed", influenced, and governed by his intellectual and moral fellow travelers...

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    2. Confusing covid-19 with an extinction event is the main reason so much nonsense is spoken about it, and so much bad policy formulated in response to it.

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  7. As a good libertarian, you should be more parsimonious in the use of "we".
    Those of us who live in the more granular world of the different localities, within the different States, etc. don't know what to make of such broad claims. I’ll address antibody testing later, but for now, just take antigen testing. Look at a State by State table of the ratio of Tests Performed per capita to Confirmed Case per capita. This is the most insightful measure of how antigen testing is keeping up with, or ahead of, spotting where trends that augur outbreaks are moving. You may have seen this been touted – but only at the country level – in sites such as https://ourworldindata.org/grapher/covid-19-tests-cases-scatter-with-comparisons?country=AUS+TWN+GBR+USA Among the various States, there are already various small to medium States with ratios in excess of 20x. 28 out of 50 have ratios of higher than 10x. (Better, the three most populous States in the United States are already well past the 10x ratio.) And all of these ratios are increasing. Of course, State in the Acela corridor are only grinding higher and are still in the mid-single digits. These ratios suggest that the US is as diverse as Europe and Asia. (My home county in FL is at 25x, higher than any Scandinavian/Baltic country. And FL ex-Dade and Broward Counties is at 16x, close.)

    As to antibody testing, quite a few Governors have gone out on a limb and have ordered loads of these kits, and studies are on the way. I am sure that political mood affiliation will seek to reduce the light we shed to heat – like most of your colleague’s critics have tried to do with his study. (I look forward to his MLB employees test.) But this criticism may run afoul of the inconvenient fact that studies that come out of locales with Progressive bona fides will not be lambasted, and this will help clarify the issue of how deadly CoVid19 really is – to a person exposed at random — but more importantly for the 65 and below segment.

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