Boosters

I was going to write about the FDA's idiotic booster recommendations, and then I found the perfect answer on Marginal Revolution, which I will quote in its entirety for the few readers who don't read MR every day

My first reaction upon hearing that boosters were rejected was to ask the same thing: would these same “experts” say that, because the vaccines are still effective without boosters, vaccinated persons don’t need to wear masks and can resume normal life? Of course not. They use the criterion “prevents hospitalization” for evaluating boosters (2a) but switch back to “prevents infection” when the question is masks and other restrictions. What about those that are willing to accept the tiny risk of side effects to prevent infection so that they can get back to fully normal life? The Science (TM) tells us that one can’t transmit the virus if one is never infected to begin with.

Also, one of the No votes on boosters said that he feared approval would effectively turn boosters into a mandate and change the definition of fully vaccinated. So, it appears that the overzealousness to demand vaccine mandates has actually contributed to fewer people getting access to (booster) vaccines, thus paradoxically contributing to spread. A vivid illustration of the problem with, “That which is not mandatory should be prohibited.”

The biggest problem with public health professionals continues to be (1) elevation of their own normative value judgements — namely that NPIs are no big deal no matter how long they last — which have nothing to do with scientific expertise, (2) leading them to “shade” their interpretation of data to promote their preferred behavioral outcome rather than answering positive (non-normative) questions with positive scientific statements, (3) thus undermining the credibility of public health institutions (FDA, CDC) and leading to things like vaccine hesitancy.

What happened to the idea that the FDA's job is to proclaim only whether a vaccine is safe and effective? Then if you want to take it, that's up to you? (And we could argue about even that, i.e. whether "safe" is enough, whether FDA should have authority to make something unproven illegal, etc.) 

I want a booster. Pfizer wants to sell me a booster. The data say it's safe and effective. Way more effective than masks. Period. 

They hypocrisy on masks vs. boosters is amazing.  

Masks redux

My previous post on Delta policy and masks led to some discussion that went off the rails, on twitter especially. An effort to summarize the point: 

From the literature I have read, masks can be moderately medically effective. The literature has pretty wide ranging estimates, from some studies and meta-studies saying no effect, and others saying substantial effects.  

Delta has a reproduction rate of 6. (Again, best guesses with varying estimates.) Even if masks are 50% effective -- which is wildly optimistic -- they reduce the reproduction rate to 3. That's more than the alpha covid with no masks. Each person who gets it passes it on to three people, about every two weeks. 

If one wishes to stop the virus, only one goal matters: Getting the reproduction rate below one. e to the 3 t is not a lot less exponential growth than e to the 6 t.  (With t in two-week or so intervals.) 

Thus a public policy response that focuses exclusively on fine-tuning mask mandates, depending on the current level of infection is bound to fail its stated goal. That is the point. 

If our policy makers were willing to say "we are passing the mask mandate so it rips through the population a little bit slower" I might not be so grumpy. 

I am glad to see vaccine incentives finally percolating out, too slowly and late. I don't know that vaccines bring R0 below one, but they're darn close. 

You beat exponential growth when case levels are low, not by waiting until there is a crush.  

Goodfellows returns

 

The goodfellows video and podcast returns! Direct link, in case the above embed doesn't work for you. 

This week's show is about covid and Afghanistan -- America gives up. 

One reason I love doing this show is that I get to ask questions about things like Afghanistan, military history, what is the nature of military defeat, and so on that I don't know much about, but Niall and H.R. know a lot about! There is little in life I enjoy so much as spouting off a hare-brained opinion and then someone really knowledgeable like Niall and H.R. swats it down and turns me around. 

Don't miss Niall and H.R. starting at 56:45. I wish I were this eloquent, and I'm proud of my fellow panelists for their deeply knowledgeable empathy. 

Adumbrations of FDA

Scott Alexander's Adumbrations Of Aducanumab is a great review of FDA snafus -- with deeper lessons about regulation in general. Yes the outcome is dumb, but incentives are to blame. That's important to understand if we are ever to fix this mess. 

Scott has some great ideas for fixing the FDA's incentives. The one I like best is to reduce its power. FDA approval currently means that insurance companies and the government must pay for drugs. Break that link. The FDA now either decides safe&effective vs. not-yet-proven, and makes taking any not-yet-proven drug illegal. Reduce the FDA to simply providing information about what's known about drugs. Finally, give the FDA budgetary rewards for approving drugs. Bemoaning regulatory idiocy is fun but gets us nowhere. Anything persistently busted is not the result of stupidity, it is the result of bad incentives. 

FDA, CDC and Covid

The story of the FDA in covid is a good place to start. It's well known by now, but we are now in the era of forgetting, and it is to nobody's interest to keep this memory alive. 

The countries that got through COVID the best (eg South Korea and Taiwan) controlled it through test-and-trace. This allowed them to scrape by with minimal lockdown and almost no deaths. But it only worked because they started testing and tracing really quickly - almost the moment they learned that the coronavirus existed. Could the US have done equally well?

I think yes. A bunch of laboratories, universities, and health care groups came up with COVID tests before the virus was even in the US, and were 100% ready to deploy them. 

As with vaccines, which took a weekend to create, the state of medical science is such that really there is no reason to have pandemics any more. Public policy? Well, that's stuck in the 1700s.  

But when the US declared that the coronavirus was a “public health emergency”, the FDA announced that the emergency was so grave that they were banning all coronavirus testing, so that nobody could take advantage of the emergency to peddle shoddy tests. Perhaps you might feel like this is exactly the opposite of what you should do during an emergency? This is a sure sign that you will never work for the FDA.

Covid incompetence

 WWII started badly for the United States. Our tanks blew up. Our torpedoes were duds. Our airplanes were outclassed. Many commanders were incompetent, soldiers green, supplies chaotic. We lost a lot of battles.  But we learned. The lessons of each mistake were incorporated, incompetent commanders sacked, soldiers learned their terrible craft. 

Delta is the fourth wave of covid, and amazingly the US policy response is even more irresolute than the first time around. Our government is like a child, sent next door to get a cup of sugar, who gets as far as the front stoop and then wanders off following a puppy. 

The policy response is now focused on the most medically ineffective but most politically symbolic step, mask mandates. All all-night disco in Provincetown turns in to a superspreader event so... we make school kids wear masks in outdoor summer camps? Masks are several decimal places less effective than vaccines, and less effective than "social distance" in the first place.* Go to that all night disco, unvaccinated, but wear a mask? Please.   

Lessons learned? Review of a great review.

After great events, will the US government and political system learn from mistakes? Or will we raise the bridges and enshrine whatever was done last time as holy writ, to be repeated again? Reputations of people in power push for the latter. But learning from mistakes is the only way to get ahead. 

Bailouts and stimulus from 2008 seem to have followed the latter possibility. Will the lesson from covid look skeptically on the disastrous performance of CDC and FDA, evaluate whether lockdowns did good commensurate with cost, question the need to spread trillions of newly printed money around, measure the  effectiveness of masks that have now become political symbols? Or will this simply be enshrined as the playbook? Do we twist every event to push our partisan narratives, facts be damned? A blame-Trump-for-everything camp offers some hope, but they're not clear what they would do differently as most of the world's response was the same or less effective than our own. 

This big question frames a must-read Alex Tabarrok Marginal Revolution review of Andy Slavitt’s Preventable. The review doesn't just destroy an otherwise forgettable book, but it really raises these larger questions whether we are so politically polarized that we can no longer learn from mistakes. 

In contemporary discussion, people can just say things that are blatantly untrue, and it all washes over us. 

The standard narrative ... leads Slavitt to make blanket assertions—the kind that everyone of a certain type knows to be true–but in fact are false. He writes, for example:

In comparison to most of these other countries, the American public was impatient, untrusting, and unaccustomed to sacrificing individual rights for the public good. (p. 65)

Data from the Oxford Coronavirus Government Response Tracker (OxCGRT) show that the US “sacrifice” as measured by the stringency of the COVID policy response–school closures; workplace closures; restrictions on public gatherings; restrictions on internal movements; mask requirements; testing requirements and so forth–was well within the European and Canadian average.

The pandemic and the lockdowns split Americans from their friends and families. Birthdays, anniversaries, even funerals were relegated to Zoom. Jobs and businesses were lost in the millions. Children couldn’t see their friends or even play in the park. Churches and bars were shuttered. Music was silenced. Americans sacrificed plenty.

... Some of Slavitt’s assertions are absurd.

The U.S. response to the pandemic differed from the response in other parts of the world largely in the degree to which the government was reluctant to interfere with our system of laissez-faire capitalism…

Laissez-faire capitalism??! Political hyperbole paired with lazy writing. It would be laughable except for the fact that such hyperbole biases our thinking. 

I think the problem is deeper. It's not that this is "hyperbole." It's that this is the sort of mushy sentiment that one can pass around at Washington cocktail parties as easily as write on the front pages of all major media these days, and everyone says yes, sure, without batting an eyelash. It's not hyperbole, it is the unquestioned narrative, it's an inshallah people can add to any statement without question. That's the true danger. 

Fast grants and the economics of subsidizing science

One of the great insights of modern growth theory -- Paul Romer's Nobel Prize -- is that ideas are the foundation of economic growth. Ideas are also "nonrivial." If you use my car, I can't use it, but if you use our family recipe for road-oil chocolate cake (yum), we can still enjoy it as much as ever. Once an idea has been had, economics says it should be used as widely as possible as soon as possible  

But coming up with ideas is expensive. And aside patent protections, I can't charge for the benefit to you of my new ideas.  So, economists naturally notice the mother of all public goods. Research -- finding new ideas --  has enormous benefits, and people will not naturally devote enough resources to finding, refining, implementing new ideas. So, economists conclude,  the government should subsidize idea-production. 

But which ideas?  Now we face the conundrum. It's just as easy to subsidize bad idea production as good idea production, and it's even easier to waste money and produce no new ideas at all. How to subsidize actual productive ideas is a hard question of bureaucratic structure. The economics of science is, I think, vastly understudied. How can government agencies or philanthropies give away money and actually do good? This topic is especially relevant as we contemplate a big ramp-up in federal spending. 

Enter today's topic, a fascinating review of Fast Grants by Patrick Collison, Tyler Cowen, and Patrick Hsu.  Read first the Marginal Revolution summary, then the full article. 

I found it as interesting for its insights into the pathologies of our current system for subsidizing research as for its summary of how well fast grants worked. 

They survey fast grant recipients. Despite being in an evident crisis, and $5 trillion being shoveled out the door... 

64% of respondents told us that the work in question wouldn’t have happened without receiving a Fast Grant.

For example, SalivaDirect, the highly successful spit test from Yale University, was not able to get timely funding from its own School of Public Health, even though Yale has an endowment of over $30 billion. Fast Grants also made numerous grants to UC Berkeley researchers, and the UC Berkeley press office itself reported in May 2020: “One notably absent funder, however, is the federal government. While federal agencies have announced that researchers can apply to repurpose existing funds toward Covid-19 research and have promised new emergency funds to projects focused on the pandemic, disbursement has been painfully slow. …Despite many UC Berkeley proposals submitted to the National Institutes of Health since the pandemic began, none have been granted.” [Emphasis ours.]

Garicano's conversations with economists

Luis Garicano has just posted a very interesting free e-book, "Capitalism after covid: Conversations with 21 economists." I was honored to be one of his interviewees, video here. Luis has a VoxEU column summarizing conversations, and twitter thread if you like reading such things. Luis is a great interviewer. 

This is not an endorsement of all the ideas! Luis found a wide spectrum of ideas, and I think that is the strong thing about the project. You can see how really smart people, on top of the latest academic research, come to still widely different conclusions about the current state of affairs and directions we should go. Though Luis is a pretty free-market Chicago guy, he did not impose that view which I find admirable. 

In particular, referring to the VoxEU column, I would take issue with 

The bulk of the shock was absorbed by the public sector budget. 

That the world could produce such a massive, coherent, and rapid economic response to the pandemic had a lot to do with the consensus that quickly emerged among economists on how best to respond to the unprecedented shock...

Unlike during the Great Financial Crisis, when there was an often-acrimonious debate between economists arguing for austerity and those arguing for stimulus, the priorities were clear: 

Central banks should be concerned with maintaining financial stability and providing limitless liquidity to debt markets. 

Governments should prioritise the maintenance of household incomes through generous support for workers’ incomes, albeit with different approaches in the US and Europe: significant expansions of unemployment insurance in the US and the general deployment of ‘Kurzarbeit’ in Europe.  

Governments should provide ample liquidity facilities to firms, making it possible for them to emerge as undamaged as possible by the lockdowns. 

Finally, large, debt-financed public investments would be needed to support the recovery. 

I  disagree loudly with just about all of this, and thereby especially enshrining these expedients as "consensus" ready to be deployed at even larger scale in the next pandemic. 

If there is consensus on anything it is that our governments completely bungled the public health aspect of this crisis, with the exception of a few countries like South Korea and Taiwan. The FDA and CDC are particularly at fault for blocking testing and vaccines. 

Why did covid produce an unprecedented economic collapse, while the 1958 and 1918 flus produced nary a blip of GDP? Because of the completely overdone business lockdowns. The economic shock was caused by the government not by the virus. What good did it do to run up government debts by trillions in order to send checks to retirees and people who were happily working? I'm sure everyone likes more money, but that has nothing to do with covid. Apparently half of expanded unemployment was stolen (I even got notice someone trying to file in my name). " large, debt-financed public investments would be needed to support the recovery." Consensus on that please? Not from here. The recovery is doing fine on its own, and adding more to the abstract sculpture taking place in the Central Valley under the auspices of a high speed train from Bakersfield to Modesto is not going to help. And why is nobody even thinking moral hazard? We now have enshrined a system in which nobody may lose money in a recession, asset prices will be propped up by central banks. Why not lever to the hilt? Why keep some cash around, as there will be no more buying opportunities? 

But that Luis interviews such good and prominent economists and finds support for this sort of boondoggle policy is interesting. 

Tackling inequality. Over the last few decades, inequality in household income and wealth has increased dramatically in the West.  

This is simply not a fact. (See Grumpy coverage of Austen and Spinter here.) Inequality in pre-tax pre-transfer income has increased. Who cares about that? Inequality of mark-to-market wealth has increased as founders stock values have risen. Who cares about that? 

Several interviewees explain the progress economists are making in tackling these problems. Atif Mian argues that to reduce inequality, policies must focus on achieving more equitable growth through a significant increase in public investment, and second, on addressing some of the legacies of the imbalances, particularly through an increase in the progressivity of taxation. 

Well, if you are a grumpy follower you will find there a well articulated points to disagree with. The US already has the most progressive tax system in the world BTW. And back to more high speed trains to nowhere.. 

Stefanie Stantcheva discusses how to design better taxes and how to improve people´s understanding of those issues. Oriana Bandiera highlights a significant shift in our understanding of poverty that implies that social assistance programmes, that traditionally were designed to subsidise consumption, should shift to being geared towards investment. Esteban Rossi-Hansberg discusses the concentration of talent and economic activity in cities and the extent to which the ‘Zoom revolution’ will upend this concentration and wonders whether that would be desirable, given the potential loss of positive externalities of physical proximity.

But here are some good-sounding innovative ideas, to give you a sense that economists don't just line up on typical left-right spectrum. I need to read those. 

Containing the new leviathan.  It is quite likely that, after the unprecedented policy response to the pandemic, governments will grow permanently larger, leading to an increase in interventionism and, potentially, crony capitalism, as Daron Acemoglu argues. Different countries will sharply diverge in their response to this “critical juncture”. The ones who better succeed will introduce stronger democratic institutions to keep governments in check, as both Acemoglu and Lucrezia Reichlin argue. We also need to improve the way public organisations are managed, a focus of the interviews with Raffaela Sadun and Carol Propper.  Wendy Carlin explains how balancing this larger role for the state requires building a stronger and more resilient civil society – strengthening the ‘third pole’.

This all sounds really interesting. Economics and economists are most interesting when out of the political boxes! 

Tackling climate change. ... Reducing carbon emissions, as Michael Greenstone explains in his interview, must be the only priority – not to be confused with delivering the goodies to voters. 

Voters and interest groups. Mother Gaia does not care if the electric car charging stations and solar panels are made in the US by union members or made in China at a tenth of the cost. 

Yet, after the pandemic, as Nick Stern argues, investing in tackling climate change is the best way to invest for the post-pandemic recovery. 

I will not pre-judge, but if this is more broken windows fallacies and create more jobs by using spoons not shovels, I will be skeptical. 

In sum, this looks interesting throughout and a good view into the spectrum of analysis that economists are bringing to contemporary issues. 

The list of interviewees is 

Debt sustainability

Markus Brunnermeier: Let’s compare the central bank to a race car
John Cochrane: Throwing money down ratholes
Jesús Fernández-Villaverde: Economists and the pandemic
Agnès Bénassy-Quéré: How to design a recovery plan

Tackling inequality

Oriana Bandiera: Overcoming poverty barriers
Stefanie Stantcheva: Taxes and social economics
Esteban Rossi-Hansberg: Will working from home kill cities?
Atif Mian: The savings glut of the rich

A more balanced globalisation

Dani Rodrik: Globalisation after the Washington Consensus
Pol Antràs: Is globalisation slowing down?
Michael Pettis: Trade wars are class wars

Containing the new leviathan

Daron Acemoglu: The Great Divergence
Wendy Carlin: The Third Pole
Lucrezia Reichlin: Democratising economic policy
Carol Propper: Targets and terror
Raffaella Sadun: Management for the recovery

Promoting innovation and curbing the power of digital giants

Philippe Aghion: Is ‘cutthroat’ capitalism more innovative?
John Van Reenen: The Lost Einsteins
Fiona Scott Morton: What should we do about big tech?

Combatting global warming

Nicholas Stern: Zero-emissions growth
Michael Greenstone: The real enemy here is carbon

Vaccine slowdown?

 

Source. Everyone seems tired of covid. And sure, inflation, debts, "infrastructure," competing voting narratives and so on are more fun. But covid is still with us. 

The graph summarizes what I've read in lots of news stories: vaccination is slowing down. There is plenty of supply, but we are running in to people who do not go get the vaccine. 

This strikes me as a tragedy. (Disclaimer: this is an exploratory post, and I'm anxious to hear about it from more knowledgeable people). It means covid will remain with us as an endemic disease, occasionally breaking out as immunity fades and covid evolves. We're on the 20 yard line, folks, it's not time to punt.

I'm pretty darn libertarian, but not about vaccinations. The US should be pushing for near universal vaccination. This is like finishing your dose of antibiotics. 

We do not have to jump to compulsion. Can we at least allow incentives? Vaccine passports sound like a no-brainer even to a libertarian. Allow me to disclose that I am vaccinated, and allow owners of private property like restaurants, bars, airlines, and so forth to demand proof of vaccination. That provides a nice incentive for people to get vaccinated. 

Our policy makers seem so completely deranged by the tiniest "equity" concerns that even this simple step is off the table. On NPR the fact that some disadvantaged groups refuse the vaccine means the rest of us can't have passports. Republicans are also refusing the vaccine, and nobody cares about that! Yes, some immunocompromised people can't get vaccines. Well, on that altar are we going to allow everyone else off the hook, or push to get others vaccinated so they don't infect immunocompromised people -- who shouldn't be going to bars anyway. This debate goes on and on, and time is wasting. 

Even the public messaging has faded away. Our nudgers in chief should be nudging like crazy -- go get vaccinated, people! 

 

I think my best moment as a blogger last year may have been my SIR model with behavior  that predicted the reproduction rate would settle down near one. When it's larger than one, people are more careful, including getting the vaccine. When it's less than one, people slack off. We are seeing a massive case of people, and politicians, slacking off of the one most important step, full vaccination. 

Vaccines and liability

I learned something from the New York Times lead editorial on Sunday. Why are we not shipping mega quantities of vaccines to countries like India? 

... as the vaccines came to market, some vaccine makers insisted on sweeping liability protections that further imperiled access for poorer countries. The United States, for example, is prohibited from selling or donating its unused doses, as Vanity Fair has reported, because the strong liability protections that drugmakers enjoy here don’t extend to other countries...

Pfizer has reportedly not only sought liability protection against all civil claims — even those that could result from the company’s own negligence — but has asked governments to put up sovereign assets, including their bank reserves, embassy buildings and military bases, as collateral against lawsuits. 

Well, you can sort of see the problem. You're a drug company. You sell a billion units of a brand new drug -- still on emergency use authorization in the US -- to, say, India. 10 people get a rare blood clot that may or may not be due to your vaccine. Local courts sue you for a gazillion dollars. Who wouldn't want liability protection? 

As the Europeans allowed trillions of GDP and quite a few lives to vanish while they haggled over a few billion in cost of vaccines, perhaps the onus on countries should be, to say, we want your vaccine, we understand it's brand new and there may be risks, we'll take them?  

The NYT is, predictably, full of bad ideas. 

Conversations: covid and (separately) nonprofits

 I did a few fun video conversations last week. 

This is a conversation with Ryan Bourne, Megan McArdle, and Alex Tabarrok on economics and the year of covid. Direct link if the above embed doesn't work. 

The conversation  is occasioned by the publication of Ryan's excellent book Economics in One Virus.  I am often asked for recommendations of general readable economics books. (i.e. no equations.) This is a gem. 

Then I had a nice conversation with Mike Hartmann at The Giving Review, link here with transcript, (slightly edited, please refer to that if you want to quote me. The above is just a screenshot, you have to go to the link). 

We explored my view that the US should eliminate the whole non-profit business, most of all the tax deductibility of contributions to non-profits, but also (less importantly) the non-profit corporate form. While many non-profits do a lot of good (my employer!) the system has become obscenely perverted, mostly as a tax-supported vehicle for political action, but also a tax dodge available only to the super duper wealthy, and a means of protection from the market for corporate control for flabby institutions. I trust that genuine useful charities will still attract donations -- maybe more -- from the substitution effect than they lose without tax deductions. 

I've long been meaning to gather facts and figures to see if this salty opinion makes as much sense as I think it does, and I'm glad to learn about Philanthropy Daily, a resource that will be helpful.

Oh yes also a great GoodFellows with Bjorn Lomborg on climate. I love talking to Bjorn. He has an extensive command of the facts and science, and he's still an optimist that facts and science will actually make a dent in this debate. As global warming moved to climate change to climate crisis to climate justice to climate risks (financial) I'm less optimistic, but hope must be let out of Pandora's box.  Also 

with Bari Weiss on media, censorship, free speech and assorted issues. Direct links, podcast  versions, and more all here. 

Goodman on single payer

With the current focus on "equity" and "disadvantage," even in the midst of a pandemic, one might yearn for the simplicity of a government run system. Surely if health care were free at the point of delivery, paid for by taxes, all the inequities of health care would disappear, no? (Sure we might all get bad health care, but we'd all get the same health care, no?) 

No. John Goodman has a nice Forbes article explaining why and giving the evidence from UK and Canada. Bottom line: Nothing is free. Everything is rationed. If it is not rationed by price, it is rationed by political access or personal connections. Markets are the great leveler, as anyone can get money but it's hard to get friends and connections. 

When Britain founded the National Health Service

It was often said "health care is a right." Aneurin Bevan, father of the NHS, declared, “the essence of a satisfactory health service is that rich and poor are treated alike, that poverty is not a disability and wealth is not advantaged."

30 years after the NHS began the Working Group on Inequalities in Health investigated and  

The Black Report found little evidence that the creation of the NHS had equalized health care access or health care outcomes at all. Here are the words of Patrick Jenkin, secretary of state for social services, in his introduction to the report: 

“It will come as a disappointment to many that over long periods since the inception of the NHS there is generally little sign of health inequalities in Britain actually diminishing, and in some cases they may be increasing. ..”

.. 30 years after Britain had nationalized its health care system and replaced private care with public care, it appears that inequalities in access to health care and health care outcomes were not any different than if the NHS had never been established at all!

Econtalk on virus

About a month ago, Russ Roberts and I had a great conversation about virus, vaccine, and tests for the Econ Talk podcast, and the free market approach. It's out now, here for the podcast, or embedded below  and here video on YouTube. The podcast link already has some excellent comments. 

Vaccine math. $500 per shot?

I'm reading up on the $1.9 trillion "stimulus." This caught me eye:

 Biden's plan would set out $160 billion for a nationwide vaccine program that would help state and local governments get the vaccine into people's arms.

There are 328 million people in the US. $160 billion is just about exactly $500 per person. 

Now, I am of the view that the government should have spent a lot more on vaccines, testing, public health and so forth, given the $5 trillion and counting it has cost the government, and more in lots GDP, jobs, years of school and so forth. This is likely the least bothersome line in the bill. 

Still, has the US really gotten to the point of health care sclerosis and dysfunction that it costs $500 -- on top of money already allocated -- to give someone a shot?  

Test snafu

Wouldn't it be nice if there were a $5 test that works in minutes, and can find asymptomatic people who might transmit covid? Imagine how many schools, businesses, restaurants, weddings, churches, and so forth could safely open with such a thing. Imagine how much the reproduction rate of the virus could be crushed. 

There is! And it's sitting on shelves, one of the biggest casualties of the US federal monopoly on this simplest of all consumer goods. From detailed Wall Street Journal coverage: 

“Antigen testing is one of the most powerful tools we have to hasten control to normalcy,” said Richard Pescatore, associate state medical director at the Delaware Department of Health and Social Services...

The tests can quickly help determine whether someone is infectious. The tests detect cases by searching for pieces of proteins from the virus. They deliver results in minutes.

Among the first rapid antigen tests cleared by regulators was the BinaxNOW, which is made by Abbott Laboratories, costs $5 and doesn’t require any equipment.

Costs $5 to the federal government. Imagine if Abbott could send it to you via Amazon or ship it in bulk to Wal Mart. Alas, rather than simply sell the tests on the open market, the federal government is the monopoly buyer, shipped them to states, and they sit on shelves: 

A modest proposal for vaccine rationing

A mid-20s child of a good friend just got the vaccine. Why? He runs a micro-brewery, which his state deemed "essential," because it's "manufacturing." 

As the WSJ reports

After nursing-home residents and health-care workers, the CDC says priority should go to those over age 75 and an expansive list of “frontline essential workers.”,

...“essential workers” ... include those who “work in transportation and logistics, food service, housing construction and finance, information technology, communications, energy, law, media, public safety, and public health. 

media! Economics blogging should count, no? 

What happens when a good is rationed? It is given out politically. 

While many states have already given priority to police and firefighters, teachers’ unions are trying to cut to the front of the line and are blackmailing politicians by refusing to reopen schools. But teachers and child-care workers face less risk than other front-line workers since children are less likely to transmit the coronavirus. 

Other unions are also lobbying for priority. The SEIU lambasted California Gov. Gavin Newsom’s well-advised decision last week to remove “essential” workers such as janitors from the state’s priority guidelines and base eligibility almost solely on age. “It’s like he’s putting us out to die,” griped SEIU United Services Workers West political director Sandra Díaz. 

Industry groups including hotels, airlines and ride-share companies are also lobbying states to have their workers vaccinated first. Gov. Andrew Cuomo this week announced that restaurant, taxi and ride-share drivers would be next in line for vaccines. But why restaurant workers before retail workers or 60-year-olds?

The WSJ suggests rationing based on age. 

The modest proposal: Why not let "industry groups" decide when they want the vaccine based on...hold your breath.. paying a market price to get it?  I wouldn't dare whisper that maybe individual people could be allowed to decide when to get the vaccine -- that is what we're talking about, when, not if --  by deciding when they want to pay for it, as our political climate cannot say out loud that anything should be rationed by willingness to pay. But surely, we can agree that profit-making businesses should be allowed to pay to get their workers vaccinated sooner -- if it's really important to them to do so -- rather than just by who has more political connections to be labeled "essential." 

Fun: Rory Cooper tweets

Fairfax schools says they're going to open up 2 days a week in March for some kids. Wanna know how? They're hiring thousands of unskilled classroom monitors to watch kids watch computer screens because their fully vaccinated teachers won't return to the building. This is nuts.

 

Jay Bhattacharya on good fellows; tests vaccines and more

Podcast:

Link in case the above embeds don't work. 

Stanford Doctor and Professor Jay Bhattacharya joins the GoodFellows for an engaging discussion of covid, vaccines, tests and more. He starts off with a view directly contradicting the conclusion I have come to: he thinks the vaccine should be deployed first to protect old people, not to control the spread of an exponentially growing and mutating virus. I love it when very well informed people disagree with me. Was I wrong?  Then Niall goes on to challenge the Great Barrington Declaration, and maybe consider that lockdowns might not be so dumb. Then the conversation gets really interesting! 

On Tuesday, I also recorded an Econ Talk podcast with Russ Roberts on the same issues. I'll post when up. 

Open smart, redux

Open smart, I and other economists argued back in March. Don't just shut lock down the whole economy willy-nilly. An auto-body paint shop (they wear masks and respirators anyway) is not likely to spread covid-19. Parks too. Test widely, randomly, to stop the spread of the disease, not just to diagnose the sick. 

At last, perhaps, we may be headed this way, reports the Wall Street Journal 

Scientists are settling on a road map that can help critical sectors of the economy safely conduct business, from meatpacking plants to financial services, despite the pandemic’s continued spread.

After nearly a year of study, the lessons include: Mask-wearing, worker pods and good air flow are much more important than surface cleaning, temperature checks and plexiglass barriers in places like offices and restaurants. And more public-health experts now advocate wide use of cheap, rapid tests to detect cases quickly, in part because many scientists now think more than 50% of infections are transmitted by people without symptoms.

We have a long way to go before vaccines stop the spread of the disease. Tests could do it now, if the FDA would get out of the way. Yet

 a year later, sufficient testing remains a critical issue.

Test detail

One of the largest studies of asymptomatic transmission to date showed that frequent testing was essential in identifying infections among a group of nearly 2,000 Marine recruits...

The study looked at cases identified with lab-based tests that search out and amplify the genetic material of the virus, but those tests aren’t as easily scaled as so-called rapid antigen tests, which search for viral proteins.

Results from lab-based tests can sometimes take days, while results from rapid tests are usually available in less than an hour...

The shift toward using frequent, inexpensive and rapid tests on the same people multiple times a week to screen entire populations—instead of one-time tests on individuals who have symptoms—will be important to efficiently break transmission chains, epidemiologists said.

“Unless we’re doing really broad, frequent screening of the people at large, we’re completely missing the vast majority” of infections, said Michael Mina, an assistant professor of epidemiology at the Harvard T.H. Chan School of Public Health. “We have to change how we’re doing this.”

I'm sure Paul Romer is saying, great, now the scientists finally get it. Well, they do. Next the FDA. 

Ventilation

Indoor ventilation has been on my mind. Why is outdoor dining safe and indoor not? Is it really safe to dine "outdoors" in a plastic tent, as has become the hilarious practice around where I live? If outdoors is safe, but indoors is warm, can we not make indoors as safe as outdoors with ventilation, HEPA filters, and UV light? 

Fresh air and effective filters indoors are important because they can remove virus particles before they have time to infect.

So this is a non-grumpy post. We have a long way to go with covid, and the next one after that. To see some durable wisdom breaking out is refreshing. 

Libertarian pandemic

 "Libertarians in a pandemic" is a good essay by Jacob Grier expanding on many themes I've written about here, whether markets though imperfect might do a better job, or at least help on top of government. And if freedom might be better in a pandemic, where all the econ 101 market failures are present, just think how well markets might allocate, say toilet paper. 

There are libertarians in a pandemic, and it turns out they have some good ideas and insightful critiques.

Tests

Let's start with the testing snafu. Tests, of course, should be run by the government because there is a big externality. I want you to get tested so you don't give me the disease. How did the the government do, relative even to a free market? 

The American pandemic response was beset by government failure from the very beginning. In February of 2020, the most urgent priority in the United States was deploying COVID tests to identify cases, survey the extent of the virus’s spread, and attempt to contain it. Although the World Health Organization had already developed a working test, the Centers for Disease Control designed its own from scratch. The CDC test turned out to be unworkably flawed, reporting false positives even on distilled water.

Around the same time, Health and Human Services Secretary Alex Azar declared a public health emergency. Ironically, one effect of this declaration was to forbid clinical labs from creating their own tests without first obtaining an emergency use authorization from the Food and Drug Administration. Bureaucratic hurdles — which included pointless requirements to send files by mail and to prove that the tests would not return false positives for MERS and the original SARS virus — slowed development. The early outbreak in Washington was uncovered in part by researchers simply defying the CDC to test samples without permission.

Grumpy economist podcast: free market tests, vaccines and more

The Grumpy Economist podcast is back, and we're going to aim for a once per two week schedule. This week we talk about vaccines, tests, masks, and how free markets would do better than the government, or at least can usefully complement the government. 

I wanted to get to the larger point, at least can we have a free market in toilet paper? Price controls in crises are one of those econ 101 questions that divide economists from everyone else. Don't transfer income by rationing toilet paper in a crisis. Let prices allocate it to who really has got to go, and give the natural disincentive against hoarding. Next time. 

 Link here if the embed above doesn't work.