The Cracks Begin To Show

[For my previous COVID-19 posts, see here and here.]

For a while my social media was filled with nothing but COIVD-19 posts.  Well, it’s still all coronavirus, but the nature of the posts is slowly morphing.

To be clear, the majority of the posts are still the same; “As Coronavirus Cases in US Spike 40% in One Day, Medical Workers Plea for Key Supplies” bemoans a typical article.

But a new strain is seeping back into the national conversation after a few week hiatus.  Often it just appears as a scapegoat–“Don’t believe the myth that we must sacrifice lives to save the economy”, writes The Guardian.  But the fact that if even needs to be posted shows a growing worry among some that the coronavirus narrative might be in danger of slipping out of their grasp.  Few are bold enough to quite say it yet, but some toe in that direction.  The generally raise the question of what a risk-reward tradeoff would look like, but stop short of answer it.  Trump, ever the tactful speaker, spoke confidently about packing Easter pews as we move on from dealing with COVID-19.

This new crop of thought, that maybe, I don’t know, if you look at the cost-benefit analysis, I mean, like, well, obviously it would be horrible to suggest, you know, but….  It’s not coming out of nowhere.

The collective confidence in taking extreme measures to combat COVID-19 has always seemed a bit quixotic.  First, it was important to do things to stop the spread.  Then, the narrative seamless turned over to flattening the curve–accepting that shutting down the economy wouldn’t stop COVID-19 from spreading but suggesting we do it anyway–without missing a beat.  The arguments for extreme suppression have always been light on the numbers and facts, other than pointing to an exponential graph and saying “look it gets big!”  Instead, they’ve been scolding, self-riteous, and condescending.  “I’m A Doctor. The U.S. Response To Coronavirus Has Been Nothing Short Of Criminal.”, writes HUFFPOST.  Any tradeoffs between approaches are a “myth”.

The Washington Post runs an op-ed: “The media must stop live-broadcasting Trump’s dangerous, destructive coronavirus briefings”.  The institution’s new slogan looms overhead.

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There remains a decent argument for the world trying to coordinate on taking the Singapore/Taiwan/Hong Kong approach–half-shut-down for a week, tons of quarantine for possible cases and good hygiene, and then let life go on; by aggressively using the most cost effective measures early, we may have been able to kill off COVID-19 at a reasonable price.

But each day the case for suppression weakens, and as the media hunkers down into its collective hard-line stance the suppression movement threatens to jump the shark.  NYC mayor Bill de Blasio calls for more suppression while saying that over half of the city will get it–defeating the main purpose of the lockdown.  While earlier arguing that the economic hit wouldn’t be that bad, pundits now have to grapple with historically large jobless claims, stock market crashes, and forcasted GDP decreases; a $100T loss now looks like if anything optimistic given the dire forcasts banks are pushing out.  China gave up on its lockdown after a month and cases are coming back; even Hong Kong, Taiwan, and Singapore and starting to shut down to prevent imported cases from running rampant, making true suppression look more and more like a pipe dream for most of the world.

Meanwhile the evidence mounts that the expected DALY loss from COVID-19 is at the low end of estimates.  Iceland leads the world in tests per capita, but more importantly it’s done randomized testing.  This lets us address one of the central uncertainties around COVID-19: what’s IFR, the infection fatality rate?  We know roughly how many deaths there are but need to divide by the total number of cases.  Well, in Iceland, 48 tests out of 5571 have been positive, for a rate of about 0.86%.  The population of Iceland is about 360k, meaning that roughly 3,600 people likely have COVID-19 in Iceland.  There has been one death, with another twelve in the hospital, giving an IFR somewhere between 0.03% and 0.33%, way lower than the CFR-based estimates floating around.  South Korea’s tests might not be random–so take this with a grain of salt–but the same math there would imply that around 2.5% of the population has COVID-19; 131 deaths out of ~1m people would imply an IFR around 0.01%.    Korea and Italy have both yet to have a death below the age of 30, bounding CFR at less than 0.10% for young people.  Given that IFR generally seems to be a factor of 10 below CFR, a < 0.01% IFR for people under 30 would put their mortality rate over the last few months in line with background mortality; it’s not even statistically significant that COVID-19 increases death rate for young people.  The average age of death from COVID-19 remains in the 70s and 80s in various populations.  Put all of this together–a young IFR below 0.01%, an average age of death around 75-80, and an overall IFR around 0.10%–and the average DALYs lost per infected person from possible death by COVID-19 is around 5 days.  It’s worth noting here that these IFR estimates are in line with those of the flu.

The math looked extremely lopsided a week ago; with IFR estimates coming down more and economic costs continuing to increase, it’s not close to being close.

And I suspect that world leaders are beginning to realize this–or perhaps knew it all along.  Trump is targeting a few weeks for lifting all social distancing in the US; China reopened after a month or so, restarting its COVID-19 spreading; and the UK fought hard to stay open before decisively losing the PR battle.  The world has pumped around $7T into the economy via stimuluses–an impressive amount, if still an order of magnitude below what’s needed (never mind the impact on global debt or inflation).  The truth is that not only is it a bad decision by orders of magnitude to shut down, but countries just can’t shut down for more than a month or so without sinking into a possibly fatal cycle of recession and debt.

We’re all used to seeing a lot of poorly thought out shit on social media.  What’s been a bit shocking to me, though, is exactly how bad the EA writing on COVID-19 has been.  It seems to be just as non-quantitative, emotional, judgmental, and wrong as the median content I see.  This really should be right up EA’s wheelhouse; I think a decent Fermi estimate does a pretty good job here.  And there were a few early Fermi estimates!  But when the assumptions they made started to seem likely to be wrong–so wrong that the conclusion flipped from pro-suppression to anti-suppression–rather than update towards being anti-suppression, EA seems to have instead kept its conclusion.

My best guess, now, is that the EA echo chamber of social media is just not representative of core EA thinking.  That, just like the rest of the world, most EAs who are anti-shutdown have decided it’s bad PR for them to say so.

Which would be comforting–at least the people who are really in charge might be right!  Except that I worry we might just be caught in a PR feedback cycle.  I don’t think it was obvious, ex-anti, that it would be political suicide to be against shutting things down.  So how did we get here?  Well, my guess is that it started off as a trickle–but the more publicly expressed opinions from thought leaders came out in favor of shutting things down, the more scared anyone who disagreed was to voice their opinion, and so we spiraled into an echo chamber.  Public opinion caused and reinforced itself, and we ended up destroying 30% of the economy because we let this spiral start.

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