Saturday, April 4, 2020

“The cure is worse than the disease”


  
Yesterday’s numbers (from Worldometers, as of about 8 PM EDT April 2)
Total US confirmed cases: 277,607
Increase in cases since previous day: 32,165 (vs. 30,085 increase yesterday)
Percent increase in cases since yesterday: 13% (vs. 14% yesterday)
Percent increase in cases since 3 days previous: 29% (vs. 30% yesterday)

Total US deaths as of yesterday: 7,406
Increase in deaths since previous day: 1,308 (vs. 985 yesterday)
Percent increase in deaths since previous day: 28% (vs. 19% yesterday)
“Set in stone” US deaths* over course of pandemic:  125,287 (based on 4% case mortality rate)
*This number assumes a) Total cases grow by 30% into the future (= yesterday’s 3-day growth rate in cases); b) We impose a massive lockdown, with prohibition of all non-essential travel, today; c) New cases drop to zero in 28 days, because of the lockdown; d) testing is widely available by the 28-day mark; and e) case mortality rate = 4%. To consider a 6% mortality rate, multiply each projection by 1.5. For 8%, double it. For comparison, Italy’s case mortality rate is currently 11.75%.

Projected as of April 11 (7 days from today):
Total expected* cases: 526,888
Total expected* deaths set in stone** over course of pandemic: 258,708
Projected** number of actual deaths on 4/11 alone: 5,938
* The expected cases and deaths set in stone numbers assume a) Total cases grow by 30% into the future (= yesterday’s 3-day growth rate in cases); b) We impose a massive lockdown, with prohibition of all non-essential travel, on April 11; c) New cases drop to zero in 28 days, because of the lockdown; d) Testing is widely available by the 28-day mark; and e) case mortality rate = 4%. To consider a 6% mortality rate, multiply each projection by 1.5. For 8%, double it. For comparison, Italy’s case mortality rate is currently 12.25%.
** Projected deaths = previous day’s new deaths number, grown by that day’s 3-day percentage growth rate. Note this is calculated completely differently from the deaths set in stone, which refers to projected deaths over the entire pandemic, and is calculated by multiplying expected cases by the mortality rate.

Projected as of April 17 (14 days from today):
Total expected* cases: 876,794
Total deaths set in stone** over course of pandemic: 392,416
Projected*** number of actual deaths on 4/17 alone: 19,669
* The expected cases and deaths set in stone numbers assume a) Total cases grow by 30% into the future (= yesterday’s 3-day growth rate in cases); b) We impose a massive lockdown, with prohibition of all non-essential travel, on April 17; c) New cases drop to zero in 28 days, because of the lockdown; d) Testing is widely available by the 28-day mark; and e) case mortality rate = 4%. To consider a 6% mortality rate, multiply each projection by 1.5. For 8%, double it. For comparison, Italy’s case mortality rate is currently 11.75%.
** Projected deaths = previous day’s new deaths number, grown by that day’s 3-day percentage growth rate. Note this is calculated completely differently from the deaths set in stone, which refers to projected deaths over the entire pandemic, and is calculated by multiplying expected cases by the mortality rate

Reported case mortality rate so far in the pandemic in the US:
Total Recoveries in US as of yesterday (4/2): 12,283
Total Deaths as of yesterday: 7,406
Deaths so far as percentage of closed cases (=deaths + recoveries): 38% Let’s be clear. This means that, of all the coronavirus cases that have been closed so far in the US, 38% of them have resulted in death. Compare that to the 4% mortality rate I’ve been using to calculate total pandemic deaths, based on cases. Of course, this number will come down as time goes on and more cases are closed in which the victim recovered. But it’s only come down by about 4 percentage points since Worldometers started publishing the recovery rate on March 26, and on about half the days (like yesterday), it’s gone up. I’d say it’s much more likely my 4% mortality rate will turn out to be too low, after the pandemic’s over and all of the bodies have been counted, than it will be too high.

Date on which the number of new deaths on that day will exceed the toll of Sept. 11: April 7
Date on which 200,000 total pandemic deaths will be set in stone: April 10
Date on which 500,000 deaths will be set in stone: April 20
Date on which 1 million deaths will be set in stone: April 29

I have had a long, complicated relationship with the Wall Street Journal’s editorial page. When I graduated from college in 19__ (excuse me, I seem to have forgotten the year I graduated. I’ll research that and let you know it in the next six months to a year. Be sure to remind me if I forget), I was coming off my years as an undergraduate economics major at the University of Chicago (including two courses with Milton Friedman).

At that time, the biggest problem was inflation, and the WSJ (following Friedman, of course) was firm in holding that the strategy of trying to hold it down by limiting price increases (started by Nixon, and pursued by Ford and Carter. These were the days when there was bipartisan agreement. Everybody agreed that it was best to pursue the current downhill path; the only problem was we weren’t going downhill fast enough) was doomed to just make the problem worse, without dealing with the direct cause of the problem: an unsustainable rate of increase in the money supply. I certainly believed that was the right analysis, although on most general political issues I disagreed with Friedman (especially in his Newsweek articles in the 1980’s, which went well beyond anything that could be deduced through economic analysis) and the Journal.

Lately, I’ve liked a lot of the Journal’s editorials, especially those opposing tariffs, rubbing China’s nose in their shameful treatment of the Uighurs, etc. However, in general I’ve found a lot of their editorials in recent years seem to take a fairly selective view of the facts (although their reporting has not. I’ve always loved the reporting). This is of course a sin that most editorial pages are guilty of from time to time, and at least they still allow very good opposing opinions to appear in op-eds, especially those of the economist Alan Blinder and the former Chicago mayor and presidential Chief of Staff Rahm Emmanuel.

However, failing to account for all the facts is a recipe for absolute disaster today. We’re seeing the consequences of that in the utter failure of this administration to prepare seriously for the pandemic, even though public health professionals rated the US as best prepared of all countries in the world for a pandemic last year. However, we absolutely need to see the facts clearly now, and take actions that will mitigate the damage, not escalate it.

A couple weeks ago, the Journal was joined by some writers in the New York Times, and many others on both sides of the political divide (and certainly President Trump!), in reciting the mantra that “the cure can’t be worse than the disease.” Meaning: Sure, there would be some benefit to shutting down the entire economy to try to stop the coronavirus cold, but that would lead to so much economic destruction that there would be even more deaths by suicide, etc. (which is of course hugely overblown. Even in the Great Depression, there weren’t many suicides – and the stories about stock brokers jumping out of high rises in 1929 were an urban legend. People will commit suicide in an economic downturn when they see no hope of recovery. If they think the government is working hard to make things better – which they clearly did after Roosevelt came into office in 1933 – they will hang on).

However, I thought events (including the huge and rapidly growing daily increases in total deaths from the virus – 1,000 two days ago, 1500 today, and onwards and upwards!) had already overtaken this view – it certainly has at the Times. But it seems the WSJ isn’t backing off of this idea, as demonstrated in their editorial “The Shutdown Crash Arrives” in today’s paper.

That editorial mainly took issue with the Trump administration for now pursuing a policy that amounts to “Hey Mr. Governor, if you think it might be good, you should think about pursuing a shelter-in-place strategy. But if you don’t think it’s the right thing for your people, far be it from us to tell you what to do.” They think even that policy is too restrictive, and they clearly want the Administration to set a plan to start easing very soon.

The administration’s policy is misguided – I certainly agree with that. But it should be far more restrictive, not the opposite. The fundamental fact is – and many knowledgeable people have said this – that the economy won’t restart until the virus is totally under control, meaning a) almost everyone who has it is under quarantine (along with all of the people they interacted with during the time they were contagious); and b) everyone else is tested regularly to catch new infections early, before those people start spreading it to others. Nobody is going to want to return to work in an office or factory, or patronize a restaurant or store, until they’re sure they won’t catch the virus from the person next to them, period. If we had massive testing available and we could literally test everybody in the country (multiple times, since the tests have reliability problems), and if we had facilities available to quarantine people separately (so they don’t spread it to all of their family members while they’re quarantined with them, as they learned the hard way in Wuhan), we could probably end the total lockdown after a month (which is what I assume in my estimates of total cases over the pandemic), and start to open up then.

But the problem is we definitely don’t have either of these things now, and given the back-and-forth manner in which this administration moves – and the wonderful habit they have of attacking everybody who tries to cooperate with them (for example, 3M and GM, let alone just about any Democratic state governor) – there’s no assurance at all that we’d be ready to start loosening in 28 days, even if we locked down the entire country today.

That is probably why Bill Gates (whose foundation has been doing great work worldwide preparing developing countries for pandemics) said yesterday that there should be a ten-week total shutdown. I’m not sure that we have to commit to doing it for ten weeks up front, but we should definitely first try 4-6 weeks. Assuming we have ubiquitous testing at that time (a stretch, to be sure!), we could then start taking controlled steps to loosen up. But the problem is if we loosen too quickly, the virus will pop back up in another month (remember, there were 100 reported cases in the US at the beginning of March. There were 277,000 yesterday. That can easily happen again and again) and we’ll have to lock down again.

Now, the Journal’s editors know all this – lots of people have been saying we need to lock down, and virtually every country with a growing problem has done this to some degree (my wife is in Vietnam now and the government has locked the whole place down, even though there are only about 200 reported cases and no deaths – although my wife believes they’re suppressing the numbers). Why are they saying this? Do they really believe workers will feel safe venturing out to work soon?

Of course they don’t, and here’s the interesting part: They say they’re very concerned about the workers who can’t work from home - unlike the editors and me and probably you. They want them to be back to work, so they can start earning paychecks again. Implicitly they’re saying “These people will be willing to bear some risk of contracting the virus, just so they can have food on the table.” But why do they have to work to have food on the table? Why don’t we just give them the money they need to survive until the economy is ready to reopen?

Of course, the answer will be “We’re already doing some of that, but there are limits to how long we can do this.” But what does it cost to give people the money they need to survive? Oh, people at the Fed and the Treasury have to go online to a bunch of businesses and individuals. With a few keystrokes, they can give them any amount of money they want.

Then the answer will be “Oh, but that will surely come back later to haunt us as inflation overwhelms us.” Well guess what – we’re overwhelmed now. We’re being offered the false choice between letting people literally starve soon, and forcing them to go back to work, when we know a lot of them will get sick and we’ll be back in lockdown in another month. There really is no option.

What would Milton Friedman say about this? The same thing he always railed about when discussing the 1930’s: The Crash of 1929 could have been a non-event (just like the huge stock market crash of 1987 – the “flash crash” – was), if president Hoover and the Fed had realized that the thing to do in a financial downturn was to create and distribute as much money as needed to get the economy moving again, and also to support people and businesses so that they would still around to power the economy when it came out of its coma. This is ultimately what Roosevelt did, when he ordered signed Executive Order 6102, which forbid hoarding gold. This freed the Fed to greatly increase money in circulation.

We need to do whatever it takes to support people while the economy is shut down. If we don’t do a total shutdown, so that we finally get control of the virus, we’ll be cycling in and out of surges in cases and deaths, until a vaccine is developed and manufactured in quantity enough to vaccinate everybody (probably two years, maybe longer).

Or we could also do nothing useful, which is the course we’re on now. To show you what we’re in for if we choose that route, here are the number of daily deaths I’m projecting for the rest of April. Enjoy reading them!

1918
1793
2381
3491
3263
4333
6354
5938
7885
11,564
10,807
14,351
21,047
19,669
26,119
38,306
35,798
47,537
69,717
65,153
86,518
126,885
118,579
157,463
230,931
215,814
286,583 – That’s April 30. In May, it starts to get really bad.




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