The economic value of lives saved

The economic value of lives saved - Printable Version

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RE: The economic value of lives saved - 76lsjumb - 05-28-2020

(05-28-2020, 09:53 PM)burger Wrote:
(05-28-2020, 09:23 PM)76lsjumb Wrote:
(05-28-2020, 02:45 PM)burger Wrote: BTW, in politics, any statement that begins with "both sides" is probably half wrong.

Because, of course, the only side that is EVER right is burger's side.

That's just science...

The idea that both political parties are equally bad and that the true answer to our problems lies in the Aristotelian golden mean between them is facile and specious. It has poisoned our politics and made the country cynical.

Thanks for the personal attack, though. Really elevated the discussion.

You should be happy that wasn't the idea I was promoting, then.

RE: The economic value of lives saved - 2006alum - 05-29-2020

(05-28-2020, 11:14 PM)CardinalSagehen Wrote: I do not ascribe to that idea. If you must know, I think the federal response has been abysmally, atrociously, embarrassingly bad.

But we are talking about a specific issue here, and I do not have to like everything that all leaders in my own party have said or done. Cuomo in particular has struck me as slow-on-the-uptake. Perhaps it was academic and nit-picky, but he also rubbed me the wrong way with his self-righteous refusal to quantify the cost of saving lives.

This crisis has left me with the overarching, sinking feeling that our system and leaders are poorly equipped to deal with highly quantitative, scientific problems. Hyper-politicization of the issues is one of the very problems that we face.

FWIW, I would largely agree with all of this. The one "both sides" statement I do feel comfortable making is that partisans on both sides are tempted to cherrypick data/results that support their underlying position. I think there's so much we don't know about the virus, about the probable economic fallout, etc., that strong claims of certainty one direction or the other should be greeted with some skepticism. That's part of what has bothered me so much about "the Stanford paper" and basically everything Ioannidis & colleagues have said about their research - they act as if they are so certain they are right that government policy should be made on the basis of their findings when the error bands on their findings would militate for a much less confident answer.

I also know that the one thing that categorically can not be fixed is lives lost - when people die or have permanent lung scarring, there is no way to undo that harm. So all along, I've erred on the side of risking an overreaction than an underreaction, as probably all of you know. But there have been many prudent measures we could have taken and haven't - everything from banning outdoor socially distanced recreation when the best science indicated almost no risk of transmission at a safe distance in the open air - to SF's newest decision to require mask wearing outside at all times. Who came up with that policy? Is there any evidence that someone running down the sidewalk and staying 5-6 feet away from a passing pedestrian who is wearing a mask poses even the slightest risk? I've yet to see one study indicating this, and as you all know, reading about COVID-19 has practically become a part-time job for me.

So I do appreciate how there is a "both sides" aspect to this problem. But I don't think that extends as far as how most people who pick a side tend to behave.

RE: The economic value of lives saved - Genuine Realist - 05-29-2020

(05-28-2020, 12:10 PM)BostonCard Wrote: I think the disconnect between us is that based on your post, it looks like you see a binary state: "containment" or "out of control", and that any country that didn't reach containment failed, and thus the fact that the US didn't reach containment is not a big deal, since no other industrialized country in Western Europe and North America was able to reach containment.

If that is your metric, then I agree with you. The fact that we didn't achieve early containment in the US was almost inevitable. The fairly non-specific presentation of COVID-19, the fact that you can get presymptomatic and asymptomatic transmission, and the relative high reproductive rate means that traditional means of containment are much harder for COVID-19 than a lot of other infections. To be clear, I don't blame Trump for the fact that there is community transmission of COVID-19.

However, within the "out of control" category, action to bring down the transmission rate early makes a big difference in the ultimate mortality rate. As I've mentioned in another post, a delay of one week in implementing shelter in place measures meant an additional 36,000 deaths in the United States. Moreover, actions are not binary either, a choice between lockdown and doing nothing; there is a lot that could have been done short of shelter in place to reduce the spread of COVID-19.

Let's compare the action of two governors (both Democratic).
On March 4, with 53 confirmed cases and one death from COVID-19 in the state, Governor Gavin Newsom declared a state of emergency.
On March 12, with 252 confirmed cases and four deaths, Governor Newsom announced that mass gatherings over 250 people were banned until the end of March and issued an order to permit the state to commandeer hotels and medical facilities to treat coronavirus patients.
On March 15, with 478 confirmed cases and six deaths, Governor Newsom called for voluntary closure of bars and in-home self-isolation of seniors 65 and older, as well as persons at-risk due to underlying conditions.
On March 19, with 1067 confirmed cases and nine deaths, Governor Newsom announced a statewide stay at home order with all residents except those working in essential occupations urged to stay at home. The state has asked the Department of Defense to deploy the USNS Mercy hospital ship in California.

On the other hand
In New York Mario Cuomo issued the state of emergency when the case count was at 89.
Cuomo announced bans on gatherings on the same day as Newsom, but set the threshold at gatherings of 500 people instead of 250 (326 cases in)
It doesn't look like Cuomo issued a call for voluntary closures
On March 19, when Newsom announced the shelter in place order in California, there were 4161 confirmed cases and 39 deaths.
When Cuomo announced the SiP order for New York, there were 7113 cases and 68 deaths. Moreover, the order wouldn't go into effect on March 22, by which time there 15,188 cases and 142 deaths.

Every step of the way, Cuomo was only a couple calendar days behind Newsom, but when you add in the fact that New York was further ahead in the pandemic, the cumulative effect was that New York putting its shelter in place order into effect March 22 was the equivalent of California putting its order into effect April 6. That effective two week delay meant that New York wound up with over 250,000 more cases and 25,000 more deaths than California.

So is Cuomo blameless for his delay, because look, California also would up with an out of control pandemic? Does that mean that Cuomo couldn't have been better, because Newsom wasn't perfect either? Does this mean there was nothing New York could have done better, because look, every state has been affected? Does it not matter all that much, because they responded more or less at the same time?

No, at every step of the way, New York was slower to react than California, despite the fact that the epidemic was more advanced in New York than California (and growing faster), and for the COVID-19 pandemic, days, let alone weeks make a really big difference in how the pandemic plays out.

Of course there are things you can question about California's response. It might have seemed like an overreaction at the time, but even Newsom could have been more aggressive and realized that even though there were "only" 250 cases on March 12, the rate of increase was 4 - 5x fold per week. He could have been more aggressive about limiting large gatherings earlier. But the fact that Newsom could have been more aggressive doesn't excuse the lackadaisical response by New York.

BC

BC, you're giving me more credit for subtlety than I actually possess. As I think you know, I'm philosophically trained and historically inclined. Many of you write with bitterness or exasperation of some window of opportunity that was missed early on. That made me wonder, because I wasn't sure exactly what then that was, or if it even existed. So I went looking for it, checking the Wikipedia accounts for various countries. I didn't know what I would find. I was not terribly surprised to find that - excepting the Asian anomalies - the Western pattern was just about identical - a high degree of confidence in January, which gradually erodes in February, and collapses in early March. That conformed to my own experience. I just don't see any window of opportunity in that time frame, not that anyone recognized at the time. When no one recognizes the opportunity, given that there are any number of competent people involved, it's intuitively plausible that the gating factor is increasing information - and I believe that is the case.

From March 10th on, I really don't have much to say, except that no window of opportunity exists. Various governmental, and regional, and even municipal, responses are too idiosyncratic to categorize. Some work better than others. If you want one observation that might or might not be significant, just eyeballing the basic Google graph, the Old World in continental Europe and Asia seems to be coping a lot better than the New. It could be that the diversity and polycultural character of the New World is a negative in this situation.

The ultimate point is a rejoinder to the cultural clash that has developed between Blue (SIP) and Red (re-opening), polarized as always by Trump and his opponents. It begins with what to me is a useless exercise in error analysis, after which the various factions group in support of one position or the other. But Covid-19 seems to me a phenomenon way beyond political calculus. We're going to have to live with this maybe for half a generation or more, and find solutions that compromise both Blue and Red positions.

RE: The economic value of lives saved - Mick - 05-29-2020

As I'd indicated earlier in multiple posts, the COVID disaster economy is harming those families with children the most. 55% of households with at least one child under 18 has experienced income loss as opposed to 40% of the households with no children:

https://justthenews.com/government/federal-agencies/survey-says-55-percent-households-children-least-one-adult-has-lost

RE: The economic value of lives saved - terry - 05-29-2020

(05-27-2020, 04:32 PM)Genuine Realist Wrote: I think I have recounted how my wife and I were in New York between February 21st and 24th. . . . Every morning, I'd . . . kill time . . . watching the news. . . . [T]here was literally NOTHING about the virus, except for growing concern about the Italian experience. It was maybe the fifth lead down. . . . These weren't even serious news items. . . . There weren't any warnings.

There definitely were "serious news items" about the coronavirus during the February 21-24 time frame, including warnings of a pandemic. A few examples:

On February 21, NBC News ran a story titled: "U.S. takes steps to prepare for pandemic as global coronavirus cases rise." The story began: "As global concerns over the coronavirus outbreak grow, the U.S. is taking steps to prepare for the possibility of a pandemic, the Centers for Disease Control and Prevention said Friday."

On February 22, the lead article on the NY Times' front page was headlined: "Surge in Cases Raises Concern Of a Pandemic." The article began: "An alarming surge of new coronavirus cases outside China, with fears of a major outbreak in Iran, is threatening to transform the contagion into a global pandemic. . . ."

On February 22, the Washington Post reported: "Coronavirus outbreak edges closer to pandemic status." The article said: "There are outbreaks. There are epidemics. And there are pandemics, where epidemics become rampant in multiple countries and continents simultaneously. The novel coronavirus that causes the disease named covid-19 is on the verge of reaching that third, globe-shaking stage."

On February 22, CNN ran a story titled: "Fears over containing novel coronavirus grow as cases outside China spike." It began: "Concerns are growing over the global spread of the novel coronavirus after a spike in cases outside of mainland China among people with no connection to China or the city of Wuhan."

On February 24, the stock market had its biggest decline in two years, which was in the headlines everywhere. Fox Business reported: "Dow tumbles over 1,000 points as coronavirus crisis spirals."

On February 24, Fox News ran a story titled: "Global outbreak causes coronavirus pandemic fears after cases jump in Italy, South Korea and Iran."

There are other examples as well.

RE: The economic value of lives saved - Genuine Realist - 05-29-2020

(05-29-2020, 11:44 AM)terry Wrote:
(05-27-2020, 04:32 PM)Genuine Realist Wrote: I think I have recounted how my wife and I were in New York between February 21st and 24th. . . . Every morning, I'd . . . kill time . . . watching the news. . . . [T]here was literally NOTHING about the virus, except for growing concern about the Italian experience. It was maybe the fifth lead down. . . . These weren't even serious news items. . . . There weren't any warnings.

There definitely were "serious news items" about the coronavirus during the February 21-24 time frame, including warnings of a pandemic. A few examples:

On February 21, NBC News ran a story titled: "U.S. takes steps to prepare for pandemic as global coronavirus cases rise." The story began: "As global concerns over the coronavirus outbreak grow, the U.S. is taking steps to prepare for the possibility of a pandemic, the Centers for Disease Control and Prevention said Friday."

On February 22, the lead article on the NY Times' front page was headlined: "Surge in Cases Raises Concern Of a Pandemic." The article began: "An alarming surge of new coronavirus cases outside China, with fears of a major outbreak in Iran, is threatening to transform the contagion into a global pandemic. . . ."

On February 22, the Washington Post reported: "Coronavirus outbreak edges closer to pandemic status." The article said: "There are outbreaks. There are epidemics. And there are pandemics, where epidemics become rampant in multiple countries and continents simultaneously. The novel coronavirus that causes the disease named covid-19 is on the verge of reaching that third, globe-shaking stage."

On February 22, CNN ran a story titled: "Fears over containing novel coronavirus grow as cases outside China spike." It began: "Concerns are growing over the global spread of the novel coronavirus after a spike in cases outside of mainland China among people with no connection to China or the city of Wuhan."

On February 24, the stock market had its biggest decline in two years, which was in the headlines everywhere. Fox Business reported: "Dow tumbles over 1,000 points as coronavirus crisis spirals."

On February 24, Fox News ran a story titled: "Global outbreak causes coronavirus pandemic fears after cases jump in Italy, South Korea and Iran."

There are other examples as well.

Indeed, Terry. You might also cite the number of smug op-eds published by the NYT, Post, and CNN, in response to to Trump's travel ban with China, on January 31st, denouncing the ban as xenophobic and generally debunking the potential of the virus to cause serious harm to society.

It's not that the public and the heads of state were not aware of the virus. It's just that no one thought that extraordinary measures were necessary to combat it. Throughout February, data continued to accumulate, mostly from the experience of Italy, which was open to the world. Stories of the type you cite were published. But these were of the 'interesting development' type. No alarm was sounded, not in the US or anywhere (the point). You'll find the rare outlier event canceled, but no sense that the coming pandemic required the extreme measures that were undertaken.

These occurred almost universally in the second week of March, usually starting about March 10th.

RE: The economic value of lives saved - oldalum - 05-29-2020

(05-29-2020, 12:48 PM)Genuine Realist Wrote: Indeed, Terry. You might also cite the number of smug op-eds published by the NYT, Post, and CNN, in response to to Trump's travel ban with China, on January 31st, denouncing the ban as xenophobic and generally debunking the potential of the virus to cause serious harm to society.

Of the rags you mention, I only read the NYT. But my recollection (admittedly faulty) is that the main criticism of the ban is that it was likely to be ineffective, as previous bans had been epidemiologically (which in fact it mainly was). But maybe that's what I remember because that's what made sense to me.

RE: The economic value of lives saved - terry - 05-29-2020

(05-27-2020, 04:32 PM)Genuine Realist Wrote: When the history of these strange times is written, I think we'll find out that what happened is a critical mass of clinical and epidemiological experience coalesced around the first week of March. You can lament February, if you believe in precognition.

It doesn't require "precognition" to "lament February." There were many warning signs during January and February that should have caused the administration to take action to prepare for the coronavirus. I'm not saying it was feasible to adopt "shelter in place" in January. But there were other steps that the administration could have taken that would have been helpful. Boston Card has made several posts on this topic over the last several weeks. I'm copying one of BC's posts here:

Lots of steps that Trump could have taken to either increase public support or take steps that the public would have been behind.

1) Stop making it worse by minimizing the significance of the virus and saying it will go away on its own, even as the cases and deaths were piling up.
2) Start socializing the potential of the virus to be very serious.
3) Put in place executive orders to cut through the red tape at FDA and CDC to roll out testing and enable expanded access to medications.
4) Develop a COVID response team that would determine what needs healthcare teams will have. Identify PPE and ventilators as your weak link before health systems are overwhelmed and centralize purchase and distribution.
5) Develop guidelines for states to implement escalating social distancing orders. The administration did a decent job in writing the guidelines for reopening; it could have provided states with guidelines on when to impose various restrictions. That doesn't mean you impose them immediately, but rather you get the states ready to impose them. Remember, a one day delay results in a ~40% increase in cases in a wave, so if you can get states to move forward their restrictions by a day or two, that makes a significant difference in the end.
6) Expand local health authorities capability to do case tracking. The CDC announced 600 additional staff today. It could have pushed this two months ago!
7) Talk to business leaders to socialize them to the possible need of having employees work from home. For whatever my complaints about Trump are, he is good at talking to business leaders. Even just "make contingency plans to have your employees work from home" would have been helpful.
8) Work with states to get them ready.
9) Start negotiations with congress to get important pieces of legislation together early. You don't have to pass them, but if you have the outlines of legislation already negotiated and ready to deploy if the proverbial crap hits the fan.
10) Most importantly, the President is supposed to be a leader; lead for frick's sake. Tell people things they might not want to hear, but that if they hear could save their lives. Tell people to be ready for the worst, but remind them that we are all in this together, and that if things start to take a turn worse, we will all work together.

Instead of doing the things on Boston Card's list, Trump spent January and February in denial. That time could have been used to protect lives and to protect the economy. Instead the time was wasted. That's why we should "lament February."

RE: The economic value of lives saved - oregontim - 05-29-2020

And while we're doing lists of what might have been done, let's look at what he actually did. He wasn't just neutral. He wasn't jut failing to act. He was in fact actively obstructing preparations, measures, and public awareness. The following is from factcheck.org:

Quote:Jan. 22: “We have it totally under control. It’s one person coming in from China. We have it under control. It’s going to be just fine.” — Trump in a CNBC interview.
Jan. 30: “We think we have it very well under control. We have very little problem in this country at this moment — five — and those people are all recuperating successfully. But we’re working very closely with China and other countries, and we think it’s going to have a very good ending for us … that I can assure you.” — Trump in a speech in Michigan.
Feb. 10: “Now, the virus that we’re talking about having to do — you know, a lot of people think that goes away in April with the heat — as the heat comes in. Typically, that will go away in April. We’re in great shape though. We have 12 cases — 11 cases, and many of them are in good shape now.” — Trump at the White House. (See our item “Will the New Coronavirus ‘Go Away’ in April?“)
Feb. 14: “There’s a theory that, in April, when it gets warm — historically, that has been able to kill the virus. So we don’t know yet; we’re not sure yet. But that’s around the corner.” — Trump in speaking to National Border Patrol Council members.
Feb. 23: “We have it very much under control in this country.” — Trump in speaking to reporters.
Feb. 24: “The Coronavirus is very much under control in the USA. We are in contact with everyone and all relevant countries. CDC & World Health have been working hard and very smart. Stock Market starting to look very good to me!” — Trump in a tweet.
Feb. 26: “So we’re at the low level. As they get better, we take them off the list, so that we’re going to be pretty soon at only five people. And we could be at just one or two people over the next short period of time. So we’ve had very good luck.” — Trump at a White House briefing.
Feb. 26: “And again, when you have 15 people, and the 15 within a couple of days is going to be down to close to zero, that’s a pretty good job we’ve done.” — Trump at a press conference.
Feb. 26: “I think every aspect of our society should be prepared. I don’t think it’s going to come to that, especially with the fact that we’re going down, not up. We’re going very substantially down, not up.” — Trump at a press conference, when asked if “U.S. schools should be preparing for a coronavirus spreading.”
Feb. 27: “It’s going to disappear. One day — it’s like a miracle — it will disappear.” — Trump at a White House meeting with African American leaders.
Feb. 29: “And I’ve gotten to know these professionals. They’re incredible. And everything is under control. I mean, they’re very, very cool. They’ve done it, and they’ve done it well. Everything is really under control.” — Trump in a speech at the CPAC conference outside Washington, D.C.
March 4: “[W]e have a very small number of people in this country [infected]. We have a big country. The biggest impact we had was when we took the 40-plus people [from a cruise ship]. … We brought them back. We immediately quarantined them. But you add that to the numbers. But if you don’t add that to the numbers, we’re talking about very small numbers in the United States.” — Trump at a White House meeting with airline CEOs.
March 4: “Well, I think the 3.4% is really a false number.” — Trump in an interview on Fox News, referring to the percentage of diagnosed COVID-19 patients worldwide who had died, as reported by the World Health Organization. (See our item “Trump and the Coronavirus Death Rate.”)
March 7: “No, I’m not concerned at all. No, we’ve done a great job with it.” — Trump, when asked by reporters if he was concerned about the arrival of the coronavirus in the Washington, D.C., area.
March 9: “So last year 37,000 Americans died from the common Flu. It averages between 27,000 and 70,000 per year. Nothing is shut down, life & the economy go on. At this moment there are 546 confirmed cases of CoronaVirus, with 22 deaths. Think about that!” — Trump in a tweet.
March 10: “And we’re prepared, and we’re doing a great job with it. And it will go away. Just stay calm. It will go away.” — Trump after meeting with Republican senators.

And that list excludes the disputed claims that he called it a hoax. Here's the text as quoted in techcrunch from a Feb. 28 Trump rally in South Carolina:

Quote:“Now the Democrats are politicizing the coronavirus. You know that, right? Coronavirus. They’re politicizing it. We did one of the great jobs . . . They tried the impeachment hoax. That was on a perfect conversation. They tried anything, they tried it over and over, they’ve been doing it since you got in. It’s all turning, they lost, it’s all turning. Think of it. Think of it. And this is their new hoax. But you know, we did something that’s been pretty amazing. We’re 15 people [cases of coronavirus infection] in this massive country. And because of the fact that we went early, we went early, we could have had a lot more than that . . . we’ve lost nobody, and you wonder, the press is in hysteria mode.“

RE: The economic value of lives saved - Genuine Realist - 05-29-2020

(05-29-2020, 02:13 PM)terry Wrote:
(05-27-2020, 04:32 PM)Genuine Realist Wrote: When the history of these strange times is written, I think we'll find out that what happened is a critical mass of clinical and epidemiological experience coalesced around the first week of March. You can lament February, if you believe in precognition.

It doesn't require "precognition" to "lament February." There were many warning signs during January and February that should have caused the administration to take action to prepare for the coronavirus. I'm not saying it was feasible to adopt "shelter in place" in January. But there were other steps that the administration could have taken that would have been helpful. Boston Card has made several posts on this topic over the last several weeks. I'm copying one of BC's posts here:

Lots of steps that Trump could have taken to either increase public support or take steps that the public would have been behind.

1) Stop making it worse by minimizing the significance of the virus and saying it will go away on its own, even as the cases and deaths were piling up.
2) Start socializing the potential of the virus to be very serious.
3) Put in place executive orders to cut through the red tape at FDA and CDC to roll out testing and enable expanded access to medications.
4) Develop a COVID response team that would determine what needs healthcare teams will have. Identify PPE and ventilators as your weak link before health systems are overwhelmed and centralize purchase and distribution.
5) Develop guidelines for states to implement escalating social distancing orders. The administration did a decent job in writing the guidelines for reopening; it could have provided states with guidelines on when to impose various restrictions. That doesn't mean you impose them immediately, but rather you get the states ready to impose them. Remember, a one day delay results in a ~40% increase in cases in a wave, so if you can get states to move forward their restrictions by a day or two, that makes a significant difference in the end.
6) Expand local health authorities capability to do case tracking. The CDC announced 600 additional staff today. It could have pushed this two months ago!
7) Talk to business leaders to socialize them to the possible need of having employees work from home. For whatever my complaints about Trump are, he is good at talking to business leaders. Even just "make contingency plans to have your employees work from home" would have been helpful.
8) Work with states to get them ready.
9) Start negotiations with congress to get important pieces of legislation together early. You don't have to pass them, but if you have the outlines of legislation already negotiated and ready to deploy if the proverbial crap hits the fan.
10) Most importantly, the President is supposed to be a leader; lead for frick's sake. Tell people things they might not want to hear, but that if they hear could save their lives. Tell people to be ready for the worst, but remind them that we are all in this together, and that if things start to take a turn worse, we will all work together.

Instead of doing the things on Boston Card's list, Trump spent January and February in denial. That time could have been used to protect lives and to protect the economy. Instead the time was wasted. That's why we should "lament February."

Terry,
With all due respect, you have missed the point completely.

Trump didn't do much in January and February (although what little he did was sharply criticized).

But neither did anyone else - anywhere in the Western would. This isn't a case where there were iceberg warnings all around, that others heeded, and this ship sailed on. No one heeded them - and, if you look at WHO pronouncements, there wasn't much in the way of warnings.

When everyone behaves in pretty much the same way, including personages of distinguished competence, it's a pretty good bet that the gating factor was available information.

That's the point.

RE: The economic value of lives saved - terry - 05-29-2020

I don't think the important issue here is whether some countries responded better than the U.S., or some responded similarly, or some lagged behind. I don't think the response of other countries is the standard we should use in judging our president's response. It's not good enough to say that we should grade on a curve and we should give the federal response a "gentleman's C" just because some other countries didn't do much better. We should have higher expectations than that.

Trump is the one who said he was the best person to lead this nation in a crisis. Trump didn't say "If there's a crisis, I will muddle along somewhere in the middle, not as good as South Korea but arguably better than Brazil." Rather, he said, "I alone can fix it." He said, "We're going to win so much you're going to be sick and tired of winning." He said he would "make America great again." We have the right to hold him accountable for the success he promised, not for doing about the same as Italy.

In a national crisis, our nation rightfully ought to look to the President to lead a successful response. This is the job Trump signed up for. He loves the power and the attention and the trappings that come with the Presidency. But the job also involves responsibility and duty. This crisis was the time when he needed to take the responsibility and do his duty. This moment called for Trump to rise to the occasion, to become the leader we needed. We have the right to hold him accountable for not being that leader.

RE: The economic value of lives saved - Farm93 - 05-29-2020

GR, What exactly did you watch in February?

By late February my local OC youth soccer league was actively discussing how we would need to eliminate post-game hand shakes for the kids. Perhaps we are a bit more aware of health trends than your average USA Fox viewer, but I have to believe most health officials understood a global pandemic was coming to the world.

At that same time several parents were very, very concerned about safety for the season, and several were already seeking refunds. Now, admittedly some of the most vocal families were of Korean and east Asian decent, but it was possible to live in the USA in February and know something dangerous was lurking in the world. News outlets with even a few international correspondents were covering how quickly and easily this virus was spreading throughout Asia and into other places in February.

But the biggest clue would have been the Diamond Princess cruise ship that was unable to return to port on February 3 2020. At that point, for those paid and/or elected to pay attention, that incident should have been a big red flag. Of course, in most of Asia officials and politicians were already paying attention to COVID, but the cruise ship was the global wake-up call out POTUS missed.

It was critical because that suggested that there must have been people who were healthy enough to board a cruise ship in January that were already carrying the virus. Given that the passengers were not together prior to the cruise human-to-human transmission must be possible. That all happened on February 3, with American citizens on board. And as often happens, if a few USA citizens are on board and impacted it becomes news in the USA.

Then by the mid month the cases on that ship exploded to several hundred cases.

I understand how busy US citizens could miss those clues and the coverage that vessel got on the BBC, CNN, etc. etc.
I also understand why FoxNews would have opted to cover the latest MAGA rally instead.

However, let's not pretend like it was not possible to know that COVID was out and about. And our POTUS certain got more than a few briefings to clue him into the pandemic beyond the cruise ship industry. He missed all of them.

Maybe he was watching the same things you watched that month.

RE: The economic value of lives saved - BostonCard - 05-29-2020

Really, you only need two datapoints.

Spread in China significant enough for the Chinese government to institute a total lockdown of Wuhan and a pretty harsh nationwide quarantine AND
Evidence of community transmission in the US.

Once you had those two data points, the second of which was confirmed by the CDC on Feb. 26, that should have been enough to act. You should have been preparing before then. At that point, you know that the virus is deadly, that it spreads quickly, and that it is already in the US.

But if that's not enough, between Feb 21 and Feb 28, the Dow Jones lost 3,700 points or 13%. The market figured out that it was a big deal. Why didn't the President?

BC

RE: The economic value of lives saved - Genuine Realist - 05-29-2020

(05-29-2020, 05:35 PM)BostonCard Wrote: Really, you only need two datapoints.

Spread in China significant enough for the Chinese government to institute a total lockdown of Wuhan and a pretty harsh nationwide quarantine AND
Evidence of community transmission in the US.

Once you had those two data points, the second of which was confirmed by the CDC on Feb. 26, that should have been enough to act. You should have been preparing before then. At that point, you know that the virus is deadly, that it spreads quickly, and that it is already in the US.

But if that's not enough, between Feb 21 and Feb 28, the Dow Jones lost 3,700 points or 13%. The market figured out that it was a big deal. Why didn't the President?

BC

This gets very, very old.

Indeed the President did not figure it out. Neither did Merkel . . . nor Macron . . nor Boris Johnson . . . nor any of their health ministers, most of whom have resigned. Which leads me to believe that the actual tipping point occurs sometime in the first week in March. That's when enough data accumulates that ALL of these leaders decide almost simultaneously to require drastic action. That's the almost unavoidable inference from the timeline.

You and Terry write as if Trump is sailing blithely along while the rest of the world is screaming warnings and running for cover. But that's not what happened. Everyone was sailing blithely along and no one was running for cover.

This is my last post on the subject. I know we understand each other. Restating uncontroverted facts gets old.

RE: The economic value of lives saved - BostonCard - 05-29-2020

(05-29-2020, 07:30 PM)Genuine Realist Wrote: Indeed the President did not figure it out. Neither did Merkel . . . nor Macron . . nor Boris Johnson . . . nor any of their health ministers, most of whom have resigned. Which leads me to believe that the actual tipping point occurs sometime in the first week in March. That's when enough data accumulates that ALL of these leaders decide almost simultaneously to require drastic action. That's the almost unavoidable inference from the timeline.

You keep insinuating that Germany did a bad job responding to the coronavirus. Whatever it is that Germany did wrong with regards to the coronavirus, I wish we would make those mistakes too, because I would rather live in a country with 103 deaths per million people and where the daily death toll has been under 100 for the last two weeks than one in which there have been 316 deaths per million people and where the death toll is hovering at around 1000. Not only is Jens Spahn still health minister, but 78% of Germans think the German government has handled the coronavirus pandemic well.

[Image: BB14HNAr.img?h=450&w=799&m=6&q=60&o=f&l=f]

[Image: BB14HNAr.img?h=450&w=799&m=6&q=60&o=f&l=f]

Also, you keep repeating that every health minister has resigned. The only health minister to have resigned is the French one, and she did so to run for mayor of Paris, not because of her COVID-19 response.

UK: Matt Hancock has been the Secretary of State for Health and Social Care since 2018.

Italy: Roberto Speranza has been the Minister of Health since last year.

Germany: Jens Spahn is the Federal Minister of Health and has been so since 2018.

France: Agnès Buzyn served as the Minister of Solidarity and Health from 17 May 2017 to 16 February 2020 when she resigned to run for the mayorality of Paris. At the time she resigned France had reported 12 cases and 1 death from COVID-19.

For what it is worth, Alex Azar is still our Secretary for Health and Human services.

And for the nth time, nobody is asking for Trump to declare a nationwide shelter in place order in late February. We were just asking for the president to prepare the response. It'd be one thing if Trump did everything he could: asked Congress for a supplemental appropriation, bashed the heads of FDA and CDC together and told them to figure out the testing or find another job, given governors a roadmap for how and when to shut down their states, replenished the stockpile of PPE, and told the American people that this is a serious deal and the government is doing x, y, and z to prepare. And it's possible that if he'd done all those things, the House would have played politics and not passed anything to make him look bad, the FDA and CDC still might not have gotten their act together, governors would have ignored him, and Americans would have taken him neither seriously nor literally. Then you say, you know what, the President did all he could have done, but our politics are broken; this is the fault of Congress and the entrenched bureaucracy, and the governors, and all of us. But he did none of that. He consistently minimized the threat; on multiple occasions said it would go away on its own, he never asked congress for money for testing, he couldn't be bothered to even listen to his health secretary (and when they did meet, changed the topic to e-cigarettes), let alone understood that there were problems in his administration getting the test right, constantly lied about the state of testing, picked fights with governors, and downplayed Americans fears. Basically, he did the opposite of what he should have done. And as the contrast between Cuomo and Newsome has made clear, policy choices and when they are implemented makes a brobdingnagian difference. Even a delay of a couple days makes a brobdingnagian difference, and the fact that the pandemic hit Europe before it hit us makes our failure to act all the more glaring.

BC

RE: The economic value of lives saved - magnus - 05-29-2020

I think this all boils down to.

Everyone else thinks the US should be the gold standard for pandemic responses, especially considering the CDC's successes in the past and our general pro US glasses.

Then there's GR, who believes our measuring stick is the rest of the Western world.

RE: The economic value of lives saved - Mick - 05-30-2020

(05-29-2020, 09:37 PM)magnus Wrote: I think this all boils down to.

Everyone else thinks the US should be the gold standard for pandemic responses, especially considering the CDC's successes in the past and our general pro US glasses.

Then there's GR, who believes our measuring stick is the rest of the Western world.

I think American political responses to crises tend to be on the slow side. Take drunk driving. There have been drunk driving laws on the books since 1906, but they didn't really get teeth until 1980, when Candy Lightner founded Mothers Against Drunk Driving.

https://www.guardianinterlock.com/blog/history-of-drunk-driving-1970/

RE: The economic value of lives saved - oldalum - 05-30-2020

(05-29-2020, 05:35 PM)BostonCard Wrote: But if that's not enough, between Feb 21 and Feb 28, the Dow Jones lost 3,700 points or 13%. The market figured out that it was a big deal. Why didn't the President?

This is actually the most telling point, because he pays more attention to the Dow than any other national statistic. You can be absolutely sure he was laser-focused on this drop, and he had two choices. He could try to address and fix what the smart money was worried about, or he could try to paper it over and deny it. The latter, which he chose, makes no sense because he can't prop up the Dow indefinitely with words (I don't think it even worked in the short term). But he didn't have the foresight or competence to do the former.

RE: The economic value of lives saved - BostonCard - 05-30-2020

So, I found a very interesting dataset, the Oxford Government Response Tracker. Basically, it tracks government action in response to the coronavirus. The stringency index is based on Eight of the policy indicators (C1-C8) record information on containment and closure policies, such as school closures and restrictions in movement (the variables are: school closing, workplace closing, canceling public events, restrictions on gatherings, public transport closings, stay at home requirements, restrictions on internal movements, and international travel controls). They show the relationship between the index and number of cases:

You can see that the United States' (and the UK's) response curve was "behind" the log of cases. South Korea's was consistently ahead (so, no surprise that they managed to contain the virus).

There is also this plot, which shows the response plotted against the number of cases:

You can see that the two laggards in terms of response are the UK and the US. Unfortunately, they didn't include Germany in the plots, but they do make the underlying data available for download:

https://github.com/OxCGRT/covid-policy-tracker/raw/master/data/OxCGRT_latest.csv

So here is the plot of confirmed deaths versus stringency index, with Germany included (I also added the date every time the stringency index went up):

[Image: image.png]

The results show that in those crucial early days, when the cumulative number of deaths was still fairly low, Germany was way ahead of the game (for example, it had hit the 25% stringency index before they recorded their first death and hit 50% on March 18th, when they still had just over 10 deaths). The US on the other hand hit the 25% mark on March 12, when there were already 30 deaths. We did hit the 50% stringency index a couple days before Germany did, but by then we had 69 deaths, while Germany only had 12. Subsequent tightenings of social distancing requirements tended to occur a few days earlier in the US than Germany, but we consistenly had over a half log order more deaths when we instituted it.

Not surprisingly, the only country that did worse than the US was the UK, where early policy was to not implement social distancing (until about March 16). At that point, deaths were rising rapidly, and though the UK went into lockdown mode quickly over the ensuing week, deaths jumped 7-fold as well.

Here, Spain is marginally better than the US, but deaths were rising quickly between the 9th and 14th of March.

The one datapoint I don't fully understand is Italy. My guess is that this early in the pandemic, confirmed cases and deaths were undercounted (or somehow the stringency index is overestimating what was happening in Italy at the time. I'll have to dig a bit more at the data to see what was driving it, but if this is to be believed, Italy actually was pretty aggressive in responding and was just unlucky.

BC

RE: The economic value of lives saved - Genuine Realist - 05-31-2020

(05-30-2020, 10:59 PM)BostonCard Wrote: So, I found a very interesting dataset, the Oxford Government Response Tracker. Basically, it tracks government action in response to the coronavirus. The stringency index is based on Eight of the policy indicators (C1-C8) record information on containment and closure policies, such as school closures and restrictions in movement (the variables are: school closing, workplace closing, canceling public events, restrictions on gatherings, public transport closings, stay at home requirements, restrictions on internal movements, and international travel controls). They show the relationship between the index and number of cases:

You can see that the United States' (and the UK's) response curve was "behind" the log of cases. South Korea's was consistently ahead (so, no surprise that they managed to contain the virus).

There is also this plot, which shows the response plotted against the number of cases:

You can see that the two laggards in terms of response are the UK and the US. Unfortunately, they didn't include Germany in the plots, but they do make the underlying data available for download:

https://github.com/OxCGRT/covid-policy-tracker/raw/master/data/OxCGRT_latest.csv

So here is the plot of confirmed deaths versus stringency index, with Germany included (I also added the date every time the stringency index went up):

The results show that in those crucial early days, when the cumulative number of deaths was still fairly low, Germany was way ahead of the game (for example, it had hit the 25% stringency index before they recorded their first death and hit 50% on March 18th, when they still had just over 10 deaths). The US on the other hand hit the 25% mark on March 12, when there were already 30 deaths. We did hit the 50% stringency index a couple days before Germany did, but by then we had 69 deaths, while Germany only had 12. Subsequent tightenings of social distancing requirements tended to occur a few days earlier in the US than Germany, but we consistenly had over a half log order more deaths when we instituted it.

Not surprisingly, the only country that did worse than the US was the UK, where early policy was to not implement social distancing (until about March 16). At that point, deaths were rising rapidly, and though the UK went into lockdown mode quickly over the ensuing week, deaths jumped 7-fold as well.

Here, Spain is marginally better than the US, but deaths were rising quickly between the 9th and 14th of March.

The one datapoint I don't fully understand is Italy. My guess is that this early in the pandemic, confirmed cases and deaths were undercounted (or somehow the stringency index is overestimating what was happening in Italy at the time. I'll have to dig a bit more at the data to see what was driving it, but if this is to be believed, Italy actually was pretty aggressive in responding and was just unlucky.

BC

I am going to reply here. I believe the key to the German response was the random fact that it was able to identify a Patient Zero and test and track from there. That's what I get from Wikipedia. Other nations were not so fortunate.