The following was a carom shot from a reader which was originally composed by a director of the Foundation for Economic Education. Good stuff:
It's possible for a disease or a trauma to kill you, not by direct injury to a particular organ, but by triggering a massive non-specific over-reaction by the immune system that causes inflammation in several vital organs all at once. Systemic Inflammatory Response Syndrome. It seems like an apt description of what COVID-19 has done to the US economy.There seem to be two approaches to the government's response to the COVID-19 situation: (i) the targeted approach where they do aggressive investigation to figure out who's sick and then quarantine those people and (ii) the brute-force approach where they say, let's not do widespread testing, let's quarantine everybody and bring the whole economy to a halt.The first was adopted by advanced Asian countries who chose to learn the lessons of SARS and H1N1, such as South Korea, Taiwan, Hong Kong, and Singapore.The second approach was adopted by China and many western countries.As best I can tell, the main reason the US has chosen the second approach is that the CDC and the FDA didn't think it was important to put local health authorities in a position to conduct widespread testing in a timely manner.I could be wrong in some of the details, but here's the gist of what I've gotten from a news sources across the political spectrum:(1) Once the genetics of the virus were mapped, the WHO came up with a model formula for a test, which many countries went ahead with, but it wasn't good enough for the CDC. US laboratories were not allowed to use their own test formulas. Labs around the world produced over a million tests while the US produced zero.(2) When they finally came up with their own formula, after weeks of work, the CDC permitted laboratories to produce tests, but prohibited them from using their tests until they got approval from the FDA. The FDA, in turn, imposed standards on the labs that included a demonstration that their tests wouldn't produce false positives for pathogens that haven't been in circulation for years, so much so that it was difficult even to obtain samples of them to run the trials. Under intense pressure as these news stories got out, the FDA recently relented, so now they have a saner standard and will grant provisional certifications, conditioned on submitting paperwork within 15 days.(3) Even if they had the test kits, labs and clinical facilities were prohibited from testing patients who didn't meet all the indicia set forth by the CDC. The authorities in Seattle discovered their outbreak only because a lab went ahead and tested people they weren't supposed to, and without waiting for the FDA approval. The response of the CDC and the FDA was to tell the local authorities that they should order this rogue laboratory to cease and desist.(4) Meanwhile, the test kits produced by the CDC had to be recalled because local health officials found that they were generating too many false positives. (If CDC had been subject to FDA certification, they would have been rejected!) The CDC produced a second version and distributed it, but as recently as this week, local health officials were complaining that the kits were incomplete. "Like getting a printer with no ink."Hence, no option to take approach #1.My suspicion is that this kind of bureaucratic obsession with maintaining control by checking boxes is a culture that's unaffacted by occasional changes of administration in Washington. What was the CDC doing in all the years following SARS and H1N1? If it wasn't their job to study the lessons learned by the advanced countries in Asia from dealing with those outbreaks, you have to ask, what exactly is their job?Flu stats:Interesting point of view and well articulated.One data point I feel alarming comes from a study done by some Swiss researchers, reported in last week's Economist magazine. They looked at data from Hubei, the province in China with the worst outbreak of the virus. Among younger people, the fatality rate was less than 1%, but for people 80+ ( a cohort with which some of us have some familiarity) the fatality rate was 18%.I am almost certainly in the minority, but I cannot avoid wondering if we in America have lost our collective mind. We are bankrupting numerous small businesses by forcing them to close while not imposing a rent holiday, and imperiling airlines, hotels, service industries of all types, etc., etc., because of the supposedly dire threat of the Corona virus. Do the facts warrant this degree of disruption?The outbreak began in Wuhan, China, on December 29, 2019. As of yesterday, March 15, the World Health Organization reports that out of the 7 billion or so people in the world there have been 153,517 confirmed cases of Covad-19, and 5,735 deaths.According to the U.S. Center for Disease Control, in this country alone there were 35.5 million cases and 34,200 deaths in the 2019-19 flu season. For the period October 1, 2019 thru March 7, 2020, the flu statistics indicate that this season’s totals will not differ significantly from the prior season and may be a bit worse.There is no question that Covad-19 can easily be spread. Of the total confirmed Covad-19 cases, almost 53% (81,048) are in China. The city of Wuhan was put on lockdown January 23, about three weeks or so after the first case was detected, but by February 1 there were 11,821 confirmed cases in China. On February 15, the number had increased to 50,054, and two days later the confirmed cases had jumped over 40% to 70,635. The earlier statistical increases were because of increased testing, and the February 17 jump was because the methodology of counting confirmed cases had changed. The totals now included not just cases confirmed by lab tests but by clinical findings at treatment centers.By March 1, the confirmed cases in China had reached 79,968 but only 1,053 have since been confirmed. The lesson is clear: a combination of isolating known cases, and careful hygiene and normal precautions by others will check the spread of the virus.The experience of South Korea is a model. It had its first confirmed case on January 20. Increase was slow until the last weeks of February when a large church congregation became a focal point of infection, and a hospital in another area also became a major source. South Korea responded by a massive public testing program for the virus, coupled with public tracking of the movements of infected persons and limited restrictions on travel and public gatherings in affected areas, with some school closings or delayed semester starts. Apart from the two areas that are the major contributors to the outbreak, most of South Korea is operating normally.South Korea had a bad experience with the MERS outbreak in 2015 because of a lack of test kits. Afterwards, the country approved rapid deployment of viral test kits, and now they are able to test more than 10,000 people a day, including at drive-thru roadside sites. It has tested over 200,000 people, up to 10,000 a day. As a result of this extensive testing, it furnishes the best data for evaluating the risk of a fatal result of a COVID-19 infection. With 8,236 confirmed cases, and 75 deaths, the fatality rate is 0.91%. The attachment to this memo shows how that risk is directly related to age, a feature COVID-19 shares with the flu where 75% of deaths in the 2018-19 flu season were people 65 or older. What the attachment does not show is how many of the fatalities were persons with major preexisting health issues. According to US CDC data, persons with such a condition are more that four times more likely to have a fatal case that those without such a condition.While it appears that the death rate for COVID-19 may be higher than for the flu, although the target age cohort may be similar, I am confident it will be much lower than current US statistics show and will be closer to those of South Korea. Until we know how many people actually get COVID-19, which will be unknown until testing is orders of magnitude greater than at present, there is no way to determine that fact accurately.When I look at the available facts, the damage being done to our economy and social interactions by the draconic steps now in vogue, the statistics about flu, and see that South Korea has managed to control the virus without bringing millions of its citizens to the brink of bankruptcy, and watch the Wall Street traders have a feast because of the volatility caused by the actions taken and/or contemplated, I find myself wishing for a Maggie Thatcher who could inspire – or order -- the nation to keep cool and carry on.Obviously the elderly, and particularly those with existing health issues, would do well to avoid mingling with the public until the danger has abated. For others, it seems to me that normal prudence and increased vigilance against contamination by use of soap, water, disinfectants, and avoidance of too close contact with others, should keep the risk to about what it is for the flu. At the end of the day, we would survive as would so many of those whose livelihood will go under because of the panic let loose in the land. At the very least, the policy ought to be to increase testing as fast as possible with a public commitment to return things to normal once a certain level of testing has been achieved, with draconian limitations continuing only in demonstrated COVID-19 hot spots.Korean Statistics:
4 comments:
Your fearless leader leading us down the road of destruction. Are you happy yet?
Pray tell, what is your solution?
Bill, the point of this blog is "we shouldn't ruin the economy just because some people will die." How can you disagree with that? If you are looking for empathy you are in the wrong place.
See: https://www.powerlineblog.com/archives/2020/03/stop-the-insane-overreaction.php
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